LifeFlight Critical Care Transport is an air medical service operated by the Nicklaus Children’s Hospital, in partnership with aviation services provider PHI Air Medical. The service operates 24 hours a day, all year round, covering a service area which includes southern Florida, the Caribbean, and parts of Central and South America. It transports an average of around 4,000 patients of all age brackets each year, albeit with a focus on emergency transport for neonatal and pediatric patients.

The LifeFlight team comprises around 40 people, including both air and ground staff, operating from a base at Miami Opa-Locka Executive Airport. “Each flight is staffed by two qualified pilots and a medical team consisting of at least one registered nurse (RN) and a second provider, which could be a critical care paramedic or another RN,” Williams explained.

The base is also home to a Sikorsky S76C+ helicopter – which, when out of service ‘due to scheduled or unscheduled mechanical downtime’, is substituted by a ‘dedicated, leased back-up Sikorsky S76C++ from PHI Air Medical’, according to Williams.

PHI Air Medical has been partnered with Nicklaus Childrens’ Health System for over a decade – in addition to providing a back-up aircraft to LifeFlight, the company also operates the service on behalf of Nicklaus Childrens’.

“We partnered with [them] for a second time in early 2013 and continue to be in contract through until early 2024,” said Williams. “They have been a great partner and their commitment to safety is impeccable.”

Williams hinted that LifeFlight was investigating the potential of replacing its current S76C+ helicopter, as well as its ground-based ambulance counterparts, with more modern equivalents in the near future: “We are also going to be looking at new helicopter and ground options to advance the mission of our health system,” he added.

Carrying young patients presents additional emotional challenges

Given LifeFlight’s affiliation with Nicklaus Children’s Hospital, the service is regularly called for to provide emergency medical transport to children – a task which often demands even greater care and sensitivity than is required for adult patients.

“A defining feature of pediatric and neonatal transport is that, in addition to the patients, we are also transporting a parent or other accompanying family member during most transports,” Williams explained. “We strive to ensure that we provide family-centered care for each and every transport, meeting the individual needs of all onboard the vehicle.”

He added that a common call-out type that LifeFlight will respond to is providing transport to the hospital for ‘infants with complex care needs at birth’, a mission which is time sensitive and often has high stakes, but which is also highly charged on an emotional level. Williams explained that it was critical to ensure that new parents had a chance to meet their newborn baby before transport, and not to overlook the importance of such moments when attempting to safeguard the patient’s health.

“Sometimes, the parents at the birthing hospital have not had the opportunity to hold or see their baby due to the critical medical interventions needed,” he said. “We ensure that we speak to the parents and explain how their infant is doing, and what will happen during the transport process. We make it a point to ensure that the mother has time with the infant before transport, for peace of mind as part of our family-centered care model.”

LifeFlight’s helicopter is equipped for ECMO and ventilation

During missions, LifeFlight’s helicopter is well-equipped with a broad range of equipment, all of which is interchangeable with the items onboard the service’s ground-based vehicles.

“We are able to offer high-frequency ventilation to not only neonates but to any age patient, nitric oxide administration, high volume and syringe pump fluid and medical administration. We have access to pediatric critical care fellows if needed, and we have even taken neurosurgery physicians for emergency procedures performed at referring facilities. We are able to transport extracorporeal membrane oxygenation (ECMO) patients via all three modes of transport (helicopter, fixed wing and ground ambulance), for which we have both a cardiothoracic surgeon and a perfusionist. For over-water rotor trips, we also have a life raft in case of emergency.”

Williams added that: “We are always looking for new evidence-based equipment that can help us care for the patients and families we serve. We are in the process of adding ultrasound usage to the team for a multitude of procedures within the patient care spectrum.”

LifeFlight works with a number of additional partners when flying internationally

Williams explained that while LifeFlight’s operations are centered on Nicklaus Children’s Hospital, ‘we are able to provide service by ground to any hospital within Miami-Dade County or out of county destination’. Additionally: “By helicopter, we are able to provide fixed-wing medical crew support for adult patients travelling internationally.”

We are fortunate that our collaborators provide us with assistance in obtaining landing permits, authorizations for entering various countries, and transferring of information

LifeFlight’s adult medical transport operations are aided by an ‘independent adult care medical director who supports us in providing transports to any facility from which a referring hospital has received medical acceptance’, Williams added.

Medical transport is always in high demand, and ‘we are always looking for ways to expand needed services within our region’, he said, of which the most critical factor is ensuring that the service has enough staff to provide coverage: “As we continue to receive requests for transport, we are actively recruiting additional members to support us with the important and rewarding work that we do.”

For the operation of its international and long-distance services, LifeFlight also collaborates with a number of third parties. “We have numerous partners among fixed-wing operators,” Williams said. “We partner with various entities for transport from remote locations that fixed-wing aircraft are not able to access. Thus, we are able to provide coordinated transport to Florida for both pediatric and adult patients in need of advanced medical care.”

He added: “We are fortunate that our collaborators provide us with assistance in obtaining landing permits, authorizations for entering various countries, and transferring of information.”

In the Bahamas, he explained that: “we are the only civilian helicopter service that is currently flying in and out of the Bahamian islands – we work through our air vendor, PHI Air Medical, to obtain approval to fly within Bahamian air space.”