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The mountainous state of Colorado features some of the most beautiful vistas in the continental United States. Sitting at the foot of the Rocky Mountains, the state’s capital, Denver, provides residents and visitors easy access to hills and slopes that offer mountain biking, skiing and hiking opportunities — but such activities do carry a risk of injury. And because they’re often in highly inaccessible or very remote areas, if there is a medical emergency, evacuation by helicopter is often the best, if not only, option.
With four aircraft across four bases in Colorado and one in Wyoming, AirLife Denver is well placed to respond to such calls for help. The emergency medical/critical care transport service of the HCA-HealthONE system of hospitals, clinics and surgery centers, AirLife Denver provides air and ground critical care transport for both adult and pediatric medical/trauma patients.
Its rotary-wing fleet is comprised of four Bell 407s and,
notably, two Eagle 407HPs — a re-engined version of the
Bell 407 that replaces the aircraft’s original Rolls-Royce 250-C47B with a 1,021-horsepower Honeywell HTS900. The aircraft are owned and operated by Air Methods Corp.
Jessy Fontes, a pilot and the manager of Air Methods’ north central region, eastern Colorado area, said the hugely varying terrain — from 3,320 to 14,440 feet (1,010 to 4,400 meters) — makes operations in the area a challenge. “In Colorado, you really don’t know on a daily basis what you’re going to get, but that is what makes flying here challenging and interesting,” he said. “We can be on a short, inter-facility, high-temperature flight request in the morning, and in the afternoon have a scene flight request well above 10,000 feet with temperatures below freezing.”
Last year marked the 35th anniversary of AirLife Denver’s rotary-wing operations, during which time it has completed over 65,000 missions. Its maiden transport flight, on May 9, 1983, saw a Bell 206L-3 LongRanger fly from Denver to Durango, Colorado. AirLife Denver completed 207 missions during its first year of service, including both on-scene and inter-facility transfer flights.
The following year, it added a second Bell 206L-3 and a fixed-wing aircraft to its fleet. It also started a communications center, and added a high-risk obstetrics team to the flight crews. Other capabilities were added as they were developed over the years, including an intra-aortic balloon pump team and a neonatal team. The retirement of the organization’s faithful LongRangers in 1997 was followed by the debut of new and more capable Bell 407s. But while these have proven a great fit for the organization’s operations, AirLife saw an opportunity to enhance its fleet with the arrival of the Eagle 407HP conversion on the market — and brought the first of the type to work in emergency medical services (EMS) into operation in July 2018.
“The 407 has proven to be a safe and reliable helicopter, but during the hot months of summer we occasionally could not conduct particular patient transports due to power limitations,” said Brian Leonard, director of business development at AirLife Denver. “With the Eagle HP, we are finding the aircraft capable of completing virtually every transport request. So far, the engine is proving reliable, and [the aircraft is] an excellent addition to the safety of our teams and patients.”
An experienced team
The organization’s rotary- and fixed-wing pilots are employed by Air Methods. Each rotary-wing pilot must pass annual checks in both instrument flight rules and visual flight rules environments. To fly in the Rocky Mountains, AirLife Denver’s pilots are required to have demonstrated mountain-flying ability, the skill to operate in “hot and high” environments, and an understanding of extreme winter mountain operations. The experience level is high, with many of the pilots at AirLife Denver having been with the program for over two decades. All AirLife Denver’s aircraft are equipped for use with night vision goggles, and the program’s crews use these regularly in operations.
Cayce Batterson, lead pilot at the AirLife Denver Frederick/Firestone base, said the 407HP’s performance helps make the crews better able to cope with the variable conditions sometimes found in and around Denver.
“We have to be prepared for snowstorms in the mountains while it’s sunny and warm in the Denver area,” he said. “With the HP’s additional performance margins, we are able to leave the snow deflectors on all season, and not worry about performance limits. This makes mission planning easier and more streamlined.”
It’s just one of the reasons Batterson and his crews have been impressed with the new aircraft.
“The Bell 407 is an aircraft well-known as a fast, reliable, safe, and strong-performing machine,” he said. “The Eagle 407HP allows us to access a greater portion of the transmission limit up into the higher density altitudes of our operational areas.”
Temperatures in Denver can be at or near 100 F (38 C) in the summer, while landing zones in the mountains range between 7,000 to 14,000 feet (2,130 to 4,260 meters) with many requiring a vertical takeoff. The vast majority of the organization’s operations require out-of-ground-effect capability and vertical takeoff/landing performance, said Batterson.
“This requires we have access to as much power as possible to allow us to have appropriate safety margins,” he said. “The HP has allowed us to access a greater percentage of torque out of the 407 gearbox due to its higher temperature limits. It has reduced the need to limit fuel, and increased our ability to respond to calls. I did a scene response this summer at a density altitude of 12,200 feet [3,720 meters], weighed 30 pounds [14 kilograms] under maximum gross weight [5,000 pounds/2,270 kilograms], and didn’t even need to pull into the takeoff range during my vertical climb over the 50- to 60-foot [15- to 18-meter] trees.”
The 407HP also provides access to a higher range of torque in cruise flight, said Batterson. “[We] have seen an ability to add around 10 knots of cruise speed over the standard 407, which is already a very fast helicopter,” he said. “Having flown all types of aircraft in the mountains here, I think the 407HP is the best of all worlds when it comes to performance, speed, safety, and reliability.”
AirLife Denver pilot Greg Poirier was similarly enthusiastic about the new aircraft’s performance. “I know that coming to work on even the hottest day in the summertime, the helicopter is going to do everything that I ask of it — no matter the temperature or the elevation,” he said.
In the first six months of operation with the aircraft, the program recorded just over 200 hours on the engine. Poirier said AirLife Denver has not had any issues with the aircraft to date, but praised the “top notch” support Eagle Copters has provided.
He said the transition from the older 407 had been very quick. “During our training flights, I was very comfortable with going up as high as we could, as heavy as we could, to really test it out — and it performed flawlessly,” said Poirier. “In the wintertime, there is not as much of a difference, but you can tell that this helicopter really wants to go.”
AirLife Denver’s helicopters are maintained by Air Methods, with dedicated and knowledgeable maintenance personnel. Each helicopter base has its own mechanic, and there are two float mechanics and two part-time mechanics available to support operations at the main maintenance base and to travel to other bases as problems arise. Each aircraft receives a minimum of three inspections from a mechanic each week, and any discrepancies are repaired at that time. Designated mechanics are on call 24/7 to address any discrepancies that may arise. While the 407HP as a type is still being learned, it is proving to be relatively trouble-free for AirLife Denver so far.
Because of weather concerns during the winter, heavy maintenance and scheduled maintenance are performed inside a hangar. In the Denver area, AirLife Denver’s base at Sky Ridge Medical Center has a large hangar facility that is perfect for this type of maintenance, while its base at Cheyenne Medical Center in Wyoming also has a hangar when needed.
A challenging environment
AirLife Denver’s other bases are all in Colorado: at Frederick-Firestone Station 2, Lincoln Community Hospital, and Holyoke Melissa Memorial Hospital. Generally, the helicopters travel about 150 miles (240 kilometers) from their bases. For longer distances and interstate flights, AirLife Denver operates two Air Methods-supported King Air 200 fixed-wing aircraft, based at Centennial Airport in Denver. These aircraft take AirLife Denver’s reach across the country, but most of its flights are to the western states.
AirLife Denver operates across Colorado and Wyoming, with its eastern bases reaching into Kansas and Nebraska. It flies to landing zones and hospitals that require a vertical takeoff and landing at elevations as high as 10,000 feet (3,050 meters).
In the summer months, AirLife Denver’s crews are challenged with high density altitudes and fast-moving thunderstorms that roll off the continental divide and strengthen as they move over the plains.
“The high temperatures place crews at density altitudes between 8,000 to 10,000 feet [2,440 to 3,050 meters] in the Denver area, and those increase to well over 16,000 feet [4,875 meters] density altitude in the highest mountains,” said Batterson. “The thunderstorms are unpredictable, and very fast moving.”
In the winter, typical challenges include low clouds, low visibility, fast moving snowstorms, and extreme winds. It is common to see lenticular clouds forming over mountain peaks and have wind gusts of over 50 knots around the continental divide. And the weather can change quickly.
“We are very cognizant of our forecasts, temperature/dew point spreads, and wind directions and velocities to keep us on the front edge of the fog,” said Batterson. “We have to choose our routes through the mountains very carefully, and realize there are times when we simply need to say no to a transport.”
Survival kits and a personal locator beacon are kept on the aircraft year-round, with snow shoes added during the winter. Crews also bring their own heavy jackets and other survival gear, such as basic survival equipment, food bars, a knife, a locator beacon, gloves, hand warmers and caps.
AirLife Denver bases perform more flights in the summer months, but they stay busy year-round conducting a mix of scene and transfer responses in the mountains, as well as in the open plains of Colorado and Wyoming. Typical scene calls can see the program responding to car accidents, climbing falls, mountain bike crashes, and horse riding accidents — as well as the entire spectrum of typical trauma and medical cases seen in any large urban area. Added to this are hospital transfers and specialty team cases that require flights for neonatal, high-risk obstetrics, and sick or hurt children.
AirLife Denver typically uses either two nurses, or a nurse and a paramedic, for its medical teams, with each team member having at least five years’ experience in critical care, paramedicine and emergency nursing. Each new flight nurse/paramedic completes a comprehensive orientation program before joining the flight crews, including supervised transports utilizing all modes of transport as well as simulated training.
The specialty transports of high risk obstetrical, high risk neonatal and intra-aortic balloon pump teams include two medical crew — either a primary flight team nurse, a specialty trained high risk obstetric nurse, nurse practitioner, or respiratory therapist.
For scene calls, AirLife Denver medical crews carry backpacks loaded with medical gear, because they might have to hike into an area beyond where the helicopter can land. The crew also has to be in fairly good shape as they might have to a carry a patient back to the helicopter. The AirLife Denver medical teams very often work autonomously in performing advanced procedures and administering medications, based on guidelines and procedures developed by — and under the supervision of — AirLife Denver medical directors.
AirLife Denver’s communications center is based at the Medical Center of Aurora-North Campus. Two communication specialists are on duty 24 hours a day, 365 days a year. The center has radios to communicate with the aircraft, map systems to track flying aircraft, and computers to control and monitor operations.
For over 35 years, AirLife has covered Colorado and the surrounding areas with the aim of getting patients to hospitals as quickly and safely as possible, in often extreme altitudes and temperatures. And with the Eagle 407HP in its fleet, it is now able to do so in a much wider range of conditions.