Marion County has a hidden gem that few may realize exists and many take for granted until they need the service. The county is part of the longest, continuously-operating air ambulance district service in the nation, and the benefits are huge.
One of the crew members of Rescue 7 is Marion County resident and paramedic, Hunter Townsend.
"People in Marion County don't know much about SEMAAD (Southeast Mississippi Air Ambulance District). They don't understand how it works or the benefits,” Townsend said. "Partially, that's our fault for not doing public relations like we should."
Emergency Medical Service helicopters serve two main functions. The first is inter-facility transport of critically ill or injured patients from smaller hospitals to larger ones. They also deliver initial care to victims or patients in remote, isolated places and perform scene transport when ground transport is not fast enough for issues such as heart attacks, strokes and emergent injuries.
The Southeast Mississippi Air Ambulance District was established in 1971 when the project, CARE-SOM (Coordinated Air Rescue Endeavor-State of Mississippi), ended. State law allows counties to come together to form a district helicopter rescue, and several southeast Mississippi counties saw the benefit of doing so to maintain what CARE-SOM started.
The average medical helicopter bill can be $30,000-$70,000 per trip. Being a part of SEMAAD means residents of the participating counties are not directly charged for this lifesaving benefit. The service will only bill insurance or third party providers. After 2015, the service no longer charged residents even if they are uninsured.
That means no out-of-pocket expenses, no deductibles, no co-pays and no fees. For example, Medicare may only pay $4,000. The rest of the cost is written off by the service.
This no cost service is in effect for county residents even if they are injured in a non-district county. The service is available to residents of the contiguous counties but not with the same no-cost benefit.
The district is made up of ten counties — Covington, Forrest, Greene, Jefferson Davis, Marion, Pearl River, Perry, Pike, Stone and Walthall. Each county pays $500,000 annually for membership. SEMAAD is the only community, tax-supported air ambulance district in the nation. It is funded by a millage tax, which is minimal compared to the benefits.
SEMAAD has helicopters in Hattiesburg (Rescue 7) and McComb (Rescue 9). They also have a non-SEMAAD helicopter on the Coast (Rescue 5) that can be used. Med-Trans Corporation is contracted for flight operations, and any helicopter owned by them, including Aircare at the University of Mississippi Medical Center, can be used in the district for the same deal as Rescues 7 and 9. AAA is the contract manager that sets up board meetings and handles paperwork for the governing agency, SEMAAD.
The current Rescue 7 aircraft is a twin engine EC 135 made by Eurocopter, and it is fully loaded with auto pilot, night vision, enhanced vision systems, radar altimeters, GPS navigation, satellite tracking, terrain alert warning and air collision avoidance systems.
The helicopter needs about 100-by-100-foot or larger, level area to land with as few obstructions as possible. If needed, the crew will land in an area close by and walk, or they will meet the ground ambulance at the nearest hospital.
Rescue 7 is staffed with one paramedic, one registered nurse and one pilot, and it can transport one patient.
Townsend is one of those paramedics. He attended Columbia Academy until the 10th grade, when he went on to graduate from Prentiss Christian. He received his associate's degree in paramedicine from Jones College. He has worked for Med-Trans Corp as a flight paramedic on Mississippi Air Rescue 7 for the past seven years. He was previously employed as an EMT for AAA. He is currently in the critical care paramedic program at Jones.
Townsend said it was actually an accident that led him to this profession. He always wanted to be a firefighter and joined Tri-Community Volunteer Fire Department when he was 16. He said he was on the scene of a car accident one day and watched the helicopter paramedic. According to him, he knew right then what he wanted to do.
"My mom (Darnell Townsend) always wanted me to go to college, but I did not want to. I was a less then desirable student, and I didn't think I could do it. I barely graduated, but my friend begged me to go to Jones for at least one year to be his roommate," Townsend said. "I did and finished with a degree. I just had to find my passion."
That passion turned out to be the unpredictable nature of being a paramedic.
"It is a different challenge every day, and you never know what you will face. You have to be able to think on your feet,” Townsend said. “I enjoy figuring out what is wrong with the medical patients and how to treat them."
But the most challenging aspect of Townsend’s job is that nothing stays the same in the medical field.
“Protocols and treatments change (all the time). It is a constant job to stay current in training and knowledge," he said.
Townsend said the employees of Rescue 7 are some of the best in the business with a lot of experience on aircrafts, and they are constantly preparing and studying. They have worked together for a lot of years and are like a family. They all get along, and it's a healthy work environment.
He said the top three characteristics needed to do well in this job are critical thinking skills, common sense, which goes a long way, and a sense of humor that helps deal with the difficult, often heartbreaking work that has to be done.
"We have a catch phrase," Townsend said, "that complacency kills. You can't afford to become complacent. Doing the same things over and over can get you or your patient killed."
The typical day for Rescue 7 is filled with extensive protocols that have been carefully crafted to ensure nothing stands in the way of saving a life, according to Townsend.
There are four registered nurses and four paramedics who work two, 24-hour shifts per week. There are four pilots who work seven days on and seven days off with 12-hour shifts.
Their shift change is at 7 a.m. They arrive about 15 minutes early to do early morning duties. They take report to tell the incoming crew what happened during their shift and engage in chit-chat.
Rescue 7 carries blood products on the helicopter, so they have to swap out the blood in coolers and check the count of all narcotics. They check the aircraft and all equipment to make absolutely sure they are ready to take any and all calls.
It is not feasible for ground ambulances to carry blood, so this is another benefit of the aircraft. They can transport two units of blood and one unit of plasma. They also carry TXA, a medicine that assists with clotting.
Peer reviews of patient care are done on charts from the day before. They critique each other's work and look for what could have been done differently, if anything. They make sure all checklists are done and completed. Educational and training components are constantly in the works as they wait for a call.
When one comes in, it is not like an ambulance call. They can't just jump in and go. The call goes to AAA dispatch first, and the Rescue 7 crew only gets the location and weight of the patient. They do not get any info as far as age or what happened.
They need to only take into consideration things like the weather and not other factors that would cause them to push to go on a call when it is not safe to do so. It does not need to be an emotional decision, which they could be making if they know, for example, that it is a baby who was in a serious car wreck.
"Crashes happen when there is pressure to take a call,” Townsend said. “Going out when you shouldn't can be deadly. Having so little information means you can be more objective and safer."
All three crew members make the decision on whether to take a call. The pilot makes the final determination, but if any of the three are against it, they do not take the call.
When they accept a call, everything they need is already ready to go. They get their things, do a walk around of the aircraft and verify that all is good to go. Once the pilot starts up the sequence, a final check is made to be sure nobody wants to cancel the flight. If not, they take off with a typical flight speed of 140 mph.
The critical phases of flight are takeoff and landing. There is total silence during those times — no radio, no talking. At altitude, they call dispatch, get more information and prepare for what is needed.
They get the height and weight of the patient or patients, so they can get correct medicine dosages and ventilator settings ready, if needed. The paramedic tapes all vital information on his leg in what is referred to as a "cognitive dump," which is when they get in a high-stress situation.
With this procedure in place, they don't have to think of all of the high-frequency issues. They are already prepared and/or written down and easily accessible.
Only one patient can be transported at a time. Nine times out of ten, the ground ambulance crew on the scene will decide who is taken if there is more than one person in critical condition. Triage is done to determine the most critical. They have to make a decision and stick to it. Two, or all three, of the Rescue helicopters can be called to one scene, if needed.
"As a whole, the air ambulances provide a higher level of critical care for patients than ground ambulances," Townsend said.
Marion County is one of the few counties that have this type of benefit where residents do not have to worry about paying the bill at a time when they have so many other things to worry about. It provides that peace of mind that can be so elusive in those moments.
