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The medics of the sky: how Carolina Air Care transports critical patients


Mike Gardner, Carolina Air Care ground critical care paramedic and Alan Wolf, UNC Health Care spokesperson, stand with Tar Heel 1 at the helipad at UNC Medical Center on Friday, Jan. 17, 2020. Carolina Air Care is the only true 24/7 neonatal pediatric special care team in North Carolina.

Carolina Air Care, the only true 24/7 neonatal pediatric special care team in North Carolina, works on the ground and in the sky to transport critical care patients to UNC Health Care System. 

Carolina Air Care consists of five helicopters, a fixed-wing dual engine airplane and specialized trucks. UNC Health Care contracts Air Methods to provide aircraft and pilots. 

Helicopters are designated with call sign Tar Heel 1-4. Alan Wolf, a spokesperson for UNC Health Care, noted the significance of having an aircraft fleet for UNC since it is a Level 1 Trauma Center. 

“It is a huge asset for patients, specifically,” Wolf said. “In many ways, it can be a matter of life or death.”

'Kids are resilient'  

Mike Gardner, ground critical care paramedic, said Carolina Air Care is a 1-call system. This means they will dispatch the closest aircraft or vehicle for the most efficient response time. 

Carolina Air Care collaborates with other bases, such as Duke and Wake Baptist, to create the 1-call system. Laura Carney, a neonatal pediatric flight nurse, explained how the team determines what mode of transportation they will use.

“The main thing that determines air over ground is if it is time sensitive,” Carney said. “Are they really, really sick where we need to minimize the time we spend out of hospital or do they need to emergently get back to an operating room for a time-sensitive, life-saving procedure.”

On the ground, neonatal pediatric flight Respiratory Therapist Kara Arnath and emergency medical technician Sean McGregor work in tandem with Carney. The team works in a special truck decked out with equipment, such as isolettes, to perform neonatal and ICU care. Essentially, it is a moving hospital.

Neonatal Pediatric Flight Respiratory Therapist Kara Arnath speaks of an isolette, a device that keeps newborns in suitable environmental conditions on Friday, Jan. 17, 2020. The isolette and other equipment are found in a special truck designed for neonatal and ICU care. Arnath works for Carolina Air Care, the only true 24/7 neonatal pediatric special care team in North Carolina.

The truck also has toys, stuffed animals and ceiling lights to comfort kids who often are in critical condition. Parents are not allowed in the back of the truck because the medical team does not want to take away from patient care.

“There’s always some emotional component of knowing that it’s somebody’s child,” Carney said. 

Arnath and McGregor mentioned that oftentimes, the children in the truck are in critical care and not all have good outcomes. But the team loves working with the kids. 

“Kids are resilient,” Carney said. “They don’t feel sorry for themselves, and they just want to get better and get back to playing and life as they know it. They are fun to take care of.”

The team of medics understands that families put great trust in them in vulnerable moments, Carney said. The medics said for them, the reward of the job is indescribable.

“To see them get better and we were the reason why they got better, it is very rewarding,” Arnath said. 

Emergency Medical Technician Sean McGregor pictured in a special truck designed for neonatal and ICU care on Friday, Jan. 17, 2020. The truck contains toys and a ceiling designed with clouds and stars, as well as advanced equipment. McGregor drives the truck as a member of Carolina Air Care, the only true 24/7 neonatal pediatric special care team in North Carolina.

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In the Air 

Onboard Tar Heel 1 are Tommy Hooks, flight nurse and paramedic, and Tommy Snow, flight medic. They respond to onsite medical issues and interfacility patient transfers.  

“You see a lot of bad stuff, unfortunate things,” Hooks said. “These are some of the worst patients we are going to be flying.”

In the limited space of the helicopter, Hooks and Snow provide critical care throughout the duration of the flight, using ventilation devices and IV drips. Both men dedicated decades of public service, including time as emergency responders, to reach this point in their career.

“There’s a lot of self-discipline involved in what we do,” Snow said. “We all love our jobs.”

Hooks described their positions as the Major League Baseball or National Football League of the medic world. Occasionally stressful, the air medics perform time-critical care. But they attribute their success and knowledge to their education and support staff.

“Our education is phenomenal,” Hooks said. “Our management staff, our administrative staff is very supportive. We’ve got the best partners.”

Carolina Air Care Tommy Snow, a flight medic, pictured with Tar Heel 1 at the helipad at UNC Medical Center on Friday, Jan. 17, 2020.

Gardener added how significant education and preparation are to get to this point in a medical career.

Snow added that Carolina Air Care also transports people who need to come to UNC Health Care because they cannot get the same treatment in rural areas. Patients suffering from traumatic burns are moved to UNC because of the hospital’s sophisticated Jaycee Burn Center. 

Carolina Air Care’s fixed-wing dual engine airplane is located at Raleigh Durham International Airport. The aircraft flies within the United States and internationally to Puerto Rico and Canada to pick up expats or cruise ship passengers who require UNC Health Service’s specialty care. 

Carolina Air Care’s number one priority is the safe transport of its patients between facilities. But as health care providers, they always look to relieve the stress of their patients.

“As a provider, you should always find a way to make a connection with a patient,” Gardner said. 

The medics work together as a tight-knit team. Arnath, Carney and McGregor described it as a family. 

Carolina Air Care’s team of medics and nurses said they want the UNC community to understand the care they provide and their dedication. 

“The next time you see a helicopter, you know what’s in the back,” Hooks said. “It could be a family member, a friend or anyone like that. It’s not just a cool helicopter flying through the air.”