MAMA's Littlest Passengers - TribPapers

MAMA’s Littlest Passengers

Two MAMAs land together. Credit: Mountain Area Medical Airlift's Facebook page.

Asheville – What if a premature baby is born in a remote homestead during a thunderstorm? What if a three-week-old starts hyperventilating at the top of a winding mountain road?

Mountain Area Medical Airlift (MAMA) has been working as an air ambulance for Mission Hospital since 1986. The lay of the land is an obvious reason why. Incidents can cause traffic to back up on two-lane, shoulderless roads, and this only gets worse during rescue operations, especially if somebody is pinned and requires time-intensive rescue work. MAMA not only flies above the fray, the helicopters can travel at 150 mph.

MAMA now operates out of two bases, one at Mission’s main campus in Asheville and another at Transylvania Regional Hospital in Franklin. The main campus has three heliports, two on the ground and one on the roof of the North Tower. Although the MAMA fleet averages three calls per day, it is not uncommon for four helicopters to be delivering patients to the main campus at once.

Part of HCA’s $5 million investment in infrastructure and technological upgrades went toward the purchase of a new Airbus EC145 in 2020. The patient care area of the new MAMA 1 is 31% larger than that of the EC135 it replaced. It allows the nurse and paramedic to walk all the way around the patient. The older helicopter remains stationed at the Asheville airport for backup. The MAMA 2 helicopter stationed at Franklin is also an EC135.

Other advantages of the EC145 include a larger fuel tank, which extends the range of the vehicle by 15%; more powerful engines; and more sophisticated instrumentation. MAMA 1 has an autopilot system that enables the craft to fly in fog and hurricane conditions. In the past, the airlifting of heavy patients was sometimes not logistically possible.

Normally, MAMA carries three crew members: the pilot, a paramedic, and a nurse. Both bases have four of each. If a baby in respiratory distress weighs less than 11 pounds, a fourth crew member, a respiratory therapist from the NICU with training in ground and air transport, will join the team.

There is no phone number people in distress can call when they want a MAMA lift. Instead, they call 911, and the first responders will decide whether or not to have the 911 center call Mission MedCom for a MAMA dispatch. With hospitals also calling for patient transfers, MedCom answers about 300 calls a day.

MedCom will call MAMA to allow the pilot to get the helicopter warmed up while the team at MedCom continues to collect information about the patient’s condition and location and identify an appropriate landing site that may also require fire department assistance for securing a perimeter. They also scan for potential hazards. Maintaining close communication throughout the flight, MedCom keeps both the flight crew and the charge nurse at the hospital apprised of developments.

About 99% of MAMA’s flights take patients to Mission, and Mission receives air lifts from Med Center Air in Charlotte as well as LifeForce in Chattanooga. MAMA is used more often now that HCA has made the decision to centralize more and more procedures at its main campus, which is the only Level II trauma center in the 10,000-square-mile region it services. Mission is also home to the only Level III neonatal intensive care unit (NICU) in Western North Carolina.

MAMA is equipped like a normal ambulance, but it can be adapted for neonatal transport. Babies can fly in heated mobile incubators with oxygen supplementation, vital sign monitors, and IV pumps. Onboard practitioners work to stabilize the baby while in constant communication with the neonatologist at Mission.

As a Level III facility, Mission’s NICU staffs pediatric surgeons, as well as the pediatric hospitalists, neonatologists, neonatal nurse practitioners, pediatricians, and family physicians found in Level II facilities. It must also provide imaging services and have access to pediatric anesthesiologists, pediatric ophthalmologists, and other pediatric subspecialists.

About 40% of NICU babies nationwide are admitted for low birth weight and/or premature birth. Another important reason babies are admitted is for respiratory issues. Others are seen for a variety of reasons, including birth defects, infection, and withdrawal if their mothers were using drugs.

About 200 of the 900 infants seen in Mission’s 51-bed NICU each year arrive by ground or air, with help from the hospital’s Infant Transport Team. Mission’s NICU celebrates returning neonates to their homes five days faster than the national average. One lady was so impressed by the motherly love showered on her baby that she became a nurse and joined Mission’s NICU team.