A Medevac Trip

Friday I was on first call.

One of our women went into possible labour at 35 +6 weeks. She had to be medevaced out. As the flight nurse was not sure if the woman would deliver on the plane or not, she asked for a midwife to accompany them. Our supervisor said yes, as there were five of us last week, and I was on my way. When there is a possibility of a birth, the flight nurses ask for a midwife or a second flight nurse to accompany them. (For anyone who has not been reading my previous notes you will need to know that a hospital is usually about 3 1/2 hours away in Winnipeg. As this baby was unlikely to need a NICU the client would be able to deliver in Thompson. Everybody who goes into labour prior to 37 weeks has to be assessed and if time permits, sent to a hospital with obstetrics, for delivery. Usually the women here deliver very quickly, so there is very often not time to send them "out".)

It turned out that this particular flight was coming from Baker Lake, with a patient for Rankin. (Now that we have four inpatients at Rankin, the hospital takes patients that need observation. They hope that the ten bed ward will eventually be fully open.)

The flight crew, on the medevac plane was based in Churchill, so I had been told that I would go with them, and our patient, to Thompson, Manitoba, and then we would fly to Churchill, and I would spend the night there. I considered myself very lucky that they booked me a hotel room. They also phoned me and told me how to contact the night clerk, as we would not arrive until at least 1am and the hotel was closed prior to that.

The flight nurse arrived, and our lady in labour was having fewer contractions. For all you midwives reading this, we now had a baseline fetal heart rate of 175-180. The client was unhappy about having to go to Thompson, but as we watched the baseline climb from 140 to 180, we were very glad we had organized the medevac.

Medevac planes are small. As you can see from the photographs with this post, there is room on one side for the flight nurse, and two other people, often another flight nurse and an escort. On the "business" side of the plane there is a stretcher with the patient, and another stretcher, which could have a patient, or, as on this flight, a baby pod. If you look past the patient you see most of the back of the plane where the baggage and extra medical equipment is stored. In one of the other photos you can see the pilot and copilot. The patient is attached to a blood pressure cuff, an oxymeter, and an IV pump. They have lots of other equipment, so they can take all kinds of different traumas. This particular flight nurse was a trauma/ER/ICU specialist. We had lots to talk about on this particular flight.

We left Rankin health centre at 19:00. We arrived in Thompson about 21:30. A proper ambulance picked us up. (In Winnipeg we get met by a private ambulance service.) The firefighter who was driving had a fair bit of information about the city. The population is 15,000. It has most of the facilities of a larger city, as it is the largest centre of northern Manitoba.

A medevac team is on the ground for 2 1/2 hours at the most. We went to the hospital, watched the nurse start an NST and admission, the flight nurse did a bunch of paperwork, we said good-bye, and left. The cab took us to TIM HORTON's. It was lovely, a sandwich and a decaf. Back to the aeroport. Apparently things changed re: where the flight crew went. The nurse was just back from her "time south" and did not know that they were using a different area of the terminal. We spent half an hour trying to figure out where we were supposed to be, being found by the co-pilot, and boarding the plane. It was only an hour to Churchill. (No wonder they did not want to take me the two hours back to Rankin and then go to Churchill. More important they would have timed out. They are only allowed to fly a certain number of hours.)

At Churchill the flight team had to get the plane into a hanger, and reload and unload medical items. It was REALLY interesting. The hanger already had a plane in it, and a large, unlicensed, Suburban type vehicle. It turned out this truck was to pull the plane!

The hanger doors went up. The pilot pulled the plane into the hanger. The doors were closed. The oxygen was checked. The baby pod was removed (as it belonged in Rankin and not in Churchill) and we got supplies onto the plane. The team then drove me into Churchill, and told me all the good things to see.

My flight the next day was not until 18:00 so I was able to do something else on my bucket list. I had always wanted to explore Churchill Manitoba, and thanks to the medevac, I was going to have this dream come true.