On October 9, 2007, in a very rural part of Reynolds County, Missouri, a school bus carrying 32 elementary school children went out of control, rolling three times.

Consider that the aforementioned school bus accident in Reynolds County required the response of 5 EMS agencies, 4 rural fire departments, 2 sheriffs departments and 3 air ambulance companies.  That’s 14 agencies, each with multiple vehicles or aircraft at the scene.  Maintaining order at such a busy scene is difficult but vital.

Now a new effort is underway to institute a system of coordination for scenes that require the landing of multiple aircraft. 

The Air Ambulance Subcommittee of the State Advisory Council on Emergency Medical Services provided a forum for Jerry Kirchhoff, with Air Evac, to express his ideas for the need for better communication when dealing with situations similar to the Reynolds County school bus accident.  The Air Ambulance Subcommittee is comprised of representatives from each of the licensed air ambulance programs in Missouri.  The subcommittee meets each month to discuss issues that are common to each program.  One of the main focuses of the group is safe operations for all programs.  Jerry’s concept was quickly embraced and a plan is now developing to enhance safe landings of air craft at accident scenes.

The plan starts and ends with communication.

“While we had no significant safety issues at the school bus scene,” says Kirchhoff, “it was clear that we needed an enhanced communications system for dealing with multiple aircraft. “

Currently, such scenes rely on the use of the Fire and Mutual Aid frequency, which is used throughout the state.  But when so many agencies are working simultaneously, the communications tend to get a bit crowded.

As the committee worked to look for solutions, it became apparent that air ambulances need to follow the National Incident Management System (NIMS) guidelines, as well as use other emergency service plans. 

As a result, Rich Lehmann, Director of the Missouri Association of Fire Chiefs and Mike Kindle, president of the Missouri Chapter of the National Emergency Number Association (MONEA) and the director of  Macon County Enhanced 9-1-1, presented information their organizations have developed on how air ambulance programs can understand existing system equipment and compatibility.

The committee is ready to put some of their efforts to the test and provided the first quarterly training for Johnson County Missouri Fire Association on April 12th in Warrensburg.  Three air ambulance programs serving the area provided a day of instruction including when to use an air ambulance, how to set up a landing zone and how to deal with downed aircraft.  In the afternoon, multiple aircraft response to scenes was reviewed.

The training closed with a table top exercise and followed by the arrival of 3 helicopters so participants could practice what they have learned.

“We wanted to see this collaborative effort result in excellent training and information that will specifically keep us all safer while we work to save lives,” said Kirchhoff.

LifeFlight Eagle’s Ruby Mehrer says the effort is unprecedented particularly because several air ambulance competitors worked together to provide the training. Directly participating air ambulance companies included LifeFlight Eagle, Staff for Life and Air Evac.  Other programs supported the effort as well.

“This effort identifies a new era of cooperation in the interest of safety,” said Mehrer.

“Putting our competitive nature aside is beneficial to Missourians all over the state as we work together to enhance safety at scene flights.  Today, most residents in Missouri are covered by a number of air ambulance services.  Coordinating our efforts, particularly at mass casualty incidents assures that patients receive rapid transport and care in a time critical manner,” said Mehrer.

Kirchhoff says he is very pleased to see participation of the agencies and the serious approach to the enhanced system needed. 

The air ambulance committee intends to use this training as a template to provide consistent training across the state of Missouri.