Critical Care

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Critical Care

Our mission is to ensure people everywhere in Maine at the point of need have access to critical emergency care when they need it and where they need it. LifeFlight is simultaneously part of Maine’s EMS system and part of Maine’s hospital system. 

While the vast majority of emergency patients are managed by Maine’s emergency care system comprised of EMS, Fire/Rescue, and hospital emergency departments, a cohort of several thousand patients a year need high-level care, similar to a major medical center ICU delivered directly to the point of need whether at an emergency scene, a health clinic, or community hospital.

Based at hospitals, LifeFlight is a mobile intensive care system staffed by specially trained critical care nurses and paramedics with contemporaneous physician support equipped with the medical technology of an ICU including invasive cardiac and neuromonitoring, airway management, multimode ventilators, multiple infusion pumps with a hospital pharmacy, bedside laboratory, ultrasound, blood, plasma, and a full complement of specialty resuscitation equipment to manage every age of patient and disease.

Specialty care is provided for premature newborns using neonatal transporters and for cardiac patients needing specialized support including intra-aortic balloon pumps, ventricular assist and tandem heart devices, Impellas, and for patients on full cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO). Each LifeFlight team and vehicle are equipped with $500,000 of advanced medical equipment onboard and carry blood and specialized medications.

LifeFlight is fully accredited by the Commission for the Accreditation of Medical Transport Systems. 

Zoll critical care hemodynamic and cardiac monitors, pacers, and defibrillators

Our critical care monitors provide noninvasive (outside the body) and invasive (indwelling catheters) to help us diagnose and respond to patients’ conditions minute to minute.  In addition to being able to monitor cardiac rhythms, provide 12 lead cardiograms, and monitor blood pressures, these advanced monitors provide crucial hemodynamic, respiratory, and neuroinvasive monitoring as well as help us track patient’s oxygen, end-tidal CO2, and temperature status. They have been specifically designed for air medical transport—with special attention given to vibration, weight, and ease of use in challenging field situations and for every age of patient.

Hamilton Ventilators

Managing acute respiratory failure in COVID patients required us to replace all of our ventilators with a state-of-the-art mobile ventilator capable of all modes of ventilation. This hospital respiratory therapy-quality, critical care ventilator meets the airway needs of literally any patient whether using noninvasive continuous and bi-level positive airway pressure support or for volume and pressure ventilation for intubated patients.

Airway Management

Intubating a patient, or placing a breathing tube, to take over breathing for a critically ill patient unable to maintain their airway is essential for some of our patients. As a critical care service LifeFlight provides elective emergency intubation for patients who are breathing but unable to maintain their own airway due to injury, illness, or respiratory failure.  LifeFlight uses state-of-the-art KarlStorz CMAC video laryngoscopes to facilitate rapid medication emergency intubation similar to hospital anesthesia followed by connecting the patient to our ventilator.

i-STAT System

The i-STAT is an advanced, handheld portable laboratory providing real-time, hospital lab blood gas reports within minutes. This allows the crew to perform blood tests while in flight and use the results to adjust the treatment therapies and care given to the patient.

Donor Blood

Universal donor blood and plasma are carried on every flight. Initiation of blood therapy is a hospital scope of practice, so LifeFlight is critical for patients who have suffered severe internal or external bleeding, or have medical forms of anemia. LifeFlight has carried blood since inception and is the only EMS service in the state allowed to initiate blood and plasma therapies. We also support our blood banks with blood drives every year. Keep track of our social media for our blood drives—your donation will save lives.

Sapphire Infusion Pumps

Our critically ill cardiac patients often require four, five, or more intravenous (IV) lines for fluids and medications. A few short years ago, these patients would have been considered too sick to even transport. But with these state-of-the-art infusion pumps, the LifeFlight crew can manage up to six different IV infusing medications and can expand as necessary for patients needing up to 14 infusing medications while in transport.  The pumps have internal medication libraries, improving safety and care. For our smallest patients, we use specialized syringe pumps to maintain accuracy of infusing medications.

Ultrasound

Imaging for rapid diagnosis and support is a cornerstone of critical care medicine. In the field, we do this through portable ultrasound, allowing us to assess cardiac, pulmonary, and bleeding emergencies as well as helping us place invasive monitoring lines and difficult Intravenous lines (IV’s).

Pharmaceuticals

Carrying a full set of medications helps us provide advanced resuscitation at the scene as well as care consistent with an ICU during transport. 

Night Vision Goggles

Nearly half of all LifeFlight’s calls occur after dark. With night enhanced vision (NVG), pilots and crew members can see landing zone obstacles such as wires, towers, trees, and rocks while flying in the dark. This improves safety and protects the aircraft’s precious cargo.

Intra-aortic Balloon Pumps and Cardiac Assist Devices

When a patient is suffering from cardiogenic shock and their heart is not pumping blood effectively, specialist physicians use a variety of invasive cardiac assist devices to bridge the patient to additional therapies or even a heart transplant.  LifeFlight is equipped with intra-aortic balloon pumps (IABP) in which the cardiac surgeon implants a balloon in the aorta to improve blood flow. The LifeFlight team then takes over care for transport. Each LifeFlight base is equipped with an IABO to allow the hospitals to transport patients without impacting their cardiac care for another patient. 

In addition, the LifeFlight teams also provide transport for patients in whom the cardiac surgeon has placed a TandemHeart© or Impella© left ventricular assist devices to support blood flow.

Extra-corporeal membrane oxygenations (ECMO)

For critically ill patients needing maximal cardiopulmonary life support, the cardiac surgeons connect the patient to ECMO, a full cardiopulmonary bypass in which the team is providing all of the support to the heart as well as the patient’s lungs, pumping the patient’s blood outside of the body to oxygenate and exchange gases.

Newborn Isolettes

LifeFlight has specialized neonatal transport isolette systems for premature and newborn infants who have just been delivered but need care in a specialized neonatal intensive care unit (NICU) at EMMC, MMC, or the major centers in Boston.  LifeFlight has these advanced systems, which is an entire miniature ICU for smallest patients.  Each of these units has special ventilators, monitors, and infusion pumps sized for small infants.