ALERT trains for snow duty

For someone buried in an avalanche, the chance of survival can start dropping below 50 percent after the first half hour.

And as ALERT’s chief helicopter pilot at Kalispell Medical Regional Center, Matt Weller knows that once the call comes in, every second counts.

Checking over the array of switches, dials and screens in the Bell 407 helicopter in the hospital’s hangar, he’s readying his crew for avalanche rescue training — one of several the specialized team of medical professionals will be required to complete this year.

It’s just one component of the rescue training in which the program’s five helicopter pilots and 24 medical personnel must participate. Still, Weller concedes that even the chopper’s quick response may not be enough to reach an avalanche victim in time.

“For a high percentage of the people who survive avalanches, there’s someone in their party who had the right equipment and training to pull them out,” Weller says. “The rate of survivability really plummets with us being here, getting the call and having to get loaded up” before a flight.

The on-duty crew consists of a pilot, paramedic and flight nurse and is tasked with first response in an area that extends from the Canadian border as far south as Ronan, and from Libby east to Browning. When they’re dispatched to the mountainous backcountry of Northwest Montana, there isn’t a moment to waste.

“There’s no map of my typical day,” Travis Willcut, the flight nurse on duty, explains. “I have no idea if I’m going to a trauma, a skiing accident [or] a bear mauling. You don’t know what you’ll get, so you have to be prepared for anything.”

ALERT operates two air ambulances: the fire engine-red chopper and a propeller plane used for long-distance patient transport. But because of the tricky terrain usually involved in an avalanche response, it’s the helicopter crew that gets the call.

In addition to the practice rescues, ALERT staffers are trained in backcountry winter survival and identifying avalanche conditions. That’s a critical skill, particularly when the crew must decide whether to land directly in the fresh chute or hike in from a safer landing spot elsewhere.

“It’s so much judgment, looking at what’s just happened: Is there a cornice above them, or did the avalanche just dump everything downhill?” Weller explains. “They might be able to jump out, or they might have a to find a place to land and hike in.”

After being dispatched to an avalanche, the crew dons beacons and loads up emergency survival bags, medical equipment and a specialized antenna bag to receive the victim’s beacon signal.

Weller fills out a risk assessment checklist, with criteria including weather conditions, crew experience and fatigue (they work in 24-hour shifts). Ten minutes later, they’re in the air.

At the scene of the avalanche, the chopper approaches the slide chute at a 50-foot hover.

Each crewmember focuses in a different direction, checking the trees to gauge wind speed and direction while scanning the snow for skis, pieces of a snowmobile or other signature debris that can help them identify the victim’s location.

“When we fly into the area, we want to identify the boundaries of the avalanche, the number of victims, where they were last seen, whether they had beacons and any witnesses on the ground,” Willcut says. “We start at the bottom of the avalanche and do a grid search to get a lock on the beacon, then throw out one of the streamers.”

Sitting in the back, Willcut opens the door and lowers the black-and-yellow antenna bag as close to the ground as possible. With the sensitivity on the transceiver turned all the way up, Weller guides the chopper along the foot of the chute, working methodically uphill as three pairs of ears strain to pick up that first critical “beep.”

Once the source of the signal is located, a neon orange streamer is tossed down to mark the spot, and the crew shifts its focus to digging the victim out.

Once back on board, Willcut gets to work stabilizing the patient. That could mean anything from basic trauma care to dealing with impaled objects or inserting a breathing tube. He’s been flying with ALERT for 14 years.

It’s chaotic work, he admits, but working as a flight nurse has been his dream since college. Willcut remembers working on a logging crew and watching an injured coworker lifted to safety by an air ambulance.

“I remember being at that scene and thinking, ‘That looks like the coolest job in the world,’” he says. “Most communities this size don’t have this type of service. I don’t think people realize how much a boon to the community this is.”

Still, the odds that the patient ultimately can’t cover the rescue costs keeps the ALERT program consistently in the red.

Director of Aviation Carson Coryell said ALERT operated at a loss of $2.6 million in 2014, the most recent year for which that information is available.

“We started in 1975 out of a community need, and it’s basically been carried on since then,” he explains. “We think it’s important to support the community that’s helped us over the years, and we just continue that tradition.”

The vast majority of ALERT’s calls come during the summer months, but Willcut notes that Northwest Montana’s growing appeal for wintertime backcountry recreation still keeps the crews busy year-round.

“Even 10, 15 years ago, there were so few people headed to those places,” he says.

Those new adventurers don’t always take the necessary precautions, and are statistically less likely to have health insurance.

“Most other companies won’t accept a flight unless you can guarantee payment or have insurance,” he adds. “Here, we go first and worry about payment second.”

On average, it costs between $800 and $1,000 per hour to keep the helicopter in the air, not counting staff salaries and medications that need to be administered en route.

Equipment upgrades and maintenance are in part paid for by the Kalispell Regional Healthcare Foundation, which hosts a fundraising banquet each spring. Last year the banquet raised more than $100,000 to help keep the air ambulance program alive.

When ALERT started, it was just the second hospital-run air ambulance program and the first to serve a rural community in the nation, so it has long been a standard-bearer in the industry. Weller said it was one of the first programs to extend its service into the twilight hours by equipping crews with night-vision goggles and was the first to comply with the latest suite of regulations from the Federal Aviation Administration.

The pilot takes pride in ALERT’s unlikely position within “sleepy Northwest Montana,” but concedes that it takes a village to maintain it.

“It’s only with the support of the community and the hospital that we’re able to continue operating,” he says.

This year’s ALERT banquet is April 23 at the Flathead County Fairground’s Trade Center Building. For more information, call (406) 752-1710, email lalsbury@krmc.org or visit www.kalispellregional.org/foundation.

Reporter Sam Wilson may be reached at 758-4407 or by email at swilson@dailyinterlake.com.