Story and photos by Kathryn Jones

A 911 call comes in about a bad car accident on U.S. Highway 67 east of Glen Rose. The dispatcher determines that a man is critically injured and calls for an air ambulance to whisk him to a major trauma center in Dallas or Fort Worth.

At the Air Evac Lifeteam base at the Glen Rose Medical Center, the helicopter pilot, nurse and medic flying the emergency mission spring into action. They know minutes and even seconds count. The three fly to the accident scene and air-lift the patient to a hospital where he can receive advanced care.

Scenes like this are part of the job for the pilots, flight nurses and flight paramedics at the Glen Rose Air Evac base behind the Glen Rose Medical Center. The 15-person base crew also includes a mechanic and a membership sales manager. Team members are on duty 24 hours a day, 365 days a year, to respond to medical emergencies in Somervell and surrounding counties.

"A third or more of our responses are at night," pilot Stephen Marksteiner said. He noted that the Glen Rose team has been receiving training on night-vision goggles.

"They greatly enhance the safety of rural operations," Marksteiner said.

Air Evac has had a Glen Rose base since 2006. The team has flown about 1,400 hours with an average 30 missions a month. In summer months, when people are more active outside, the number can climb to 40 to 45 calls a month.

The team responds to a range of medical emergencies, including heart attacks, strokes, falls, serious car accidents, four-wheeler accidents, head traumas and spinal injuries. The clock is ticking for them to respond within the "golden hour" the time from when a traumatic injury occurs until the patient reaches advanced care which can improve the patient's outcome.

For example, the team transported a Somervell County Fire Department member who got caught in a flash fire in a trailer near the Comanche Peak Nuclear Power Plant.

"Because we monitor the EMS frequency, we cranked the aircraft and got to the scene very quickly," Marksteiner recalled. The crew flew the injured firefighter to the burn unit at Parkland Hospital in Dallas.

"Those are the kinds of things that make you feel good that you could help," Marksteiner said.

The team also has responded to some horrific accidents, including when a Cleburne police officer last year rammed into a car turning left on U.S. 67 east of town; he later died. They also were called when some young people got swept away in floodwaters in the Paluxy River several years ago.

"Even in the outcomes that aren't always good, the reality is they call us when all else has failed," Marksteiner said. "You know you gave them the best chance you could."

The Air Evac Glen Rose base also has a memorandum of understanding with the power plant to respond to an emergency there if needed.

Since most rural and small-town hospitals can't support a dedicated air medical transport on their own, interest in the Air Evac program is growing. It's the largest independently owned and operated air medical service provider, with more than 800,000 members nationwide. Selling memberships allows it to focus on under-served rural areas where other providers may not go because of low population density, low Medicaid rates, poor reimbursement or other factors.

Without a membership, the cost of the Air Evac service averages $8,000 to $10,000 a flight. A one-year members costs $50 to $60. Three-year and five-year memberships also are available, as is a monthly membership for $6.

"I live in Glen Rose, so for me having a helicopter here is an asset," said Martha Nichols-Headrick, the base program director and a flight nurse.

She knows that firsthand because her daughter had to be flown to Cook Children's Hospital after she developed a respiratory problem and quit breathing. All turned out well.

"Just because we live in a small county, we shouldn't be treated as second-class citizens" when it comes to access to air medical service, Nichols-Headrick said.

The Glen Rose Air Evac team typically responds to calls within a 70-mile radius. There are 19 bases in Texas. Sometimes several of them are mobilized at once, such as after last year's mass shooting at Fort Hood in Killeen. Four Air Evac helicopters responded to that disaster.

"It was controlled chaos" at the Army base, recalled flight nurse Jarrett Wharton. "The emergency room was a sea of people."

The Glen Rose team transported one of the shooting victims to a hospital.

All four pilots and some of the medics have military backgrounds. The pilots flew Apache, Black Hawk and Chinook helicopters. Paramedic Darren Pieren was a scout sniper for the U.S. Marine Corps during the first Gulf War. Now they are using their military training and discipline to carry out life-or-death civilian missions.

"They are looking for a career that dovetails with their military experience," Marksteiner said.

Much of the training in the military focuses on how to operate out of rural areas, pilot Vince Hendricksmeyer noted.

"A lot of the skills transfer, such as landing in a field somewhere and looking for obstacles and wires, he said.

The shift from military to civilian work also brings different kinds of rewards.

As pilot Hendricksmeyer put it, "Instead of making patients, I'm taking patients."

"It's a different kind of satisfaction," Marksteiner added. "When you get a patient from an accident scene or take them from a small hospital to a large one, you help save lives."

The helicopter at the base is a Bell 407, which Marksteiner described as "powerful, nimble, robust, durable and reliable. It's the Ford 150 of helicopters." The chopper functions as a flying emergency room to treat and stabilize patients until they can get to a major hospital.

Visibility affects the flight team's ability to respond more than anything. Pilots need a minimum vertical visibility of 800 feet in the daytime and 1,000 feet at night and horizontal visibility of at least three miles in the daytime and five miles at night. During the snowstorms in February, the Air Evac team was grounded, Nichols-Headrick said.

Safety remains the top priority for each mission. Any member of the three-person team can call an end to the mission if he or she feels it's unsafe. They call it the "51 percent rule."

"The military bludgeons into you that you never compromise safety," Marksteiner said.

"We don't just have a safety program, we have a safety culture," Nichols-Headrick added.

The Air Evac team so far has maintained an accident-free record.

To learn more about the Air Evac program, call (800) 793-0010 or visit glenrose.lifeteam.net.