Minutes after being hit by a car and thrown from his bicycle last summer, Ryan Koehler came to and text-messaged his family to say he was OK.
Koehler, 18, was already in a helicopter en route to a Boston hospital. His family had not yet left Pelham.
Emergency responders believed her son had a brain injury because he was unconscious and having a seizure, Linda Koehler said. But by the time she arrived at the hospital, it was clear her son just had some cuts and scrapes.
Regardless, she said last week she is still happy he was flown by medical helicopter to Boston, just in case.
"I think they did what they needed to do," she said.
Ryan Koehler's accident happened in Pelham, where emergency responders request more medical flights than other local towns. They don't keep statistics, but fire Chief Michael Walker counted nine patients who have been flown to Boston in just the last four months.
While the sound of a chopper overhead in Southern New Hampshire is familiar, it's not as common as the sound of an ambulance siren. But local emergency responders in large towns say there are plenty of traumatic injuries happening that require quick transportation to Boston hospitals.
Each emergency response team must follow the same criteria though, according to Steve Turner of the state Medical Control Board. The patient must have multisystem trauma, multiple broken bones, a head injury, respiratory arrest, or a penetrating or severe injury to the abdomen or chest, he said. Crews cannot call for a medical flight if the patient is dead or in cardiac arrest.
The patient, not the town, pays for the transport, Turner said.
For Linda Koehler, that bill was pretty hefty. She said she was shocked to see the flight cost $7,490, but figured she would deal with it as the price of her son's survival. Her insurance company ended up paying the whole bill.
Boston MedFlight, the primary helicopter service for this region, charges a $6,500 base rate, according to Executive Director Suzanne Wedel. She said they add a mileage rate to that price, but wouldn't disclose the rate. They also provide $2 million in free care each year, Wedel said.
The nonprofit organization does about 3,100 transports a year, but only 40 of those calls were to Southern New Hampshire in 2007, she said. Only 18 percent of their transports are from an accident or emergency medical scene, Wedel said. Most of their trips are between hospitals, she added.
Boston MedFlight has three helicopters. Six to eight times in 2007, they couldn't respond to calls in Southern New Hampshire because all three helicopters were tied up, Wedel said.
When that happens, the Dartmouth-Hitchcock Advanced Response Team in Lebanon gets the call. D-HART spokesman Jason Aldous said they responded to Southern New Hampshire 11 times last year. Nine of those were in Derry, one in Kingston and one in Londonderry.
Local responders don't hesitate to use the service, hoping to save a life or providing care that isn't available at local hospitals.
Derry requested medical flights 11 times last year, less than 1 percent of their calls, according to EMS director Chuck Hemeon. It's all about getting patients the level of care they need in the shortest amount of time, he said. A helicopter can get to Derry from Boston in 10 to 12 minutes, he said.
"We call it the golden hour — injury to time of surgery," Hemeon said. "Take them to a community hospital that doesn't have the resources, they would have to be shipped then to the outlying hospital."
In Salem, the in-flight time is just eight minutes, according to Deputy Fire Chief Michael Wallace. Salem used a medical flight 14 times last year.
"So, we figure a person needing that critical care, we'll fly them to the best trauma hospital in the country," he said. "It's a great tool in our toolbox to use."
Departments often call MedFlight before they get to the scene, based on initial reports. Once they get to the scene and assess the patient, they may call the helicopter off. Boston MedFlight doesn't charge for canceled requests.
When a report came in two weeks ago that a car had hit a utility pole in Plaistow and the passengers might be trapped, the dispatch immediately sent a request to Boston MedFlight. But when crews arrived, the car had just driven into the woods and the passengers were fine.
The request was canceled, and the helicopter turned around.
"Everybody does that," Plaistow Deputy Fire Chief John Lovett said. "We call based on dispatch information, get there and then cancel."
But Walker, the Pelham fire chief, said he has never canceled a request for service. And unlike smaller departments that call mostly for car accidents, he said this year they have used helicopters to transport a boy who fell off a skateboard, another boy who fell off a bike, a woman who was thrown from her horse, a man who was hit by a car and five car accident passengers.
"It's fairly regularly," Walker said. "I wish we didn't (call as much), but that's the nature of things."
Medical air transports in 2007
Derry: 11
Hampstead: 6
Kingston: 3
Newton: 2
Pelham: 9*
Plaistow: 6
Salem: 14
Windham: 3
* Number of times called in 2008 to date.
