It's not UPS !!!

The "Medevac" dual engine KING AIR 350 based in Cambridge Bay
This model can fly to any of our communities
and return to Edmonton without refuelling. 

This weekend was a busy one. It started out late Friday afternoon. I hadn't completed my end of week tasks in the xray area before we had another late Friday gathering of nurses and doctor and lab staff gathered once again in the ER area of the Kitkmeot Health Centre. It was just after 4 pm.

Just like the week before, once again, Sandy at the head end rolled the patient in...the Fire Chief leading at the feet. The injuries were severe, but not yet life threatening...this was no drill. Someone in town had rolled his snow machine...the human body being no match for the aluminum and fiberglass powerhouse and inertia.

The door is always open and they are always on alert!

Chest injuries and a leg...this time. The patient conscious, in pain...but coherent. We did our deeds as trained professionals working in unison, the simulation the week before had made for a better team response. The various injuries were assessed physically and radiologically and then the call was made.

Co-pilot's cockpit

If you add a Patient...there ain't much room

When serious injury, surgical intervention or the patient's condition warrants overnight stays and inpatient stays, the call goes out for transfer. Since these patients are not able to travel by commercial airlines, the transfer falls upon the men and women tasked in the north with MEDICAL EVACUATION.

The MEDEVAC teams work various rotations. They are company based contracts in 3 major communities...one in each region of Nunavut. At the airport, they will have their own hanger and the planes are stored inside these at the ready. The crews have accommodations in town and usually work a month in and a month out. There are two distinct components to the teams...aircraft and patient. They fly in all types of weather and are an important component of medical care in the north, extending a lifeline to the south.

Their teams consists of flight nurse and paramedic...pilot and copilot. Each has a clearly defined role...a finely tuned chorus...the variable is always the patient. It's could be someone who's appendix is about to perforate, an individual with a bowel obstruction, someone who has suffered heart irregularities, or a myriad of other medical conditions and/or complications. They are ready at the call.

Late Friday afternoon, while everyone else in Cambridge Bay was having their evening meal, this team was planning a flight to Stanton Territorial Hospital in Yellowknife. Like any flight, commercial or private, a flight plan has to be filed once the weather conditions have been assessed. The plane is always at the ready.

The hangar is huge, the patient can be loaded inside...out of the wind

Meanwhile, back in the Health Centre, the flight nurse and paramedic or other health professional readies the patient for transport exchanging information with the medical staff who treated the patient and getting acquainted with the individual, if they are conscious. There is room on board for an escort. Long before the patient is transferred to the airport and the awaiting plane, the loved one has had some time to travel home, grab a few clothes and essentials and make their way back to their loved one at theHealth Centre...who has no been prepared for transport.

Patient transport to the airfield is provided by the community ambulance. The MEDEVAC plane and patient, on arrival at the destination airport, is met by paramedics from that community. While working in Rankin Inlet, I had always hoped to see the plane, with its cramped interior...but never actually had the opportunity.

That is until yesterday...you see, we had two ‘medevacs’ on the weekend...and at some point, I may have mentioned a desire to actually see the plane and its equipment to have a better understanding of what is involved after the patients leaves our care. Yesterday, just before closing, Gary, the flight nurse stopped by the department.

You wanted to come see the plane..I'm heading out now...I checked with the boss...grabbed my call phone and my cell, donned my boots and coats and was off. On the way to the airport we met the pilot and co-pilot walking along the road and Gary stopped to introduce me. A few twists and turns around some snow banks and drifts and we were at the edge of the runway, parked in front of the hangar.

The outlets: suction, oxygen and electrical above the patient's stretcher

“It's not heated inside”...”but you're out of the wind”, I replied. Inside, I expected minimal light inside, but was amazed as the lamps were bright and reflected well of the skin of the plane. I expected bigger…the air was still...my feet making noises in the gravel floor as I walked along....to the front...across the back and then inside.

We talked about bringing the ambulance inside the hangar to transfer the patient away from the winds. We talked about the plane being inside the hangar reducing the frost on the wings and eliminating the need, in many cases, of de-icing before takeoff.

I looked at the doorway half expecting a double width...but it was a normal width door. I had to ask twice or more....”How do you get the patient's inside?” Gary quietly explained the sequence and then it was up the five steps and inside the fuselage to try to process the explanations that were taking place.

My guide, Flight Nurse Gary.
The patient care area is very compact.

The pilot and co-pilot seats and instrumentation was easy to visualize. I could see the seats for the escort and an additional one should there be an additional patient needing transport from the community. But what intrigued me the most was the working area.

The incubator ready and warmed...all set to go as needed.

Two leather seats sat against one wall of the fuselage.The stretcher was opposite. Overhead was an array of outlets, electrical, gas and suction as would be needed on many flights. Various canvas bags hung along that wall with carabineers providing easy access and movements of the attached bags in order to reach critical tubes, catheters and equipment that might be needed during the flight. 

The backboards...ready to immobolize

This very compact, yet highly specialized work area was illuminated from above by those same lights you have while flying commercial airlines. I took a few photos while discussing the work operations and then it was time to leave the plane.

A quick trip inside one of the prefabs, I met their operations chief, saw their lounge and then went to their supply room. There, plugged in and ready to go, was a warmed incubator...covered to keep it clean and warm. Over in the corner were the two back boards for spinal injuries and patient transfers. Other supplies, for re-stocking, were there as well.

Walking down those five steps from the aircraft I had wondered how many...how many had survived? On the way home and last night I continued…How many had been saved? What was the survival rate of their transports....what was their toughest, most challenging case…their best reward?

I never asked those questions...it's a code that most health care people follow. It's a coping mechanism...a means of keeping those moments we share with our patients…a personal one. As medical staff we all have stories...and baggage that we carry, long after our day is done. Some cope easier than others...most can handle the pressures, while some are unable.

Jack Spyker, Paramedic
1988-2015
Knowing Jack this would have been a self-portrait

Help is easier to access today and most employers are recognizing the importance of decompression following major incidents but for many help is still too far away…too difficult to access, and carries stigmas. Now, while in the midst of my tour of duty here in Cambridge Bay, I’m drawn to remember my friend, my colleague from the camera store, an extremely talented photographer, and one of the most enthusiastic paramedics that ever served his community…both in Hamilton-Niagara and in North Battleford,  Saskatchewan.  

It’s almost been a year, Jack Spyker, but we remember you! I remember hearing the news of his passing during my last weeks in Rankin Inlet in March. At his remembrance celebration, I met his friends and colleagues from Hamilton-Niagara and elsewhere, his parents Dorothy and Jack Sr. and sister…his best friend Drew. It was all so sad…so much life ahead…ended.

After spending a few minutes with the crew and seeing the equipment yesterday…and knowing Jack was a former Air Cadet and had done some skydiving, I could see him in this role as the onboard paramedic. Jack, here in Cambridge Bay, you would have certainly enjoyed the challenge! We, truly, remember you!

To the hundreds, perhaps thousands, of paramedics working across Canada, in all types of terrain and climates, we are humbled to say THANK YOU for your services! Stay Safe!

Their greatest fear...if I ask for help...
GO...ASK !!!