Palm Beach County’s Integrated Trauma System Helps Save Lives in the “Golden Hour”

Rapid intervention in trauma cases during the “golden hour,” a short window of time after a severe injury, can spell the difference between life and death. That’s why establishing a high-quality, efficient trauma system was a top priority for the Health Care District of Palm Beach County after voters approved the District’s creation 20 years ago. One of the Board’s first actions was to purchase a Trauma Hawk helicopter to airlift critically injured patients to designated trauma centers.

The Health Care District of Palm Beach County operates two Trauma Hawk air ambulances that last year transported nearly 800 patients to the county’s two Trauma Centers for lifesaving care.
Photo courtesy: ©Health Care District of Palm BeachCounty / Mark Mennie2010
Today, the District operates two helicopters, which are part of an integrated trauma system that delivers medical care by coordinating an enhanced 911 communications and dispatch system, EMS and fire rescue personnel, a Trauma Agency, two Level II Trauma Centers, and their rehabilitation centers.
“Since 1991, Palm Beach County’s Trauma Hawk air ambulances have ensured that traumatically injured patients receive the care they need – safely and quickly,” said Gerry Pagano, the District’s Director of Medical Transport and Aeromedical Facilities. Pagano, who also serves as the program’s chief, has more than 40 years of experience in both public service and air transportation.
The District’s two Sikorsky S76-C+ helicopters, which transport an average of 700-800 trauma and critically ill patients per year, are staffed 24/7 to save lives. With a cruising speed of up to 178 miles per hour, they generally fly under 1,000 feet and can land in a variety of different environments – even on an interstate highway, a baseball field or a lot behind someone’s home.
The Trauma Hawk flight crew is highly skilled and experienced. The team includes at least one commercial instrument-rated pilot, a Florida-licensed registered nurse who is also a state-certified paramedic and an additional state-certified paramedic. All pilots and maintenance staff are Health Care District employees. The District collaborates with Palm Beach County Fire Rescue which staffs Trauma Hawk’s medical crew.
Trauma Hawks have a stretcher system designed and built for rapid loading of up to two patients. Onboard, there is space for easy access to patients and sufficient storage for specialized medical equipment, such as oxygen systems, IV fluid warmers, suction systems, patient monitoring devices, electronic therapy capabilities, ventilators and infusion systems.
The helicopters and staff are stationed at a state-of-the-art Aeromedical Hangar facility at the Palm Beach International Airport. The 25,000-square-foot facility includes the hangar, maintenance facility, administrative offices and living area. 
Through Pagano’s oversight, the Aeromedical program has maintained an excellent safety record with a zero accident rate in its nearly 20 years of operation. 
“We’ve always had a strong culture of safety,” he said. “The Trauma Hawks are twin engine aircraft with an excellent performance capability. The aeromedical program has obtained its operating air carrier certificate, installed flight and data tracking systems, and most recently received IFR (Instrument Flight Rules) authorization. In addition, all 15 Trauma Hawk pilots periodically receive simulator training.”
The Trauma Hawk helicopters are on wheels, which allow them to roll into the position needed at a rescue site in the safest manner possible. To avoid the possibility of injuries, rotor blades can be stopped while both engines are running.
When patients arrive by helicopter at one of the District’s Level II Trauma Centers, either St. Mary’s Medical Center or Delray Medical Center, a minimum of 11 medical professionals gather in a “resuscitation” room to provide immediate care. From there, patients may go to the OR, ICU or a hospital floor. Depending on the trauma injury and the patient’s needs, some are discharged, some may go home with home health nursing or equipment, or to one of the trauma program’s two rehabilitation centers.
“We have a very coordinated system that integrates all the different facets of trauma care so patients can receive all the services they need to return as functional members of society, said Sandra Smith, R.N., M.S.N., the District’s Trauma Agency Administrator.
The Health Care District’s Chief Executive Officer, Dwight D. Chenette, MBA, MPH, noted that since 1992, the trauma system has saved nearly 50,000 lives through its coordinated model of care. “Equally impressive is the fact that our trauma system has a preventable death rate of less than one percent – significantly above the national average.
“There is a strong commitment and dedication of all people involved in the trauma program to making sure we continue to provide excellent care to Palm Beach County citizens and visitors,” Chenette said. “We have many success stories, and take tremendous pride in seeing our patients come back and express their appreciation. Their gratitude has touched all of us as professionals.”