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Air Ambulance Meets Critical Care Needs of Remote Alaskans
By Marie L. Monyak


February 20, 2006
Monday AM

Ketchikan, Alaska - Speaking before the Greater Ketchikan Chamber of Commerce last Wednesday was Dr. Eric Stirling, owner and medical director of Guardian Flight, Inc.

Ed Fry of Guardian Flight introduced Dr. Stirling who graduated from Loma Linda University, California in 1974. He is board certified in both Emergency Medicine and Internal Medicine and has over 50,000 on-call hours to his credit.

jpg Dr. Eric Stirling

Dr. Eric Stirling, owner and medical director of Guardian Flight, Inc.
Photograph by Jason Cerovac

Guardian Flight is a regional air ambulance service located in Fairbanks, Sitka and Ketchikan. Although Guardian Flight was started in Fairbanks by Frontier Flying Service in 1997, they separated and became a privately owned company in just three short years keeping Fairbanks as their main base of operations. After providing critical care air ambulance service to the Interior they opened a base of operations in Sitka in 2004 followed by our local service here in Ketchikan in 2005.

In Ketchikan, a Lear 35A jet is available around the clock with a two-pilot crew, flight nurses, paramedics, physician assistants and respiratory therapist. The Lear jet is always fueled and ready for any emergency and has the capability of carrying two patients and when every minute is critical, the jet has a cruising speed of 500 mph getting the patient to a regional medical center in record time.

Dr. Stirling told the audience that he wanted to talk about cardiac patients in Alaska and what their options are.

Giving some rough statistics, Stirling said, "There will be somewhere between a million and a half and two million heart attacks in America this year and a half a million cardiac deaths. You ask, what is the standard of care? The standards are that you should have a catheter in your heart, in that coronary artery, inflated to open up that artery in 90 minutes. That's a little tough to do here."

As Stirling stated, "Door to needle time is a common emergency room term. In other words, when you hit the door of the emergency department, how long is it before they drip that magic clot busting drug into your vein and do the next best thing to having a catheter in your heart. Every hospital tries to get that time under 30 minutes."

"One of the most rewarding things that has happened to us here in Ketchikan last summer is that we were able to go out by float plane or rotor wing and give that medicine three times which saves hours and hours," Stirling explained, "and every minute is another percentage of your heart muscle that won't come back."

Stirling continued, "If you can get that medicine on board [administered], 60 to 70 percent of people open up that artery and buy you the time to get down to a cardiac center. I think this has been our biggest success."

As an afterthought, Stirling asked the audience if anyone knew what a single dose of the clot busting medicine cost. The gathering was quiet until Stirling told them it was $2800 to $3000 for a single dose and then people began to gasp.

Using the cost of the drug as an appropriate segue, Stirling began to speak about preventing heart disease, thus the need, for such an expensive drug. Saying that exercise will not prevent heart disease came as a surprise until Stirling explained that it's the dynamics of what is happening in the body that needs changed.

"Things have changed in the last few years, there are these little plaques, these rough areas that get inflamed, they break off, they collect things, they clot." Stirling said. "Everybody over 50 should be taking an aspirin and a lot of people should be taking Lipitor.

Stirling was excited as he said, "I think you're going to find major changes in the next few years. CAT scanners are getting advanced enough now, the newest generation of them is incredible in diagnosing coronary disease. Other things are progressing; 60 to 70 percent of bypass surgery is done off the pump, the heart is still beating, they do a small incision and send you home in a day or day and a half, two days at most."

The sad news was that although there are tremendous changes in coronary care and treatment, "When you live remotely and need help urgently, there still isn't a community below the size of Anchorage that can support critical cardiac care which leads me to our [Guardian] mission here."

When asked to come to Ketchikan, Stirling said he did a lot of investigating and learned that no one has ever based a jet here. When weather is bad a jet can't always get in but one can get out. Also, he decided that he would only open a base in Ketchikan if it would be both regional and long-distance.

"It doesn't help people outside the city limits if all you have is a jet sitting here," said Stirling. If you can't go to Hydaburg or Stewart or a logging camp it serves no purpose. By using float planes and rotors Guardian is able to reach even the most remote sites and towns.

"We [Guardian] are the only medevac service in Alaska where everything is under on roof.
We have our own pilots, our own aircraft, our own full system, so we have some flexibility to operate," Stirling informed everyone.

"When I started in this business in 1989, we had treatment for heart attacks that consisted of one, a lot of sympathy, two, a lot more sympathy and three, some morphine along the way and some oxygen and you spent three weeks in the hospital. It's come a long way since then."

It sure has, and Ketchikan is fortunate to have Guardian Flight and their skilled medical and flight staff on board.

This week's guest speaker at the Greater Ketchikan Chamber of Commerce luncheon Wednesday will be Bruce Garrison from the Department of Labor and Workforce Development who will speak about employment taxes.


On the Web:

Guardian Flight, Inc.

Information on coronary artery disease - Mayo Clinic

Marie L. Monyak is a freelance writer living in Ketchikan, Alaska.
Contact Marie at mlm1x[at]

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