How Vanderbilt LifeFlight revolutionized trauma care in Tennessee 40 years ago

Trauma surgeon Dr. John Morris stepped into Vanderbilt University Medical Center to build its first trauma center from the ground-up 40 years ago, and he was filled with excitement for the newness ahead.

On the 40th anniversary of Vanderbilt LifeFlight, Morris reflects on how the program revolutionized health care statewide.

Trauma care was relatively rudimentary in 1984. There were no designated trauma centers at the time, and the state wouldn’t establish its organized trauma system for another four years.

Morris quickly realized Vanderbilt needed to reach beyond the ever-growing bounds of Nashville and into rural Tennessee.

“It didn't take a rocket scientist to know that the key to having a successful trauma center in Nashville was to be able to bring patients from the rural area into the urban area,” Morris said. “The key with trauma care is to concentrate a large number of patients in the hands of a small number of physicians.”

So that’s what Vanderbilt did.

Building Vanderbilt LifeFlight

Morris became the first director of the health system’s LifeFlight program, which has spent the last 40 years deploying trained medical professionals to care for patients in emergency situations while transporting them to the nearest hospitals.

“I remember the first day of training, the entire day was spent learning how to get in and out of the aircraft,” Morris said. “That was how juvenile we were in the very early days. Since then, we have progressed. We have one of the best, if not the best, safety record in the country.”

A Cambridge University Press article identified a total of 87 accidents and 239 fatalities associated with air-medical flights from 2000 through 2020, according to data from the National Transportation Safety Board. None of those were affiliated with Vanderbilt.

While medical helicopter crashes are statistically rare across the U.S., they are common enough for the National Transportation Safety Board to urge medical helicopter companies to improve safety rates as recently as 2020 .

In four decades, Vanderbilt LifeFlight has transported 80,118 patients in 76,942 flights without any major safety incidents.

Nine helicopters, 32 ambulances

Now, the program reaches across most of the state and even into southern Kentucky with its nine helicopters, 28 advanced life support ambulances and four large critical-care ambulances.

Morris said the last 40 years have seen constantly improved avionics and increasing sophistication in the way doctors and nurses are trained to operate in medical aircrafts.

“Basically, the flight nurses are providing a mobile intensive care unit in a space the size of a jacuzzi,” Morris said. “It's really remarkable when you see the types of things that they're capable of pulling off.”

These in-air treatments include transports while using balloon pumps for a patient’s heart, blood transfusions and a number of complicated cardiac-resuscitation techniques.

“I was incredibly fortunate to be a part of that incredible team as both a clinician and a leader during a significant time in the program’s beginning and growth,” former director Jeanne Yeatman said.

She grew the aircraft fleet from one to four vehicles and started the process to fund a $1.1 million dollar helipad at the children’s hospital.

'What can we do on the way?'

Dr. Ashley Panas spent the last 12 years as a flight physician with LifeFlight, and she said no flight is ever the same as the last. From children to the elderly, car accidents to strokes, Panas typically spends no more than an hour with each patient in transit.

“It’s doing that really hard math problem of: 'What can we do on the way, and what can wait until the hospital?'” she said. “There are some patients for whom time is really of the essence, and so no matter what we do, we need to always be moving forward, moving them towards definitive care.”

Vanderbilt is Middle Tennessee’s only level-one trauma center, and in recent years the hospital has expanded its LifeFlight program, adding bases in Wilson, Montgomery and Coffee counties.

Flying into those bases and other rural hospitals across the state has given Panas firsthand experience with the struggles smaller hospitals can face, like lack of resources and employees. No matter where they land, though, she said she is always glad she gets to be the first doctor there to help the patient.

“Truthfully, every time I'm in the air on the helicopter,” Panas said. “I really do have that sense that this is where I'm supposed to be.”

Hadley Hitson covers trending business, dining and health care for The Tennessean. She can be reached at hhitson@gannett.com . To support her work, subscribe to The Tennessean .

This article originally appeared on Nashville Tennessean: How Vanderbilt LifeFlight revolutionized trauma care in Tennessee 40 years ago