LORAIN COUNTY -- It's 6:45 a.m. and the next flight team has arrived at the Lorain County Regional Airport.
Life Flight Medical Director, Dr. Craig Bates has been flying missions for six years. Today he's working with Flight Nurse Specialist, Amy Armbruster.
The first thing they do is take a computer analysis test that checks their fatigue levels and determines if they're fit to fly.
Meanwhile, the same procedures are taking place with the two other flight teams based at the Portage and Wayne county airports.
MetroHealth is no longer home base. The helicopters were moved to strategically cover Northeast Ohio.
"It means that they're never more than than minutes away from getting Level One trauma care," Dr. Bates says.
However, potential weather issues and unscheduled maintenance may ground one or more of the crews on any given day. There is a "spare" helicopter available if needed.
One would think practicing medicine in a medical helicopter would be an extremely stressful job, but you'd be wrong.
Dr. Bates says it's quite the opposite because the focus is only on their patient and not on the extraneous distractions that can happen in MetroHealth's busy emergency department.
"It's exciting we all are a bit of adrenalin junkies and it keeps the job interesting," Dr. Bates says.
While there's not much room to move inside the EC-145 every high tech medical device is within reach of the medical team.
"Most of the stuff we can do in the first thirty minutes except for X-rays and CAT scans," Dr. Bates says.
Metro's LifeFlight is one of few programs in the country where a nurse, physician and two pilots are standard. However, on some flights, the physician may be replaced by a specially trained Nurse Practitioner.
Regardless, safety is always the priority and everyone has a say in the mission. The motto is "four to go, one to say no."
"You gotta make good decisions and the best way to avoid incidents and things going wrong with patients or with aviation is to have a good safety culture and focus on the risk and do what you can to mitigate it," Dr. Bates says.
Armbruster has been with the program a year but has flown with other medical flight teams. She finds this job incredibly rewarding.
"We see people at their worst and see some horrific things but sometimes we can see those patients come back and go home and that's wonderful," Armbruster says.
There are 26 pilots that fly with the program. Dave Reese is Lead Pilot with 18 years experience, including a stint in the Navy.
"I love to fly and I get to help people in their hour of need and I get paid to do it," Reese says.
But these pilots do more than fly. They will assist the medical team when needed, retrieve medical equipment on scene, load and unload the patients, and help coordinate with emergency crews on scene.
Their job is to fly and safety is the utmost priority. That's why they told where they're going, but not what's waiting for them when they get there.
"The weather decision can be a very difficult decision on whether to go or not and they don't want that decision tainted by us worrying about the patient," Reese says.
In the last 30 years, Metro's flight program transported more than 85,000 patients. What you may not know is the crew also includes a ground unit and a Lear Jet used for international transport.
The program has received international recognition.
The type of helicopter has changed and the new EC-145 has advanced aviation safety features on, such as such as a terrain warning system, real-time satellite weather and weather radar, allowing greater flexibility in dealing with potentially changing weather conditions, especially in Northeast Ohio.
They also use night-vision goggles to assist evening navigation.
While you may have seen LifeFlight land near a highway accident scene, those types of runs are only 15 percent of their actual flights.
The helicopter is mostly utilized for critical care transport between hospitals and it may surprise you to know that not all of the patients end up at Metro.
The best interest of the patient is always the priority, so if another hospital is closer and appropriate they may land there.
While the flight team may be the most public crew members, there's a staff of nine flight communication specialists who coordinate everything they do.
They are either EMTs or EMT-Ps and operate the high tech computer dispatch system.
And back at the Lorain county airport is a team of specially trained mechanics who go over each helicopter with an experienced eye every day.
While the helicopter and medical devices may have changed in the last thirty years, Metro's mission has not.
And when they're not in the air the team is busy educating the community including rescuers, firefighters and paramedics and taking part in various disaster preparedness drills.
"It's just a long history of service to the community it's really just a reflection of what Metro does a lot of folks helping out in ways that not everybody realizes and Life Flight's just the most public example of that," Dr. Bates says.