In summer 1983, Joan Sullivan Garrett, then a critical-care flight nurse and chief medical officer, was aboard a helicopter evacuation flight, responding to a rural traffic accident in the San Tan Mountains in Arizona. She, her paramedic and the pilot were advised a car had rolled over and a child was thrown from the vehicle.
Upon landing, the paramedic assessed occupants of the car and Garrett headed for the child, an eight-year-old boy who was lying on the front seat of a pickup truck. Garrett told him she was going to take him on a helicopter ride. "As I prepared the IV, the boy said, 'I'm brave, I'm not afraid.' He reached up and grabbed the lapel of my flight suit and said, 'I love you.' Then he lost consciousness; his heart stopped, he stopped breathing."
She and her paramedic pulled out all stops to save the boy, who she calls “Tommy,” and were able to get him to the hospital. Although Tommy died more than 33 years ago, Garrett said, "It's as real today as it was then."
When asked if she still thinks about this tragedy, Garrett replied it never leaves her. "I still smell jet-A, feel the heat, smell the dust in the road and see the car where the accident happened," she said. "It's an important event that has shaped and designed the kind of services that MedAire provides today. That whole event was the impetus that got me to look way beyond my day-to-day job; it was the driving force of founding MedAire in 1985.”
A Rough Start
"Each day that I struggled to build MedAire, no one I talked to could comprehend what I was trying to offer," said Garrett, MedAire's founder and chairwoman. "It was difficult: metaphorically, doors were slammed in my face. Nevertheless, I was passionate about what I was bringing. I knew there was a need and it was difficult to get me to go away. In fact, people said I was relentless."
The first thing Garrett did was design an advanced medical kit, as flight attendants and pilots had nothing to work with. "Even if flight attendants or pilots wanted to do CPR, they didn't have any protective equipment; all they had were bandages," she said. "I knew we could add some basic things to these kits [so] they would be less reluctant to help someone."
She also developed a training program for management of in-flight illness and injury. In addition, Garrett provided training on how to properly use an automated external defibrillator (AED).
"Then feedback started coming in: someone saved their father from choking; another saved someone from drowning," she said. "Things that we trained them to do they thought they'd never remember. More and more lives were being saved, and every step of the way there was positive reinforcement, a reason to keep going. Tommy was my fundamental driving force to never give up."
Devoted to her life-saving training program, Garrett worked two or three jobs to support herself and her children while launching MedAire. "Venture capitalists liked the idea, but they didn't want to put money on the table,” she said. “Or if they did, they wanted to own the company. I decided to go it alone."
It was Gulfstream Aerospace that first contracted with MedAire in the 1990s to provide its customers with MedLink, AEDs, first aid kits and medical training. Soon other aircraft OEMs also took notice of MedAire's services.
MedAire (Booth N3510) now provides services and remote medical care programs for business aviation, air charter companies, aircraft manufacturers and 75 percent of Fortune 100 companies. It also provides services to 150 airlines, half of the world's superyachts and the commercial shipping sector.
Be it from air, sea or land, MedAire has taken more than one million calls. Asked how many lives MedAire has saved, Dr. Paulo Alves, MedAire's global medical director of aviation health, replied, "You can't count things you avoided. Because of our medical tools and training, illness in many cases is detected quickly and remedied."
"When I started MedAire, with my first aid kit in tow, I'd knock on hangar doors and visit small and large flight departments," Garrett said. "I'd talk about my aviation training program, but didn't mention MedAire—it was a non-starter. No one could conceive the thought that flight attendants or pilots could talk to a doctor in real time."
Now the company has a MedLink global response center located in the emergency department of Banner-University Medical Center Phoenix, which is a Level I trauma center. The response center is staffed by board-certified emergency physicians and registered nurses.
One of the ways that MedLink physicians are able to provide medical diagnosis and treatment in real-time is via Remote Diagnostic Technologies's Tempus IC, a vital signs monitoring system that transmits data, voice and video. Most of the medical issues MedAire deals with are simple in nature, including gastrointestinal problems, allergies, nausea, fainting and anxiety.
As for in-flight emergencies, Alves said cardiac arrest is by far the most challenging situation. "They might not be the most frequent events, but they are the most serious,” he said. “Sometimes, a heart attack starts with symptoms of feeling nauseated or faint. So it's very important to pay close attention to a person having these symptoms."
As more people are flying on private jets, Alves said medical risks in business aviation are different today from just a few years ago. "What we see are threats of epidemic infectious diseases, such as bird flu. We had the Middle East respiratory syndrome [MERS] virus,” he noted. “This is important because in certain countries, like Saudi Arabia for example, no one is immune to this airborne virus. The Ebola virus in Africa, another example, heightened concern for business aviation."
He said MedAire is on top of medical threats around the world and keeps its clients updated. "We give our business aviation clients pre-travel and post-travel advice," Alves explained. "Because business aviation is more flexible, it's easier to prevent situations from happening."
A Global Enterprise
Outside of its headquarters in Phoenix, MedAire has offices in London, Singapore and Dubai. In addition to the medical side, the company works with clients around the globe providing around-the-clock travel security briefings/solutions, airspace assessments, logistics and overall security to mitigate risk.
MedAire currently has a workforce of 350 people worldwide, including more than 50 MedLink physicians. The company is now part of International SOS, which has 11,000 employees and makes its 26 assistance centers available to MedAire.
"MedAire is growing at a phenomenal rate," said MedAire CEO Bill Dolny. "We're now up to 600 calls a day for all of our services. That gives us the ability to have such a large infrastructure. When I say this, I mean when calls come in we're ready. Within 45 seconds, a MedLink physician is on the phone."
Dolny said that, due to evolving technology, MedAire is now able to provide customers teleconsultations with a physician, and without a physical examination, prescribe medication. Currently, this program is available in 13 cities in the U.S., UK and Australia. Within an hour, a customer's medication is delivered, which saves a customer money and time.
Six years ago MedAire developed the Aviation Travel Security Brief, which is used by many flight departments when they fly to high-risk areas, Dolny said. “What MedAire provides is aviation-specific security information. It's the airport, where they park, how safe is the parking area and hotel routes from the airport. We're talking about the asset, flight crew and the executives.
"Because business aviation operators are going to all sorts of new places, we now see that some of the safest places have become some of the most unsafe places in the world. Our mission is to help our customers stay safe wherever they're operating aircraft, and to deal with any risk they may encounter," he concluded.