Flight nurse cares for special cargo

(Coloradoan.com) When a pregnant mom is in trouble anywhere along the Eastern Plains, Fort Collins’ Kristi Giltinan is likely dispatched to help.

The 34-year-old Fort Collins nurse is the newest member of Banner Health’s 2-year-old Med Evac high-risk obstetrics team. When she gets a call, a chopper picks her up at McKee Medical Center and flies to wherever she’s needed — two lives are depending on her.

It’s Giltinan’s job to ensure the mother that both she and her baby are being taken care of, assess their conditions, stabilize them and get them to the closest hospital equipped to deal with high-risk pregnancies.

Team in action

When Kayedeane Samber’s water broke at 4 p.m. March 8 — she was sitting at her desk at Sterling Regional Medical Center — her babies were too premature to be delivered there.

Pregnant with twins and having suffered a late-term miscarriage three years earlier, Samber’s was considered a high-risk pregnancy.

She was 33 weeks along, three weeks too early to be delivered at Sterling Regional. The hospital, part of Banner Health, called the high-risk OB team and Med Evac to scoop up Samber and get her to Greeley.

Sophie, the twin on top, was detaching from Samber’s placenta and “decided it was time to go,” Samber said.

Her sister, Emmee, on the bottom, was along for the ride.

“It was such a sense of relief at seeing those ladies (the flight nurse and high-risk OB nurse) walk through the door,” Samber said. They took control, cocooned her up, hooked her to their machines for flight and tried to reassure her.

They landed at NCMC 32 minutes later and by 7:40 p.m. her two daughters were born, both weighing less than 4 pounds.

Sophie started exhibiting some heart issues and was flown to Children’s Hospital in Denver. Emmee went the next day. Both spent the next 44 days at Children’s. “They were just a little too tiny and a little too early. They are perfect now,” Samber said in a telephone interview from her Sterling home.

She’s grateful the Med Evac team was there.

“They took charge and I just knew they were prepared” for whatever happened. “They kept making my fear less without giving me the ‘everything is going to be just fine speech.’ They were giving me the information I needed.”

Taking flight

Giltinan, a nurse since 2008, always pictured herself as a flight nurse but didn’t think it was possible for an obstetrics nurse.

In June she found out differently. After training 80 hours a week for six weeks, Giltinan became a certified high-risk OB nurse — the only one at McKee Medical Center.

In two months she’s been on seven high-risk OB flights. Each one is different; each a challenge.

Being the only high-risk flight nurse at McKee “is pretty cool,” she said. “It’s a very big deal for (McKee) moving forward.” Hopefully, Giltinan said, McKee will start accepting more high-risk pregnant patients.

Similar to Sterling, McKee won’t deliver babies earlier than 34 weeks.

Before 34 weeks, moms are sent elsewhere. “Now I get to take care of them and take them to the appropriate places,” Giltinan said.

Her most critical patient so far has been a mom with pregnancy-induced hypertension. She was 25 weeks pregnant “and very sick,” Giltinan said.

The only way to get the hypertension under control was to “get the baby out.”

The infant was delivered at 25 weeks. Unlike patients she cares for at McKee, Giltinan and the rest of the flight crew rarely know the ultimate outcome for patients they transport.

The mother of two — including a 15-month old daughter Ashlyn, Giltinan said being part of the high-risk OB team has changed her perspective on nursing. “It definitely makes me more aware … and more thorough.

“On the other hand I don’t get too high strung when we have a more high-risk patient because I know what we can do, what to look for. I’m just better educated now.”

Starting the program

The high-risk OB team was added to the North Colorado Med Evac team about 18 months ago when they discovered the only medical flights with true high-risk obstetrics service was Air Life in Denver.

Adding the service in Northern Colorado “was completely customer driven,” said Daniel Beckle, Med Evac program manager.

“A lot of times (Denver) was tied up or not available. We started looking at how else to transport these patients.”

In an urban area, they can be taken by ground ambulance.

In the more rural areas that Banner serves, time is not on their side. There’s no option but to fly patients out.

The high-risk obstetrics team consists of eight specially trained labor and delivery nurses and a medical director.

“I don’t know how rural areas like this would do what they do” if it didn’t have the Med Evac helicopter, said Samber, the twins’ mom.

What the team won’t do: deliver a baby in flight.

They do their best to stop labor before the patient gets on the flight or ensure they’ll be able to get to the hospital before the baby comes.

So far, the high-risk OB team has flown on more than 100 flights. Giltinan was on the 100th flight, a woman 27 weeks pregnant in pre-term labor.

Eventually, Giltinan says she wouldn’t mind being trained to handle all types of Med Evac cases. For that she will have to work in the intensive care unit. “I have such a passion for OB,” she said. “I’ve been on the OB units since 2001 and it’s definitely my calling. I just love OB. I love the one-one-one and most of the time it’s a happy ending.”