STARS, the Shock Trauma Air Rescue Service, provides helicopter emergency medical response services for people in rural Western Canada who have life-threatening medical or trauma-related incidents and need to be transported to high-level medical care as quickly as possible.
Dr. Gregory Powell founded STARS in 1985, after a pregnant woman died from blood loss enroute from her rural community to a hospital, leaving her partner alone with a newborn child. Powell had served as chief of the emergency department at the University of Calgary’s Foothills Medical Centre and was also a trained pilot.
“If we had a bit more speed and talent applied to the pre-hospital part of their care, [such deaths could be prevented]”, Powell told CTV News. Powell, who was STARS’ president and CEO for 27 years, was appointed an Officer of the Order of Canada in 2006.
That tragedy motivated him and a few of his colleagues to create the helicopter air ambulance service so that no matter where they lived, all Albertans could get the critical live-saving care “they deserved and required,” said Nicole Segstro, STARS VIGILANT’s director of business development and sales.
From the beginning, STARS was built and supported by the community it served. In the early days, the pilots and medics were mostly volunteers because STARS was a non-profit and couldn’t afford to pay salaries, says Segstro.
“The funds we needed to keep the lights on in those early days came through grassroots programs like bake sales and 4-H sales,” she said.
The first STARS base operated in southern Alberta, primarily in the Calgary region. Today, STARS has six bases across Western Canada, in Calgary, Edmonton, Grande Prairie, Saskatoon, Regina and Winnipeg, and 10 Airbus H145 helicopters in its fleet. All flights include two pilots, a flight nurse and a flight paramedic. A transport physician may also be part of the in-flight crew in serious situations, says Segstro.
STARS is still a non-profit, funded by individual and corporate donors, service groups and government contributions.
“Our mission is to provide critical care anywhere, whether by air, ground or virtually,” said Segstro. Because government funding varies per province, she explained, “We rely heavily on fundraising activities through our foundation team, and through STARS VIGILANT, which is our revenue-generating arm.”
Work-alone and remote worksite monitoring services
STARS first introduced the STARS VIGILANT fee-for-service program in the late 1990s. When businesses register work sites that are farther than a 20-minute drive to a major hospital with the STARS emergency link centre along with the site’s Emergency Response Plan, it is assigned a site registration number.
“Having that number allows us to co-ordinate and expedite the medical response more quickly and mitigates any risk of misinformation being passed on during a crisis situation when people may be in a heightened state of stress,” said Segstro.
STARS VIGILANT also offers monitoring services for employees who are working alone or in high-risk situations, ensuring that they are safe and accounted for throughout the entire course of their day and providing timely and accurate medical response to alarms.
“What’s best for the patient is very much a physician-led decision, made with the patient at the forefront.”
Nicole Segstro, STARS
Although the service doesn’t replace onsite medical or 911 services or the OH&S requirement for a transportation plan – and the decision as to whether STARS will fly to any particular spot is always based on location, the severity of a patient’s injuries, weather conditions and aircraft availability – Segstro said, “It has become an integral part of the safety plan for all industries across Western Canada,” working in co-ordination with organizations to help with the preplanning of their year ahead.
STAR VIGILANT services are used by industries including oil and gas, forestry, mining, road maintenance, social services, education and transportation.
“We’re now monitoring between 3,900 and 4,200 sites every day and respond, on average, to 100 to 150 requests from work sites every year,” said Segstro. “About 80 per cent of those are from individuals in distress, and 20 per cent are accident- and trauma-related.”
The STARS VIGILANT Emergency Communication Centre is its critical care logistics hub, co-ordinating emergency response plans and connecting patients with help beyond STARS. Introduced in 2008, its emergency communications specialists are available 24/7 to educate environment, health and safety teams and field staff, activate emergency response plans, respond to calls and use geographical information systems (GIS) mapping technology consistently and accurately to confirm incident locations, and notify stakeholders when there is an emergency.
Registering with STARS VIGILANT is easy, says Segstro, and can be completed in minutes 24 hours a day, seven days a week, by calling its emergency communications centre at 1-888-888-4567. The cost of the program to each organization varies, depending on the number of sites, number of individuals onsite and number of days the sites are registered.
“One phone call to STARS gives organizations access to a multi-agency response that allows us to facilitate and co-ordinate the best possible medical response for the patient based on a dynamic set of circumstances,” she said, including the severity of the patient’s illness or injury, the level of medical support the organization already has at that work site, the site’s location and the weather.
“No two requests come in the same way and no two receive the same medical response.”
Nicole Segstro, STARS
“All decisions are made with the transport physician, who quarterbacks the facilitation and co-ordination of the medical team,” and who works with the STARS emergency link centre and other health care providers within that province, said Segstro. “[This is] what we call ‘the chain of survival’ – to determine where the patient should be transported to and how they should be transported.”
That could mean going to the scene by helicopter or arranging for a ground ambulance, fixed-wing airplane or chartering a helicopter company, whatever is the fastest way to get the patient to the hospital.
“No two requests come in the same way and no two receive the same medical response,” said Segstro. “That’s the power of having that transport physician, because he or she can determine what is best for the patient at that time. It’s very much a physician-led decision, made with the patient at the forefront.”
Shaping the future of critical care
“From a single helicopter to a network of highly skilled professionals STARS has grown into a leading-edge innovator, harnessing our passion for saving lives to shape the future of critical care,” said Segstro.
In 2013, STARS’ base in Regina became Canada’s first air medical service to stock blood for transfusions on its air medical missions. Today, all six bases offer “Blood on Board” service.
“We’re also constantly looking at ways we can push our boundaries with technology, to expand what critical care anywhere looks like,” said Segstro. STARS partners with local, national and international researchers to identify pre-hospital critical care best practices.
Since 1985, STARS has been a lifeline for patients in rural, remote and Indigenous communities across Western Canada.
“Providing critical care to the patient in the shortest period of time, anywhere, has been our goal since our very first mission, and it is our guiding light in everything we do,” said Segstro.
