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Published on May 24, 2017

“A helicopter has crashed in my backyard!”

“A helicopter has crashed in my backyard!”

This is part of a continuing series of stories from Cape Cod Healthcare’s Cape Cod Health News, exploring the world of paramedics and EMTs across Cape Cod, and their incalculable contribution to the region’s healthcare system. There are nearly 1,000 of these professionals who also serve as firefighters in all 15 towns. Paramedics undergo up to two years of classroom training and 400 hours of clinical work in the hospital, as well as continuous retraining coordinated by the Cape and Islands Emergency Medical Services System.

300The Chatham Fire Department responds to 2,700 calls a year, most requiring paramedics and EMTs to rush in ambulances and trucks to the scene. But, rarely do they get a call like this.

The 911 alert came in June 2016 from a woman who had just watched a helicopter crash behind her house at the edge of Crow’s Pond.

In seconds, firefighters, paramedics and even Chatham members of the Barnstable County Technical Rescue Dive Team, as well as fellow Tech Team members from surrounding Fire Departments were speeding to the accident. The Coast Guard and town harbormaster also were alerted.

All their combined skills and experience would be needed to recover and save the pilot, John Ryan, and his passenger, professional aerial photographer Tyra Pacheco.

Rescuers realized immediately they could not maneuver vehicles into the marsh to reach the victims. The next minutes would require not only all the training they had accumulated over combined decades, but also instant innovation and teamwork.

The day was clear when Pacheco and Ryan were just finishing a photography shoot of Chatham homes for their real estate company clients. Then, with virtually no warning, the craft began losing altitude. Ryan was able to deftly maneuver it away from the nearby houses, but as a result, the craft landed precariously at the water’s edge, with both victims nearly submerged.

Five more feet and they probably would have drowned before rescuers could reach them.

As the lifesavers arrived, they found both occupants severely injured. While Ryan was somewhat outside the helicopter, Pacheco was trapped inside the mangled craft, recounted Lt. Dave Ready.

“We were at least 100 feet away from any apparatus,” he said. “It would have been very difficult to get heavy extrication equipment down there. As a result, crews on the scene rushed to get hand tools like hacksaws, crow bars and bolt cutters.”

As Deputy Chief Peter Connick, who is now chief, assumed command, the rescuers worked feverishly to carefully cut away the sharp metal entrapping Pacheco, while simultaneously caring for her and assessing as best they could her injuries, which would include crushed bones.

“Both victims were in extreme pain,” said EMS Coordinator Mark Heller. “We were able to get Ryan’s leg splinted and transport him on a backboard to more solid ground. But, freeing Pacheco required extraordinary care and teamwork. It was not only the challenge of cutting away all the metal, but assuring that her airway was not compromised because she was neck deep in water.

“She could accidentally drown if the helicopter tilted  too much, it would cause more damage to her bones as well and she could also bleed out,” explained Heller.

On Cape Cod, every one of the nearly 1,000 firefighters in all 20 departments is also either a paramedic or an emergency medical technician (EMT).  While most cities and larger population areas may separate the functions, this is not financially feasible on Cape Cod as departments in recent years have fully professionalized – drastically reducing or totally eliminating on-call and volunteer members.

“That’s something the average citizen probably doesn’t understand,” said Heller. “They see a fire engine and assume it’s a firefighter. They see an ambulance and they believe it is an EMT or paramedic. But, they all are one in the same. On a single shift, we might rush to a fire, a water rescue, and transport a half dozen people to the hospital. That takes intense and continuous training as well as constant attention to physical conditioning.”

Transport To The Ambulance

“The rescue team understood how the helicopter landed, so they concentrated on Pacheco’s left side,” recounted Ready. “We could eventually see what was beneath her. Among her more obvious injuries was a partial amputation of a finger.”

Once they successfully freed her, rescuers confronted the next challenge: How to get her to the ambulance. A decision was made to carry her on a stretcher to the harbormaster’s boat and go around to Ryder’s Cove to meet the ambulance, which would speed to Barnstable Municipal Airport where medical helicopters would be waiting to rush Pacheco and Ryan to a trauma center off Cape.

“Only then were we able to start assessing her injuries and evaluating vital signs,” said Heller. “We suspected a fractured pelvis and femur. Her entire left side was impacted. We were alert for fractured ribs and a punctured lung, and we were constantly attending to her airway.”

As they rushed to the airport, paramedics administered pain medication and fluids. Pacheo had been in the water for a good half hour and hypothermia was developing. Rescuers had to ever so carefully remove her clothes and swath her in warm blankets.

At the airport, both the Chatham paramedics and the flight team focused even more on advanced procedures to secure Pacheco’s airway.

In the ensuing days, all the parties involved would meet to debrief and assess each step of the rescue. Could they have done something differently? Did all their advance training translate to the right decisions? Would they do something differently in the future?

Because it was such a rare incident, with so many rescue elements and coordination required, how could it serve as a case study for other departments at upcoming training sessions conducted by the Cape & Islands Emergency Medical Services?

Two months after the crash, Pacheco was still recovering from her life-threatening injuries in a rehabilitation hospital. In an interview with the Cape Cod Times, she reported she could stand, but put weight only on one leg.

As the paramedics on-the-scene determined, nearly the entire left side of Pacheco’s body suffered multiple fractures, including her ankle, pelvis, leg, arm, shoulder, elbow, and neck. She also damaged three spinal vertebrae and severed part of her index finger.

“Every day I wake up and I’m just grateful,” she told the newspaper. The fact she survived the crash and was pulled from the marsh in time, “doesn’t make any sense,” she marveled.

To Heller, Ready, Connick and their colleagues, though, it truly does. They trained for just such an outcome.