Colleton County Fire Rescue and Med-Trans Open Hybrid HEMS Program

Care Flight’s Bell 407 GXP flying over rural Colleton County – Colt Roy Photo

This story was originally published in the September issue of Heliweb Magazine. You can check out the full online article HERE.


Colleton County, SC – A community partnership began recently in South Carolina between Med-Trans Corporation and Colleton County Fire Rescue to form the recently launched CARE Flight program on June 15th, 2017. The hybrid partnership between Med-Trans and Colleton County Fire Rescue is a first in the state of South Carolina and is different from conventional HEMS programs across the nation. With this partnership, Med-Trans is responsible for providing the aircraft, pilots, flight nurses, and a mechanic, while Colleton County Fire Rescue is responsible for providing paramedics. This partnership is noted in the helicopter’s bold paint scheme which includes a winged Maltese Cross, the symbol for firefighters, with a Star of Life centered inside.

The layout of Colleton County provides responders with several challenges and this program is already making leaps and bounds to address in the short time since it has been established. A majority of the 1,100 square mile county is considered rural with a population of only 38,000 people. In comparison, neighboring Orangeburg and Charleston counties have a population of 90,000  and 350,000 people respectively,  and are nearly the exact same size with respect to square miles or smaller.

Due to the distance from many medical and trauma emergencies to the nearest appropriate medical facility, air based transportation had been utilized heavily in Colleton County, and that has been credited with saving many lives. In many cases, a critical patient doesn’t have the time required for ground-based transport.

A Program Is Born

Speaking with Colleton County Fire Rescue Chief Barry McRoy it was clear after only a few short minutes into the conversation that a change was needed. The department had what he referred to as “several issues” with the previous air medical provider in the area. The Fire Department wasn’t alone with these issues, which lead the Colleton Medical Center to decline the renewal of the lease with the previous air ambulance service. That’s what led McRoy to search for a better solution. Talk between Colleton County Fire Rescue and Med-Trans began in October 2016 where all these previous concerns were brought to the table. The suggestion was made by Med-Trans to look at bringing a hybrid program into the county, and the rest as they say, is history.

When the previous providers lease expired at Colleton Medical Center on May 31st, the partnership had a program that was turnkey ready for operation, and on June 15th CARE Flight officially opened their doors and accepted their first patient. Since that day, there has been very little downtime for this flight crew. While officials from Med-Trans wouldn’t divulge the total number of transports to date, we do know CARE Flight handles on average a minimum of one transport per day.

A Role Model System

What Fire Chief Barry McRoy called the most impressive aspect of the CARE Flight system he best described as a “Fully integrated system where the fire-ambulance-helicopter-trauma center all works with seamless integration to provide the best level of care for the patient.” The biggest benefit of this integration comes from the reduction in the time it takes for the helicopter to be called. In the world of EMS, minutes are a valuable commodity that most patients deemed critical enough to warrant an air transport simply don’t have. Not every transport is flown from a scene, as many of the flights involve facility to facility transports as well. The real win for the Fire Department is that Med-Trans actually reimburses the department for the flight paramedics. What this means for Colleton County Fire Rescue is that all the added benefits of this hybrid system and the service to the citizens they are charged with protecting comes at virtually no cost to the department.

The service to the community doesn’t stop there, currently, the program is working on providing a ground-based service for the flight crew to operate during the times weather prevents flights to be made. If the final approval is given for this venture, an ambulance would be staffed with a Paramedic and a Registered Nurse, which exceeds the level of care a typical Advanced Life Support ambulance can provide.

New Delivery

While the first three months of CARE Flight’s operation took place utilizing a 2014 year model Bell 407, the program recently took delivery of a brand new 2017 Bell 407 GXP. The 407 brings a huge upgrade over the previous provider’s capability which includes a stronger lift capacity. This new helicopter also boasts a number of safety features which help reduce the pilot load, allowing the pilot to focus on the safe operation of the helicopter. Noticeably is the Garmin 1000 that places all avionics and terrain avoidance data directly in front of the pilot. This data can prove valuable in the event of an in-flight emergency. Now with the touch of a button, a list of airports along with their respective frequencies and approaches can be brought up, which is both safer and quicker for a pilot compared to the old way of pulling charts.

Other safety features include a pop out float system which is essential for a single-engine helicopter operating in an area with large bodies of water. CARE Flight is able to fly from point A to point B legally, which saves precious time for any patient on board who is en route to advanced care. Also featured on this configuration is an auto-pilot feature.


With any new program, there are things that work brought across from previous operations, while others will not. Another unique aspect of the CARE Flight program is while pilots are required to complete quarterly check rides every 120 days, so too are the flight crews. Check rides are completed with the entire crew aboard, adding to the overall realism by having the crew aboard to simulate a real flight condition and reality that all of the lives aboard need to be preserved.

About Colt Roy

Editor and Photojournalist for Currently employed by the Department of Defense as a Firefighter/EMT. Past North Charleston Fire Department and Whitesville Fire Department. Colt is also the owner of 3 House Photography where his work that doesn't go to is published. Colt uses Canon gear and is currently shooting with 5D Mkiii and 6D cameras along with the 24-105 F4L, 70-200 2.8L IS ii, and 14 2.8L ii Canon lenses along with the Sigma 50 1.4 Art and 150-600 Sport lenses. Colt also uses a 360Fly HD 360 camera to capture events as they unfold.