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Saving lives is a growth business for REACH Air Medical Service, which uses helicopters and airplanes to transport critically injured patients.

The Santa Rosa company's revenue grew to $40 million last year, up 33 percent from 2006.

It has expanded rapidly in the past three years, adding air bases in Oregon, Illinois and remote areas of California.

Demand for air ambulances is strong in Sonoma County and other locales where hospitals with trauma units can be more than an hour's drive away for some residents.

REACH's appeal is easy to understand: In the remote coastal enclave of The Sea Ranch last week, a 79-year-old resident collapsed of an apparent heart attack. His heart was barely beating, about 10 beats per minute. At that point, without treatment, his remaining life could be measured in minutes.

A REACH medical helicopter touched down in The Sea Ranch 15 minutes after his collapse.

Todd Peltier, a registered nurse with REACH, jumped out of the helicopter and rushed to his side.

Peltier and a REACH paramedic loaded the patient into the helicopter and got to work, inserting a breathing tube and applying an external pacemaker, which brought his heart rate back to 70 beats per minute.

The REACH team had the patient at Sutter Hospital within 30 minutes of the heart attack -- a trip that would have taken more than an hour by ambulance.

On Thursday, the man was moved out of the intensive care unit -- a new pacemaker in his chest -- and was expected to make a full recovery.

Lots of people contributed to saving his life: his wife who called 911 and administered CPR; the paramedics who arrived first in an ambulance; and the doctors and nurses at Sutter. But REACH fills a life-saving niche that wasn't around 22 years ago.

"Every day, I know we make a difference. It's great," said Jim Adams, chief executive officer at REACH and a former flight nurse.

Without access to trauma care, people with critical injuries are up to twice as likely to die because of missed diagnoses or treatment delays, according to the Centers for Disease Control and Prevention.

"They are a godsend when it comes to getting patients from point A to point B quickly," said Jan Gritsch, trauma program manager at Memorial Hospital. "The whole premise of the 'golden hour' is that if you can get a patient to a trauma center within an hour, their mortality rate will drop."

REACH, which stands for Redwood Empire Air Care Helicopter, employs 260 people who help manage a fleet of 16 medical helicopters and four planes. It expanded to western Oregon in 2006, and to the Chicago area this year.

The idea of air ambulances came out of the Vietnam War, and then blossomed alongside the growth of hospital trauma units in the 1980s, Adams said.

Sonoma County is primarily served by four emergency helicopter services -- REACH, Sacramento-based CALSTAR, the Sonoma County Sheriff's Department and the California Highway Patrol. Only REACH and CALSTAR are staffed with registered nurses.

"You can consider us a flying intensive care unit," said Darin Huard, a flight nurse for REACH.

Dr. John McDonald started REACH in 1987 while working in Memorial Hospital's emergency room, which he also co-founded in 1971.

McDonald, who died in a plane crash in 2000, wanted to extend the benefits of Memorial Hospital's ER to people living in distant parts of the North Coast. Air ambulances allowed him to do that.

Just over 20 years later, the company is saving lives not only in Sonoma County, but now in other parts of the nation, too.

"Northern California became saturated with air medical services in the last couple of years," Adams said. "In 2005, we realized the way for us to stay ahead was to branch outside the area."

On July 1, REACH opened its newest air base, in Imperial County, in a remote part of southern California on the Mexican border. It just bought a new $5 million helicopter, and expects to take possession of five more by mid-2009 in anticipation of growth. It has 12 air bases now, including one in Oregon and another in Illinois.

"I would not be surprised if we had at least another five air bases by 2010," Adams said.

All of REACH's flights, even those in Chicago and San Diego, are run out of the command center in a business park near the Sonoma County Airport.

About 60 percent of the company's business is flying patients from one hospital to another. The remaining 40 percent is picking up trauma victims from remote locations such as The Sea Ranch and flying them to area hospitals. It expects to transport 5,500 patients this year.

The company charges about $14,000 to pick up a trauma victim in Bodega Bay and fly him or her back to Santa Rosa.

REACH does not screen for insurance. As a result, the company wrote off about $31 million in uncollected payments in 2007.

Some of that whopping figure comes from people who were unable to pay, but a significant percentage was from state Medi-Cal payments, which only cover about a third of the costs incurred by REACH.

Fuel costs also have risen sharply in recent years.

"I remember complaining about aviation fuel going over $1 a gallon in 2001," Adams said. "Now, it's more than $5."

Also hurting the company are recent wildfires. The smoke has grounded some flights because of low visibility.

"We experienced something in the last two months that we never had before," Adams said. "We had a big hit in revenue in June because of smoke."

To help offset costs of uninsured or underinsured patients, REACH began an insurance program in 2005 that allows an individual to pay $25 a year for a plan that would cover the cost of a medical flight. It costs $45 for a family.

About 20,000 people are enrolled in the plan, Adams said.

With its 16 helicopters, REACH is still relatively small among national providers. The largest U.S. company, Denver-based Air Methods, operates 322 helicopters.

Growth is strong across the industry, said Blair Beggan, marketing manager for the Association of Air Medical Services. The number of medical aircraft doubled to 800 in less than seven years.

"Companies are opening new bases and spreading out to more rural areas," Beggan said.

Also, as medicine continues to specialize, patients are more frequently flown from one hospital to another that caters to a specific need.

"That is a big reason for the growth too," she said.

You can reach Staff Writer Nathan Halverson at 521-5494 or nathan.halverson@

pressdemocrat.com.