Part of the LifeFlight crew: An inside look at the role respiratory therapists play in life-saving flights

Jessica Carew’s workspace is a little different than most medical professionals. 

As a registered respiratory therapist with EHS LifeFlight and the IWK Health Centre, she helps to provide critical care to sick or injured patients as they’re transported across the Maritimes to the IWK in Halifax.

Her workspace is loud and cramped: there is only so much room in the back of a Sikorsky S76 C+ helicopter once her medical gear is loaded up, and she can’t fully stand.

Sometimes, they’ll respond to a call in a fixed-wing Beechcraft King Air 200. But in these tight quarters, working as a team alongside a registered nurse, Carew helps save lives. 

Given that she’s responding to neonatal, pediatric and obstetric calls, she’s often working on babies or children and prides herself on helping to make a positive difference. 

“I love doing this job,” Carew told The Chronicle Herald. 

Becoming a LifeFlight respiratory therapist doesn’t happen overnight.  

Carew said there’s rigorous training, starting with a degree in respiratory therapy, and plentiful time working in hospitals. Optimally, prospective LifeFlight crews have three to five years of experience before becoming eligible for service. 

Once part of the crew, there’s further training to deal with the realities of treating patients in the air, not to mention fewer resources on hand. There are only eight respiratory therapists on the team at one time, working in four-day rotations to cover the 24 hours in a day. 

So, why do Carew and others like her opt to work in such a stressful environment? 

“Working in the hospital is great,” she said. “We have a wonderful role at the IWK but I was really looking to have that autonomy and I really like teamwork so, being able to have that wonderful relationship with our nurses and just being able to practice at a higher level.” 

There’s no doubt the stakes are high. 

“I can say with confidence, us being there, being able to provide critical care, being able to get there, and being able to get there in a timely fashion has definitely helped the outcome of patients,” said Carew. 

Respiratory therapists took part in 400 LifeFlight missions in 2025. 

Treating a patient in the air can be challenging, forcing Carew and her peers to rely on their instincts and training as they monitor their patients. 

Some trips can be uneventful. But others require drastic action. 

“Being at altitude can change your patient’s condition,” she said. “Something else we have to rely on is all our other senses. Being in a helicopter or in the plane, it’s very loud. We have to wear hearing protection, so we can’t rely on the things you do in the hospital all the time.” 

For example, Carew is unable to monitor a patient’s breathing with a stethoscope like she would normally, given that she can’t hear. Instead, she relies on sight, touch and other instruments. 

Although they try to provide treatment such as intubation (which entails putting a plastic tube in a patient’s throat to help with breathing) before boarding the aircraft, Carew is able to provide emergency intubation in the air. 

“We’re responsible for maintaining a patient’s airway,” she said, which could include intubation or putting a patient on oxygen or a CPAP machine. 

LifeFlight’s success rate for intubating a patient on the first try for pediatrics is among the highest in the country at 92 per cent. 

“We’re pretty prideful on that. Our experience in the hospitals helps, and we do a lot of training,” said Carew. “I think that really attributes to our success.” 

Next week is recognized as Respiratory Therapy Week in Canada, and Carew said she prides herself on the work she does to help patients and parents during a stressful time. 

“It’s their child, this is the worst day they’ve had, so making sure they’re included and understand what’s going on (is important). If we can bring them on the flight on the way back, absolutely, we’ll try and do that,” she said.

“It takes a village.”