The loudspeaker crackled in the dayroom of the Los Angeles County Fire Department's Air Operations wing, headquartered in Pacoima. Among the several dozen people who work here ? the pilots, crew chiefs, paramedics, mechanics, nurses, supervisors and administrators ? even the veterans of war admit they feel a twitch in the stomach as they await what follows the series of bell tones.
In this case, a 2-year-old girl had been hurt in a park in Santa Clarita and needed to be flown to Childrens Hospital Los Angeles for treatment of a head injury.
Before the dispatcher finished relaying the details of the mission over the loudspeaker, pilot Karl Cotton strode toward his assigned helicopter. He would carry out preflight checks and fire up the turbine engines while the crew chief and paramedic sized up the task.
As the Bell 412 lifted off Barton Airfield, the air was hot and the copter's windows were open. "Smells like a fire day," Cotton said.
He would be proved right later that afternoon, when a brush fire threatened homes in the Topanga Canyon area.
The girl in Santa Clarita had tripped and hit her forehead on a curb but was still conscious. With her older sister along to provide comfort, the girl was flown to the hospital while paramedic Tim Ruddell kept tabs on her vital signs and radioed ahead to the hospital.
When not assessing her condition, Ruddell used his finger to stroke the girl's tiny ankle in an effort to calm the fear expressed by her darting eyes and occasional whimper. She appeared to have weathered the accident well, but tests would be run to make sure.
"She wanted mommy, that's all she wants," Ruddell said after the girl's safe arrival at Childrens Hospital.
The mission was one of about 1,800 emergency medical calls handled every year by Air Operations in Los Angeles County. In addition to transporting patients, air squads perform roughly 100 rescues a year and dump water on about 500 fires, said Senior Pilot Virgil L. Benson.
On a typical day, squads are on call in Whittier and locations near Sylmar and Malibu. At night one squad stays on duty in the Antelope Valley and another waits for calls from the Pacoima airfield on the southern side of the San Gabriel Mountains.
A day may pass without any calls at all, leaving the squad members free to watch TV, surf the Internet or balance checkbooks. And although some calls may be canceled in mid-flight, others signal tragedy.
An accident several months ago in the Antelope Valley left four children in full cardiac arrest after the car they were riding in plunged into the California Aqueduct. To transfer that many patients at once required a bigger helicopter than the Bell 412.
Air Operations was able to deploy one of its new Sikorsky Firehawk helicopters to the scene of the accident within minutes.
The Firehawk is a Blackhawk helicopter, converted from military to civilian use. The Firehawk dispatched to the scene of the accident in Palmdale took all four children to Childrens Hospital along with eight paramedics.
Three of the children died shortly afterward, and the fourth suffered brain damage.
"I don't know if anyone ? even the military ? has airlifted four patients in cardiac arrest before," Benson said. "The entire thing was a tragedy, but operationally we have capabilities we didn't have before."
Typically, Air Operations has its hands full fighting fires this time of year. But it also has plenty to do before the vegetation dries out and Santa Ana winds mark the start of the fire season.
"The sun brings out trouble," said crew chief Rafael Rodriguez, a paramedic. "It may start out as a great day, but once somebody bonks their head, it's 'You call, we haul.' "
Rescues and transports become trickier in steep canyons or in places where a helicopter can become entangled in power lines. The squad has used night-vision goggles to great advantage for the last two years, Rodriguez said.
Paramedics learn one of the trickiest maneuvers involved in Air Operations ? riding the "hook." It's the business end of a motorized hoist used in cliff and canyon rescues of both people and animals.
Suspended from the hook, paramedics have been lowered onto mountaintops, sometimes only to watch the person they set out to rescue slide out of their reach and off a cliff. Most of the time, they make "clear saves," such as a canyon rescue several years ago above Altadena, when a boy was hooked to the hoist just as a section of trail fell away in a landslide.
Sometimes, the toughest moments have nothing to do with harrowing rescues. There are times, for example, when homeowners blame Air Operations for the loss of their houses in wildfires.
Occasionally, a mission will shake a hardened rescuer to the bones.
Benson recalled an incident from the 1980s when Air Operations was asked to transport a 13-year-old Lancaster girl who had been bitten by a poisonous snake.
After loading the girl aboard his helicopter, Benson learned of the child's plight. Her parents, both addicted to heroin, were in jail. In her loneliness, the girl had taken to "hugging the family rattlesnake to her chest," Benson said.
"We can handle almost anything, including when people don't wear their seat belts," he said. "It's gross abuse and the impact to children which is toughest for us."
By Emmett Berg, Special to The Times