Black Hills Life Flight Adds Lifesaving Clinical Capability

Emergency air medical bases can now perform open thoracostomies

RAPID CITY, SD, April 6, 2026 - Flight nurses with emergency air medical provider Black Hills Life Flight, located in Rapid City and Hot Springs, now have another option when treating patients suffering from a collapsed lung due to excess air or blood trapped in the chest cavity. If their traditional procedure, a needle thoracostomy, does not result in the lung reinflating, nurses are now trained to perform an open thoracostomy (also known as a finger thoracostomy). While more intrusive, this procedure is considered a more reliable method of addressing this life-threatening condition in a pre-hospital setting.

"The addition of the finger thoracostomy capability allows our crews to rapidly relieve life-threatening tension pneumothoraces (excessive pressure from air trapped in the chest)," said Black Hills Life Flight Nurse Megan Catalano. "This procedure can significantly improve oxygenation, blood pressure, and overall patient outcomes, especially for critical trauma patients in rural areas where time is a limiting factor."

When pressure builds in the chest due to air or blood, it can not only collapse the lungs, but also compresses the heart, making it difficult to circulate oxygen around the body effectively. Previously, crews were able to use needle decompression, which is often successful but also has limitations due to needle length or blockage. Having two proven methods for relieving this pressure gives flight nurses more options for helping patients survive chest trauma, frequently caused by motor vehicle accidents, falls, or other emergencies. With an open thoracostomy, the flight nurse makes a small incision between the ribs on the patient's side and inserts a finger to release the trapped air or blood. It allows more air/blood to escape, leading to a fuller reinflation of the lung, over a needle thoracostomy.

"Open thoracostomy is intended to optimize oxygenation and relieve pressure, particularly when needle thoracostomy has been unsuccessful or when transporting patients with known tension physiology without immediate access to a chest tube," said Air Methods Regional Clinical Director Teather Campbell. Black Hills Life Flight is part of Air Methods, the nation's leading air medical provider.

With both rotor and fixed wing aircraft, Black Hills Life Flight serves not only the people of South Dakota, but eastern Wyoming and Montana, and western Nebraska as well. Their clinicians have at least three years of experience in an emergency or intensive care setting before joining a flight crew, and they receive ongoing advanced training. Their aircraft are equipped as flying ICUs, carrying the medical equipment and medications needed to provide lifesaving care for trauma, cardiac, stroke, pediatric, neonatal, high-risk obstetrics, and other critical patients. They also carry a Zoll AutoPulse CPR device for in-flight mechanical CPR, as well as whole blood that can be administered in-flight for patients suffering from severe blood loss. The ability to perform open thoracostomies is another tool in their nurses' belts to provide the highest level of care when every minute counts.

"Having this capability enhances our ability to deliver advanced, definitive interventions earlier, ensuring patients receive the highest level of critical care from the moment our crews arrive." said Catalano.

Air Methods is committed to providing air medical services to all members of the communities they serve and are in-network with most major health insurance providers for emergency air medical services. Additionally, their patient advocacy program works with all patients, regardless of insurance, to ensure affordability without the need for an air medical membership.