OWLS HEAD — In the state with the oldest population in the country, most of Maine’s year-round islands have a median age that is significantly higher than the mainland population. Census statistics show that the median age—the number at which half the population is older and half younger—on 11 of the state’s 15 year-round, unbridged islands jumped significantly in the period from 2000 to 2010.

Islands that had increases in median age in that period were: Chebeague, 49 to 57.9; Cliff, 45.5 to 53.3; Great Diamond, 48.7 to 60.3; Long Island, 44.3 to 52; Peaks, 42.4 to 51.3; Isle au Haut, 41.5 to 49.5; Islesboro, 45.9 to 52.1; North Haven, 38.7 to 44.5; Vinalhaven, 40.2 to 45.1; Great Cranberry, 51 to 58.5; Swan’s, 40.9 to 46.3.

Four islands saw decreases in median age during the 10-year period: Matinicus, 47.8 to 47; Monhegan, 48.5 to 45.8; Frenchboro, 43.5 to 27.2; Islesford, 43.3 to 41.

The age-related ailments that come with the “graying” of year-round and summer populations has broad impacts, including on emergency medical services.

Aging island populations and a seasonal influx of summer residents and tourists are considered the primary reasons for an estimated 40 percent increase in medical flight evacuations from islands in Penobscot Bay over the past decade.

“I do a lot of medical flights,” said Kevin Waters, owner an operator of Penobscot Island Air in Owls Head, where the Knox County Regional Airport is located.

In one three-day stretch, Waters and his pilots did two medical evacuations on Tuesday, including a night flight; two on Wednesday; and three on Thursday. Among the emergency medical issues was a possible cardiac arrest and possible food poisoning that involved severe nausea and dehydration.

Some emergencies are seasonal. In the winter, icy roads result in car accidents; in the fall, deer are on the move and cause crashes.

In 2012, Waters’ service conducted 183 “medevacs,” primarily for Vinalhaven, North Haven, Criehaven, Matinicus and Big Green islands. Islesboro generally medevacs via its frequent ferry service or LifeFlight.

Potential medevac situations are partly defined by the island’s available medical practitioners and the timeliness of available ferry or other boat service.

PIA is the only island airplane service in Maine. The nine Penobscot Bay islands comprise its core business, but it does occasionally serve other islands when requested, Waters said. Islands elsewhere along the coast generally medevac via ferry, fireboat, private vessel or, depending on the severity of the situation, LifeFlight.

Piloting small Cessnas, PIA generally operates regularly scheduled mail, grocery, freight and passenger flights, taxi service, “flightseeing” and charters for government agencies such as the U.S. Forest Service.

For medevac calls, PIA is usually on the scene in 20-30 minutes. Poor weather can delay response. The pilot for the next available plane loads in portable medical gear—stretcher, oxygen, trauma kit—and runs a checklist.

On the island, emergency responders prepare the patient for transport and provide PIA with an estimated time of arrival at the landing strip. Most islands have an emergency responder who can ride to the mainland with the patient and hand off paperwork to the next ambulance crew. If the island doesn’t have a responder, PIA requests a emergency medical team from a mainland fire department.

The return to the mainland takes about 15 minutes, compared to an hour or more by ferry. Back at the Knox County airport, the patient is transferred to an ambulance, and PIA transports medical staff back to the island. Depending on the type of situation, PIA might fly the patient directly to Bangor or Portland.

To ensure smooth, quick transitions, PIA also conducts biannual in-service training on the islands to orient medical staff to the planes—basic but crucial stuff such as avoiding the propeller and how to load in.

“People get jazzed up. They come running toward plane,” said Waters. “A lot goes on. That makes it challenging—but there are a lot of good folks.”

In general terms, LifeFlight of Maine has also seen fairly significant increases in island calls since about 2010, said marketing and educational outreach manager Melissa Arndt.

“Prior to that, the number of patients transported from islands each year remained relatively steady,” she said. “However, from 2010 to 2011 the number of patients increased by about 50 percent, and from 2011 to 2012, the increase was more than 70 percent. We also see a bigger jump in calls from the islands in the summertime as populations swell with part-time residents and visitors.”
The recent overall increase may be due to a couple of factors, she said: “One is the greatly enhanced aviation infrastructure we’ve been working to implement across the state, which includes additional weather reporting stations, better landing zones and a network of GPS approaches we can utilize in low-visibility weather that previously may have been outside of our safety standards. The other is more widespread education about the availability of LifeFlight’s services and when it’s appropriate to make use of those services.”

Island communities, she said, typically call when someone becomes critically injured or ill and time is of the essence to ensure a positive outcome for the patient.

“Folks on the island understand that difference,” she said. “They know, when they see a patient, whether to call a boat, call a plane or call LifeFlight.”