FORT COLLINS (AP) – Dee Judd was home alone July 12 when her blood pressure spiked to dangerous levels. Her brain fuzzy and her body aching and burning from head to toe, life moved in slow motion.

Thinking she might be dehydrated from working in the garden on a hot summer day, she steadied herself along the wall in her Glacier View home to get to the couch, drank water and took her blood pressure: 312 over 218, a life-threatening reading.

She didn’t trust the number and thought, “The cuff must be broken. I just need to rest.”

Her husband, Al, was on a motorcycle trip in Oregon with his son and wasn’t expected home for days.

When water and rest didn’t help, “something in my head said to call 911,” Dee said.

As soon as she told the dispatcher her blood pressure, the dispatcher called for LifeLine, UCHealth’s helicopter emergency medical service.

More available than everMedical helicopters can provide faster access to life-saving care, especially from rural Colorado, but arrive with a cost. Bills can range from $10,000 to $50,000, or more.

Over the past two decades, there has been an increase in the number of medical helicopters and flights in Colorado, said Randy Kuykendall, director of health facilities and the emergency medical division at Colorado Public Health and Environment.

Prior to 2002, hospitals owned most air ambulances, but after Medicare increased its reimbursement rate, for-profit operators expanded their presence, according to a Consumersunion.org report.

In 2003 there were 545 helicopters flying out of 472 air bases across the United States; by 2015, the numbers nearly doubled, with 1,045 helicopters at 864 bases, the report estimated.

Poudre Valley Hospital and Medical Center of the Rockies, which share a helicopter, provided 288 transports from accident scenes and between facilities last year, according to UCHealth. The hospitals’ helicopter has flown 217 transports so far this year, 54 were on-scene pickups. The remainders were transfers between medical facilities.

Banner Health, with three aircraft stationed in Akron, Greeley and Boulder, made between 500 and 600 transports, said Pamela Howes, spokeswoman for Medevac, Banner’s air ambulance service.

Given their increased prevalence and associated costs, there is a growing debate among northern Colorado emergency responders whether choppers are being overused.

Herb Brady, fire chief of the Windsor-Severance Fire Rescue, won’t allow his crews to call for a helicopter because ground transport is generally faster. His ambulances can get patients to trauma centers in “usually well under 30 minutes,” he said.

Situated between Greeley, Loveland and Fort Collins, Windsor-Severance has five hospitals within reasonable driving distance: North Colorado Medical Center in Greeley, McKee and Medical Center of the Rockies in Loveland and Banner Health and Poudre Valley Hospital in Fort Collins, Brady said.

Windsor-Severance has four ground ambulances, fast response times and high clinical ability, he said. “I’ve seen some crews get off the scene in three minutes,” he said.

“An ambulance charge is about $2,000, and a helicopter is $28,000 to $38,000 and it adds zero to patients’ outcome,” Brady said. “If you can drive to a trauma center in 30 minutes, you shouldn’t even think of a helicopter. Outside (that distance) there has to be a lot more thoughtful consideration before you saddle a family with this debt.”

Randy Lesher, chief of Thompson Valley EMS, shares much of Brady’s thinking. “It’s pretty rare for us to call a helicopter,” he said. Thompson Valley covers Loveland, Johnstown, Berthoud and west into the foothills.

“Sometimes up in Storm Mountain or Rist Canyon that are quite a ways up there ... getting folks out of those areas” may require helicopter services, he said. “Most times we can have the patient to the hospital faster by ground.”

Data from UCHealth shows no helicopters were sent to pick up patients in Loveland or Windsor in 2017.

Thompson Valley calls for a helicopter less than once a month.

Lesher isn’t against air transport when it makes sense. “When you are talking about trauma or cardiac events, the only things that help these people are surgeons and cardiologists,” he said. And time is critical.

When transporting long distances, such as to the burn unit in Greeley or Children’s Hospital in Denver, air medical services “start to make sense big time,” he said.

‘Helicopters are too expensive’Dee Judd, 66, didn’t want to be air lifted. Drifting in and out of consciousness, she told Glacier View Volunteer Fire paramedics, “It’s OK, I’ll wait for the ambulance. Helicopters are too expensive.”

Worried she was having a stroke, paramedics convinced her every minute and every second mattered.

“The next thing I knew I was being put in a helicopter” en route to Medical Center of the Rockies, a 1-hour-and-20-minute drive from Glacier View, but only 28 minutes by air.

“I went from being scared to thinking, ‘God, please let me come home again.’”

Patients over pocketbooksToday, there are 22 air ambulance agencies licensed to operate in Colorado, Kuykendall said, up from 17 in 2010, according to the state. Only eight have business addresses in Colorado.

Kevin Waters, EMS battalion chief for Poudre Fire Authority, said decisions to use an air ambulance are based on their best medical knowledge and assessments. PFA called for helicopter transports about 10 times last year and about 11 so far this year.

“We generally know how long it will take to get to the hospital based on the time of day, traffic conditions, etc.,” Waters said.

PFA decides whether to put a helicopter on standby or in the air the moment a call comes in. That allows the flight crew to be in the air and minutes closer to the scene if needed. If crews on the ground determine a helicopter is not needed, it will return to base. No patient is charged for that level of preparedness.

About 85 percent of standbys return to base without transporting a patient, said Duane Rorie, nurse manager of the UCHealth LifeLine air medical program.

“If we think the best decision is to put a patient in the chopper, we will put the patient in the chopper,” Waters said. “We are not unaware the costs associated with helicopters are high, but we have to make decisions based on what is medically necessary.”

First responders know it’s more expensive to fly patients to hospitals, but “we want to make sure we are doing the right thing for the patient,” Waters said. “If someone is having a heart attack and needs to get to the catheterization lab and it’s the difference between a 15-minute flight and 45 minutes on the ground, we know the outcome will be significantly better” with quicker treatment, he said.

UCHealth monitors the outcome of every air-lifted patient, he said, and fewer than 10 percent are discharged from the emergency room the same day. “Just because they discharge someone from the ER doesn’t mean it’s not a good transport,” he said.

‘The best mistake I ever made’Al Judd caught the first flight home from Oregon after learning his wife was in the hospital. Had he been home when his wife initially protested a helicopter ride, he could have eased her mind.

A month earlier he had purchased a LifeLine “membership.”

The $65 annual fee covers any costs related to an air transport that insurance doesn’t cover.

“When I signed up, I kind of poo-pooed it, thinking we didn’t need it, but what the heck, it was only $65,” he said. “It was the best mistake I ever made.”

The couple isn’t exactly sure if their insurance paid the entire bill or if Reach – the umbrella company for LifeLine – paid the balance. They only know it didn’t cost them a dime.

Now the Judds recommend everyone living in the remote areas of Larimer County have a membership. Glacier View Meadows is about 35 miles northwest of Fort Collins in Livermore. Many of its year-round residents, like the Judds, are retirees.