View the full ALERT 50 Year Anniversary Commemorative Publication here.

Labor and delivery nurse Rosie Brester was working at Kalispell Regional Hospital in 1979 when she was told to hop onto an emergency helicopter. 

A few hours later, the team — Brester, a physician and a pilot — loaded a Browning woman onto the helicopter. The woman was seven months pregnant and seemingly ready to deliver, but was not making any progress, Brester remembered. 

But as soon as the helicopter flew over the Hungry Horse Reservoir on its way back to Kalispell, Brester caught the woman’s baby at 7,000 feet.  

“After 75 successful trips to Kalispell General Hospital for expectant mothers, it was the first in-flight delivery,” the Hungry Horse News reported at the time. 

Brester worked to keep the baby warm until the helicopter arrived at the hospital.  

“I don’t know what caused her to suddenly be able to deliver, but she had her baby right then,” Brester said while sitting on a couch at Logan Health Medical Center this week. “She was OK. She trusted us.” 

The mother named her daughter Emily Angel, Brester said, a tribute to her beginnings in the sky. It was one of seven trips in the air that Brester would take over her decades-long career as a nurse. 

Forty-six years later, it remains the only in-flight birth in the history of ALERT.  

The Advanced Life-Support and Emergency Rescue Team program, known as ALERT, marks the 50th anniversary this week of its first flight in 1975. It was the first rural hospital-based air ambulance service in the United States and responds to emergencies, transports critical patients, and assists with search and rescue.  

The program began to provide quick access to rural workers across Northwest Montana after a logger was severely injured in a workplace accident. His crew worked with a nearby Forest Service helicopter to form a makeshift rescue operation, but the logger died.  

ALERT has evolved over the decades to include two helicopters and a fixed-wing airplane. In addition to aircraft-specific pilots, both aircraft are staffed with highly trained registered nurses and paramedics.  

More recently, the team added a neonatal and pediatric specialized team dedicated to providing care and transport of patients from premature birth through 18 years of age.  

When Logan Health Children’s hospital opened on July 1, 2019, efforts to add a pediatric flight team came shortly after, spearheaded by registered nurse Brian Stewart.  

“As the hospital and the population grew within the valley, [we] started to see a need for having somebody who could take care of newborn babies and transport them to appropriate facilities to take care of those babies,” Stewart said in a Logan Health video honoring the anniversary.  

There are currently three nurses focused on pediatric and neonatal care, with one opening that completes the team of four. 

The newest member of the team, flight nurse Stacey Verhoeven, began her career in Denver before eventually moving to Bozeman. She jumped at the opportunity to join the ALERT team, fulfilling a goal of working with a flight team specializing in the care of children.  

“The advantage of having a [neonatal] team is that [premature] babies have very specific needs, quirks and different things. If you aren’t familiar with them, you wouldn’t necessarily know how to care for them,” Verhoeven said. 

There is a learning curve to providing care in a helicopter, Verhoeven said. It requires a lot of trust between the three crew members in the aircraft.  

The helicopter has space for a registered nurse, a paramedic and a pilot, with the patient lying on the left-hand side, feet near the pilot’s head and head near the nurse.  

Expanded equipment includes an isolette, an enclosed bassinet used to provide a controlled and safe environment for premature or sick newborns, and nitric oxide, which is used to regulate blood pressure in the lungs. 

“It’s a very meticulous thing with those kids because what you do transferring them can make all the difference on what their outcome is,” Verhoeven said. “A lot of people think babies are just little adults but they’re not, they have a lot of specific needs.” 

Infants, especially premature ones, are extremely fragile humans, flight nurse Jordanna Munsell said.  

Growing up in Kalispell, Munsell was aware of the importance ALERT has played in the community and her mother would donate art to the annual banquet supporting the program. She remembers when a friend was airlifted to a hospital in Spokane, Wash., after an injury because there wasn’t a children’s hospital yet in Kalispell.   

Also a pilot, Munsell, worked on a flight team in Northern California, but decided to move back home to be near family. Working for ALERT allows her to combine her love of flying and providing care as a nurse.  

“There are very specific considerations in how we deliver care to infants,” Munsell said. “We have things the adult world doesn’t use.” 

The team will often fly to smaller hospitals across the region ahead of a premature birth. Those hospitals typically don’t have the necessary supplies or infrastructure to care for a premature baby, so the ALERT crew will take the baby to the neonatal intensive care unit at Logan Health.  

Providing care in a rural area is different from what flight nurse Jenn Trawick experienced coming from the Washington, D.C., area where she was a flight nurse for a larger system of hospitals. She joined ALERT in 2021.  

“I’m used to places where you could throw a rock and hit 10 hospitals. Here it is so different. There are hospitals without access,” Trawick said. “You’re sometimes the only person that is able to give someone medical care. Sometimes you’re the only advocate that patient has.” 

Growth in the ALERT program and pediatric hospital has meant the ability to care for young patients in a way that wasn’t always possible 50 years ago.  

“That’s the best way,” Rosie Brester said, referencing the dedicated team and equipment now assigned to medical transport that exists decades after she delivered the baby in a helicopter. “And I know they’re doing a good job.” 

Reporter Kate Heston may be reached at 758-4459 or [email protected].