SALINAS, Calif. — Flight nurse Rose Gaither keeps injured people alive until they reach the hospital. It is a job she calls an honor. Working in a cramped helicopter, with medical equipment hanging from the ceiling just inches above her swiveling bucket seat, she makes life-or-death decisions ...

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SALINAS, Calif. — Flight nurse Rose Gaither keeps injured people alive until they reach the hospital. It is a job she calls an honor.

The Soquel, Calif., resident works in a cramped helicopter, with medical equipment hanging from the ceiling just inches above the swiveling bucket seat where she sits. She makes life-or-death decisions for gravely ill patients while conversing with emergency dispatchers or hospital personnel on the radio and juggling all kinds of challenges.

Extra flight-nurse training enables her to perform advanced emergency care normally done by physicians, she said.

In 23 years with California Shock Trauma Air Rescue (Calstar), Gaither has treated victims of car crashes, gunfights, drownings and many other accidents.

Last year, she landed amid absolute chaos on Highway 101, after a bus carrying French tourists overturned near Soledad, Calif. Then there was the recent landing in a horse arena after a young girl’s bad fall, and the collapsed Cypress Freeway in the moments after the Loma Prieta earthquake. A lot has gone on, she says.

At age 56, Gaither said she is proud to be the oldest Calstar nurse and the one with the most years on the job.

There are many things that drive nurses to quit long before 20 years on the job.

But not Gaither; she loves it.

“There is a tremendous amount of camaraderie because of what we do and the horrific things we see,” she said. “But what is touching is the resiliency of the human spirit and the courage we witness. The things people survive are incredible.”

One of her recent patients was a 6-year-old boy who was accidentally shot in the abdomen with a 12-gauge shotgun, she said. The round was shot at point-blank range and shattered his spleen, liver, intestines and more. He had lost a liter of blood by the time he was loaded into the helicopter, Gaither said.

A medic had used a blanket and a stiff cord used in air tubes, called a stylette, to hold his torso in place like a corset, she said. The flight nurses had to breathe for him and get a lot of fluids back into his body, quickly, she said.

About a month later, while working on another call, Gaither met the boy’s parents in the pediatric intensive-care unit,

“I introduced myself and all three of us broke down crying,” she said. “He certainly defied the odds, and he definitely would have died without rapid transit. It was everyone’s expertise that kept him alive; it was an absolute team effort.

“That is why it is such an honor to do this job. It is unbelievably rewarding and challenging.”

Jeff Terpstra, division chief of the Aptos-La Selva Fire Protection District, has worked with Gaither as a paramedic instructor, on the county Pre-Hospital Advisory Committee and on emergency calls.

“She is so friendly and enthusiastic and cooperative that when you hear her voice on the radio you know it’s going to be a good call,” he said. “She is just one of the people who has the appropriate amount of energy and can keep her cool inside. She can integrate into the care we’ve already done, and is just kind of the epitome of teamwork.”

Terpstra said she saved the life of a truck driver during the 1989 Loma Prieta quake, after the helicopter landed on the double-decked Cypress Freeway in Oakland, Calif., which had collapsed on itself.

“There were cars burning and they didn’t know how stable the structure was, but there she is in there with this pinned truck driver,” he said.

“She stayed with him for hours; it’s an incredible story.”

Gaither likes to focus on teamwork.

She wants to talk about how pilot Markus Lavenson landed a helicopter that lost one of four rotor links on a flight over the Santa Cruz Mountains a few years ago, despite the helicopter vibrating so badly that he couldn’t read the instruments.

Obviously passionate, she wants to warn people to take precautions. She doesn’t want to have to give you a ride.

Wear a helmet when bike riding — adults, too — and keep the chin strap fastened; use your seat belt; belt the child into the shopping cart; teach kids how to swim; and don’t ever get into a car with someone who is intoxicated.

“Please,” she says. “We see so much tragedy that just didn’t need to happen.”

Gaither has bright blue eyes and spiked hair and a youthfulness about her.

Off the job, her three Maltese dogs keep her entertained, she said, and she loves to bike and swim and compete in the occasional triathlon.

Gaither jokes that one of the best parts of the job is that there is no adult supervision — either in the old World War II-era barracks housing the Salinas, Calif., base (“kind of like a firehouse and kind of like a slumber party,” she says) or in the air.

Squeezed in the helicopter, typically, are two nurses, a patient and a pilot, except when they pick up assault victims at Soledad prison and a guard also squeezes in, Gaither said.

There is no high-level trauma hospital in Santa Cruz County, so depending on the seriousness of their injury, patients are flown to Santa Clara County trauma hospitals relatively often.

California Shock Trauma Air Rescue is the largest nonprofit air ambulance on the West Coast, a spokesman said. Headquartered at McClellan Airfield, bases in Salinas and Gilroy serve Santa Cruz County.

Stanford Life Flight also operates there.

Gaither has found her dream job with Calstar.

She said she knew as a child she wanted to be a nurse, “or a nun, but I wasn’t Catholic.”

She discovered Calstar while working in the trauma unit at Daniel Freeman Memorial Hospital in gang-infested Inglewood, behind bulletproof glass, and seeing a flight crew come in one day. She said she knew right away that was what she wanted to do.

“You have to be willing to go out on a limb,” she said. “This is the farthest thing from a warm, controlled environment. You are out there in the rain, and the patient is cold and altered, and the most simple thing can be challenging. Then you are talking on the radio and their life is just slipping through your fingers.”