As the Blue Angels roar across the sky Saturday, another team stands ready to perform a synchronized ballet of medical preparedness.

Dr. Keith Lara, director of emergency medicine at Kalispell Regional Medical Center, puts in perspective the task of serving an expected crowd of 50,000.

"It's one of Montana's largest cities at that moment," he said.

Lara brings his experience providing care for a crowd of almost 40,000 at the air show six years ago, as well as events in Tennessee. The Kalispell crowd kept the team on its toes.

"There were four criticals who would have done poorly at home," Lara said.

Their ailments included heart attacks and a gastrointestinal bleeder. But, thanks to good planning, the team reached and stabilized the patients before whisking them off to the hospital.

"It was a very safe, well-run operation," he said.

His volunteer medical team includes Dr. Leonard "Bud" Desmul, an emergency-medicine specialist at the medical center, as many as three nurses and a host of emergency medical technicians. Lara said a bicycle patrol of EMTs would provide surveillance of the crowd.

"They can get in and out of the crowd really easily and radio in for help," he said.

If an emergency occurs, a physician and nurse rush to the patient aboard a four-wheeler equipped with a gurney and an intravenous line.

"We try to do everything to stabilize them," Lara said.

Within minutes, an ALERT helicopter swoops down at the Edwards Jet Center to fly the patient to a team at the medical center.

"We're in constant communication with the ER," Lara Said. "We'll have two doctors on duty there."

The airport team also stands prepared for lesser medical problems, with laceration trays for cuts and conditions related to extreme weather.

"Mostly, we're going to be treating heat strokes," he said.

They also stand ready for the worst of possibilities - an air crash that causes mass casualties. Lara said the team has a disaster strategy, complete with an incident commander.

"We have a plan where a whole cascade of things happen," he said.

It includes calling in people to the hospital and mobilizing fire and rescue units from across the valley.

However, Lara stressed that the Blue Angels have many safety features in place to make certain the disaster plan remains just that.

"There will be no energy performances into the crowd," Lara said.

He explained that the high-energy maneuvers go parallel to the crowd rather than perpendicular, which is what happened during an air-show disaster about 10 years ago in Italy.

Lara recently met with and satisfied advance Blue Angels representatives that the medical planning passed muster.

"They are very detail oriented, very obsessive compulsive," he said with a laugh. "Just what you want in those guys."

Reporter Candace Chase may be reached at 758-4436 or by e-mail at [email protected].