There’s no greater gift a man/woman who sacrifices their life so that others may live. These are the words that our Police Officers, Firefighters; and Emergency Medical Services (EMS) live and work by everyday. Now that the United States of America has increased its homeland security alerts level to high. These men and women serve as the First Line of Defense and Rescue in this new era of international and domestic terrorism.
There are over 1 million Firefighters in the United States, of which approximately 750,000 are volunteers. •Local Police Departments have an estimated 556,000 full-time employees including about 436,000 sworn personnel. •Sheriffs' Departments account for 291,000 Full-time employees, including 186,000 sworn personnel. •There are over 175,000 Nationally Registered Emergency Medical Technicians (EMT).
These men and women wear the uniforms of their various professions chosen careers, such as Firefighters committed to provide Fire suppression. Police Officers committed to provide protection and maintaining law and order, and Emergency Medical Service Personnel committed to the pre-hospital treatment and transportation for both medical and traumatic injuries. These three public safety agencies today are serving the citizens of the United States as the primary agencies charged with the prevention, defense, and response as defined by the Department of Homeland Security. Each agency serves a particular role and responsibility. However September 11, 2001 exposed the need for the three agencies to have the ability to respond to, coordinate and communicate with one another in the course of a (MCI) Mass Casualty Incident.
The Government Annual budgets post 9-11-2001 federal budget has included expenditures that are still needed in the strengthening of America's First Responder’s made up of Police, Fire and EMS. The expenditures are meant to better prepare Police, Fire and EMS in making our homeland safer. The Department of Homeland Security defines “First Responders,” as Police, Fire and Emergency Medical Services.
On September 11, 2001, Firefighters, Police officers, EMT’s and Paramedics made the ultimate sacrifice as they ascended stairs in the two towers of the World Trade Center to reach victims trapped at the point of impact and above. Police, Fire and EMS are credited for the evacuation of 25,000 men and women prior to the towers collapsing, Several Hindered EMT’s Paramedics, Firefighters, and Police Officer’s from various Jurisdictions were injured as a result of continued rescue efforts. In 2005 two (2) EMT’s and have died as a result of their response after developing fatal respiratory illnesses. Many other EMT’s and Paramedics have been diagnosed with respiratory illnesses that have lead to permanent disabilities and their health continues to decline.
Today EMS, Fire, and Law Enforcement agencies who have received Federal money are utilizing these funds to provide additional training, better communication systems and equipment to better respond to Mass Casualty Incidents (MCI). First Responders who are charged with the protection, Fire suppression, and medical treatment continue to prepare for any potential terrorist attack or attacks.
Just as the military continues it missions in both Iraq and Afghanistan in combating various terrorist cells, the same is true about are “First Responders, ” continue their efforts to both prevent and yet prepare for any natural or terrorist attack.
This ongoing training and retooling of equipment, mutual aid resources, and providing communications that provides interagency use. As Police Officers, Firefighters, EMT’s and Paramedics will be the first responders to any potential terrorist attack and or natural disaster these professional men and women will once again be on the front lines and will be the ones called to respond.
It has been 4 ½ years since the Untied States was so cowardly attacked and already it seems that the public has forgotten the sacrifices that were made on September 11, 2001, when terrorists boarded airplanes, turned them into flying missiles, causing the murder of the passengers and crew members. But we must also remember that on September 11, 2001, Police, Fire, and EMS responded to the world Trade Center in New York, the Pentagon in Washington and to a field Pennsylvania as a result of their responses over 25,000 individuals were rescued prior to the towers collapsing and the pentagon wall falling. 4 ½ years ago actors put on a benefit program “To honor the heroes of 911, and joined the call to fight.
”Today’s many of these same actors are protesting our President and our military’s action that has thus far prevented any additional terrorist attacks in the United States, however other countries such as our great neighbor “Great Britain,” was attacked in 2005. This is proof that we can not relent or retreat or other attacks will begin again.
Germany and France governments have accused the President and the United States of being a “warmonger.” Those same accusations are being stomped by individuals and actors decrying our fight that has kept terror off our shores. The brave men and women who serve in our “volunteer,” military have given their lives in the service and protection of their country.
The men and women who are fighting in Afghanistan and Iraq remember that on September 11, 2001, 3,025 Civilians, Military, Police, Fire, and EMS were killed. Our first line of Defense showed their heroism and sacrifice saved over 25,000 souls. Our Military is doing the same they are saving and protecting our nation along with their heroism and sacrifices. Apparently actors and some Americans fail to understand that these battles have proven to prevent more loss of American citizens, Firefighters, Police officers, and EMS Personnel.
An editorial that was given by a Canadian television anchor Gordon Sinclair from Toronto stated the following: This Canadian thinks it is time to speak up for the Americans as the most generous and possibly the least appreciated people on all the earth. Germany, Japan and, to a lesser extent, Britain and Italy were lifted out of the debris of war by the Americans who poured in billions of dollars and forgave other billions in debts. None of these countries is today paying even the interest on its remaining debts to the United States. When France was in danger of collapsing in 1956, it was the Americans who propped it up, and their reward was to be insulted and swindled on the streets of Paris. I was there. I saw it. When earthquakes hit distant cities, it is the United States that hurries into help. This spring, 59 American communities were flattened by tornadoes. Nobody helped.
The Marshall Plan and the Truman Policy pumped billions of dollars into discouraged countries. Now newspapers in those countries are writing about the decadent, war-mongering Americans. I’d like to see just one of those countries that is gloating over the erosion of the United States dollar build its own airplane. Does any other country in the world have a plane to equal the Boeing Jumbo Jet, the Lockheed Tri-Star, or the Douglas DC10? If so, why don't they fly them? Why do all the International lines except Russia fly American Planes? Why does no other land on earth even consider putting a man or woman on the moon? You talk about Japanese technocracy, and you get radios. You talk about German technocracy, and you get automobiles. You talk about American technocracy, and you find men on the moon - not once, but several times and safely home again. You talk about scandals, and the Americans put theirs right in the store window for everybody to look at. Even their draft-dodgers are not pursued and hounded. They are here on our streets, and most of them, unless they are breaking Canadian laws, are getting American dollars from ma and pa at home to spend here. When the railways of France, Germany and India were breaking down through age, it was the Americans who rebuilt them. When the Pennsylvania Railroad and the New York Central went broke, nobody loaned them an old caboose. Both are still broke. I can name you 5000 times when the Americans raced to the help of other people in trouble. Can you name me even one time when someone else raced to the Americans in trouble?
I don't think there was outside help even during the San Francisco earthquake. Our neighbors have faced it alone, and! I'm one Canadian who is damned tired of hearing them get kicked around. They will come out of this thing with their flag high. And when they do, they are entitled to thumb their nose at the lands that are gloating over their present troubles. I hope Canada is not one of those.”
What a remarkable in moving editorial one which still rings true today.
If Iraq is not stabilized as well as terror cell’s defeated and disarmed, America will once again place our soil, treasures and our front line defenders of Emergency Medical Services, Firefighters, and Police Officers, back in another Mass Casualty Incident that our military would have thwarted.
What do we say to these brave men and women who have make the sacrificed their lives, who have been injured and disabled so that others may live, including the lives of the very celebrities who are willing to participate in making movies of war, and then decry the military’s action preventing yet another 9-11?
The Federal Governments First Responder Initiative is helping these brave Americans do their jobs better. Building on existing capabilities at the Federal, State, and local level, the First Responder Initiative provides an incentive to develop mutually supportive programs that maximize effective response capability. Through joint planning, clear communication, comprehensive coordination, mutual aid at all levels and increased information sharing, America's First Responders need the newest training and equipment that will save lives in the event of another terrorist attack, now is not the time to stop the Military or decrease funding for our First Responders.
Many people have visited websites which contain tributes to the many civil and civilians hero’s of September 11, 2001, and one image that frequents so many sites including my own has been the picture of a New York firefighter passing the U.S. Flag to a Soldier with the caption reading “will take it from here.”
The military has been fighting the war on terrorism in Afghanistan and Iraq. We must continue with Operation Enduring Freedom in the fight to prevent further terrorist attacks that cause such destruction and the loss of more American lives. Many people visit this wonderful site for various reasons, some visit to learn more about our Paramedics EMT’s, Firefighters, and Police Officers. Some visit to learn about whom these individuals are, and others are actual members of these Public Safety Services.
Please keep the men and women of EMS, Law Enforcement, Firefighters, EMS and our Military in your prayers.
Sources: Office of Homeland Security, FEMA, Gordon Sinclair
If an unconscious patient is encountered, follow the sequence below:
1) Shake patient and ask:
"Annie, Annie, are you insured?"
2) If no response, position patient to open pockets.
(Listen for loose change while positioning patient)
3) Extend neck. Open mouth and look for gold fillings.
( If time allows, check airway.)
4) Palpate neck for gold chains and necklaces.
Note: Carotid pulse may be an incidental finding.
5) Palpate pocket for wallet.
(Tell bystanders you are checking for femoral pulse.)
6) If uninsured, call for help immediately.
7) Traditional CPR is optional at this point.
8) If no response to CPR, proceed to ACLS (Advanced Cash Liability Survey)
MEDICAL TERMINOLOGY FOR THE LAYMAN
ARTERY -- THE STUDY OF FINE PAINTING
BARIUM -- WHAT YOU DO WHEN A PATIENT DIES
BENIGN -- WHAT YOU ARE AFTER YOU ARE EIGHT
CESAREAN SECTION -- A DISTRICT IN ROME
COLIC -- A SHEEP DOG
CONGENITAL -- FRIENDLY
DILATE -- TO LIVE LONG
FESTER -- QUICKER
G. I. SERIES -- BASEBALL GAME BETWEEN SOLDIERS
HANGNAIL -- COAT HOOK
MEDICAL STAFF -- A DOCTOR'S CANE
MINOR OPERATION -- COAL DIGGING
MORBID -- A HIGHER OFFER
NITRATE -- LOWER THAN A DAY RATE
NODE -- WAS AWARE OF
ORGANIC -- CHURCH MUSICIAN
OUT PATIENT -- A PERSON WHO HAS FAINTED
POST-OPERATIVE -- A LETTER CARRIER
PROTEIN -- IN FAVOR OF YOUNG PEOPLE
SECRETION -- HIDING ANYTHING
SEROLOGY -- STUDY OF ENGLISH KNIGHTHOOD
TABLET -- A SMALL TABLE
TUMOR -- AN EXTRA PAIR
URINE -- OPPOSITE OF YOU'RE OUT
VARICOSE VEINS -- VEINS VERY CLOSE TOGETHER
Lee Greenwood's "Proud to be an American"
The Rules of EMS
Sick people don't GRIP
Air goes in and out, blood goes round and round, any variation on this is a bad thing.
The more equipment you see on an EMT's belt, the newer they are.
Being an EMT means having extended periods of intense boredom, interrupted by occasional moments of sheer terror.
Always follow the rules but be wise enough to leave them sometimes.
If the patient vomits, try to hold the head to the side of the rig with the least difficult cleanable equipment
if you absolutely must vomit, than it is probably best to turn your head away from the patient.
If I'm up, EVERYONE is up!
When responding to a call always remember that your ambulance was built by the lowest bidder.
If its stupid, but it works, then it ain't stupid!
The important things are always simple.
The simple things are always hard.
If the patient is going to vomit (especially projectile) be sure to aim towards any bystanders that would NOT clear the scene.
"When in trouble, when in doubt, run in circles, scream and shout".
When a call comes in 2 minutes before shift change, you will always pass your relief 1 block from the station. He/she it will be laughing and waving at you.
You are bound to get a call either during dinner, while you are on the can, or at 2:00am in the middle of a great dream.
When it comes to needles, 'tis better to give than to receive.
Listening to some EMT's talk on the radio makes you wonder why they don't become professional auctioneers.
Most of your patients are healthier than you are.
Being in emergency services means you get to celebrate your holidays with all your friends, while on-duty.
Being an EMT means you get to expose yourself to rare, exotic and exciting new diseases.
You fall, you call, we haul, that's all!
If you have a ride-along you want to show the real world, nothing will happen that shift.
You can't cure stupid
if it's wet and sticky and not yours, leave it alone!
Heaven protects fools and drunks.
The address is never clearly marked.
The stereo must always be louder than the siren!
You know you are in trouble when the directions to a patient's house include... “Turn off of the paved surface..."
The pain will go away when it stops hurting.
The larger the house the furthest from a door the patient will be.
If the patient fell and was moved by the family, they will have moved them so that climbing stairs will be involved.
Is Heaven in the Yellow Pages?
Mommy went to Heaven, but I need her here today,
My tummy hurts and I fell down, I need her right away.
Operator can you tell me how to find her in this book?
Is heaven in the yellow part, I don't know where to look. I think my daddy needs her too, at night I hear him cry. I hear him call her name sometimes, but I really don't know why.
Maybe if I call her, she will hurry home to me. Is Heaven very far away, is it across the sea? She's been gone a long, long time she needs to come home now! I really need to reach her, but I simply don't know how.
Help me find the number please, is it listed under "Heaven"? I can't read these big big words, I am only seven. I'm sorry operator; I didn't mean to make you cry, Is your tummy hurting too, or is there something in your eye?
If I call my church maybe they will know. Mommy said when we need help that's where we should go. I found the number to my church tacked up on the wall.
Thank you operator, I'll give them a call.
HEAVENS PHONE NUMBER
It is the VETERAN, not the preacher,
who has given us freedom of religion.
It is the VETERAN, not the reporter,
who has given us freedom of the press.
It is the VETERAN, not the poet,
who has given us freedom of speech.
It is the VETERAN, not the campus organizer,
who has given us freedom to assemble.
It is the VETERAN, not the lawyer,
who has given us the right to a fair trial.
It is the VETERAN, not the politician,
Who has given us the right to vote.
'TWAS THE NIGHT BEFORE CHRISTMAS,
HE LIVED ALL ALONE,
IN A ONE BEDROOM HOUSE MADE OF
PLASTER AND STONE.
I HAD COME DOWN THE CHIMNEY
WITH PRESENTS TO GIVE,
AND TO SEE JUST WHO
IN THIS HOME DID LIVE.
I LOOKED ALL ABOUT,
A STRANGE SIGHT I DID SEE,
NO TINSEL, NO PRESENTS,
NOT EVEN A TREE.
NO STOCKING BY MANTLE,
JUST BOOTS FILLED WITH SAND,
ON THE WALL HUNG PICTURES
OF FAR DISTANT LANDS.
WITH MEDALS AND BADGES,
AWARDS OF ALL KINDS,
A SOBER THOUGHT
CAME THROUGH MY MIND.
FOR THIS HOUSE WAS DIFFERENT,
IT WAS DARK AND DREARY,
I FOUND THE HOME OF A SOLDIER,
ONCE I COULD SEE CLEARLY.
THE SOLDIER LAY SLEEPING,
SILENT, ALONE,
CURLED UP ON THE FLOOR
IN THIS ONE BEDROOM HOME.
THE FACE WAS SO GENTLE,
THE ROOM IN SUCH DISORDER,
NOT HOW I PICTURED
A UNITED STATES SOLDIER.
WAS THIS THE HERO
OF WHOM I'D JUST READ?
CURLED UP ON A PONCHO,
THE FLOOR FOR A BED?
I REALIZED THE FAMILIES
THAT I SAW THIS NIGHT,
OWED THEIR LIVES TO THESE SOLDIERSWHO WERE WILLING TO FIGHT.
SOON ROUND THE WORLD,
THE CHILDREN WOULD PLAY,
AND GROWNUPS WOULD CELEBRATE
A BRIGHT CHRISTMAS DAY.
(CONTINUED)
SOON ROUND THE WORLD,
THE CHILDREN WOULD PLAY,
AND GROWNUPS WOULD CELEBRATE
A BRIGHT CHRISTMAS DAY.
THEY ALL ENJOYED FREEDOM
EACH MONTH OF THE YEAR,
BECAUSE OF THE SOLDIERS,
LIKE THE ONE LYING HERE.
I COULDN'T HELP WONDER
HOW MANY LAY ALONE,
ON A COLD CHRISTMAS EVE
IN A LAND FAR FROM HOME.
THE VERY THOUGHT
BROUGHT A TEAR TO MY EYE,
I DROPPED TO MY KNEES
AND STARTED TO CRY.
THE SOLDIER AWAKENED
AND I HEARD A ROUGH VOICE,
"SANTA DON'T CRY,
THIS LIFE IS MY CHOICE;
I FIGHT FOR FREEDOM,
I DON'T ASK FOR MORE,
MY LIFE IS MY GOD,
MY COUNTRY, MY CORPS."
THE SOLDIER ROLLED OVER
AND DRIFTED TO SLEEP,
I COULDN'T CONTROL IT,
I CONTINUED TO WEEP.
I KEPT WATCH FOR HOURS,
SO SILENT AND STILL
AND WE BOTH SHIVERED
FROM THE COLD NIGHT'S CHILL.
I DIDN'T WANT TO LEAVE
ON THAT COLD, DARK, NIGHT,
THIS GUARDIAN OF HONOR
SO WILLING TO FIGHT.
THEN THE SOLDIER ROLLED OVER,
WITH A VOICE SOFT AND PURE,
WHISPERED, "CARRY ON SANTA,
IT'S CHRISTMAS DAY, ALL IS SECURE."
ONE LOOK AT MY WATCH,
AND I KNEW HE WAS RIGHT.
"MERRY CHRISTMAS MY FRIEND,
AND TO ALL A GOOD NIGHT."
A Soliders Christmas
Women and Emergency Medical Services
In December of 1979, the first major article regarding women in emergency medical services appeared in “Emergency Magazine, “the article dealt with several subtopics, by the late seventies the number of “Female Medics was on the rise. The article left out the correlation of women working in fire departments as well was law enforcement, which at the time of the article statistical information showed that the percentage of women working in fire departments accounted for only one percent of the work force, and women in law enforcement averaged six percent of the work force.
The articles focus was on the ability to work in the field as well as their agility abilities versus male emergency medical technicians. Emergency medical systems around the country began to change as a result of the Vietnam War, soldiers who served as medics were returning home and were highly trained in advanced techniques involving shock trauma. The United States Department of Transportation was in the process of providing legislation, training guidelines and regulations for emergency medical services.
By the seventies emergency medical services was becoming a more professionalized organization. The early days of funeral homes providing load and go transportation had given way to private ambulance services, fire department EMS, and police agencies that were now providing a higher level of patient care. Because of the training that our service men had, as they return home they were applying for positions as police officers, firefighters, and emergency medical technicians thus making these professions heavily male dominant.
Emergency medical services level of training was continuing to rise, States instituted Departments of Emergency Medical Services that dealt with state wide training, legislation, protocols, and instituted requirements that EMS Personnel to be State certified and licensed.
In the early seventies Jack Webb who had stared in “Dragnet,” created the television show “Emergency.” Emergency was based on Los Angeles Counties Fire Department Paramedic Program. The show was focused on two L A firefighter/Paramedics. This was the first real public exposure of the Paramedic Program. Towards the end of the series the television show did an episode about a woman who was training to become a Paramedic the show depicted the “bigotry and male chauvinism regarding females doing a man’s job.”
When I started in Emergency Medical Services in 1979, I was first working for the Sheriff’s Department as a cross trained Police Officer/Paramedic; we were using suburbans specially outfitted with advanced life support equipment. The Police Emergency Unit responded to medical and trauma calls as a non transport vehicle, as well as performing law enforcement functions. At this time there were no female cross trained Police Officers/Paramedics. Prior to receiving my certification as a Paramedic I attended Davenport College Center for Emergency Medical Services. The class was made up of 25 male students and four female students.
As I and my classmates under went the required 640 hours of training needed for certification, there was a lot of classroom study, in addition to the classroom work we were also required to undergo practical training. Practical training included emergency room, surgical, OB, and field ride along's. The class also participated with in-house practical training using mannequins, mannequins arms used for learning how to establish IV’s, and mannequins foe practicing advanced airway management. The class took turns at being patients and working in teams of two in providing patient care. Using classmate cars we simulated removing injured patients from vehicles using backboards and KED’s. By the end of our training four males and one female had dropped out of the program.
In the late seventies the number of women working in the field of emergency medical services in Kent County Michigan was numbered at approximately Seventeen. Kent County consisted of four ALS Services: Mercy ambulance service, Buds Ambulance Service, Life EMS, and two volunteer staffed rural ALS Ambulance Services Rockford and Sparta.
Agility tests are required to become a candidate in law enforcement as well as for fire departments, emergency medical services, had and has no such agility test to become an EMT/Paramedic candidate. An EMT must meet the requirements as outlined in the state EMS Page. In the field of emergency medical services the average number of individuals assigned to an ambulance, are two individuals, and in some areas three member crews are utilized.
Lifting is the most essential function of the emergency medical technician job description, and lifting is the most frequent cause of back injuries in our profession. The heaviest patient that I ever assisted in lifting, weighed 755 pounds and required an additional crew, as well as three firefighters from an engine company, some other examples involving lifting obstacles are patients in homes that were on second and third floors with no elevators just spiral stops.
In the many years that I worked as a paramedic, I have had both male and female partners. Referring back to the top of this essay in the article a “male,” emergency medical technician stated that a woman partner “ in his opinion would “always be calling home, and checking on their kids.” Another statement made was that “Female partners either refused to lift or required additional help to lift a stretcher with a patient because it was too heavy.”
I have had the true honor of working with very dedicated female partners, who were invaluable assets, and truly professional female medics. Truth be told I had a male partner who could not consistently and properly lift a stretcher, and I’ve also had only one female partner who could not properly lift a stretcher, both of these individuals eventually quit.
Women belong in emergency medical services, and emergency medical services need these professional and dedicated medics. Women medics in many cases provide an emotional aspect that some male medics can’t provide. I have seen men and children that were involved in medical emergencies and traumatic incidents, who were initially very agitated, were a woman partner was able to calm the patient down better. (The Florence Nightingale Syndrome) This by no means takes away from their skills and delivery of excellent medical and trauma intervention.
The number of women in emergency medical services in the Kent County has dramatically increased since the late seventies and women now make up approximately 50 percent of the EMS work force. Today the number, of women continues to increase, as well as in law enforcement and fire departments throughout the United States.
This is one paramedic who does truly believes that women do belong in emergency medical services. Throughout my site there are several information and data that that indicate EMS it’s growing and improving, and EMS is doing just that.
Three major changes that I feel need to occur in todays Emergency Medical Services Profession is that an agility test needs to be incorporated prior to becoming an EMT/Paramedic. Second, EMS needs to incorporate a training program dealing with proper lifting skills techniques. Third, Volunteer, Private, Fire, and Government Emergency Medical Services Agencies need to provide weight and exercise areas for all EMS personnel.
Respectfully,
Dave D.
http://www.davesems.com
JUST ANOTHER DAY IN EMS
I delivered a baby on the ambulance stretcher
I baptized a newborn whose life ended before it began.
I hugged a frightened child.
I was kissed by an intoxicated old man.
I held the hand of a teenage girl while she delivered a 3 pound baby.
I listened to the mournful squeak of a stretcher being wheeled to the morgue.
I gently stroked the fragile hand of a 102 year old woman.
I hesitated at the outreached hand of a 300 pound prisoner in handcuffs.
I trudged for ten hours in my boots.
I had a teenager vomit on those same boots.
I rubbed the feverish body of a 14-year-old cancer patient.
I cradled the ice-cold hand of a child hit by a car.
I was referred to as "an angel of mercy".
I was called every four-letter word in the book.
I always see fear in people's eyes.
I never see joy or relief.
I listened to a tormented voice pleading for the preservation of life.
I heard the threatening words of one bent on self destruction.
I spoke with a girl who was hoping she had the flu, not a pregnancy.
I see innocent people hurt by a drunk driver, and the drunk driver is never hurt.
I marveled at the genius of a cardiologist.
I saw a 12-year-old boy who shot himself in the head, and the gun was still loaded at his feet.
I talked in circles with a schizophrenic person.
I was horrified at the battered body of a child whose parents were incapable of love.
I gazed at a horribly burned body.
I shuddered at a cold water drowning.
I see women beaten up by their spouses, but they never press charges.
I walk into houses and do CPR with family watching over my shoulder in tears.
I arrive at serious auto accidents, and the first words I hear are, "Am I going to die?"
I find out hours later they did die.
I listen to the repeated question "Why?” from a family devastated by death.
I search my soul for the answers to their question.
This is just another day in EMS.
SOMEONE SAVED A LIFE TODAY
These brave fearless 'Fighters' that step out into the night,
Working under extreme conditions, for which we have no insight. Their continued schooling is never ending, for to them, your life is only just beginning. Crawling through pieces of what used to be a car, To find a person lying there in need of CPR.
They are called Paramedics, a link between life and death,
All give a priceless gift, the gift of breath. The equipment they must carry, you may not understand, But one kneels beside you, as another takes your hand. They feel the Angel standing there, but refuse to let you go, Searching their deepest thoughts of knowledge that they know.
Until such time their job complete, and you return to them,
Only then will they place you in a physician's hand.
They no sooner leave the hospital, another call comes through, Lights flashing, sirens screaming, fighting traffic to get to you. A child this time in need of help, unsure of what went wrong, They begin their protocol of survey; soon realize this one is gone. On bended knee, heads hung low, a tear slips down their cheek, Always asking questions, looking for answers that they seek. The shift will be a long one, twenty four hours to be exact, A proud profession that they chose, without even looking back.
And the next life that they save, to bring a loved one home,
Perhaps it will be your life, or it could be my very own.
Every EMT and Paramedic has this thought before every shift in the back of HIS or HER Mind.
"Will I save a life today? Or will this be my last day of life."
We never share this thought or want to admit it to ourselves. But it is there; we know that we risk Our lives to save others. We always try to do it safely and with great care. But with the knowledge that things do happen and can happen when at a scene.
Things we cannot control. That is what we accept when we take our oath to save lives. We just pray we will never have to face that day. Sadly many emergency workers have faced this day.
For our families and friends that we leave behind is our hope that they are comforted with the knowledge that this brave man/woman who has been taken from their family while performing their job as an Emergency Medical Technician/Paramedic, The medic was doing what he or she loved to do and which they were trained to do, trying to save a life or lives.
God grant me the serinity to accept the things I cannot change.Guide my hands to change those that I can and lord give me the wisdom to know the difference." In EMS we all learn to quickly that somethings we cannot change an we must accept that as no failure of our own. To you so much of myself that I give Some ask why, I simply say So that others may live
1. Responded to a 69 y/o male, in acute cardio-pulmonary arrest. Pt. was unresponsive...
2. Pt. states she fell upstairs...
3. B/P is 115/63...
4. Mechanism of injury was a tree, approx. 4 feet in lenght...
5. Pt. states she may, or may not be pregnant...
6. Pt. rates the pain at 15, on a scale of 1 to 10...
7. Pt. denies any history of experience...
8. Accidently dropped gurney. Pt. bounced approx. 6 inches superior to the gurney then 6 inches anterior to the gurney...
9. Pt. voices no complaints; unresponsive, disoriented to time and place...
10. Gave Pt. 10 amps of Epinephrine...
11. Pt. states they take Viagra daily. No change noted with high flo 02...
12. The Pt. is alert and oriented times 4. Pt. has no recall of how accident happened...
13. Responded to a 1 vehicle rollover. All four wheels were superior to the roadway...
14. Pt. with apnea, at 24 RR per minute with 3lpm 02, by NC...
15. Pt. denies any prior suicides...
16. PT's 9 y/o son states that this is moms first time pregnant...
17. Pt ambulatory on scene with no motor movement in lower extremeties, bi-lat...
18. Found Pt. sitting bi-laterally to the toilet...
19. Pt. states he has no feeling from his toes down...
20. Pt. exhibits projectile hyperemesis with nausea...
21. Responded to a 43 y/o female, exhibiting symptoms of hypothermia. Husband states she was very hot approx. 12 hours prior...
The Last Call
I stood staring out the station bay window, staring onto the black rain soaked street.
The station is quiet, the rig is silent, the faint sound of sirens past echo in my ears.
The smell of diesel hangs in the air like a vivid dream.
It's 3 a.m., I still see the pain. I still see the fear. I still hear the sorrow. I cannot sleep.
The silence is pierced by the emergency tone, my heart begins to beat fast, a
thousand thoughts rush my mind in an instant, what kind of terror has shattered the night?
As the bay door opens, the rig awakens with mighty Vengeance.
The dispatcher tells of a baby who will not wake up.
The dark silent street suddenly comes to life, red pulses of light disturb the night, sirens shatter the eerie silence.
My heart feels like it will explode, I must cage my fear, my sorrow , my pain.
The doctor tells the parents their baby is now in God's hands, his ever loving
embrace.
I walk what seems like a thousand miles, I stand outside of the hospital in the cold rain as the tears stream down my flushed cheeks.
I replay over and over the baby's lifeless thousand mile stare, this time the angels
beat us to the call.
I feel empty. I feel cheated. I feel angry.
It's 5 a.m., I stare blankly out the station bay window. I am numb. The sounds of painful cries echo in my ears, the smell of diesel is intoxicating. The rain gently falls.
The night is silent.
By Ben Deacon,
EMT (c)
I hear people saying we don't need this war
I say there's some things worth fighting for
What about our freedom and this piece of ground.
We didn't get to keep 'em by backing down
Now they say we don't realize the mess we're getting in. Before you start your preaching let me ask you this my friend
Have you forgotten how it felt that day? To see your homeland under fire and her people blown away.
Have you forgotten when those towers fell?
We had neighbors still inside going thru a living hell, and you say we shouldn't worry 'bout bin Laden.
Have you forgotten?
They took all the footage off my T.V. Said it's too disturbing for you and me It'll just breed anger that's what the experts say. If it was up to me I'd show it everyday.
Some say this country's just out looking for a fight. Well after 9/11 man I'd have to say that's right. Have you forgotten how it felt that day?
To see your homeland under fire and her people blown away. Have you forgotten when those towers fell?
We had neighbors still inside going thru a living hell and you say we shouldn't worry 'bout bin Laden
Have you forgotten?
Now I've been there with the soldiers Who've gone away to war And you can bet that they remember just what they're fightin' for. Have you forgotten all the people killed? Some went down like heros in that Pennsylvania field. Have you forgotten about our Pentagon? And all the loved ones that we lost and those left to carry on.
Don't you tell me not to worry about bin Laden
Have you forgotten?
Have you forgotten how it felt that day?
To see your homeland under fire and her people blown away.
Have you forgotten when those towers fell?
We had neighbors still inside going thru a living hell
And you say we shouldn't worry 'bout bin Laden
Have you forgotten?
Have you forgotten?
WRITTEN BY:Country Singer Darryl Worley (c)
Have You Forgotten?
America Under Attack(9-11-01)
The sun arose, the morning came, Another day was just beginning when suddenly America was under attack from the air.
Both I and my fellow Americans watched as three planes were deliberately flown into three buildings two later fell. A fourth plane, hijacked and was rerouted to another target, which was stopped by a group of new American hero's who gave their lives that ended the attacks on our Country.
September 11, 2001 now remembered for the hero's that emerged throughout that awful day. as hero's a day of hell. Like Pearl Harbor, There was no way that we could have known, That these animals secretly plotted to kill Men, Women, Mothers, Fathers, Sisters, Brothers, and Children, all of them...
A hijacked plane, a broken heart, An awful way for a day to start. A horrid day for Our Country, and for all the victims... and their families. The little boy who called his dad, and said he'd love him like mad, as the plane he was on, that was deliberately flown into one of the three building's, killing both him and fellow passengers and the victims in those building's.
The Paramedics, Firemen, and Police Officers who lost their lives, after already saving many other lives will always be remembered. Many hero's were forever lost, in these acts of Terrorism against Our Country on Sept 11, 2001.
Palestinians where shown celebrating. They danced and cheered for an act that God himself will condemn, they celebrated for the pain caused, and for the many lives lost in these act's of terrorism. Also killed were many individuals from 165 other nations.
We are Americans and we are proud and United! We were strong before the attacks, and today, we are still United and the United States of America is still a Strong and Powerful Nation.
We did not let these animals kill our way life, or Our nation. The American People continue to grow stronger, and we are even more united. We will not relent, we will not hide, we are not in turmoil. We are America, One Nation under God Indivisible, with Liberty and Justice for All.
We have taken the fight to the cowards, they run and hide in caves, Our military has taken the fight to these terrorist animals and we are winning the battle, that the terrorist began.
Author: Dave D. Webmaster
http://www.davesems.com
CURRENT LODD
Doesn't it seem that more and more physicians are running their practices like an assembly line? Here's what happened to Buford...
Buford walked into a doctor's office and the receptionist asked him what he had. Buford said, "Shingles." So she took down his name, address, medical insurance number and told him to have a seat. Fifteen minutes later a nurse's aid came out and asked Buford what he had. Buford said, "Shingles." So she took down his height, weight, a complete medical history and told Buford to wait in the examining room. A half-hour later a nurse came in and asked Buford what he had. Buford said, "Shingles." So she gave Buford a blood test, a blood pressure test, an electrocardiogram, told Buford to take off all his clothes and wait for the doctor.
An hour later the doctor came in and asked Buford what he had. Buford said, "Shingles." The doctor said, " Where?" Buford said, "Outside in the truck. Where do you want them?"
The Granny
A little old lady goes to the doctor and says, "Doctor I have this problem with gas, but it really doesn't bother me too much. My farts never smell and are always silent. As a matter of fact, I've farted at least 20 times since I've been here in your office. You didn't know I Was farting because they don't smell and are silent."
The doctor says, "I see, take these pills and come back to see me next week."The next week the lady comes back. "Doctor," she says, "I don't know what the heck you gave me, but now my farts...although still silent...stink terribly."
The doctor said,
"Good!!! Now that we've cleared up your sinuses, let's work on your hearing."
DAVE'S EMS HEADQUARTER'S
EDITORIALS & HUMOR
Sometimes people will die despite your best efforts!
In the event of Rule 2 refer to Rule 1!
Just remember it's their emergency, not yours!
A systole is a very stable rhythm!
Dead people very seldom get any better, but they never get worse!
If it felt good saying it, you probably shouldn't have!
A patient’s weight is in direct proportion to their altitude in a building!
Can you walk? ....Have you tried?
If EMS workers never eat, sleep, or go to the bathroom...nobody would ever get sick or injured!
Cover your ass! (CYA)
The amount of whining an injured patient does is in inverse proportion to the severity of their injuries!
Be scared of the child that isn't crying!
If you go on an MVA after midnight and don't find a drunk...keep looking...someone is missing!
All bleeding stops eventually!
Equipment will fail only at the time that you really need it!
Better to be looking at it than looking for it! (reference your equipment)
Expect to get screwed and you won't be disappointed!
If you have to ask, seek a refresher course
Never ASSUME (because if there was ever a profession that it could bite you in the a*s, this is it.)
Never take the previous call with you to the next.
There is no I in the word TEAM.
Be able to turn it on and off like a light bulb or it will catch up with you and burn you out.
All bleeding will eventually stop.
All patients will eventually die.
If you drop the baby, fake a seizure!!!
The rule of 3's - If it's 3:00am and there is 3 flights of stairs they will be 300+ pounds!!!
Skinny people don't need ambulances!
The patient will always be in the most difficult part of the house there is to get them out of, (up steep stairs, in the basement, or in the back bedroom of a house trailer).
The size of the car is in inverse proportion to the patient (it’s always the 300+ woman that wrecked her Yugo!)
When things really get you down, remember the Paramedic Code. "We Can't bring back the dead, only kill the living"
Never tell your superior that m.s.d.s. stands for my sh*t doesn’t stink...they'll never believe you anyway.
Asystole: The mother of all bradycardias.
Go Big or Go Home.
Asystole: The mother of all bradycardias.
You get a 3 just for showing up-Glascow coma scale
If there blue... give'um O2
During lunch remember "Never trust a skinny cook"
Cardiology lesson.. "bumps are good, flat is bad"
Oxygenation lesson......no one should look like Papa Smurf!
Don't be the first one thru the door.
Don't be teamed up with anyone braver than you.
When in doubt, the mike is keyed.
If everything goes right and your patient is happy, look for it! Something must be wrong...
Make sure you'll get flowers from the family and not the family gets flowers from you...
Children crying do it to show you they're alive.
When working a code and all else fails drop the pt. it could be the right answer.
If all else fails use O2 (the miracle drug).
If you start to understand the Psyches. Its time for a 72 vacation.
The Psych. doctors are scarier than most of the pts.
Always remember the ABC's of EMS; Ambulate Before Care
That dog that "never bites"...REALLY DOES
Never trust your vehicle to be fully stocked.
If you don't have it, improvise.
Your immune system is so well developed it has been known to attack squirrels in the back yard
Speed up or slow down, but get the h*ll out of MY way!
Only skinny people live on the first floor.
When the moon is full you will not get much sleep.
When you show up if he is cold you are too late.
Always give Narcan near the hospital not on scene.
When you ask someone how much they have drank it is always just one beer not the truth how many they really have.
Don't get too comfy the EMS gods will be watching.
When the going gets tough adapt, improvise, and overcome.
At 3AM when it’s calm, tell the rookie not to say a word.
If it smells like gangrene when the lights are out don't be surprised when you turn them on. (Just shake your boots out later.)
If you don't see it, you don't hear it, but you smell it! The first assumption was right, no need to examine.
If it’s Loose, don't pull on it...
If it's tight don’t loosen it....
And if you think you might have known where it belonged, but you’re not sure, put it back where you found it!!!!
Air goes in, Air goes out, and Blood goes round and round." Anything other than that is bad thing.
I go home at the end of the shift
My partner goes home at the end of the shift
Any variation of rule 1 or 2 is NOT allowed
If you don't recognize the rhythm shock it till you does.
An oxygen mask is NOT a source of entertainment!
If it's wet or sticky and not yours - Don't touch it!
When you get old, always live on the first floor of the house. People only get sick on the second floor.
When you get old, and live in an apartment building, always live near the elevator. Only people who live at the end of the hall get sick. Never tell your superior that m.s.d.s. stands for my sh*t doesn’t stink...they'll never believe you anyway. Always remember that code 3 makes you invisible.
NAVIGATION MENU
Humorous EMS Definitions
Artery-the study of painting
Bacteria- the back door of the cafeteria
Barium-what the doctors do when patients die
Bowel-a letter like A, E, I, O or U
Cesarean Section- a neighborhood in Rome
Cat Scan-searching for the kitty
Cauterize- made eye contact with her
Colic- a sheep dog
D & C- where Washington is
Dilate- to live long
Enema- not a friend
Fester-quicker
GI Series- a soldiers ball game
Hangnail-a coat hook
Impotent-distinguished, well known
Labor Pains- getting hurt at work
Medical Staff-a doctor's cane
Morbid- a higher offer
Nitrates-cheaper than day rates
Node-was aware of
Outpatients- a person who fainted
Pap Smear- a fatherhood test
Pelvis- a cousin of Elvis
Post Operative- a letter carrier
Recovery Room- a place to reupholster
Rectum- dang near killed them
Seizure- a Roman emperor
Tablet- a small table
Tumor- more than one more
Urine- opposite of you're out
Q. How come the Police come to the call with you?
A. Investigation, crowd control, and to keep me from getting my butt kicked by an irate bystander/family member/patient.
Humorous EMS Questions asked
Q. How come all the Firefighters come to the call too? What do they do?
A. Beats the heck out of me, it's not like the patient is on fire hopefully!
Q. Can I and my four kids ride in the back with my boyfriend to the hospital?
A. No.
Q. Can I have a band-aid?
A. This is an ambulance; our band-aids are 8 inches x 6 inches. How many do you need?
Q. Why did you bring the patient here?
A. I guess the sign out front that says "Emergency Department; Physician on duty" fooled me into thinking that this was a hospital that treated patients!
THEVETERAN
Remember Our Fallen
Brothers & Sisters
Serinity Prayer
Pledgeof Allegiance
I pledge allegiance to the flag of the United States of America, and to the Republic for which it stands, one nation under God, indivisible, with liberty and justice for all
States will deny registration or take other appropriate actions in regards to applicants for registration or re-registration when a felony conviction has occurred. Decisions effecting eligibility will be based upon the following categories.
EMT Certification – Criminal Convictions
Preamble
EMS practitioners, by virtue of their state licensure, certification, or national registration, have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to personal property. In this capacity, they are placed in a position of the highest public trust, even above that granted to other public safety professionals and most other health care providers. While police officers require warrants to enter private property, and are subject to substantial oversight when engaging in “strip searches” or other intrusive practices, EMTs are afforded free access to the homes and intimate body parts of patients who are extremely vulnerable, and who may be unable to defend or protect themselves, voice objections to particular actions, or provide accurate accounts of events at a later time.
Citizens in need of out-of-hospital medical services rely on the EMS System and the existence of state licensure/certification or national registration to assure that those who respond to their calls for aid are worthy of this extraordinary trust. It is well accepted in the United States that persons who have been convicted of criminal conduct may not serve as police officers. In light of the high degree of trust conferred upon EMTs by virtue of licensure, certification, or registration, EMTs should be held to a similar, if not higher, standard. For these reasons, the EMS certifying/licensing/registration agency has a duty to exclude individuals who pose a risk to public health and safety by virtue of conviction of certain crimes.
General Denial
Registration of individuals convicted of certain crimes present an unreasonable risk to public health and safety. Thus, applications for certification by individuals convicted of the following crimes will be denied in all cases.
Felonies involving sexual misconduct where the victim’s failure to affirmatively consent is an element of the crime, such as forcible rape.
Felonies involving the sexual or physical abuse of children, the elderly or the infirm, such as sexual misconduct with a child, making or distributing child pornography or using a child in a sexual display, incest involving a child, assault on an elderly or infirm person.
Any crime in which the victim is an out-of-hospital patient or a patient or resident of a health care facility including abuse, neglect, theft from, or financial exploitation of a person entrusted to the care or protection of the applicant.
Presumptive Denial
Applications for registration by individuals in the following categories will be denied except in extraordinary circumstances, and then will be granted only if the applicant establishes by clear and convincing evidence that certification will not jeopardize public health and safety.
Applications for certification by individuals who have been convicted of any crime and who are currently incarcerated, on work release, on probation or on parole.
Application for certification by individuals convicted of crimes in the following categories unless at least five years have passed since the conviction OR five years have passed since release from custodial confinement whichever occurs later:
Serious crimes of violence against persons, such as assault or battery with a dangerous weapon, aggravated assault and battery, murder or attempted murder, manslaughter except involuntary manslaughter, kidnapping, robbery of any degree; or arson.
Crimes involving controlled substances or synthetics, including unlawful possession or distribution, or intent to distribute unlawfully, Schedule I through V drugs as defined by the Uniform Controlled Dangerous Substances Act.
Serious crimes against property, such as grand larceny, burglary, embezzlement or insurance fraud.
Any other crime involving sexual misconduct.
Discretionary Denial
Applications for registration by individuals convicted of any crimes including DUI, but not including minor traffic violations may be denied after consideration of the following factors.
The seriousness of the crime.
Whether the crime relates directly to the skills of pre-hospital care service and the delivery of patient care.
How much time has elapsed since the crime was committed.
Whether the crime involved violence to, or abuse of, another person.
Whether the crime involved a minor or a person of diminished capacity.
Whether the applicant’s actions and conduct since the crime occurred are consistent with the holding of a position of public trust.
COPYRIGHT 2001-2012: Dave’s EMS Headquarters and its website davesems.com, logos, statistical data and graphics have been properly and legally registered as defined by the U.S. Copyright Office in accordance with Federal guidelines. Therefore, the Site and Material is legally copyrighted.
Prerequisites that One Must meet Prior to Applying to become a Medic Candidate
NO SUCH PROFESSION—AMBULANCE DRIVERS!!
MOST DON’T REALIZE WHAT AN EMT OR PARAMEDIC IS OR WHAT THEY DO SOME SAY THEY’RE JUST AMBULANCE DRIVERS THIS PLAINLY IS NOT TRUE
THEY DO DRIVE THE AMBULANCE WITH THE LIGHTS AND THE SIREN BLOWING BUT OTHER TIMES THAT SAME DRIVER IS IN THE BACK TRYING TO KEEP A LIFE GOING OR THAT SAME PERSON MAY BE OUT IN THE MUCK, THE BLOOD, AND POURING RAIN WORKING TO GET A DRIVER OUT OF THE CAR WHO IS IN SEVERE PAIN AND PINNED IN HIS/HER VEHICLE
BUT THE CALL THAT HURTS THE WORST FOR ALL EMT’S INVOLVED IS THE CALL WITH THE CHILD WHOSE PROBLEM CANNOT BE SOLVED. EVEN WITH ALL THE TRAINING AN EMT OR PARAMEDIC RECEIVES THAT ONE CAN POSSIBLE TAKE, SOMETIMES THE INJURIES ARE TO SEVERE THAT THE TRAINING AND THE THOUSANDS OF DOLLARS IN EQUIPMENT IN THE MOBILE ER (AMBULANCE) STILL WILL NOT MAKE A DIFFERENCE.
IT IS THEN THAT YOU WILL SEE THAT STRONG EMT OR PARAMEDIC WITH TEARS RUNNING DOWN THEIR FACES AND A LOOK OF HUMILITY. THE THOUGHTS OF THIS CALL WILL NEVER GO AWAY BUT THE EMT AND PARAMEDIC REALIZES THERE WILL BE ANOTHER DAY AND ANOTHER PATIENT.
A DAY IN THEIR LIFE THAT THEY LISTEN FOR THE CALL AND WHEN THEY ARRIVE ON THE SCENE THEY REALIZE AFTER ALL, THAT SOME DAYS OR GOOD AND SOME DAYS ARE BAD, BUT ONE THING FOR CERTAIN, WITHOUT AN EMT OR PARAMEDIC AVAILABLE TO REPOND TO YOUR CALLS FOR HELP, LIFE WOULD CERTAINLY BE SAD.
EMT’S AND PARAMEDIC’S RESPOND TO YOUR CALLS FOR HELP, WHEN YOU NEED IT THE MOST! MEDICS RESPOND JUST AS FIREFIGHTERS RESPOND TO YOU CALL FOR A FIRE!! MEDICS RESPOND JUST AS POLICE OFFICERS RESPOND TO YOUR CALL OF SOMEONE WHO IS BREAKING INTO YOUR HOME.
HOWEVER THE HEADLINE DO NOT READ FIREFIGHTER DRIVER OR POLICE DRIVERS RESPONDED TO …!!
As Obesity Increases, so does Challenge's to EMS
As recently as two decades ago, ambulance service crews rarely encountered patients who were overweight or obese.
These days, it's not unusual for paramedics, both here and nationally, to transport patients who weigh 300 or 400 pounds -- sometimes even in the 600- to 700-pound range. Or more.
That's because obesity rates for Americans have more than doubled since 1976. As the waistlines of Americans have grown, so too have the challenges for EMS personnel in cost, personnel, equipment, training, safety and transport protocol.
In the United States, 34 percent of adults and 17 percent of children were obese, while more than two-thirds of adults and almost one-third of children were overweight in 2007-2008, according to findings released in January by the Centers for Disease Control. Height and weight calculations determine who is considered to be overweight or obese.
Because being overweight or obese can lead to or exacerbate serious health problems, it's no surprise that Emergency Medical Service crews are caring for more of those patients. "We've seen an absolute increase," said Todd R. Pritchard, operations director for Medical Rescue Team South Authority, which serves Baldwin Township, Castle Shannon, Dormont, Green Tree, Mt. Lebanon and Whitehall.
"Obviously this is not a scientific measure, but years ago patients who were 250, 300 pounds were rare. Now it seems every patient weighs 250, 300 pounds. We occasionally run into patients who are 500, 600, 700 pounds but they are few and pretty far between," he said.
"It definitely is a burden on the EMS system from a resources standpoint. It is not something we're not capable of dealing with, but it does take extra resources." Pittsburgh EMS Chief Robert McCaughan, who has been in the emergency medical services field for 35 years, said that decades ago, bariatric patients "would be something we would see periodically but not with the frequency we are seeing these days."
In recent years, he said, the issue has become a regular topic of discussion and concern at EMS professional conclaves. "This is a challenge the EMS industry is facing across the country and obviously not just locally," the chief said. "The bottom line is this is nothing specific to Pittsburgh or Allegheny County, but it's nationwide."
To deal with increasingly heavy patients, EMS equipment manufacturers have designed everything from higher weight-rated and wider stretchers to air-assisted lift devices to ambulance ramps and winches. The equipment makes moving and transporting bariatric patients more efficient and safer for them as well as for medics, who otherwise might suffer back and muscle injuries from lifting. These changes aren't cheap.
Retrofitting an ambulance to accommodate obese patients can cost between $20,000 and $40,000, so services throughout the state have entered into cooperative agreements for use of bariatric transport equipment, said Joseph Schmider, director of Pennsylvania's Bureau of Emergency Medical Services. The bureau is part of the state Health Department. Because of the increasing numbers of bariatric patients, Mr. Schmider said, upward of 50 specially equipped ambulances are in use throughout Pennsylvania, spread among 16 EMS regional councils. That gives the 1,017 state-licensed ambulance services access to them through cooperative agreements between agencies.
Ambulance services in Pennsylvania respond to 1.8 million calls a year -- or one call every 18 seconds -- but the commonwealth does not track the percentage of those calls that involves overweight or obese patients. Nevertheless, Mr. Schmider said, there are more than enough reports coming in from local ambulance services to know there has been a steady increase in the weight of patients.
"I've been in this business since 1978 and we never had bariatric ambulances back then. If there wasn't an increase, there wouldn't be a need for these special ambulances," he said. "Bariatric patients are a challenge obviously because of their size. With the equipment we have now it is getting easier [to transport them] once we get them outside. Usually the hardest part on any call is getting the patient outside."
Chief McCaughan said his bureau spent an additional $12,000 in 2008 to retrofit an ambulance for bariatric patients because city EMS crews were caring for more of them. Purchases included ramps, a winch and a motorized, wider stretcher with a capacity of 700 pounds. Crew chiefs decide at scenes whether the specially equipped ambulance is needed.
"We saw the trend starting to increase and recognized the increased demands on personnel and the challenges the situation presented and certainly the potential for injury," he said, noting the bureau has responded to calls for patients in the 400- to 600-pound range. The bariatric-equipped ambulance averages about 100 calls a year -- a small portion of the 57,000 calls handled annually by the bureau. Nevertheless, the expenditure was necessary and cost-efficient, Chief McCaughan said.
"It may seem like a lot of money, but the reality is with the potential savings in injuries and people being off work for shoulder, back, knee injuries it more than pays for itself. The key is, it's much safer for the patient and the crews," he said. Southbridge EMS has spent about $20,000 to buy air-assisted lifting equipment and cots with 700-pound capacity and lifting capability. Operations manager Dan Miller said the equipment is needed in about 5 percent of the 4,500 calls the agency responds to in Bridgeville, South Fayette and Cecil.
"I've been in this field for 25 years now, and you used to have a particular patient or two you would encounter who were heavy," Mr. Miller said. "Now we see this more often in the category of needing lifting assistance. "Typically, in the overweight area, we see people from 250 to 400 pounds. Every once in a while we may get someone over 400 pounds. Definitely the equipment has addressed the change."
Crews are trained to use specialized equipment and to lift safely. They also are advised to call for additional manpower from the agency and from fire and police departments if moving a patient is beyond their capability, he said. Mr. Pritchard said over the last five to eight years, MRTSA has purchased stretchers with weight rates of 650 pounds, up from previous models that had a capacity of 450 pounds. The agency has entered cooperative agreements with Southbridge and Baldwin EMS for use of special equipment.
Usually, overweight patients can be transported simply by summoning additional personnel, he said. In the last year, special equipment was needed in only three of the 9,000 calls the service responded to; one of those calls was 500-pound patient's trip home. "From a logistical standpoint, more resources are involved in moving an [obese] person. Maybe we'll need four people on the scene instead of two," Mr. Pritchard said. "It definitely adds some additional challenges.
"The average home is not designed for moving a patient under the best situation. In this area, there are a lot of steps. Sometimes the stairs are not wide enough," he said, requiring the service to use its special stair chair, equipped with tank-like tracks. Regardless of the challenges, EMS officials said, their crews must treat overweight and obese patients with the same respect they would show any other patient.
In a 2007 article, the Journal of Emergency Medical Services provided "10 Tips for Transporting Obese Patients." No. 1 on the list: "Always treat the obese patient with dignity." "You don't want to turn it into a spectacle by any stretch of the imagination," Mr. Pritchard said. "If dealing with someone over 500 pounds you may need to call the local fire department for additional manpower, but you don't want to make it into a neighborhood spectacle.
"You want to respect the patient's privacy and dignity so you keep it as low-profile as possible." Many obese patients are embarrassed by their weight, he noted. "They know they weigh a lot and know the challenges that presents us and some of them apologize," Mr. Pritchard said. "We tell them, 'Don't you worry about a thing. We'll get you there. We're here to help you.' "
By Michael A. Fuoco, Pittsburgh Post-Gazette
Michael A. Fuoco is a general assignment reporter. He holds a bachelor's degree in English from John Carroll University and a master's degree in journalism from Penn State University and is a fellow of the Knight Center for Specialized Journalism at the University of Maryland. Since joining the Post-Gazette in 1983, he has written spot news stories, investigative pieces, enterprise stories, features and for more than a decade covered Pittsburgh police. He has received numerous local, state and national awards for his writing. An adjunct faculty member at the University of Pittsburgh where he teaches writing
Article: Sam Venable: Life can be gone in an instant
