I would guess most people have heard of EMT’s and paramedics. Paramedics were made “famous” by the hit show in the 70’s called EMERGENCY! that featured L.A. County’s first paramedics and the life-saving equipment and training they brought to the aid of citizens. Before that, an ambulance, usually a station wagon with a high top conversion just drove really fast to a call, loaded the patient and drove really fast again to the hospital. That’s the long and the short of it.
Fast forward to today, and we have highly trained paramedics and emergency medical technicians providing care and treatment to people in communities and commuters on the highways. The Dustoffs of Vietnam brought helicopters into pre-hospital medicine. Medicine was once what we thought would help a patient to now what we call evidence-based medicine.
In the 25 years of practicing prehospital medicine, I have had very few calls, that have resulted in actually saving someone’s life. Sure, there have been many cardiac arrests, but it is very difficult to survive sudden cardiac arrest, despite the extraordinary measures we take in the field to save someone. In the 1960’s only a physician could perform CPR. Now any layperson can (and should!) learn CPR.
One time I was waiting for my order of food at a local mall and my partner had gone to a different establishment. While I was standing there, I got a tap on the shoulder. I turned around to a teenage girl holding her neck with both of her hands. This is known as the universal sign, and no matter what culture or society people who are choking will do this. I asked, “are you choking?” Almost in disbelief, I scanned quickly for my partner – nowhere in sight. I asked again, and she nodded yes. CRAP, I thought to myself. I hope I can do this. I spun her around and gave her three back-blows, still nothing, I decided one more, and I will switch to abdominal thrusts. I drove the heel of my hand in between her shoulder blades and this HUGE, and I mean HUGE flower of broccoli flew to the floor intact. I looked at her as she began to start breathing normal again. I was at the right place, at the right time, with the right knowledge to save that girl’s life.
Today I was dispatched to a person that was stung by a bee. Make that several bees. I’ve been to a hundred of them. Either they have used their Epi-Pen already, or there was no allergic reaction, let alone anaphylaxis to speak of. Well, today was just a touch different. The city FD arrived just ahead of us. The hospital just over a mile away. The victim standing in his driveway. His ears 3 times their normal size and red, his lips nearly the same. I took one listen to his lungs and he wasn’t breathing well at all. He was able to walk to the ambulance and the four of us went to work. teamwork like that is what makes public safety work and save lives. Because I had the highest level of training, I asked everyone to take on a specific task. This included vital signs, getting demographic information, getting the equipment I would need out, getting an EKG, providing oxygen to name a few. It may seem like chaos, but it’s really a seamless chorus of synchronized actions. It never happens the same way twice, but if everything goes right, its almost magic to the providers. This guy was in dire need of a couple things. Epinephrine and Benadryl. He got them both within 5 minutes of us being on scene. By the time we arrived at the hospital not 15 minutes after watching bees fly in and out of his house, his breathing was getting better and the swelling was starting to be reduced. If he didn’t have a phone with him, was more allergic, stung more times, there is a high likelihood that he would not be with us anymore. Today, my partner and two firefighters saved someone’s life. It very rarely occurs actually. 99% of the calls we respond to are not life threatening. We certainly respond to calls of consequence, but the life and death calls are few and far between. Good training, dedication to medicine, and teamwork make these things happen.
