Category: international

Generation Y

Earlier this week I travelled to Hamburg, a great city in the far north of Germany, with a rich history of trade and some beautiful views (especially in the snow), even if the general attitude of the folk there can be rather cool and direct…consider yourself warned 🙂

IMG_6323There was a lot to see and do, including some very early Porsche experimental vehicles in the Prototyp Museum, strolling along the Reeperbahn, and finding out that apparently the fifth member of The Beatles was a police van. Who knew?

Hamburg, being a hanseatic city, thrived and thrives on trade through its port, which it has been relying upon for centuries. Knowledge, experience and wisdom has continually been passed down from one generation to the next in a move to keep the city, and the trade, at the top of its game.

What has that got to do with Paramedic Services, I hear you ask? And for the more established adults amongst you, dear readers, do I detect a hint of frustrations at us Young ‘uns, with all their Facetagram, Twitspace, Blogtube, glued to their screens all day and night? And for fellow Young ‘uns, I can hear your sighs when you think about those old guys who just don’t get what the net is all about.

Well, earlier this week I attended the 1. Zukunftsforum Rettungsdienst, the 1. Future Forum for Paramedic Services in Hamburg, to talk about just that: Generation Y – our expectations and demands.

Keep your eyes peeled for next weeks post…

This means nothing to me…oh Vienna!

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Schloss Schönbrunn. And snow, lots of it, in fact!

 

Actually, it meant quite a lot – so enough of the reference to 80’s pop music. I chose Vienna for my birthday destination because….well, I don’t really know. I had been before, couldn’t remember much – I believe I had not hit my teens yet, and as such it was a few earth rotations around the sun ago.

Vienna turns out to be a beautiful place, with spectacular old buildings, scrumptious food and a sophisticated yet laid-back cultured vibe. I can only recommend that you should visit it, and eat, drink and be merry there. I’m not one for much repetition, so I’ll leave you to check out my other halves delectable musings here.

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 Through conference attendances I had got to know some lovely Austrian Paramedic folk. As one does when visiting a country of foreign friends, one calls up (well, emails) in advance to organise a coffee together and the next thing you know you have a shift on an ALS response vehicle booked. Can’t help myself – and I count myself especially lucky as my other half is not only tolerant of such fun outings, but actively encourages me to do them (which she planned to turn in to some time to pursue her own interests, like watching some equine practice prancing. I might be losing some brownie points here, but I really can’t warm myself to horses. They have big teeth and don’t talk).

My alarm went off at 5am. Early? Yes. Girlfriend snuggled beside me on the mattress all warm and cozy? Tick. Could I have done with a bit more sleep? Indeed…but I was up and showered and ready to go in no time, excited by the prospect of experiencing another ambulance service!

After finding a little local bakery that mercifully opened early enough for me to buy all the danish (read: viennese) pastries within the city limits, I was fed and watered and awake to jump in to my Wiener Rettung (Viennese Rescue) experience. Now only to find out where I have to go…

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The Entrance Sign

As has often been the case in the past, someone saw me confused & pondering in front of the new building (the main building was closed and locked and dark), let me in and in a friendly manner pointed me in the right direction.

After a quick tour around the building (nice and modern, with beds, a comfortable communal, kitchen and outdoor area), and I am introduced to the Paramedic I will be following for half the shift. I say half a shift, as I only wanted to spend a coupe of hours to gain some insight, and not a whole day; it turned out to be a quarter of a shift, as the guys and girls in Vienna still do 24hr shifts, with the possibility of 15-20 jobs in that time frame. Phew!

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My ride for the day.

I was going out on the ALS response car that morning, with a Paramedic driving, and an emergency doctor treating. When I say Paramedic, I mean a person who is trained in emergency care, and – at the highest level – can intubate and cannulate. Nevertheless, they are still very transport focussed, and paramedics take a backseat in clinical care, leadership and development – most likely because the system is so heavily focussed on doctors as advanced providers. Even worse, Vienna is the only city in Austria that has an entirely career based ambulance service – the rest of the countries ambulance services release heavily on volunteer input. Often, I was told,  the ambulances are staffed with two volunteers with lower qualifications. Vienna is fighting this, and trying to bring forward the concept of a paramedic services within the country. They are doing a fine job it seems within Austria, but in an international comparison there are some areas where they are lacking.

But don’t write them off just yet, they have some interesting things to show to the world! They have just started a new level of Paramedic within the service. Qualified Paramedics are undergoing a three year course to further their knowledge and experience in such areas as critical care, primary care (community paramedicine), and field supervision (teaching and quality assurance), and they are building the course on input from a variety of international best practices – so hats off to them! I am looking forward to seeing them progress, and hopefully joining the international Paramedic playing field in due course.

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The ambulance garage. Obviously.

I went out on three jobs all together, including a 20+ minute run to backup a cardiac arrest. Not only was the job on the other side of the city, but it had also just started snowing heavily – and with heavily I mean approximately 15cm (6 inches) of snow in one morning. A standing and sliding ovation to the Paramedic I was with who safely navigated the traffic that morning.

And now, a few impressions, facts a figures from my shift:

Vienna runs approximately 35 ambulances throughout the day, additionally 6 ALS response units staffed by a Paramedic and a Doctor. The ambulances are staffed with three people – a wheeler, a healer and a dealer (OK, I made that rhyme up…one person drives, one attends and one is an additional pair of hands). This can get quite cramped inside the van conversion ambulances they use – working on a sick patient, there were two paramedics, a doctor and myself squeezed around the patient, and we could barely close the door. The service is considering in to larger vehicles for the future I have been told.

The Wiener Rettung only do emergency work, all patient transport is done by private and/or not for profit organisations such as the Red Cross or the Samaritans.

In the event of a cardiac arrest, the closest vehicle is sent – including the above mentioned patient transport vehicles or as well as the police as first responders. They are backed up by an ambulance and an ALS response car. The fire brigade are not involved at all – they were apparently invited, but declined.

There are no response time targets to be upheld, but a unit that has been alerted from station must be mobile within 2 minutes during the day, and three minutes at night.

Joining the service is an interesting path, one that I had not heard of before, some interesting ideas. After being accepted, either as a rookie to Paramedicine, or even as a qualified member, you start off doing station duties. You get to work, put on your uniform, and you clean and restock vehicles, inside and out. This is to get to know how the station operates, picking up the culture (e.g. cleanliness) and where everything is kept in the vehicles. If there is a staff shortage on that day, you will also man the ambulance if need be. After a period of station duties, you then progress to permanent on road duties.

After five years as a Paramedic, one can apply to work in the control room – this is often done by those who have injured themselves on the job and cannot work on the road, or those who have done their decades of work and prefer the slightly more controlled environment. Calltaking (via AMPDS) and dispatch is done at the same desk by the same person.

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Goodbye Vienna, hope to see you again soon!

I had a great time in Vienna, and being allowed to experience their ambulance system was the cherry on top of the trip. I would like to sincerely thank all involved for giving up their time in showing me around and meeting me, it was very appreciated.

Finally, I would urge everyone working in the field of paramedicine to consider visiting other services when they are on holiday. Not only do you get great insights and make some new friends, but you also get to see the area you are visiting from a local paramedics perspective – a view that is quite different than that of a tourist. Give it a go, I’d be very interested in your experiences.

For those wanting more information:

SwissScapes

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OxyBear is saturated.

 

_MG_1209StethoLion hears you breathing.

 

_MG_0940Emergency!

 

_MG_1183 …whilst it’s cousin naps, solemnly waiting for an emergency of it’s own…

 

IMG_8204…wishing it had a bed of it’s own, an actual ambulance bed…

 

Thanks to Martin Greca for the photos. They are Creative Commons licence, but please get in touch with me via the Contact! page if you want to use them.

Bern Baby Bern

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Up next on the second day of the meet up was a guided tour of the Paramedic Service in the Swiss City of Bern, curiously named the “Sanitätspolizei”, literally “medical police”. I guess that gives a whole new meaning to the term “Cardiac Arrest”…

In reality though, the terminology can be explained historically – over a century ago, it was realised that a dedicated corps was needed to help people with medical problems in the community (well, get them to hospital). This group was recruited from the police force, and the police moniker stuck, although they have nothing to do with the police at all.

044When the service was being set up early last century, a specialised water rescue group was also needed. So the Sanitätspolizei got lumped with that too, and has proudly kept it to this day and age. Every ambulance is fitted to tow one of the many boats that can be found at their HQ.

 

The 6 day rota that staff work seemed interesting; day shifts on day 1 & 2, moving on to a night shift from the evening of day 3, finishing on the morning of day 4, and having day 5 & 6 off.

Far more interesting (read: different, strange) was the way vehicles are staffed. To understand this, I will list the “clinical points” that are given to staff of varying clinical grades:

  1. Student Paramedic, year 2
  2. Student Paramedic, year 3
  3. Qualified Paramedic
  4. Experienced Qualified Paramedic
  5. Experienced Qualified Paramedic with ICU/Anaesthesiology nursing qualifications, OR Junior Emergency Doctor
  6. Experienced Emergency Doctor

There are a pool of staff floating around the station (the only station in Bern) at any given time. Staff are not assigned to a specific vehicle during shift, or have a certain partner. When an emergency call comes in, the calltaker/dispatcher (same person) triages the call. Depending on the nature of the call, a varying amount of “clinical points” are needed to appropriately staff the vehicle. A patient transfer job (all done by these guys and girls) can be handled by a single qualified person, only three points are needed (there will always be a fully qualified Paramedic on every vehicle). If a call is deemed low to medium priority and needs (minimum of) six clinical points, it could be two qualified paramedics, or an experienced qualified paramedic with a year three student. Cardiac arrest calls have the highest point count at 9, and one of the staff have to have at least 4 points to their name. For calls like this, they try to put three staff on a vehicle.

To get the resource running, the dispatcher broadcasts the names of the staff that they want to respond, they go down to the garage, get a “job fax” (a printout stating the nature of the call). Staff then grab a vehicle, tell control what vehicle they are on, the call details are sent to that vehicle (including sat nav), and away they go. After a call is finished, the vehicle is returned to base, the crew restock and clean it, as it unlikely that they will use it themselves in that configuration again.

Confused much? So were we.

IMG_8208Emergency! Jackets and boots are not allowed past the garage, so staff leaver them here, ready for their next call

A few numbers before I leave you with a selection of vehicle pictures:

The Sanitätspolizei Bern

  • have 150 staff
    • 15 of those are office based. They are all qualified paramedics, and can respond to calls if need be (non-clinical work such as accountancy and HR are dealt with by the city of Bern, and are located elsewhere, separate from the service).
  • receive 186 000 calls for help annually (510 calls a day)
  • dispatch 39 000 calls annually
  • do both primary (75%) and secondary (25%) calls.
    • On average, once a week the water rescue team are dispatched. Approximately half of the staff are water rescue trained, both above the water (boats) and below (rescue divers).
    • 2% of secondary calls are made up of transporting corpses to the mortuary. These transports are done with neutral coloured vans with undercover lights and sirens if needed – an example given where expedited removal is needed is to clear the high speed rail lines after people have been hit by a train.
  • have a company policy that staff must use the sliding pole to reach the garage when called out. It is seen as too dangerous to use the stairs. This caused amusement amongst some of us, as in Germany many services have banned the use of sliding poles as it is seen as safer to use the stairs.

And now, finally, the moment you’ve been waiting for. Colorful cars!

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The group around a Mercedes Sprinter 315, coachwork by the German company Ambulanzmobile, type “Delfis”. This is the main type of emergency ambulance in use in Bern.

 

036Mainly used for nonemergency calls is the smaller VW T5, coachwork again from Ambulanzmobile, type “Hornis”. Can be used for emergencies as well, has all the same kit, just less room.

 

049The so called “Hochlang” (literally: talllong, because it is tall and long) built on a Mercedes E Class chassis is a dying breed – as they age, they will not be replaced by newer versions. They are primarily used for long distance transfers – colleagues who have used them love the smooth ride, but this comes at the expense of far less room compared to other types of vehicles.

 

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An officers/supervisor car, Mercedes ML.

 

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And they even have a Lambo in the garage!

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Thanks for additional pictures by © Nils Düster and (cc) Martin Greca. To get in touch with them, please contact me via the Contact! page

Mountains and Madness

A few months back I was made aware of rettungsfachpersonal.de – a high quality German speaking forum for paramedics and those interested in topics about and around paramedicine. Their user meeting was coming up in May, and I might be interested in coming down to Switzerland for a few days. Well….why not?

The meet up was spread over three days. The first day was more of a get to know each other day between paramedics and some emergency physicians from all over Germany, Switzerland, one from Papua New Guinea and yours truly from London. The interesting thing when meeting people in real life after knowing them only from a forum, is the need to establish a link between their online user name and their real name (and their face). Having been quite new to the forum I just had to get to know everybody, end of story. Nothing better than a good old fashioned barbecue then!

IMG_8196Yes, those are actually tofu sausages in the bottom right hand corner, sourced from ethically slaughtered tofu animals.

Set in a scout style wooden hut in the swiss alps (you’d have to be about 1.50m (4’11”) to walk around comfortably in the bedrooms), it was back to the basics: five minute drive to the next tiny village, luckily we had running water and electricity. But no comforts of a luxury hotel – wash up yourself, make your own room (i.e. bring your own sleeping bag for the 8 person sleeping room with bunk beds). I didn’t mind it, nothing wrong with making do with the bare necessities…we’re often enough used to it at work after all! Even the (very) near by (restless) cows with their bells around their necks all too soon became a background noise that I could easily zone out from.

The afternoon, the evening and the night progressed. Food was heaped on to the flames, drinks (kept cold in a trough) were distributed generously (but not too generously). Stories, systems, scenarios and studies were exchanged. Ideas and concepts were conceived, discussed, formed, changed and adapted.

After surviving a night bunched together with various snoring colleagues of various snoring intensities and various snoring intervals (with varying snoring rhythms and notes, including but not limited to: staccato, legato, samba, jive, E flat minor and G sharp), the late morning breakfast was just what was needed to wake us up for the afternoon, our visit of the Paramedic Service in the Swiss City of Bern, the Sanitätspolizei Bern…

LondOne, Two, Three!

Omne trium perfectum – everything that comes in threes in perfect

After gaining some interesting insights how paramedics operate in London by riding out with Lysa Walder in 2009 and InsomniacMedic in 2011, the year has come where I put myself in the hot seat and actually work in London.

After two shifts in the capital of the United Kingdom, the largest city in Europe and one of the most vibrant and exciting cities in the world, what does Yours Truly think?

In brief: Yours Truly is happy. It’s busy, there’s traffic everywhere, there are people everywhere, and its not hot.

Some of my initial impressions in a bit more depth include:

– it’s much busier. Generally you will get a job the minute you begin your shift, and then when you clear or “green up” at hospital or whoever you left your last patient. This is good, this keeps me awake.

– in these two twelve hour shifts I’ve possibly encountered as much heavy traffic as I have in two years in Perth. Again, this is good (yes, I know you think I’m mad)

– Roll In, Roll Out stretchers are nowhere to be seen. The majority of ambulances have tail lifts, some have ramps. Much more back and shoulder friendly. This is good, obviously.

– whilst we’re talking equipment, the vehicles are bigger here too. Funny – when you think of it, in Western Australia (WA) we had wider roads and less traffic, but smaller vehicles…go figure. In the UK, at led thou can stand up straight in the back of the vehicle even if you are taller than 160cm. I like this. A lot. The only thing I miss are the red lights lunching off the walls at night – UK law states no forward facing red lights allowed on any vehicle.

– being a bigger city, there are obviously more ambulance on the road, and many more paramedics on shift. They’re everywhere, impossible to know all of them, which makes it all a little less personal…but on the upside you get to see and meet new people every time. And not only London Ambulance Service paramedics, there are various private frontline service staff (like myself), people from neighbouring services and patient transfer staff milling around too – an interesting mix. In Australia every state or territory has one single statutory ambulance service. UK ambulance services seem to like to contract private services to cover peak periods. A new concept to me.

– FRU, RRU, PRU: Fast, Rapid, or Paramedic Response Unit. Different names, same thing: single responders in a car that are sent out to get to patients quicker. Again, this doesn’t really exist in WA. A new experience for me arriving at a patient that is already receiving paramedical care.

– not only are there different response vehicle types, but also more levels of responders. Every frontline emergency ambulance in metropolitan Perth is either a double paramedic or a paramedic/student paramedic crew. Here, very rarely do two paramedics (as in UK HCPC registered paramedics) work together. Frontline crews are usually made up of either a Paramedic or an (Emergency Medical) Technician as the clinical leader, teamed up with a Technician or a driver with advanced first aid skills (ECA, Emergency Care Assistant). In WA, I was one of many paramedics. Here, I am one of many paramedics too, but also with many technicians and ECAs, who have a lower clinical rank. I was at a job where we were backed up by a double technician crew – I was the only paramedic on scene. New experience working in the city and being the only ALS trained person on scene.

– i=Information. We all know that the information sent to us by Comms/Control/Dispatch is hazy at the best of times…and that is not their fault (well, not always, but we all make mistakes occasionally!). Easy fix? Don’t give out much information. Typical call out info for me, apart from the address, was: “49M, sick” or “23F, OD”. No names, no background info, if there was any hint of danger on scene they would radio that information through. I was used to much more information being sent through (that was generally inaccurate)…after an initial light shock at the lack of information I started thinking this may not be such a bad idea- at least it gets you thinking in many more directions; especially as a student I noticed I (and many other colleagues) would easily be lend and fooled by on screen information that had nothing to do the the main condition the patient was presenting with.

– uniforms: yep, they’re dark green too, but that’s where the similarities stop. I’m wearing epaulettes (a word nobody seems to be able to spell correctly) again, but unfortunately UK paramedic uniforms don’t boast reflective strips anywhere except on the jackets.

…and what about the patients? A bit early to tell, but for a general summary: people are people. Same problems, slightly different way of tackling them. What I have noticed in some is the typical British stoic stiff upper lip and politeness, manifesting in a stubborn “I’m perfectly all right, thank you” (no, you’re not), and “it feels like I need to…well…this sounds rather awkward…like I need to fart. Sorry for being so rude!”

To which I reply: “Stop being so British!”

And then there’s the sightseeing. I going to parts of London I haven’t been before. I was telling my crewmate the other day what would be the peak of my paramedic career: driving around Trafalgar Square on Blues’n’Twos, followed afterwards by parking the ambulance up on Westminster bridge and getting a photoshoot of the “man and his van” with Big Ben in the background.

“You’re such a tourist!” she replied with a smile 🙂

Ambulanzia Paramedici

3am. Early morning. Dark of night. Witching hour.

Whatever you call it, many a body clock reaches it absolute low within the 24hour period. A busy nightshift with a rest period between 0300 and 0400 is generally bearable; one without is intolerable.

We had been out all night. We had worked all types of calls, minor to major. My level of enthusiasm was not at its peak, but bobbing around in the sea of sleepiness. I was hoping for a short break; a pause to let my heavy eyelids droop over my dried and tired eyes, to be allowed to escape in to a warm, soft and happy dreamworld. But none of that happened. Instead, we received yet another call after handing our patient over at hospital.

I closed my eyes anyway and leaned my head on my hand, elbow on window sill, whilst my partner navigated the dimly lit streets, devoid of any activity in the dead of the night. I would have drifted off if it were not for the bouncing of our wheels, indicating the ambulance was just about parked in the driveway. A quick drink of water, a quick glance at our patients name from the screen; reluctantly opening the van door I feel a cool breeze engulfing my face, and take a few deep breaths, hoping the flood of oxygen to the system will wake me up a little more. I grab my gear, and groan at the sight of a bunch of wet and narrow stairs – could be a complicated extrication.

We are met inside by the daughter, who states mum had a funny turn, and was worried. We awkwardly gathered some history, as it appeared our patient did not understand a word of english – not making things any easier. Luckily the family were more than happy to help. I commenced taking vital signs, and whilst taking a blood pressure, sitting next to the patient on the bed, I wished that I could just let myself fall back, stretch my back and sprawl my limbs across the big and comfy bed.

But that probably wouldn’t look too professional, so I didn’t.

The decision to transport to hospital was made, and in order to try and establish a little more rapport, I crammed out some (pseudo?) italian, “hospitale” and “ambulanzia” whilst pointing to the door that we must now head outside. A little sigh of relief was breathed internally when she insisted on walking herself (which was fine with her presenting condition). She even insisted on sitting in the ambulance, which meant that we could sit approximately opposite each other on an equal level, and look each other in the eye (as opposed to physically having to look down on somebody who is lying on a stretcher – bit of psychology involved there I reckon!).

We were going along in the back of the ambulance, and all of a sudden our patient opens up and speaks (heavily accented but understandable) english! Huzzah! Communication breakthrough achieved. A few personal details for the paperwork done, and then we got on to the details of her life – where in Bella Italia she comes from, her love of cooking and baking, Pasta, Lasagne, Pizza, Tirami Su – you name it, she had an authentic recipe stashed away in her memory, and regularly made use of it for the family. She then asked me what I do, or rather what I call myself. “Paramedic” wasn’t quite understood. “Medici?” She asks me? No, not a doctor, I am a “Paramedici!” Showing her my Ambulance Paramedic badge, I repeat: “Ambulanzia Paramedici!”

“Ah, Ambulanzia Paramedici!” Her face lightens up even more, and I am proud to have established a little foreign language communication.

So proud, in fact, that I reply with “Si, senorita!”, only then realising that I am way off the mark with the language again. The last few minutes of the trip continue like this, me trying to get my point across with italian(ised) words and (authentic?) hand gestures, and she guessing the meaning and then teaching me one or two new nuggets of vocabulary. In between all this, I occasionally catch the bleary eyed nothingness expression of my colleague in the rear view mirror, which was turning in to a slightly less bleary eyed look of puzzlement, then finally in to an occasional chuckle and snort of my poor grasp (and interesting try) on the Italian language, together with a little astonishment where all the fatigue had gone to.

USOZUK

A chilly, bright and clear night. A cuban bar, Mojitos, fireworks.

Reminiscing…past, present and future.

What was initially going to be a catch up after work turned in to a fair bit more. Having a drink with Lysa Walder always takes you places (previous adventure here). Last night we were joined by Thaddeus Setla, Tom Bouthillet and crew, during their visit from the States here in London to film their Code STEMI project.

Drinks, ideas, opinions, information flowed freely. I got ‘caught’ in between Ted and Lysa (who hadn’t met before), which was quite an experience, with some flashback for me: On my left an American paramedic-turned-filmmaker, with whom I had done a shift with last year and had a great time. On my right an English paramedic and author, with whom I had done a shift with three years ago. and me, an (ex) Aussie Paramedic, in the middle. US-OZ-UK.

It is always interesting to see the impression that places leave with visitors…in this case: what is stereotypical British? I’ll leave you with Tom’s thoughts of a typical 999 call between an Emergency Medical Dispatcher (EMD) and a Proper British Gentleman (PBG – spoken in a very posh accent):

EMD: “999, what’s your emergency?”

 

PBG: “Good afternoon. We seem to have this slight issue. You know this whole breathing thing that we all generally do? Well, she’s not really doing it much. Not at all really.”

 

EMD: “OK sir, you’ll need to check her pulse, and if no pulse is there, commence CPR. Open her airway by tilting the head back, and start by giving two breaths via mouth to mouth…”

 

PBG: “Her mouth? (with a hint of disgust). Sounds rather troublesome.”

Clearly he’s been watching too much Monty Python. I’ll leave you with fireworks instead!

(thanks to Lysa for taking the photo!)

NYC: Maimonides Medics

June 2011

The day had come: Time to see what New York City Paramedics do. The grime of the city. The hustle and bustle. The intensity. The size. New York City. I was excited.

I had sorted a shift out from Australia via some contacts (thank you again if you’re reading this!). A few emails and a phone call later, I’m booked in. After borrowing The Worlds Smallest Ironing Board from the hostel, coupled with The Worlds Worst Iron, my crease free shirt (NOT!) and I were on their merry way to Brooklyn.

The Subway, or any underground train for that matter, is a semi-magical type of transport. Descending in the the depths of the earths core, you are whisked away in a steel can on wheels, propelled through a network of subterranean tunnels, only to submerge in a completely different biotope.

I felt like I had come out on the Wrong Side Of The Tracks:

[youtube http://www.youtube.com/watch?v=uAFDeC7TVyQ]

…and when you’re in f*ckin’ Brooklyn, you best watch your back!

Woah. Dirty streets, rubbish lying around, big mean-looking guys with tats walking around. A dark freeway underpass. A broken fence. I looked around, and felt like the proverbial sore thumb sticking out. No one really took notice of me, but There was no way in the world I was going to do anything to draw further attention towards my person. No way was I taking my iPhone out to take pictures. I made sure my valuable were as safe as possible, and out of sight. I morphed in to “man on a mission”, and headed straight to the ambulance station, trying not to leak any signs of curiosity of the neighbours or indeed the neighbourhood. Because I was just that – curious. But I was attached to my health and my life. (I’m sure this was a bit of an overreaction, but you can never be sure…and this was precisely the landscape that is always portrayed in various US gang films…).

I arrived in one piece at Maimonides EMS depot (pronounced May Mo Nuh Deez. Maimonides was a medieval Jewish Scholar). Phew. Knock Knock? Noone. I walk in, and am greeted by some paramedics, who direct me upstairs to the supervisors office. A few doors and some very narrow stairs later, Henry greets me with a big smile, welcomes me, and eagerly gets right in to it: “Let’s head downstairs, I’ll show you around and introduce you to the paramedics”.

We head back down, but the crew for the shift is not there yet (admittedly, I am very early).  “Here, I’ll show you your truck!”. And yes, it really was a truck:
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We chat for a short while about the service, but then his phone rings and Henry excuses himself. “Grab some food in the meantime! It’s EMS week, help yourself, go right ahead”. Well, free food, can’t decline a friendly offer, can we? The banquet had been ransacked by earlier crews (it was early afternoon already), but still plenty to be had.
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Eventually, some people in uniform wandered in, who turned out to be the medics I would be riding with soon. We go through the different kit they carry, compare each others respective guidelines and protocols, and are bleeped immediately for a standby position. You see, in New York, all Ambulances except FDNY (pronounced fid-nee, or fud-nee if you’re from New Zealand) get dispatched from street corners, not from stations (more on that in another post).

Halfway to our streetcorner, we are sent on our first job. Oh yeah, this ALS truck is now running hot! Big, boxy, bouncy, bad. Together with the fine and silky smooth roads (NOT!) of NYC, it would make for quite an unpleasant ride if I were not so excited. And another thing: Drivers of all emergency vehicles are quite playful when it comes to sirens: wooowoop. wup. wuup woop. wooohoooowailwailwail. woop. wail wail. HONK yelp yelp HiLo. HONK woop.

A haemophiliac in a high rise building has called, thinking he has broken a bone. We’re in “The Projects”, the New York term for low income (generally ugly high rise) housing. And I get the picture pretty quickly: Dark and dirty entryway, a lift smelling of stale urine with goodness-knows-what smeared over the graffiti. Creaking, the lift sneaks us up multiple floors, spits us out in a tight hallway, where mum (or should I write mom) awaits us: her brother has a bleeding disorder, heard and felt a snap in his thigh, which is now slightly swollen and tender. And he can’t weight bear.

Luckily we have the carry chair handy.

Our patient is comfortable as long as he isn’t standing, but the upper leg is tender to touch. All vitals within normal range, declines pain relief, so apart from monitoring and transport there is is not much more to do.

We arrive at hospital after an uneventful transfer where, once again, it becomes painfully (for the seasoned US medic, not me) obvious of the stretcher systems that are in place in most of the US & Canada: Person A must hold half the patient + stretcher weight, whilst Person B must fold or unfold the legs of the stretcher. Man, you gotta hold a lot of weight, that can’t be good for your back! I think that topic alone is worth an additional blog post (at the risk of even more wrath in the comments section)

Back in the van, restocked and roomy (yes, this thing is rather large), we are sent to our street corner again. Not a bad corner, as far as street corners go: Close to a major road, yet quiet, a supermarket for food nearby, and free public WiFi.

And we wait for another job.

And wait.

And wait.

And wait.

And fall asleep.

A nine hour shift with one job. It’s light. Nothing. Then it turns dark. Nothing. BLS crews whizzing past us on lights and sirens. NYPD screeching past. Firetrucks honking their airhorns as they hurl past. But this ALS crew isn’t needed anywhere.

Observers Curse.

NYC EMS: An Introduction

June 2011

What would NYC be without EMS? Only half a trip for me!

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My first encounter with an ambulance. It conveniently parked in front of me, inconveniently the fence would not move out of the picture, despite much begging and pleading on my behalf (note to self: fences a much better behaved back home).

That day, twitter came to the rescue for my evening plans. Murphy (@Murphquake) told me about the Dinner Presentation that was being put on for EMS week by the NYC Regional EMS Council. A free event? Dinner? I’m there!

And there I was. Standing there, in my lonesome, in a big hallway, people with all sorts of uniforms coming and going. I enquired politely about the evening at the entrance desk, explaining that I was a visiting Paramedic from Australia.

“AUSTRALIA!? Wow, come right in. What T-Shirt size are you? (wow, free tshirt too??). Here, grab one, head that way, the buffet is in that corner, help yourself, grab a seat anywhere you like, and enjoy the evening. Speeches etc begin in 45 minutes. Here is a guide to the evening. Enjoy yourself!”

Right, thats sorted then. I may not know anybody by face, but there is free food, lots of people in the same profession, and a few empty seats around. Jump right in, I say.

With a precariously heaped plate in each hand, I navigate myself to a table where people seem cheery enough to accommodate myself. Turns out they were a whole family dedicated to EMS, from Daughter and Son in law right through to the grandparents. We got some great insights from each others country over copious mounds of food (this is America after all), and I was asked if I was heading out on a shift in New York at all. Even before I could answer, one of them had run of to fetch ‘a friend of theirs’, who came back shortly after. I was introduced to Barry, one of the Paramedic supervisors in the Borough of Queens.

“Here’s my number. You call me tomorrow, and I’ll get ya sorted”. Spoken in a perfect New York accent.

This was going to be excellent.