Menu

flobach.com

Contemplating life.

Report, part 5

Let me take you away, if allow me, to a bygone era. A time of fuzzy hair, cool sunglasses, green pants and orange stripes. A time of precautionary immobilisation after minor fender benders and let’s intubate everybody. Oh, some still do that? Let’s gloss over that.

Board the time machine, get on your cool, and make way:

New York City Emergency Medical Services of the early 1990’s.

[youtube http://www.youtube.com/watch?v=ZXQfuwbUtk4]

[youtube http://www.youtube.com/watch?v=VmjZFtRR7Kw]
[youtube http://www.youtube.com/watch?v=qCZC7De1O2k]
[youtube http://www.youtube.com/watch?v=3VPZzKGCfLc]
[youtube http://www.youtube.com/watch?v=4fzldeaIhaA]

NYC: Caribbean Care part II

June 2011…a continuation from NYC: Caribbean Care part I

So, this shift we would be doubling up – two qualified NYC Paramedics, two student Paramedics; one from New York, the other from Perth, Western Australia (me, in case you’ve missed the point). Me, the one wearing green with reflective bits. Working for St John Ambulance. Which is funny, because the other student is doing his Paramedic course through St John College. Coincidences!

Doubling turned out to be a great thing. For the whole shift, we now had an even number of people on the ambulance, no third wheel feelings. Whilst driving, the two paramedics sat up front, and the two students in the back. I could compare the courses we have been going through, with plenty of time. Education levels, content, delivery of material etc. were all discussed. On the job, he attended, one paramedic always at hand to give help out if needed (which wasn’t), the other paramedic grabbing the stretcher if needed. And I hovered in between, but never felt spare. Jobs were discussed together, food was eaten together, I learnt a whole lot. Driving to hospital space was tight in the back and if the patient wasn’t too sick, I hopped up in the front and chatted with the driver medic. The shift flew by, and we all had a ball of a time.

Untitled

Ready to go!

So, what did we do all day? We were en route (“enn rauwt” as opposed to “on root”) to a standby when we get diverted code three (lights and sirens) to a fifty something year old female feeling faint with leg pain. Woo woo, flash flash, woo woo woo woooooo…in the US, especially in NYC, paramedics love to play around with their sirens. Little woop here, longer wail there, chuck in some yelp and phaser, ending with a blast from the air horn. It’s their culture I guess, though sometimes I wish they’d just leave the bloody thing on. They’re a playful bunch.

We fight our way through traffic, our red and white beacons ricocheting off street signs. I miss the blue of our Aussie ambulances – a colour only recently allowed on ambulances in NYC, and even then only facing the rear. This is explained by the fundamental difference in retinal physiology between UK and NYC citizens – the cone cells are structurally completely different between these two species – the NYC kind would be mesmerised and perplexed by forward facing blue lights, hence the laws to prevent such horrors. The UK specimens would equally be in deep strife, but in a different way. Here, red flashing lights are only allowed to be rear-facing. Imagine how the British would be confused if this were not regulated by the law. This, I presume, is also the reason for strict border controls, limiting the intermingling of these fragile species in unfamiliar environments.

Anyway, back to our call. We turn on to our destination street, and immediately know where the house is – there’s a big red fire truck with fifty million flashing lights parked right outside. FDNY (pronounced Fidney, rhyming with my hometown Sydney) respond to all emergency medical call outs as first responders – helpful in some situations, overkill in others. We crowd inside the little house, six firemen, four paramedics, and begin history taking and treatment. It is quickly assessed that the Firefighters are superfluous on this call, and, after answering a few questions why the heck I am running around like an employee from the sanitation department, they are about to leave…when two police officers poke their heads round the doors. Apparently NYPD are also dispatched to every emergency call, slightly over the top in my humble opinion. They know they are not needed, but we thank them anyway and they head off, probably to the nearby donut shop.

I am amazed at the amount of resources thrown at this job. Three vehicles on a lights and sirens response, ten professionals from three different services. America is the land of plenty, think big, but it begs the questions “is it worth it?” and “can they afford it?”

I’ll let you discuss and decide that one.

Back to our patient, we treat, transport and joke, all the way to hospital. Our patient is stable, her spirits are high. Then we arriving at the hospital – a bit of an eye opener. It’s bursting at the seams it seems, and it’s only a tuesday afternoon. Three people to a cubicle, nil privacy. If you were to draw the curtains, they would drape over the person lying on the centre bed. This isn’t a quite place. Staff scurrying around, some barking orders. Some guy is screaming for food. I position myself in a corner for a better overview of the department, and realise that this “some guys” deep coarse voice actually originates from some haggard old woman with an haggard old face on a haggard old body. Rough times indeed.

In the other corner, someone else starts shouting. A trauma call is brought in by an EMT crew (trauma is a BLS call in New York City, unless it is obvious that ALS intervention is needed and subsequently requested). We are quickly triaged briefly, vital signs are taken by EMS in hospital. Pt is loaded on to a bed in the exam room, examined, and we leave.

Outside, a FDNY EMS lieutenant is having a discussion with paramedics about using the scoop stretcher as an immobilisation device. He skims around the point, not accepting it for such a use; the paramedics insisting that it can be used (we certainly did in Western Australia…we didn’t even have spineboards until the beginning of 2011!). His way or the highway. We don’t bother to get involved, and choose the highway, outta here for more street action.

Mind you, on the subject of spinal immobilisation (or attempted stabilisation), the 15 minutes I spent at hospital was quite an eye opener: three more people are brought in to the ER strapped on to spineboards. And there are more lining up outside. Overkill.

It’s time for restocking the van as well as our stomachs. We head to a German Deli, where I grab the highly recommended roast beef roll. Well, a small to medium sized roll with a ton of roast beef stuffed inside.

We have enough time to eat without having to wolve it down – then right on the last bite, back to the truck for another call. It is now pouring outside.

We pull up outside the apartment building. A family get together, they have come from everywhere: Puerto rico, hawaii, and nana wants to fly back home tomorrow…well probably not, as she has a chest infection. Treat, transport, joke – a good routine. At hospital, we are told that our last patient has been discharged with nothing serious to report.

We make ourselves clear for another job. The radio crackles to life…and…standby. We park up on a nearby corner, and let our bellies digest teh roast beef a little more. Andrew (the NYC student) and I compare our education programmes a little more. He has gone through EMT school for three months, graduated as a basic, then decided to go to paramedic school. Generally this is one year full time, and costs around 9000 US$. This is then followed by taking the State and National Registry tests to become a qualified Paramedic. Quite compressed compared to what I’m going through (three years university plus three years on road experience).

The day wears on…do I want to go home, I am asked? No brainer there: “Hell no, I’m going to stay right until the end! Having too much of a good time!”

Waiting is tough and uses up a lit of energy. It’s food time again, so the collective agreement. Spanish pork with rice, we have to show you this stuff they insist.

Untitled

Food. A lot of food. Too much food. Yummy food.

Full to the brim. Cannot walk. Roll to the ambulance. I want to explode.

The last job of the day comes in (burp, ooh my yummy tummy hurts), a girl in her twenties complaining of a sore throat. Yup, gotta end the shift on a high note – ALS, lights and sirens to our patient with a cold…and a bit of attitude as well. Apparently she has been prescribed penicillin…but she has ben taking it now for six hours, and its not working. Gozo explains how penicillin works, but she’s having none of that, and wants to go to hospital. She happily walks to the van.

I pop myself in the front, and chat to Drew, who has been a paramedic for five years. He is studying psychology; his long term aim to get out of EMS, as he can’t see EMS providing a long term future for himself. Hoping to progress on to a Masters and possibly an PhD, things he laments that are missing in the world of Paramedicine…until I explain how things work in Australia, how the majority of education is university based, how you can get in to research, you don’t necessarily have to work for a state/county/municipal paramedic service; you can end up working/teaching at a university…or so much more. His jaw nearly hit the floor, and I may have detected a bit of envy oozing out of his pores.

At hospital, we bump in to relatives of our chest infection nanna, who confirm the paramedics provisional Dx of a chest infection. They thank us again for helping out, and we say our goodbyes.

Then a commotion from a few beds down the aisle – a loud moan, a shriek of a relative, followed by much rattling, wailing and high pitched screaming.

A patient is having a tonic-clonic seizure in his hospital bed, together with a screaming and freaked out relative at his bedside, having no idea what is happening. Hospital staff are extremely slow to respond, but my trusted paramedic colleagues are quick to take action, positioning the patent on their side, trying to calm the relative down, explaining what is happening. A junior doctor arrives after a minute, and is completely flustered. The nurses aren’t much better. Gozo orders the doc to get some Midazolam for this patient, all whilst continually talking to the relative, explaining what is happening (“no, the devil has not taken possession of you loved one”, he explains in Spanish), and occasionally interjecting with some paramedic wisdom directed and Andrew and myself. Andrew is especially interested and excited, as he has never seen a seizure before – and we were just discussing different seizure presentations and treatments earlier on in the shift. And not playing my own interest down, this was only the second seizure I witnessed, and in quite a different environment I’d expected – an overcrowded emergency room in NYC.

The seizure subsides, the situation is under control, and we stroll back to the Ambulance. But what do I spot there? As we leave, we walk past some EMTs who have come rom La Guardia Airport – and they don’t look like regular EMTs. Probably because of the gun and cuffs next to their penlight and trauma shears on their belts. They are police officers from the Port Authority Police. Their uniforms have EMT and Police written all over them. Police officers in EMS duty. Not sure If i agree with the concept, but there you go. They’re a BLS only system, ALS backup is called from NYC EMS.

Outside, another interesting sight: a FDNY ambulance, but this is a HazTac/Rescue unit…cool. These are the guys that go in with the dirty stuff, CBRN, confined space rescue etc – similar what the UK HART units do.

Image from Wikimedia Commons

One of the FDNY Haz-Tac EMTs spots us, a big brawny bloke with a crew cut, and walks towards us with a quizzical look on his face (the look of the day, it seems):

“Two questions: 1) are you gay, and 2) can you keep a secret? He winks at me with a dirty smile, slaps me on the shoulder, and I explain myself (yet again) why I look like I work for the sanitation department. He gives us a bit of an insight to the ins and outs of the HazTac units.

And thats it. Not many calls, no life or death situations, but what an informative and exciting day! We finish out shift half an hour late, but no-one really cares, we all enjoyed ourselves. We drive a few minutes back to the depot, clean and restock the van with the other crew that is taking it over for the rest of the night. Drew is on for a double shift, and so keeps the keys of the van.

Gozo looks at his watch: “I was told you’re taking the subway home. Nope. No way you’re taking the subway home, it’s hell dodgy at this time of night! Wait for me, I just need to finish this paperwork and I’ll drive you home. No ifs or buts.”

Can’t argue with that!

NYC: Caribbean Care, part I

June 2011

 

[general chatter in the background, footsteps, doors opening and closing]

*cling*

*clink cling*

*tap tap tap*…pause…*tap tap tap tap, tap tap*

*beep beep*

*beep beep*

Such would have been the backdrop standing next to me at the payphone of the hostel I was staying in. I’m following up from the previous nights offer of getting out on shift with Paramedics in the New York City borough of Queens, having dialled Barry’s number. After a short wait my call is answered.

“Hello it’s Barry” it comes in a thick New York accent, reminding me more of “The Godfather” than “The Paramedic”. It seems that I am on speakerphone, and that he is driving. I imagine the telephone on the other side of the line set in a massive black Cadillac being driven though the streets of Manhattan, tommy gun on the passenger seat and a dead body in the boot. And the Fedora casually slanted on his head in true gangster fashion. I give myself a mental kick to focus back on the task at hand.

“Hey Barry, Flo here – the Paramedic from Australia. We met last night at the REMSCO dinner.”

“Yeah, how ya doin’ ?. You got something to write? June 32nd (obviously that’s not what he said, I’m just de-identifying the date for the blog), you come to our Hospital in Queens, and we’ll get you on a truck!”

Times and directions were exchanged. I was being picked up from the subway station. The shift was sorted. Brilliant. Gold Class service right there.

On the day, I arrive in Queens, find the hospital (no problems due to the easy directions) and call call Barry to let him know I have arrived. He’ll be there in ten minutes, I should have a look around in the meantime – something I don’t need to be told twice. There were a few ambulances parked near the Emergency Room entrance, so I went to have a sticky beak at the closest one, and take a picture whilst I was awaiting my chauffeur.

“Hey, you can’t take a picture of that without us!”

A loud female voice carried from the next ambulance parked just down the road, slightly bossy but with a distinctive giggle in there.

The three EMTs are just restocking their vehicle a few metres down the road, and are obviously not envious of the attention the other ambulance is getting. “Well, you better clean up the van and pose for the lens!” I reply, beginning to walk towards them. Apparently the girls didn’t quite anticipate this reaction, and looked rather startled. When you tell somebody to point their camera in your direction, you would never in a million years expect them to actually do just that, would you? Must be female logic…

Anyway, the three of them turned out to be bright and chirpy, with the startled face quickly turning in to a quizzical face, what I am doing here and what’s with the green trousers and the reflective stripe? Apparently, in NYC, green uniforms are associated with the sanitation department (some old medics will remember that NYC ambulance uniforms actually were green back 20+ years ago), but I was quick to take my jumper off and show my work shirt, revealing the (to Americans) foreign term “Ambulance Officer”. We all had a good chat, laughs; Discussions and comparisons followed, and a few minutes later i think we have three potential new visitors to Australia. Barry, the supervisor turns up, and sees me chatting away to to a bunch of his girls. He shakes his head with a grin.

We drive ten minutes down the road, talk about how things in NYC run, his history (active paramedic, paramedic and EMT instructor, his roles as supervisor). The station is again a large garage, parked full with about 10 ambulances, lockers, mechanical stands around, mess room adjacent. I am first introduced to the head of the service, we exchange a few introducturies and I quickly explain what I’m doing on this trip. No time for much more, I whizz off with Barry to the mess room, he has sorted out a crew that he wants to put me with, only the hand picked best guys for the Australian visitor apparently!

There are about ten EMTs and paramedics milling around the mess room, some on break, some ending their shift, some getting ready for their upcoming shift. Then I am privileged to one of the best introductions towards the staff:

“Everyone, i want you to welcome flobach – all the way from Australia! I met him at the REMSCO dinner the other night, a good guy, and I wanted to show him how we  do EMS in New York City (Yeah! show him the real NYC, people mutter, and nod their heads in a mix of love towards their home city and profession). I want you to look after him. Flobach will be going out with you, Drew and and Gozo. Your shift goes until 11pm – I want you to drop him off at the subway station, I don’t want him running around here on his own at night, do you hear? Take him right to the station, and look after him. Have fun guys!”

With that, he shakes my hand, gives me a smile, and leaves. None of this wandering in to foreign paramedic quarters, trying to explain to disinterested crews why you are giving up your spare time to do a shift. This was a smooth start!

With that introduction, I slot right in. The crews are interested about my background. We chat about Australia, their service, my trip, the lot. I feel more than welcome.

I show them pictures from Australia, and all of a sudden everybody wants to move there. Conveniently, I tell them, my service is just having a massive recruitment push…eyes light up…and I wonder if I should charge my employer commission for recruiting potential new employees. They like the idea how things in Aussie run. No calling for orders. The drug range is decent. The working conditions are great, leave, pay, vehicles, roads. A very attractive place indeed. Surgical cricothyroidotomy raises eyebrows. They may be getting ondansetron next year…I tell them to look forward to it:-)

Meanwhile, Gozo is twirling his neatly trimmed moustache, worried about the unilateral greying. I suggest colouring it in with a piece of charcoal a trick I learnt from my dad. He’ll give it a try, he reckons.

Finally, our truck arrives, after being held up on a late job for 45 minutes. A student on placement, Andrew, shows me around the truck, as he is attending today – the paramedics are really only there to help with extrication and make sure he is up to standards.

I need to briefly pop back in to the office to sign an indemnity form so I won’t sue them – fair enough – when one of the paramedics pokes his head around the office door and asks for Barry to come in to the mess room.

“Um, boss, student is out with us today, can’t really take flobach.”

“No way, he’s going out with you guys! He’s come all the way form Australia!”

“But student actually pays money (via his paramedic course) to come out on a shift…”

“But this guy has travelled all the way around the world from Australia!”

“Put him with the other crew”

“No”

Hmm…pensive silence.

“Can they both come out with us?”

“I guess so…nothing stopping you really!”

 

Stay tuned for part two…

Ormskirk

Yes, Ormskirk. A little town in the North West of England, 14 miles north of Liverpool. Bus driver, pub owner, town locals…all asking me the same question: “What are you doing here?!” It seems visitors, be it from London or from Mars, are a rarity. Ormskirk is not a place that prides itself on tourism.

Doesn’t matter to me, I didn’t get to see much of the place anyway. I was here for the Continuing Professional Paramedic Development – a one day conference put on by the UK College of Paramedics.

The day started off with Dr John Freese, Chief Medical Director of New York City Emergency Medical Services. A rather good speaker with an interesting background (John started as a basic EMT in the rural US, worked his way up to Paramedic, then turned to medicine). His talk was based around trauma care in the US, its history and direction of the future. Some interesting points I picked up:

  • Skill decay is a big problem amongst NYC paramedics. Intubation success rate is approximately 30%, many paramedics don’t even get a chance of intubating, and their average training is far less than that of an average UK paramedic.
  • For severe trauma patients, definitive care is needed. Where this care is provided best (i.e. what is the most suitable hospital), NYC EMS has developed a simple reductive flow chart based on patient presentations, events and mechanism in order to determine if a patient should be taken to a trauma centre, and if so, what level. An important note was emphasised: the clinicians decision. The chart could not indicate any need for higher care, but the paramedic must still be allowed to take a patient to the highest care facility if judged so by their clinical experience.
  • Then the big one: “Spineboards: they need to go”. NYC EMS has realised that far too many patients are immobilised for no good reason. Research is proving that immobilisation is possibly doing more harm than good. Currently, new guidelines are being written in order to drastically lower numbers of spineboard usage in NYC. Personally, I applaud this. A big step in the right direction.
This talk was particularly interesting for me, as I had just visited New York last year (if you’ve been reading this blog recently, I am just putting up the stories now). Very nice having seen NYC EMS, then hearing all about it from the Chief MD.
Up next was Professor Kevin Mackway-Jones, Medical Director of the North West Ambulance Trust (NWAS). The presentation was similar to the previous, but this time from the NWAS perspective – a much more diverse landscape with urban, regional and rural settings (something you wouldn’t find in NYC!).
  • To provide a similar level of care that urban area enjoy everywhere in the NWAS catchment area, another 14 full time helicopters and anaesthetist would need to be employed. Far too expensive and ridiculous, he explored the alternatives: Full time HEMS, vs on call residential doctors, vs volunteer doctors (e.g. BASICS), vs full time specialised (critical care) paramedics. The last option won – cost effective, good exposure means good quality, experienced, available and a good skill set.
  • Kevin agreed with John about spineboards, and repeated the overuse of the device, stating that many UK services are re-evaluating their use. Additionally, he stated he is not convinced by pelvic splints; there is not enough evidence to support them.
Next speaker was Professor Andy Newton, Chair of the College of Paramedics and Clinical Director of South East Coast Ambulance Service. After some information update from the College itself, Andy got us in the right mood with a clip from the Simpsons: Homer as an Ambulance Driver (could unfortunately only find it online in Italian). Some points Andy talked about:
  • The history of Paramedicine, especially with regards to the “founder” of out of hospital care, Dominique Jean Larrey.
  • The specialisation of the workforce. The police have a very specialised workforce: General duties, traffic, homicide, fraud…certain cops target certain crime. Paramedicine should (and is) heading int he same direction: Paramedic Practitioners for minor issues that can bypass the A&E department, Critical Care Paramedics for very serious cases.
  • Apparently providing Ambulance Services in the United Kingdom costs 2 billion Pounds annually (surprising actually, since London’s Metropolitan Police alone have an annual budget of 3.5 billion Pounds. Compared to the 282 million Pound London Ambulance annual budget).
  • Then a great point: “Paramedics as a disruptive technology“. Adapted from the business world, the point was made how Paramedicine is influencing healthcare, changing the way care is delivered (e.g. via Paramedic Practitioners), together with potential ways Paramedicine may influence the provision of healthcare in the future.
  • Another video, this time from a cardiac arrest in London from the early 1980’s. Horrible grey uniforms, ghastly hairstyle, but the intubation was spot on (unfortunately nobody cared about chest compressions…). Nothing how an arrest is run in 2012, thirty years later.
After lunch, there were two more presentations; Sudden Arrhythmic Death, and Obstetric emergencies.

In other words: Quite a good event. Interesting speakers, decent venue, and a good attendance. Can’t ask for much more! For those who would like an online summary, I did tweet most of the event under the #ParaUKCPD hashtag on twitter (should be visible on my timeline, dated 19th October).

Couldn’t make it? I will be visiting the Emergency Services Show in Coventry on the 21st and 22nd of November, tweeting and blogging again. Hope to see you there!

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:
Untitled

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.
Untitled

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!

Untitled

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.