Lights & Sirens
My daughter is an Emergency Medical Services (EMS) professional. She works with a partner on an ambulance and responds to 911 dispatch calls. I have always held in high esteem those who devote themselves to this kind of work. I confess, however, that until my daughter began in this profession, I barely gave a thought to the stressful, dangerous, and horrific events these real-life superheroes engage in each day.
They are EMTs, Advanced EMTs, and Paramedics. They work for public and private emergency medical response agencies as well as fire departments. They are highly trained and skilled medical professionals, who often risk personal safety to reach people wherever they are, sometimes in their darkest hours, in order to save lives and alleviate suffering. They’re the first and sometimes the last face a patient sees during a traumatic or catastrophic event, such as car accidents, drownings, fires, cardiac arrests and strokes, drug overdoses, suicide attempts, and mass casualty shootings.
Emergency medics are exposed to contagious diseases and viruses; scrape the skin of a homeless person from the burning hot pavement; get kicked, punched, and spit on by intoxicated or psychotic patients.
They witness the excruciating pain of those faced with the sudden and tragic death of a loved one.
They bring routine, discipline, and comfort to chaos. People’s lives depend on their quick reaction and competent care. They treat and stabilize patients in preparation for transport to an appropriate hospital for further medical attention.
There are also the calls for sore throats, headaches, flu symptoms, stubbed toes, and lifting a patient from the floor back into bed. Not everyone knows how to access the healthcare system in lieu of 911.
“The care we provide runs the gamut of life,” shares an EMT of twenty plus years who wishes to remain anonymous. “You can’t imagine this job until you’ve stood in the dark, foul smelling, urine-drenched bedroom of an unresponsive elderly and lonely man – working tirelessly for 15 minutes to revive him. It’s very sad. But when the call comes, no matter the situation, it’s our job to make haste and to make it better – if we can.”
The service these medical first responders provide is invaluable. They carry physical and emotional lives in their hands. It’s one of the most stressful jobs in the country and the pay is not nearly commensurate with the services rendered, the inherent risks, nuisances, crises, and tragic circumstances the psyche must endure.
Thank goodness they do it. But why do they?
Forty-seven-year old Jeff Buchanan, a former paramedic, now serves as Deputy Fire Chief at Clark County Fire Department (CCFD) Station 18. It’s near the Strip and one of the busiest fire stations in the country, dividing services between the two million Las Vegas residents and the forty million annual visitors. Most of their calls are EMS related.
“I was in the hotel industry and didn’t feel fulfilled professionally. I took a fifty percent pay cut, basically, to pursue job satisfaction. I wanted to be a stronger part of the community. I wanted to help people in their time of need,” Buchanan says.
“For the most part, that’s why we all do what we do,” Buchanan continues. “Emergency Medical Technicians (EMT) and Paramedics are often the most selfless, resilient, loyal individuals you will meet, willing to put themselves out there for the well-being of total strangers,” he adds.
Buchanan now serves those who serve. He heads up a team whose mission is to ensure that their “family” of fire fighters are equipped with the best of what is necessary to do their jobs safely and successfully.
The specific responsibilities of EMTs and Paramedics depend on their level of certification.
An EMT has the skills to assess a patient’s condition and manage respiratory, cardiac, and trauma emergencies. An Advanced EMT performs additional medical procedures, such as administering intravenous fluids and some medications. Paramedics can give medications orally and intravenously, interpret electrocardiograms – which monitor heart function – and use other monitors and complex equipment.
While protocols vary from state to state, Buchanan explains that in Las Vegas, all CCFD ambulances have a Paramedic on board and primarily respond to life-threatening calls. They generally do not, however, transport to hospitals. They work in tandem with AMR Ambulance and its sister company, Medic West, who provide the patient transport. AMR and Medic West ambulances have at least one Paramedic on their ALS trucks (Advanced Life Support). EMTs or Advanced EMTs run 911 calls on their ILS trucks (Intermediate Life Support).
Damon Schilling is a former paramedic with AMR now serving as AMR’s Government and Community Affairs Manager. He keeps an eye on healthcare legislation and county and city ordinances as they pertain to the EMS industry as well as overseeing community engagement. While both he and Buchanan espouse the virtues of being an EMS First Responder, they also point out the post-traumatic industry hazards as a result of witnessing the worst moments of a person’s life.
“So many broken, burned, and dead bodies. So many lives ruined or ended,” says Schilling. “It chips away at the spirit, especially if you’re a parent and it involves children. Images that can’t be undone that last for a lifetime. It makes life tough to cope with and can lead to unhealthy consequences – something we aim to avoid at all costs.”
Both agencies have support programs for their employees. AMR/Medic West offers CISM – Critical Incident Stress Management. CCFD offers a Peer Support Team. Each is staffed with EMTs and Paramedics specially trained to support and counsel their peers – in confidence – for as long as it takes to resolve any issues.
Schilling believes in the importance of the public’s help with patient injuries – at the onset of the emergency and until medics can arrive on scene.
“Rather than people recording from their phones what ends up being the demise of a person in an emergency, we would prefer they have the training, and thus confidence, to help save a person’s life,” he says.
AMR offers community education on how to “stop the bleed” and “hands only CPR.”
During October 1, EMS crews were overwhelmed by citizens who wanted to help but were not trained in proper intervention. Following the Sandy Hook shootings, twelve of the student victims could have survived if people knew how to “stop the bleed,”
“It doesn’t have to be a mass shooting. It could be a car accident. Or someone injured up on Mt. Charleston. Lives can be saved if the public is trained to perform CPR and to stop the bleeding enough to keep a patient alive until the professionals can get there to perform further life-saving measures,” Schilling says. He adds that there are Good Samaritan laws to protect people from liability under such circumstances.
“Better to take the time to learn the skill you will hopefully never need, then need the skill you wish you had when needed,” he says.
In addition to life-saving medical training, EMS providers are taught to observe on-site priorities and protocols. Their own safety comes first, then that of their partner, and finally the safety of the patient. “If the medic is injured, they can’t help the patient,” says Schilling.
Medics are taught to analyze each situation for potential threats – and to do so within 30 seconds of arriving on scene: Is there a gun nearby that the patient can reach; is someone coming up from behind who can attack; how many people are in the room; where are the exits and to never get trapped in the back of a room; how to quickly diffuse family members screaming what the medic should be doing; are there pill bottles, alcohol, paraphernalia, or biological contaminants in the room; do they need back-up from police or biohazard units?
“You can’t get tunnel vision. If you do, you’ve lost,” say Schilling. “Often a patient is circling the drain. You must have a clear and calm mind to quickly assess in order to provide appropriate, valuable, and definitive care, while maintaining a safe environment.
“And, it’s key to gain the patient’s trust by saying something like, ‘Look at me…if I’m not panicking, you don’t have to panic.’”
Response time is critical in emergency situations, but so is driving safely. Nevada law prescribes driving with due regard during lights and sirens — which essentially means use common sense given the surrounding road conditions. AMR imposes additional regulations that include maintaining the left travel lane, giving civilian drivers an opportunity to pull-over to the right, and, when appropriate, ambulance drivers may not exceed 10 miles per hour over the posted speed limit on any roadway.
Schilling describes the typical emergency medic as having a Type A personality, extremely compassionate, self-motivated to keep current with industry advancements, a capacity for human kindness, and possessing an analytical mind. Buchanan adds to that a great sense of humor — even if dark at times.
“EMTs and Paramedics are some of the funniest people you will ever meet,” says Buchanan. “Humor is a natural and necessary mechanism to help cope.”
I will never take this extraordinary group of real-life superheroes for granted again — no one should. They are some of the hardest working members of our community, often working at their own peril, on behalf of the well-being of others.
I am proud of my daughter for the career choice she has made. I thank her, and all first responders, for their selfless service to the community.
They don’t do it for the recognition, but you might want to express your appreciation when you see them about in the community. It’s the least we can do. They deserve it, and then some.
Paramedics triage shooting victims and transport them to local hospitals.
EMT Ariel Wexler, daughter of writer, Lynn Wexler.