Second Look

Mar. 1st, 2012 05:53 pm
talonkarrde: (Default)
The life of an EMT (or more actually, EMT-B, with B for Basic) is generally not a glamorous one. We sleep through some quiet shifts (hence the occasional reference that we are Earning Money Sleeping, if we're getting paid) and we get calls on the hour, every hour, for our entire shift on others. When we do get calls, we usually give them oxygen, handle some physical traumas through bandages and splints, and occasionally perform CPR, if it's called for.

That's about it, really — it's part of the reason that medics and more medically trained personnel derisively refer to EMTs as ambulance drivers.

We're not authorized to give medicine or to start IVs, to start; all of that's handled by the paramedics and above. We're there mostly to stabilize and assess, and serve as the medical first line of defense for anyone that might have encountered a medical issue and can't respond to it themselves. Functionally, a lot of the time, we'll show up, assess a patient, and then either drive them to the hospital or stand around awkwardly, waiting for the medics to arrive, with their EKGs and IVs and the things that actually make a medical difference.

Granted, it's not to say that anyone can do it — there is a minimum requirement of at least a hundred classroom hours (and usually more), which is a fairly significant amount. The situations we walk into are often tense for multiple reasons, and there are definitely cases where EMTs make a difference. And, of course, we do actually save lives from time to time, because there are things that the general population can't do (especially under pressure) that we can do, are trained to do, and probably have much more experience in doing.

To be fair, though, CPR doesn't work as often as people might think, given the media's treatment of it as the sort of magic way to bring people back from the dead. But that's probably a story for another time.

One of the biggest ways that we are able to effect change, though, comes from a completely separate — but no less important — responsibility, one that took up an entire chapter in our textbook. You see, in the United States, every single state has a law that designates medical professionals (and many other groups) as having a duty to report child abuse and neglect. As an EMT, we're often the only people that ever even see a child in a case like this, because the abuser will often try and shield them from the medical community — they don't ever take them to the hospital, and we're often called only when the case is fairly severe, and the child legitimately needs some medical care, but even then, the abuser will try and refuse (which they are legally allowed to do, as they are the legal decision-making adult).

But as long as we're called, we're generally able to take a look at the child, and this is where the responsibility comes in. There are some things to look out for, of course, that are fairly obvious — small round burns, from cigarettes, regular patterns, from a hot stove, or a 'glove' like burn, from scalding water. But more discreet are the psychological signs; after being close to hurt children for a while, we get to be pretty good at identifying how they should be reacting and how they shouldn't.

With calls for children, there's always a heightened amount of alertness, a special notice that everyone on the team will casually exchange with each other in a glance or two before we walk in the front door. There's no change on the outside, of course, because anything we do obviously would alert the abuser and that's something that we can't afford, but I could tell you the details of some of the houses I've been in better than my own, even after being there once, for ten minutes. That's what this responsibility means to us.

This is usually where the actual story starts, but unfortunately, that's not something that I can do for this entry; their right to privacy is simply too high for me to say anything, really. After all, these are children, with the rest of their lives ahead of them, and nothing I say should ever go back and haunt them. And of course, in this situation, there is no way to get consent.

All I can say is that my time as an EMT wasn't always glamorous, or even acknowledged by others in the medical community, but I've seen firsthand that it makes a difference. We save lives from time to time, but it never, ever means more than when we can make a correct report, and get a followup from youth services or the police later, and know that we've saved someone from abuse.
talonkarrde: (Default)
Hi drivers!

I'm an EMT, and I ride in and drive an ambulance sometimes, and I wanted to say something today.

From my experience with you guys, I know that most of you are in a bit of a hurry - you might be late to work, or need to go pee really badly, or have some other pressing reason you seem to be dropping bricks on your gas and brakes instead of gently easing them down.

And, well, most cars might be pretty spiffy about getting out of your way, but every once in a while, you see this big, bulky vehicle that doesn't accelerate as fast as you want us to, sometimes. It's probably frustrating to watch us go slower than you in the middle lane, or sometimes even the fast lane, and not seem to understand your high beams or your horn beeps as a sign that we should be pulling over into the slow lane. I realize that this makes you want to cut us off.

For both of our sakes, please don't.

Even though we don't always have our emergency lights on and sirens blazing, we often still have a patient in the back. We do transport people from time to time, even though it's not an 'emergency', and some of these patients we have are only barely stable, so we try and make the ride as smooth as possible. Now, if you've driven on roads, any roads at all, you realize that they are not what we spend the majority of our state and federal budgets on. You may realize, even in your nice sedan with those nice shocks, that the roads are almost always terrible and no matter how slow I'm driving, there will be bumps that are uncomfortable to ride through. This is why we sometimes prefer the middle lane, or even the fast lane, because they tend to be more smooth.

I apologize for getting in your way - but like I said before, please don't cut me off. There are a couple reasons not to.

First and foremost, my vehicle is probably triple the size of your car, and is much more massive. If you remember high school physics, you'll know that I have a lot more momentum than you, which means that if forced to decelerate quickly, there will be a lot more force applied.  If I hit you, I will most likely be able to drive away with a few scratches while you will unfortunately have a twisted piece of metal to send to the salvage yard. As a corollary, because this ambulance is so massive, I can't stop on a dime, even though we try and keep our brakes fresh. If something goes wrong, I am likely to plow into you, even though I will try to avoid it.

You see, there's a lot of paperwork involved, even if it's just a light tap between bumpers, and I hate paperwork.

But here's the kicker: being that I'm in an ambulance, I possibly have a patient in the back, even if I don't have my lights on. Sometimes, they are stable adult humans that are going to dialysis that we chat with. Other times, they are three year old toddlers that are on artificial ventilators, have trach's, and are very precariously stable. They may not be able to sit up and thus can't ride in carseats, and so are instead belted as best we can (not that well) to our stretcher. We watch them carefully and drive very carefully, avoiding potholes and choosing the lane that will give us the smoothest ride, and we go as slow as possible without endangering other motorists.

For a child like that, braking very hard very suddenly is quite possibly going to have adverse effects. As such, it's nothing personal, but if you cut in front of me and then we need to stop suddenly, I will without hesitation rather hit you and have your car's crumple zones - or whatever else - take the majority of the decelerating force than possibly hurting this child by braking too hard.

I don't like paperwork, but I'm sure you understand that I dislike significantly more having anything happen to our patient on my watch. And, of course, I sure you understand equally well that I would hate for you to be even the slightest bit responsible for any of our patients having any issues whatsoever which could result from an accident involving you.

So drive carefully around us, please, and we will continue hoping that you'll never need our services.

Your friendly neighborhood EMT,
-Sean

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talonkarrde: (Default)
Talon

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