Testing purposes only

Today was the state practical exam for EMT-B, which means I'm up at 4:00 a.m. and on the road. The test went well; it was a lot less intimidating to do than it was to think about. The way the test works is fairly straightforward; you have four stations, each with one or two sections. If you fail more than two stations or pass all stations, you are sent home without word; if you fail only one, they keep you and have you re-take that station. I was sent home directly, which means I either failed miserably or passed, and since I don't believe I screwed anything up in a major way, I'm guardedly optimistic. I won't know for sure for a few weeks, at which point I'll either be able to re-test or schedule my written exam.

My shift last week was uneventful - no calls. Just a test prep session. I did manage, however, to completely destroy my transmission first thing in the morning to the point where I have to find a new car.

Sorry for a pretty weak post, but I've been up for 12 intense hours. You'd think I'd be used to that kind of thing by now.

White knuckle excitement

For the people who have known me longest, the statement "Oh, I drive an ambulance now" never fails to elicit a laugh. This isn't because anyone thinks I'd be bad at it per se, but because those who know me know that, generally speaking, driving is my least favorite part of modern life by far. When I do drive somewhere, I sit with my seat all the way up, tense on the wheel, and I tend to drive slow enough to guarantee someone will always be tailgating.

While this has kept my record clean as a whistle thus far, these are generally not traits associated with ambulance driving, although we are encouraged not to speed, even with the lights on. It doesn't pay for itself; you'll get there a minute or two faster at best and at worst you flip a top-heavy, incredibly expensive ambulance.

I got my first taste of driving a couple weeks ago. I would liken it to driving a u-Haul full of your stuff. It's incredibly heavy, slow around turns, and very wide. Backing up is an exercise in prayer, since you can't see behind it at all without someone spotting you.

And what's the first call I drive to? The ski resort parking lot on a very, very busy day. There are kids running in all directions, the lot is pure ice, and of course no one is getting out of my way. To top it off, I have to back into a space that is approximately exactly the size of the ambulance and has a wooden fence on either side. I manage to do it with the help of a spotter, knuckles white and nerves shot. I'm glad I'm not this nervous around patients.

It's an odd feeling, sitting behind the wheel of an ambulance. Think of how you feel when you see a set of flashing lights behind you; there's a moment of shock and panic, no matter how calmly you deal with it afterwards. The way in which drivers react can be erratic, and that, coupled with a truck you can't see behind, comes with giant blind spots, and costs about $100,000 without the equipment in it is why I don't think I can pull this job off in a major city.

12:01 a.m. - Finish setting up blog. Turn on radio, go to bed.

4:00 a.m. - I wake up to radio noises. Put on clothing as fast as possible, but not fast enough - I see the ambulance pulling out of the garage as I run in. It was a simple run to the nursing home, and the others were considerate and let me rest. I usually use a pager at night, which makes a loud beeping sound before switching to radio, but they're out of comission, so I used a radio, which apparently doesn't wake me up fast enough. They were called back by dispatch before they even got on scene, though, so I missed absolutely nothing except a coffee run.

6:00 a.m. - Come home and everything's snowed in. Shovel for a couple hours.

Coffee. Tired. 8:00 a.m.

Man in uniform

After a snowstorm, it's always likely that we'll get an increased number of calls for motor vehicle accidents, which is actually a call that so far I haven't seen. However (knock on wood) that hasn't happened yet tonight, even though we've just experienced the worst snow of the season and getting here at all tonight was pretty rough. So far, I've made myself a cup of sleepy time tea and ate a number of delicious cupcakes that our squad president baked.

But as I'm sitting here listening to radio chatter and playing with my penlight, I'm reminded of the times lately that one of the most fundamental things associated with medics - the uniform - has come up. I definitely didn't realize exactly what it meant until I was in one, but uniforms are tricky things. For example, everyone in the squad knows exactly what each patch means and how to tell something like an EMT's level of training with a glance. However, that's not general knowledge among the people who call us, or even necessarily among other members of emergency services. When people see a uniform, they immediately and understandably associate it with all of their concepts of the skills and secret knowledge members of that profession are supposed to have. In our case, that means that by glancing at us, someone will probably assume that we all can do CPR well, shock a person out of cardiac arrest, put in a breathing tube, and perform other procedures. While this may or may not be true in a lot of cases, the important thing is that people don't look at me in the field and see someone who may never have dealt with a broken leg before; they see a trained professional who is there to make everything better, and when you're faced with that, it's a staggering feeling.

For example, I responded to a call for a possible concussion at a sporting event a couple weeks back that, when we arrived on scene, was clearly a minor injury but still definitely worth a trip to the hospital, to be on the safe side. However, the coach wanted us to bring the patient to a hospital much closer to the patient's home, which would have put us out of service for at least an extra hour, as this hospital was much further away from our garage. The coach approached me about this and started asking questions, and I froze up - I didn't know protocols concerning where to bring patients and couldn't answer even a simple question like "what are her options on where to go for treatment?" Luckily, a more experienced EMT with me quickly fielded this, and she ended up going to the hospital closest to us.

Another time, more recently, I was asked by a very worried mother if she could ride with her daughter to the hospital. I managed to think through that one, and immediately answered yes, since I knew this was something we did allow. That was an occasion where the entire family was around one downed member, and they would have all liked to crowd into the back with us. These are the situations where no amount of technical knowledge will answer for even a little bit of experience.

People drowning will latch on to anything they can to pull themselves out - even friends who try to help them. People in emergency situations probably feel and act in much the same way, and they look to a uniform as something they can hold on to for security. Being placed in that role and being able to act responsibly, which means being honest and not just saying that everything is going to be fine, is going to take a while to get used to.

First things first

This blog is about my recent love affair with Emergency Medical Services, or EMS. It's written from the perspective of a student fresh out of an EMT - Basic course hitting the real world for the first time. To give you a further idea of my own perspective, I've just finished school at a tiny liberal arts college, and half of the challenge so far is moving from the well-known comfort of academia, where ideas and actions can be toyed with indefinitely without consequence, to the back of an ambulance, where ideas only matter if they lead to direct, real action, which is anything but inconsequential.

I'm not writing this with the intent of staying anonymous, since I realize how pointless that would be in the modern day. I am, however, compelled to point out that all of the viewpoints expressed here are my own and reflect in no way the views of the EMS profession or my ambulance company. Patient confidentiality is also very important to me, so I will make it a point not to release details that I believe will allow someone to be identified. If you read a post and find something that you think violates this confidentiality, please let me know and I'll immediately remove it.

Finally, I'll try to keep things as understandable as possible for the lay-reader, but a knowledge of the basics of the EMS system is probably necessary to figure out what I'm talking about half the time. For the basics, check out these articles on Wikipedia: EMS, for an overview of the system as a whole, and EMT for a description of EMTs themselves.