Volunteer Ambulance Corps

I tried a new adventure this week: I did a ride-on shift with the Ossining [NY] Volunteer Ambulance Corps. Some background:

I play volleyball with a paramedic at the O.V.A.C., and when I was at IBM I worked with two volunteer Emergency Medical Technicians (EMTs). I’d often said that I admire people who do that sort of thing, devoting their time to helping people. When I told my volleyball teammate that I’d been laid off, she suggested that it might be an opportunity to look at something completely new... like taking EMT or Paramedic training.

The idea struck a spark, but it took a few months for me to get around to setting up a ride-on, where I’d really get to see what they do.

For those who don’t know the difference: EMTs have a relatively brief training period, and are only authorized for basic life support (BLS) tasks: CPR, giving oxygen, splinting, that sort of thing... and, of course, transport. Paramedics have significantly more training, and they can perform advanced life support (ALS) tasks, such as running IVs, giving certain medications, and using the defibrillator. Ossining has two ambulances — one with two EMTs and one with an EMT and a paramedic — and a “fly car” — an SUV that a paramedic goes alone in.

The protocol at Ossining is that whenever possible, either both ambulances or the two-EMT ambulance and the fly car go to a call. That ensures that there’s a paramedic there, so ALS is available. And if the paramedic decides that ALS isn’t necessary, the EMTs take care of the situation and, if necessary, the transport, leaving the paramedic available for the next call.

On my day, we had an extra EMT with us, one who is just finishing his paramedic training. I rode in the “bus” with my paramedic friend and two EMTs.

The shift started at 8 A.M., but it wasn’t until a little before 10 that we got our first call. After that they came pretty steadily, with just short gaps... six calls for us, all told (and a couple of calls we didn’t go to because we were busy — the fly car took those).

The calls varied in scope:

1. A worker felt strange, enough so that the crew called us. The paramedic asked some questions, did some basic exam. Blood pressure high, nothing else obvious. EMTs transported him to the hospital.
2. A woman cut her leg. EMTs cleaned and bandaged it, no transport needed.
3. A man with a history of emphysema complained of shortness of breath. Nothing immediately urgent, so EMTs gave oxygen and transported him.
4. A woman fainted at her workplace. Vitals were normal when we got there, but paramedics gave her a saline IV and we took her to the hospital. Very nice (new) emergency department. Not crowded, not hectic.
5. A woman was in an auto accident, complaining of neck/back pain. No ALS needed, but the other bus was busy, so we transported her.
6. A man thought he was having a heart attack at his workplace. He looked pale and ashen when we arrived, high blood pressure and tachycardia (rapid heartbeat). Paramedics gave him aspirin, nitroglycerin, and saline, monitored him (EKG, BP, oxygen level) in transit — his stats went back to normal.

And that was the day. No traumas, nothing very challenging,[1] but a variety of things that let me see these folks in action.

Two things struck me, in particular. The one I completely expected is that the paramedics and EMTs are well trained, competent, and effective. The area covered is small enough that we were just a few minutes from every call. Everyone knew just what to do, and did it with confidence.

The other thing was less obvious: they have a practiced, easy “bedside manner”. One of the most important parts of what they have to do is to make the patients feel calm, safe, and relaxed. Think about it: you’ve collapsed at work and the ambulance has come for you! You’d have to be agitated, frightened. And the EMT talks with you calmly, the paramedic has a soothing manner with you. It’s OK. We’ll get you to the doctor, and you don’t need to worry. I could see the difference that made.

I’ve asked my volleyball teammate to let me know when the next EMT class is. I’m going to learn to do this, as part of giving back to the world.
 

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[1] I actually felt a little odd at the start of the day, in that I knew that if we didn’t get any calls I’d wind up spending the day watching dumb stuff on TV... but that it was kind of weird to hope that a few people would get sick or injured so that my day would be more interesting.