Some people excel at everything they do, some are great at a lot of things and then there are the rest of us; people who are great at one or two things and struggle with the rest. It is what makes the world work, if we all were great at everything we wouldnâ€™t need each other now would we? But as great as it would be to not need anybody, it wouldnâ€™t be so nice to not be needed.
I am an EMS officer working in a busy fire department. I need good EMTâ€™s with me on medical calls. I donâ€™t need great ones, but if they are great, thatâ€™s great, but good will do. I was a good firefighter working with great firefighters when after ten years I made the decision that my talents were better utilized in our EMS division. I left my position as firefighter at Engine Co. 9 in the cityâ€™s east side and transferred to Rescue Co. 1 in South Providence. It was there that I showed that though I loved Engine and Ladder Company work, my forte was EMS.
I could still keep up with the firefighters I had been working with for ten years; I just wore a different hat. I took a lot of heat for becoming, as people assigned to EMS in Providence are called, a â€œRescue Blow,â€ but I was comfortable with my decision, and as time progressed it turned out to be the right one for me.
A big reason I made the move was because the firefighters I worked with were simply bad EMTâ€™s. It wasnâ€™t lack of skill or training. The problem was with the firehouse culture. Most people believed that EMS was a secondary role of the fire service, and though necessary not all that important. The firefighters went through the motions of EMS reluctantly, never embracing what could be enormously gratifying responses and simply showed up and did the bare minimum until â€œ the EMTâ€™sâ€ got there.
It is taking a lot of time, but that culture is changing. Some traditions die hard, and the firefighterâ€™s reticence to embrace the role of EMT is one of them. But traditions do emerge, and slowly the very definition of a firefighter is beginning to include EMS with all the rest. The publicâ€™s perception of a firefighter now includes the people who arrive before the EMTâ€™s, and stop the bleeding, or shock the heart, or deliver the medication that gets people breathing again, be it an allergic reaction or an overdose.
Now, if we can get the firefighters to embrace their emerging image, everything will fall into place. In the meantime, here are a few things for the reluctant firefighter to consider while waiting for the EMTâ€™s.
– Scene size-up isnâ€™t just for fires
Just like a fire scene, a good scene size up is imperative, and should be instinctual. Headaches could be linked to CO poisoning, injuries from seizures could be prevented by making patients aware of potential hazards, and injured children may be being abused. By being observant on scene and staying engaged on the call much more than just medical aid is rendered, Sometimes, through simple observation causes of illness and injury and subsequent treatment can be vastly improved. Best of all, you donâ€™t even have to touch anybody.
– A good patient assessment is better than no patient assessment
The EMS officer en route to the scene is not looking to cure cancer or the common cold, or to diagnose strange diseases, we just want a good set of vitals. Blood pressure. Heart rate. Respirations. Blood glucose if appropriate and you have the equipment. Plus, getting vital signs forces you to connect with the patient, thus becoming more present on scene and an overall a more satisfactory experience will ensue for both the firefighter and the patient, and almost as important; the patientâ€™s loved ones. Waiting for the EMTâ€™s is a waste of everybodyâ€™s time. After all, you ARE THE EMTâ€S!
– Patients at ease have a better chance of getting better
Setting the stage is up to you, the entire job can go well, or go downhill. First impressions mean a lot to patients. You have been invited into their home during a stressful time; be respectful, ask questions but donâ€™t interrogate. Donâ€™t expect everything to be clean and orderly, people live the way they live, itâ€™s just the way it is. Be a pro, everybody benefits.
– A clear means of egress makes life easier for everybody, especially the EMS Officer
Chances are the patient will be leaving his or her home, and we will be doing the moving. Instead of standing around, think about the job at hand, what will make the moving easier? Table in the way? Move it! Boxes in the stairway? Move them! People in the way? Get them out of the way!
– Carrying people makes you big and strong and better firefighters!
The most important thing a firefighter can do on an EMS call is to never, ever let the EMS officer carry a patient. And every now and then it wouldnâ€™t hurt to give his a partner a break too!
By working together everybody benefits. After all, we truly are all in this together, even the patient, without whom there would be no need for any of us.
EMS1 editied my article. Sometimes being edited is great, sometimes not so great. (I never said I was a great EMS Officer. I may have thought it, just never started an article with that thought!)
Here’s the published version: