Which way did they go?

Thursday, April 28 2005

In TV-Land the EMS crew wheel you in through the big “Emergency!” doors, and the DOCTORS run over to meet them, (hahaha) and THEN, (hehhaha) the doctors (hmmph ha) listen as report is given (ahHAHA) AND THEN get right to work on that patient! (HAHAHA, oh jeez, stop it!) The Drama Unfolds as the patient is heroically worked…

Well, okay, it could happen that way, somewhere. Say it does, doesn’t matter, as that sidesteps the important questions.

What, you must be wondering, happens to the Ambulance Guys? Let’s see.

Your ambulance crew consisted of at least two people, the driver (rather self-explanatory) and the Lead. Lest I offend my own sensibilities let me point out that the driver is almost always trained to the same level as the Lead, and usually puts on the Lead hat on alternate duty nights, alternate calls, or special situations (burliest EMT might take the violent patient, female EMT the rape patient, etc., regardless of “whose turn” it is to drive.)

To differentiate on-scene, know that the Lead EMT or Paramedic is the person who does most if not all of the talking and note-taking while the driver is taking vitals.

Some situations require more than two hands in “the box”. CPR, for instance, works better with at least two people, in which case a third person is needed to drive. In such a situation a driver is pulled off another piece, e.g. the fire apparatus or second unit which also came to the call.

In Reality Land both the lead EMT and his driver wheel you into the ER room or curtained alcove and help move you from the cot (that gurney thing on wheels) to the ER bed. The driver takes the cot out while the lead remains with the patient to give report to the nurse. Once report is given (and in some jurisdictions a signature must be obtained), the patient is officially “turned over” to the hospital and the lead EMT may leave the patient.

While the patient and lead EMT are in the room, the driver meanwhile has taken the cot out and cleaned it, replaced the linen and restocked any items used in transport. The back of the ambulance has been cleaned, equipment has been cleaned and put away. A conscientious partner will also clean the door handles (both inside and out), steering wheel, gear shift, emergency brake handle, lights-and-sirens switches – anything a bloody glove might have contaminated. Seat belts and buckles. The Whole Shmear.

The nurse arrives, the report is given, the lead EMT bids farewell and buena suerte to the patient.

“But DTs,” you protest, “The work is complete! Yon driver has striven mightily to be-sparkle the bambulance!”

Ah, the work is not yet finished.

In most hospitals, usually just inside the ER, you will if you look find a small room designated the EMT Room, Report Room, EMS Personnel Only – the name doesn’t matter.

Devoid of fancy equipment, lacking airtight doors, rarely equipped with any window or observation port, these rooms are still really decompression chambers. This is the place to which bambulance folk disappear once they’ve given report to the nurse or doctor and placed the patient into the hospitals hands.

These rooms usually boast some form of non-tallow-burning artificial lighting, a relatively flat horizontal surface, and a bewildering variety of second-hand butt slings into which your weary EMT may plop.

A factual report must now be written, in which no turn of flowery phrase is tolerated. “Arrived to find 52 year old male complaining of chest pain 8/10…” is demanded. “It was a dark and stormy night. My medic-sense began to tingle just before the tones dropped…” is frowned upon. Leave out nothing, but include no speculation or diagnosis – “the patient had Quagmire’s Disease” – ‘cuz you don’t know that for sure.

Signatures from all hands on board the bambulance, a copy dropped off with the ER, and your crew is now back in service for the next call.

As Paul Harvey says, “Now you know the rest of the story.”

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