09 January 2010

REALLY?!?!? You need it when...

Just for the sake of time, I'm not going to go into a lot of detail here. But I've gotta vent and you're reading this....so you're fair game.

When I'm at work during the nights, I don't mind running ALS back-up for the county. Sometimes when things are slow and I'd much rather catch a nap, I really just don't mind doing it. It's just my nature I guess; but some of this stuff has got to stop!

My partner and I were on post in the western part of the county last night when a volunteer squad received a call for a subject experiencing nausea and vomiting. They had a crew available and responded. Knowing that they had a crew and it was, or sounded like, a BLS call; we repositioned and posted at Base 2...a more central location. There we've got some recliners, T.V., facilities and creature comforts.

Now it took us about fifteen minutes to get there and we had just gotten settled in when the volunteers signed enroute to the ER and requested ALS assistance. The com-center set tones for ALS and then contacted our agency for availability. My super contacts me to see if I'm interested, and I figure what the heck; "sure I'll go". We mount up and head up the road about five miles to rendezvous.

I enter their truck with my I.V. stuff in hand and ready to distribute my life saving skills accordingly. Nothing to this. Been sick for the past three days throwing up and denies any drug usage OTC or Rec. Vitals all in normal parameters. I.V. established and a 250cc bolus for good measure. Life saved, we're good. Right?

We clear up and head back to Base 2 for some shut eye. Just as I've gotten my boots off the same stations tones drop for a cardiac with chest pain. The same crew signs enroute and my partner and I mount up to head in that direction non-emergency.

Now you've got to understand that the way our ALS assist works around here is crazy. We can't call the com-center and tell them we've got a medic truck in the area; we've got to wait until we are requested to respond. I know; stupid, right? It is!!

We've pulled over about a mile from the call location and I get in the back to get my leads loaded, that way I can just grab my monitor, jump on their truck and get a 12-lead. As I'm finishing that, they (the BLS crew) sign enroute to the hospital. I wait and fully anticipate that they will be toning out for ALS at any second.....but they don't. So we go down the road about a mile and pull into a shopping center to wait. Sure enough here they come, lights a flashin' and siren a wailin'. I pull out behind them and follow at a distance. They're running about 60mph and running pretty hard. I figure there must be something going on in there and surly at any minute I'd get a call asking if I was available. Didn't happen. They continue on down the road at warp7 pulling away from me the whole time. Finally, at a point where they're about 3THREE3, that's right; THREE minutes from the ER, the ask for ALS to be toned out.

I get a call asking if I'm available, and I have to say "no".

If they stop and I get on the truck to do ANYTHING besides say "Hi my name is...", that will delay the patient from definitive care at this point. Besides that station is getting ready to drop a call and we'll have to go pick it up. But to my surprise, they pull a crew out of the woodwork and cover it.

I went on to the ER to ask the crew why they waited so long to get the help the patient needed. Their response absolutely floored me.

"We knew you were tired and the last thing you said was that you were going to try and get some sleep". True, I did say that. But, REALLY!! They continue with their sorted explanation saying that the patient had already taken some aspirin and their pain went from an 8/10 to a 6/10 and "was feeling a little better". However, "she was having a little tightness in her chest and we thought she was going to get better by the time we got to the ER, but she wasn't". I shit you not folks...she said this with all sincerity and believed herself when she said it!

Nothing I could do, so I said my piece in only a way that I can and went on my way.

I just don't get it. You call me out, and I don't mind, for a patient who is dehydrated and could have waited until they got to the ER for fluids. But a patient with a cardiac history experiencing pain of 8/10 with "tightness" in her chest....and you wait until you're three minutes from the ER to ask for a medic truck!! One, because you thought is was going to get better. Two, because I said I was tired! REALLY!! C'mon guys...get it together. This is insanity at its finest.

Thanks for listening. Off duty, lights out, we'll do it again at 1900hrs.


  1. Uhhh....uummmmm.....don't volunteer EMS get pretty much the same training you ALS guys do, with the exception of ALS?!? Don't they realize a patient with chest pains (DUH!!!) can go into vfib at any second? Considerate of them to leave you alone if you were tired, but if you're the closest available, shouldn't they have called you back?!?!? For real!!! Keep up the good work! And the next time I'm down there and should I have a medical emergency, screw volunteer! I'm specifically asking for YOU!!!!

  2. I'm not dogging the volunteer system specifically; it's a product of it's own making. But we've got to have some common sence in this business....peoples lives depend on it.

    I have a post that I'm putting together on a call I had a couple nights ago. Minutes could have litterly ment his life.

    Thanks for reading!!!