Copyright 2006 Marin Independent Journal, a MediaNews Group publication
All Rights Reserved
Dr. Tom Gross
Marin Independent Journal (California)
Late one evening, we received a call from our dispatch that a woman was having difficulty breathing. Our engine arrived at her house first, followed only a few minutes later by our ambulance, which had been en route from a different location. We had only recently been at the scene of a motor vehicle accident and had not changed out of our heavy protective gear, known as “turnouts.”
We knocked at the woman’s door, and were shown in by her daughter. They were both surprised that the fire department had shown up.
“I called for some medical assistance,” she exclaimed. “I didn’t know that the fire department would come also.”
When I was a child, emergency medical response was performed by volunteer rescue squads, trained in first-aid. With time, many of these squads became incorporated into the local fire departments. At the same time, medical training for field providers became standardized with the Department of Transportation Emergency Medical Technician curriculum and later with advanced training for paramedics.
In some areas, medical response is provided by private companies. In many other areas, this service is provided by paramedics and emergency medical technicians who are also firefighters. Regardless of whether the service is provided by a private provider or a public agency, the quality of care is monitored by state and county EMS agencies. If you dial 911 in Marin County and report a medical emergency, your local fire department will respond. In fact, our calls for emergency medical service now outnumber our calls for fire suppression.
The American College of Emergency Physicians, or ACEP, has designated the week of May 14-20 as EMS week. This week is a time to remember that not all medical care takes place in a warm and well-lighted hospital. Emergency care often starts in a patient’s house or at their work. It often starts on a sidewalk, in the crumbled remains of a small automobile or down a muddy embankment in the rain. An ACEP press release describes EMS as “responsive to all kinds of medical emergencies despite weather conditions or hazards.”
EMS is a system, an Emergency Medical System, made up of dispatchers and administrators, firefighters and paramedics, and physicians and nurses, whose purpose is to provide emergency care to anyone who calls. When you have been in a motor vehicle accident, we rush to your location to get you safely out of your vehicle and to the hospital.
We have established agreements among the various medical providers in the county so that the patient experiences a seamless transition from a crumbled car in a ditch to definitive medical care at the hands of trauma experts. We have even conducted drills with the local hospitals to see if we can discover ways to improve the transition of care from the field providers to the hospital.
When you hear us coming up behind you, red lights flashing and sirens blaring, we may be enroute to a fire, to the site of a hazardous materials spill, to a motor vehicle accident or to the home of someone having a medical emergency.
In order to help us get through safely, please slowly pull to the right, in accordance with the vehicle code. Do not pull left. If you are stopped, such as at a traffic light, please stay still. Expect that, if there is room, we will move cautiously past you on your left. Once we go by, do not pull out again until you have checked to see if there is another emergency vehicle coming along behind.
As our patient discovered the other night, we tend to travel in large groups.
Dr. Tom Gross is the emergency medical services director for the Novato Fire Protection District.