When seconds count, don't count on EMS
Problem is, the need hasn't changed since EMS was invented; people have just become more needy
By Michael Morse
“She can't walk!" shouted somebody from a second-story window as we approached a rear door.
We pushed some trash aside and stepped in, climbed 12 or so steps and walked into the apartment. As soon as we entered, the patient stood up, shouted "get me out of here!" and headed for the door.
The window yeller looked on, then added, "take her to a nursing home, she hasn't changed her clothes in a week!"
She walked into the ambulance, plopped onto the stretcher and waited. I sat in the captain's seat, palms and fingers cradling my head, willing my heart rate to slow down. Once I got control of that, I figured the dizziness would stop. The patient on the stretcher droned on about wanting an IV, wanting a blanket, wanting something, I don't know, I wasn't able to hear her.
We had arrived at her residence at the same time my radio started the transmissions that will last in my head long after I leave the EMS division of The Providence Fire Department:
"Expedite that rescue, CPR in progress."
"Any rescue to clear?"
"Rescue 5, are you available?"
"Negative, on scene with a patient."
"Rescue 3, are you available?"
"Negative, transporting to Rhode Island Hospital."
"Ladder 3 to Fire Alarm, CPR in progress, Police Officer involved."
"Roger Ladder 3, we have mutual aid responding."
"Rescue 6, your status?"
"Transporting to Fatima."
"Any Rescue to clear? Any Rescue to clear?!”
The transmissions continued. My head kept spinning. My patient kept on complaining. She was 50 but looked 70, cigarette smoke embedded in her skin, greasy hair tied back, wary look on her face as if she was used to being cheated.
We had been called to her home at 8:30 in the morning for an elderly female vomiting. The rest of our fleet was catering to what has become business as usual for EMS in an urban setting: Intoxicated males, person down, person tired, person in and out of consciousness, children out of control in the classroom, pysch transport, minor injuries from an assault, people involved in fender benders, no injuries but demanding transport to the ER, person who wanted their blood pressure checked, headaches … and a decorated police officer dead in his cruiser with firefighters doing CPR, waiting 15 minutes for an ALS ambulance from a town 15 miles away.
And my radio went on …
"Ladder 1 with mutual aid, respond to Crossroads for an assault in the lobby…"
"Engine 3, respond to 99 Kennedy Plaza with mutual aid for an intoxicated male…"
"Engine 13, respond with mutual aid to Roger Williams Park for an intoxicated male…"
“Ladder 3, ETA on that rescue?!”
And the voices in my head started …
... and the lady on the stretcher kept on complaining.
... and my head kept on spinning.
... and it hasn't stopped.
I've been banging my head against a wall for years. Nobody listens, nobody cares. A good cop dies while our six ALS ambulances continue to be used as taxis for the homeless and street sweepers for the city.
The powers that be say we need more resources to keep up with the ever-increasing demand for EMS services. Runs are up, numbers are up, need is up.
Problem is, the need hasn't changed since EMS was invented. People have just become more needy. As long as we cater to that, and bill accordingly, the watered-down version of EMS that is eating the people responding to the calls alive will sink under its own weight.