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Emotional roller coaster: Living the extremes of EMS

Emotional extremes are common in EMS and remind us of exactly why it is that we wear the uniform

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San Francisco Fire Department personnel at the scene of an emergency.

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By Justin Schorr

Paramedics and EMTs are on an emotional roller coaster most days. We can go from delivering a healthy baby to a call where a child was beaten to death. Or vice versa. Emotional extremes are not uncommon, and they can remind us of exactly why it is that we wear the uniform.

Working a recent shift, I was able to experience the most extreme high and extreme low of modern EMS. This wasn‘t the usual thing folks think paramedics deal with. There were no gunshot wounds or dying children. We didn‘t perform a daring rescue high above Main Street or extricate a family from a burning car just before it exploded. No, instead we were treated to the extremes of why people call 911.

An actual emergency
Just before our pesto pasta hit the table at the firehouse, the call came in for CPR in progress. About 50 percent of the time someone is simply trying to exaggerate the situation and the other 49 percent someone is simply asleep. This was the 1 percent.

A woman was found slumped over at her desk by a co-worker. Remembering the community CPR training class, they began compressions and called for an AED. While the 911 dispatcher confirmed compressions were being performed and dispatched us to the call, another co-worker attached the AED and shocked the heart.

No response.

Two minutes later, compressions still going, another shock was delivered to try to jump start the heart.

No response.

Responding from not far away, our first engine was in the door quickly and took over chest compressions and shocked the woman two more times. During all of these interventions, they were able to start an IV and examine the patient‘s airway.

The paramedic was down on his knees near the patient‘s head, looking into her throat with a tool designed to place an airway tube. A smile broke across his face as he reached for the long forceps and buried them almost completely into the patient‘s mouth. A misshapen piece of almost chewed food that resembled a wet towel was removed and set aside.

Less than three minutes later, her heart began to beat again as the oxygen was once again able to reach her lungs.

She went from dead to alive right there in front of her coworkers, her desk and the scattered photos of what appeared to be two grown children and more than a few grandchildren in frames all around the office.

The ambulance arrived and she was as stable as we could make her, all six of us having exhausted every tool we had to save her life. At the hospital, the doctor‘s face contorted as we showed him the food discovered in her throat. Had he been any less experienced, there might have been a gag or a dry heave.

Minutes later, after being rushed out of the room, there we were, half of the team that brought her back, suddenly not looking forward to the cleanup and restocking that lay ahead.

A different kind of emergency
As we were putting the kit back together about 15 minutes later, another call came in for a traumatic injury.

At the scene, a well-dressed, middle-aged man walked towards us. I could still feel the sweat in my t-shirt under my uniform shirt, realizing that I never checked to see if it was clean before taking this call.

His finger hurt.

Sometime in the last few hours, he began to feel a slight throbbing in his finger and wanted to make sure there wasn‘t a more serious problem that needed evaluation.

This is where a less-seasoned crew might have broken down and gotten upset. Less than 30 minutes prior, they were literally breathing life back into a dead body, and now someone might have a boo-boo. It‘s enough to send a flickering of burnout into full flashover. Had I even 10 years ago been experiencing this extreme shift, I likely may have quit on the spot.

The crew sat him down and performed a complete exam. The manner in which they did it was a reminder of why I love working with these professionals. You would never know what they‘d been doing just a few minutes prior. There was no complaining, no sighs, not even a hidden eye roll.

Not once did they try to compare one call for service to the other, or try to make this man feel bad for calling so soon after someone who truly needed their skills and tools.

After the patient signed our refusal of transport after being offered an ambulance, the crew began to gather their gear and head for the door.

“You‘ve been from one extreme to the other haven‘t you?” I asked them, curious to hear their response.

“That‘s why we‘re here. From someone who needed us and didn‘t know it to someone who maybe didn‘t but knows now for sure. I‘ll take that all day long,” he said.

So will I.

Uniform Stories features a variety of contributors. These sources are experts and educators within their profession. Uniform Stories covers an array of subjects like field stories, entertaining anecdotes, and expert opinions.
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