What EMS providers can learn from Greek Coast Guard documentary

"4.1 miles," an Oscar-nominated documentary short film, shows a single day of rescues of Syrian migrants attempting to cross the sea from Turkey to Greece


"4.1 Miles," an Oscar-nominated documentary short film, shows the magnitude of the Syrian refugee crisis through the at sea rescues made by a Greek Coast Guard captain and his crew. The film, named for the four-mile span of the Greek sea between Turkey and the small Greek island of Lesbos, shows rescues of dozens of Syrian migrants who have risked their lives and likely all of their treasure to attempt the dangerous open water crossing.

Daphne Matziaraki, who created the film for the New York Times Op-Docs, wrote, "I followed a coast guard captain for three weeks as he pulled family after family, child after child, from the ocean and saved their lives. All the ones in this film were shot on a single day, October 28, 2015. Two additional rescues happened that same day but were not included."

Watch the 20-minute film while waiting for your next call or in an EMT class or company training activity. Daphne Matziaraki concludes the film with the grim statistic that 600,000 migrants are believed to have attempted crossing this span in 2015 and 2016. After watching, read my takeaways for EMS providers and add your own in the comments. 

Rescuers do what they know, believe to work

Trained EMS providers will quickly critique and share Matziaraki's surprise that the Greek Coast Guard personnel seemed to lack basic life support skills. Look past rescuers and laypeople providing improper or inadequate care to drowning and hypothermia patients. Instead, consider your role to better inform laypeople in your neighborhood or community in drowning prevention, airway management, hypothermia treatment, rescue breathing and hands-only CPR.

Train for MCI response with an all-hazards approach

MCI preparedness requires an all-hazards approach. In "4.1 Miles," the mechanism of injury for dozens and hundreds of patients is immersion, hypothermia and submersion. Patients don't need pressure dressings or tourniquets, they need removal from a hazardous environment and triage — rapid sorting to identify drowning symptoms like airway compromise and absent or inadequate ventilation.

The film also provides a stark reminder about the importance of not letting patients deteriorate. Once rescued from the scene, rapid evacuation to shore and additional resources is an important task. Just as important, though, is preventing patients from further heat loss while finding and caring for the most severely ill and injured patients.

Keep parents and children together

There is no doubt that allowing mom to ride in the ambulance complicates assessment and care for EMS providers. There is also tremendous opportunity for mom, dad or another caregiver to console an ill child or share important history information during the ride to the hospital.

The frantic screams from parents and children on the deck of the coast guard boat is the rawest animal emotion — a parent separated from its offspring. Think carefully about any formal policy or informal practice that makes it OK for EMS providers to not transport a child with their parent in the same vehicle, especially when that parent or caregiver doesn’t have a method for self-transport to the hospital.

Never underestimate the pull of something better

People who are suffering will take, and have taken for centuries, extraordinary risks for the pull of freedom and from the push of suffering. Before risking everything to cross the Greek Sea, the migrants in "4.1 Miles" escaped Syria and traveled across Turkey. There is not an ocean wide enough, a chasm deep enough or a wall high enough to keep out people who are desperate for something better. 

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