You never know what to expect
When you work as an after-hours emergency
responder, you never know what your next night shift is going to throw at you.
Each 911 call that come in could be anything from a crank call to a major
incident. To uncover more of what goes on after dark, we’ve been speaking with
emergency services personnel from the Midwest about what
their jobs entail.
Today, we’re covering a few examples to
show the sheer variety of 911 calls that these brave individuals receive.
First up is a mother who called 911 after
her child suffered an allergic reaction to something they had eaten. The mother
was quick to spot her child’s red marks and rash, so administered an epi-pen
for three seconds before calling for emergency medical assistance.
Chicago’s firefighters were the first to
arrive on the scene, so we are assessing the patient when the emergency medical
services arrived. The Chicago Bureau of Operations reports that many of its
4,500 paramedics and firefighters are “cross-trained” to enable them to support
each other in this way.
The paramedics phoned medical control during
their assessment of the patient and the hospital asked them to ensure that the
child’s mother had another epi-pen to hand, as epinephrine doesn’t last long. The
team advised the mother of this and warned that child may have another allergic
reaction.
They also confirmed that the mother had
done everything correctly in caring for her child. The mother planned to notify
the child’s pediatrician and take direction from them. As such, the parent signed
a refusal of care document and the emergency services personnel headed back to
base.
A separate 911 call was a report of a
‘person down’ in a Chicago park. Not knowing what the circumstances were or
even whether the individual was breathing, a fire truck with five crew members
and an ambulance with two paramedics rush to the scene.
The emergency services team found the patient
– a man of around 50 years old – leaning over, in a sort of sleeping state. The
paramedics opened his eyes and saw pinpoint pupils, indicating that the man had
taken some type of narcotic. They rushed him to the ambulance, hooked him up to
an IV and placed him on a heart monitor.
The patient heart was beating normally at
first (known as normal sinus rhythm), but then when to sinus tachycardia (a faster
than normal heartrate). His breathing also went from around 18 to around 12.
The paramedics set off for the nearest
hospital and gave the patient 4 mg of Narcan – a medication that blocks the effects
of opioids (and in particular the decreased breathing that occurs during an
overdose). 30 seconds later, the patient woke up.
Once the patient was reoriented, the
paramedics questioned him about whether he had taken any drugs. The patient
denied doing so, saying that all he had had was a hot dog. When the emergency
responders queried whether the hot dog might have had some heroin in it, the
patient declined to comment!
Upon arrival at hospital the patient was
given a room. Staff advised that he had been there several times before for
drug overdoses, with his drug of choice being heroin.
Our third example today demonstrates just
how much paperwork a relatively ‘routine’ (if there is such a thing!) 911 call
can generate.
Emergency services were called to assist an
elderly man who had fallen while getting into bed. His neighbors had called
911 after seeking to check on him and getting no response.
Paramedics arrived on the scene to find the
patient conscious and alert. He had no bruising or bleeding, was not short of
breath, had no chest pain or chest pressure and no signs of stroke. They took
his vital signs (BP 150 over 70, pulse rate 80, respiration 18) and used an EKG
monitor to check his heartrate.
The 4-lead and 12-lead EKGs showed that the
patient had a pacemaker, but the results were otherwise normal. His heartrate
was 90 and his pulse was regular. His respiration was 18, with 92% oxygen
saturation (which means he was getting good air).
Other tests that paramedics carry out in
cases such as this include checking blood sugar (low or high), that eyes open
normally, that verbal responses are normal, that the patient is oriented,
smiles, follows directions and interacts with those around him, and that motor
responses are as expected (i.e. the patient obeys commands and responds
appropriately to stimulation).
At the end of all these tests, the patient
is given a score. The process is based on the Glasgow Coma Scale, which
assesses the impairment of consciousness and which has been used around the
world since it was first described in 1974.
Paramedics also have to run through a
patient’s history, including any allergies or alcohol or drug indicators (none,
for this individual). They also have to note down any language barriers, skin
examination results, neurological function, any abrasions around the head
(none, in this case), any neck distensions (jugular vein distension), the sound
of the patient’s lungs (clear) and whether their pupils are equal and react to
light (they were and did).
In this case, the patient did have some
swelling. The paramedics gave him oxygen and encouraged him to go to the
hospital to get checked out, all the while noting the details in their
narrative of the callout.
The situation shows how incredibly thorough
the emergency medical services are. The patient wasn’t in any pain, but the
team ensured that he was fully checked over and cared for – despite the small
mountain of paperwork that such checks entail!
while this story is inspired by actual persons and events, certain characters, characterizations, incidents, locations and dialogue were fictionalized or invented for purposes of dramatization.
by Will Knight Photography LLC
