Riding in vans with paramedics, part three

Read the first article in this series here.

A car accident is reported on the outskirts of Urbana, involving two vehicles. No serious injuries, but five people are involved, so we head over to see if we’re needed.

We get to the scene, and it looks like someone going north turned left on yellow while someone going south went straight on yellow. Then physics happened, resulting in two pretty smashed up cars in the middle of the intersection. But medics don’t have to figure out who’s lying about where they were and what they were doing when the light turned yellow. They only need to worry about who they can help feel better.

The driver is hyperventilating with some minor friction burns; everyone else seems fine. Ralph Nader and his airbags, pain in the butt though they may be, just saved five more lives. After a few minutes, the driver is doing well enough to switch from oxygen to cigarettes, despite Dave’s gentle suggestion that maybe she should wait a little bit on that. She says she wasn’t supposed to leave Fisher tonight anyway and her mom is going to kill her. Maybe so, but the accident didn’t. She signs some papers saying she doesn’t want to go the hospital.

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It’s now about 11:00 p.m. Dave is hungry for dinner, but Leann already ate. Before going back to the “corner” to wait for our next call, Dave and I decide to get some Chinese food. We swing by Campustown on the way. It’s really hopping, lots of people milling about, a few stumbling along, but not 9-1-1-I-need-a-medic-level stumbling.

Leann gets off work tonight at 1:00 a.m., so in a couple hours we’ll drop her off and pick up Tommy, another EMT-Basic. Both Leann and Tommy worked the day shift today, 7:00 a.m. to 7:00 p.m., but there was a shortage tonight, so Leann is working straight through, and Tommy went home to get some sleep before coming back in to work the second half of the shift.  They aren’t necessarily excited about it, but they get overtime pay, which is sorely needed.

We decide on a six-minute Chinese place, where they guarantee food in six minutes or less, a good choice when emergencies lurk. Leann stays in the unit while Dave and I go in. We find that the six-minute guarantee actually refers to the time it takes for the guy to get off the phone before taking our orders. We also find that the fried rice and hot and sour soup that they used to give as part of the meal now costs extra. Dave haggles to no effect. Then the guy gives us each a free soda. We aren’t sure why, but we’ll take what we can get.

“Definitely the pay is one of the few negatives about this job,” Dave says, while we wait for our food.

An EMT-Basic in Champaign County makes about $9-10/hour. An EMT-Paramedic starts around $12-13/hour, and the top pay, even with 25+ years of experience, is around $20/hour. Wages are similar at PRO and Arrow, while one or two ambulance services in East Central Illinois pay a bit more, but most others pay significantly less. Given that a nurse fresh out of a two-year nursing program can make $23-25/hour to start in this area, it isn’t surprising that many qualified paramedics are lost to nursing or firefighting. The invisible hand of the market and all.

“In most cities in Illinois and around the country, career EMTs and paramedics are part of the city fire department and are members of the firefighter’s union, so they’re making $50, 60, 70K to start,” says Dave. “But here locally, paramedics are on private ambulance wages, without a union. The thing is, it’s unusual for private ambulance services to take 9-1-1 calls. Often they just do hospital and nursing home transfers. So our wages reflect private standards, even though we do full medical emergencies.”

Dave loves being a paramedic. But with four kids at home and few advancement options within EMS, he’s decided to start nursing school next fall.

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A half an hour later, we are once again sitting in parking lot D-9, polishing off our terrifically mediocre dinner. A call goes out up near Rantoul for someone with vaginal bleeding that won’t stop, a call that I am very glad we don’t have to take. The PRO unit up there already will take her to Provena or Carle (or perhaps even to Gibson City Hospital), so we’ll need to drive up north to maintain coverage. Dave hopes to make a quick gas station bathroom stop first.

But before we can stop anywhere, the radio emits another high-pitched squeal, making me jump a little in my seat. It’s another call, also near Rantoul. Wait, is this the previous one again? Nope, it’s a different one.

Single-person motorcycle accident. Head injury. Shit. It’s a real-life, all-hail, pray-for-Jesus trauma emergency. And we’re still sixteen-some miles away.

“Buckle up,” says Dave. He flips on the lights and sirens and off we go down University, up Cunningham, Route 45 – 60, 70, then 80 miles per hour. A few cars ahead of us pull over and brake. An annoying number of people do not notice until we are almost behind them, requiring us to slow down. One person freaks out and stops in the middle of the road, eliciting very loud and long air horn blasts plus some family-unfriendly language from Dave.

“Is this normal?” I ask.

“You’d be surprised,” shouts Leann.

“I just want you all to know,” says Dave, “that I still have to pee.”

They get a few more updates over the radio as police officers arrive on scene. Thirty-something male. Possibly intoxicated. Not wearing a helmet. Bleeding from the head. Dave yells back at me, “When we get there, it sounds like we’ll be throwing him on a backboard and heading to Carle as quickly as we can.” 

I gulp and breathe deeply as the ambulance speeds north. Knowing that paramedics deal with trauma and being in the middle of it are suddenly two quite different things. But I buck up. An extra pair of hands might be helpful. Oh, right, gloves! I find a pair, pull them on, and wait for the worst.

From a bend in the road, we see him on the shoulder, writhing around, police circling him, holding him down to keep him from sustaining further neck or back injuries. An officer directs Dave where to park and we jump out (I remember the lights!), Dave and Leann grab the trauma bag, a backboard, the cot, and head over to the motorcyclist.

I hold back, not wanting to get in the way, but also not wanting to get too close. Dave gives two, three, four thick gauze pads to the officer who is trying to stanch the bleeding from the back of Jonathan’s head. There’s a large pool of blood underneath him. The officer reports that his skull feels “spongy” in parts. I sidle up to some bystanders.

“He’s been fighting it the whole time,” says one. I want to look away, but can’t.

“What took you guys so long?” asks another, with a tinge of accusation. “Another ambulance passed right by us.”

That would have been the first Rantoul call. “There was another call right before this one,” I said, trying not to sound defensive. “They were already on their way to the hospital with their patient. We came all the way from Urbana.” Jonathon not only made some bad choices tonight, he also appears to have bad timing.

He’s fighting, but we don’t know whether it’s the alcohol or a head injury. He’s now on a backboard with a collar around his neck to protect his spine, but he’s moving so much that the collar is useless. He’s in the ambulance, with Dave and Leann working on IVs and vital signs, an officer holding him down, and another officer driving. I am drafted into civilian pre-basic EMT services and hold the gauze to his head, while trying and failing to keep his head immobile. Dave and Leann work efficiently, talking both forcefully and gently to Jonathon, trying to keep him awake without aggravating him. They cut away at his leather jacket and jeans, looking for injuries. Jonathan, in a lucid moment, tells us his name and where he’s from, but quickly goes back to swinging his limbs around and growling incoherently.

As we pull into the ER bay at Carle, Leann hands me the bag of IV fluids, and I rush inside with everyone else, still nicely dressed but now with bloody surgical gloves. Ten to fifteen nurses, doctors, anesthesiologists, and whoevers form a gauntlet to the operating room, where we wheel in Jonathon. I hand over the fluid bag to someone and step clear of the action.

Dave speaks loudly and clearly to the team: what happened, where the known injuries are, what they’ve done so far. Jonathon is still fighting and grabs a big burly male nurse, who grabs him back and yells at him. “DO NOT GRAB ME! UNDERSTAND? DO YOU UNDERSTAND?” This is surprisingly effective, and Jonathon finally lies quiet. He still knows his name; that’s a good sign. The hospital staff takes over then, turning his body, stripping him down, putting him under.

Only after I calm down a little do I get the vibe of the room: annoyance, maybe a tinge of disgust. Is it the alcohol? The fighting? The lack of a helmet? Understandable I suppose, but it’s my first time rushing into an emergency room like this, the first time holding a man’s bleeding head during an emergency. I hope he’s OK, even though the helmet and the alcohol do annoy me later.

After the trauma team takes over, Dave and Leann take a moment to exhale in the hallway and begin their next task of wiping off the blood and changing the linens on their cot. They chat with the officers who rode down with us. They’d been on scene dealing with Jonathan, the blood, and the uncertainty for over ten minutes before we got there, with limited medical supplies. Dave and Leann thank them over and over for their tremendous help throughout the call.

Then the trauma surgeon comes out to the hallway for something, see us and calls down “Hey great job tonight everyone. You did well.”

Dave smiles. Later, he remarks that when the EMTs rush a patient into the ER, they are typically among the lowest paid people in the room (second only to the hospital techs). Sometimes it’s enough to simply get a thank you from someone who appreciates a job well done. So respect from a trauma surgeon is a pretty big deal.

It makes their next set of tasks just a little bit easier: they still have to clean pools of blood from the back of the ambulance, wipe down and sterilize all surfaces, and get the unit ready for the next call.

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Next Up: “Tuesday” the amateur drunk