When I was but a wee little lad, well, 17 years old, I had the opportunity to take the EMT class offered in my little rural county of NJ. As part of taking my EMT, I was taught some very very important rules, one of which was the simply, and yet undeniable truth that as an EMT, it is critical that:
"You never upset the dispatcher, they get to tell you where to go, and can be your best friend, or your worst enemy. Whatever you do, never, ever, EVER, piss off the dispatcher."
I can say, from experience that dispatchers do in fact have an extremely difficult and stressful job. While working for the ambulance corporation after I graduated college, I had the opportunity to dispatch for several shifts. Probably the most stressful day I've ever had at work was the day that I sat behind the dispatching screen and had to make sure my trucks got to the right place, on time, and picked up the right people.
Unfortunately, as much as that rule may be critically important when it comes to dealing with dispatchers, I am about to break it, well, maybe just bend it. I hope that my dispatcher readers will forgive me.
August, I think 2007, although it might have been 2006, I'm not sure. The squad is in the middle of fair week, which is basically 10 days of at least 14 hour days (often longer.) The fair shut down relatively early this evening, and the ambulances returning to the station make a small convoy. Just as I reach the station parking lot, the tones sound, and send us on a run. The run was dispatched as a suicidal female, which a leg injury. (pay attention, this is going to be important later.)
Because of the scattered nature of duty crews during the fair, the crew for the evening is scattered around the four winds. (Translation: we aren't sure where they are.) One of them was in the mini-convoy of ambulances, so she's in the parking lot ready to head to the run. I offer to ride along with her, so the crew is complete. Just as we're getting ready to put the rig in service, actual crew member 2 pulls in. I offer to bail, but they decline. In service we go.
Half way to the job, we get a radio call that the 3rd actual member of the crew will meet us half-way there. Again I offer to jump out, and drive his truck back to the station, but the offer is declined. We continue onto the job, and arrive on location at the same time the first responders from the local fire department arrive on scene. The state troopers are already on location. This shouldn't be too bad.
Grab the gear, say hello to the first responders, walk to door, knock.
No answer.
Knock on door.
No answer.
Knock on door.
"Hey guys, over here," says the state trooper from the side of the house.
Walk around the back of the house to find the following scene: One trooper walking in front of us, one trooper in the back yard (flashlight in elbow, off), a middle aged couple is standing in the back yard, probably about 25 feet from the back wall.
"Hey troop, what's going on?"
"She was drinking, got emotional, and either jumped, or slipped off the deck."
"OK"
As we walk up, the crew heads towards the middle aged lady standing in the backyard. As a general rule, she seems to be alert and oriented, knows what's going on. Doesn't seem emotionally upset, etc.
As we approach, we're discussing if our patient needs to be
backboarded. She fell, which calls for it, but she's up and walking around, which probably means that any damage that might have happened would have happened already. We decide that just as a precaution, looking at the deck, we're going to go ahead and backboard here for transport.
I approach the middle aged man, whom I presume is the husband of the patient, and attempt to gather information. I think the trooper overheard me start asking questions about the man's wife, and realized my mistake.
"That's not her, she's over there."
Turn around to see one of the troopers had turned his flashlight on, and is pointing it at the ground almost underneath the deck, where a young lady (late teens, early 20's) is laying on the ground.
"Oh,
ok," we
repond. Only, as we approach the patient, it quickly becomes evident that in fact, she is NOT
ok, and the situation is NOT
ok. Patient is responsive, but only to extremely loud, or painful stimuli. She smells like alcohol, won't answer questions appropriately, and is generally combative.
Take a quick look at the deck, and realize that it's at least 20 ft off the ground, which makes the mechanism of injury significant, which translates to a recommended
ALS response, and a consideration of transport to the trauma center. The semi-
conscous nature also calls for
ALS, and a possible trauma center, because we can't tell if it's alcohol, or a fall that is causing her to be semi-conscious and combative.
I run back to the rig, call dispatch and have them start
ALS, and put the helicopter on standby. Run back and check on the crew, and ask K if he wants the patient to fly. We're not sure we need to, but the trauma center is a good 45 minutes from where we are standing, and we're not sure we're going to get a medic. At that point, dispatch comes back on the radio and tells us that indeed, we are not getting a medic, as the nigh unit is tied up at the moment, and we'll call our dispatch when they are free.
We make the decision to fly the patient to the trauma center. We package her on the backboard, and as we get ready to move to the rig, for further
eval, and to begin transport, the medic unit signs on the air, looking for an update from our crew (they must have been almost clear at the local ER.)
For whatever reason, my portable radio won't reach the medics, so I call one of them on the phone, and give him the run down on the patient. The medics are understandably questioning how a emotionally disturbed patient with a leg injury has transformed into an
ALS run, but settle down when I explain what's going on. We agree to meet at the landing zone for the helicopter.
We do the transport, and at one point during it, patient stops breathing, and then starts on her own again. We finish the transport, meet the medics, and they do their thing. They aren't sure the patient needs to fly either, but we can't rule it out, so we let the bird continue in.
Ends up the patient is transported to the trauma center, and is treated and released, no permanent damage.
The part of this story to make note of, we were dispatched to an emotionally disturbed patient with a leg injury. Both of those calls are
BLS only. I'll give the dispatcher credit, it was an EDP, and she had a leg injury, but the whole, jumping off a second story deck, and being semi-
consious, that's just a LITTLE important! We walked into a job and got blind sided, which should happen very very rarely!
Make sure the information that you get and pass along is as good as it possibly can be. The little pieces of information are often the most critical and are always the ones that are overlooked! (this holds true for everything, not just EMS.)
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