To The Rescue: A Matter of Life and Death
AFSCME represents roughly 5,000 EMTs and paramedics in about two dozen locations around the country, including New York City, which boasts about 2,500 emergency rescue personnel who are members of AFSCME.
ALTOONA, PENNSYLVANIA
The alarm cuts like a knife through whatever restful thoughts are on the minds of the paramedics of Altoona Medical Emergency Department (AMED) Station 430.
Duty calls!
Ray Nedimyer, a 15-year veteran of the department and a member of AFSCME Local 3156 (Council 83), quickly joins paramedic and operations manager Jack Seymore in their ambulance.
A 69-year-old woman has fallen at a nearby housing complex for the elderly. Within minutes the paramedics arrive and are led by the apartment manager to the victim’s room, where they find her sitting in her bathroom.
“What’s your past medical history, ma’am?” Nedimyer asks politely as he takes her blood pressure. “It’s 150 over 100,” he says. “You’re in pain?”
“Oh, very bad,” she replies.
But the woman’s injuries are not severe and she opts to forego an ambulance trip to Altoona Hospital — a decision the paramedics first clear with their command physician before they can return to the station.
It has been a typical emergency call in this hilly railroad town, a two-hour drive from Pittsburgh to the west.
Unlike the fictional, burned-out New York City paramedic played by Nicolas Cage in last year’s movie, “Bringing Out the Dead,” Altoona’s 31 union paramedics and emergency medical technicians (EMTs) are eager to hop into their ambulances and rush to the scene, sirens blaring.
It’s “where the action is,” says EMT Robert Seiler, whose classification does not permit him to perform the full range of medical techniques permitted of a paramedic.
“It’s like the all-access pass,” he adds, explaining why he loves his job. “It’s the action, and knowing that your actions are going to make a difference” in whether a patient lives or dies.
A DANGEROUS JOB. AFSCME represents roughly 5,000 EMTs and paramedics in about two dozen locations around the country, including New York City, which boasts about 2,500 emergency rescue personnel who are members of AFSCME.
They face hazards every time they roll out on a call.
“They may risk noise-induced hearing loss from ambulance sirens and back injuries from lifting patients. EMTs may be exposed to diseases such as hepatitis-B and AIDS, as well as violence from drug overdose victims or psychological emergencies,” according to the Bureau of Labor Statistics.
Just trying to get to a patient is dangerous. There were an average of 385 ambulance accidents each year in New York state between 1991 and 1996, according to a study cited by Emergency Medical Services, the Journal of Emergency Care and Transportation.
Two deaths and 707 injuries resulted from the 392 crashes in 1996 alone, the magazine reported.
Nationwide, 141 emergency medical service (EMS) providers who have lost their lives in the line of duty since 1993 have been honored by the National EMS Memorial Service — and more names are being added annually.
“You never really think about it up-front,” Altoona paramedic Mike Estep says of the occupational hazards. “You take the precautions you’re taught to take, but if you let it affect how you treat people, you’re going to mistreat somebody somewhere along the way.”
“You can’t be perfect 100 percent of the time,” adds Estep’s station colleague, paramedic Robert Shirk. “When you get on a critical call, there’s a lot of movement around, and I once accidentally stuck my partner with a dirty needle. ... To this day I still apologize to him.”
“We haven’t had any serious incidents,” says paramedic Rick Guinard, president of Local 3156. “A few needlesticks. But that’s a problem across the health care system.”
They take precautions. “We have the personal protective equipment like gloves, glasses, gowns — whatever we need,” Guinard explains.
Plus, he adds, there is continual training, which is critical not only for the patients but also for the safety of the paramedics and EMTs.
TOUGH CALLS. The morning’s calls this day in early December began with the elderly woman who had fallen, followed by a woman with rectal bleeding, a man with a hemorrhaging nose and a young wheelchair-bound woman whose multitude of aches and pains brought her to tears.
It’s is a typical day for AMED Station 430, but the evening is still young.
While the EMTs and paramedics complete paperwork, perform maintenance chores and wait for the next call, heroin addicts may be overdosing. Weary office workers driving home may be taking foolish risks on the road. A retiree may be having a heart attack.
This is what the paramedics and EMTs of AMED live for, and not much upsets them, they insist. “I’ve seen drownings and I’ve seen shooting [victims], and I’ve seen people decapitated,” declares Estep. “That’s all part of what we do.”
Still, one kind of victim does break through their tough exteriors.
“Children, of course,” says Shirk, a father of three. He recalls a 4-year-old girl who was killed accidentally by her young brother. The boy was jumping on a bed, causing a rifle to discharge.
Everyone in the station, “even myself, shed a tear over that one,” says the 16-year veteran. “It was such a shame.”
Paramedic Bryan Starr, whose younger brother, Matthew, also is a paramedic at AMED, says his worst memory also involves a child’s death — from drowning.
Coming home and looking at the face of his own child made it even harder. “It’s just lying at home and seeing my boy ... and the thought of him just not being there anymore,” he explains. “A 4-year-old hasn’t experienced anything, and they haven’t had a chance to live life.”
PRIVATIZATION CONCERNS. A trained ambulance corps emerged in America during the early 1960s when doctors discovered that cardio-pulmonary resuscitation could restart a human heart.
While fire departments provided most of the early paramedic services, private companies also ran ambulances. But a reputation for inconsistent quality among private services, along with the passage of the federal Emergency Medical Services Act of 1973, helped make local governments the main providers of such services.
But private ambulance services again began making inroads as municipalities experienced budget constraints during the 1980s. Although they didn’t gain a stronghold in Altoona, privatization is a growing concern elsewhere.
Besides the direct threat to the jobs held by publicly employed EMTs and paramedics, privatization endangers public health.
“Our concern is [that providing] medical care to the people of this city should be based upon the needs of the patient, not the profit margin,” says Patrick Bahnken, president of EMTs and Paramedics of New York City Fire Department, AFSCME Local 2507 (DC 37).
“Naturally, when you work for a company that’s motivated by profit, clearly patient care is secondary,” he explains.
For instance, paramedics employed by private companies are “usually lower paid and the personnel they hire are less experienced and less trained,” says Guinard of Local 3156. Also, unlike public services, private ambulance companies screen patients “to make sure they have insurance” before deciding whether to take a call, he adds.
TO THE RESCUE. The man lies face-down on the floor of his unlit apartment, waiting for the paramedics.
By his outstretched hand is a cell phone, his lifeline to the 911 operator. It’s still on.
Flashing red lights from the ambulance bathe the dark street in an eerie glow as paramedic Estep and partner Doug Brown, a part-time EMT and mathematics professor, quickly make their way up the steps to the man’s apartment.
The door is unlocked. Estep and Brown enter and fumble for the light switch.
The alcoholic reek of the man’s apartment gives the paramedics their first clue. They help him to a chair and ask about chest pains. He had called 911 complaining of difficulty breathing.
A pulse-oximeter, which tells how much oxygen saturation is in the blood, is attached to a finger.
“I feel like I’m just going to pass out and die,” the man says. “It’s from the alcohol.”
“Ever taken any medication?” Brown asks.
“Tons of them.”
Brown asks him to gauge his chest pain on a scale of one to 10.
“Sir,” he says groggily, “I don’t know. I know I need something to drink.”
The man remains seated as the paramedics leave him to search his apartment for medications. “Oh, Christ,” he says to himself as his arm visibly shakes. “I can’t go on like this... I don’t want to even... live anymore.”
Taking out and lighting a cigarette, the man reveals he’s a former Vietnam veteran, 52, a widower.
“What’s that in your hand?” asks Estep. “You’re having chest pains and you’re smoking cigarettes?”
“Just a couple of drags,” he pleads, taking a puff.
Walking with a cane, the man is helped into the ambulance. Brown stays in the back with his patient.
“I’m so embarrassed,” the man says. “I’m shaking like hell and I need a drink.”
“This is an alcohol-induced depression-type problem, I believe,” says Estep as he drives to the nearby Veterans Hospital. “Now’s the time of year we get a lot of depression. The majority are suicides.”
“I want to die,” says the man, who sadly adds that his wife had died three years ago, this month.
A sign in lights greets them as they pull into the driveway of the hospital:
“Happy Holidays to All. Peace on Earth.”
By Clyde Weiss
