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I am a trained volunteer Emergency Care Attendant (ECA) for my work. That is basically one step bellow an EMT. I am trained in triage and prehospital emergency medical care. In that capacity I respond to medical problems at work before EMS arrives. In some cases they call me before EMS to triage the patient and determine if they need an ambulance or just need to go to an urgent care or see their primary care physician.

So the other day I got a page saying that somebody had a severe migraine and a history of heart problems. The first thing that comes to mind is a stroke. I haul my butt over with my big red medical backpack. The lady was not doing well. Her speech was unintelligible. She was unsteady on her feet and almost fell over sideways when I tried to check for arm drift (a stroke sign). She had been unable to even swallow her migraine medicine. When I had her squeeze my hands she felt weaker on her right side. At that point I am convinced that she likely is having a stroke and EMS is dispatched.

Within just a couple minutes the fire fighters arrive. There are four of them on a fire truck. They got there so quick I couldn’t even finish taking vitals. I never knew how hard it is to get a blood pressure on somebody retching. Anyways they take over and then two paramedics arrive and start going to work. From that point on I was pretty much cut out of the loop because I passed on what I knew and they were higher level of EMS credentials so it was their scene.

What I wanted to bring up her is that for one patient we have a first responder, 4 fire fighters with a fire truck and 2 paramedics with an ambulance. That is a lot of people. This is a reason that ambulance rides are so expensive.

Though I don’t really want to criticize it because it is needed sometimes. I can arrive extremely quick because I work there so I can get some eyes on the ground and early intervention. Fire fighters usually can arrive before the ambulance and they are fully trained EMT-B in Austin. That allows quicker delivery of critical care. The paramedics have much better training and equipment but they take longer to get there. They all serve a role.

Also you may say that 7 people is too much and you might be right. But if a patient goes into cardiac arrest I am familiar with what we call pit crew CPR. Basically we can crowd 5 people around one patient all of us with specific roles and responsibilities in order to treat the patient. To be honest if me or somebody I love cardiac arrests I want a full pit crew there so that treatment can be delivered quickly and efficiently. In other cases a lot of extra hands are good, I have patients that are so heavy it requires 4 fire fighters plus the paramedics to move on to a stretcher.

We have a very excellent emergency medical system in the US. But I doubt most people realize the resources mobilized by calling an ambulance. Though most people know that an ambulance ride comes with a huge medical bill. I don’t want to get into the financial cost benefit analysis of this system because I don’t have enough knowledge about that. I just want people to be aware of what goes into an EMS response and that sending that many people is not always a waste. But you pay for what you get and in the US you get world class EMS.

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