The Woodward News

September 11, 2012

Behind the scenes with EMS

“When you’re in EMS, EMS is your life”

Rowynn Ricks
Woodward News

Woodward, Okla. — We've all seen an ambulance, with lights flashing and sirens blaring, racing toward some emergency.  (Hopefully after we've stopped and pulled over to the side of the road to let the ambulance pass by safely.)

But have you ever wondered what those medics do when they aren't responding to an emergency?

Recently The News got a behind the scenes look at life as a medic during a recent ride along with a Woodward County EMS crew.

During our 24-Hours in Northwest Oklahoma project on Aug. 31, I spent 4 hours with ambulance partners Marty Graham and Tiffany Smith.

Graham, a paramedic, has 15 years of experience, while Smith, an EMT-basic, is relatively new to the field after only one year on the job.

Both Smith and Graham said it takes a certain kind of person to be a medic.

Part of that is because of the sheer time commitment involved with first training to become and then working as a medic.

"When you're in EMS, EMS is your life," Smith said.

She should know because not only does she currently work full time as a medic, but she is also going to school on Mondays and Wednesdays to earn her paramedic certification.

"So in my down time, I'm usually doing homework," she said, noting that between attending class and studying, "it's like having another full-time job."

Her schedule is about to become even more hectic, because "I'm getting ready to do clinical hours," Smith said.

This includes 100 hours of work in an emergency room, 32 hours in a critical care unit, 16 hours in an operating room, 16 hours in labor and delivery, 24 hours in pediatrics, 8 hours in medical direction, 16 hours in psychiatric care, and another 180 hours in EMS and EMS internship, she said.

That's all in addition to her work duty.

Graham's life also still revolves around EMS even when he isn't on duty with an ambulance crew.  That's because Graham was recently promoted to EMS dispatch supervisor.

"So he's up there in our dispatch center during his down time," Smith said.

Woodward County EMS medics work 24-hour shifts from 8 a.m. to 8 a.m.  And when their shift is over, a crew is then on "recall" duty for the next 24-hours.

When on recall, a crew can go home but must be prepared to be called at any time to come into the ambulance base within 15 minutes.  Smith and Graham said they could be recalled anytime the current duty shift crew has to leave town, whether it's for a transport to Enid or Oklahoma City or if for an accident somewhere in the county.

The purpose of recall is to ensure that there is always a crew available in town to cover any other emergencies that might arise.  However, for Smith and Graham, it means that you are essentially on-duty for 48 hours at a time.

"You don't plan anything when you're on recall," Smith said.  "Because the minute you start a nice dinner, you'll get called in."

After the recall shift is over, the crew will get 2 days off.  But that's only as long as there isn't multiple emergencies that mean calling in more crews beyond the recall shift.

"It's not unfrequent that we have to call off duty medics to be ready to come in when we have lots of things happening at once," Graham said.  "Recently we had to have a 4th crew come in because we had 2 crews out on transfers, another one in Mooreland on an emergency call, so the 4th was in to cover the town.  We had a 5th crew on reserve in case the 4th got called out as well."

However, not every day is that busy, as was the case on Aug. 31, when the crew only had about 3 calls for the whole day.

But even just a few calls can involve a lot of work.

"Each call we go on takes about an hour on average.  Between responding to the scene, getting the patient packaged and into the ambulance, then transported to and unloaded at the hospital, it takes an hour at least before we can get back to base," Graham said.

"Then after each call, we have run reports that we have to complete, which takes another hour after the call for every patient we had to transport," Smith said.

That's because the report is very detailed as it covers everything that was done to treat each patient while they were in the ambulance crew's care, she said.

If any medications were used, then there's additional paperwork that must be completed, she said.

In addition, after each call there are certain tasks that must be done to prepare the ambulance for the next call.  For example, fresh linens must be placed on the gurney and any supplies that were used on the call must be restocked.

When it comes to stocking the ambulance, Graham said, "we have to have two of everything."

"Because Murphy's Law is always in effect so that anything that can go wrong will go wrong," he said.

We came across just one small example while Graham was showing me a laryngoscope, which is an instrument used for inserting a breathing tube into someone who may be having difficulty breathing.

The flashlight on the laryngoscope, which helps to light the inside of the throat as the instrument is inserted, was not working properly because the batteries inside the instrument were almost dead.  Smith quickly replaced them with fresh batteries and the instrument was ready for use again.

However, the incident showed how important it is for the crew to not only restock supplies after each call, but to also make routine equipment checks to see that everything is working properly and replace batteries as needed.

While batteries are checked pretty much on a monthly basis, other things are checked and restocked more frequently.  For example, the crews exchange empty oxygen tanks for freshly-filled tanks about once a week to make sure there is always an adequate oxygen supply on hand in the ambulance.

Smith said they also have to take routine inventories of the trucks.

"We have one person who's in charge of counting every single alcohol swab, needle, and bandage on every truck," she said.  "And we'll have another person in charge of the drugs and keeping track of those."

Yet another member of the EMS team will be in charge of ambulance maintenance.

And the assignments go beyond the ambulance itself.

"We all have household duties because we basically live here at the base on our shifts," Smith said.  "So we have dishes, vacuuming, laundry."

"We have a person who's in charge of going to Wal-Mart and getting ink and paper for the office, and other things like coffee," she said.  "Coffee is a must-have.  If the coffee pot is off, we've got trouble."