I met my crew of two once back from the first call. The woman I already knew because she was one of my class TAs (teaching assistants). The man was new to me, he didn’t speak much. They were getting dressed and readying the truck for calls.

The way an ambulance typically works is this: There is a driver and a tech on each shift. They alternate roles on different shifts. The driver checks engine fluid levels, tire pressure, etc. Anything that has to do with driving the truck and getting everyone from point A to point B is the driver’s responsibility. The tech is responsible for all things patient care. Tech checks supply levels, oxygen tanks, means of extrication on the outside of the truck, etc.

Let’s call the guy Braeden, because I really like that name, and the lady, um, Kimberly, because it makes me happy to put those two names together. Alright, Braeden was the driver this time, meaning that Kim would be the tech. Great! I knew her and she would let me touch the patients. I wasn’t sure what tall, dark and silent over there would let me do.

Kimberly walks me around the truck with her, checking oxygen masks (we needed to grab a few more adult sizes), scoop stretchers and their bags, oxygen level in the oxygen tanks (There are D sized tanks on the stretcher and in the ‘green bag’, as well as 3 back-up D tanks stored in the truck. There is also one main ‘M’ tank that supplies oxygen to the patient when they are within the patient compartment.) We also checked the cab. Kim wiped everything down with disinfectant and took my photo. She gives me instructions and hints about how each call will go, depending on if the patient is ‘sick’, meaning a life threat exists, or ‘not sick’ meaning there is no pressing life threat (although the patient can still be sick by other standards and commonly is. This is just EMT jargon.)

About the patient compartment: When you’re looking into it from the back, where the double doors are, the stretcher/bed is on the left and the bench is on the right. Straight ahead is a clear walking area and eventually the cab of the ambulance. At the head of the stretcher is where the tech sits with really ill patients. Everything an EMT needs for airway management is accessible from that seat. Suction, oxygen, oro- and nasopharyngeal airway adjuncts, and so on. A common mantra is, “If you ain’t got airway, you ain’t got nothing.” Good job patching up that patient’s profusely bleeding bullet wound, too bad he stopped breathing halfway through. As Captain Scarna sarcastically says, with a smirk and a balled fist, “Strong work!” Also on the left wall are compartments with supplies for wound management. On the right side, at the foot of and above  the bench, are supplies like sheets, splinting materials and saline. Nothing used for life-saving situations is on the right because it is far form the tech. Also from the tech seat is computer control of the patient compartment (lights, oxygen, heat and air conditioning) and hands-free communication; the tech wears a headset and the button you push to transmit while you talk has been made into a push pad the tech can engage with their right knee. How cool is that!?

On to the call. We are dispatched for an EDP (emotionally disturbed person/patient). As we head to the call, I sit in the tech seat. Other than the bed, it’s the most comfortable seat in the ambulance. I really have no idea what to expect, dispatch has not given details except that PD (police, EMS loves acronyms, it’s kind of out of control) are on scene.

We find a young adult female sitting down, as well as a young adult male and two PD. The female is our patient. Kim gets the story from PD and we walk the patient into the patient compartment. After an argument with a boyfriend, the girl threatened to hurt herself if he left. Just that statement gets you a ride to the hospital. If the report comes from a credible source, EMTs can not legally leave you alone. You must be transported to an ER and seen. Not only must you go, you will go. If PD has to get involved and restraints are used, you will be transported to the hospital. Capt like to say, “That buys a ride.” The reasoning is, if you kill yourself or attempt to without being transported, that’s on the EMT’s head.

The girl was hostile and had no idea who had called the police. The police, in turn, had called us due to her statement. Questions the patient was asked included: “Have you had thoughts of harming yourself or others? Have you made plans to end your life? Have you made plans to end someone else’s life? Do you see or hear things other people don’t see or hear?” It was so blunt to me, but we’re told not to beat around the bush because the questions have to be asked.

Because the patient was upset and not acutely ill, we did not get a set of vitals on her. We transported to an ER and filled the nurse in on what was happening.

Fun fact: Upon arrival at the ER (emergency room, if you’ve been wondering) we are supposed to transfer care to an acceptable person. Meaning, you can’t dump your patient in the waiting room and go to the next call. Get this: (in Boston) doctors DO NOT count. If you transfer care to a doctor, it’s abandonment! Who knew? The reasoning is that doctors just want to know what’s going on so they can see if they have to be there or not but don’t typically do things that the nurses do to check patients in and start a file. We usually transfer care to the charge nurse (the nurse responsible for the shift). [ A bit about the charge nurse, this person is so BA. They have a few of their own patients, but they also make sure that all the floor nurses have everything they need.  These heroes dictate the schedule, who is admitted to the floor, as well as the complexity level of patients (how sick they are). They are the supervisor/management for the shift. What a huge responsibility. Thank a charge nurse!

After we transferred care, Kimberly finished up the PCR (patient care report), we cleared out of the hospital and indicated that we were ready for another call. On the way out of the ER, I was wearing a high visibility vest, another of my TAs was working and he said, “You look a little too much like an EMT right now? You look official.” Little did I know, that was code for, “You’re only supposed to wear your high viz vest at motor vehicle collisions.” Kimberly explained that once we got into the truck. Needless to say, I took it off.