By Michael Morse
It is late, really late. The later it gets, the earlier it gets. You are responding to a homeless shelter for a 30-year-old female complaining of dizziness. You have been here a million times, and are reasonably certain Betty awaits you, belly full of booze, lungs full of crack cocaine, and brain full of years of drug and alcohol abuse.
The women’s dorm is on the third floor, and there is no elevator. The ambulance is responding from the opposite end of the town. You and the crew arrive on scene, and head up the stairs to bring her down.
If this were an alarm of fire on the third floor of the shelter, with reports of a female occupant, a full alarm would be dispatched: four, five, six or more crews heading to the scene; engine companies; ladder companies; a battalion chief; a rescue, if available; a rapid intervention company; command company; and whoever was on the air at the time. The arriving companies would automatically don their packs, grab their assigned tools or lines, and begin the attack.
But this is not a call for a fire. It’s another EMS run.
At the top of the stairs, a hysterical woman leads you to a still form lying on the floor. It’s Betty, and she’s nearly dead. Overdose. Her respirations are down to two a minute, and her pulse is thready. A little naloxone should do the trick…but the Narcan® is down three flights of stairs and in the rear compartment of the truck. The bag valve mask? In the truck too, along with the oxygen and delivery devices.
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By the time one of the firefighters returns with the gear, Betty is pulseless, and you are doing CPR. The ambulance crew arrives, establishes an IV, and delivers 2 milligrams of Narcan, but what good is that when the heart is no longer beating? Your compressions get a little of the medication on board, and she has a rhythm. The ambulance crew uses the gear they brought with them, gets a pulse, administers a little epinephrine, and revives her while you and your crew watch.
You help carry her down the stairs, and she’s back to her usual self by the time the ambulance rolls away. You gather the gear that you had to double back and get, and thank your lucky stars that Betty made it. Nobody wants to live with the knowledge that somebody died because the right equipment was not available when needed.
Complacency kills. Bring the bag, bring the defibrillator, bring the oxygen, and bring it every time. Think of going into a fire without any tools or a charged line. No firefighter worth their salt would even think of such a thing, and no firefighter should arrive on an EMS scene empty handed.
If you are a firefighter, make it your routine to take your assigned equipment, drag it up the stairs, and, 99 percent of the time, drag it back down. If you are an officer, communicate with your crew that you expect them to bring the tools needed to do the job, every time, no exceptions. It is amazing how quickly a good call can go badly. What is even more amazing is how simple it is to avoid a bad call.
Leave it behind and you take chances with somebody’s life. Heavy emotional carnage awaits a firefighter who knows that somebody died who could have lived. Bring it–you will never regret it.
Michael Morse is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.
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