 Saint Barnabas Medical Center Paramedics Pam Trumbull and Jane Noonan receive an emergency call from a senior housing complex in West Orange. There are five local senior housing complexes and Ms. Trumbull, a paramedic for two years, and Ms. Noonan, a seven-year veteran, are frequently called to these facilities.
As they rush to the scene in their emergency vehicle, which is clearly marked with the words ‘Saint Barnabas Paramedics,’ several motorists seem oblivious to the emergency and continue to block their progress. Ms. Trumbell sounds the vehicle’s siren.
At the building complex, the next hurdle is encountered. Although a policeman is waiting for them, the building is locked and they wait briefly for a building manager to appear. Once inside, they speak with the patient, a woman in her late 80s, her family and the Emergency Medical Technicians (EMTs) who arrived first.
The EMTs have checked her blood pressure and report that she is experiencing heaviness in the chest that has not been relieved by her nitroglycerin pills.
Ms. Trumbull has many questions, ranging from if the patient has allergies or any previous surgeries to the name of her private physician.
“On a scale of one to 10, with 10 being the worst you ever felt, how is your pain,” she asks the elderly woman. Behind the patient, who lies on a stretcher, sits a photograph of her and her husband with their hands clasped together. It is a gentle reminder that this woman’s life goes well beyond this moment in time when she lays on an emergency stretcher.
On any given day, these paramedics receive numerous emergency phone calls. On the other end of each phone call received, there is someone in pain, an individual with family and friends who love and need them, a person who requires immediate assistance. Every call is important; every call matters.
At the direction of an emergency medicine physician, the woman is transported to the local Emergency Department by an ambulance service and receives aspirin by mouth, additional nitroglycerin under the tongue, and Lasix® through an intravenous line. One paramedic also draws blood in the ambulance, which will be given to the laboratory upon arrival to detect any changes in cardiac enzymes. Emergency medical care is brought directly to the patient and the treatment she receives increases her chance of survival and recovery.
| “We handle any potentially life-threatening situation,” says Tony Raffino, Assistant Director of the MICU at Saint Barnabas. “Most of our calls are for heart attacks, congestive heart failure and diabetic emergencies, and we have a 70 percent treatment rate of all of the patients who are evaluated by the MICU.”
During an emergency, patients and family members often do not realize the skill level or services that paramedics can provide. While first aid squads, staffed by EMTs, receive 180 hours of training, paramedic training requires a minimum of two years EMT experience, 400 hours of didactic training and over 900 hours of clinical training during an 18 to 24 month period. They must pass a national test, sponsored by the state, which contains written, oral and practical sections. A passing grade of 80 is required in each section.
“Paramedics train in every department in the hospital, including the operating room, catheterization labs and burn unit, because in many cases we are the gatekeepers to the hospital and often the first contact a patient has with Saint Barnabas,” says Ron Jacobs, a member of the MICU for 13 years. “We also train in both the geriatric programs and on the pediatric unit because we need to understand every age group.”
Advanced Care for the Community
While EMTs provide vital basic life support functions, paramedics can offer more advanced care, including insertion of a breathing tube, administration of more than 40 different medications, manual defibrillation, synchronized cardioversion, I.V. therapy, 12-lead EKG, external cardiac pacing, blood collection, needle chest compression and a variety of other lifesaving techniques, all done in coordination with physician communication. In addition to the medical care provided, paramedics also give support to grieving family members and help to coordinate the necessary arrangements in the event of a loss.
“Unlike a hospital setting, paramedics are often giving care in an uncontrolled environment,” explains Mr. Raffino. “It can be 15 degrees outside, pitch black with fog and rain and you find a person on the ground outside as the result of a heart attack or a shooting. No matter what the conditions, we are there to stabilize the patient and assist him or her in getting to the hospital.”
There are seven full-time, paid paramedics at Saint Barnabas, and 35 per diem paramedics who offer 24-hour staffing, seven days a week.
“This is where treatment begins,” says John Brennan, M.D., Vice President for Emergency Services for the Saint Barnabas Health Care System and Director of the Pediatric Emergency Department at the Medical Center. “They are one of the hardest working groups of people I have ever known.” |
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