My AEMT class is big. Probably around 40 people in it, if I had to guess. All I know is that we had students perched on window sills during the last class because we were out of chairs–and this isn’t a small room either. And of those 40, I’d say almost a quarter do not work as EMT’s.

Call me ignorant, but I had no idea how hard it was for some people to find work as EMT’s. Apparently I live in a nice, cozy, little bubble of happiness. I had a job secured on the EMS division of the fire department when I was still in First Responder school. The only conditions to my employment were that I became a licensed FR, and that I turned 18 years old. I knew I was lucky, but I didn’t realize just how lucky until this class.

Many of the students in my class are working at Walgreens, or Dunkin Donuts, or Chili’s, or whatever. They haven’t been on a truck in ages. Some haven’t ever worked on a truck. During that first night of class, one by one, we have to stand up and give our name, our hometown, who we work for, and why we want to be in class. Several students said the reason they’re coming to AEMT school is because they can’t find work in EMS as a licensed basic. So they figure an ALS ticket will help them get a job.

For their sakes, I hope they’re right. I worry about my ability to perform as a provider, and I’m on a truck nearly every day. I might just be driving, or it might just be a simple BLS transfer, but at least I’m in my environment. For me, there was a bit of a learning curve between what I learned in EMT class and what I had to do out in the field. I’m not saying that we throw the book out the window when we respond to calls. But there are some things you just don’t learn until you actually do it. Like listening to a blood pressure while bouncing down roads riddled with frost heaves. Like crunching ribs when you do CPR. Like seeing what a truly sick person looks like and remembering what to do.

I’m trying not to sound like I’m judging these EMT’s that can’t find work. If you can’t find work, you can’t find work. I suppose doing this is the most that these EMT’s can do. And who knows, maybe they’re naturals at this. Maybe they can leave for a while, and get back into the swing of things in no time at all. But I worry for them. I hope this works out for them, really. In the meantime, I’m going to try to not take what I have for granted. It seems I’m luckier than I realize.

If you know me out in the real world, you would see that I’m shy, quiet, reserved. It usually takes me a while to warm up to new people. In social situations, I spend a good chunk of time observing, just trying to figure out who’s who and where I fit into the group. I try to get along with everyone, and for the most part, I do that. With very few exceptions, I’m nice and polite even to people I can’t stand. Part of that is because I hate confrontation and strive to avoid it. The other part of it is that I try to be respectful of everyone.

I’d like to illustrate a very important difference between respecting an individual and being respectful towards that individual. Respect is earned. Respect comes when one demonstrates some quality which is another individual finds admirable and oftentimes uncommon. Of course, everyone’s definition of an admirable trait differs slightly. You will respect a person who demonstrates traits you find desirable. That in itself is shaped by who you are and what experiences have made you that way. Some find intellectual brilliance to be worthy of respect. Others, the ability to stay level-headed in times of extreme stress. Still more, finding the strength to persevere. For you, maybe it’s the ability to speak one’s mind and stand up for what he believes is right. Or maybe someone’s sunny disposition, finding the best in everyone he meets. Maybe it’s the proof of reliability, dependability, and trustworthiness. The list goes on and on. What’s odd about it is that it’s not really something you can control. You don’t really give respect any more than a sport’s official gives an athlete a trophy, or a teacher gives a student an “A”. The athlete and the student earned their rewards. The official and the teacher, despite their significant roles, don’t really do much except present the rewards. Someone earning your respect tends to be a big deal. The dynamic of a relationship–be it professional, friendly, romantic, or otherwise in nature–changes when respect is earned or exchanged. Not everyone is necessarily worthy of having his name mentioned when the sentence, “I respect _____” leaves your lips.

But everyone is worthy of being treated respectfully. We owe it to one another to be kind. Or, at the bare minimum, polite. Life is stressful. Nobody needs to tell you that; you know firsthand. As does every other person in this world. There is no shortage of stress in our lives, ranging from merely inconvenient to earth-shatteringly heartbreaking. Events cause a sizeable percentage of these. Most of these are out of our control. What’s frustrating is that people can cause plenty of stress too–and that can be helped. How often do you take out your frustrations on other people–people who might not have anything to do with why you’re upset? I’ll raise my hand and say I do it. I’m guilty of it. It’s understandable, even if it’s not justifiable. But to be nasty to people just to be nasty; just to momentarily feel that you’re in control of others, and thereby in control of the situation, is not okay. It happens sometimes, but that’s when you apologize and make ammends. Because that’s what grown-ups do–or should do. You are in control of your actions, and as a result, you are capable of making the decision to be respectful or disrespectful. To speak to someone with malice, with a fire in your voice and a bite in your words, is disrespectful. It drives me crazy when people justify their actions by ending their confrontation with something to the effect of, “It’s okay, I don’t respect him.” As if that makes it any better.

You don’t have to respect everyone. In fact, you shouldn’t. You have no responsibility to respect people. Don’t respect anyone, for all I care (although that’s probably a fairly miserable existance). But you do have a responsibility for your actions. So you do have a responsibility to be civil; to treat people as people. Everyone has stresses, problems, and frustrations. Why should you add yourself to their list? Take that into consideration next time you find yourself snapping at the nurse who is a little flustered. Or tearing into someone at the registration desk because he’s not moving quickly enough for you. Or digging into your new partner, who hasn’t quite gotten her bearings yet.

You don’t have to respect someone to be respectful to him.

What has two thumbs and started AEMT school? This kid?

Yes, real AEMT school, not EMT-I school. It’s exciting! It’s new! The textbook feels so much larger than my EMT-B textbook (although I don’t know for sure…I gave my basic book to a friend when he started taking the class and haven’t seen it since), and it’s much more densely packed with knowledge than my basic book. I’m going to get new drugs to use, new toys to play with, new skills to develop. It’s going to be interesting.

But I worry. One nagging thought has emerged and tugged away at my insides, making me squirm in my seat during lecture. What if I’m not ready for this? No, really. I voiced that concern a little while ago, and most everyone shrugged dismissively and waved their hand, saying, “You’ll be fine. If you take the time to even worry whether or not you’re ready, than you probably are.” Maybe. But I know that I’m not ready to do neurosurgery. Just  because I recognize that doesn’t mean I can roll into an OR and go, “I admit my faults, so now I’m okay! Nurse! Hand me a scalpel! It’s go time!”

Although I whole-heartedly enjoy doing BLS transfers, I know it has allowed for my critical thinking skills to atrophy. There is no puzzle to figure out. There is no decision making. It’s me, the patient, my stethoscope, my BP cuff, and one long ride to another facility. I enjoy interacting with these patients. Meeting them on a non-emergent level allows me to get a better picture of who they are as a person; see the human being beyond the vital signs and Glasgow Coma Scale. Learn about their families, their jobs, their worries, their hopes…it’s all really cool. It satisfies the people-person side of me, the part that’s curious about people and the human condition. But it leaves the clinician part of me wanting more. I know I’m not the EMT I was six months ago. While I’ve learned more in books and by talking with the paramedics, I have yet to use much of it in the field. I don’t care what you say: book smarts and field experience are two separate animals, with a very loose connection between the two.

I know I can pass the class. I’m good at school. But my concerns stretch beyond that. Am I a good enough practitioner where I can use all of the new tools I’ll be given to benefit a patient? Will I be able to think creatively and get to the heart of the problem–and once there, know what to do to treat it? Or at least prevent it from getting worse? I don’t know…something about actually sitting in this class makes me wonder. For now, I’m trusting that my department wouldn’t pay for my education if they didn’t believe I could do it. I’m hoping that by the end of this class (late September, by the way), I’ll have gained back the skills and confidence I had before–and then some, with any luck. Espeically when nursing school will be starting up by then. And I’m trusting that when I complete this class, my preceptors at my department will know when to cut me loose to practice on my own without them.

Only time will tell, right?

We were all standing in the kitchen, chit-chatting about this and that. But standing still and talking doesn’t last long in a firehouse. We’re all fidgety individuals. So, we start going through the cupboards, looking for God only knows what. We come across a little cookbook, and start flipping through the recipes, pointing out names and making sarcastic comments.

“‘Randy’s World Famous Spaghetti Sauce.’ Huh. I’ve lived in the world a long time, and I have never heard of Randy’s spaghetti sauce. Anything that advertises how good it is in the title is an automatic no-go.”

“Orange zest and barbecue sauce? No. Nope. You’ll never sell me on that.”

“Wow, this will taste absolutely amazing!” Said no one, ever.”

And somewhere in the middle of this, we come across a recipe for “Mongolian Ski Beef.” What?? The recipe itself makes no sense, but it’s really the title that grabs us.

“Ok, ten bucks if you can slip the phrase ‘Mongolian Ski Beef’ into the next call. Twenty bucks if you can slip it into a patch to the hospital.”

Game on.

She wavered on edge of consciousness; sometimes barely focusing on her surroundings, but usually not. You could blame that on all the pain medication the doctors had given her, in an effort to make sure the last feeling she would have on this earth was something other than pain. Her body had been fighting for years, but it ultimately was a losing battle. That’s why she lay there on my stretcher, bundled under so many blankets, on our way to the hospice.

I looked at the paperwork we had been given. The number printed beside the word “AGE” didn’t seem to match up with the human being before me. Both the treatment and the disease had etched deep wrinkles into her skin; wrinkles she shouldn’t be old enough to have earned.

I hated myself for even having to take a set of vitals on her. She’d had years of being poked, prodded, scarred, and hurt in the medical field. Can she not be allowed peace and rest even as she dies? I apologized for disturbing her as I wrapped the blood pressure cuff around her arm. I silently cursed the protocols that made me do this, even this minor non-invasive procedure. I just wanted to let her be. “What will taking a set of vitals do for us?” I thought bitterly as I inflated the cuff. “There’s nothing we can do regardless of what they are. Regardless of what level provider is in the back of this truck. Regardless of what tools they have in their arsenal.”  At least she didn’t seem to mind too much. I’m just one more person in a medical uniform to her, I suppose.

Her bloodshot eyes remain half-open, unblinking. Her respirations are so shallow, I had to watch her intently to make sure she was still breathing. There are no more than a few days’ worth of beats left in her heart, I’d been told.  My pulse quickened, as if to make up for the both of us, as the thought runs through my head: what if her heart gives out before we make it there? A cardiac monitor would be nice right now, at least so the green peaks on the screen can give me the comfort of knowing her heart is still and constantly beating. But without one in this BLS rig, I make do. I take her hand in mine, rubbing the back of her hand with my thumb, and grasp her wrist with my other hand. Her pulse thuds gently against my fingertips. I take comfort in the quiet, steady rhythm; hoping that it doesn’t stop before we arrive. I keep my fingers on her pulse for the remainder of the trip, each thud taking her a little farther away from the world.

When the rig stops, and the parking brake pops on, her eyes open and focus. She looks around the ambulance slowly, briefly. “We’re here,” I offer with an uncertain smile. What expression should you wear when you essentially tell someone you’ve brought them to the place they will die? She looks out the window at the carefully manicured landscape.

“Oh well,” She says, smiling for the first time all transport. There’s a twist to that smile; a bitterness, a sadness, a resignation? It’s nothing I can place, nothing I can describe in a word.

What do you say to that? What is there to say to that?

Later that night, I reflected back on the events of the day. How I looked into the face of a woman dying. How there was nothing I could do—or anyone could do—to change what she would soon face. How I had so little in my power to make her any more comfortable. Wondering if there was such a thing as dying with complete dignity. How an hour before I’d met her, death and dying were the farthest thoughts from my mind. And suddenly, it was so forefront, so nearly tangible. I sat, blinking, thinking, not sure how or what I feel.

My phone buzzed in my pocket. A text message from my pregnant friend, “I hope Little Wiggly One is this jumpy tomorrow night so you can feel (or SEE!) her!” I’m even more uncertain how to feel. My hand was holding onto someone so close to the end of her life only a few hours before. And a few hours from then, my hand would be resting on someone who hadn’t even began her life yet. It’s all a circle, and it’s all so out of my control.

The heavy door squeaks open, the shrillness piercing the bay’s silence. The others have long since fallen asleep, and I am certain that the noise didn’t disturb them. Still, I take a moment to absorb the returned silence, holding my breath, listening for sounds of stirring behind the wooden door that separates the bay from the bunk room. But there is no creak of the wooden door, no trudging footsteps, no groggy voice asking what I’m doing. It’s late, and I should be in my bed. But I’d been lying there forever, it seems, and my mind is clouded with tired, negative thoughts. So I give this a try.

I climb into the massive ambulance. It really is huge. Most would agree it’s far too big for the roads we travel. Regardless of its size, it’s a beautiful truck. Brilliant red and white paint, with our name printed out in traditional fire department gold leafing. I sit myself on the bench seat, exactly opposite the monitor seat. My eyes close slowly, and I take in a few nice deep breaths. Yes, even though I now know all too well what goes on in the back of the ambulance, I take comfort in the clean, blended smell of bleach, fresh linens, plastic, cavi-wipes, and metal. They say that scent is the sense most closely tied with memory. So maybe that’s why.

I think about the first time I was ever in that ambulance. The first time I ever drew in a lungful of that scent. My future preceptor sat across from me in that monitor seat, having only been introduced to me minutes earlier. He explained everything to me, showing me the equipment, describing what it does. I sat in wonder and amazement. My eyes couldn’t take in enough of this place; my ears couldn’t possibly hear everything I wanted to know. It was all way over my head. There were so many details about so many things. There was a depth to everything that I couldn’t even fathom. I had no idea how I was going to learn all this, or how I would ever fit in with these people.

But I felt it with every fiber of my being. I knew it better and with more certainty than I’d known anything before in my life. I belonged here. I needed to–and somehow, would–make this work. It’s such a cliche to say, “It’s not a job, it’s a calling.” But for the first time, that line made perfect sense.

I open my eyes, and I’m back, alone, in the dimly lit ambulance. It’s just as clean and perfect as it was on that first summer’s day, that first time that I came to the fire department. I remember the pure, innocent amazement I felt that day. I had no idea what I would see, who I would meet, what stories I would gain. But I knew, beyond a shadow of a doubt, that I’d found something special. It was a fondness for a career I knew so little about, and yet I’d had such a clarity in that moment. Here, in the quiet of the night, I sit in the ambulance and allow myself to re-live that feeling, to regain that clarity. All the stresses of school and work just melt away. All the questions with the implied negative answers that my mind concocts during my darker hours…it all seems so silly, so trivial, so minor and incidental to the way I felt then. Every time I find myself buckling under stress, I give myself a minute to sit in the same spot I did on my very first day, and everything just falls into place.

For the record, this didn’t happen at band camp. This was a band competition. No, I wasn’t in some cool high school garage band with some crafty, angsty name like “Public Nostalgia” or something, playing at the local “Battle of the Bands.” Nope. I was a legit band geek. Loud and proud, my friends. (I didn’t even play a “cool” instrument. I played trombone. Hell yeah.) And we were competing in a concert band competition in Florida.

My high school concert band was about 70 strong. We are lucky to have a strong arts program at our school. But even little Grover’s Corners isn’t immune to the state of the economy, so we don’t receive much in the way of funding our arts program. We fundraise for the things we really want, and make do with the rest.

This means we don’t have concert uniforms. Not that it matters, really. Every other year, our concert band leaves home and goes off to a big competition somewhere using the money that we’d worked so hard for. Aside from that, we only really play for our community. They love us and think we play wonderfully no matter what we look like.

But on this beautiful Florida day, we can’t help but notice how out of place we are. We are wearing what we always wear for our concerts: a white dressy shirt or blouse, and black dress slacks or a skirt on bottom. We all look similar, but it’s obvious that we each pulled our outfits from our own individual wardrobes. Some shirts are whiter than others. Some are button down, some are pull-over. Our pants are varying shades of black, in very different cuts and styles. We’re not matching. But we’re here, and we’re doing our best.

The band that performed before us files out of the auditorium. Every one of them wears a dark red, button down shirt. The boys sport black pants, while the girls wear high-waisted black skirts. The heels of a hundred pairs of identical, polished black dress shoes and high heels click against the polished floor. Most of them don’t so much as glance at us, but the ones who do look our way do so with superior stares; eyes looking us up and down. Some of us meet their stares with indifference, and others become suddenly engrossed in taking meticulous care of their instruments. Sure, we feel a little self-conscious. We do not look quite so polished and professional. But we earned our right to compete here.

A woman with a clipboard informs us that it’s our time to perform. We exchange nervous smiles, squeeze excited hands, and whisper jittery “Good luck”s to each other. We pull a little at our clothes, smoothing out some of the creases that the iron failed to correct this morning. Our band director, our beloved and fearless leader, smiles the warmest, most genuine smile in the world. He just glows with pride. He knows how hard we’ve worked to be here. Although we know he’s probably wracked with nerves on the inside, it’s his pride in us that he chooses to let shine through. It’s contagious. We can’t help but let our chests swell with pride too.

We file out onto the stage, shoulders back, heads up, backs straight. We smile, and some freshmen even let out a nervous giggle. When we arrive at our seats, we glance around at each other knowingly. We’ve done this hundreds of times in practice. We’re good at what we do, and we know it. And right now, there a few people in the audience who are waiting to know it too.

We play our little hearts out. Admittedly, we’re a little taken aback by the fantastic acoustics in the room (a luxury we don’t have in our giant rectangular classroom. It’s an acoustical nightmare). But we sort it out. We do our best. We complete our last song, beaming 70 smiles up at our director, and he reflects them all back to us. The judges thank us for our performance, and we thank them for their time. We leave the stage with the same proud steps.

We might not be much to look at, but we do our jobs well. Nearly all of us carry instruments with dents, scratches, and fading finishes. Our concert attire is far from uniform. But we have an immense pride in what we do. So we polish our dinged instruments. We iron our mismatched clothes. And we do our best every day, determined to show everyone our talents and abilities.

Moral of the story? It doesn’t matter if your ambulance is older than anyone on your crew. It doesn’t matter if your issued uniform is sun-bleached and wearing thin. It doesn’t matter that your equipment isn’t the flashiest or most impressive. When you step out in public—be it running to the grocery store for your on-shift dinner, coming to a patient’s aid, or walking into the hospital—do it with pride and confidence in your abilities.

She sat on her living room couch. She kept her head down, her light brown hair shielding her from our presence. Her mother stood in the hallway, her outward expression revealing anger, disgust, frustration. But her red eyes, wet eyelashes, and occasional sniff gave away her true internal emotions of sorrow.

Our patient held a dishtowel to her forearm, which I slowly removed. The bleeding from her lacerations had mostly stopped, only leaking a little. I tore open a 4×4, wiped away the blood, and taped it to her arm.

We talked quietly to one another. She spoke only when necessary; she was too lost in her grief to do anything that wasn’t immediately required. Her heart had been broken that day for the first time, by her boyfriend of one year. Silent tears rolled down her cheeks, and she stared at the floor. This was the worst day of her sixteen years of her life; the worst thing that had ever happened to her. And she was in the throes of the emotion that anyone would feel on the worst day of their lives.

I could’ve told her so much, but I knew she wouldn’t believe any of it. She would probably nod, and offer a weak, polite, transparent smile. I’d had a boyfriend when I was her age, and after much emotional turmoil, he’d broken up with me too. I thought my heart had been broken beyond repair. We were supposed to be forever, my boyfriend and I. We were sixteen, but, like most puppy loves, we’d had our whole lives planned out. Just like I’m sure she and her boyfriend did.

Absentmindedly, I tucked her hair behind her ear, probably just like her boyfriend had. And–although I know she wouldn’t believe me–just like her future boyfriends would. She raised her eyes to meet mine briefly, before returning her gaze to the floor.

It hurts. I remember. You remember. We’ve all been there. That first broken heart hurts on a level you previously thought unimaginable.  And right now, there’s nothing I can say that will change that. But I can offer a ride to the hospital. I can offer an unbiased ear, and a shoulder to cry on. I can give her privacy in a little mobile box. In the ambulance, the walls are blank. There are no corkboards, tacked full of ticket stubs, photobooth pictures, and still-frames of the cheery couple, to remind her of what used to be. There are no dresser-tops with vases of flowers. There are no memories and reminders of what was, and what she thought would be forever. Sometimes, that’s what you need; just to get away for a bit. But that’s the very thing I hope to remind her of, as I keep my arm around her, gently guiding her to the ambulance. She needs to get away for a bit: not forever.

As we take our ride to the hospital, a tone goes off for a second call. It was something that sounded gory and dangerous. Like “hero’s work.” Like “a real call,” or “a real emergency.” I sat there, holding her hand. Between sniffles and coughs, she began verbalizing what had hurt her so much. To her, at this moment, this was “a real emergency.” This was painful. This was real. She needed help. And at that moment, despite everything else that was going on in the world, my help was needed here. Not on my knees in some car wreck, shattered glass and blood around me, shouting above the roar of the Jaws of Life, with TV crews pulling in not far behind us. No. My place was here, with her hand in mine, passing her 4×4′s after we’d run out of tissues. This was where I needed to be.

As I’ve said like a jillion times on this blog already, our fire department has changed a lot. A few months ago, we had two regular paramedics that were available 3 days a week for very specific hours. This means many of our calls were run at BLS level. Sometimes we called for “ALS intercepts,” not “paramedic intercepts,” because we knew one wasn’t available. And even then, sometimes EMT-I’s weren’t there, and we’d bring in some serious calls with a crew of basics.

Then we hired about 10 paramedics from out of the area. All of the ones I’ve worked with are amazing and very talented at what they do.  We’re also doing interfacility transfers now, which has allowed for some really cool and special opportunities to work alongside paramedics on some very sick people.

But there’s still a disconnect between the old fire department crew and the paramedics. And I really wish there wasn’t…I’ll get into that at a later date. Most of us get along great! There are some learning curves and misunderstandings to be had, sure. But we work through them, and we’re respectful of each other.

Well, mostly. Until this little exchange the other day.

 

“Hey, so I’m going out to Big Medical Center on a transfer,” Paragod says.

“Oh cool, have fun. Be safe,” I reply, going back to writing a report.

“But that means you guys are going to be without a paramedic for 5 hours…what are you going to do if you get something serious?”

“We’ll just have to run it with what we got. You guys forget, we used to do that all the time. It’s no big deal.”

“Right. I can’t imagine what a shit show you guys must have been before we showed up. Now you’re like a real ambulance service.”

 

What?

That’s when you change the pronunciation of “paramedic” to “par-AM-a-dick.” No, as basics, we don’t get to do much. But that’s not to say that we don’t do our jobs well. Believe it or not, we’ve run some nasty calls as a BLS crew. What’s more, we’ve actually had some meaningful saves. Yeah, without a paramedic. Can you believe it? Apparently he can’t. Just because we weren’t able to stick people full of holes, and push drugs through their veins doesn’t mean that we were “a shit show.” And we were a real ambulance service for many years prior to your arrival on EMS, and probably even prior to your arrival as a human being on this earth.

I joke about how I’m useless as a basic. But that’s just it—I joke. Because it’s not true. I’ve gone on a tangent before about this, and I’ll probably do it again (just not now…this post is getting lengthy and unruly enough as it is…). I don’t know if his inflated ego was taught to him, or if it seeped into him from the cultures of where he’s worked before, or if he was just born that way. But, contrary to his thoughts, the “B” at the end of “EMT-B” does not stand for “bitch.” Quality patient care is not specific to higher level providers. Anyone at any level can do it. And if you know any arrogant jerks like this paragod I described, ignore his derogatory crazy talk. You are better than that. Remember that.

(Firstly, thanks to CCC for inspiring this with his series of “Things That Bother Me”. If you haven’t read his stuff yet, you probably live under a rock, and should go check it out.)

I don’t know about you guys, but where I work, our first-in bag is freaking huge. I wish I had a scale at work so I could weigh it, but, no dice. It’s designed to be worn like a backpack. When I wear it, it extends from about C5 to my sacrum. And the bag easily doubles my depth (if that makes sense…the line from the anterior of my body to the posterior). It’s also a good 3 inches wider than my shoulders on each side. The bag is absolutely packed with equipment and supplies too. You have to muscle the zipper a little to convince it to close back up.

In addition to our traditional first-in bag, we also now have an “airway bag,” which contains everything we could possibly use to manage the “A’s” and “B’s” of ABC. This bag is a bit smaller than our first-in bag, and at least has a narrower profile. The bag we bought is the same that is used by emergency medical helicopters. So it holds A LOT of stuff while taking up as little space as possible. That being said, it’s about the size of a hiker’s backpack…you know, the kind with the aluminum frames and whatever?

We’re supposed to take these two bags with us to every scene. Frankly, I think that’s a little ridiculous. Every scene? When was the last time you were called to a house where space wasn’t an issue? I’m almost convinced that the wider your hallways, the less likely you are to ever need 911. Most of the time, we always could use at least a few more inches of room to make our lives a bit easier. So why are we adding two hefty bags to people’s backs? It makes it that much harder to navigate the narrow spaces. It also limits our range of motion until we find a place to set down the bags.

And that’s the other thing that kills me. A good chunk of the time, that’s all that’s done with the bags: they sit there. Rarely is there a time where I need anything out of the first-in bag, other than a BP cuff and a stethoscope. And maybe the occasional 4×4’s.  I have yet to need anything out of the airway bag, seeing as we keep a couple NRB masks and nasal cannulas on the stretcher. So, we bring out these bags, take up room, further limit space, and bring them back to the ambulance. Because we are told we “have to.” Well that seems logical.

To be honest, I’d like to have the blessing to use my discretion as to what I might and might not need. I’m lucky to have competent dispatchers who almost always are capable to convey the severity of calls, even if the chief complaint is sometimes a little off. That, combined with the learned (and always learning) skill to size up scenes, I think we have a good idea as to when we should be bringing in equipment to stabilize a patient before transferring him to the ambulance, and when lugging in so much stuff is unnecessary. We literally have at least one of everything that’s on the ambulance in our first-in bag and airway bags. It seems, at times, a bit excessive. Are there times you need a lot of equipment right then and there? Sure. And that’s when the first-in and airways bags are convenient. But most of the time, basically bringing the entire ambulance inside the residence with you seems a little over the top.

I don’t know. Just my two cent