By Daniel Walmer
The Lebanon Daily News
LEBANON, Pa. — A ladder slips, and its owner falls from the roof of his house and slams against the concrete sidewalk below, leaving him writhing in pain.
Soon, sirens fill the air as an ambulance approaches. From inside, emergency medical providers pour out, quickly immobilizing the victim and loading him into the vehicle. Inside, the providers perform medical care en route to a hospital, where they unload the patient safely at the emergency room.
Think of emergency medical services, and this may be the picture you imagine. But providing emergency care is just a small part of the work providers do on a daily basis, according to Ralph Backenstoes, president of the Lebanon County Ambulance Association and a full-time paramedic with First Aid and Safety Patrol in Lebanon.
“I have a whole host of other duties,” he said.
When Backenstoes first arrives at FASP and any time a patient is delivered to the hospital, he has to check all supplies in the ambulance and clean the vehicle to make sure it is decontaminated and safe for patients, he said.
In between runs, he must fill out a report about each case - a practice many EMS providers consider the worst part of the job, he said.
“I would rather run calls all day than fill out the paperwork,” he said.
EMS providers also must frequently wash their uniforms, maintain the cleanliness of their stations and complete a variety of ongoing training, Backenstoes said.
Just to maintain their emergency medical technician certification, EMTs must complete 24 hours of training every seven years, he said, in addition to other training such as hazardous-materials training that must be completed on a regular basis.
Between their various duties, EMS providers commonly work for many hours without a break, forced to skip lunch, and are often interrupted while going to the bathroom, Backenstoes explained.
And a quick look around the office building at FASP shows that the providers themselves are just the start when it comes to providing effective EMS services.
Holly Dohner is surrounded by computers, radios and phones at her desk, and she needs every bit of her organizational powers to match emergency service needs with available EMS providers. She has to balance routine ambulance transports with emergency calls that come in from 911 dispatchers - which can go from few to many in a hurry.
“The unpredictability is the hardest part, because you just don’t know when they’re coming in,” Dohner said.
Barbara Chambers is hard at work on the seemingly never-ending task of billing insurance companies for the 18,000 emergency calls FASP answers annually. Billing for each emergency must occur within 24 hours of the call, Chambers explained.
Even after filling out the reports, “we do a lot of follow-up calls, tracking down the money,” she said.
First Aid and Safety Patrol receives minimal government funding, and without the billing, the organization would not be able to fund its more than $5 million annual budget, Backenstoes said.
In the back of the office building, Gregg Smith is in charge of keeping the organization’s 72 desktop computers, laptops and other technology running 24 hours a day, 365 days a year.
“Everything we do is computerized now,” Smith said. “Being on call around the clock takes a toll on you.”
First Aid and Safety Patrol is fortunate compared to volunteer emergency departments, which have to accomplish the same tasks without being paid, Backenstoes said. Since they do not have employees to bill insurance companies, they also have to spend time raising funds to keep the departments going.
While people may associate community fire departments with fighting fires, a large part of what they do is emergency first aid because they may be able to arrive sooner than the closest EMS unit, said Joan Sallada, EMS chief of the Bellegrove Fire Co. Almost all members of the all-volunteer department are trained in first aid and CPR, and in an average year the department responds to three times more quick-response medical calls than fire calls, she said.
Just as at FASP, the calls themselves take less time than things like maintaining supplies and keeping the department financially afloat, Sallada said.
“Running calls is only five to 10 percent of the work,” she said. “You’ve got to run this like a business.”
But there are things citizens can do to help overworked EMS services, Backenstoes said.
The most important is preventing EMS from being needed in the first place, he said, through knowing first aid and things as simple as having a fire extinguisher in your house and taking your medicine. It is also helpful to have your address clearly marked on your house, he said.
And one thing most EMS providers desire may be the simplest of all.
“A thank you is a nice thing,” Backenstoes said.
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