An inspiring story from a recent house fire in New York City reminds us of just how quickly we can be called into service to truly save a life. Upon arriving at the scene of the structure fire, firefighters were advised that a baby was still in the burning building. After quickly finding the infant, the rescuer opted to hand the baby out a window instead of carrying the child back through the smoke and fire to the door he came in.
Fortunately, other firefighters were outside near that window and took the child. They carried the baby to a nearby EMS crew and the medics quickly got to work, administering hydroxocobalamin and other resuscitative measures before transporting the baby to an area hospital.
In almost all our EMS runs throughout our shifts each day, we are given some advance information about the patient we are responding to treat. It may not be 100% accurate and it certainly isn’t detailed, but we have the opportunity to begin at least a little bit of mental preparation and planning with our partner.
When at a fire scene or other type of stand-by staging, sometimes, the patient is just suddenly there, and you have to go from zero to 60 to jump into action. Your brain and body get no notice of the emergency you are expected to handle.
No-notice life-threatening emergency
My last zero-60 response occurred several years ago during a structure fire stand-by. As we sat there watching the flames shoot out of the attic of the building, a police officer pulled up and parked right in front of the ambulance. Quicker than my partner and I could say “what the heck does he think he is doing?,” the cop jumped out of his squad and frantically waved us over. We hustled over to find a severely burned apartment occupant lying in the back seat. Needless to say, we went from zero to 60 in a matter of seconds and immediately began caring for this no-notice life-threatening emergency.
The fire service has a saying that I have seen posted in many fire houses over the years, “Expect fire, expect victims.” We all know how easy it is to slide into complacency after answering dozens of false fire alarms or countless EMS calls for minor conditions. You let your guard down, and you quickly begin to expect that there won’t really be a fire or a life-threating condition during the call. Motor vehicle crashes, lift-assists, Life-line alarms, welfare checks, sick persons and weakness complaints can all contribute to the “no big deal” mentality.
Whether you prefer to call it public safety or emergency services, we are expected to always be ready for “the big one.” It isn’t easy, but it matters when it matters. We must have the mindset that each response we are called to could be actual fire, a life-threatening condition or a bad guy with a gun. Now, I am not saying we need to run lights and sirens to every call or jump out of the rig with every piece of resuscitation equipment in hand, but we also can’t find ourselves surprised when the true emergency presents itself.
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What steps can you take to be prepared when on stand-by?
- Make sure your emergency equipment is ready to go, stored in an easy-to-retrieve manner and that you know how to use it. For EMS crews, that might be your jump bag, airway equipment and multi-function monitor. While on stand-by, is your equipment pulled out of compartments and loaded onto the cot to be quickly moved to a patient?
- Discuss roles and responsibilities with your crew members. If a patient suddenly presents, do you know who will take lead, who will grab equipment and who will start vital signs?
- Know the basics of the scene. Where is incident command? What are the routes out of the scene and to the closest hospitals? Where could a landing zone be set up? Where are the areas of the scene that might be most likely to produce a casualty?
- What is the communication plan for the event? What channel is IC on? What frequency will be used to request your services? How will you communicate with other EMS resources? Can your dispatch center reach you on this scene? If it is a special event stand-by, do you have the phone numbers of the key officials, and do they know how to get in touch with you?
- Last but not least, have a mindset to respond. Instead of pulling your phone out to scroll through social media, spend a few minutes thinking through a few scenarios of emergencies that might happen at that type of scene. Remind yourself of the first few critical steps needed to respond. How would you ventilate a child pulled from a smoky house? How would you stop the burning process for major thermal burns? How do you remove the helmet from a football player that can’t feel his arms and legs and is having trouble breathing?
It is easy to arrive at a stand-by and settle into your seat relieved to get a break from other 911 calls. But whether it is a scene of an active emergency, like a structure fire, or a planned sports event, take the extra steps to be prepared to go from zero to 60. It is what a professional would do and the effort will be worth it when the patient needs it most.
Stay safe out there.
