My partner, Art Young, and I responded to a call in an apartment building for a man experiencing "trouble breathing." As soon as we entered the apartment, something seemed wrong about the call. You know what I_m talking aboutƒthe type of call where the hair on the back of your neck stands up for some strange reason.„
The apartment was unkempt: Clothes and newspapers littered the floor, and the patient was seated on a dirty couch behind a coffee table covered with full ashtrays, empty liquor bottles and unopened utility bills.
The man was sweaty and restless, rambling that there were "people out to get us all." He was clearly paranoid, and our uniforms, patches, stethoscopes, kits and equipment did little to help. My partner gave me a wink and moved our gear out in the hallway to reduce the man_s anxiety. While he was in the hallway, Art quietly radioed for police backup.
When Art re-entered the apartment, I was on one knee next to the patient, trying to calm him down because he was now ranting about killing somebody. Art scanned the area from his more distant position, looking for weapons or other threats. Then suddenly, just as Art spotted a big ring of keys on the coffee table, the patient grabbed it in his fist and, with keys extending out between his fingers, took a swing at my face. As I ducked, Art pushed the patient back on the couch, twisted his arm behind his back and pried the keys from his hand. By the time the police arrived, we had used medical tape to bind the patient_s hands, feet, knees and legs together. We had him "stabilized" in a manner never mentioned in any EMS national standard curriculum.
I had learned some valuable lessons. Not only was I too close to the emotionally unstable patient, but I had made myself more vulnerable by kneeling and reducing my ability to flee. My partner had saved me from facial trauma.
So how valuable is your partner, and what is a good partner worth to you? As one popular TV commercial would say, "priceless." A good partner is reliable and ready to assist when you_re in danger or in need of extra support or resources. They always have your back. A good partner also possesses strength and dependability; they won_t let you down when you need them most. They_re as strong and dependable on the last call of the day as they were on the first.
But in this incident, we also had secondary "partners" many EMS systems fail to provide to each crew memberƒportable radios. Often, agencies arm their crews with just one portable radio per vehicle, leaving providers dangerously vulnerable when separated from each other. Everywhere I_ve managed EMS I fought the battle to make sure each person that exited a unit had a portable radio. I consider portable communications to be as critical as all the other personal protective and safety equipment assigned to personnel.„
EMS providers frequently find themselves separated from their partners, whether at a domestic violence call, extrication or fire scene. And when something goes wrongƒsuch as a building collapse, explosion, patient going berserk or shots firedƒpersonnel will run for cover and get separated. Each crew member needs to have portable communications to ensure their safety, call for help, or simply to be reached to respond to an assignment while separated in a large emergency department.
Some will complain that it_s too expensive to add extra portables to each unit or that there_s no place to add extra in-vehicle chargers. Neither is a good excuse, particularly when the ambulances have an interior headset system for each crew member, chrome wheels and $2,000 in reflective exterior striping and lettering.„
I_ve also had EMS managers tell me that multiple radios from the same vehicle would cause confusion for communications center personnel or incident managers. That_s easily solved by identifying the portables by vehicle role or position. For example, Ambulance 21_s driver would be portable 21A and the shotgun/senior attendant_s portable would be 21B.„
A first-arriving ambulance will have a difficult time establishing effective triage and transportation operations at an MCI if only one portable radio is available during the critical first minutes of the incident. Staging and transportation coordinators must have portable communications available to them immediately.„
The backbone of successful emergency operations is effective communications. It is also an area often noted in after-action reports as having gaps or deficiencies. Address this need in your organization and ensure each person exiting an ambulance or ALS-response unit is armed with a portable radio. Their safety is worth it.„JEMS