Ambulances & Vehicle Ops, Cardiac & Resuscitation, Operations, Training

Varmints: What’s going on back there?

Issue 4 and Volume 34.

Saint Sue and I just celebrated our 38th wedding anniversary, Life-Saver. That reminded me again, as it reminds me every year, how she stood up there in front of her parents — polite (but socially focused) friends and married an ambulance driver making less than $10,000 a year. In their view, my place on the food chain was about par with common houseflies.„

I loved that girl with all my heart. The fact that she loved me right back filled my life with joy, but even then I understood why her family’s friends saw me the way they did. There were no “emergency medical services” and no paramedics. No 9-1-1 system, no CPR, no National Registry, no National EMS Educational Curriculum, no licenses and no certs other than Advanced First Aid. We looked like security guards, we were broke, and we had no pedigrees. Many of us were students, enrolled at colleges that weren’t Princeton or Dartmouth. In their eyes, we were mutts.„

If that wasn’t enough, none of them had any idea of how much talent it actually took to operate an ambulance — simultaneously planning the route, negotiating the traffic, battling the weather, beating the clock, operating the warning equipment, minding the radios, watching the instruments, sensing the mechanical behaviors of the vehicle, thinking for every other driver on the road, and constantly accommodating the activities of a partner who might be caring for as many as four patients at a time — on the strength of very little medical background. Anybody who thinks that’s a short list should reprocess the word “simultaneously.”

In fact, experienced on-scene decision-makers still underestimate those challenges. How many times have you seen them put two paramedics in the back of an ambulance with a critically ill patient, and entrust their welfare to the newest, least-experienced firefighter they can lay their hands on?

All of which is even more dangerous today. Talk to anybody who runs calls for a living, and they’ll tell you. More of our patients are threatening us today than ever in the history of this important business of ours.

These are hard times for working people all over the world, and plenty of them are afraid — mired in the worst crises of their lives. As you know, most handle it pretty well. Some who don’t are still manageable as patients anyway. But others, who are much more dangerous, are not. A small, but increasing percentage are simply varmints — gutter-dwellers, who have no sense of respect for you or anyone else. You’ve met some of them, and you know what I mean. It’s like they’re Martians or something. They don’t think like you think, and they warrant your constant attention. Just tack that on the list of things you have to pay attention to, as you operate that ambulance of yours.

When I accepted my current position, I noticed the crews were rotating their rearview mirrors counter-clockwise about 30 degrees. EMTs usually do things for a reason, and sure enough, they had a good one. In a Type III ambulance, rotating that mirror gives you a partial view of what’s happening on the bench and a partial view of traffic through the rear windows. Unfortunately, in the process, you forfeit most of both views.

A very smart paramedic named Roger Olson pointed out that the agency north of us was using dual interior mirrors in their Type III Braun ambulances. Braun had equipped each of their units with a rectangular, mildly convex mirror that comes with an aluminum bracket you can mount on the windshield frame, just above the existing Ford mirror. The crews say it takes some getting used to, but once you do, you wouldn’t want it any other way. We purchased one and installed it, and have now ordered enough for the rest of our little fleet.

This isn’t just another gizmo. It’s a valuable safety adjunct, and it deserves your agency’s serious consideration. You’ve probably seen similar mirrors in school buses and airport shuttles. (They transport varmints, too.)

Braun lists two part numbers: 33861 for the bracket and 166190 for the mirror. The total price is $57 plus shipping. You can order them only through a Braun dealer. JEMS

For a list of ambulance accessory dealers, visit