Administration and Leadership, Airway & Respiratory, Cardiac & Resuscitation

Tourists Make the Best Patients

Issue 4 and Volume 36.

As the snow thaws and saddened skiers and snowboarders begin to melt away, a new breed of travelers make their way to our fine state. “Flatlanders,” as we call ’em, are drawn here, of course, by our picturesque Rocky Mountains and panoramic highway view of a million other RVs just like theirs. I’m not trying to be arrogant here when I say that we look down on these flatlanders from an 8,500-foot elevation; in our neck of the woods, we literally do. Tourists are good for any state’s added revenue, and this naturally includes the coffins of EMS. Errr, I mean coffers.

Every state has its own cultural, historical, linguistic and environmental qualities (Wal-Mart not included). If not appropriately familiarized with and prepared for it, an outsider might just find themselves in a whole heap of trouble.

In Colorado, it’s primarily the environmental hazards that will more than likely lead to physical discourse (i.e., What the heck was I thinking?) for the unsuspecting sight-seer. Let’s not confuse stupidity with inexperience here. When someone who lives at a negative-50-foot elevation (New Orleans) and has a history of having one lung removed decides he doesn’t really need to bring his water pills for his congestive heart failure for his day trip to Pikes Peak and then proceeds to tell you at the summit—through his purple-mountain-majesty-color lips—that he can’t breathe, it really does take all your strength not to sarcastically offer him a cigarette while saying, “Let’s see if this helps.”

Some tourists are well aware of altitude hypoxia in relation to their own cardiac or respiratory history and will try to take appropriate precautions. One medic told me of a tourist who refused to open the windows of his car—preventing patient access. Apparently, the patient had the perception that as long as he kept his car windows rolled up and sealed while driving from the base of a mountain to its apex, he’d prevent the altitude pressure conversions from entering the vehicle.

The problem with scenic views lies in their capacity to engross the viewer to the point of fatal distraction. I’ve seen patients who have driven off sides of mountains, and yes, even walked off the edge of trails and cliffs. The smarter tourist pulls to the side, steps out toward the middle of the road, takes a picture, and then seconds later gets struck by another vehicle. Speaking of struck, wild animals, such as Colorado bison, love to strike a pose over your carcass after you tried to get a close-up shot of their adorable firstborn.

Weather is another big issue here. You wouldn’t think that would be the case in a state where sunny days and thin air can give you melanoma 365 days of the year. I always love the first heavy snow of the year. It’s the only chance I get to meet a lot of Californians. How do I know they’re from California? Because their upside-down license plates on their SUVs tell me so. Lightning here, for some strange reason, has a natural attraction to tourists—specifically Texans—which kind of surprises me, considering they’re poor conductors of intelligence.

I know. That wasn’t very nice. But each state has its rivals. I’m sure there are some folks out there who think Coloradans (snowbirds) are a bunch of granola-eating, tree-hugging mountain muffins. This may be so for the true natives of John Denver’s home state, which by the way consists of eight people—if you take away the five million Californians.

To be fair, I’ve certainly made my own sight-seer blunders. One time, I visited New York City and thought I could take the subway anywhere I wanted. Another time, I thought I’d take an early evening stroll around a Minnesota lake without bug screen. Once in Nebraska I went outside my hotel to see what was up after I heard air raid sirens blaring and saw cows flying past my window.

My most embarrassing moment, though, came when I was in Ocean Shores, Wash. I thought it would be a great idea to drive my rental car along the beach after giving a talk at a local EMS conference. I was cruising along pretty well until I stopped to admire the sunset. Bad idea.

I soon found myself spinning my wheels, and—within seconds of the sand reaching the bottom of my door panel—I saw the tide was coming in as fast as the sun was going down. Fortunately, a huge truck pulled up alongside me with a Good Samaritan inside offering to pull me out. I couldn’t help but notice a Star of Life sticker on his rear window. After freeing me from the sand, without making eye contact, he rhetorically asked, “You ain’t from around here, are ya.”

“No sir,” I replied, embarrassed, while subserviently kicking the sand. “I’m from Texas.”

Until next time, letters to the editor from California and Texas need not be
submitted. JEMS

This article originally appeared in April 2011 JEMS as “Tourist Trauma: EMS response to sight-seeing blunders.”