Today, I had the chance to spend a day with a paramedic running emergency medical calls in a county outside of Baltimore with my friend Liana. For anonymity’s sake, I will not disclose the exact location of the county.
As certified Emergency First Responders in MD, we can do almost everything EMT-Bs can with a few exceptions. Below is what it was like to assist a paramedic (who we will call JP) on an 18-hour shift.
11:40am: Wake up. Shower. Brush teeth.
1:02pm: Our paramedic friend JP will be here in 20 minutes to pick us up. Panic, I’m running late.
1:20pm: All ready. I jog over to McCoy to meet up with Liana and the paramedic.
1:23pm: Liana and I climb into JPs car and we begin the drive to the county. We chat mostly about emergency medical services, future career aspirations and what we hope to see during our shift.
2:35pm: We arrive at the firehouse. After unloading all of our stuff, we go to the Advanced Life Support Medical Unit car and perform preliminary inspections to make sure all of the supplies we may need are present.
3:00pm: Inspection is done and the car is in working order. Liana radios in that the “Medical Unit is now in service”.
3:07pm: Just as we are about to sit down in the station, the radio crackles and the “ALS” (advanced life support) unit is dispatched. We rush out to the car and get on the road to head over. With sirens blaring and lights flashing, we power through almost every intersection and manage to get all green lights because of an onboard computer that changes the traffic grid.
Dispatch: Called to the security office of a large industrial complex. 54 year old male complaining of chest pains and trouble breathing, no history of heart disease.

The intricate dashboard of an ALS Vehicle
3:11pm: JP sighs, fearing that the call will not be an actual heart attack but merely someone who is exhausted.
3:15pm: We arrive on-scene. I’m really nervous for my first call. A Basic Life Support (BLS) ambulance is already there. I grab the medical bag and defibrillator and climb into the ambulance with JP and Liana. The man is already being given oxygen so we hook up a cardiac monitor to his chest and begin heading towards the hospital in the ambulance.
3:17pm: His sinus rhythm and blood pressure look normal, signs that he may not be having a heart attack. JP performs some tests and determines that the man is probably not having a heart attack at the moment, but we continue to take him to the ER to be safe and make sure he didn’t just catch one early.

A normal sinus rhythm reading
3:34pm: We arrive at the local hospital. I help an EMT wheel the stretcher into the ER and we pass him off to the hospital. JP fills out some paperwork. Our medic unit goes back into service.

Liana outside of the ER after a call
3:57pm: Liana, JP and I decide to head to the beach to relax and wait for our next call. We start driving towards the beach but the radio cackles almost immediately.
Dispatch: Called to a private residence. 58 year old female suspected intentional overdose (suicide).
4:08pm: We arrive on scene again and the BLS ambulance is already there, along with numerous police cars and a fire truck as is protocol for suspected suicides. We rush into the building with medical supplies and a defibrillator again. A woman is laying on the couch and is almost unresponsive to verbal stimuli. An empty bottle of Ambien is next to her and a firefighter is examining it. We bundle her up and rush off to the hospital.

The ever-important defibrillator/ 12-lead ECG monitor
4:11pm: The woman starts coming to a little bit. We ask her if she had the ambien and she says yes. She has also consumed a large amount of alcohol and it was a suicide attempt. JP calls the poison control center and they advise him to administer something. I am not paying attention to what it is, but he sticks in an IV line and we continue to the ER.
4:29pm: We wheel the woman into the ER. The doctor signs off and takes her into a room. I take off my gloves and get a new pair. I talk to JP about the call and he thinks the woman may have been faking because she was very responsive to pain when he put in the IV line, inconsistent with an ambien overdose. He leaves it ultimately up to the doctors to decide that, however.
5:50pm: We are back in service. Hoping for some time to breathe after the first two calls.

After each call, we have to pack up and clean all the medical equipment we used. Some of it is disposable
6:05pm: Or not. The radio cackles again and we get our next dispatch.
Dispatch: Called to a private residence. A 6 year old female is having an asthma attack and her medication has not helped.
6:45pm: After navigating towards the residence for about 10 minutes, we get a call saying “Cancel ALS Unit”. We sigh because this means we drove almost all the way there for no reason, the BLS unit could handle the call on their own. As soon as the call was cancelled, we get a new dispatch. Lights and sirens, on.

Driving the vehicle at night is a completely differnent experience than during the day
Dispatch: Called to a private residence. 34 year old male with a history of anxiety experiencing chest and back pain.
7:01pm: We meet the ambulance on the road because they have already had time to ‘package’ up the patient and put him on oxygen. We climb aboard the ambulance and JP takes over (the person with the highest certification automatically commands an ambulance).
7:05pm: The ambulance keeps driving towards the hospital but his vitals all look normal as does his skin tone. The call is downgraded to a non-emergency and we turn off lights and sirens and drive to the hospital like a regular car. JP thinks it was just an anxiety attack.
7:16pm: We drop the patient off at the hospital. He does not have a high priority so he does not get a room right away, but a doctor signs off and we can leave again. *BEEP*, the radio calls us into action before we can even start to take a break.

Me standing outside one of the ambulances after a call
Dispatch: Called to a private residence. 38 year old male actively having convulsive seizures, no history of epilepsy.
7:33pm: We get to the household and the BLS ambulance is already there as usual. The man is slightly photophobic because of the seizure he just had but he is awake. We dim the cabin lights to add comfort, and JP starts an IV drip. It was quite impressive how he put the needle in despite the ambulance experiencing slight turbulence. The man has abnormally high blood pressure and is quite disoriented, so we take him as a high-priority patient.
7:50pm: We arrive at the hospital again and drop the man off. He gets a bed in the ER almost immediately and several nurses come to check in on him. The doctor signs off for us, so we leave. We hope that this time we will actually get a chance to have a break. “Medic Unit is ready”. We head to a gas station
8:12pm: This is the sketchiest gas station I have ever seen. It is right behind a prison, but luckily the police use it to refuel so cops pass by regularly.

Scary prison in the background
8:23pm: We have just finished filling our tank and are on our way to the lounge so we can relax. Wait, nevermind, the radio crackles again.
Dispatch: Called to a Church. 19 year old female had a seizure lasting approximately 30 seconds. No history of epilepsy.
8:26pm: Luckily the Church is right nearby where we were, so we reach there within a few minutes. The BLS ambulance is there and the front of the Church is very crowded with people standing around the girl worried about her. It turns out she was playing the piano for the Church and had an absence seizure, fell backwards and hit her head. She has a large hematoma on her forehead and we decide she is at risk for a serious neck injury.
8:28pm: Since she is a patient with a neck injury, we have to immobilize her spine and strap her to a backboard. I assist the people in strapping her down.
.jpg)
A patient being backboarded
8:36pm: She is ready for transport so we put the backboard onto a stretcher and wheel her to the ambulance outside. Off to the hospital again. She is not really responsive to any verbal stimulus, so we keep her as a very high priority patient.
8:39pm: As we are driving in the ambulance towards the hospital, she begins to wake up. As with many people who have just had a seizure (aka who are post-ictal), she has no idea what happened or where she is. She begins to panic but her mom calms her down. She also complains of nausea so JP administers an anti-nausea drug. Her oxygen mask and the collar on her are bugging her as well, but we ask her to keep them on and she complies.
8:44pm: We arrive at the hospital and she is admitted right away. The doctor signs our papers, and we stay afterwards to do a bit of paperwork and restock on some ambulance supplies we are running low on.
9:22pm: Done with the paperwork and back in service. We head off to Wendy’s to get some food hoping that we do not get interrupted.
10:20pm: Wow, no calls for a whole hour. We are relieved, and go to the drive-through window at Wendy’s.
10:30pm: Finally getting a chance to sit down in the lounge! Liana, JP and I eat our Wendy’s and chat relaxedly.

This was actually the fist time I ever ate at Wendy's
11:17pm: Still no calls, wohoo. We decide to head to one of the firehouses to socialize with some of JPs firefighter friends.
12:04am: Still sitting in the firehouse. A Hazardous Materials truck gets dispatched to a house because of a smell of gasoline so we get ready in case they call for ALS.
12:24am: They did not call ALS, the monitors did not pick up any toxic chemicals. Relief. Dealing with HazMat emergencies is outside of my protocol so I would not have been able to help. We are still relaxing in the firehouse. Liana is falling asleep on one of the chairs.

Firehouse party
1:17am: Still no calls, such a relief. We decide to take a late-night trip to the beach that was interrupted last time.
1:24am: We pull out on the highway but get a new call. Sirens and lights, on.
Dispatch: Called to a private residence. 35 year old male with a history of asthma having difficulty breathing.
1:35am: We arrive on-scene and the man is already in the ambulance. We attach a pulse oximeter and monitor his oxygen levels closely. We give him a mask with pure oxygen to help him breathe. JP decides to administer a vasodilator to help him breathe because his oxygen levels were dangerously low. The ambulance begins heading towards the hospital.
1:52am: Slide the stretcher out, wheel him into the ER. I am starting to get used to this. I have been there so many times at this point that the admitting nurse recognizes me and says hello. A doctor signs our paper and we head off. We are all hungry so we head to WaWa to grab some food.

The Christmas tree in the ER is decorated with catheters, facemasks and other medical equipment
2:35am: I buy some candy (healthy, I know) at WaWa to satisfy my sugar cravings.
2:53am: We get back to the EMT lounge and relax by watching some TV. It’s some cooking show called Chopped.

Relaxation at its finest
3:35am: I look around and realize I am the only one awake. I have too much adrenaline to sleep so I watch more TV.
4:30am: Urgh, still can’t sleep. I listen to some music and channel surf.
5:01am: My memory gets fuzzy here and I think I passed out. Finally, some rest.
5:32am: Never mind. The siren goes off inside the lounge and we are dispatched yet again. We drag ourselves out of bed to listen to the call.

The ER late at night as seen from the ambulance
Dispatch: Called to a private residence. One and a half year old baby boy is in respiratory arrest.
5:34am: We put the pedal to the metal. This is a very critical call because the child is not breathing, so we rush as fast as we can to the scene.
5:39am: We meet the ambulance on the highway and climb aboard. The baby has begun breathing on his own, but his oxygen saturation levels are still a little low. We are relieved to see him cry and kick a little because he is breathing on his own. JP administers a vasodilator and some oxygen.
5:50am: We arrive in the ER and a large number of nurses are already waiting outside to accept the high-priority patient. JP carries him into the hospital and puts him down. I carry the portable oxygen tank with me so the baby can continue breathing as we carry him in.

Ambulance ready for the holidays
6:40am: We are still in the ER restocking supplies and waiting for the doctor to sign off on our sheet. He signs it so we finally get ready to leave. We are all feeling pretty exhausted. We head back to the firehouse to try and sleep on the couch.
7:35am: We stop at Panera to get some breakfast. The food brings me immense joy.
8:02am: We get back to the firehouse. Sweet, sweet sleep.
8:30am: Wait, never mind. We get dispatched to a nursing home.
Dispatch: Called to a nursing home. 84 year old male actively seizing.
8:45am: We are about to pull up when they cancel us over the radio. The BLS unit could handle the call by themselves and did not need us. We drive back to the fire house.
9:02am: We hit the couch again. This time I fall asleep almost immediately, but JP stays up to type up some medic reports.
9:50am: The next paramedic starts his shift slightly early. I wake up and we go to the car to begin getting ready to hand it over to the next paramedic.

Me looking up who is on call after us
10:30am: The car is fully-stocked with supplies and we park it back in the firehouse. Our shift is over, and we are relieved. We get in the car and head back to Hopkins. I fall asleep against the window, smushing my face attractively.
11:30am: We get back to JHU and I thank JP for this great experience. I really enjoyed helping him out. Liana and I head back to our dorms.
12:30am: Finally get to sleep. Relief. The shift was completely worth the sleep deprivation. I am glad to have done the Hopkins Emergency Response Unit class to become an Emergency First Responder so I could have this experience.
Although I am not pre-med, this experience was great for me and I plan on being a volunteer EMT-B or paramedic when I am older.