By Melanie Jacob
Journal Staff Writer
It's a difficult job, but somebody's got to do it. The Emergency Medical Services (EMS) field may have come a long way since the old days, but changing demographic trends means the challenges are still there.
In Humboldt, paramedics have been seeing a shift in the types of calls they've been getting. While it's still in the minority, they've been getting more alcohol-related and drug-related calls.
"You don't quite see the abuse of the system in rural areas as you do in the city centers," said Derek Dagenais, an EMT paramedic supervisor. "But we've been seeing more calls that do with the RCMP emerging in the past three to five years. Trends tend to change as populations change.Economic changes in the province affect us because we're part of health care."
The problem with these minor calls isn't the calls themselves. Dagenais says that they understand that in rural areas like these without any after-hours outlets for minor injuries, calls like these are unavoidable.
The problem is that these calls may be simple, but they still take up a lot of time. They can tie up an ambulance for an hour or two when that vehicle could be better used elsewhere.
"In rural areas, there aren't a lot of other options for these people except for the emergency departments (ED)," he said. "We don't have drop-in clinics where patients can go to otherwise, so after hours they all flow into the EDs and that can be a problem."
In terms of demographic shifts, paramedics have been dealing with increasing cases of self-harm, mental illnesses, and preventative injuries (e.g., senior falls can be prevented by installing grab bars and removing throw rugs). On a situational basis, they also face new challenges such as locating people calling from cell phones and obese patients.
According to Dagenais, everyone is treated equally, but there are things people can do to make their jobs easier. Know your location when calling for help. Although police can track cell phones, it takes time. Also, be prepared with information such as the patient's medications, health cards, and any allergies he or she might have. Turn the lights on and secure any loose pets.
"Even the most friendly dog, when they see their master in need and in pain, tend to turn on us and that can be a risk to us," said Dagenais. "People think of the old days when the ambulance comes and throws the person in the back and then goes screaming lights and sirens to the hospital, but that's no longer the case. We'll set up right in their living room or kitchen or backyard or wherever they are and whatever treatments need to be done at the time will be done at that time."
What many people don't realize is that the EMS has changed a lot even in the last decade in terms of equipment and treatment. Much of what is done in the emergency department of a hospital can be done portably in the back of an ambulance or right in someone's living room.
The Humboldt EMS is especially fortunate because they are equipped with fairly new and current equipment, including advanced life support. Many of the difficulties they have now are external.
"Safety is a really big challenge for us," said Amanda Zelle, an intermediate paramedic. "We have safety vests now just because we've been running into different types of clientele. We're really into preventative safety."
When paramedics are at a call on the highway, they run the risk of running into not just volatile patients, but also drifters and people passing through. If drugs, alcohol, or weapons are involved, the risks increase dramatically. It was after one particular incident in which a crew was bear sprayed that the decision was made to get ballistic vests.
"We wear glasses when we're around infectious patients and we wear gloves with every patient, but the protection level with paramedics wasn't there," said Dagenais. "We deal with people in the worst moments of their lives and sometimes the people that are there to help them can kind of be a target for physical or verbal abuse."
Also, while it may not seem as dangerous, public spectators cause problems as well. Traffic that's allowed to move through a scene tends to cause numerous problems because many people want to slow down or stop and look. A lot of people whip out their cell phones too.
"People in the rural area are very nosy and want to know what's going on and who's involved," said Zelle. "When we're going to a car accident, don't follow an ambulance or other emergency vehicle, don't come up with video cameras and all that kind of stuff because you're just another hindrance and another potential patient that we don't have the time to deal with at that point in time because our other patients are critical."
Aside from it being a hindrance and slowing down traffic, it's also illegal and insensitive.
"It's not an issue for us to be on camera, we expect to be watched by the public and that's okay," said Dagenais. "What it is is patient privacy and give these people their dignity. I know people like that gore factor, but at the end of the day, it's people's privacy."
On the upside, much of what a paramedic does is spent trying to prevent accidents, injuries, and problems from happening in the first place. A regular day that isn't spent out on a call is spent doing quality checks, restocking, and maintenance. Outside of that, individuals can choose to do educational programs for the public such as the falls prevention program and youth education in the schools.
"We have a lot of public relations and safety programs. There's always something we can be doing," said Dagenais. "If one piece of equipment fails, we have to have a backup. We have a lot of redundancies so if something breaks down we have a method to go back to. We spend more here dollar wise on preventative maintenance than we do on fixes to ensure those things don't happen."
Currently, the Humboldt EMS covers a total distance of approximately 3,500 square kilometers, which is approximately 30 minutes in any direction from Humboldt. They communicate with adjacent EMS districts and assist each other out when necessary. As the population grows, so will their resources.
"It's a catch-22. You have more resources, but at the same time those resources can be overloaded with more people," said Dagenais. "I think sometimes people are afraid to seek help because they're afraid it's going to get them out of their home or it's going to label them. They don't realize that there's so much more help out there that will keep them in their home and will ensure that they're not in the hospital."
At the end of the day, despite the challenges and difficulties, Dagenais acknowledges that they're very fortunate compared to the way things were for paramedics in the past. The pay is better, they get more days off, and the shifting patterns ease some of the stress. Now, all he wants is for people to recognize and appreciate the work that the EMS does.
"There's so much more training and education to what our people do," he said. "I just want people to appreciate health care providers overall."
