First Shift (4/7) - 8am to 4pm
I started at C-MED and then I moved to dispatcher and call taker. Basically, C-MED controls the ambulances and ER, and connects them in one line. During my shift, I observed that sixteen ambulances were directed to the Bay State Hospital, four ambulances to the Mercy Hospital, and just one call was directed to the Holyoke Hospital.
Two hours later, I moved to dispatcher and using a headphone listened to how the dispatcher contacts the EMS crew. I observed how the dispatcher balanced ALS and BLS in the city, and sent ambulances to the scene. Also, I observed whether the EMS crew requested for an additional ambulance at the scene. Sometimes, the EMS crew need not request for a backup ambulance. In fact, there is a protocol to be followed- if the call is for a cardiac arrest emergency, then the dispatcher has to send a BLS and ALS. From the dispatcher room I learnt that every single step such as arriving, picking up, transferring, and clearing for next call comes from the ambulance. In all, I spent three hours at the dispatcher.
Call taker was the last step that I had to finish during my shift in the dispatcher room. I spent three full hours listening to 911 calls. The calls observed were as follows-
A non- emergency call that concerned a transportation request for a 16-year-old female.
A 45-year-old male had attempted suicide. The patient was having hallucinations and admitted that he could hear voices around him. Within five minutes, the ambulance arrived.
A 65-year-old male patient having stroke. We directed his daughter, who had called 911, to do the stroke test. The patient was not able to smile on both sides, his arm was raised unevenly, and he could not speak a full sentence. Thus, it was deduced that the patient showed strong evidence of stroke.
An 88-year-old female was shaking, snoring, and experiencing difficulty in breathing. The patient was sitting on a chair and we asked her daughter to note the breathing rate of the patient, to lay the patient down on the floor, and to open her mouth manually until the ambulance arrived.
On the whole, most of the calls were transportation requests and non-emergency in nature.
Second Shift (4/10) - 9pm to 6am
During this shift, first I started observing at the C-MED. In the first 30 minutes, we directed only three ambulances to the hospital. Later, we got a call from the ambulance and it requested a line to the Bay State Hospital as the patient suddenly requested for going to mercy. The situation was slightly confusing. Most of the ambulances were directed to the Bay State Hospital since the facility has a level one trauma center.
Two hours later, I moved to observe with the dispatcher. Within five minutes of my arrival here, we directed an ALS ambulance to attend to a cardiac arrest call and backed it up with a BLS ambulance. Usually, the dispatcher maintains and measures the distance between the scene and the nearest ambulance though GBS. However, in this case at one point of time we lost the location of the ambulance and had to contact it via the radio. Later, we got to know that the GBS on the ambulance was dysfunctional, which made it impossible for us to establish a connection. Hence, we allowed the ambulance to return back to the AMR garage so that the GBS could be fixed at the earliest. During this shift, we were running ten ambulances in Springfield and Holyoke- six ALS and four BLS. Then, in two hours I moved to the call taker as I do usually. The calls received were as follows-
A weak 21-year-old female in a single-family home. The patient was weak, vomiting, breathing heavily, and suffering from stomach pain.
A granddaughter called 911 for her 86-year-old grandfather from an apartment. She informed that he had had a stroke in the past. At the moment the patient showed strong evidence of stroke.
A 70-year-old male living in a single-family home suddenly felt weak, had headache, and experienced drowsiness. A witness preformed the stroke test, and the patient showed uneven smile with arms rising equally.
An 88-year-old male living in a single-family home fell down and lacerated his arm.
Third Shift - 9pm to 6am.
As usual, I started at the C-MED. This shift was a bit quiet as we only directed two calls to the Bay State Hospital in thirty minutes. Then, within fourteen minutes, we directed six calls to the Bay State Hospital with three of the calls being on priority one and the other three on priority two. Three hours later, I moved to the dispatcher. We were running seven ambulances, three ALS and four BLS. The two ALS ambulances were on a call and one of the BLS ambulances was on a long-distance transportation request to Boston. After another three hours, I moved to call taker where I observed only three calls in three hours. The calls observed were as follows-
A 28-year-old female living in an apartment had dizziness, headache, difficulty in breathing, and was feeling clammy. The patient said that she had asthma, but she did not have an inhaler.
A 50-year-old female suffered from dizziness, headache, difficulty in speaking, and shortness of breath. A witness preformed the stroke exam, and found that the patient could not raise both arms equally.
A 55-year-old female was completely alert, but the patient had shortness of breath, was feeling clammy, and suffered from COPD. The patient used an inhaler, but said that it was not effective.
Fourth Shift - 8am to 5pm
In this shift I preferred to start and finish at the call taker as I believed that I had observed enough in the C-MED and dispatcher room, and felt that further observations would not help me. At the call taker I observed a lot of 911 calls. The calls observed were as follows-
A neighbor called 911 for a 21-year-old female who was violent, aggressive, and threatening to commit suicide.
Transportation was requested to a rehabilitation center for 405Ib with no precaution.
A 67-year-old male experienced chest tightness. The patient was prescribed aspirin, but he did not take the medication.
A 93-year-old female called 911 for swelling in the ankle. Patient was on oxygen and completely alert.
An adult male suffered from a car accident and experienced numbness in the arms.
A witness called 911 for an adult female who had seizures at McDonalds. The patient was awake, but confused.
A witness called 911 for a motor vehicle crash. No details were obtained.
A 61-year-old female was coughing blood since the day before and had difficulty in breathing.
A 72-year-old female suffered from chest pain that radiated to her shoulder, experienced difficulty in breathing, and was in a confused state. The patient was taking trazodone 150mg and aspirin.
A 43-year-old female had difficulty in breathing, altered skin color, and was clammy. Patient was prescribed inhaler, and took it. But the inhaler was not effective.
