This is a repost of a 2017 Blog Post Heat Stroke Call at My House
We need trained EMS volunteers with an interest in EMS. Sadly to be a firefighter you're forced to also be an EMT even if you have no interest in EMS.
The LMRFD did send a volunteer firefighter to EMR training, but he apparently had no interest.
In 2018 a group of NACFD firefighters including myself and Scott Aitken from the LMRFD took an EMR course taught by NACFD in Kingman.
I took the final test and was awarded a certification as an Emergency Medical Responder from the same people who certify EMTs and paramedics.
As I understand Scott didn't have any interest in EMS and after taking the training never bothered to take the test to become certified as an Emergency Medical Responder.
2017 Repost of Blog.....
Every EMT in Arizona should know the signs and symptoms and how
to care for a heat stroke patient. The call at my home went very badly....
A friend was out in the heat too long and when her husband came in and told us
his wife had vomited, she was confused, disoriented and was having problems
walking. We got her into the shower and removed most of her clothing to
begin cooling her off. Her condition continued to deteriorate over the next few
minutes so I called 911 to request the LMRFD ambulance.
She
stopped breathing several times after what looked like a seizure. I called 911
again and I was told the LMRFD ambulance was on the way. but the dispatcher
refused to give me an ETA.
After
several more calls to 911 asking for an ETA finally an EMT from Meadview
arrived on a fire truck. He brought in a heart monitor but no oxygen or
suction even after we had told dispatch she had vomited and stopped breathing
several times for as long as two minutes.
As
I walked into the bathroom I told the EMT that the patient was decorticate
posturing. He said I don't know, I’m sorry I’m just an EMT and pointed to his
EMT patch.
When I ask the EMT if I could see the rhythm or if he needed to
use my AED? The EMT said he had pads on but wasn't authorized to use the heart
monitor. The EMT was sitting on the floor holding the heart monitor the entire
time my wife and her friend cared for the girl. The EMT kept saying I’m sorry I
don't know what to do I’m just an EMT.
The EMT on the fire truck asked dispatch to have a helicopter
put on standby, I asked him to please cancel the helicopter and start AMR, and
he refused. I told the EMT to document on the chart that I had asked to cancel
the helicopter and start AMR.
I called again and asked dispatch several times for an ETA for
the ambulance and again she refused. I ask her to start AMR and again she
refused. I know from monitoring the fire frequency that it’s standard practice
when the LMRFD ambulance isn't available to start AMR ambulance from Kingman.
The EMT appeared to be very inexperienced and really not
prepared to be on calls alone. Numerous times he said over and over I’m sorry
I’m just an EMT and would point to his patch.
Paramedic
When the ambulance arrived I told them it wasn't possible to get
the stretcher into the bathroom and asked if they had a transport chair,
they said no and rolled out the stretcher. I told the EMT that we wanted her
transported by ambulance and not by helicopter. The paramedic yelled at me from
the bathroom saying “he doesn’t get to make that decision, I do”
I ask why if they were tied up they didn't call AMR, the EMT in
the ambulance said "he had worked for AMR for 12 years and it always take
2 ½ hours to respond to Dolan". Why he would say something so untrue I'll
never know. AMR responds to Dolan on a regular basis and it takes 45 minutes to
an hour at most.
They couldn't get to the bathroom with the stretcher and carried
her out on a tarp. Using a tarp to move the patient almost bending her in a U
shape when she was already vomiting and having respiratory distress was a bad
choice in my opinion. I've used someone's kitchen chair many times to move a
patient from a difficult area or down stairs.
If she had vomited there's a good chance she could have aspirated, something
that can cause severe complications.
AMR is called all the time to Dolan when the LMRFD ambulance
isn't available. Why on this call when all of the LMRFD resources were tied up
on another call didn't they call AMR as is usually done?
When the LMRFD left my home the helicopter hadn't launched yet,
and gave a 30 minute ETA. Its only 37 miles from my home to Kingman Regional
Medical Center. If it’s only 30 minutes or so running code to get the patient
to Kingman Regional Hospital Emergency Department why sit and wait a half-hour?
The helicopter flight time was 30 minutes, 5 minutes to land, 5-10 minutes to
load the patient, 30 minute flight time to the hospital, they were diverted to
another hospital so 35 minute flight time? So 75+ minutes for helicopter
transport rather than 45 minutes to the Kingman Regional Medical Center.
Was a $22,000 helicopter ride to a level one trauma center
necessary when she was she released a couple hours later?
As
an EMT I was taught that heat stroke is a true medical emergency with a 70%
mortality rate. For an EMT in the Arizona desert to not know what decorticate
posturing is, let alone that it’s a sign of heat stroke and a true medical
emergency again shows the EMT lacks the experience to be on calls alone.