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.... The Patient should always come first and rapid transport to definitive care should be the rule, not the exception... The paramedic on this call was out current Chief Bonnee....
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.
The paramedic on this call was Chief Bonnee before he was chief...
