Modern Day Medicine at 60 Miles Per Hour

Every day we see emergency vehicles racing the clock to save lives. Most of us pull our vehicles to the right and let them pass, but what exactly is happening in the back of that truck? What’s going on at 60 miles per hour?

The precursor to our current EMS system focused only on the transportation aspect. There were some treatment modalities in place and some systems with military style ambulance systems, but many community’s first ambulances were actually hearses. These hearses were operated by local funeral homes. If you survived your accident, you got “just a ride to the hospital”. If you didn’t, the mortician had a new client to take to the cemetery.  

Luckily, modern-day EMS is quite different. Paramedics, for example can administer many medications and provide the same treatment typically found in Emergency Departments. They can monitor cardiac electrical activity, assist with breathing, and treat a wide variety of illnesses. In fact, there are even some parts of the country that are beginning to allow Paramedics to deliver TPA, a medication created to break up the clots formed by stroke.

So why are EMS professionals at times deemed the “forgotten” civil service? What hinders our local EMTs, Paramedics, and First Responders from being known for all they do?

Some might say it’s because they’re gone before the press gets to the scene, others believe it’s because blood and gore turns many people off. Or perhaps it’s the mystery and lack of understanding of what actually happens when the doors are closed and the sirens turn on. So, what exactly is going on in the back of that ambulance racing down the street?

In current times most ambulances contain more than just a driver. The training, understanding, and professionalism of today’s EMS Professionals has come a long way from their morbid beginnings. Today’s EMTs and Paramedics are trained in current BCLS, ACLS, PALS, PHTLS, and so many other classes with random abbreviations. In all seriousness, these first responders receive not only highly intense training, but are tested in the most stressful and trying of situations.

Most Basic Life Support (BLS) ambulances, staffed by EMTs, are equipped with the minimum of an automated external defibrillator, oxygen, equipment to treat traumatic injuries (including tourniquets and quick clot), and equipment to treat multiple other types of medical emergencies. Advanced Life Support (ALS) ambulances and fly cars, which are staffed by paramedics, contain everything in a BLS ambulance, plus a wide array of medications to treat many types of medical emergencies, ranging from severe nausea to poisonings and cardiac arrests.

The typical EMT sits through approximately 120 hours of classroom training, in which the student learns the basic skills to function in an wide variety of emergency situation. After spending some time working in the field, an EMT can choose to continue his or her education to become a Paramedic. Paramedic Training, or “medic school” as it is known by most who work in EMS consists of an additional 1,000 to 1,200 hours of classroom and clinical education. Roughly equivalent to an Associate degree. These “paramedic interns” must master a myriad of medical subjects and clinical skills.

So, what is actually covered in these training courses? In EMT school, one will learn the basics of Anatomy and Physiology, medical legal situations, and how to recognize the signs and symptoms of and treat different traumatic and medical emergencies. They will then be tested on both a skills examination and a written examination to ensure they have mastered the fundamentals to become an EMT.

In medic school the basic fundamentals of EMT class will be reinforced and added upon. Topics studied include intubation, cardiology, neurology, respiratory, pharmacology, and other important medical topics they’ll interact with during day-to-day operations. Think of it as an overview of medical school, but in nine months. Paramedic students are required to learn ACLS (Advanced Cardiac Life Support), and PALS (Pediatric Advanced Life Support). Paramedics are also required to pass either a state or national certifying examination as well as a regional protocol examination. But the knowledge base can go even further then just that learned in the classroom.

Even after class is complete the learning isn’t over. EMTs and Paramedics are required to take continuing medical education classes and recertify their credentials on a predetermined schedule, typically every three years. This helps to make sure that EMTs and Paramedics staffing your local ambulance are up to par on the latest of medical knowledge and technology.

Considering how far EMS has come in just a few decades the possibilities for the future are endless. Recently, “Community Paramedicine” has entered the forefront, this program involves Paramedics being sent to do follow ups non-emergent medical visits. There are also some areas of this country (including parts of the New York Metro Area) in which specialized ambulances are being equipped with CAT Scan devices to detect and begin treating strokes in the field. While these ambulances are staffed with doctors working with the Paramedics. It is safe to say that this goes above and beyond the idea of it being, “just a ride to the hospital.”

So, the next time you see an ambulance racing down the streets towards a call remember that in most cases, it’s not “just a ride to the hospital.”