I know that my 7.5 years pales in comparison to many of those that are on the Job currently, but I feel like I have seen my share of “emergencies” in this time. What constitutes an emergency though?
Merriam-Webster defines an emergency as “an unforeseen combination of circumstances or the resulting state that calls for immediate action”.
We’ve all been there – 2am, at the nursing home for “unusual labs” but the patient states they don’t really want to be transported – but their Doc says they have to. Yea, it gets frustrating, especially when they’ve had the labs for the past 18 hours and are just now calling us, but I’m not physician. Hell, I haven’t even finished college. I can read, and can see what the lab report says, but that doesn’t mean I would truly understand what it means. The other portion of this side of the spectrum are the patients who have a broken nail (I have been dispatched to a call for a broken finger nail). We get these calls from years of telling patients “We’re here for you, calls us if you need us” or similar statements. We are here for the public, but phrases like these lead to over worked 911 systems. I’ve been told by a close friend that a large metropolitan area (not in VA) that utilizes a priority/triage based system of receiving and dispatching emergency calls. This method of dispatching helps to ensure that the most critical patients receive the most appropriate care as fast a possible, while more stable patients receive it as units are available. Now, I’m not familiar with this set up personally, so if someone has personal knowledge of it, please let me know.
What really brings this question to mind tonight isn’t the overworked EMS system, but the fact that I received a phone call the other evening from a family friend about an odor of gas in her house. She was calling me because her husband was out of town and she knows I’m a firefighter. Well, I was at work so there wasn’t much I could do for her personally. My response was simple – get out and call 911. Sure, it may just be a pilot light out, or something arbitrary like that, but why risk it? She wasn’t too keen on calling 911. As a firefighter with access to gas monitors and PPE, the odor of gas isn’t as great a concern to me. But for an average person it should be considered an emergency. Same as a CO detector going off should be an emergency (unless its a low battery alert which is a different noise from an alarm).
I have met more people on fire service calls apologizing for calling 911 and having us come out than any other call type. I look at it from the stand point that if you call because your CO detector is going off, or you have an odor of smoke or gas then calling us is a preventative measure. Similar to going and getting a yearly physical. Why put yourself at risk? We are here to serve the citizens, tax-paying or otherwise.
The public calls on us - Firefighters, EMTs, Medics – to come and assist them with something that they perceive to be an emergency, whether we see it as such or not is a different matter.
What is an emergency? Who decides?
Good article. As I see it, an emergency is anything that has the potential to get worse if it isn’t properly addressed. We are in the business of responding to emergencies.
Interestingly enough, what we consider an emergency doesn’t necessarily line up with what the average joe thinks is an emergency, or even what the cops and docs think is an emergency.
In my experience, those “weird labs” calls you speak about are an emergency to the hospital in the aspect that they have finally cleared a bed and an empty bed is a bed costing them money. That is not an emergency, but the docs certainly seem to leverage us into action by using it as one.
The broken nail is an emergency in that the individual is probably so dependent upon others to make decisions for them that they don’t even know what a real emergency is. Stupid, yes; emergent, not really; but in their perspective, why not call 9-1-1? They’ll come solve the problem for me.
Just like everything we deal with in this job, we have a more cynical eye because we have genuinely seen it all, and if we haven’t, we’ve seen something that resembles it. So our perspective is a jaded one. For me, unless my kids have an active arterial bleed, they can walk it off. So despite a few near-misses that have gotten me in trouble for underestimating the severity of my childrens’ health (hey, they teach me to look for life-threatening signs, not red spots, so no, I didn’t catch their Scarlet Fever and I don’t remember covering that in paramedic class), my kids are probably a little tougher than the rest of the linoleum lizards at school.
Just as beauty is in the eye of the beholder, so is an emergency. Our job is to go there, put a smile on our faces, stop the loss (or perceived loss), and help facilitate their experience. Be that pointing out that the flowing water from the leaky pipe can be solved by turning off the water to the house (from the service valve they didn’t know existed), to splinting a hiccup, or whatever calms them down and reassures them that all is well in the world.
Good job. Keep the faith and remember that the first pulse to check at the scene is your own. Unless it is our house burning down, it isn’t our emergency, it is theirs. We’re there to make things better. Stay safe.
I’m a first generation firefighter too. No history of ANYONE in my family EVER having been associated with the Fire Department, and to this day I still can’t figure out how I ended up a Fireman. That said, I’m coming up on my 27th year in a big city Fire Department and as I look back I realize that for the most part it’s been a great ride, and it’s been a true honor and privilege to serve and work with some of the finest people on the planet. As for what constitutes a true emergency, trust me, you’ll never figure it out. It’s been my experience that the people who don’t need 911 call at the drop of a hat and those who truly need us are hesitant to call. You know them, they’re the ones who are all apologies when you show up, doesn’t matter if they’re having a heart attack, they’ve lopped their hand off with the lawn mower, or their freakin’ house is on fire, the first thing out of their mouth is, “I’m sorry I called.” Damndest thing I’ve ever seen. The only advice I have to offer is embrace and love the stupid people, they are your job security and they are an endless source of entertainment. You will never run out of stories and when you tell them to outsiders who aren’t associated with the Fire Department they’ll never believe you. More importantly, love the guys you work with. They’ll be the ones you can lean on in good times and bad, and trust me, sometimes it’ll seem like nothing but bad times. They’re the ones who will ALWAYS be there whether the dog leaves you, your kids leave you, or your old lady leaves you. These are the guys you will form lifelong friendships with, the guys who will be there through thick and thin, the guys who got your back no matter what, the guys who’ll drag your ass out of that building right before the roof crashes in and then look you straight in the eye and say, “GODDAMN, that was fun!” So tighten up your seatbelts, grab aholt of the Jesus Christ bar and hang on, you’ve got front row seats to the greatest show on earth, the human condition!
Sadly some folks see their stubbed toe or knee pain as an emergency because it hurts and this is the most traumatic thing they have ever had to face. Some people are also chronic 911 junkies who actually have a NEED to call for help. Doctors in the local hospitals here are starting to get tough on these frequent flyers and refuse them them any “pain management” drugs until all the labs/x-rays come back (in most cases they are all negative) then cut them loose.
The implementation of the 911 system makes it so easy to dial those magical numbers and the guys in the big red truck or the guys with the bed on wheels show up and fix whats wrong. Most (what we all would call the bulls**t calls) are usually scared lonely people who need some type of kindness shown to them and a little human interaction, even if only for the 10 or 20 minute ride to the ER. It’s not hard forget the human factor in the equation when we get called out at 2am and have to crawl out of that warm rack and into a cold rig because Jane Doe is having a panic attack and calls 911 and says she is having chest pains. Don’t forget that there is a flip side to this coin, the person who is in active MI and says he’s OK and that it’s just gas because he doesn’t want to be a bother and have any fuss made over him.
Nursing homes are a whole other story, 90 yr old Esther falls 3 days ago and started acting funny around noon so they put her in bed. Now it’s 4am and they think maybe she needs to go in and get looked at… imagine that…
911 is another beast all it’s own, we will get tripped out for active seizures and it’s given the lowest response priority (right up there with a hang nail) next call is a psych and it’s given the same response priority as a cardiac arrest…
These are the things we all love and hate about EMS but it’s also what makes it EMS. What is an emergency is a relive question, it is dependent on the person and their perceived level of comfort in dealing with a set of circumstances.
Good post. We have a notorious caller who is disabled and uses City FD/EMS to come pick up his remote when he drops it. I swear, can’t make this stuff up! The city I speak of does triage 911 and I have seen benefits and detriments to this. The nearby town i live in doesn’t triage, but is MUCH smaller, therefore less emergencies. For the city FD if a call is “mandown” or “unknown medical” or “toe hurts for 3 weeks” they respond Code 1 (flow of traffic) if they are at a hospital dropping off they may take a few min to get rig back together then roll. A CPR in progress call or even a chest pain/SOB or bleeding, etc would get nearest inservice engine crew and closest available ambulance Code 3. Sounds pretty good right? Well I am also an RN in an industrial setting, and once had a pt go down on me in a bathroom no where near our facility. I went to help with what I could carry and asked security to call 911, the call came in as unknown medical mandown, took 30 min for response. Just so happened that I knew the crew and we discussed what happened. My lesson learned is that from now on I call 911 and make sure that age, status and location are clearly defined. I “know” better, imagine a hysterical mom of a choking infant or 3rd party caller who thinks that dad may have passed out during a phone call, i can think of plenty of situations where a 911 dispatcher would have to make some VERY TOUGH decisions, I guess I just hope that training and judgement err on the side of caution?
I agree with above: It’s their emergency, not ours, we are their to make everything all better.