“Thank God it's a paramedic and not a nurse.”
When the citizen injures himself, a paramedic is as close as a phone call to
911. (In the United Kingdom, the unconscious party dials
0800.) Chances are that an arm or leg is hanging by a skin tag and blood is spurting everywhere; or a plaything has been captured inside a bodily orifice and will not come out; or conversely, a play appendage has been captured inside a bottle and will not come out. The citizen can call for the paramedics, secure in the knowledge that they are professionals and the incident will not be converted, ever, into cheap gossip in town.
As the citizen is at the phone, he can also call for a pizza, which will arrive at about the same time. The vehicle with the pizza is the one without all the flashing lights, unless the pizza delivery boy is taking selfies while he drives.
The Grim Reaper curses when the ambulance careens onto the scene, and sometimes the Three Fates sigh too. Death will once again be thwarted by the arrival of the paramedic, even when you have sideswiped a camper van into the ditch alongside the Interstate.
When encountering a teenager who has hanged himself, the paramedic is the only person who is entitled to quip, "How's it hanging?" before commencing CPR.
Unlike the pizza delivery boy, the paramedic is a trained professional. Paramedics train for months, learning physiology or at least common body shapes. They study complex medical conditions, how to save lives, and how to generally be kick-ass in the face of death and destruction.
Of course, soldiers train on what to do in the event of war, or at least a war that goes exactly as planned. The one thing paramedics don't learn is that emergency intervention rarely goes exactly as planned either. This renders most of their training useless (except for the "kick-ass" classes).
Doctors famously earn their Ph.D., then go for four more years, then spend a residency practicing perfect bedside manner after going without sleep for a week. This is because the purpose of medical training is to earn a high enough salary to afford malpractice insurance. In contrast, the purpose of paramedic training is to get services out to the public as quickly as possible, safely working for a government body that cannot be sued. So paramedics are cranked out in two years at the Vocational Technical or Community College. This gives the patient the warm feeling that he is being treated by someone who is Community minded, or Technical, or somewhat Vocational. And wearing a lab coat and a clip-on tie doesn't hurt either.
During their education, paramedics practice on patients at nursing homes. There are several good reasons for this:
- The patient is grateful for the attention from a nice young man willing to hear one more time that story about re-taking that hilltop in Korea.
- The patient's perception is so reduced that he never questions why the needle is being stuck there.
- The patient's assets are either already squandered or already in the hands of the heirs, who have no motivation to spend some of it on a pesky lawsuit when the old crone was on her last legs anyway.
Most paramedics work for municipalities. This means that there is both great political pressure to equip ambulances with the newest technology, and great bureaucratic inertia to keep there from being any of necessary expendables aboard. Because of this, paramedics have learned how to save any life using only a BIC pen, duct tape, and condoms.
Despite always being out of the right size of bandages, ambulances always have defibrillators. Defibrillators are marvelous devices. They let paramedics shoot electric arcs almost as awesome as those of Emperor Palpatine.
- Some paramedics work in the military, with the same implications.
Being compared to firefighters is paramedics' primary occupational stress. Firefighters put out fires. Not all paramedics even hoped to be a firefighter. Most hoped to be an astronaut. (Being compared to "firemen" is worse, as paramedics never arrive via locomotive.) In fact, one of the principal stresses on the paramedic is finding things for the attending firefighters to do on the scene to keep them feeling important.
Paramedics receive physical stress through carrying fat people down stairs and up into the ambulance. As a rule of thumb, the fatter they are, the higher they live in the apartment.
One reason paramedics are confused for firefighters is that many work for the Fire Department. There are more reasons for this than the desire to strut around in uniforms, the same impulse that led Chief Justice Rehnquist to think his robe needed dopey rank insignia during the impeachment of Bill Clinton. It is all about funding. For example, having a firefighter die in the line of duty — likewise having a paramedic go "down" from driving the ambulance too fast to pick up the squad's order at Pizza Hut — always shakes more money out of the City Council, which benefits everyone. With luck, a widow will go to the Council meeting and sob about respect for the First Responders.
The desire to wear uniforms is not completely childish, however, as some patients resist the insertion of a catheter by a person wearing overalls, sneakers, and an AC/DC concert T-shirt.
Myths about paramedics
- They get misty-eyed about the people they didn't save.
- Like all medical providers, paramedics accept the limitations of medicine (rather better than lawyers do). And paramedics in particular tend to forget where they put the clipboard, much less whom they couldn't save.
- They drive like bats out of hell.
- Drive like a bat out of anywhere and the patient in the back, who might have at least one City Councilor on speed-dial, will put you in the newspaper instead of him.
- They have sex in the back.
- As pretty much every secretion of the human body ends up all over the ambulance at some point, it is not an arousing place to disrobe.
- They tell people to fight while doing CPR.
- In fact, discussing medical needs with the other providers on scene usually beats murmuring to an unconscious person. Even having a crowd of friends and relatives gather around and get in the way, holding the hand of the unconscious person, choking back tears, and disclosing that Fred is not really his father, does not seem to revive victims of transient psychogenic syncope the way it does in soap operas.
- They're ambulance drivers.
- For the love of God, people, the stuff in the back ain't just for show! A cop isn't a cruiser driver, is he?
The biggest myth about paramedics is that they mean free medical care for everyone. Perhaps the reader can read more about this in the Spanish
Inciclopedia, or the Mexican
Wetback-opedia. In fact, the illegal knows that it is hospitals that provide free hangover remedies; the ambulance is merely a taxi that reassuringly lacks the meter and any way to swipe a credit card. Some paramedics deliver a subtle hint by inviting the "patient" to take the seat behind the steering wheel. Illegals are remarkably able to describe their maladies to the paramedic, retreating to No hablo inglés only when the police arrive.
In the white community, there is a persistent myth that, if a child is running around the house and playing, there still might be something significantly wrong with them that requires dialing
Myths about medical emergencies
- If you're really drunk they'll pump your stomach.
- Gastric lavage has fallen out of favor, but this remains a useful myth to keep Junior out of the Jack Daniels.
- Good Samaritans should cover with coats someone who falls over in the street.
- Perhaps, but in the hour before the ambulance arrives, you are going to feel a real nip in the air.
- Shocking people restarts their hearts.
- Actually, defibrillation or synchronized cardioversion does nothing less than cause transient pauses in ectopic... You know what? Never mind. Sure. Shocking people is like pressing
RESETwith a paper clip.
The most intractable medical myth is that the health complaints of attractive blondes warrants immediate emergency attention, no matter how slight the complaint may be. Oddly, this myth is confined to the paramedic community.
The angry paramedic
Most citizens understand the extreme importance of not pissing off a paramedic. This is more important even than not angering a postal clerk or a social worker. Anyone who can revive you from death could, in theory, elect to leave you there. Short of lethal vengeance, the angry paramedic has a palette of half-measures for self-amusement, including making the patient soil himself through creative mixing of morphine and demerol. Even short of that, the patient must realize that he is dependent on the paramedic for the very air he breathes, which ideally should not include an ammonia inhalant. And there is always morphine on hand to adjust the cranky patient's attitude. So be nice.
The angry paramedic uses the following techniques to deal with the problem patient:
- Using the largest IV you can find, and starting the IV in the penis is fair game, at least to Army paramedics. Cold packs in the groin area seem to cool off hot heads. Neither cold packs nor IV bags leave bruises.
- Oxygen tanks make a ding sound when impacting the cranium. This has been tested successfully in Memphis against a knife-wielding patient. Simply note on your report that you "applied O₂ to the face."
- 8 D-cell magnesium flashlights are not just for checking pupils. Splints and clipboards also have many "off-label" applications.