February 09, 2012 at 5:59 PM
Balancing the physical, mental and psychological demands of emergency treatment
By Michael Peeling, The Paris Star
Sandy Taylor learned a lesson in paramedicine the hard way.
A few years ago, the Paris-based personal trainer was alarmed to find she was experiencing a rapid heart rate.
The experience frightened her, not knowing it could have proved to be lethal.
“I didn’t know it at the time, but when it happened again I called 911,” she said.
The paramedics who showed up to take care of her when she felt the most vulnerable made a lasting impression on Taylor.
“I got great care,” she said. “I didn’t know what was going on, but I felt I was in very good hands. They explained everything to me. They would say, ‘I’m doing this because ... ‘ all the time. I didn’t know if I was going to live, so it made me feel a lot better about the situation.”
Taylor’s appreciation for paramedics and the work they do has only grown over the years, particularly since meeting Sharla Kokanie and Tracey Emmos.
Kokanie and Emmos have both been paramedics for about 13 years.
When they went looking for a trainer to help them better physically handle the demands of being a paramedic, they were referred to Taylor.
The fit felt even better when the three women realized they were neighbours.
Before Taylor started their training, there were a few questions in need of answers, such as ‘Why do you want to be stronger?’
The answers are many and often unpredictable for a paramedic.
The heavy equipment they have carry from an ambulance to a patient is just the start.?
“A lot of the people we help are not ambulatory,” Kokanie said. “They’re not able to walk.”
What makes mobilizing these patients are the frequently awkward positions paramedics find them in.
For example, Emmos has found people wedged beside beds or in between a toilet and a wall.
“It’s situations like that when regular lifting techniques are not appropriate,” Kokanie said. “You’ve got to do whatever you can to McGyver a way to get them up and onto a stretcher. Then you’ve probably got to carry them down stairs while still treating them. It’s a real challenge. It’s hard on the body.”
To illustrate Kokanie’s claim, Emmos recalled having to climb inside a vehicle involved in a collision to help a couple inside.
There was a possibility the woman had a broken back and she was entangled in her husband.
“I was contorted in there for 40 minutes, and I had to come with a plan to treat them until they could be removed,” she said.
GETTING MORE COMPLICATED
And for a paramedic, treating a patient hasn’t gotten any simpler.
Long gone are the days when their predecessors were little more than ambulance drivers who could not provide emergency care, just a ride from point A to the hospital.
“There are a lot of misconceptions about paramedics,” Emmos said, then referred to Taylor’s medical emergency. “If we know what condition you’re suffering from, we can give you medicine to stop the pounding. We’ve come a long way.”
Taylor shakes her head in amazement and admiration listening to the paramedics.
“I couldn’t do what they do,” she said.
Emmos and Kokanie are both advanced care paramedics (ACP), which requires them to undergo more training and continuing education than a primary care paramedic (PCP).
Studying and training to be a paramedic requires a minimum of two years in a community college course, completing the provincial examination for paramedics (EMCA), securing a job with an ambulance service, obtaining certification from the Medical Director for defibrillation and symptomatic relief medications and competing against other paramedics for advanced training.
Glen Cunnane, a paramedic for 17 years, notes becoming an ACP could involve up to another year’s worth of schooling.
An ACP, unlike a PCP, for example, can administer approximately 20 different drugs to a patient instead of the basic six, and use a manual defibrillator.
They can also intubate a patient, which involves putting a tube down the throat and into the lungs to enable breathing.
When a patient is in serious respiratory distress, paramedics can break out a CPAP (continuous positive airway pressure) machine.
Emmos, Kokanie and Cunnane said the impact of using a CPAP machine can save a patient from an extended stay in hospital and, consequently, a considerable number of taxpayer’s dollars.
INSPIRED BY BROTHER’S PLIGHT
A family medical emergency inspired Emmos to become a paramedic.
Her brother fell down an elevator shaft. As a result, he fell into a coma and didn’t come out of it for weeks.
When he awoke, he suffered from a brain injury and underwent extensive rehabilitation.
“It was that exposure to the emergency element of the situation that got me interested in paramedicine,” she said. “The element of being there and be able to help.”
Kokanie was looking for a job with an element of unpredictability and outdoor activity.
“I like the unknown part of the job,” she said. “It’s not an indoor job and I like the freedom. On any given day you don’t know what you’re going to get. Anything could happen.”
Kokanie had looked into becoming a physiotherapist, but found it boring.
“I needed more excited and action,” she said.
EACH DAY DIFFERENT
The demands of a 12-hour shift vary considerably for a paramedic, from answering two calls to more than a dozen.
“Calls range from not feeling well to cardiac arrest to a car accident,” Cunnane said. “You name it.”
“Anything to do with a child is the worst call you can get,” he said. “It’s not the most traumatic injuries. Many of us have kids, but you have to learn to separate yourself when those calls come in. They can tear you apart. They are always difficult and you imagine your own child in the same situation.”
Two calls he attended stand out in his mind. The first involved two children and their mother dying in a fire, while the other was the mysterious death of an infant.
When people ask Emmos how she can continue to do such a difficult job, she talks about the life-affirming aspects of being a paramedic.
“I’ve had some great moments in my career,” she said. “I’ve delivered four healthy babies. Even when there isn’t a happy ending, I can always say I did what I could. I did the best I could.”