If family or bystanders investigate,

they'll find that everything we do is scrutinized in the most minute detail,

especially our chute time (time from call to unit), response time (time

to get to the scene), down time (how long we're on scene providing care),

and transport time.

And, just in case they fear

a cover-up in the recording of these times, nearly every EMS call in the

nation is recorded and time-stamped. If anyone tries to doctor the times

recorded on the log in order to appear in a more favorable light, they'll

fall victim to the unalterable time stamp.

Secondly, care rendered on

scene can take many forms. A lot of the variation is simply a medic's

own habits. One thing that is overlooked by civilians is the fact that

whatever you take from the truck to the patient must be brought back again,

along with the added weight of the patient.

Most of the equipment we use

in a code (cardiac arrest) is very heavy or bulky to carry alone, and

carrying it can actually cause more delay for the patient. Personally,

I prefer to work codes in my truck. It's just a more controlled environment

in a place where everything else is out of control.

The article didn't say specifically,

but I would imagine that the patient received CPR along with ventilation

on the way to the ambulance.

Your article did mention the

fact that the rhythm was un-shockable. There are only two shockable rhythms

in the field. Simply put, by the time a medic reaches a patient the rhythm

has usually deteriorated into asystole, or flat line. You don't shock

that. A heart's rhythm can't be diagnosed outside of the ER without some

kind of monitor, only whether or not a pulse is present.

Finally, most people don't

understand what it is that we actually do. We're not just "load and

go" services anywhere. We can do nearly everything in a medic unit

that can be done in the ER, except for suturing.

A unit's downtime on the scene

of a code is not normally cause for speculation of "what if."

On a code, we push the same drugs, intubate the same trachea, and shock

the same rhythms that are done in the ER.

It's also mentioned in the

article that since there were a lot of people carrying the stretcher,

the patient should have been loaded faster. Unless I know a person on

scene who's known to be an EMT or medic, no one but me and my partner

handles the stretcher.

Why? Those things have collapse

triggers which can be very tricky. An untrained person making one wrong

move can send it crashing to the ground. Not only does this raise the

chance for further patient complications, it can, and often does, hurt

one or both of the medics.

If I'm hurt, I can't help anybody

and I have to wait for and tie up another unit for the same call. Not

to mention that my injury may also require a trip to the ER.

These situations are extremely

tragic. And it's much worse when the patient is a young person. I know

of NO medic with whom I've ever served who didn't bust a gut to save a

life.

But the medical director for

my medic class told us to always remember that some patients, no matter

how skilled the medic nor how fervent his effort, simply insist on dying.

Rule #1 is that people die. Rule #2 is that medics aren't allowed to change

Rule #1.

Ben Wyles, medic

Natchez, Miss.