Two days with the Dorchester County Emergency Medical Service
We all know that when you dial 911 you get police, fire or EMS. We all see the ambulance go by with that spark of curiosity…is it a wreck, is it a fire, is it someone we know?
The daily life of EMS can be both dramatic and boring. It can involve call after call with no time for a break during a 24-hour shift. Or it could involve one or two calls in a 24-hour period, the rest of the time spent waiting.
Day 1, 10:30 a.m. – psych call
The call comes out as unconscious, not breathing. Medic 1 is rolling within a minute. As it nears the address, dispatch comes back on and tells it to stage. This means the rig stops, out of sight from the address, and waits until law enforcement clears the scene so the ambulance can continue.
Apparently, there is no one unconscious and not breathing. Apparently the issue is more of a psychiatric one. We are cleared to continue to the scene.
A man is sitting on the end of a bed in his mother’s bedroom. He is the only one home. Law enforcement is there in force as apparently this is the second call to this address in a short period of time.
The first was a report of “a large black male hiding in a closet.” The second was “my daughter is unconscious and not breathing.”
Neither is true but the product of a hallucinatory state. The man doesn’t want to go to the hospital. Both law enforcement and EMS try to gently suggest that this would be the best thing for him.
Finally, a conversation with mom, over the phone, convinces him. He climbs onto the stretcher and lets us transport him to Summerville Medical Center.
This is what is called a psych call.
Although it is the first call of the “prime time” – 10 a.m. to 10 p.m. when it is the busiest call volume for Dorchester County EMS – it is not the first call of the shift. That was around 8:30 a.m. when a call came in for a possible stroke. Turns out is was not a stroke but partial information that scared the caller into calling 911.
EMS structure, history
Normally, Medic 1, which is stationed at the county EMS headquarters on West 5th North Street, is the busiest of the eight ambulances. However on this day, it is very slow.
Headquarters houses two ambulances – Medic 1 and Medic 8. Medic 8 is a floating ambulance, meaning that it roves the county filling in if an ambulance is out on a call. So if Medic 2, at Old Trolley Road is on a call, Medic 8 will head that way to cover the station until Medic 2 is back in service. Or maybe it heads up to St. George because Medic 5 is on a call. The turn around time for Medic 5 is about three hours as it takes approximately 45 minutes to get from St. George to Summerville Medical Center and longer if it goes to Trident or MUSC.
Today, the paramedic and EMT-Intermediate who are working – Paramedic Josh Arrant, 35, and EMT-I [Intermediate] Mike Bisnett, 23, – spend a good portion of the shift doing other things. Bisnett studies and Arrant spends the day talking about what Dorchester County EMS is all about.
Arrant is working overtime, having just finished his own 24-hour shift, he is covering for a colleague.
EMS works 24-hour shifts on what they call a 24/48 cycle. So, 24 hours on and 48 off. Unless, of course, there are shifts to cover. Shift supervisor today is Captain Jody Tucker, paramedic. His job, says Arrant, is to make sure everything runs smoothly, put out fires, and know where every ambulance is at every moment.
“And he does,” says Arrant. “When it is his shift, you could call him at 3 a.m., wake him up and ask him where Medic 6 is and he can tell you.”
Dorchester County EMS runs three shifts – A, B and C shifts – which are assigned by the days of the week not the hours. And they rotate as do personnel assignments. One week Arrant might be on Medic 1, another week, he might be assigned to Medic 5.
Each team has a crew chief and a crewmember. Arrant is Medic 1 crew chief today. Bisnett is its crewmember. Anyone with Lieutenant rank, such as Arrant, is station supervisor.
There are seven grounded stations with one truck per station. In addition to Medic 1, 2 and 5, there is Medic 3 – stationed in Ridgeville, Medic 4 – in Harleyville, Medic 6 – in North Charleston on Ashley Phosphate and Medic 7 – at The Ponds.
Dorchester County EMS mission is to provide exemplary medical services to the citizens, visitors and neighbors of Dorchester County by creating and maintaining a nurturing environment that recognizes the unique contributions of each employee, pursuing excellence through state of the art training and technology. Recognizing human rights, dignity and diversity, being responsive to the needs of a growing and changing community and advocating health and safety through education and involvement in the community.
To this end, Arrant says, they conduct numerous CPR classes and other community training events.
Under the leadership of Douglas H. Warren, EMS director and Wendy Lee, deputy director, Dorchester EMS has grown since its inception in 1994. Prior to 1994, emergency medical care was provided by private establishments including Bryant Funeral Home, Herbert’s EMS and Summerville Ambulance.
At its beginning, Dorchester EMS had only four staffed medical units. Medic 1 in downtown Summerville, Medic 2 in the Oakbrook area, Medic 3 in Ridgeville and Medic 5 in St. George. As the years passed Medic 4 was established in Harleyville.
With the enormous and rapid growth of the county, three additional vehicles and a rapid response vehicle were placed into service.
Further, Dorchester County EMS has earned CAAS certification (Community Accreditation Ambulance Service) – no easy feat. The certification is based on quality of care, standards and procedures followed by the department. It was the second organization in the state to be awarded the certification.
5 p.m. – medical alarm
After a very long day with no calls since the morning ones, Medic 1 is dispatched for a medical alarm alert. EMTs are told, when they arrive, along with members of the Old Fort Fire Department First Responders, that the button was pushed by accident. However, it is apparent that there might be more at play.
The patient is in a wheel chair and alone, although there are a number of small dogs in various crates in the home. She has numerous medical issues. While the EMTs are there she attempts to get her son to come home. He won’t. She then calls a friend and, in tears, talks the friend into coming over. She says she doesn’t want to go by ambulance to the hospital and signs off with the medics.
So was the alarm activated by accident or was she simply lonely?
Unknown but not all that unusual, Arrant says.
Medic 1 returns to base.
7:35 p.m. – suicide threat
Medic 1 is dispatched to a threat of suicide. It is instructed to stage and await law enforcement clearance of the scene. Medic 1 stops, out of sight, and waits. And waits. Dispatch comes back on and tells Medic 1 it can cancel the call per Summerville Police. This is unusual, says Arrant, as police rarely assume the responsibility of determining a call medically unnecessary. However, he explains, this could be a case of a domestic argument where the threat of suicide was used solely to manipulate the other person.
This, too, happens with some regularity.
8 p.m. – station duty
Arrant’s shift is over and he is relieved by Paramedic Tammy Reilly, 30, of Summerville, who takes over as Crew Chief. Reilly is the mother of twins and, in addition to working full time for DCEMS, she is also a substitute special education/autism teacher for DD2 and part-time paramedic for Orangeburg County. She also teaches first aid and CPR.
Those who are on duty at 8 p.m., have station duties. This includes vacuuming, washing floors, emptying the trash, making sure all the dishes are washed and scrubbing the bathroom.
Reilly and Bisnett split the duties.
9:30 p.m. – dinner run/‘seizure’
Duties finished, the crew decides to make a dinner run, ordering fast food, and then stopping to fill the fuel tank. While at the gas station, they are accosted by an old acquaintance. This individual is an alcoholic, always drunk, who repeatedly calls 911 claiming to have had a seizure so that he can be transported to Summerville Medical Center where he can get a meal.
He never has seizures, they say, but it is often up to EMS to deal with him instead of police.
Tonight, however, Reilly calls SPD. She tells the man that he has not had a seizure. He tells her that everyone is stealing his money. Police arrive and take over. The rig returns to base.
The night quiets down.
There were a couple of other calls throughout the night, Reilly says.
The divorce rate is high in the world of EMS. And even though a lot of relationships are between EMS, or EMS and law enforcement, it doesn’t seem to make much difference. The divorce rate, says Arrant, is 80 to 90 percent. He blames it on the long hours, the type of schedule (24/48), the low pay that has them all taking extra shifts, and the inability to really plan ahead. For example, even if you have a vacation scheduled, if no one can be found to cover your shifts, you have to work. “It makes it tough to go somewhere, or buy plane tickets, and so forth, says Arrant. There are no holidays, no weekends, etc.
“It is a family atmosphere here,” says Arrant. “Just the other day, our Deputy Director volunteered to work a shift for one of our scheduled medics, because she had family issues.”
“We [DCEMS] have some of the most motivated, educated and dedicated of any EMS around.”
(To be continued….)