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Updated 10 June 2014

A day in the life of a paramedic

On the front line of the battle between life and death it's the paramedic who has to stay calm and think fast, making sure every second counts. Robert Mckenzie, a paramedic with KZN Emergency Medical Services, takes us through a typical working day.

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My mornings start like any other person’s, I presume, except I wake up to multiple messages on my phone informing me of the motor vehicle collisions and incidents that occurred the night prior.

Properly loving coffee more than most, I started my day with a seemingly short drive to work. During my drive, I began to prepare myself mentally for the day ahead, as it is usually quite hard since you never know what’s going to happen. Today I worked the day shift from 07:00 to 19:00.

When I arrived at base, I met some of the paramedics who had worked the night shift; they were exhausted, but in a light-hearted mood, as they were glad that their shift was over. I asked how the night shift was, and “it was crazy man” was the brunt answer I received.

I should have known it was busy; it is a weekend at the end of the month after all. Some crews had ended up travelling several hundred kilometres during their shifts.

I ran into the night shift paramedic in the Advanced Life Support paramedic’s office, which is more of a mini store room with medical stock, equipment and monitors than a traditional office. She walked out of the base directly to her car, deliberately not stopping to talk to anyone, as it would delay her getting home and into bed.

A quick staff parade is done at the beginning of every shift to check vehicles for defects or damages, to see if all the equipment works and is charged, and to make sure we have all the medical stock we would need; we try to keep enough stock on response vehicles to be able to start basic treatment for a mini bus loaded with patients, which is normally 16, at any time.

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I stopped by the Emergency Call Management Centre before I left for the day. I helped the dispatcher reprioritise the cases, which are mostly assault cases, and then I left for the first call of the morning.

There has been a house fire, and the police and fire department that were on scene suspected that an elderly lady had died. An ambulance crew and I were dispatched to the scene, but we arrived too late; they lady had already passed on. An unattended candle left burning during the night was the suspected cause of the fire.

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I was dispatched straight away to another case about half an hour away. As I got closer to the area, I had to get directions from the people who lived there. Navigating in rural areas is quite difficult, as there are very few roads that have names. As for those that do have names, they are not marked; there are no street numbers.

Some of the houses have five digit numbers painted on their sides, but there doesn’t seem to be any logical numerical relationship between the numbers. Therefore, directions are normally given in the form of landmarks, such as community halls, bridges, schools and little spaza shops. 

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I know which turn off from the main road I needed to take; I was told I needed to pass two schools on my left and the scene will be before the blue tuck shop. Not long after turning off the main road, the road turned to gravel and I was reminded why our response vehicles are 4x4 bakkies and not sports cars, as some paramedics have in the city. After driving for some time, I realised I had gone too far.

I turned around and proceeded back in the direction I had come from; this time I managed to see a sign board that said, “Lucky shop,” which was where I needed to go. Turns out the scene was located at a red shipping container, and not a building as I had been expecting.

The ambulance arrived on the scene shortly after I did. As we treated the elderly patient, I remembered one thing many paramedics tend to forget. It is crucial that we tend not only to the patient, but the patient’s family as well, as they are normally concerned about their relative and need to be reassured and informed as to everything that is being done to their family member.

We transported the patient to the hospital in a serious, but stable condition. At the hospital, the doctors and nurses were still busy treating the over influx of trauma patients from the previous night.

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I continued my day as such. Later in the evening, I was dispatched to a motor vehicle collision about 40 minutes away from the base. We battled to respond to the call, as there was work being done on the road, but we eventually managed to get to the scene.

While driving, I noticed a truck on the side of the road, with its hazard lights on. A few people stood behind the truck, while others ran closer. Everyone was standing around a man lying motionless on the side of the road. After a few moments, I realised the man had been hit by the truck, and the accident had just happened!

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The station officer continued on to the original accident, as I stopped to assist the man. I parked my response vehicle between the oncoming traffic and the injured man; the scene was on a bend in the road and it was almost dark.

I was worried that ongoing vehicles were going to hit us while standing on the side of the road. Using the two way radio, I asked the control centre to send the police and an ambulance to come and assist me.

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I carried my equipment to the man’s side, and I noticed that some of the bystanders had already started to cry, thinking that the man had already died. I assessed the man; he was critically injured, but still alive. I was the only person from emergency services on the scene, but I started treating the man by giving him oxygen and hooking up monitors to check his vital signs.

A police van arrived from the nearby station. A single policeman came out, put his gloves on, and began helping me while the others assisted with the flow of traffic. When the ambulance arrived, the ambulance crew assisted me in treating the patient.

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We administered the required medical care to the man and loaded him into the ambulance; by this time it was dark and it had started to rain. We were glad to be off the side of the road as cars were driving faster and faster around the corner, passed the scene, despite the police warnings.

The trip to the hospital seemed to take forever as we had to pass through the same section of road work to get to the hospital. A trauma team awaited our arrival at the hospital. We handed the patient over to the doctors and filled them in on what had happened.

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During a handover to a doctor, you tell them three things: what is wrong with the patient, what the injuries are, and what your treatment has been. You are then required to complete a written handover that goes into the patient’s file, which the doctor signs.

It was well over 19:00 when we finally got back to the base. The night shift crews, who were by now rested, were full of energy and jokes, ready to start their last night shift before going off on their rest days.

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While driving home, I couldn’t stop thinking about the case I had just completed: Was there anything I could have done differently or better? Would the patient be O.K.? These thoughts continued to flow through my mind all throughout my drive, but quickly ended when I got home.

I opened the door to my tired son screaming, “Daddy’s home!” My baby was safely asleep and my other son needed to be carried to bed; he fell asleep on the couch, not managing to stay awake to see me arrive home.

My working day is now over. I am at home, something that I cherish. There is always a phone that can ring, with someone on the other line saying, “There is a child,” “There is a bus overturned,” “Multiple critical patients; we need you,” “There is a…” before you can even say “Hello.” A paramedic is never really off duty.

About Robert Mackenzie

Robert is married to to Charline and has three children, two boys and a little girl, Mia He works for KZN Emergency Medical Services (EMS), the former EMRS in KZN. After shool he obtained a N.Dip in EMC and BTech in EMC from the Durban University of Technology.

He started as a shift paramedic and is now responsible for clinical coordination in the Ugu health district.

He's on several committees at a district and provincial level for EMS and the Department of Health. He often ends up seeing clients in the pre-hospital environment as a Advanced Life Support Paramedic.

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