First aid

Updated 09 June 2014

Saturday night in an ambulance

It's a busy and bloody Saturday night on an ambulance in Cape Town. Chris Erasmus went along for an exhilirating, scary and surprising ride. Here's his story.

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I am handed a reflective vest with the words “observer” printed on it and gestured towards the back of the ambulance.  I will be riding along with volunteer paramedics Cameron and Heidi.  This is the start of the Saturday evening shift.

Hout Bay Volunteer EMS is a volunteer based organisation serving the local community.  It is run by roughly 39 volunteers.  It is overseen by Metro EMS and relies entirely on sponsorships. 

Inside the ambulance
The current team updates us on the status of the patient, as well as the ambulance. Once inside it is bigger and brighter than I imagined it to be.  I recognise a black cylinder of medical oxygen, a defibrillator, boxes with latex gloves, compartments filled with medical supplies.

The side panels have colour coded charts that are used for quick reference for various conditions. Ambulances are co-ordinated across the peninsula by two-way radio via the Metro control centre in Tygerberg. In front there are some well thumbed map books, a GPS and controls for the sirens and emergency lights.

And on to the first patient of the night. A boy lies on the stretcher. A woman is sitting with him. He has been vomiting for two days now and is seriously dehydrated. Cameron is talking to the woman, reassuring the boy and checking his vital signs. He is given a gel to aid with the dehydration. 

Cameron smiles at me, “He is going to hate me for this.”   He pricks a finger to analyse the blood.  Moans followed by blips and beeps.

Volunteers Heidi and Cameron after the end of their shift.

“I am changing his status to Orange,” he calls to the driver, Heidi, after checking the readouts. Orange means that medical care is required within the next 30 minutes. We reroute to Victoria Hospital Emergency Room. The driving with a patient on board is usually more gentle if the patient's condition is not life-threatening.

ER is busy – soon they will reach capacity and forward patients on to the next hospital, but we still manage to get inside. There is a central work station. Stretchers carrying patients fan outward from this point, beds framing the outer border. 

Staff members have a fluttering of quick exchanges with Cameron, and as soon as his clipboard is signed, they curve away in different directions. They return to their respective patients. 

A handheld radio crackles. I look back over my shoulder and notice a drip being attached to the boy’s spindly arm just as we leave the ER.

Who are these volunteers?
Cameron is a full-time student. He completed his BAA (Basic Ambulance Assistant) while still at school, and was registered with the HPCSA at the age of sixteen. He is also a police reservist, volunteer mountain rescuer and a lifeguard. 

Heidi was born in the Netherlands and has been living in Cape Town for two years. She works for a variety of NGOs and uses her spare time to do charity work. She also sings in a band.

Volunteers are paired up with whoever has similar timeslots free, and a compatible skill set, so that together they form a functional team.

The panga injury
We return to Hout Bay over Constantia Neck. The next patient slips in and out of consciousness. He is also fall-down drunk and has had a close encounter with a panga. He is patched up, placed on a drip and delivered to the ER.

The situation is much the same for the next patient. Male, drunk and with an injury to his forearm. He is accompanied by his partner, Marie. Marie is petite and about six months pregnant. The man complains about stiff bandages.

Cameron starts to loosen them, but he soon discovers why they were so tightly bound by the first responder. It takes a while to bandage faster than the blood can gush to the ambulance floor. Marie says nothing, shows no emotion. Her black eyes just stare into the void.

The vast majority of the calls we attended to were alcohol-related. I am not surprised by this, but seeing the extent of the abuse was grim. I know there are many angles to this. Nanny state, free will, choice, responsibility, socio-economic issues. Enough objections to never get a constructive result. 

It really would make sense if some of the very profitable liquor companies in our region took some of their profits and funded an ambulance in the area. Fuel vouchers from a variety of fuel stations help fuel this ambulance.  Others should follow their example.

Communities come together in strange and sometimes beautiful ways. Free coffees given by the all-night petrol station were heart-warming. 

Back in action

The next call comes from Control as a 33-year old male having seizures. Priority One.

Suddenly it’s all lights, sirens and purpose. We fly through red traffic lights. 

Community members hail us to the scene. Two men are sitting on a third. Another two are attempting to manage gyrating arms and legs. His feet are crudely bound with someone’s washing line. We are in the dark pathways between shacks.  People of all ages are milling about.  There is excitement in the air. 

Cameron approaches the patient to establish his level of alertness, and is bitten by him.  

The man manages to free an arm and throws Cameron to the ground. Cameron recovers quickly and handcuffs him.

Technically he has a right to refuse care, but here is the dilemma. If he is allowed to go free, he will only create more patients for us. 

The man seems almost "too well". He is just about overpowering four grown men. Police are dispatched and arrive within minutes. Scott is placed in the back of the police van. He is not pleased with his new surroundings.  A real lock up and go.  

A bottle of brandy, combined with a generous helping of Tik seems to lie at the bottom of this patient's problems. He is giving some very clear instructions involving the mothers of all those around him. These are delivered in three of the official languages. Not many people have heard the rap version of 'Jou ma se p...' to the tune of Umshini Wami.

Who are we to judge?

Judgment never comes into it. Drunk drivers, domestic abusers, criminals, and innocent ones all receive the exact same level of care. A paramedic will also protect your dignity if you are not able to. Bystanders have been arrested for taking pictures.

I remember an incident about thirty years ago. My parents hosted a dinner party and one of the guests had a seizure. It seemed pretty serious. The ambulance took hours to arrive and had to be push-started by the guests.  Currently the average response time for a Priority One call is 12 minutes. Some things do get better.

In this together

Ultimately I found riding along to be a connecting experience. It’s positive when the SAPS van gives a little flash of the headlights and an acknowledging blip on the hooter when passing the ambulance. 

The emergency services acknowledged one another. From Fire services, Metro EMS, SAPS to Neighbourhood Watch there was a mutual respect. The sense of solidarity was a pleasant surprise.

People do stupid, horrible things to one another, but there are also many expressions of humanity. Some so small we hardly notice them.  Seeing the traffic split open to make way for us was heartwarming. By giving way, you help. By not rubbernecking, you help. By not making hoax calls, you help. 

Being on a shift was an adrenalin rush, but it was also stressful. Being a paramedic must be extremely tough on a physical and an emotional level. Imagine if your working life consisted of a string of the most traumatic moments of others' lives. Paramedics do not always get the praise and respect they deserve. 

After the shift the ambulance is prepared for the next team. The floor is scrubbed, the stocks replenished, and the paperwork finalised. The mood is positive. There’s some banter. 

My reflective bib is returned to its locker. I notice Heidi return the supper she never had a chance to eat to the boot of her car. 

I ask Cameron how many people thank him for helping. “Not many really,” he says, smiling.  “I did rescue a person at the beach earlier this year.  He was floating face down behind the breakers.  I rushed in. Gave him two breaths in the water, swam him back and resuscitated him on the beach.

“We are Facebook friends now."

Read more:

A day in the life of a paramedic
The helper's high

 

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