#2. Procedures Are Constantly Changing, Then Sometimes Changing Back
Even if you've never taken a class in CPR, you know the general concept: If someone isn't breathing and doesn't have a pulse, then it's time to open up a can of CPR (and no, that's not the can with the blue ribbon on it). You do the chest compressions and pause between every few to do mouth-to-mouth.
Well, you're doing it wrong. A while back, EMTs had to unlearn all of that -- it turns out CPR actually works better without the mouth-to-mouth rescue breaths. There are studies that show that CPR performed with only chest compressions results in 60 percent fewer dead people. In fact, traditional CPR with mouth-to-mouth is often as effective as doing nothing at all, except when CPR is being performed on small children.
"Let him go. Even if he survives, he'll never dance again."
Hey, what about another staple of movie emergency medicine: the tourniquet? You know, somebody is bleeding badly, so they use a belt or rope to tie off the limb to stop the bleeding. Are EMTs supposed to do that? It depends on who you ask, and in fact varies from one ambulance service to the next. Some experts still stand by them, some say they just kill off tissue in the limb. Learn it today, unlearn it tomorrow. Relearn it again next month.
And that's par for the course; crews will often be trained on new gadgets, only to see them yanked later when it turns out they don't actually work (like medical anti-shock trousers that came in and out of fashion in the '80s and '90s).
Also, the patients are changing. Specifically, they are getting fatter. A heavy patient is going to need the same kind of attention as an average-size patient, but the methods must be altered dramatically, much like the Boba Fett costume the aforementioned heavy patient purchased from eBay last Halloween. Crews have had to completely rethink logistical problems with getting obese patients out of buildings with narrow halls, doors and stairs without everyone on the crew throwing their back out. It also means new equipment, as ambulance services across the country have to buy vehicles with specialized cots, ramps and winches to lift patients weighing between 350 pounds and Mighty Joe Young.
In case of emergency, the winch is made of chocolate.
The ambulances themselves have to change to accommodate this, too -- they have ushered in the use of bariatric ambulances, or "fat trucks." These are designed to be double-wide to accommodate heavier passengers, or as this article literally stated, "to ferry the most obese."
Via Adam Harnett
And they're occasionally used to render aid to beached whales.
But nothing you see there addresses the difficulty of removing a patient weighing just shy of a ton from the seventh floor of an apartment building when they literally cannot even fit through the doorway. Presumably at this point, the EMTs just start a controlled blaze in the lobby and let the fire department come figure it out.
#1. Crews Are Constantly Getting Attacked
You might expect EMTs to be relatively safe when dealing with patients -- after all, they are there to help. But in fact, EMTs face a lot of danger in the field, and they do so without the weapons and authority that police officers have. EMTs have been hit with cinder blocks, stabbed by syringes (often still filled with drugs), chased by dogs and shot at on a regular basis. In Boston, for instance, 28 percent of total EMT injuries in 2006 were the result of violent assaults.
"Sir, we're here to help. I'm gonna have to axe you to put that down."
One study conducted in 1999 found that, over a 12-year period, each paramedic involved was assaulted an average of nine times, with the attacks reading like a laundry list of every injury sustained by Christopher Lambert in The Highlander, including "170 cases of blunt trauma, 73 lacerations, two gunshot wounds, 10 stabbings, one burn, eight fractures, nine dislocations, one choking and 56 cases of miscellaneous body injuries."
Not all of them are work-related.
Sure, part of it is because they have to plunge into the bad parts of town no matter what time of night. But even in the nice parts of town, they're still not safe, and it's often because of the patients themselves. Sometimes patients are panicking, sometimes they're drunk or high or in shock. And of course, sometimes they're just insane.
And it isn't just the patients who can pose a threat to an EMT -- they can encounter hysterical family members and violent bystanders who attack them out of misplaced blame and rage. At which point we're assuming the universal answer to them is "Hey, just be glad this ambulance hasn't exploded yet."