While visiting Las Vegas I had the opportunity to do a ride along with the Clark County Fire Department. Their agency responds to about 120,000 9-1-1 calls per year. Last year my agency was just shy of 600. CCFD is the proud home of Station 18 – “the pride of the strip” – which has the honour of being the busiest firehouse in the United States.

All it took was a quick call to Fire Administration and asking for the EMS coordinator, who after a brief conversation directed me to the EMS supervisor to find the actual station I would be posted at for the day. I wound up at station 23 in the heart of the ghetto of North Las Vegas. I was excited for the onslaught of crime, grime, and blood that awaited me as an overanxious newer EMT.

I reported at 0900. We got our first call shortly after my arrival for a woman “feeling sick.” Code 1 alpha response. Snooze. I think I’ve been on that call with my agency. The medic let me start doing a full patient evaluation, but eventually cut me off when the transport ambulance arrived. “Okay, so what hospital do you want to go to?” One of the unique things about a pay for transport system is that everyone “should” go to the hospital. The cost of transport is not figured into what is or is not in the patient’s best interest.

The engine then went on a call for 23 yof with abdominal pain. WTF ru serious? I thought I left the world of volunteer EMS? The captain bet the engineer on the rescue a drink that the patient would be at least 300 pounds. Apparently she was not, and the captain sent a rookie to go pay the debt in fire service gold: mountain dew.

The third call was back pain coded as a charlie with code 3 response. “Must be some really bad back pain.” The guy has an irregular heart rhythm that was a fun ECG to look at. The transport medic got very excited about the degree of the block and the conduction ratio, the non conducted beats, etc. While I kept it to myself, I understood (and could see) everything he was talking about. The fire medic, however, made fun of transport medic. I could almost hear him say “nerd alert” under his breath. Back at the station the captain remarked, “it’s not really that hard. You ask if you want to go to the hospital and put them on oxygen. Start an IV if they’re actually sick. The end.”

Keep in mind these were the only calls that occurred between 0900 and about 1700. I was allowed to stay at the station until 2200. The crew apologised that their clientele was disappointing today. I responded that I understood how that always seemed to work with ride-alongs. Depressed and exhausted, I was ready to give up and leave around 2100, but got into a conversation with the engine medic about a house he was building. At 2155, as I was gathering my things, the whole station was paged for a multiple shooting. 4 victims. One in the chest. Police report code 4 to enter.

Hell. Yeah.

Normally my job is to grab the airway bag. When we arrive, the medic yells back, “just get a backboard; we’re getting out of here.” The victim had a single superficial wound near his right clavicle. PD reported that they thought it was likely a ricochet. “Hablas ingles?” No, of course not, but AOx4 – we think. Occlusive dressing on, even though it wasn’t sucking let alone bleeding much. NRB on. Collar on. Roll. Back clear. Backboard under. Straps on. Gurney. Lift. Headbed. Into transport ambulance. Code 3. Go.

In transport I was attaching leads, spiking IV bags, adjusting drip rates, checking breath sounds, and monitoring LOC and airway. Being an intermediate it was awesome to understand every detail of what the medics were both doing and saying. My assessments and interventions were productive. I was helping this guy.

It was the closest to being alive that I’ve felt in a long time. And on top of it the transport medic was smokin’ hot. The call was so good, I thought I needed a cigarette after – and I don’t smoke.

Yeah, that good.

After that call, I had no doubt in my mind that I wanted to go to paramedic school. The longer I do theatre, the more bored I get with it. In the mean time it pays three times as well as any EMS job I could get, if I could get hired anywhere. However, this all occurs to me as I’m sitting through a 4-day seminar for theatre-sound related training. At lunch I drifted off in a conversation when an ambulance went by. I’m writing this post in class right now because I’m fantasising about being back on the front lines, speeding around with lights and sirens blaring, making a difference.

I hope this isn’t some fleeting infatuation. I need career true love.

Mat Goebel
EMS Fellow

My research interests include EMS, EKG, STEMI, cybersecurity, data viz, ML, and NLP.