Blood and broken bones are all part of the job

They are the people on the frontline, first on the scene, the ones who pick up the pieces after the road accidents, the shootings and other serious incidents. The Emergency Medical Services is faced with death, injury and trauma on a regular basis. Their work is this week being celebrated in the island’s first Emergency Medical Services Week. While EMS encompasses fire, police and the St. John’s Ambulance, today we focused on the ambulance staff whose services are often overlooked by the public. The Bermuda Sun sat down with EMT workers and joined them on a weekend shift to get an idea of the work they do.

At one time Emergency Medical Technicians were hired to drive ambulances and perform basic first aid but they are now an integral part of the pre-hospital care giving system.

There are three levels to the job, EMT, EMT-I (Intermediate) and EMT-P (Paramedic). At mid level, staff can perform serious medical procedures under the instruction of a doctor (see story below).

They are constantly training and retraining to keep on top of the ever changing and evolving skill sets. They are also required to be Advanced Driving License holders.

Not only have their duties expanded, their workload has taken a sinister turn in Bermuda with an unprecedented rise in shootings and road traffic accidents.

EMT Wesley Wilson has worked in Emergency for 35 years. He said: “Back in the day we rarely had to deal with the things occurring now. The scenes have been very much more traumatized than previous years.

“From the security point of view, we now have guards at Emergency, the doors have been locked and we get swiped in or security lets you in. That gives you an idea of how things have changed.”

EMT-I Raymond Tucker explained how it is particularly difficult being an EMT in Bermuda as more often than not you are going to know, or know of the person you are treating.

“The ultimate goal is to provide care so you must never compromise that.

“A few of us have had to pick up relatives but you have to function and if there is any sorrow or grief it has to take place after.”

Another problem EMTs encounter is complaints from the public.

Mr. Tucker said: “It’s down to a lack of knowledge — they say we don’t arrive quick enough.

“We want to be able to make the public more aware of how they can best assist us.

“Bermuda needs to raise it’s par level in terms of learning basic first aid and CPR.

“If you can give breath of life to someone — don’t waste it trying to tell me it took me five minutes to get here.”

A night shadowing EMTs ends in the assault of a pregnant woman

I was recently invited to experience first hand what these everyday heroes go through. While I expected the odd traffic accident or bar fight, I never thought I’d have to see a pregnant woman lying on the pavement after being assaulted.

12am: I was introduced to EMT-I (Intermediate) Veronica ‘Ronnie’ DeSilva who has been an EMT since 1986 and has worked for the hospital since 2000 and Josh Correia who has been training as an EMT for two years and volunteering his time for six years.

The role of the EMT has expanded considerably in recent years from driver and first aider to qualified provider of medical services under the instruction of doctors. This includes resuscitation, defibrillation, controlling severe external bleeding, prevention of spinal injuries, nebulising asthmatics and splinting of bone factures.

Ronnie, as the mid-level EMT-I, is further qualified in her responsibilities to provide pre-hospital emergency care. She explained that EMT-P (Paramedic) is the next level up but although we have one on the island we cannot currently utilize them — something that is likely to change in the near future.

As they talk, they show me around the vehicle and give me a run down of the procedures. They are stocking the ambulance with supplies, putting new batteries in the defibrillator, checking machinery and so on.

Finally they make sure everything is tightly packed away — something I realize the importance of later in the night. 

12:20am: We head inside Emergency through the “staff only” entrance and I get a new perspective on hospital life. It was a full house when I arrived — they were trying to get as many people admitted as possible to make room for any new emergency patients.

Everything seemed relatively calm until a patient started shouting out that he was in severe pain. We headed around to his unit and the patient, who had been drinking heavily, claimed he fell down the stairs at a bar. There was a large pool of blood on the floor from lacerations on his arms and as Ronnie cut off his jeans we saw there may be a fractured or broken bone. They get him x-rayed and splinted and administer an IV of morphine to deal with the pain before cleaning up and bandaging his cuts.

1:44am: We got our first call out of the night — a road traffic accident on Harbour Road. EMT Heather Roque asked if I get seasick which I took take as a joke but she sent me up to the front seat anyway. It wasn’t until we were flying round hairpin bends at least 50 miles per hour, that I realized exactly what she meant. While I was safely tucked away up front, she seemed to have a limb in every direction keeping things from flying around, including herself, all the while with a smile on her face.

“I have had to straddle patients before to keep them in place,” she recalls. Now I understand why all the supplies and equipment need to be so tightly packed away.

I got my first experience of EMT Wesley Wilson’s utter command of the road — we seemed to be parked at the scene within a couple minutes of starting the engine. It gave me a whole new perspective of Bermuda’s roads and a new respect for the skill of these advanced drivers

When we arrived, the police were still on the scene but the rider was not — someone had abandoned a motorbike on the side of the road and fled the scene.

Abandoned vehicle

“We’ll get a call in four hours when the alcohol’s worn off,” observed Heather. Drivers under influence often don’t realize the extent of their injuries until they sober up and the pain kicks in. They also abandon their vehicles for so they don’t get arrested for drink driving.

As we left the scene we saw pools of liquid in the road — everyone instinctively checked to make sure it wasn’t blood.

2:20am: When we got back to Emergency there was a new arrival — a young man had been drinking and had a bike accident. His foot was covered in blood and a part of it was hanging loose while the ball of his foot looked broken. Sitting in a wheel chair on his own in a room with blood dripping on to some white padding — he looked scared and in serious pain. I went over to try and cheer him up. His voice sounded full of remorse — whether the accident was his fault or not, he knew he had done wrong by drink driving and apologized to the nurses for wasting their time. Ronnie was keen to get the message across through me that there is no excuse for drink driving. “Tell them — don’t drink and drive. They think it is okay because Bermuda is small they don’t have far to go but five minutes is all it takes. Prevention is the key in accidents — you know you shouldn’t do it. Weekends and nights before holidays are the worst.

“Speeding is another one — Bermuda has narrow roads, you can’t speed here.”

As the patient was carted to another area of the ward, a man followed behind him with a mop and bucket for the blood. He turned to me and said: “my work is never done here.”

3am: Things seemed to have calmed down so I went back to the EMT staff room to get my things together. Heather tells me how frustrating it can be as an EMT seeing people so often putting their own lives at risk with barely a thought. “Despite what we feel, we have to treat everyone equally — medical assistance is first and foremost.”

3:20am: Just as we are finishing up, there is an ambulance call. A pregnant woman has been assaulted and I’m back in the front of the ambulance. Ronnie and Wesley get the woman, who is clearly in distress and crying, onto the stretcher and into the vehicle. Ronnie shows the utmost professionalism on the way back, she reassures the patient and tells her to be calm for the baby. She checks her temperature, asks about allergies and checks for the baby’s heartbeat. She asks her about her attacker and while she reassures the woman she is careful not to go too deep into a counselling role.

Ronnie later explained to me you have to hold back a certain amount, you can’t get too involved.

When they got her to the hospital Ronnie worked to get her admitted into the maternity ward immediately.

After waiting around a while I decide it’s time for me to go home. Through the night I had seen blood and bad injuries but it was seeing this woman lying in the road that will stick with me the most. I felt drained by this last experience but my little stint with the ambulance is pitiful compared to what these guys deal with on a day-to-day basis.