He flops down on the black leather couch, joining Emergency Medical Technicians Casey Gundersen and Dan Sapp. It is 10:40 on a Wednesday morning.
The room is spacious and clean. Only a large jug of dish soap sits on the counter in the kitchenette area. Paperwork has been filed into the computer and put away. The three are quiet as they sprawl across the couches; the only noise in the room comes from the big-screen TV. They are watching ER.
A lady enters the scene, foaming at the mouth.
“Seizures?” Loughnane wonders.
“Rabies?” Gundersen asks, as they try to diagnose a TV character.
The next man entering the ER is having difficulty breathing.
“Chest tube,” Loughnane states matter-of-factly.
In the next scene, nurses are inserting just that.
A few minutes later, the screen goes black and the credits begin to roll. As if on cue, the squad room erupts into an alarm-clock-like beeping, called ‘tones,’ the signal that there is a call.
“Perfect timing!” Gundersen says, as she and Sapp pull on their boots and head down to the ambulance.
Sapp is the driver for the day and he flicks on the lights and siren as he pulls out of the station onto Reservoir Street. As crew leader, Gundersen directs him where to go and will be assessing the patients today.
“Female. 92. Abdominal pains.” The dispatcher relays the information over the radio.* About seven minutes later they arrive at the scene. Opening the back of the ambulance, they pull out the gurney, the oxygen bag, and a jump bag containing instruments to take vitals. They head to the apartment upstairs.
The woman is sitting in a chair by the window. Gundersen greets her and asks a few questions, assessing the situation.
“Do you feel dizzy,” Gundersen asks. “Do you think you can stand up and walk to the gurney?”
They strap her onto the gurney and wheel her back to the ambulance. They head to Rockingham Memorial Hospital.
Gundersen checks the woman’s blood pressure.
“It’s a little high,” she explains. “Did you take your medicines today?”
Sapp radios in, “Rescue 47 is in route to RMH, priority three.”
Back with the patient, Gundersen asks, “do you feel weak?”.
Tired is the reply.
They wheel her to a hospital room and leave her in the care of nurses. Sapp changes the linens on the gurney while Gundersen fills out the paperwork. When they are finished, they load the gurney back into Ambulance 47.
A few businesses in the area offer discounted or free drinks for the EMTs and they decide to get some and fuel up on their way back to the station. “I’m not lying when I say not having my coffee in the morning throws me off,” Sapp explains as he jumps out and runs into 7-Eleven. One large cup of coffee and 15 gallons of diesel later, they head back to the station.
Gundersen climbs out, walks upstairs, and takes her bagged lunch out of the fridge. Suddenly, tones go off again in the room. She grabs a bottle of juice and out they go again.
Training
Hours of training are required before becoming an EMT Basic. CPR certification is mandatory, as is attending two observer shifts. This observation helps prepare the applicant for rescue work and tests the ability to handle the degree of stress and trauma involved. After filling out the application, one is considered a trainee.
“Everyone is pretty helpful because we’ve all been there,” Gundersen says. “You pick it up pretty fast.”
Within the first year, an EMT trainee must sign up to take an EMT Basic class, and complete an Emergency Vehicle Operations Certification class to be certified to drive the ambulance. An advanced class is offered later, enabling an EMT Basic to become EMT Enhanced.
“It was hard to balance everything,” says Gundersen, who also is a student at James Madison University. “[EMT Basic] was three hours, two times a week, plus I had all of my JMU classes. But it was interesting, and has helped me become a better provider.”
The squad schedule is not easy. Harrisonburg Rescue Squad has six shifts ranging between six, eight and 12 hours each. Duty officers pull 24-hour shifts, managing the station and deciding when to call in for extra help if they get too busy.
Each shift has a minimum of two and a maximum of three people. One person drives and the other navigates and performs the medical procedures. A third person could be either a trainee or an observer.
Fortunately, the training and hard work pays off. One of Sapp’s more memorable calls was a multiple entrapment. “I was the first driver on the scene. All I heard when I stepped out was, ‘We need full immobilization over here!’”
He opened the back of the truck, grabbed a collar and back board and headed to the scene. A man in the collision was able to get out of his car, but then collapsed. Sapp had to cut off the man’s clothes and try to control his heavy bleeding.
“You don’t want to say you’re glad that bad things happen, but when they do, you’re glad you’re there,” Sapp says.
Gundersen recalls another incident where she was talking to a man who was having chest pains.
“Then he just coded,” she says. (Code blue means the person’s heart or breathing has stopped.) She had to use automatic-external-defibrillators to shock his heart back to life.
“When he came back, he didn’t realize what had happened,” Gundersen says. “If we hadn’t been there, who knows what would have happened. It’s those moments — they hold you over for months!”
Covering the County
Time is of the essence when doing emergency work. All the rescue squads in Rockingham County transport patients to RMH, so the drive can take anywhere from five to more than 20 minutes.
Captain Jeff Werner of McGaheysville says it takes about 15 minutes on average to get from a scene to the hospital. The McGaheysville Station covers Massanutten and the outlying areas near Elkton.
“Traffic is always a concern,” Werner says, “especially with the east end of the county growing so much.”
However, their 20 to 30 volunteers consist of Basic Life Support (EMT Basic), Advanced Life Support (EMT Enhanced), and even higher ALS, which is “basically, an extension of the hospital,” Werner explains. “They’re like paramedics, and they work hand-in-hand with RMH.”
Their calls vary day-to-day, but, Werner says, “Special weather events always add to call volume.” Conditions of snow, flooding, severe cold, or severe heat all contribute to the 750 calls McGaheysville receives annually.
Harrisonburg Rescue Squad has the quickest response time since they are the closest to RMH. Still, every minute counts.
“You never know what you’re going to get,” Sapp says. “One time dispatch will tell you code blue and you get there and the person is fine. Or worse, the opposite happens.”
Gundersen once got a call for a woman in labor with contractions one minute apart.
“I was like, ‘I’m not doing this!’ as we rode to the hospital,” Gundersen recalls. “We got her into a room and less than a minute later, she gave birth.”
Ironically, Gundersen is now applying for medical school and considering going into obstetrics and gynecology (OB/GYN).
Although rewarding at times, the job can be difficult as well. Driving in dangerous weather conditions and helping patients can be stressful and emotionally draining.
While the best part of his job is helping others, Captain Werner admits the hardest part is “dealing with a situation where the outcome is not what you want — even though you know you did your best.”
Harrisonburg EMT Michael Emswiler also references the long shifts as something that make the job difficult.
“The last night I worked 7 p.m. to 7 a.m. and there goes my Saturday.”
“But,” Gundersen adds, “saving someone’s life because you and your crew were prepared makes everything worth while — the many hours of training, the tiring shifts and the tough calls. It’s those moments that keep you coming back.”
Last year, Harrisonburg Rescue Squad responded to more than 6,000 calls. July 20 was their busiest day of the year when they responded to 37.
“You usually run about 17 to 18 calls a day,” EMT Kristin Grimm explains. “Each call takes about an hour, so you can see that there are hardly enough hours in the day.”
Equipment & Gear
Harrisonburg is prepared with five ambulances, three service vehicles and one squad truck which responds to traffic crashes. Emswiler estimates that each ambulance costs between $100,000 and $160,000, depending on the technology that comes with it.
In January, the station got brand-new turnout gear. These suits are used for rescue work during extreme conditions like fire and traffic accidents. The outfit comes with boots, pants, a jacket and helmet for an estimated $1,500.
“It’s the most expensive suit I’ll ever wear,” Emswiler says.
JMU Involvement
Harrisonburg’s Rescue Squad has 99 volunteers, 46 of whom are JMU students. Gundersen and Sapp both are biology majors at JMU and volunteer on the rescue squad for the experience it provides.
Because a large portion of Harrisonburg’s EMTs are JMU students who graduate and move on, the squad has a three-year turnaround. The pre-medical program at JMU encourages students to get out into the community and have hands-on experience. Becoming an emergency medical technician is one example of that.
Student EMTs balance time between classes and volunteering. The EMT program requires 48 hours a month. To get their hours in, sometimes they work the 12-hour shift.
“You just cram during the weekdays and give up going out on a Thursday night,” says JMU sophomore and EMT Paul Watson. “To us, this is fun!”
In the downtime between calls, Gundersen admits sleep only occurs sometimes, and getting homework done is rare. Yet the EMTs enjoy each other’s company.
“People are pretty cool about hanging out [even when they’re not on duty],” Grimm explains. A guitar sits in the corner next to the big-screen TV, complete with DVDs and video games.
Sapp agrees. “Most people like to have a good time,” he says. “It’s a laid-back atmosphere when you’re not on call, which makes it easier when you are on.”
One thing is certain: when in a crisis, one can count on the EMTs. For all their training and dedication, Emergency Medical Technicians are equipped for the job.
“We have a saying around here,” Gundersen says. “We’re the best part of your worst day.”
*situations have been altered to protect patient privacy.
