Last week, Wade went on a ride-along with Mesa Fire and Medical. The Mesa fire department had recently changed its name to better reflect its work. With 85% of all calls being medical, the name Mesa Fire and Medical was more appropriate.
I was based at Station 201, which is the main station for the City of Mesa and being one of 25 stations. Station 201 houses a Ladder, Engine, Rehab/Specialist Unit and a District Chief. The station had 10 staff on while I was on duty. The were two ambulances, but these were specialist units and were not manned on the day I visited. One of the ambulances was a specialised mental health unit and responded to the large amount of alcohol and drug cases or mental health calls that the station dealt with. It is staffed by a paramedic and the Australian equivalent of a mental health practitioner. The second ambulance was co-managed with a local hospital and was what we refer to in Australia as an extended care paramedic ambulance. The basic aim of this ambulance was to reduce the number of persons going to hospital and tying up ambulances for minor complaints. This crew could undertake a wide variety of primary health care related tasks (inc wound care, wound dressing, provision of medication).
EMS is handled differently in Mesa than what I have seen in Australia. Each call for medical assistance sees a Ladder or an Engine dispatched, along with a private ambulance. The Mesa Fire / Medical staff are all EMT certified with a minimum of two in each apparatus being Arizona certified paramedics. The scope of practice is similar to ICP in Australia, with RSI, Ketamine and EZ-IO being the recent additions. Once at the call the Mesa Fire / Medical crew would initiate treatment and the private ambulance would arrive to transport. It was great to see the public and private providers interacting so well together and working as a unified team (certainly something that Australia could learn from). If the patient was not critical the private ambulance would transport, otherwise a Mesa Fire / Medical crew member would ride with the private ambulance and be returned to the station. Here is a summary of the calls for the day:
1: Male, 81 years in hospice. Reduced LOC, with distended abdo. Not able to talk and was in obvious pain when palpated on the abdomen and when moved. Transported.
2: Female, 86 years. Fell from chair and now on ground with hip and back pain. Immobilised on spine board and transported. Given IV fentanyl. Transported and escorted to Level 1 Trauma Centre. This Pt was a FF's grandmother, so it is the Departments policy for the FF/EMT's to follow into the hospital and provide extra care until the FF/EMT is released from duty to attend.
3: Female, 23 years. Pumping gasoline for the first time and some splashed in face. Transported
4: Female, 67 years. Sudden onset nausea/vomiting and hypertension ++. Dizzy and unable to walk unaided. GIven ondansetron and transported.
5: Male, 10 months. Focal seizure activity for first time, then post-ictal. Unknown cause. IV started and transported with escort to Paediatric facility.
6: Female, 38 years. In alcohol rehab facility. Second witnessed seizure for the day. Transported.
7: Structure fire. Unable to locate.
8: Structure fire. Turns out to be a bon-fire in the back yard for a BBQ. Homeowner now not enjoying a BBQ!
The crews work a 24 hour shift, 0700 to 0700 and I was with them until 2200. The average workload for the day was 10-12 calls per crew. Each shift the crew put $6 into the kitty and they go shopping and in turn, cook lunch and dinner. I was invited to buy in for dinner and we had chicken burgers. Of course one of the crews had a call just as dinner was served! Lunch we ate out. Where ever we went people would approach the crews to thank them for there service and the great job they did. There is certainly a high level of patriotism in the USA.
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