What Happens when someone Calls 911
They roar down the streets, their sirens blaring and lights flashing as they arrive on the scene of some emergency. And those in need are so relieved to see them coming. For people in medical distress - heart attack and stroke victims, people with gunshot wounds, survivors of car crashes, drug overdoses and scores of other scary situations - these emergency vehicles and their skilled crews who rush to the rescue can sometimes mean the difference between life and death. In route, the dispatcher alerted the crew that the patient's heart had stopped. When they got to the scene, they took over from a bystander who was performing CPR, and gave the young man's heart repeated shocks with a defibrillator, until his heart restarted. Across the U.S. emergency medical services (EMS) systems are out there helping people and sometimes saving lives. In this article, we'll look at the history of the ambulance, how the vehicles are equipped and what sort of professionals staff them, as well as how the 911 system that dispatches ambulances works.
We'll also look at problems within the EMS field, such as the surprisingly hefty bills that some patients get, and how ambulance and emergency care is evolving thanks to technological innovations. What Happens When Someone Calls 911? Why Are Ambulances So Expensive? The concept of ambulances grew out of the need to transport wounded soldiers from the battlefield, rather than leaving them behind to succumb to their injuries, die of hunger or thirst, or fall into the hands of enemies. In the 500s C.E., the Byzantine Emperor Mauricius outfitted rescue squads of horsemen with special saddles that enabled them to carry wounded men to field hospitals. In the 11th century, crusaders came up with the innovation of wagons, staffed by nurses. By the early 1700s, European cities were using corps of volunteers to carry injured civilians on foot using stretchers. Edward Barry Dalton, a former army surgeon appointed to head the Metropolitan Sanitary District in New York and surrounding counties, developed what probably was the first modern-style ambulance system, in order to cope with a cholera epidemic.
Police and sanitation inspectors who came upon a sick person would contact a dispatcher by telegraph, who then sent a wagon staffed by a disinfection team, which then transported the patient to a hospital. In fact these four principles (calling in, dispatch, transportation and hospital) are still the core of the modern ambulance system, even if the modes of delivery might have changed. The development of the automobile in the late 1800s made it possible to transport patients much faster than horses could. By the 1950s, ambulances were all over the place in the U.S., but the business of picking up the sick and injured was often chaotic and haphazard. In addition to hospitals and fire departments, towing operators got into the act, as well as funeral home operators. In 1973, 300 EMS systems were established throughout the U.S. But they normally don't transport patients, explains Scott Buchle, program manager for Penn State Health Life Lion EMS in Hershey, Pennsylvania. That's the job of ambulances, which also have the ability to respond to more complicated situations.
According to Buchle, there are two basic types of ground ambulances, differentiated by the level of care they are capable of providing. BLS crews also are trained on how to extricate car crash victims from the wreckage of their vehicles. Online PDF tools equipped with automated defibrillator devices that they can use to shock the heart of a patient who goes into cardiac arrest. They also carry NARCAN, an opioid antidote that's used to treat overdoses. The next level of service is provided by advanced life support (ALS) ambulances, which are staffed by paramedics and nurses, who have advanced training, as well as EMTs. An ALS team can respond to more complicated health situations, and is able to provide a higher level of care, such as administering medications and initiating intravenous (IV) therapy to deliver the drugs directly into a patient's veins. In addition to full ambulances, EMS services also may use chase cars - basically, passenger vehicles that will transport an additional paramedic and his or her equipment to the scene of a medical emergency, until an ambulance can get there.
At that point, the paramedic will jump on the ambulance and accompany the patient back to the hospital. The type of vehicle sent to a call depends upon the nature of the emergency. A BLS ambulance might handle a patient with a broken leg, but if that person is in cardiac arrest, a dispatcher may send an ALS vehicle instead, according to Buchle. Ben Weston, M.D., an assistant professor of EMS medicine at Medical College of Wisconsin, who also works as a medical director for two local government EMS services. There's the familiar minivan style, but other ambulances have a pickup-truck chassis with an attached patient compartment. Inside, ambulances carry an assortment of lifesaving equipment. BLS ambulances carry portable oxygen supplies and masks, cervical collars, slings, backboards to protect patients with spinal injuries, and kits with towels, dressings, scissors, clamps and sterile gloves to use in delivering babies. They also often have the tools to take blood samples and perform simple lab tests, which can be transmitted directly to the hospital while in route.