Happy 35th Anniversary to the Company I Work For!

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As I mentioned in yesterday's Photo Hunt post, American Ambulance Services, Inc. celebrated its 35th anniversary on Friday evening with a party under the tent at the American Wharf Marina. Today, however, marks the official date of that anniversary.

On June 24th, 1972 Ron Aliano, CEO of The American Group, started his ambulance service in Norwich with just two ambulances that operated out of the back of a service station. If you want to know what it was like, it has been suggested that one watch the 1978 movie "Mother, Juggs, and Speed" as that will give you a pretty good idea of what early ambulance service was like. Personally, having seen it, I find that to be a little bit scary and I'm glad I never needed an ambulance back in the 70's!

In 1986, American moved into its new headquarters at One American Way and those original two ambulances have definitely multiplied over the years. Now their are over 50 vehicles in the fleet including both ambulance and chair car vans as well as over 200 employees consisting of Emergency Medical Technicians, Paramedics, Chair Car Van Drivers, Schedulers, Dispatchers, and Office staff.

I joined American on June 3rd, 2003 after breaking my vow to never dispatch again - yeah, that worked out real well, didn't it? - and though there are times when I want to do nothing more than beat my head against the counter on which my keyboard rests in sheer frustration, I have never regretted taking the job. I have met some of the nicest people at AASI that can be found anywhere on the face of the earth and they have made a sometimes over-the-top stressful job more than tolerable.

They're so good, in fact, that I was awarded Employee of the Year in 2004 and I have never once forgotten that it was only through them that I was able to achieve that honor. I've always believed that a dispatcher is only as good as those people he or she dispatches and I can honestly say that the road crews I work with are some of the best anywhere. I appreciate every single one of them even though I probably neglect to tell them that as often as I should.

In a post awhile back I mentioned that as a police dispatcher I worried about the men and women who were "under my care" and Bulldog, a favortite EMT and regular reader of this blog, asked me the following question:

"... how do you feel now that you dispatch EMT's & Paramedics as opposed to cops? Is your "worry level" higher or lower because of the difference in actual job specifics? Not trying to put you on the spot ... just curious!"

Up until now I hadn't had a chance to address that question but I have been giving it a lot of thought ever since it was asked. My level of worry now depends on the type of call that I'm sending a crew out on. If it's just a routine transfer or even a lights-and-siren transfer from one facility to another, my worry is mainly one of road safety. Just because there's a large white and orange ambulance possibly with lights flashing and siren wailing doesn't mean that people will always notice said vehicle and I worry that a crew is going to get t-boned, hit head-on, or even have a tree jump out at them (ah yes, Titan and the tree - I remember it well ...). Accidents are a constant source of concern.

As for other worries, I don't fret quite as much as I did when dispatching police officers as EMS is normally looked on as "the good guys" but that doesn't mean that something can't go wrong on what may appear to be a routine call, especially when it comes to psych transports. I learned to worry about "my guys" as a police dispatcher and even though I haven't done that particular job in years, I carried that over with me and I still worry about "my guys" - just now on a slightly different level. Hope that answers that for you, Bulldog, without being too vague!

Unless something in my life changes drastically (like finding that elusive winning lottery ticket or having Prince Charming sweep me off my feet and cart me off to his castle) I'm pretty sure I'll still be at American when its 40th anniversary rolls around five years down the road. I'm sure that's going to be quite the party, too! In the meantime, Happy 35th and - as always - "safe trip and 110 upon turnover"!

Medical Terminology for the Layman

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Today marks my 4-year anniversary at American Ambulance as an Emergency Medical Dispatcher. To say that the transition from police dispatcher to ambulance dispatcher was a little tricky would be about right.

Prior to setting foot in the "Ivory Tower of Dispatch" at AASI, I was totally clueless as to how a commercial ambulance service operated. I was under the misguided impression that ambulances were like firetrucks or police cruisers in that I thought they either stayed in the bay waiting for the tones to go off or cruised around in their assigned "beats" waiting for some sort of emergency that required their services to occur. Wrong!

For some reason, I never gave a thought to scheduled transportation for patients (which I had a bad former police dispatcher habit of calling "subjects" when I first started!). Trips from nursing homes to doctor's appointments, transports to dialysis, transfers between one medical facility to another ... those were all things that I had absolutely no clue about. 911 I was more than familiar with but calls from SNFs (skilled nursing facilities) and hospital discharge planners were completely alien to me.

Even more confusing was all of the billing information I had to learn. At the Police Department we didn't need to worry about a person's insurance coverage unless it was motor vehicle related but at American I've had to learn about Medicare, Medicaid, Blue Cross/Blue Shield, Aetna, Healthnet, Connecticut Health Network - the list is as endless as are the requirements for each type!

One of the other things that I was pretty clueless about was medical terminology in general. If someone had difficulty breathing than that was what they had not dyspnea! A nosebleed wasn't epistaxis, blood in the urine sure the heck wasn't called hematuria, and as far as arrhythmias went I wouldn't have known the difference between bradycardia (slow heartbeat) and tachycardia (fast heartbeat) were I experiencing it myself!

Four years and countless dispatches later I can now almost pronounce 'epistaxis' without tripping over it too badly and some of the other terms have become quite familiar to me. I'm still no expert, and never will be, as I don't work directly with the patients but instead hide behind a dispatch console and tell EMTs and paramedics where to go and what to do when they get there. As I have said in several posts previous to this one, I know my place in the medical field and it's not out in the field looking at broken bones or other assorted traumas!

I thought the rest of you might enjoy some basic medical terminology so that when you're watching House or Grey's Anatomy or another medical show, you'll know what they're talking about and have even more of an appreciation for the drama that can ensue in any sort of medical environment. Use these words to impress your friends and family with your new-found medical knowledge and razzle-dazzle your own doctor the next time you're in for a check-up!

Medical Terminology for the Layman

• Benign: What you be after you be eight
• Bacteria: Back door to cafeteria
• Cesarean Section: A neighborhood in Rome
• D & C: Where Washington is
• Dilate: To live long
• Enema: Not a friend
• Fester: Quicker than someone else
• Fibula: A small lie
• Impotent: Distinguished, well known
• Labor Pain: Getting hurt at work
• Medical Staff: A Doctor's cane
• Node: I knew it
• Pelvis: Second cousin to Elvis
• Rectum: Damn near killed him
• Seizure: Roman emperor
• Tablet: A small table
• Tumor: More than one
• Urine: Opposite of you're out
• Varicose: Near by/close by
• PRN: Urinating nurse

Oh come now - you didn't think I was going to be serious, did you? That's what they make WebMD for!

Some days at work are better than others. Wednesday was not one of them!

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I had a sneaky feeling that it wasn't going to be a good day even before I left the house when my pager went off advising me that a particular road in Norwich was closed due to a working structure fire. For those of you who aren't familiar with fire terms, a working structure fire means that a structure is on fire and firefighters are working at putting it out. Leastways I think that's what it means!

The road in question wasn't one that I had to worry about traveling but whenever there's a working structure fire in the area, American Ambulance sends out what is called the Rehab Unit. In a nutshell that's a trailer that is equipped with heaters, blankets, hot beverages, water, medical supplies, etc - anything that is needed to help firefighters who are battling not only smoke and flames but also weather elements like extreme hot and extreme cold.

Having never been bitten by the 'fire bug' myself, I have no desire to don 80+ pounds of turn-out gear and battle a fire but I have come to know a lot of people who do and from them I've learned that fighting fires can be pretty intense. It only makes good sense to have equipment nearby to help these guys out - a lot of whom are volunteers with their local departments.

Upon getting turn-over from the midnight dispatcher I was informed that, sure enough, a crew had been at the fire scene with the Rehab Unit and I was going to have to figure out who was going to go down to replace them as the current crew was off at 0700 hours (7:00 a.m. to you non-military types). Not everyone who works at American as an EMT or Paramedic is trained on the Rehab Unit so before anyone can be sent, one has to consult the list of qualified people and see who's working that can go.

What that meant for me was that I was going to drop down a full BLS car when I sent that crew to replace the crew that was already at the standby. On top of that, there were two burn victims of the fire and it sounded like we would be transporting at least one, if not both, to the closest hospital with a Burn Center. In our neck of the woods, that just happens to be Bridgeport Hospital which is about 75 miles south of us. Needless to say, it wouldn't be a quick trip.

The first hour of my day went by relatively okay and then someone seemed to open up the floodgates somewhere as I took several emergency calls, a couple of long-distance transfers (including the expected one to Bridgeport), and the hospitals that we service started calling in with one discharge after another. This was all in addition to the calls that were already scheduled on the spreadsheet laid out in front of me.

Soon I had every car at my disposal out running calls and yet the phones kept ringing. Add on to that a suspected HazMat spill at one of the local elementary schools developed and before you knew it I was giving serious consideration to biting my nails as I found myself starting to clench my teeth! Every time I thought I had a little bit of breathing room, the phones would ring again and I'd have to juggle things around a little more.

The crew at the fire standby with the Rehab Unit cleared from there basically just in time to go to the elementary school for the HazMat spill as somehow a small batch of white powder had turned into a Level 3 HazMat incident which took up two additional ambulances along with the Rehab Unit. Things were not looking good as I started to wear out my eraser moving calls from one spot on the spreadsheet to another.

Shortly after that I had to put two of the guys who work in dispatch that are also EMTs out on the road with medics to make up a couple of cars as I had run out of regularly scheduled road people and I had a need for more ambulances. Before the day was done the Director of Operations, the Director of Quality Assurance, and the guy who does the mountains of paperwork that we generate were all out running calls in various parts of the city. Falls, seizures, chest pains, alcohol intoxication, difficulty breathing - it seemed like if there was an ailment out there, someone was calling in with it!

It wasn't until 2000 hours (for the militarily challenged, 8:00 p.m.) that I finally had a clear screen on the computer in front of me. No calls were glaring at me from the open work module, there was some white space actually showing on the spreadsheet, and I could at long last breathe a sigh of relief after what had been one of the busiest and most stressful days that I can remember in awhile. Granted, calls kept coming in but at least it was at a slower pace that didn't require a high level of erasing or teeth-clenching!

I'm sure it would have been much worse were it not for the expertise of my Supervisor and his many years on the job (he always seems to make it look easy - damn the man!) but I have to say that I was quite glad when 2300 hours (11:00 p.m.) finally rolled around and I could put another double shift behind me for another week.

For all I know, today is going to be just as busy but I'm not going to worry about it as it's my day off and I plan on spending it not thinking about work. Unless, of course, I hear a siren wail past the house ...