During National EMS Week, Ellicott City Station 2 invited a reporter and a photographer for a ride-along to experience a day in the life of EMS members.
According to department spokeswoman Jackie Kotei, Howard County Department of Fire and Rescue Services responded to more than 33,000 incident calls in 2014 with 23,000 related to EMS.
According to Capt. Ronald Lagana, Ellicott City Station 2 averages about 18 to 20 calls in a 24-hour period.
"Many of those calls can come after midnight when we're sleeping," Lagana said. "Ambulances are constantly busy in the county. This is a very busy station because it's almost central in the county, so we respond to various neighborhoods when other units are out."
Lagana said each day often begins and ends with both career and volunteer members gathered around the kitchen table, sharing thoughts and processes as working firefighters, paramedics and EMTs. Members also continue their training in the station's gym and online classes.
"If we're not running calls, we're training," Lagana said. "You fall back on your training a lot. Your training becomes instinctive."
And members must ready when the alarm bells sound.
At 7 a.m. on May 21, EMT Nate Martin and paramedic Alex McWethy began their 24-hour shift inside the fire hall at the helm of an ambulance, Ambo 2-5.
"As far as the unit goes, it kind of works like a toolbox," Martin said of the rig. "There are compartments all over it and each compartment has different types of equipment in it."
On both sides of the ambulance's exterior, compartments hold larger equipment, like backboards and stretchers, for different types of calls, ranging from car accidents to in-home emergencies. Inside, cabinets line the walls with medications, bandages, tubing, gloves and masks.
"For any kind of call we run, this has everything," McWethy said. "It's just everything ready to go, on the go."
As Martin and McWethy organize their ambulance around 11:30 a.m., a blaring alarm and flashing lights abruptly drown out the previous shuffling.
"That's us," Martin said. "Time to go."
McWethy said the call was for a young adult with abdominal pain. Inside the ambulance, Martin was in the driver's seat, while McWethy navigated their route using a mobile data terminal, or MDT, similar to an ordinary laptop.
"That is where the calls generate," Martin said. "Dispatch sends them to us and it comes on the map. We use that to locate the call and get to where we're going. We also communicate with dispatch through that so we can tell them where we are and what we're doing."
Martin said the MDT also helps to find alternate routes in heavy traffic or construction. After finding a new route, the team will alert dispatch, which will inform all other ambulances to avoid that particular roadway.
When they arrived, Martin and McWethy grabbed a red duffel bag filled with additional supplies and went inside to assist the young adult. The team decided to take her to a local hospital for further evaluation and helped her into the ambulance, where she laid on a gurney.
After she was secured, Martin used a monitor-like life pack device to read her heart rate and blood pressure. McWethy then jumped in the driver's seat as Martin asked the patient about her pain as well as previous medical information, which he recorded in another laptop called a Toughbook.
"All the information, the patient's demographics, the symptoms, what we did, how we treated, it's all very closely monitored and tracked," Martin said. "We have a 100 percent question-and-answer in Howard County, so every call that's logged gets checked by someone in Howard County. It holds everyone accountable and makes sure the job gets done right."
To retrieve information, Martin said it's crucial to relate to the patient through conversation.
"You have a very short amount of time with each patient, so you have a very small chance to build a little of rapport, which helps you get the information you need and helps them see that you're a human being and that you're really just there trying to help them," Martin said. "It gives a sense of normalcy to an otherwise abnormal event."
Sometimes, Martin said, patients do not share certain information because they either forget or believe it is irrelevant.
"It becomes very subjective," Martin said. "Between us, the nurses and the doctors, we know what we're looking for. Sometimes, a patient is like, 'Oh, nothing,' and we're like, 'It's a big something.' "
At the hospital, McWethy and Martin take the patient on the gurney to the nurses' station, where they begin transfer of care, sharing all their collected patient information.
"When we get to the hospital, that information then flows to the charge nurse, who's going to decide where the patient goes, who's going to see them," Martin said. "Then, we take that patient to the bed and we transfer them to the actual nurse who is going to be caring for them, specifically."
Both Martin and McWethy tell the nurse everything the patient shared and anything they found important in their review. Martin said all details are important because, so far, the EMT and the paramedic have spent the longest amount of time with the patient.
"Just let the doctor know, 'Hey, I saw this,' and let them make the call," Martin said. "It's just like we want the patient to tell us everything. The doctor and the nurse want us to tell them everything. It might be something that's meaningless to us but meaningful to them. Communication is huge."
Once they complete the transfer of care, Martin and McWethy said they clean the ambulance with disinfectant wipes and are back on the road, awaiting the next call.
"No call is the same," McWethy said. "You can read a textbook and it tells you how to do one thing. It's completely different when you're out here. You have to have your own thinking and make your own calls. It's not the same every day."
Both agreed that each call is just as important as the next with the sole goal of saving a life.
"One of the biggest things for me, personally, is on EMS when we show up and somebody is not breathing, their heart is not beating and then, by the time we get them to the hospital, they are breathing, their heart is beating, that's incredible to me," Martin said.