Lee High School

Rescuing More Than Others

Paramedic

Samantha Gonzalez

Senior Capstone

Brian Cahoon

April 13, 2018

 Gonzalez 1

Samantha Gonzalez

Senior Capstone

April 13, 2018

Mr. Cahoon
Rescuing More Than Others

Many paramedics have responsibilities that other civilians might not imagine.

Transporting deceased bodies, overdose cases, family passings, etc. It is a very sensitive topic for

some but, it is almost a normality for first responders to experience these traumatic cases. When

first responders first arrive at a scene, there is nothing they can expect to witness. Paramedics

have to be able to deal with the emotional tolls of suicide and death, responding to the

opioid crisis, and the challenges and triaging severe injuries.

Many paramedics and Emergency Medical Technicians have seen traumatic events that

flashback into their mind once in a while. An estimated 25 to 30 percent of first care providers

are diagnosed with PTSD (post-traumatic stress disorder) because of the enduring stress of their

critical working conditions (Parkinson). The symptoms of this specific disorder are said to be

concurrent throughout the entire duration of the career. Murders, fatal car crashes, infant deaths

and family deaths are some of the horrific tragedies that can be witnessed in this career.

(Jennings.) Suicide is also another substantial tragedy that first care providers may witness.

“34,000 people will die by suicide in the U.S., and another 500,000 will be seen in the

emergency department for treatment of self-inflicted injuries” (Zygowicz). “Alcoholism, drug

abuse, and other mental illnesses such as schizophrenia, mood disorders and, depression increase

the risk of suicide” (Fleming). When working as an Emergency Medical Technician, paramedic,

or any first care provider, stress is expected to be present. Many encounters stumbled upon in the
 Gonzalez 2

job are often reminisced and can cause nightmares. “Each one of these suicides leaves a small

mark on your soul” (Fleming). “Often, in this specific line of work, learning how to cope with

stress and trauma have been one of the biggest aspects of this job that are often overlooked”

(Landis). Peer support and informal counseling are all to be used by paramedics who were

dealing with post-traumatic stress symptoms. Seeing a therapist or psychologist is recommended

but does not always has a positive outlook by many. “Consistent occupational mental health

statistics within the EMS and fire service remain elusive” (Fleming). When working in a very

high demand career as an Emergency Medical Technician, police officer, paramedic, etc. there

are many illegal sightings that are likely to be seen; for example, illegal selling of drugs and

opioids.

Opioids and all other types of drugs have been one of the biggest cause of deaths in the

past years. In the past handful of years, the opioid epidemic grew substantially, and first

responders are the most affected. More than 42,000 Americans died of opioid overdoses in 2016,

a 28 percent increase over 2015 (Ingraham). The opioid epidemic is now considered a national

emergency due to the number of Americans that are risking their lives to get that “high” they

experienced the first time taking the drug. “We are at ground zero for the opiate overdose

epidemic. We are all suffering. Our overdoses have increased 50 percent in the last two years”

(Lewis). Different types of opioid drugs have started fresh in the market and old drugs are kept

in; they are illegally distributed and consumed which causes paramedics to wonder. When a first

care provider enters the scene in which they are called to be present in, they might witness a

patient who is unresponsive, in cardiac arrest, or not breathing. Using nitrile gloves and wearing

masks are said to be the most effective way to safely approach and transfer a patient because

opioids are in the air or absorbed into the skin when in close contact. Paramedics and emergency
 Gonzalez 3

medical technicians are very prone to opioid contamination because of the line of work they are

routined to work through. Often, when taking care of patients who have overdosed, first

responders are likely to meet the same addict two or three times for the same reason. The need

for the drug used to reverse the effects of an extreme overdose, called Narcan, has grown

exponentially. Many paramedics remember patients who have overdosed. “...As a paramedic,

you walk into a scene, you smell certain smells, you have a vision and auditory experiences,

sometimes there are tastes of things in the air. All five of your senses are impacted” (Shade).

Getting patients to a hospital after an overdose can be tricky, but there is a routine that first

responders go through to make the trip even shorter for their patients.

Paramedics are responsible for triaging a patient safely to the nearest hospital to complete

the treatment for their patient. First responders give the least amount of treatment; they are

responsible for getting the patient together before their hospital visit. There are many different

ways that paramedics can triage a patient. One way is through S.T.A.R.T (simple triangle and

rapid treatment) or using S.A.L.T (sort, assess, life-saving interventions, treatment/transport).

The main goal for a trauma triage to have a routine is to sort patients on the severity of their pain

and getting them to the hospital as quickly as possible. They are separated by colored tape (also

known as triage tags) that identify them by their injuries. There are four tags, red being the one

that identifies a patient who is to be transported immediately, yellow identifies urgent patients

that have not so life-threatening injuries, green is for patients with no life-threatening injuries

and the black tag which indicates a deceased patient. In emergency calls with several injured

patients, supplies are limited so identifying the most injured patient is important. The plans are

very tedious so paramedics follow them with great understanding.

 Gonzalez 4

Many first responders feel as if they are responsible for the deaths of patients they might

encounter. Paramedics might go through the symptoms pertaining to post-traumatic stress

disorder or could go through a rough case of someone overdosing on opiates and not having

enough time to save them. Getting a patient to the hospital and them surviving is very rewarding

but can be costly to their health. Working as a paramedic requires a lot of hard work and

dedication. Dealing with emotional tolls of suicide and death, responding and reacting to the

opioid crisis and getting through the challenges and triaging patients to the hospital with severe

injuries are some of the most critical aspects of working as a paramedic.

Works Cited

Bernstein, Lenny. “How the Government Can Fight the Opioid Epidemic under a Public Health

Emergency.” Michigan ELibrary, 26 Oct. 2017.

 Gonzalez 5

Bledsoe, Bryan E. (2018). The 21st Century Paramedic. [online] Jems.com.

Bradbury, Shelly. “As the Opioid Epidemic Grows, Paramedics Feel the Weight of Tragedy.”

Pittsburgh Post Gazette, 10 May 2017.“Opioid Overdose Crisis.” National Institute on

Drug Abuse, Mar. 2017.

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, EMTs

and Paramedics

Callwood, Alison. "The Reliability and Validity of Mmis in Values Based Recruitment to

Nursing, Midwifery and Paramedic Practice Programmes: Findings from an Evaluation

Study." International Journal of Nursing Studies, 2018.

Eastwood, Kathryn, (2018). "Patient and case characteristics associated with 'no paramedic

treatment' for low-acuity cases referred for emergency ambulance dispatch following a

secondary telephone triage: a retrospective cohort study." Scandinavian Journal of

Trauma, Resuscitation and Emergency Medicine, vol. 26, no. 1, 2018.

Edgerly, Dennis. “The Basics of Mass Casualty Triage.” The Jems, 1 May 2016.

Epitropoulos, Alexa. “Opioids in Alexandria Part 4: The Opioid Crisis through an EMT’s Lens.”

Alexandria Times, 22 Nov. 2017.

Friese, Greg. “Proactive EMS Approaches to the Opioid Crisis.” EMS1, 15 Aug. 2017.

Grevin, Francine. “Posttraumatic Stress Disorder, Ego Defense Mechanisms, and Empathy

among Urban Paramedics.” Sage Journals, 1 Oct. 1996.

Hsieh, Arthur. “The Opioid Epidemic and the EMS Provider.” EMS1, 23 Aug. 2017.

Jurisova, Erika. "Coping Strategies and Post-Traumatic Growth in Paramedics: Moderating

Effect of Specific Self-Efficacy and Positive/Negative Affectivity." Studia Psychologica:

Journal for Basic Research in Psychological Sciences

 Gonzalez 6

Lamplugh, Mark W. “The Stress in EMS: Effects of Stress on the Unsung Heroes of the EMS

Profession.” The Jems, 8 May 2017.

Landis, Ben. “Senior Capstone Mentor Interview.” 29 Mar. 2018.

Landro, L. (2018). Paramedics Aren't Just for Emergencies. [online] WSJ.

Mirhaghi, Amir, et al. "Systematic Review of the Personality Profile of Paramedics: Bringing

Evidence into Emergency Medical Personnel Recruitment Policy." Eurasian Journal of

Emergency Medicine, no. 3, 2016, p. 144. EBSCOhost, doi:10.5152/eajem.2016.80299.

Redeye, Michelle. “The EMT Who Sees the Opioid Crisis Firsthand.” The Job, 27 Apr. 2017.

Stanley, Ian H. “A Systematic Review of Suicidal Thoughts and Behaviors among Police

Officers, Firefighters, EMTs, and Paramedics.”National Center for Biotechnology

Information, Clinical Psychology Review, 28 Mar. 2018.

Zygowicz, Wayne M. “Suicides Affect Patients & EMS Providers.” The Jems, 31 Mar. 2011.