A difficult choice confronted Justin Osgood last week when his father suffered a grievous chainsaw injury:
Wait for an ambulance or jump in the car and race to the hospital?
After speeding through downtown Lincoln, at times allegedly topping 100 mph, Osgood made it to the hospital. While his father, Dwight Osgood, is recovering, Justin Osgood faces up to six months in jail on a charge of driving to endanger.
It seems obvious that the Osgoods should have called and waited for an ambulance, rather than risk injuring others in their race to Penobscot Valley Hospital. But in rural areas of Maine, that wait can stretch to agonizing lengths as paramedics make their way to the scene.
“I can only imagine how terrifying it is to sit there and watch your loved one suffering,” said Shaun St. Germain, director of Maine Emergency Medical Services.
How do you decide whether to call for help or hit the road? St. Germain offers some advice.
First, he explained the training and equipment you’ll find on ambulances. Then he offered advice about when to call 911.
The training of ambulance staff varies from town to town.
If you call 911, the personnel coming to your rescue will fall into one of four categories:
— Emergency medical responders are trained in basic and advanced first aid. They include police and firefighters, but not typically ambulance personnel. If you live in a town that contracts with another municipality for ambulance service, as in Osgood’s case, an emergency responder might arrive first to render aid while the ambulance is on its way.
— Emergency medical technicians are the entry-level staff on ambulances. They complete nearly 200 hours of training and provide all levels of first aid. They can control bleeding, administer epinephrine to quell allergic reactions, provide Narcan to overdose victims and give nitroglycerine to cardiac patients, among other services.
— Advanced EMTs can do all of that plus provide additional services such as starting IVs and administering treatments to help patients breathe.
— Paramedics are the highest level of emergency care on an ambulance. They can insert breathing tubes, provide advanced cardiac monitoring and administer a wider range of medications. While not every ambulance service in Maine includes paramedics, many do, St. Germain said.
Ambulances stock different levels of medical equipment.
All ambulances must stock basic equipment, but some carry extras such as cardiac monitors and more extensive medication kits. In Osgood’s case, the ambulance that attempted to intercept him was stocked with gauze pads impregnated with a clotting agent to stem bleeding. All ambulances are permitted to carry those pads, but some services choose not to spend the money for them, St. Germain said.
He was reluctant to second guess the Osgoods’ actions, but he said, “It sounds to me like if they had stopped at the ambulance, they would have been able to get him bleeding control immediately, as opposed to waiting until they got to the hospital.”
“We have a limited amount of blood in our bodies, and you certainly don’t want to take chances on losing it,” he added.
Calling 911 doesn’t mean you’ll get loaded into an ambulance.
All 911 dispatchers in Maine are trained to coach callers on basic emergency medical interventions, such as how to control bleeding. They’ll help you start taking action right away and then guide you through whether an ambulance is needed. If it’s not, you’re still getting assistance from trained personnel.
“Any time [people] feel there’s an emergency, we would prefer that they call an ambulance and at least get evaluated,” St. Germain said.
In other words, “We’d rather be called for a nonemergency than not called for an emergency.”
Even if you wait for an ambulance to arrive, you’ll get probably get treatment faster.
Osgood undoubtedly started the trip to the hospital sooner by getting in the car with his son and instructing him to “Go faster!”
But patients who take themselves to the emergency room are first triaged before they receive treatment. As just about anyone who’s ever visited the ER knows, you end up waiting if other patients have more serious ailments.
With an ambulance, your treatment starts as soon as it arrives at your house and continues all the way to the hospital. Paramedics also notify the hospital and inform them of your condition. That way, doctors and nurses are prepared for your arrival.
Those precious minutes can make the difference between life and death.
“Fortunately everything turned out OK for this gentleman, and I’m happy for that,” St. Germain said. “But it could have gone bad.”
