Emergency Medical Technicians (EMTs) and Paramedics (Medics) train their diagnostic and treatment skills in a controlled classroom environment long before they apply their training in a live environment. Typically, the first chance to practice their EMT skills takes place during a “ride-along.” The first ride-along is a memorable experience where, under the auspices of a seasoned and competent practitioner, the chaos of reality is used to measure the true depth of one’s medical skills and to build the fledgling EMT’s confidence. I went on my first ride-along 29 years ago this week. I can recall almost every detail of that night, the locations, the patients, the smells, the panic, everything.
I was paired up with a crackerjack team for an overnight shift in the North Sacramento area. Jason, the Medic, and Kim, the EMT were highly respected by their colleagues. He was the fly by the seat of his pants, punk rock, live on the edge type, and Kim was competent, pretty, and grounded. Together, they looked like the actors you might get if you called Central Casting to get a Medic and an EMT for a Hollywood movie.
Before we headed out to save the world, Kim familiarized me with the old Ford ambulance and Jason inventoried the drugs in his med kit making sure the rig was properly stocked. When we completed our important tasks, Kim told me to hop in the back. Jason jumped into the passenger seat, and Kim took the wheel. She fired up the ambulance, grabbed the radio mic, and said, “dispatch, this is the 140 car, we’re 10-8.” Dispatch responded, “140 is 10-8, proceed to post at the Triangle.” Before we got out of the parking lot, we received another call from dispatch, “140, Code 3, possible heart attack in progress.” I looked at my watch. The Golden Hour for saving heart attack victims is 8 minutes. I wondered if we would make it?
Five minutes after the initial 9-11 call, we were banging on the door of the duplex where the medical emergency was taking place. The door opened and a panic-stricken woman pointed us to the living room where a middle-aged man was doing push-ups. Push-ups? As the man performed his push-ups he growled, “Look, I’m fine. Ain’t nuthin’ wrong with me. I ain’t getting’ in no ambulance.” Jason and Kim were calm, but my heart was trying to leap out of my chest. I looked to Jason for direction. He leaned over toward my ear and softly said, “Relax. He’ll drop in a minute or two. They always do.” I thought, “Oh, this is what the textbook meant when it listed denial as a symptom of a heart attack. This is not what I expected.”
As predicted, our heart attack sufferer dropped like a sweaty rock. We scooped him up. Loaded him in the ambulance, and headed out Code 3 to Mercy San Juan Hospital. I will not go into all of the medical details, but you will be glad to know that our push-up patient survived the ride and was still alive the next morning. However, something quite formative happened on the drive to the hospital.
Despite Kim’s skilled driving, the lights, sirens, bouncing, and swaying made the ride chaotic. It was a perfect situation to test my EMT skills. Jason thought the same. “Scott,” he yelled, “get me a blood pressure.” I was good at that skill. In fact, I was the guy that all my classmates turned to for help when they were struggling. “No problem, Jason,” I responded confidently. But there was a problem. With all the chaos, I could not hear the heartbeat start and stop as I released the air out of the blood pressure cuff. I could not do it. I could not believe that I was failing at this beginner level task. I started to perspire as my heart rate increased. I could not hear the patient’s heartbeat. Now what?
Jason slid toward me on the bench, looked me in the eyes, and firmly said, “watch this.” He pumped up the blood pressure cuff (sphygmomanometer) to 190 then began to release the air. His stethoscope was still hanging around his neck.
“Mark when the needle begins to bounce and when it stops.”
190, 180, bounce at 170, wait, wait, wait, bounce at 100. “170 over 100,” I proudly declared.
Jason said, “Well, probably more like 160 over 90 if you could actually hear it.”
“Ok, 160/90. Is this a better way to take blood pressure?”
“No, but it works when you can’t hear, and you are bouncing around in the back of an ambulance. You can also calculate the patient’s heart rate that way. Just count the bounces for 10 seconds and multiply times 6.”
I used that no stethoscope technique more times than I could count over the years and taught it to many EMTs who did their first ride along with me.
The stressful conditions of the ride-along that revealed the limits of my ability, caused me to look to my mentor for guidance and humbled me enough to see things in a new way. It was a necessary part of growing me into an effective EMT.
You know, that is a lot like the way things work with God. We listen to our spiritual teachers and learn. As we go through life, God allows us to experience moments and sometimes seasons of chaos. Those times of testing, or ride-alongs, reveal how far we have matured as Christians and areas where we still need to grow. They also lead us to look to the Lord for safety and direction. Through it all, we draw closer to God as we become more like Jesus.
Christians in America experienced a ride-along during 2020. It was a gift from God. So, I ask you, how did you do? What did you learn? Where do you need to grow?