/ 14 July 2004

Paramedics: We’re not like tow-truck drivers

”I hope you don’t get car sick in the back there,” says paramedic Stewart Masson squeezing the speeding response car between a slow moving truck and a causeway bridge, his speedo nudging the 160kph mark, the siren sending peak hour motorists scattering like ants.

The scanty information provided to the emergency operator had only said that a taxi and a Golf had crashed. As he approaches intersections he hits the siren button and the traffic parts down the middle, creating a makeshift emergency lane over the white line. Even Johannesburg’s hardened taxi drivers hastily lurch left.

At a busy multi-lane intersection, a woman motorist sees the instantly blank space in front of her and senses her chance to outwit other Joburg drivers and be in front, and shoots over the intersection, giving Masson an embarrassed look.

”The far lane is the worst — everyone stops and you live in fear of someone coming from the furtherest lane and you not seeing each other and T-boning,” he says, doing a fast eye-contact orbit around the intersection to confirm that everybody has seen him and his bright red ER24 response car.

On the freeway, advanced driver training kicks in and he gears up, heads into the emergency lane and swoops past the near-standstill traffic on the N1, at times gearing down to squeeze back into the traffic to bypass off-ramp standstill, road debris, or an elderly motorist pottering next to his parked car.

In another part of the city, a Netcare911 paramedic and a team from provincial services are probably doing the same thing, as all say the public have taken to covering their bases by phoning all emergency services when help is needed.

As a top-level paramedic, Masson’s job in the response car is to get to the scene first, assess the situation and order additional ambulance back-up if necessary, or to cancel the ambulance if it’s not needed.

In the boot of the car is a portable survival kit containing all the equipment and medication needed to deal with traumas ranging from severe injuries to respiratory failure and, deep in the boot, is a supply of fluffy brown ”Medi Teddies” to cheer up distressed children.

Following closely will be an ambulance kitted out as a mobile intensive care unit and back at HQ is a room full of young men and women ready to drop their steaming mugs of morning coffee and run to their vehicles if needed.

At this accident, Netcare911 got there first and have prepared three people to be transferred to hospital. Once on a scene, by law Masson cannot leave if he is needed, regardless of whether the patient will be able to pay or not, so before withdrawing he has to confirm that it’s okay to go.

As he drives away waiting for the next call, this time with no sirens and at a normal speed, Masson quips, ”Anyone for Rennies? I live on the things.”

Masson is one of the country’s paramedics who reacted strongly to a recent article that they could be placing other road users’ lives in danger in their race to get to a scene first for the financial benefits, with some likening them to tow truck drivers. All believe it is their job to get to the scene of an accident as fast as they can and both ER24 and Netcare911 invited Sapa to join them for a morning.

Packing the post-160km an hour indigestion remedy away, Masson says: ”We don’t race each other. Maybe there is something at the top level between companies, but the guys on the ground all get on fine and we work together at scenes.”

He’s flipping through radio stations taking in news bulletins, fielding calls from the control room.

He explains that when they receive a call they know very little about the situation and try to get there as quickly as possible because every second counts if it turns out be a life-threatening situation.

He says that last year, when a young paramedic crashed her response car and died, and her colleague was seriously injured, ”was the worst year of my life”.

Later, Netcare911’s Craig Grindell, who has been a paramedic for 13 years, agrees.

”If a child’s life is on the line, we don’t know until we get there whether it was life threatening or not, and whether we should have sped. The concept of being seen like the tow-truck industry is really not right. We are all highly skilled and our only objective is to save people’s lives. We all have lives and families and we don’t want to get hurt.

”We are trained to drive safely and correctly. You’ve got to understand that wherever we go there is a life on the line,” Grindell continues.

”We all know each other and most of us have worked together at some stage. If there is rivalry it’s not over who can take a patient, but it’s out of a passion, a pride to save lives. It’s in our heart and soul to save lives and there are guys who will do anything to keep you alive.”

Both companies say that at huge accident scenes the most experienced paramedic takes control of the scene and all the teams present — private and provincial — work together.

This is played out on Roodepoort’s Ontdekkers road where ER24, provincial paramedics and the local fire brigade rally around an unconscious security company employee who flipped his car racing to a panic button call.

One person holds up the drip, another leans into the crumpled car to keep his body still, another monitors his vital signs, while the fire department slices the vehicle’s roof off to free him, and yet another makes his firearm safe from accidental discharge.

On the way back, between flipping through news broadcasts and discussing breakfast possibilities, Masson gets a call: ”Witkoppen. One year old. Respiratory failure.”

Besides their response cars, ambulances and helicopters, each service has a call centre manned by operators who all have as their minimum qualification a basic ambulance course. Each centre also has a doctor and highly qualified nursing staff on hand to help judge the skeletal information provided to the operator.

A dispatch operator sends out the stacatto-like information to the response vehicles and the ambulances.

Himself the father of a toddler, Masson floors the accelerator to cut a normally half-hour journey to the Witkoppen clinic, to eight minutes, vital for avoiding long term brain damage associated with respiratory failure.

He gets a brief rundown from the staff gathered around the struggling infant, while on a bench nearby, her mother watches silently as Masson adjusts oxygen levels and tries to insert a rehydration drip into the child.

After consulting with the nursing sister, they decide the private ambulance will take mother and baby to Johannesburg Hospital and a pregnant woman, also waiting for an ambulance, will go with the provincial service, which also arrives.

”This was a philanthropic one, wasn’t it,” said the appreciative nursing sister to Masson who knows that the young mother from Diepsloot will never be able to pay the average R750 to R1 000 starting fee for the company’s services.