If you're thinking of becoming a paramedic, this article is for you.

My morning starts like any other person’s morning, I presume, except there are messages on my phone, about motor vehicle collisions and incidents that happened the night before…
While driving to work, I am already starting to mentally prepare myself for the day ahead, which is quite hard, as you don’t know what’s going to happen during the day.

The day shift is from 7am to 7pm, and I’m standing in on a shift that doesn’t have an Advanced Life Support paramedic.

 
Emergency Vehicles at the base at shift change, when I came on duty.

I met the night shift paramedic in the Advanced Life Support paramedic’s office, which is more of a mini storeroom with medical stock and different kinds of medical equipment and monitors, than a traditional office. She had just returned from an ICU transfer (when a patient is moved between two hospitals). A brief, “you just have to change the oxygen and I’ll see you tonight” was the hand-over as she walked out of the base directly to her car, deliberately not stopping to talk to anyone, as it would delay her getting home and into bed.

A quick staff parade is done before checking the response vehicle. You have to check many things, like whether the vehicle is safe and if the medical stock is in working condition and charged. We have to roughly keep enough stock on the response vehicle to start basic treatment for a mini bus load of patients, which is normally 16.

 
Staff cleaning the ambulance before going on a case.

After checking the response vehicle I make a turn at the Emergency Call Management Centre, where the emergency calls are received. Because some of the paramedics have already taken details for cases; I have to help the dispatcher to reprioritise the cases, which are mostly assault cases. While there, I’m informed that a house fire has broken out. The police and fire department, who are at the scene, suspect that an elderly lady has died. An ambulance crew and I are dispatched to the case.

Just after turning off the main road I was told that an ambulance had already reached the scene and sadly the lady had already passed away. An unattended candle left burning during the night was speculated as being the cause of the fire.

I was then immediately dispatched to another case – this time a medical case, about half an hour away.

When I got closer to the area, I had to get directions to the scene from the ambulance crews who are more familiar with the area. Navigating in the rural areas is not the same as the urban areas – very few roads have names, and if they are named, they aren’t marked. There are also no street numbers. Some houses may have a five-digit number painted on the side, but there doesn’t seem to be any logical numerical relationship between the numbers. Directions are normally in the form of landmarks, like community halls, bridges, schools and little spaza shops.  

A picture of the surroundings where I stopped to get directions to the scene.

Not long after turning off the main road, the road turns to gravel and I’m reminded why our response vehicles are 4x4 bakkies and not the sports cars that some paramedics in the cities have. After driving for some time I suspect I may have gone too far and I ask for directions from a mini bus driver, who doesn’t know the name of the shop I’m looking for, but assures me that I have gone too far. Meanwhile, the emergency call management centre had been in contact with the family of the patient, who said they saw me drive passed. So I turned around and proceeded back in the direction I had come from. This time I managed to see the sign board, which was in fact a red shipping container and not a building, as I had been expecting. The ambulance arrived on the scene shortly afterwards and the elderly patient was treated for her medical condition. We then transported the patient to hospital in a serious but stable condition.

One thing many paramedics forget is that during emergencies you have to treat the patient and the family. The patient for whichever condition or injury they have and the family who is normally very concerned about their relative and need to be reassured and informed as to what has been done to help the patient.

At the hospital the doctors and nurses were still busy treating the excessive amount of trauma patients that had been brought in from the previous night.
 

A panoramic picture of the scene where we picked up the patient.

We then handed the patient over to the doctor. The ambulance was given further details and I started to proceed back in the direction of the base. On the way back to the base I came across the fire department and a tow truck parked on the side of the road. I thought there may have been a collision that they were attending to, but it was for a car that had caught alight. The fire department had already extinguished the fire and thankfully the driver had managed to escape without any injuries. As you can see, the car was severely burnt and beyond repair.

The car that burnt out

When I arrived at the base there was no time to put my feet up and relax. I had plenty of laborious admin work to complete – but just as I started, I was again dispatched to a bottle store, where two men had been fighting.

To my relief, I could see that the police were already at the scene.

The argument apparently started because the one owed the other a R6. As a result, one was hit on the head with a bottle, while the other had been taken away from the scene by his friends. I bandaged the man’s wounds and checked his vital signs. He was stable, but due to being under the influence, he didn’t realise the severity of his wounds and tried his best to convince the policeman for a lift to his house. He eventually realised that he needed to go to hospital for stitches and was then taken to hospital by the ambulance.

By mid-afternoon there were no cases outstanding.

Early evening I was dispatched to a motor vehicle collision about 40 minutes away from the base.

While driving I noticed a truck on the side of the road with its hazards on. There were a few people standing behind it, with others running closer. I immediately stopped, got out of the vehicle and moved closer to the scene. A man had been hit by a truck – the accident had just happened! The station officer continued to the original accident, while I stayed to assist the man. I parked my response vehicle between the oncoming traffic and the injured man, as I was worried that oncoming vehicles were going to hit us. Using the two-way radio, I asked the control centre to send the police and an ambulance to assist me.

I carried my equipment to the man’s side. Some of the bystanders are already crying, as they thought the man is dead. After assessment I found that the man was critically injured, but thankfully still alive. I’m still the only person from the emergency services at the scene, so I start treating the man by giving him oxygen, putting up drips and connecting the relevant monitors in order to check and monitor his vital signs. A police van arrives from the nearby station. One of the policemen puts on gloves and helps me, while the other assists with traffic flow passed the scene. When the ambulance arrived, the crews assisted me. We administered the required medical care to the man and put him in the ambulance. It was already dark with rain starting to fall, but we were just glad to be off the side of the road as cars were speeding around the corner, despite early warnings from the police and RTI.

When we eventually arrived, a trauma team was waiting for us to hand over the patient. During the hand over to the doctors, you tell them what is wrong with the patient, what the injuries are and what your treatment has been. You then also complete a written hand over, which must be signed by the doctor and placed into the patient’s file.

It was already well after 7pm when we returned to the base.

While driving home, I thought about the case I had just attended to. I wondered if there was anything I could have done differently or better and if he will be okay… but as soon as I got home, and heard my son scream “daddy’s home”, those thoughts ended. My baby was safely asleep and my other son needed to be carried to bed after falling asleep on the couch, not managing to stay awake to see dad.

My working day was over for now; I was at home – something which I cherish, because a paramedic is never really off duty. There’s always the possibility of my phone ringing, with the person saying “there is a child”, “a bus overturned”, “multiple critical patients, we need you”, “there is a…..” before you can even say hello.

Find paramedic jobs here or jobs in the medical field here.

Thank you  Robert Mckenzie for submitting his story and informing us of what it really takes to be a paramedic.