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Riding with the rescuers: Four hours with a CRS crew

November 09, 2001

Riding with the rescuers: Four hours with a CRS crew



By Bob Maginnis


For more than a year, I've written off and on about Community Rescue Service, the financially strapped ambulance squad that handles more than half of all emergency medical service calls in Washington County.

But what does it mean to respond to a call? Late on a Friday night in September, I found out, when I went on a "ride-along" that lasted from 10 p.m. to 2:30 a.m.

My guide was Chris Amos, chief of CRS, who also works for the Metropolitan Washington Airports Authority as a paramedic and firefighter. Amos was with the first crew to respond to the Sept. 11 attack on the Pentagon.

Thankfully, we don't see anything like that during my ride, but at 10 p.m., a couple of CRS personnel have gotten calls from family members who hear fighter jets they assume are circling the presidential retreat at Camp David.

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There's little time to reflect on that, however. The lights flash, the tones sound and I jump into the back of the ambulance as the crew responds to a "code," which means someone who has stopped breathing.

Amos leads the way in his car to an address in Hagerstown's North End. When we arrive, personnel from the Long Meadow Fire Company have already started working on the patient, a man in his 70s with no history of heart disease.

His wife has told the crew that they'd been watching TV together and she assumed that he'd just dozed off - until she tried to wake him and couldn't. Small groups of neighbors come by to comfort the woman.

As the crew works on him, compressing his chest to keep the blood moving through his body and "bagging" him to force air into his lungs, they find that he has no blood pressure, making it difficult to find a vein that hasn't collapsed so they can inject him with drugs.

The place him on a stretcher, then load him into the ambulance, while I watch, perched between the two front seats. Amos tells them to stop compressions, then pours medicine directly through the tube into his lungs.

The heart monitor registers only when they're doing compressions and the crew suspects that he might have stopped breathing for as long as 20 minutes before the wife noticed. Still, Amos spurs them on, telling them that the patient's belly isn't hard and that the pupils of his eyes aren't "blown."

Unfortunately, it isn't enough. When they arrive at the hospital, the emergency room doctor questions what they've done, and for how long.

"I think you've done all you can. I'm going to pronounce him at 11:58," he says.

Amos explains later that people who "code" are revived in fewer than 10 percent of the cases. Either the patients ignored the first signs of a heart attack or were too far away from emergency care. In many cases, he says, they linger just long enough to allow family members to say their good-byes, he says.

After the patient is pronounced dead, the crew gathers in the back of the hospital, where they re-stock the supplies they used from bins they access by punching in a numbered code.

There are more than 100 different devices, needles, tubes and the like and as one younger crew member works on the re-stock, Amos gives her a quick tutorial on why two devices that appear almost indentical are used for different purposes.

He's a patient coach who's been running with the fire service since he was a teen-ager, getting up to deliver newspapers after a night spent responding to fire calls. On a cool night when I'm wearing an insulated undershirt over a heavy flannnel, Amos wears a tee shirt. He's kept warm, or so it seems, by the burst of adrenaline that comes from responding to life-and death calls.

None of what I've heard about territorial or policy disputes seems relevant here. Everybody is working together, focused on the job at hand.

Then comes a call from Hagerstown's South End. For the second time today, a frail, white-haired woman has called with "trouble breathing."

Her house is tiny and so crowded with knick-knacks and furniture that it's hard to see how she moves from one room to another. A crew member speaks to her patiently, explaining that she's hyperventilating because she's having a panic attack. To their surprise, this time she says she'd like to go to the hospital.

As the ambulance pulls away, Amos wonders about the lonely existence she'll come back to. Then a second vehicle pulls up, driven by Terry Gearhart, the assistant chief, who's just seen a woman in the West End who put her hand through a window at a tavern. Despite a nasty cut between her fingers, she refuses to be stitched up or transported.

"She said, 'I'm not paying $300 to ride in that thing,' " Gearhart said.

It seems I've been riding along for about 20 minutes, though three hours have passed already. Then the tones sound again and we're off to a local nursing home. Even at this hour, patients are awake, sitting in the hall. One little old lady, her feet propped up on a chair, hollers "Hi boys" and waves to everyone.

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