York Region paramedics love their demanding, high-stress jobs

YorkRegion.com
Aug. 7, 2014
Chris Traber

Jason Baertschi does not recall how he ended up in front of a car last month. Perhaps, the idyllic East Gwillimbury summer day prompted respite from vigilance while the teenager walked to his summer job.

He does remember being clipped, thrown to the pavement and staying down, frozen in pain and shock.

The distraught driver immediately called 911. It was determined that of the first responders, an ambulance was most urgent. The operator connected to York Region Emergency Medical Services’ dispatch based in Barrie.

Lead York EMS paramedics Jordan Kachur, 29, and Leo Rosswill, 51, were starting their 12-hour shift at EMS regional headquarters near Sharon.

Kachur answered the red phone in the ready room. 

“Book on code four,” parlance for a struck pedestrian, he heard.

With the urgency of scrambling fighter pilots, the duo, with a combined 36 years of paramedic experience, had 90 seconds to get their ambulance, No. 3156, out of the cavernous garage and on the road. The state-of-the-art vehicle, one of 50 at the ready or on patrol in York Region 24/7/365 rolled out as the pair were radio briefed on the situation and the victim’s location via an electronic mapping system.

With the confidence afforded by experience and emergency driver training, Kachur deftly maneuvered the rolling medical clinic, lights and sirens on, through the summer afternoon. Traffic is light and obedient, giving way to the ambulance speeding to the scene. The truck with a base price akin to a very exotic imported sports car and a life span of 200,000 kilometres, arrives to find the teenager splayed on the road.

Rosswill and Kachur are all business. They meld competence with compassion, mindful that the young man is not only hurt, but also traumatized.

They ask the driver if the victim was hit or run over. Was he unconscious? They speak with their patient by name. It is calming. They gauge the extent of his injury. Can he move his toes? Fingers? A preliminary exam suggests they’ll take him to hospital.

With severe injuries, the paramedics are trained to provide critical intervention, IVs, airway protection and controlling major bleeding.

With grievous injury, they work within the “golden hour,” attending and delivering the patient to doctors to optimize survival rates.

Alternatively, they could call in provincial Ornge air ambulance for transport to Sunnybrook Hospital in Toronto, the regional trauma centre.

The young man is fitted carefully with a neck brace. He is rolled gently onto a backboard, lifted onto the wheeled stretcher, strapped in and secured in the ambulance.

As Kacher drives, Rosswill checks the patient’s heart rate, pulse and blood pressure, asks about any existing medical conditions, allergies or issues and tends the lad. They arrive at the hospital within minutes.

The aforementioned scenario was based on a simulation, staged to ensure public safety and any real patient’s privacy.

The role of the moaning, groaning victim was authentically portrayed by Baertschi, a Georgian College Paramedic School student. He is conducting York Region EMS public education programs for the summer.

Kacher and Rosswill are very genuine paramedics. They did, for demonstration purposes, attend the faux accident in real time with real world EMS practices and protocols.

On any given day, the 550 full-time and casual York paramedics attend bona fide emergency calls.

On a yearly average, they respond to 75,000 dispatches of which 60,000 result in transport to a hospital, EMS chief Norm Barrette said.

His professionals respond to three typical types of calls. While ranging in complexity, they are categorized as medical, injury and mental health. Timing and tactics are everything within the realm of EMS.

York Region paramedics are meeting and even exceeding approved response time targets set out by Ontario and the Ambulance Act.

York EMS consistently responds within Canadian Triage Acuity Scale guidelines, tending to a patient within eight minutes 75 per cent of the time or better, Barrette said.

A paramedic’s job is fraught with risk, the chief confirmed. No call is typical or predicable, he said. They face roadside and traffic hazards and peril in residences and workplaces. There is the threat of violence and hazardous materials. Subject to patient’s mental, physical, intoxicated or medicated state, they can be combative. Because of the heavy lifting involved, 18 per cent of paramedics report a lost time work-related injury annually and two-thirds said they were victims of some form of violence each year, according to a recent Canadian Journal of Emergency Medicine survey.

“It’s a physically and mentally demanding job,” Kachur said. “Dealing with what we sometimes see is challenging.”

Rosswill agreed.

“The toughest calls are when kids are involved,” he said. “And, shift work can be tough on your family.”

“It’s a job like no other, Kachur said.

“There’s something different every day,” he said. “It can be exciting.”

Paramedics have to endure routine, Rosswill noted. Typically, they are on alert at their base or on the road providing “emergency coverage” to ensure ambulances are strategically placed throughout the region. Once they have delivered a patient to hospital, crews must stay until “transfer of care” is complete. Depending on the day, a crew’s hand off of a patient to medical staff can be minutes or hours, Kachur said.

“It’s certainly not as dramatic as television, although sometimes it’s very much like a television show,” Rosswill said.

Their daily shifts are stressful because of the importance of their duties, the men said. Collectively, the duo have delivered 14 babies.

“That’s one of the better parts of the job,” Kachur said.

Still, paramedics everywhere are susceptible to post traumatic stress syndrome.

“It’s troubling,” Barrette said. “Paramedics deal with very difficult situations. There’s a misconception that their uniform is a shield. As a profession, we need to get in front of the well being of our front line.

“We’re making mental wellness and resilience a priority.”

There are a multitude of positives, the chief said. The upside of a paramedic’s work becomes evident at the department’s annual Survivor Day. Patients who were clinically dead and revived by paramedics are invited to meet their rescuers.

“When you have 40 to 50 survivors in one room, it’s incredibly joyous,” Barrette said.