Ask Us Anything About… Emergency Medical Services

Description – The video begins outside the Penn State Health Milton S. Hershey Medical Center™s Emergency Department. We see the side of an Ambulance with the words, Penn State Hershey Life Lion on the side. As the first person speaks, the camera moves to the back of the ambulance with the ambulance doors open. We see two male individuals standing next to each other looking at the camera. From left to right is, Scott Buchle and Scott Gilbert.

Scott Gilbert  – From Penn State Health, this is Ask Us Anything About Emergency Medical Services, I’m Scott Gilbert. There are steps everyone can do to help EMS crews do their live-saving job. This involves clearing the way when emergency vehicles are approaching, and making it easier for them to find your home. As September is national preparedness month, we thought it was a good time to check in with Scott Buchle. He’s Program Manager for Penn State Health Life Lion EMS, and he’s here to answer some of my questions and your questions today. Just add them to the comment field, here, below this post, and we’ll be sure to pose them to Scott. Hey, Scott. First of all, thanks a lot for being here.

Scott Buchle  – My pleasure.

Scott Gilbert  – I’d like to ask you a bit about — it’s a bit of a traffic question, I guess.

Scott Buchle  – Sure.

Scott Gilbert  – If I’m driving down the highway, or maybe in a city, and I see an ambulance coming up behind me, what are the steps I should take? How can I be safe, as a driver, but also make way for the ambulance?

Scott Buchle  – Sure. The first thing to do is, do not panic. When it’s a firetruck, an ambulance, a police car — a lot of times people will panic, break right in front of the emergency vehicle. Okay? The other thing is, do not directly stop in front of the emergency vehicle, because, then what happens is, the emergency vehicle has to serpentine around all the other cars that are stopped.

Scott Gilbert  – So, is the idea to make way, or is it to just stop wherever and let them go around?

Scott Buchle  – The idea is to yield to the emergency vehicle. If you have room to get off to the right side of the road, pull to the right, that’s the law in the commonwealth. A lot of people — some people will pull to the left. Which, again, makes it more of a serpentine for the emergency vehicle. If you’re driving a big fire truck, that’s kind of a problem. So, ambulance, police car, fire truck, whatever — pull to the right, do not panic, and leave as much room as possible. If you’re in a situation where you do not have room to pull to the right, try and get over as best you can. A lot of times we see people at intersections, where it’s a red light, and they don’t have room to move. So, what’ll happen is, people will start to slowly part their cars to make room for the ambulance, or, worst case scenario, we have to wait until the light turns green and then proceed through.

Scott Gilbert  – Sounds like some common sense, pretty much.

Scott Buchle  – Correct, correct. Yes.

Scott Gilbert  – Good deal. Let’s say I’m the person who called 9-1-1, and I requested the ambulance. What are some things I can do to help the ambulance find my home? I’ve heard things, like leaving a light on outside, making sure you have a prominently-displayed house number. Are those things helpful?

Scott Buchle  – Absolutely. Those are two of the biggest items — the light on, especially, at night. If possible, if somebody can go out and help flag the ambulance down, that would be great. The biggest thing is just numbering on your house or wherever — your business, wherever you’re living. We run into a lot of complexes or apartment complexes, townhomes, and so forth, where the numbers are very obscure. They might be hidden by vegetation, or they’re just too small to read. So, the bigger the number, the better. We have GPS tracking in all the vehicles. So, we’re pretty precise at finding your home. But, no system is absolutely perfect. So, I think the large numbers is the biggest help. Lights at night. And, again, if somebody can go outside and help flag the ambulance down, that’s best.

Scott Gilbert  – You’re watching Ask Us Anything About¦ Emergency Medical Services from Penn State Health. Thanks for tuning in for this Facebook live video. I’m Scott Gilbert, alongside Scott Buchle. He’s program manager for Penn State Health Life Lion EMS. And, we welcome your questions, whether you’re watching this video live, or if you’re watching it on playback, just add them as comments in the comment field below this Facebook post. And, we’ll make sure we track down some answers for you. You know, Scott, once the EMS crew arrives at the home, what are some tips, there, for kind of helping them do their job? For example, if I have pets, I imagine that could be a factor.

Scott Buchle  – Absolutely. Pets have a tendency to be a problem for EMS crews when they come to a house. A lot of people think that the bigger pets — big dogs are more ferocious. That can be. In our experiences, my own, personally, as well, I think the little dogs are more ferocious.

Scott Gilbert  – Is that right?

Scott Buchle  – Absolutely, yes. They are very fierce sometimes. But, the thing is, we don’t want to hurt the pets. So, with the smaller animals, we don’t want to step on them. We’re bringing equipment in with us. So, we don’t want to have the smaller animals get injured. The bigger animals, you know, they have a tend– animals are smart. They know when someone is sick. So, sometimes they will park themselves beside the patient, and they don’t really want to move. So, if you can take your pets and put them in another room, outside in the backyard or wherever, so they’re not in the way, that’s the biggest help. The next thing to do is, make sure we have room to get into a patient. Sometimes that might require moving some furniture. EMS crews sometimes will move furniture to make way for the ambulance cot to come inside, and so we can extricate the patient. Sometimes we will also call the fire department to come out and help us with extrication of a patient out of a building, whether it be moving furniture, or just helping to carry the patient. Again, so, that’s more importance to make room and get your animals out of the way.

Scott Gilbert  – Often when we go to the doctor’s office, we’re told to have medications ready to show to the doctor. And, when there’s an ambulance coming to your house, same advice applies, right?

Scott Buchle  – Absolutely, yes. It is — part of this job, sometimes, is playing detective. We have people who will go for a 9-1-1 call, and we will get handed several bottles — several bottles of medication. And, we have to take the time to write those down, to take that list along to the hospital with us. We really don’t want to take the medications to the hospital, just for fear they might get lost or separated from the patient. There’s a lot of money in those pharmaceuticals, so we don’t want them to get lost. So, our recommendation is, everybody, regardless if you take one medication or if you take 100 medications, should have a list written down of what you take, how often you take it, and what the dosage is, and who the physician is who prescribed it. A lot of times, people have several physicians who prescribe different medications. So, again, that makes our jobs easier and also the nurses and doctors, here, at the emergency department, and also throughout the health system, as they’re trying to piece together what might be wrong with a patient, what the reason is for a certain medication, and who prescribed it.

Scott Gilbert  – Let’s talk a little bit about the different types of ambulance crews that could show up at a home, based on the type of call. We hear about BLS — Basic Life Support, ALS for Advanced Life Support. This type of vehicle, here, is?

[Description “ The camera pans past the shoulder of Scott Buchle to show inside the ambulance. We see a gurney and additional seating areas as well as cabinets for ambulance supplies. ]

Scott Buchle  – This is technically a mobile intensive care unit. It can do the duties of a basic life support unit, as well. The — to qualify as an ALS unit, you have a paramedic on board, and you have advanced life support equipment. All of our ambulances are dual-role. And, the difference between the two is, a basic life support ambulance is staffed by two emergency medical technicians. They have an AED — an Automated External Defibrillator. They do not have a medication bag. That would come with a paramedic. The paramedic — the difference is in the skillset of the providers, between an EMT and a paramedic. So, the paramedics would have the heart monitor. They would be doing the IVs. They would be doing the advanced airway skills, carrying more medications. So, that’s pretty much the difference between the two.

Scott Gilbert  – So, a cardiac arrest or a life-threatening situation would call for ALS.

Scott Buchle  – Correct. Now, in some situations, you may get both units, depending how municipality is structured. For most of the areas that Life Lion EMS serves as a 9-1-1 coverage, we provide sole service; whereas, one of our units — one of our ALS units will respond. There are some other areas where we work with neighboring BLS units. So, this ambulance would bring the paramedic and the equipment, where one of our ALS squads would come with the paramedic and equipment, and then they would jump on that BLS unit and take the patient to the hospital.

Scott Gilbert  – Now, you did touch on, briefly, the difference between EMTs and paramedics. Can you explain that a little more depth, just so — people may hear the terms and think that they’re interchangeable. But, that’s actually not the case.

Scott Buchle  – Sure. The difference is basically skillset and education. Both of them are certified through the Commonwealth of Pennsylvania. An emergency medical technician goes to school for roughly about three months. They have a certain skillset. There’s also [helicopter landing] —

Scott Gilbert  – Do you hear something, or is it just me?

Scott Buchle  – I think it’s our big cousins down the hall coming to visit us, so — [chuckle]

[Description “ Loud helicopter noises are in the background and as the individuals continue to talk over the loud noises, the camera pans to the left to see the helicopter landing on the helipad in the distance.]

Scott Gilbert  – Yeah, so what you’re hearing right now is a Life Lion critical care helicopter. It’s literally landing right behind us. And, I hope you can still hear us. But, it’s landing right behind us, at the landing pad, which is just outside the emergency department, here at the medical center. So, that’s what you’re hearing right now, is one of our Life Lion helicopters landing an air ambulance, if you will. And, I think that sound will be subsiding, here, very shortly. But, yeah. So, an interesting distinction there between the EMTs and paramedics. I know they have both of those on board the helicopter, too. And, it’s an interesting distinction.

Scott Buchle  – So, the EMTs and the paramedics, again, the difference is the EMT’s basic life support. There’s also new certification in the Commonwealth of Pennsylvania called Advanced EMT. It’s kind of a bridge between the EMT and the paramedic level. A paramedic program — paramedics will go to school for roughly about a year-and-a-half to two years. It’s pretty much an associate’s degree-level program. It has more clinical time involved. They get into more of cardiology interpretation, advanced airway skills, medication. And then, furthermore, is the critical care transport mode, i.e. the helicopter which just landed. Our critical transport team is staffed with paramedics, and also critical care nurses. And, obviously the nurse goes to school for their amount of time. So many years, they get their nursing degree. Also, to work on a critical care team, they have to have a certain amount of years’ experience in an ICU or in the emergency department doing nursing-level care, to get to that transport team level.

Scott Gilbert  – A lot of different levels of care available, each catered to whatever the call, in particular, is all about. Makes good sense. We — like I was saying earlier, we welcome your questions for Scott Buchle. He’s Program Manager of Penn State Life Lion EMS. And, we do have a comment here from Tim. He says, thank you Penn State EMS. I have intractable epilepsy, and I’m blind. I appreciate your videos. I have a medical alert bracelet and a vagus nerve stimulator card. Well, thank you, Tim. Thanks a lot for your comment. We appreciate you tuning in for this video. And, we appreciate everybody’s comments and questions. Feel free to leave those in the comment field, again, below this video. Can we talk about skills people might be able to learn at home? So that they can help a friend or a family member until help arrives. I’m thinking of things like CPR.

Scott Buchle  – Absolutely. CPR, we recommend — everybody can do CPR, from pretty much any age group, at this point. Children, you know, not really little kids, but I know of some kids in the eight-year-old range who have learned CPR and done it successfully. We recommend that for everybody. In addition to the CPR is basic first aid. How to control bleeding — sudden bleeding or severe bleeding, which will help save a life until EMS gets there.

Scott Gilbert  – Okay. A lot of important skills there. And, people — where can people learn those types of skills? I guess they can probably contact — even, I know the medical center offers classes and that type of thing from time-to-time. But, any advice for people on that?

Scott Buchle  – Yeah, absolutely. You can pretty much find community CPR classes at various locations — local fire department, EMS services offer them. We offer them through our resuscitation science’s institute here, at the Penn State Hershey Medical Center. Also, sometimes municipalities will offer those as community courses. And, the other thing, too, is reach out to local community colleges. Here, in the Harrisburg area, we have Harrisburg Community College, for example. They offer community CPR courses, as well. But, contact the Red Cross, the American Heart Association. They can put you in touch with local CPR classes that are being held.

Scott Gilbert  – Especially important to know those skills, perhaps, if somebody in your home has special medical needs. And, I’m wondering, also, is it important to register or to at least notify crews, in advance, before a call happens, just to let them know that somebody has special needs, perhaps if they are on oxygen or have some sort of medication condition, again, prior to any call taking place, just as an FYI?

Scott Buchle  – That is good information to have. A lot of times — and, that’s something that used to be very, very prominent a long time ago, before the majority of the state went to an advanced 9-1-1 system. I’ll talk about that in a second. If you have a medical condition, it is not a bad idea to give that information to your local EMS provider. The challenge, though, is if your local EMS service is tied up on another call, the 9-1-1 center will dispatch the next neighboring, appropriate unit to your call. The 9-1-1 centers are very skilled at asking information when a call comes in. So, they’ll be quick to get the information. The other thing, too, is that a lot of people — talking about the 9-1-1 system, a lot of people think that when they call 9-1-1, there’s a delay because the 9-1-1 operator is on the phone with them for a certain amount of time. They are — as they’re asking information, they’re typing it into the computer, and they’re sending it down the line to another dispatcher, who’s actually talking to the ambulance, police car, firetruck that’s coming to your house.

Scott Gilbert  – Okay. So, that dispatch happens immediately, even as they’re gathering additional information.

Scott Buchle  – Correct.

Scott Gilbert  – And, when it comes to that 9-1-1 call, any other advice for people to keep in mind when they’re calling 9-1-1? Some mistakes maybe people make? I know one is, sometimes people hang up too soon.

Scott Buchle  – Absolutely. Pretty much in any area of service by Life Lion EMS, and throughout all central Pennsylvania, it’s an advanced 9-1-1 system. So, as soon as they pick up the phone, they pretty much can see who the caller is, and their information. There’s still some cellular phone limitations out there. That’s being worked through. It’s a lot better than what it was. But, we do run into people who — in a panic, they will call and say, hey, I need an ambulance, and they hang up. And then, the 9-1-1 dispatcher has to call back and figure out what the — or what specifically is wrong, to send the most appropriate ambulance. So, the big thing is to stay calm, have patience with them. And again, you know, the dispatcher’s going to ask you several questions. They’re going to triage the call. They’re going to send the most appropriate unit and make sure that they have the right address.

Scott Gilbert  – You’re watching Ask Us Anything About¦ Emergency Medical Services from Penn State Health. I’m Scott Gilbert, alongside Scott Buchle. He’s Program Manager for Penn State Health Life Lion EMS. And, he’s here to answer questions, as well as mine. So, feel free to leave those questions in the comment field below this Facebook post, even if you’re watching it after it’s live. If you’re watching it on playback, we can still track down some answers for you. You know, we mentioned earlier, Scott, that September is national preparedness month. And, I don’t want to let you go without the opportunity for you to share some tips on how people can be prepared. I do know that at PennStateHealthNews.org, our online newsroom, the Medical Minute from last week shares some important information, including some quotes from Scott Buchle. And, we’ll make sure we share that quote with you, or the link to that, rather, in the — in this Facebook post. But, in addition to that — any other important tips for preparation, especially as we see some of these disasters happening, like floods, and hurricanes in other parts of the country?

Scott Buchle  – The big thing is to have a plan. Prepare early. And, the one thing that we try to tell people, too, is — in today’s day and age, I think people need to be self-sufficient for 48 to 72 hours. The biggest thing is, people don’t plan for a disaster. Simple stuff, like food and water, batteries for flashlights. Everybody has a cell phone. But, what happens if the power’s out for three days, and now your cell phone battery dies? So, have a way to recharge your cell phone. Another thing, too, is know your evacuation routes. If you have to leave your home suddenly, or your office, where are you going? Where would you go to? And then, once you have that plan, communicate that with your loved ones and your family. One of the other challenges in a disaster is reunification. Families get split up, and then, obviously, the communication systems are either stretched thin or damaged, to the point that there’s no communications. Now, families have a very difficult time reuniting with each other. The biggest piece of advice we give people in a disaster situation is, use your head. And, don’t make a simple problem a big problem. I use flash flooding for an example. A lot of people think that if there’s a flooded road, they can drive right through it. And, that’s, you know, simple — a simple solution of just turn around and go the other way. But, what happens is, they drive out in the middle, and now the water is up to their windshield. And, fire department, EMS have to come, and we have to rescue them. Now you’re putting, you know, yourself at risk, obviously, but also the rescuers are at risk, as well. With the situations we see down in Texas and down in Florida — yeah, people have to understand, too, that the first responder system is designed to handle a set number of emergencies in any given community on an average day. Alright? So, there’s not an ambulance, or a firetruck, or police car for every single citizen, should they need it all at once. So, that’s where we see challenges in a situation like down in Florida and Texas, where not everybody — you know, there were people who were waiting for a while for ambulances and help to get there, because the emergency responder system is so stretched thin that we were backlogged in calls. And, it takes hours, and sometimes days, to get to them. So, that’s where the self-sufficiency comes in and being prepared for those emergencies. If you have to relocate — we go back to the medications. Have your medical history with you — your medications, and so forth, all written down. So, if you have to go to a shelter, somebody there can help you get the medications you need, and help you with any type of medical care that you might need long-term.

Scott Gilbert  – That’s all very good advice, especially because we’re no strangers to flooding, flash floodings, and winter storms. So, as we head into the winter — I know it’s in the 80s this week. But, soon it’s going to be snowing, believe it or not, and so it’s always good to be mindful of those tips.

Scott Buchle  – It’s hot out here today, but it will be cold in two weeks, probably [laugh].

Scott Gilbert  – I know. We won’t be sweating like this in two weeks. Right? Exactly. And, like I mentioned, we have a Medical Minute at PennStateHealthNews.org from just last week. So, make sure you go online and check that out for additional tips on how to prepare for an emergency, including how to compile an emergency kit that you can keep in your home or car. Scott Buchle, he is Program Manager for Penn State Life Lion EMS. Thanks so much for your time today, Scott.

Scott Buchle  – Absolutely. My pleasure.

Scott Gilbert  – We really appreciate the information. And, again, feel free to post your questions, if you have some that we didn’t answer. And, thank you very much for watching Ask Us Anything About¦ Emergency Medical Services from Penn State Health.