I’ve had the privilege of serving as an emergency medical services (EMS) provider for 17 years and as a critical care paramedic for the last three years. I now work with the Vanderbilt LifeFlight Ground Transport team, which handles long-distance emergency transports for patients in need of a higher level of care. When you or a loved one call 911, a lot happens between that initial call and the patient’s arrival at the hospital. I want to give you a behind-the-scenes look at what unfolds during those critical moments.
The process begins the moment a call is placed to 911. As sirens sound, a whole network of health care professionals from dispatchers and EMS crews to hospital staff spring into action to make sure care is delivered every step of the way.
Before any of that happens though, we take the time to prepare ourselves for the shift. At the start of each shift, the supervisor meets with the communications center to determine staffing for each ambulance and then we begin checking the equipment. We make sure everything is stocked and ready such as syringes, medications, monitors and other tools that might be
needed during an emergency response. Every second counts in an emergency and our ability to mobilize instantly depends on being fully prepared.
When a 911 call comes in, dispatch alerts the nearest crew using “tones,” which also share quick details about the situation. This could include the patient’s current condition or whether the location poses any access challenges. We are expected to be en route within one minute, which is a benchmark known as “chute time.” That doesn’t leave much room for hesitation, which is why preparation, practice and muscle memory are essential.
Once we arrive on scene, we quickly assess the patient and it usually becomes clear whether someone is stable or not. If the patient is stable, we use that window of time to gather as much medical history as possible from family members or friends who are present, including medications, allergies and recent symptoms to help inform our course of action and relay the
information back to our counterparts in the Emergency Department. However, in many cases, we must make decisions with limited information and rely on our training and experience to guide care.
We then stabilize the patient, whether through IVs, medications or other interventions, and transport them to the most appropriate hospital, which is not always necessarily the closest one.
Local facilities like Vanderbilt Tullahoma-Harton Hospital provide certain emergency services that can serve patients with varying care needs, such as chest pain, stroke and more. However,
when a higher level of care or specialized treatment is needed, we may need to reroute or use a LifeFlight helicopter to quickly transport the patient to a hospital that is further equipped to meet the patient’s needs.
Throughout the transport, we’re in constant contact with the receiving hospital. We radio ahead to give a brief overview of the patient’s condition so the emergency room can prepare.
Sometimes we even work directly with ER staff while we’re en route to expedite care. I remember one case where a patient needed an urgent CT scan. By coordinating with the hospital team while we were still on the way, we got him scanned quickly, and that response time and teamwork ultimately helped to save his life.
EMS is about so much more than just getting a patient from point A to point B. Whether we’re responding to a critical trauma or checking in on a patient who often falls and just needs a little help, we’re bringing a high level of care to patients wherever they are. Sometimes that means starting treatment even before we reach the hospital doors. Ultimately, our role is to help people get where they need to go, and sometimes — in a life-threatening emergency, for example — that’s everything.