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N A SUNNY FRIDAY
afternoon, a police
car was trying to make its way through early rush
hour traffic in downtown Manhattan. Filling the street
with lights and sirens, the police car wedged itself
into any opening in the traffic. But the traffic was
slow to respond. After a few moments of precarious
maneuvering, the cars finally opened a path for the
police car. And as quickly as the police car zipped
through, the opening was again filled by the rush-hour
traffic.
It is a scene New Yorkers can encounter almost everyday
- traffic blocking the way of emergency vehicles like
police cars, fire trucks or ambulances. But when the
emergency vehicles are responding to a call, any delay
can be a matter of life or death.
According
to data from the city's fire department and Emergency
Medical Services, only 12.6 percent of the people
who have a cardiac arrest - the most dire and the
most easily measured medical emergency - reached the
emergency room alive in 1998. The number of reported
cases of cardiac arrests in the city in the same year
was 6,030. Unless the patient restores a normal heart
rhythm within five to seven minutes, he dies.
Response
time is an important issue to any EMS as it is often
the barometer of efficiency. Naturally, the city administration
has tried to cut it down by employing various measures
such as the fire department's taking over of the city's
EMS in 1996. Their 1997 data show that they were able
to cut the average response time by more than two
minutes, to six minutes 43 seconds within a year.
However, the response time to cardiac arrests in 1998
was still over 10 minutes in half of the cases.
By
comparison, EMS vehicles in Phoenix had a response
time of four minutes and 12 seconds in life-threatening
emergencies. It was under six minutes in the Seattle
area.
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Evening
rush hour traffic at 72nd St., Amsterdam Avenue
and Broadway
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"Oftentimes, motorists have no place to go when they
are stuck in traffic," says Marie Diglio, 42, who
worked as a paramedic for eight years in the 80s and
now is the executive director of operations at the
Regional Emergency Medical Services Council (REMSCO)
of New York City. "In New York City, people hear sirens
all day long and become numb or non-responsive to
it."
"When motorists give you way," continues Diglio, "they
often play with you by following behind your ambulance."
In such situations, ambulance drivers have to worry
about not stopping too fast so that the cars behind
do not crash into the ambulance, she says. "Traffic
is a lot worse now then back then."
Paradoxically,
it is often safer and faster for ambulance drivers
when they do not turn on the lights and sirens. "When
people see the lights and hear the sirens, they don't
know what to do," explains Bree Akesson, a crew chief
of CAVA, Columbia University's Emergency Medical Services.
"They panic and pull over to the left instead of to
the right. Or they stop right in the middle of the
street." The CAVA ambulance does not turn on the lights
or the siren especially if the patient is not in a
critical state, she says. "It works really well."
CAVA
ambulance uses its sirens and light, or "go hot,"
only on 30 percents of its calls, says Akesson. "Most
of our responses are hot just because we don't know
what's up with the patients," she says. "But once
we get there and see that they are stable, we go cold."
Generally,
cabs are less cooperative than passenger cars. "If
you are persistent enough and you are right up behind
them with the lights and the sirens on, they are going
to try to move out of the way," Akesson says. But
ambulances take a risk in doing so. "A lot of times,
you'll see them drive right through the red lights
or make a right turn on a red light."
According
to Diglio, pedestrians can present problems as well.
"Many people have their headphones on and do not pay
attention," she says. "All the tall buildings create
an echo effect and people have no awareness of where
the sirens come from."
In
areas where traffic is not as heavy, problems can
arise elsewhere. Paramedics often have to deal with
poor elevator conditions. Once a patient is in an
ambulance, the paramedics can only try to keep him
alive and stable until he reaches the hospital. Although
paramedics can do most of the things that an emergency
room can do, their resources are limited.
"I've seen responding ambulances stuck in the traffic,"
Akesson says. "It must be so frustrating."
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| de·fib·ril·la·tor
(dê-fîb¹re-lâ´ter, -fì¹bre-) noun - An electrical
device used to counteract fibrillation of the
heart muscle and restore normal heartbeat by applying
a brief electric shock. |
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