|Emily MacLeod wears a respirator as part of her job as a paramedic.|
Emily MacLeod was working as an Occupational Therapy assistant when she developed an interest in the prevention side of health care.
“Paramedics are the clinicians who recognize the early signs of issues,” she says. “Sometimes how quickly we respond to something in the field, like strokes and heart attacks, which have windows for treatment, helps with recovery. It’s about making sure we have the right assessments for the right patients and getting them to the right facility at the right time, and that was interesting to me.”
Twelve years later, she’s now an Advanced Care paramedic, which means she performs more medically related care, such as intubation and suturing. The 42-year-old mother of two works out of the Pugwash EHS station. She’s also a senior operations paramedic which means taking care of management issues: sick calls, truck issues, staffing issues or anything that arises during the day.
Since paramedics are often the first medical staff to interact with a person who may have symptoms of Covid-19, the pandemic has changed significantly the way paramedics do their job, even when they need to respond quickly to a crisis.
At the start of every shift, the crew cleans their truck (ambulance), even though the crew on the previous shift already cleaned it. Emily says everything that could possibly be touched – every door knob, cabinet handle, radio, button – is wiped down again. Then they make sure they have enough gowns, goggles, masks and gloves, as well as respirators, which are worn if a patient tests positive for Covid-19.
“Right now, our initial contact is one medic dons a surgical mask, goggles and a gown, and there are four questions we ask at the door to decide if we need to upgrade our Personal Protection Equipment (PPE) or keep it the same,” she says. “If we have to upgrade, the initial medic backs out and goes to respirator. We also add a face shield over top of our goggles. Usually we’re double-gloved, and we’re already gowned.”
With that extra level of preparation and protection, the paramedics know they’re going to be uncomfortable – because those materials don’t breathe – and they also know the mask and respirator, and resulting dry mouths, make them harder to understand.
“Especially for senior citizens, so we’re speaking louder and more clearly. And it’s scary for the younger patients; they look overwhelmed when we come in looking like aliens,” Emily says.
She’s not on the truck as much since the pandemic hit Nova Scotia; many days, she’s at the office doing a PUI, which is ‘patient under investigation’ for Covid-19.
Emily explains that when a crew comes into contact with a patient who may have symptoms of the virus, she runs through a checklist with them to make sure they used the appropriate PPE at the appropriate time.
She knows first-hand the importance of wearing the proper protective gear: Her fiancé, James, a paramedic based in Oxford, recently spent two weeks in isolation – sequestered away from Emily and the couple’s three children – because of a possible exposure.
“James had a patient who went into cardiac arrest so he immediately began cardiac arrest protocol instead of backing out, putting on gear and going back in,” she says. “He only had on minimal PPE because the patient screened negative. But cardiac arrest puts him in a high-risk category because you’re closer to the patient and closer to bodily fluids.”
She admits it’s hard because the response to help is automatic, but “no matter where or at what stage you go in, you have to go in with respirator, goggles, face shield, gown and double gloves.”
Despite being in the office more dealing with the paperwork that is part of the pandemic’s impact, Emily happened to be working on the truck the night when Canada’s worst mass killing began in Portapique.
An MCI – multiple casualty incident – is an event that could possibly overwhelm available resources, such as the closest hospital. But an MCI in the middle of a viral pandemic? How does that affect the work of paramedics?
As Emily and her partner, Jesse, rushed to the scene, they discussed what to do. They knew it was a shooting, so they expected to be dealing with gunshot wounds.
“We decided we wouldn’t have time to back out so we went in with everything on. In a moment where someone is critically injured, we don’t have time to stop, back out, put more stuff on.”
They arrived to a chaotic scene on a dark, rural road. “No one can understand the scope of that unless you were there,” Emily says. “It was horrendous.”
In that situation, everyone was at risk, but there were injuries that needed to be tended to.
“You definitely think about the risk at any scene, whether it’s an active shooter or at the side of the highway,” she says. “We rely on the other agencies, like police, to say it’s safe to come in.”
The next day, Emily was back at work. “After big events, we tend to go back to our trucks because our partners are our sounding boards,” she says. “We debrief as a crew.”
No matter what crisis she’s facing as a paramedic – a pandemic, a multiple casualty incident, or a night with just a couple of calls – what Emily loves about her job are the people she’s called in to help during a shift.
“Everyone has their own experience,” she says. “We meet people from all walks of life so you have to have a lot of empathy; there are a lot of fight complaints, drug and alcohol abuse. You go from seeing the worst to meeting some very interesting people.”
~ by Sara Jewell