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| 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.”
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