Every time I arrive at New Orleans EMS operational headquarters, I am amazed by how inconspicuous and small it seems for the action which takes place here on a daily basis. The two low slung trailers, which hold administrative personnel, almost blend into the background of the I-10 above, and stray cats wander the periphery. Beyond those it resembles a large parking lot, full of regular cars and ambulances. Today they have from four to six trucks posted around the city at any given time, ready to respond within minutes to emergencies, but this was not always the case. Although it is not a clear beginning, EMS in New Orleans is considered to have started with horse-drawn carriages provided by Charity Hospital in the early 1900’s. Over time, horses were replaced with early automobiles and eventually the ambulances used today. Similarly, the personnel staffing the mobile units have evolved. The responsibility of providing EMS was transferred to the New Orleans Police Department in 1947, meaning police officers worked the trucks. As emergency medical technician and paramedic training became available, the police department incorporated these certifications into their service, and today all trucks are required to have at least one nationally certified paramedic on board. Also aiding with the high call volume are two supervisors, also paramedics, in sprint vehicles. The New Orleans Health Department had taken over the division by the time Hurricane Katrina ravaged the city in 2005. Most of the rebuilding which occurred thereafter made NOEMS what it is today. The operational side of NOEMS was placed under the New Orleans Office of Homeland Security and Emergency Preparedness, but all funding comes from the New Orleans Health Department and therefore that portion of the city budget.
New Orleans is also nationally celebrated for the work it is able to perform in New Orleans, a city with one of the nations highest trauma rates. Military personnel have even trained with NOEMS to prepare for trauma they might see in combat, and my EMT-basic claimed they would not have survived the combat zone without their training here. EMTs and paramedics on staff are more than willing to share some of the horrifying things they have seen on duty, with the unfortunate but necessary callous attitude adopted by most of them. In order to survive in such a demanding and exhausting job, emotions have to be set aside and cases cannot be connected to personal life. I have noticed the population base in New Orleans can be incredibly trying at times when it comes to a service which does not discriminate against any caller with an emergency, in my mind the ultimate public service. A lot of dispatches are for patients with advanced cases which could have been managed long ago with preventative care, but the lack of education is to blame in these instances. Additionally, abuse of the healthcare system is rampant. A large portion of the population uses emergency departments for complaints which would be better managed by family doctors or urgent care, also at a lower price. Yet the most frustrating part of all these issues is the minimal time frame EMS staff have to interact with their patients, since little to no change is able to be accomplished within the time frame. EMTs and paramedics are left to deal with problems caused by bad policy and infrastructure. Instead, the most they can do is give their patients the best care within their scope of practice and hope their influence will cause change in the future. Those EMS personnel who cannot manage all of this tend to leave for other, more pleasant careers. However, no medic or EMT that I have met is able to maintain this façade when it comes to children. Even though they will tell you it is easy to blame adults because they have been alive long enough to know better, children are innocent and never deserve the afflictions which befall them. The quietest and most somber call I have ever worked was an infant in cardiac arrest. There were no jokes or fun afterwards, only quiet reflection revealing the still human side of my medic and EMT-basic.
Another amazing quality of the majority of staff at NOEMS is their eagerness to teach, especially when it comes to volunteers such as me. Questions are encouraged, whether they pertain to a call, operation, or hypothetical scenario. Even though the job is hard, it is these moments where the medic’s and EMT’s passion for their work shines through. Most of the time, these lessons are discussions in which they encourage me to use my own knowledge base to come to the proper conclusion. Riding with NOEMS has easily magnified my medical knowledge and made me a better EMT. Before undergoing the extensive testing necessary to become a supervisor for Tulane EMS, I decided to ride consistently and frequently with NOEMS. Watching my crew in action as they digested a scene, determined life threats, and moved the patient towards higher care gave me unparalleled insight into pre-hospital care which is necessary as a supervisor. However, I would like to think the ride-alongs are not one sided when it comes to learning. My service to them is more than just an extra, capable set of hands to ease their burden. I would like to think I serve as a reminder of the reason they love EMS and were eager to a pursue a career in the field. My presence hopefully becomes a break in the monotony, as they have someone to educate and cultivate in the next generation, which will be responsibly for instituting the social change which is sorely needed in New Orleans. I know through my career in medicine I can apply what I have and will learn with NOEMS to make the healthcare field a better place, and I appreciate the opportunity I have been given.