EMT's needed at Florida High School Games

LARGO, Florida -- The mother of a Largo High School football player is still in shock after her son was accidentally knocked unconscious during a game on Friday night.

"I didn't know if I was walking on the field to a paralyzed child or to a dead child. Just walking out there was just the worst feeling any parent can feel at the moment," said Melissa Bonacci.

It happened as the Largo Packers squared off with the Falcons at Dunedin High School.

"I can't really remember it fully, but I remember the play and how I went in, I was just too low and his knee just hit right on my temple and that's all I can remember," said Taj Taylor, Bonacci's son.

Among Bonacci concerns are the lack of EMTs stationed at high school football games that can attend to an injured player.

"At least can we have a paramedic on site? At least just have them there that they could be the first responders," she said.

I took those concerns to Pinellas County School Athletic director Nick Grasso, who told me the district did away with EMTs years ago and that they do have health care professionals at all games.

"There were two certified trainers, one from Largo Med, one from Morton Plant, and there was also a medical doctor, a physician on site," said Grasso.

Bonacci said there were people there helping her son, but they did not have the proper equipment that EMTs have to look after Taj.

Grasso told 10 News by phone, "We ask that our schools also have a safety security medical plan as well as a safety security plan in place."

Bonacci said it took the ambulance 20 minutes to arrive at the field to take her son to the hospital.

Grasso said, according to reports that he received, it only took them about five minutes to get there.

Still, the concerned mother said she plans to push to have EMTs stationed at high school football games.

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EMT Job Spotlight – Movie Set Medic

Movie set emergency medical technicians spend many hours on the set watching after the actors, crews and supervising many of the stunts for safety precautions. People may think that working on a movie set is glamorous, but most of the time medics are standing around in the heat, snow, rain and wind waiting for something to happen.

Preparedness of Medics

Set Medics are ready and able to assist in the coordinating and management of the need for medical staff on any type of production. Most set medics will work on a production for the full length of time that it takes to make the movie. Other Medics may have obligations on two sets as fill-ins or relief medics.

Responsibilities of Movie Set Medics

Depending on the type of movie being filmed, how many cast members involved, the environmental situation and the number of dangerous stunts for the day, the medic could be standing around or be very active. Set medics are the first responders when accidents happen. If someone sprains an ankle, falls or performs a stunt wrong and gets hurt, the medic has to be right on top of the problem. An EMT has an extensive amount of medical training and is prepared to care for anyone who gets hurt, until more medical help arrives. Set medics are also responsible for seeing that the whole crew maintains a healthy body with plenty of liquids for proper hydration. Staying hydrated will help the crew, actors and all the staff to fight off heat and cold exhaustion.

Stunt scenes that may involve demolitions, car accidents or jumping off high buildings all need to be planned out in perfect timing. When something goes wrong and someone gets hurt, the medic needs to have the knowledge, quick thinking and medical training to take care of any unforeseen situation. The medic needs to know when to call in transportation to a hospital and when the individual can be cared for on the set. Lives depend on the set medic and every action that he or she takes.

Emergency Services

Set medics will also coordinate emergency contacts with the local community in which the movie is being filmed. Medics will learn where the local hospitals are located, how to call for an emergency flight for air transportation for serious injuries and the estimated time it would take services to get to the production site. Medics will have all the proper phone numbers for the fire department, police and a hospital, so no time is wasted getting the proper emergency care for victims.

Supplies and Equipment used by Set Medics

Usually only one EMT is needed on a movie set. If a problem occurs, the EMT will have portable equipment to use to handle the injuries. If the movie is being filmed a long distance from a hospital or the stunts are complicated and at higher risk, there may be two EMT’s on the set. EMT’s will have resuscitation and comprehensive trauma equipment with them on every set. They will also be equipped with an automatic external defibrillator, cervical collars, backboards, and kits for both severe and simple burns. Basic first aid supplies are always available along with over the counter medications for simple ailments. Medics for movie sets work long hours and many times well into the night.

Just because the production crew has wrapped for the day or the season, the medic has to stick around until the crew taking down the sets are done. The medic will have all the same equipment on hand for five crew members as he did for a full crew working on the set. The medic never knows when accidents will happen and he or she needs to be prepared at all times.

Unusual Challenges Set Medics Might Face

Not all production sites are on nice level ground. Many adventure and thriller films are in remote areas, on top of rooftops, deep into the swamps or out on the rough seas. Set medics have to be prepared for any type of terrain where the film may be in production. Those medics who are required to cover the production crew in a water or swamp location will have various types of boats, ATV’s, and jet skis available for rescuing any victims of accidents. Other equipment and supplies that medics might need in a challenging situation might be vehicle extrication equipment, ropes or even medicines for remote areas.

Movie set medics will have all the proper training for the medical needs of victims and the equipment they might have to use in order to get to the victims. Portable air conditioned first aid station can be set up on any production site. Usually they are set up on remote sites or sites that may be miles away from any other emergency facility.

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Concert and Special Event EMS

   

Anywhere a large crowd congregates, the need for a well-prepared emergency medical team is present. To provide the best possible service to their communities, it is essential that EMS agencies covering concerts and other large gatherings take all the risk factors into consideration and make sure the proper equipment and resources are in place to address all potential scenarios.

MONOC EMS, headquartered in Wall, NJ, provides standbys as well as active MCI-style response to a wide spectrum of events. These include small gatherings like funerals, health fairs, sporting competitions and community events, which require only single BLS units, and larger crowds such as at concerts and theme parks, involving thousands of people.

In both scenarios, it is important to be prepared for the worst, because you never know what you'll get. The overcrowded heavy-metal concert may prove to be completely uneventful, while the small-town bingo game can yield more patients than ever imagined. Either way, it's imperative to have all potentially needed equipment at the ready, even if it's not directly on site. If your service takes on the responsibility of such events, you'll be squarely in the public eye--either making positive, professional impressions, or rubbing people the wrong way.

There are several important factors to keep in mind when taking on special event work:

Professional appearance: It is imperative that staff look professional. If climate and conditions permit, it's a good idea to utilize Class A dress uniforms. (Of course, if it's expected to be 90-degree weather with 95% humidity, opt for the cooler short-sleeve shirts.) Short pants, regardless of weather, are a bad idea: EMS providers will be working outdoors, kneeling on pavement, gravel, etc. Shorts can be a certain knee-scraper. Some services use alternative uniforms for special events, but this can be counterproductive--if an employee fails to show up, a supervisor will have to find a replacement with the proper uniform, which may not have been furnished to all employees. Another point to consider is that regular duty uniforms were developed to display an agency's patches and certifications, and represent the image the service wants to portray to the public. Using an inexpensive golf-type shirt defeats this purpose.

Drugs/alcohol: At events where alcohol is served, you might expect to encounter injuries from fights, falls, etc., as well as cases of acute intoxication. Plans must be in place for utilizing security staff or the local police. Often, a mere police presence can help persuade uncooperative patients to go to the hospital. Concert EMS staff should be educated on ways to assess and treat patients who have overdosed on street and designer drugs such as LSD, PCP, ecstasy, GHB or even nitrous oxide. There have also been cases where concertgoers have maliciously exposed EMS providers, police and security to drugs. Therefore, inform staff to be extremely cautious to not accept food or water from the public, allow themselves to be sprayed, etc.

Specialized equipment: Different events require different equipment. For example, to provide emergency services at an offshore powerboat race, it is necessary to provide staff with personal flotation devices and waterproof radio protectors. At the local auto track, they'll need hearing and eye protection, turnout gear and shoes with oil-resistant soles. At a nighttime event with a large crowd, it is a good idea to give providers small chemical light sticks that attach to uniforms with safety pins. These serve a couple of purposes: They help the public quickly identify EMS providers if they're needed, and they can serve as safety beacons for providers needing assistance. It can be difficult to identify exact locations in calling for help over the radio; light sticks can be easily picked out of a large crowd.

Because large crowds often come with large noise, special noise-canceling radio headsets are a wise investment for reliable communications. When selecting headsets, try them on, and consider that they'll likely be worn for extended periods in the hot sun and should be as comfortable and nonrestrictive as possible.

Patient movement devices are necessary but not always feasible, yet carrying patients for long distances can be a nightmare for your employees. Consider specialized solutions such as wheelchairs, rescue sleds, golf carts, bicycles, etc. While these can be expensive, they can prove invaluable. Modified golf carts and Gator-type all-terrain vehicles can cost up to $20,000 but are a must at places like theme parks and large concert halls, where ambulances might be unable to navigate through crowds or down small passageways.

Boston EMS has been successful using single-provider Segways to move paramedics through crowds at the annual Boston Marathon, and EMS in Chicago utilizes them during special events in their downtown and lakefront areas. They carry cardiac monitors and defibrillators, obstetrical kits, advanced airway supplies, pharmaceuticals and other lifesaving equipment in detachable packs. The Segways are not only an excellent way of getting to victims quickly, but also a good public relations tool.

Agencies in coastal areas might benefit from the use of boats or personal watercraft. These can be crucial to gain rapid access to patients. But remember, simply acquiring a specialized vehicle or piece of equipment doesn't mean just anyone can operate it. Some states require motor vehicle licensing for personal watercraft and boats, and the industry standard for police and EMS personnel using bicycles is training and certification by the International Police Mountain Bike Association.

OTHER CONSIDERATIONS

Health and safety: When planning for any event, it is essential to provide for restroom facilities, private break areas (preferably air-conditioned or heated, as appropriate), food and, most important, water. If a safety officer is designated, their first task should be to ensure that all teams of providers have been provided clean, preferably cold water. Having this on hand will keep them hydrated and eliminate a need for unscheduled breaks.

Because outdoor concerts and special events often occur in hot weather, consider what type of food is provided for emergency personnel and how it will be stored. If refrigeration is not available, rule out foods that will easily spoil. Use sunblock to prevent burns and skin problems. In cold or rainy weather, while it may not be possible for providers to remain in shelter, they should have good-quality outerwear. Waterproof boots are essential--nothing slows an employee like cold, wet or blistery feet.

Resource planning: Someone is paying for the services provided at concerts and special events, and these people are trying to manage budgets. They become frustrated with unplanned last-minute add-ons (additional generators when they thought power would be provided, portable fencing, additional security, etc.). Of course, event promoters often think emergency medical services are provided at low cost or for free because they've dealt with volunteers or other agencies with low overhead. These volunteer services may be compensated with perks like free tickets for their families, free food, event memorabilia, etc.

Unfortunately, providing service proficiently requires a certain amount of expertise. This is not to say volunteer services don't have it, but unless they are acclimated to the challenges of mass-gathering events and the host venues and their pitfalls, someone else might better maximize chances of a safe event. Many colleges have volunteer EMS, and their crews have become very experienced in providing service at sporting events, concerts, etc. They know what to expect, are familiar with routes to hospitals and have proper communications with law enforcement. But a big event coming to a small town that has never had anything similar could present some real tribulations.

  If an agency provides regular service to the same venue, it is a good idea to set forth standards with the owner, manager or promoter. For example, MONOC routinely provides services at concerts at the local PNC Bank Arts Center. It worked with management there to develop service-level guidelines based on event attendance (See Table 1). These can change based on things like patron demographics, potential alcohol sales and weather forecasts.

Table 1

• Attendance: 0-7,000 Minimum EMTs: 4 Minimum Supervisors: 1 Minimum Paramedics: N/A
• Attendance: 7,000-12,000 Minimum EMTs: 7-12 Minimum Supervisors: 1 Minimum Paramedics: TBD
• Attendance: 12,000-17,500 Minimum EMTs: 12-22 Minimum Supervisors: 2 Minimum Paramedics: 2

It is easy to be influenced by the event promoter or venue operator when planning resources. To keep costs low and profits high, they are motivated to have minimal EMS staffing, while the EMS agency is prudent to have more than what is needed, to ensure preparedness for the unknown. At its local venue, MONOC experiences a specific annual event that taxes its resources. With proper planning, it is often necessary to demand the venue pay for adequate resources. It is the patrons at the event and the EMS agency that will suffer if proper personnel, vehicles and supplies are not immediately available.

CONCLUSION

Understand and accept that EMS cannot do everything to ensure a safe environment for event patrons. Communications with other entities are essential to ensure other vital tasks are completed. Without law enforcement, unruly patients can harm those attempting to care for them. Without traffic control, emergency vehicles may not be able to access necessary areas or egress to hospitals. Maintaining relationships with not only ranking officers and management, but line staff as well can be useful when dealing with police, fire, vendors and staff. If you're nice to the stadium beer vendors, for instance, they'll be more likely to help you if you need ice.

Working with law enforcement, fire, hazmat, venue staff and others to develop an emergency plan will be an arduous task. But if tragedy strikes, it will help you mitigate whatever the disaster is. From 1992-2002, there were 232 deaths at concerts and festivals around the world, and more than 66,000 injuries.

Planning for concerts or special events requires an EMS agency to consider many factors and utilize any resources available to ensure the event remains safe and orderly. The best scenario is for all workers, like all attendees, to leave with only good memories of the event.

BIBLIOGRAPHY

1. FEMA. Special Events Contingency Planning: Job Aids Manual.

2. City of New Orleans. EMS Special Event Coverage Equipment.

3. Lavelle K.  Emergency Training & Consulting.

4. www.crowdsafe.com.

5. Mariano JP. First aid for Live Aid. J Emerg Med Serv, Feb 1986.

6. Lichtenstein I. EMS at rock concerts. Fire Chief, Nov 1983.

7. Parillo S. EMS and Mass Gatherings.

Andrew T. Caruso has been involved in New Jersey EMS for over 20 years as both a volunteer and career provider. He has spent the last 10 years at MONOC EMS; first as a dispatcher and ultimately in his current position as director of operations. One of his responsibilities since starting at MONOC is overseeing the different types of special event contracts including The PNC Bank Arts Center, a 17,500-capacity amphitheater. He can be reached at andy.caruso@monoc.org.

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