On the front lines: ‘Anxiety on every call’

A typical shift during the pandemic highlights the uncertainty faced by first responders

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By Sara Criswell

During my hour-long, daybreak commute to work this morning, I contemplate why I didn’t retire when this whole COVID-19 thing started.

Truth is, after 21 years as a firefighter and paramedic, I still love my job. The risks are worth the rewards.

Sara Criswell is a firefighter/paramedic with the City of DeSoto, Texas, serving her community through the COVID-19 national emergency.
Sara Criswell is a firefighter/paramedic with the City of DeSoto, Texas, serving her community through the COVID-19 national emergency.

We are learning more about this virus every day, and it requires us to modify the way we run calls. Each day we come to work, it seems a new protocol has been implemented.

As firefighters, we frequently say, “Adapt and overcome.” This is exactly what we are doing in my department.

Shift prep: ‘I’ve been on a steady dose of Benadryl for a month’

When I arrive at the fire station, and before I can actually go in, I am required to take my temperature and document any headache, sore throat, cough, fever, etc.

Once inside the station, our crew immediately disinfects everything: doorknobs, computer keyboards, locker handles, toilet handles, refrigerator handles, chairs, tables, etc. Then we disinfect the piece of equipment we will be riding for the day.

Today, I’m working on the ambulance, so my partner and I thoroughly sanitize every surface. (I’m allergic to rubbing alcohol and I’ve been on a steady dose of Benadryl for a couple months now.)

Despite the current medical PPE shortage, our department provides us with a gown, safety glasses and an N-95 mask that I wear on every call.

COVID calls: ‘It’s all very time-consuming, but necessary’

Our chiefs have been incredible forward-thinkers since the start of this pandemic. They created a COVID squad and a COVID dispatcher position.

The COVID dispatcher is a paramedic who screens the 911 calls by asking the caller questions to determine whether to dispatch the COVID squad or regular MICU. If it’s determined that the caller is a possible COVID-19 patient, they send the COVID squad, a separate two-person crew staffed entirely by overtime personnel who personally volunteer to respond to calls that place them at the highest risk of exposure to the virus.

On one of these suspected COVID-19 calls, only one paramedic approaches the residence and places a mask for the patient somewhere the patient can easily get to it, like their front door. After the patient puts the mask on, that same paramedic will take the patient’s temperature and other vitals, and inquire more about their symptoms.

If the patient requires transport to the emergency room, an MICU is called to the scene. The patient is escorted to the MICU and assisted into the back, unless the patient needs to be transferred on the stretcher, in which case, the second paramedic will don full PPE and assist.

This system has greatly reduced the number of crewmembers exposed to the virus. Without our chiefs taking this forward approach, more crewmembers would be exposed to the virus, potentially taking it home to their families.

After we transport a suspected COVID-19 patient to the emergency room, the MICU must be decontaminated at the hospital. We use a spray, much like a fog, to disinfect the back and front of the MICU. Our gown, mask and glasses are placed into biohazard bags to be decontaminated.

When we arrive back at the fire station, we change clothes, shower, then wash the clothes we just took off. It’s all very time-consuming, but necessary to prevent exposure to ourselves and other patients.

Patient care: ‘It was heartbreaking leaving the family crying’

Generally, we are dispatched on non-COVID-19-related emergency calls to which we still must respond.

For motor vehicle accidents, we don our gown, mask, safety glasses and gloves because we never know the condition of any of the occupants. We immediately take temperatures of all involved.

I go on an MVA that required transport to a trauma center ER. We wait outside the ER for a nurse to get a temperature on our patient before being cleared to bring them through the doors. It’s difficult to slow my thinking down and see the greater need of gaining COVID-19 information prior to getting my patient attention for their serious injuries. The uncertainty of what we will encounter and how we will handle it causes anxiety on every call.

Another call involves a medical emergency of an 84-year-old woman who is vomiting and not responding. With full PPE, I take her temperature, which is normal, and radio back to the crew to gown up and come in. We determine she is possibly having a stroke and feel transport is necessary.

We load her onto the stretcher while the family is frantic. They don’t want her going to the hospital due to the pandemic. We explain our findings, and the family suggests they will meet us at the hospital. I explain that they are not allowed in the hospital.

It is heartbreaking leaving the family crying, begging us to leave the woman with them instead of taking her to the ER.

Social distancing stress: ‘I understand the pain of distance’

The fear of unknowingly passing the virus to our families at home is also significant and weighs on my mind.

I know one firefighter who now lives in his camper in the driveway outside his home. He fears infecting his family members who have preexisting health issues. He cooks all his own meals, does his laundry at the fire station, and only sees his family through video conferencing.

I understand the pain of distance, too. I have a grandchild who was born in March, and I have yet to meet her for fear I might inadvertently spread COVID-19, as I’m unsure if I’ve been exposed. And I have postponed any visits to my elderly parents because I don’t want to spread the virus.

I work with a paramedic who signs up for the COVID squad. He understands the seriousness of the virus. He explains to patients, with compassion and humility, the severity of this virus and the potential outcome should they go to the ER. This same paramedic has a 3-year-old at home born with a major heart defect and has oxygenation issues. He risks a great deal for the better good.

At the end of the day: ‘It’s hard to suppress the feelings of guilt and worry’

When the shift is over, it’s hard to suppress the feelings of guilt and worry. But as I contemplate my shift on my hour-long daybreak commute back home, I reflect on the rewards of this job, especially during this pandemic.

It is because of the selfless men and women in my department who continue to serve those in need; the forethought and planning of our chiefs that allow us to run calls as safely as possible; and the support of the community we serve that will be the reason we adapt and overcome these difficult times.

One day soon, I’ll retire, but for now, I love my job way too much.

About the Author

Sara Criswell has been a firefighter/paramedic with the City of DeSoto, Texas, for 21 years. She graduated from the DeSoto Fire Academy in 1999 and graduated from the University of Texas Southwestern paramedic program in 2000. Criswell was an instructor with the DeSoto Fire Academy from 2000-2007. Her husband and son are both firefighters in Plano, Texas. 

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