Wednesday, August 5, 2009


It's been a jam-packed last few days. However, since I'm so tired I'm going to post now about yesterday (Tuesday) and tomorrow I'll write about our hike up Matafau.

On Tuesday morning, we woke up bright and early to head over to Nu'uuli and finish meeting with our fourth and final cohort of kids. We are now 100% done collecting data for the summer! The only work we have left now is delivering a presentation to some of the research staff at the community college tomorrow (Thursday) morning.

With work out of the way, I scooted out for the afternoon on Tuesday to finally ride along on an EMS shift. I was assigned to work with a paramedic named Joe and his crew. We were one of two ambulance crews on for the 3-11pm shift. Given all that time, I had a chance to talk quite a bit with Joe and some of the other EMTs. I ran into two examples of how small this island is: 1) Joe lives right accross the golf course from us; and 2) One of the female EMTs is the mother of three of the children who participated in our study.

Joe told me a lot about the American Samoan EMS department, correcting some of the information I posted earlier. The service is about as old as me (21), and Joe has been working there since the beginning. The service does all of its own training at the basic and intermediate levels; paramedics need to be trained in the States. Currently, the department employs about 30 EMTs, all full time (40-hours per week) and paid. Though EMS used to be a branch of LBJ Hospital (the office is on the hospital premises), it was recently transferred to be under the Department of Public Safety (police). This has really shifted up the budget, and now more than ever they are strapped for cash. They can bill individuals for ambulance calls, but realistically the only way to collect money is from patients who have Medicare (this is actually a common problem for EMS departments around the country).

The service has three ambulances in service, two of which are vans and one of which is a traditional box. The trucks are scantily equipt (even the stretchers are held in by wooden blocks in the vans), and the AC in the box ambulance is not functioning. If the ambulances were to be inspected, they would fail by any US standards. This is remedied, however, by the fact that each EMT carries a bag with his or her own equipment, including blood-pressure cuffs, bandages, IV supplies, and drugs. As Joe put it, the EMTs here are "incredibly creative," being forced to deal with very limited resources. I don't want it to sound like their gig is run out of a shack - it isn't. Every EMT seemed extremely well-trained and capable of delivering high-quality pre-hospital care.

While on shift, we were only dispatched to one call, a male having breathing trouble. He actually lived out on the very western tip of the island, but his family drove him in the back of a pick-up truck, so we met him halfway with the ambulance (otherwise, it would have been nearly an hour drive each way). Actually, he'd been having breathing trouble since 11am, but since he lives up on a mountain, he didn't have access to a phone until his son came by; only then did he call 9-11. Joe put him on some nebulized Albuterol, which seemed to dramatically help his breathing, and he was doing much better by the time we delivered him to the LBJ emergency room.

This turned out to be our only call for the night. We took the ambulance out for a "Golden Arches" run for dinner, but I spent the rest of the time talking, reading, or watching TV (rousing episodes of America's Got Talent). Overall, it was a great experience - I learned a lot, and everyone was very friendly. My only regret is that I didn't contact the EMS office earlier in the summer so I could have rode along more shifts.

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