Wonder Why My Back Hurts?

By Gary Harvat CMTE, EMT-P (ret)*

I guess things happen unbeknownst to me anymore. The other day, I arose at my normal time of 5:12 AM (don’t ask me why it’s 5:12 but it’s been that way for years). As I placed my feet on the floor, I could detect that some gremlin came calling in the middle of the night as my back felt like it had completely disconnected from my pelvis. Not sure how one can go to bed feeling great and then arise feeling like I just did a fireman’s carry with a 1968 Chevy Vega over my shoulder.

Wonder Why My Back Hurts?As my luck would have it, my wife spied me as I ambulated ever so slowly toward the shower and asked, “What in the world is wrong with you?” I thought for a moment and the only response I could muster at this ungodly hour was simply, “LifePak 4.” Now, my wife, God Bless her, has no deep understanding of where I came from professionally speaking. She doesn’t know a LifePak 4 from a tire iron and to be honest, for this I am thankful. However, she pressed me a bit more and inquired as to what this “Pak-thing” to which I was referring to. I told her I would communicate better post-shower and kept hobbling forward.

Several minutes later, I emerged, and there she was waiting for an explanation as to what had happened to me and furthermore, what was I mumbling about with this LifePak comment?

I sat on the corner of the bed and explained that during my EMS career in the 1970s, the LifePak 4 was the go-to cardiac monitor/defibrillator. I explained I had carted this darn thing up flights up steps hundreds of times and given its weight of 40-50 pounds it was probably a contributory factor to my now current, back problems. She understood a bit better but looked at me in the same way as our Boston Terrier does when I attempt to have a conversation with her (you know, that cocked-head tilt that dogs give you when you are confusing them).

So, this got me thinking about the industry that I love and value so much but also the toll it has taken on my physical self. I thought about all the things we used to lug around and how the EMS world has changed in so many ways – ways for the better I might add.

As much as EMS is still the “new guy” in the public safety world, many advances have been made to better assist those dedicated EMS professionals. These advances have not only improved patient care but also increased EMS provider longevity.

For instance, today we have great stretchers that not only load themselves into the patient compartment but also minimize back injuries of the provider while doing so. I remember those Ferno Model #30 stretchers. While they served us well with adjusting levels, they were still stretchers that were heavy and wonky but also became harder to operate when a patient was placed on that foam mattress with the dark red vinyl cover. I recall a move that involved carrying a 250-pound steelworker from his three-bedroom Cape Cod down the cement steps to the inclined driveway all followed by the coup de gras, the killer “lift on three” lumbar jerk into the back of the ambulance. Not fun and my back ached, but I loved the work and was ready for the next call even though my lumbar felt completely disassociated from the rest of my spine.

Next, I thought about the advances in medication administration. I must relate, I thought I was hot stuff with a drug box full of 50mls of Bicarb, six 100 mg of injectable Lidocaine’s and 4 ready-jects of 1mg Atropine. Now, as I peer at the medication arsenal today, I see meds for multiple types of emergencies. To some degree it’s a small CVS pharmacy that the medics of today must be well-versed in the administration, contraindications, dosages and side effects of each. Too much for me to now comprehend but great for those guys in the field to help stabilize and save patients from an untimely demise.

While endotracheal intubation has long provided a sound route for definitive airway control, one cannot forget its street predecessor, the infamous Esophageal Obturator Airway. I recall using this device for the first time. I was so proud of myself that I effectively placed this long, tubular “cork” down a patient’s esophagus. Even more amazing was that I was able to ventilate the patient through tiny holes that would hopefully, oxygenate the lungs without having a molecule of air head down that nasty path to the stomach.

How about those six-foot wooden long boards with all the straps flapping? These straps made the board a substantive trip-hazard as one dragged it out from under the bench seat to the patient lying in the middle of a busy roadway. Using these boards proved quite helpful most of the time. However, moving a patient with your fingers locked between the openings on the wooden board usually led to an exercise in hand dissection for splinter removal post-call. They looked very functional but some of the worst splinters in my life came from those boards, trust me. Splinters were one thing but then you took the board, the patient and then set it atop the mattress on the Model #30 – more weight and more lumbar jerks into the patient compartment. Ouch.

As we close, let me pay homage to the Medical Anti-Shock Trousers, the MAST Trousers (aren’t we stating Trouser twice here?). These things were marketed akin to the second coming of Jesus and were going to save just about anyone who showed up with any malady short of an impaled object jutting out of their abdominal cavity. They were world renown for squeezing a small truckload of blood up to the patient’s core and when properly utilized, were promoted as a tremendous life-saving tool – that is until the ED nurse or surgical resident took their “cut a penny in half” shears to them at the patient’s bedside.

While I am certainly a bit envious of the tools today’s EMS teams have at their disposal, I am also a bit thankful that I was able to use resources that were not always great in number or style to save a life. While I continue to mumble LifePak 4 when my back hurts, I quietly appreciate the times I had lugging that thing around, and to be honest folks, even with the great devices and advancements in prehospital medicine out there today, I would not change a thing. Limited resources taught me how to think outside the box in caring for a patient and as much as I am no longer functioning in the field, I do miss the times I had there in the 1970s and 80s. For those of you that have the auto-load stretchers and the cardiac monitors half the size of a shoebox, good for you. Go forth and serve our industry well. While my back pains me, it also reminds me of a time in my life that I would never change for love or money.

*Gary Harvat is QMC’s Vice President of Client Success and a veteran health care provider with over 45 years of commitment and service to emergency medical services.

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