I am riding in a tactical fighting vehicle on the last day of a training event for the United States Air Force with six other airmen and Army National Guard soldiers. We are the last vehicle in our convoy when we see unexpected smoke over the next hill in the lead vehicles. I radio the convoy commander, silence. I radio the emergent channel, still nothing, but silence. As we began to approach where we observed the smoke, I saw it then. A friendly tactical vehicle was rolled and the engine was on fire. There was smoke billowing out from the front of the vehicle. It was also the vehicle the convoy commander was in. I could feel the heat from inside our own vehicle. We immediately emerged from our own. There were two passengers on the ground, one was still while the other was choking and shaking violently. The remaining two passengers waved us over, explaining that they needed emergency help. The passenger, who was lying still, happened to be the driver of the vehicle. His battle buddy stated he had apparently inhaled a cloud of vaporized engine coolant. Our convoy was the recovery team, which in translation means that we are the mechanics. I was trained to maintain hydraulics systems on planes. My brothers and sisters to the right and left of me were also mechanically inclined, not one of us was a medic. Thankfully, we are airmen first, mechanics second. The Army is similar, they are soldiers first. We are all trained to not only utilize weapons and support the mission with some sort of specialty, but trained to provide casualty care. Which means that the injured soldiers received the care they needed, and lived beyond this day. While I facilitated the AED defibrillator, other members provided chest compressions and breaths, another called up a 9-line Medical Evacuation Request, and others assessed the remaining members who were in the vehicle roll over. In the military, you never know what you might encounter, just like you never know what will walk through the walk-in clinic.
Although I do not regularly see the same caliber of excitement in my current rural walk-in clinic that I had seen in the field that one day, I still support a considerable amount of trauma and emergency situations. Where I currently work is the intermediary between farm towns and the big city. Working in a rural medical walk-in clinic that serves as a hub between zero care and intensive emergency care serves me with the reminder everyday. That there is need for current and up-to-date training in life saving techniques; certainly, with this comes another reminder: physical and mental wellbeing.
CPR is a physically and mentally demanding task which requires stamina and strength of the core, back, shoulders, chest, and arm muscle groups. Not being physically and mentally prepared for BLS and ACLS is like jumping in a pool to save someone who is drowning when you do not know how to swim yourself. It will not work and the patient will ultimately suffer from your inability and unpreparedness.
While I had the opportunity to successfully put my life support skills into practice, I firmly believe in being a life-long learner. I am constantly learning and training for any situation. My time in the United States military has taught me many things, but the first is to always be fluid and think critically, every single person matters and contributes to the mission. The military has also taught me to keep a warrior’s mind and body, which dictates how I keep in top physical performance and mental acuity. I stay prepared for emergency situations by maintaining my BLS certification, re-reading my old EMT-B textbook and utilizing resources like Up-To-Date at the rural walk-in clinic I currently work at. I also stay prepared by keeping proper PPE, one-way valve masks, and other basic emergency medical equipment in my house and car because emergencies can happen anywhere at any time. I have even taught my own daughter how to call 911 on my cell phone at her young age and memorize my own number in case she gets lost or needs help.
It is critical that everyone learns BLS. It is not limited to just those in medical or combat situations. I believe that each job should require this training along with other new-hire provisions. Whether you work in finance, in retail, or even in the food industry. Or perhaps it is added to secondary physical education or health classes. The situations in which BLS should or is executed, can make the difference between life or death until medical help can arrive.
To those who seek our help and care, we the clinical professionals, are a beacon of hope that shines true at all hours and brings with it the chance of becoming once again whole. Emergency medicine is not only a single niche of care but covers all walks of medical care from gerontological, “family medicine,” pediatrics, orthopedic, and of course acute trauma and emergency medical care; indeed, emergency medicine is the catch-all, do-all of medicine. Although those on shift are limited in number, we are, at times, the guardians between life and death. Access to emergency medicine is a paramount necessity to all walks of life, despite socioeconomic inequity; from rural to urban, rich and poor, healthy and chronically unwell. That is why proper BLS, ACLS, and PALS training and education are imperative, because every life within our community depends on it. They depend on us.