‘We Can Never Get Comfortable’: Q. and A. With a Rescue Paramedic

Part of an elite group, Syndie Molina is one of 104 rescue paramedics among the roughly 3,000 emergency medical technicians and paramedics employed by New York City. She works from 10 p.m. to 6 a.m. at the Fire Department’s Emergency Medical Services Station 4 in downtown Manhattan. Ms. Molina, 35, lives in Nassau County with her 9-year-old son.

What’s the difference between an E.M.T., a paramedic and a rescue paramedic?

An E.M.T. will take care of basic life support. If you have the flu and you call, the E.M.T.’s would get there. And then say they realize you can’t breathe, now they’re going to call the paramedics. The difference between the rescue paramedics and the regular paramedics is we have additional training to not only provide medical care but also to do it in a confined space, high-angle rescues, trench rescues, under the subway, all sorts of different situations.

I would say probably 75 percent to 80 percent of the calls I’m just using paramedic skills. The rest of the time I’m responding to a rescue assignment.

Tell me about your training.

Rescue training is three weeks, 8- or 10-hour days. In the mornings, we’re working with the firefighters who are in the Special Operations Command. So you’re outside; you’re on rope; you’re rappelling off the building. The afternoon is adding the medical element in. The doctors come in and lecture. One of the scenarios that they had was a guy on a scaffolding, and he collapsed — no one can get to him. Not only are we on the rope on the side of the building, but now we have a patient. So you’re lowering yourself to get to the patient. You’re actually upside down and you’re intubating someone. You’re kind of like Spider-Man.

How do you prepare for terrorism?

We get training as far as recognizing terrorism and then different types of bioterrorism. We have to go for refreshers every few months.

We’ve had trainings where a bus explodes and then you come on scene — what do you do, what do you see? You have to suit up in these suits to provide you with extra protection. Scenarios will be created for us and we have to figure out what to do because you can go in to rescue someone and be a casualty also.

I think since Boston, security is high. Even among my co-workers, we had started to get into that comfortable feeling. And then the Boston bombing happened, more people are looking around, wearing their vests. It was just a reality check; we can never get comfortable.

Recently, you helped with the rescue of a man trapped in the muck of the Second Avenue subway project, 75 feet underground. What was your role?

I was the rescue paramedic that actually had to go in as far as helping with medication management and monitoring the patient. It was a long extrication to get him out. So I had to make sure we was getting enough oxygen, his body temperature was being maintained, talk to him, keep him comfortable and such. He needed pain management. Make sure he’s not having a bad reaction to the medication you gave him for pain. One of the medical directors was there, and a medical team. The firefighters were also there. It’s a team effort. You work with what you have and you work together.

What’s a call that has stayed with you?

My first pediatric arrest. We’re going back seven years. I remember the day, her face, how old she was, her name. She was only 3 months old. When I got there, the father and mother were there. I had a new paramedic with me, so I was training them. This is where we can walk in and look at a patient. This baby already had signs she had been gone for a while. But you still try to work the patient. I guess it’s more psychological because it’s a baby. It’s hard. And then to find out the next day it was the father who killed her because of shaken baby syndrome. Certain people, they stick with you for one reason or another, they stick with you.

Do you get any surprises?

We got this call and it was a naked guy in the middle of the night at a drugstore. The drugstore called. He was in his birthday suit. We had to get him into the ambulance and get him to the hospital for psychological evaluation because he wasn’t himself, I guess you could say.

A reader wanted to know how to use defibrillators. In case someone is having a heart attack, he wants to be able to help. Any pointers?

Those defibrillators actually talk to you and walk you through it, but I definitely recommend taking a CPR class. Those first 10 minutes after someone has a heart attack, pretty much those are the most crucial. Sometime it takes us 2, 3 minutes to get to the person. Maybe even 5 or 6 minutes by the time we’re dispatched and the unit responds and gets to the location. So I would recommend, if you can, take a CPR class. The F.D.N.Y. offers them for free.

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