From the archives (Story originally published Mar 14, 2012)
By Marietta Brill
Say it’s 2am and your roommate passes out on the way home from The Whiskey Bar from alcohol or whatever. Or suppose a car checks your bike and you go flying. Perhaps you see your sweet 78-year old neighbor on McGuinness, the one who makes sugar cookies after church, but she looks pale and confused and can’t answer you.
Don’t panic. Hovering like benevolent big brothers within blocks of even the most remote NYC location are ambulances staffed with medical responders ready to help.
There are 410 ambulances stationed strategically throughout NYC, nine in Greenpoint and Williamsburg that can reach you in about six minutes. Although an accident might knock your body for a loop, you have more control over your fate than you think. Here are some ways to make the best of a bad situation.
1. Know when to call 911
No one can be refused care in an emergency room. This is a beautiful thing for the spirit, not so beautiful for the pocketbook, because those who can pay cover the costs for those who can’t. The average cost of an ambulance ride is $1,099, according to the 2011 Mayor’s report. Even when covered by health insurance, the deductible and copayments are often exorbitant. For this reason—and to avoid the long and potentially harrowing wait in the emergency room—consider carefully whether you could do without an ambulance, give your doctor a call, and hail a cab. More important is to know when you shouldn’t mess around, when you should call 911:
• Signs of appendicitis: severe pain in your abdomen, in the middle or lower right side of your abdomen, or loss of appetite
• Signs of a heart attack: chest pain, pain spreading to your shoulders, cold, sweaty skin, or nausea
• Signs of a broken bone: pain, swelling, inability to move when you put weight on the injured limb
• Uncontrolled bleeding due to an accident, vomiting blood, or black, tarry stools (signs of blood)
• Signs of a stroke: blurred vision, severe headache, difficulty speaking, dizziness
• Signs of drug overdose or alcohol toxicity
2. Know how to handle 911
To get the fastest and best response, follow three simple rules: stay calm, answer all of the call-taker’s questions, and never hang up—no matter how irrelevant the questions seem.
As calmly as possible, tell the 911 call-taker the reason for your call (“If they’re screaming, we can’t understand them!” said an FDNY dispatcher at Metrotech). You’ll be asked the age, status (breathing/conscious), and condition of the person. Based on what you say, you’ll get transferred to an EMS dispatcher for your borough who will dispatch an ambulance, ask you more questions, and possibly tell you what to do until the responders arrive. Now is not the time to doubt the expertise of a city worker—this ain’t the DMV.
You might think the questions are irrelevant and wasting precious time, but your ambulance is on the way while you’re talking—and your apparently useless conversation provides vital information to the EMS personnel en route.
(See: The 411 on 911.)
By the way: never hang up on a 911 call-taker, or they might think you’ve passed out and send a cop car around. Also, FYI, prank 911 calls are illegal.
3. Know where you are
It’s in your best interest to know your exact street address, not just the cross streets. On a land line, your exact location is easily found. But 911 can only locate cell phone users within a few dozen feet. A warning to the 87 million people with Internet-based Voice Over Internet Protocol (VoIP) phone plans: take a close look at your contract for disclaimers about 911 service. You might not gain connection during a power outage or when the Internet connection fails, or you may need to update your location with your provider. If you don’t know the address, look for landmarks or describe buildings around you.
4. Know what to expect in the ambulance
Ambulance trivia: did you know that you can hail an ambulance if you see one driving by, like an uber-expensive EMS car service?
Your ambulance is the hospital equivalent of a fast-food restaurant. Most ambulances are staffed by EMTs trained to provide basic life support (BLS) services before you get to the hospital—from delivering babies to CPR to spinal immobilization. Paramedics are trained in advanced life support (ALS), so they can perform some invasive procedures like intubation and dispense medications.
Be comforted by the fact that you don’t need to travel this dismal journey alone. Unless you’re in critical condition or need CPR, you can take a friend or relative to hold your hand.
According to an EMS dispatcher, “Yeah, we take riders in the trucks all the time.” In ems lingo, a rider is an extra passenger and a truck is an ambulance. In fact, they encourage riders for women and children to make the patients feel more comfortable and minimize distrust.
5. Know where you’re going
How to put this delicately? The go-to hospital in North Brooklyn, Woodhull Medical and Mental Health Center, may not be one’s top choice for emergency care. As one reviewer wrote, “…if I got shot in the dick right in front of Woodhull (which isn’t that far-fetched a scenario), I would crawl to Broadway and catch a cab to Beth Israel.” But for regular hospital care, Woodhull has managed to eke out a place—albeit last place—on US News and World Report’s Best Hospitals in New York, NY†. It must be doing something right. Indeed, 51% of people surveyed said that they would recommend it. According to the report, Woodhull is especially good at nephrology (matters of the kidney) and for ear, nose, and throat care.
But if you don’t need dialysis or have a bad flu, can you ask the ambulance to take you somewhere else? The answer depends on whether you’re deemed “stable” by the EMS worker. Stable means that by the time you arrive at the more distant hospital a) you’ll still be alive and b) your health won’t be further compromised. If you’re stable, you can ask the emt or paramedic to shuttle you to the nyc area hospital of your choice (sorry, no free ride to the Mayo Clinic). There’s a little red tape involved. Your EMS responder has to clear your change with a “medical control physician.” You’ll also have to sign a form agreeing that if you get worse, you’ll be taken to the nearest 911 receiving hospital. When these details pan out, it behooves you to have a sense of which hospital you want (see: Where To Go for What Ails You).
If you aren’t stable, you’ll be taken to the nearest facility that can handle your problem. Mostly that means Woodhull, unless you have a condition that it can’t handle.
For example, because Woodhull is not a trauma center, you’ll be taken to Elmhurst or Bellevue—unless you’re in good enough shape to request Weill Cornell, the city’s top ranked Level 1 trauma center.
The 411 on 911
A few years ago, the fire department used to handle all 911 calls. In 2006, the FDNY and police department-operated EMS merged to share the task in a few square blocks of space at 9 Metrotech Center in South Brooklyn, a room abuzz with 1,500 call-takers who process some 14 million 911 calls a year, dispatching over 950,000 ambulances and fire engines to handle over 1 million emergency incidents.
As of January of this year, the last police officer was put into place, completing the transition to the new, centralized “Emergency Communications Transformation Program.” Mayor Bloomberg’s objective was to reduce response time and lower costs. Today, your 911 plea will be answered by a police department dispatcher who assesses the type of emergency being reported—fire, crime, or medical. In a medical emergency, your call is shunted across the room to an FDNY operator who dispatches a local ambulance while the call-taker gathers more specific information. To help everything go smoothly, here are a few things you should remember:
• Call for emergencies only; if you’re not sure, call anyway. The 911 call-taker will let you know if you should call 311 instead. Since the advent of 311, the call volume has decreased dramatically, allowing for faster response times and better medical care.
• If you call by mistake, don’t hang up. Let the call-taker know so that she doesn’t think you’ve passed out.
• Stay calm and answer all questions.
• Know your address and/or landmarks, especially if your address isn’t marked on your house or mailbox.
• Know that prank 911 calls are illegal.
Ambulance response times will get faster in our neighborhood with construction of the FDNY’s new Greenpoint EMS (actually in Williamsburg) station that boasts environmental sustainability and a super groovy design by Michielli + Myetzner Architects. Due to open in August 2012 on Metropolitan Avenue, the 12,400-square-foot space is sustainably constructed, with passive solar features, as a hub for four emergency medical units, a place where crews of up to 150 men and women can restock their ambulances with life-saving medical supplies, change clothes, rest, get fit, cook, and have meetings. Details like translucent glass, retro fire engine-red paint, and restrained touches of gritty urban materials give the FDNY a locally appropriate hipster cachet. (See a rendering below.)