Stuff You Should Know - Selects: How Paramedics Work

Episode Date: October 12, 2024

Paramedics are not EMTs. Or fire fighters. Or cops. But they do ride around in ambulances (and drive) to help to save lives. It's a stressful job and in this classic episode we shine a light on this noble profession. See omnystudio.com/listener for privacy information.

Once again, we find ourselves in an unprecedented election. And with all that's happening in the lead up to the big day, a weekly podcast just won't cut it. Get a better grasp of where we stand as a nation every weekday on the MPR Politics podcast. Here our seasoned reporters dig into the issues that are shaping voters' decisions and understand how the latest updates play into the bigger picture. Listen to the MPR Politics podcast on the iHeartRadio app or wherever you get your podcasts. This election season, the stakes are higher than ever. I think the choice is clear in this election. Join me, Charlemagne the God, for We the People,

an audio town hall with Vice President Kamala Harris, and you live from Detroit, Michigan, exclusively on iHeartRadio. They'll tackle the tough questions, depressing issues, and the future of our nation. We may not see eye to eye on every issue, exclusively on I Heart Radio. They'll tackle the tough questions, depressing issues, and the future of our nation. We may not see eye to eye on every issue, but America, we are not going back.

Don't miss this powerful conversation with Vice President Kamala Harris. Tomorrow at 5 p.m. Eastern, 2 p.m. Pacific, on the free I Heart Radio app's Hip Hop Beat station. Hi, everybody, Chuck here. I just realized I have almost cut my finger off while I was playing with a pocket knife just now. And it's bleeding quite a bit.

So I'm gonna call 911. And in the meantime, I'm gonna listen to this episode from April 12th, 2018, how paramedics work. Oh, thank God. 2018, How Paramedics Work. Oh, thank God. Welcome to Stuff You Should Know, a production of I Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark with Charles W. Chuck Bryant and there is Jerry Jerome Rowland.

And this is Stuff You Should Know, the Emergency. We should have a new podcast called Sirens Around the World. It's the most annoying show ever. It would be pretty annoying, but there'd be some subset of people who like just really despise themselves that it'd be popular among. So we would love it? We don't hate ourselves, do we? Tell me, I need to know. No. I guess it depends on the day. I didn't want to hate myself.

Sometimes I want to punch myself. Does that count? No, I know exactly what you mean, man. Sometimes I'm just like, I am so sick of myself. Is that what you're talking about? That was a good song. Remember that song? No. Sick of myself?

No. That was Matthew Sweet. Oh, yeah? Wow, that's weird that this is going on right now, because Matthew Sweet just popped up like randomly in the last couple days in like an article I was reading. I was like, I forgot about him. Haven't heard about him in 20 years and then bam, Boddermeinhof here he is again.

Well he's still around. He's an Atlanta guy, you know. I didn't know that. Yeah. Well that's cool. Yeah, I know. I think that's like the way it goes. Just because you had one hit and the world came and like listened to you and then moved

on doesn't mean like you're like, okay, well, I guess I'll go bury myself alive now in my own backyard. He had two hits. Usually, the artist like keeps going. Yeah. You know? Yeah, he had two hits though. I know Girlfriend and then the other one you're talking about.

Yeah, Girlfriend. That's a great song. Yeah, that's a great song. Yeah, it's a good song. Okay, so obviously what we're talking about today are paramedics. Paramedicine really is what we're talking about. Yeah. Which is, it's actually a pretty interesting topic because you kind of look into it, you're like, oh, these people save lives.

That's great. Here's some of the life-saving techniques that they do. Fantastic. But there's actually so much more, too. It's got a really interesting history. It's got a... It's one of those things where it's way worse off than it should be as far as funding and logistics and stuff like

that goes. I just find it interesting. It's interesting to kind of poke into a topic and then find that, oh, this is even more interesting than I thought. Matthew Feeney And have it poke back? Dr. Michael O'Brien Yep. With forceps. Matthew Feeney So I guess we should say right off the bat that the word paramedic, para means alongside,

so alongside medicine, I guess, which I'm not quite sure what that means. Matthew Fesne-Selassie So, what I think it means is as follows, Charles. These people, paramedics, they are not doctors, but they work with and alongside and really honestly as an extension of a doctor, an MD. Okay. I'll buy that. So that's what I think it means, because it's not like what they're doing is a different type of wacky medicine, like they're actually doing the same type of medicine that an ER

doctor, an ER nurse would be doing in an ER. They're just doing the same type of medicine that an ER doctor and an ER nurse would be doing in an ER. They're just doing it out in the field. Could you imagine how disconcerting it would be to be like on the ground and have a paramedic come up and like blow green dust in your face or something? You're like, what are the chicken bones for, man? Oh, man. Blow green dust in your face.

I don't know. It would depend on what the effect of the green dust was. That's true. So, I think that's what paramedic means, right? Okay. We can go further back, actually, and describe what ambulance means. We know that one for certain. Yes.

That came around in 15th century Spain during the Inquisition. They clearly had a lot of need for medical work. And they actually had field hospitals that were called ambulancias. Right. It was just basically like a mass unit out in the field. And then eventually the French, shortly after, I think under Napoleon, they innovated on the ambulance and said, well, that's great, that's neat that we have these things out in the field, but there's some guys way over there who are injured and they probably wouldn't

die if we could get them to these ambulances, these field hospitals, right? Right. could get them to these ambulances, these field hospitals, right? So they came up with basically mobile ambulances, which is this idea of a flying or a moving ambulance, which is like a little medical facility that they would put the people into and move them away from battle to go patch them up rather than waiting for the battle to end. Well, yeah, and before that even, during the Crusades, when they also had a great need for medical care, there were the Knights Hospitaller, Hospitaller? I think Hospitallier.

Oh, whoa. Is there an extra, I might be putting an extra syllable in there. Well, that's all right. I'm known to do that. That's your pastime. Knights Hospitaller, that's what I'm going to say, of the Order of St. John of Jerusalem. And they were the first, kind of the first people to practice emergency medicine on the battlefield.

And they even invented the, what we now call the stretcher, although it's still called a litter in some circles. Yeah, it's a pretty intuitive thing, but it works. Someone had to think of it. A couple of sticks with some canvas stretch between them, throw a person on there, you can pick them up, two people can pick them up and get them off of the battlefield lickety split. Hooray. battlefield, Lickety split. So yeah, so this is the idea of emergency medicine grew basically exclusively out of

warfare over the centuries. Well, yeah, but what's remarkable to me is that from that time, I have the right idea. Let's get these people out of here quickly. It took about 130 years all the way until the mid to late 1960s until they said, hey, wait a minute, if we actually put trained medical people in these things and weren't simply driving people to a hospital, we might have even more luck. Yeah. That was the late 60s.

Isn't that amazing? It is. And at the time it was, so a lot of medicine was practiced through house calls, right? Oh yeah. Including emergencies. Like if there was an emergency

and you could get ahold of a doctor, the doctor was expected to go out to that emergency and do what they could. But more often than not, either the cops or local morticians were tasked with, basically it was called like a scoop and run, or scoop and carry, where you just basically get the person out of that car wreck

or from the bottom of that ladder, or whatever just happened to them, throw them in the back of a car, a cop car or a hearse. I would looked it up. The Ecto-1, the Ghostbusters ambulance, is a modified Cadillac hearse. So they would throw some... I imagine that was a sinking feeling. It really was.

For a mortician to show up in a hearse and be like, I'm going to take you to the hospital. Depending on what happens, you may be back in the same car. Yeah, and talk about a conflict of interest, you know what I mean? Yeah, that's a good point. Hopefully not, but yeah. Take the war away? On paper, yeah, right.

Or they just, you know, casually put their hand on the person's nose and mouth in the back seat. It's dry. The thing is, though, is whether the mortician or the cops were getting you to the hospital, even when you got to the hospital, even when you got to the hospital, it's not like there was such a thing as an ER room. ERs didn't come about really until like the mid-70s, where you could find them in fair abundance around the United States. Like ERs just didn't exist.

It was, here you go, doc. I know you just delivered a baby and you treated somebody else for angina, but now you've got to put this person's head back together. Yeah. And it was all just medicine at the time. So yeah, the idea of getting somebody to a hospital and having a medical person, a professional in the car that's transporting them, it came out of Ireland, I think, right? Yeah.

Big shout out, 1967, to Dr. J. Frank Pantridge of Belfast. He had a study. He published a study that said, hey, you know what? We have more success saving people's lives when our mobile units have a physician or a nurse inside. Right. And everyone went, huh, never really thought about that. But there it is, there's a study.

Yeah. Pretty cool. So he definitely set the stage for this. And then the year before, there was a report, I think it was a year earlier, right? The one from Congress in America? A couple years, 65. I think it was like the National Academy of Sciences or somebody, basically got together with another group and said,

let's study accidents. And what they came up with was this idea that there was like this overlooked disaster that happened. Like accidents were a huge, major leading cause of injury and death in the United States. And this this inquiry determined that we weren't doing much about it. And specifically, a lot of people died who otherwise wouldn't have if there had been something like an emergency medical service to attend to them at the accident scene and on the way to the hospital and then having the hospital actually know what they were doing as far as emergency medicine goes.

Yeah, it's just staggering to me. It seems so intuitive, and I can't believe it took that long for this to happen, you know? And in fact, the Emergency Medical Systems Act was signed in 1973, Systems Act was signed in 1973, which basically said, we need a standardized system here, nationwide. Yeah. That was after that paper came out in 1966. Yeah. It was many years later. Yeah.

I mean, that's the speed of government, I guess. Sure. And then in 1977, the publication of the first, very first national standard curriculum for EMTs and paramedics. 77. Yep. And then so alongside this, para this, there were people like around the country, universities around the country and around the world who were kind of all recognizing all of this at the same time, that there's a lot more that could be done for people who were injured in

accidents and So you had the people at Pitt University of Pittsburgh taking up the cause so Panthers. Yeah, they started Is it the Panthers? Yeah, huh? They started creating some of the first curriculum for paramedics some of the first curriculum for paramedics, some of the earliest tests for paramedics. The University of Cincinnati came up with the first curriculum for training physicians in ER medicine. I think the University of California was an early entrant into the world of teaching paramedicine.

And I think they were the first one to be accredited in 1980. Like they had their operation going for years, but they were the first one to say, hey, somebody take a look at this and make sure we're kosher. And then we can say we're an accredited training facility for paramedics. Amazing.

It is pretty amazing. And then the problem is this. So the federal government got into the act in 1973 It is pretty amazing. And then the problem is this. So the federal government got into the act in 1973 with the Emergency Medical Services Act. But by 1981, there was an omnibus budget that said, we're out, we're done, we're not funding emergency services anymore. And then from that point forward, the emergency service system in the United States, whatever

had been developed to that point, broke into patchworks of state, local, county programs. Sometimes multiple ones within a single county. I think there's a county in Michigan that has like 18 different emergency services. And that has kind of created this where we are now, which is people doing the absolute best they can in what amounts to a broken system in a lot of ways. Should we take a break? Sure. All right.

When we come back, we will put the broken system behind us momentarily and talk about EMTs and paramedics. Once again, we find ourselves in an unprecedented election. And with all that's happening in the lead up to the big day, a weekly podcast just won't cut it. Get a better grasp of where we stand as a nation every weekday on the MPR Politics podcast. Here our seasoned reporters dig into the issues

that are shaping voters' decisions and understand how the latest updates play into the bigger picture. Listen to the MPR Politics podcast on the iHeartRadio app or wherever you get your podcasts. This election season, the stakes are higher than ever. I think the choice is clear in this election. Join me, Charlemagne the God, for We the People, an audio town hall with Vice President Kamala

Harris and you live from Detroit, Michigan, exclusively on iHeartRadio. They'll tackle the tough questions, depressing issues and the future of our nation. We may not see eye to eye on every issue, but America, we are not going back. Don't miss this powerful conversation with Vice President Kamala Harris. Tomorrow at 5 p.m. Eastern, 2 p.m. Pacific on the free iHeartRadio app's Hip Hop Beat Station. Hey, I'm Jacquees Thomas, the host of a brand new Black Effect original series, Black Lit, the podcast for diving deep into the rich world of Black literature. I'm Jacquees Thomas, and I'm inviting you to join me and a vibrant community of literary enthusiasts dedicated

to protecting and celebrating our stories. Black Lit is for the page turners, for those who listen to audiobooks while commuting or running errands, for those who listen to audiobooks while commuting or running errands, for those who find themselves seeking solace, wisdom, and refuge between the chapters. From thought-provoking novels to powerful poetry, we'll explore the stories that shape our culture. Together, we'll dissect classics and contemporary works while uncovering the stories of the brilliant writers behind

them. Black Lit is here to amplify the voices of Black writers and to bring their words to life. Listen to Black Lit on the iHeartRadio app, Apple Podcasts, or wherever you get your podcast. How do you feel about biscuits? Hi, I'm Akilah Hughes, and I'm so excited about my new podcast Rebel Spirit, where I head back to my hometown in Kentucky and try to convince my high school to change their racist mascot, the Rebels, into something everyone in the South loves, the Biscuits. I was a lady rebel. Like, what does that even mean?

The Boone County Rebels will stay the Boone County Rebels. It's right here in black and white in Prince. A lion. with the image of a mission. It's right here in black and white in Prince. A lion. An individual that came to the school saying that God sent him to talk to me about the mascot switch is a leader. You choose hills that you want to die on.

Why would we want to be the losing team? I just take all the other stuff out of it. Segregation academies. When the civil rights said that we need to integrate public schools, these charter schools were exempt from that. Bigger than a flag or mascot.

You have to be ready for serious backlash. Listen to Rebel Spirit on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. All right. So if you want to ride in an ambulance or drive an ambulance and get on the scene and help someone out who's in need, there are a couple of ways you can do it. You can be an EMT, Emergency Medical Technician, and this is the person who has undergone between about 120 and 150 hours of coursework. They're well-trained in all kinds of life-saving procedures. If you need CPR, if you need oxygen administered, if you were having some bad

allergic reaction, that your life is in jeopardy. But there are limits to what they are allowed to do. So one thing they cannot do, even in the case of giving shots, is they can't break the skin. Which is super interesting. I never knew that. Dr. Peter Coughlin Yeah. I didn't know that either. But you can consider an EMT like an entry-level paramedicine professional. Right.

That's where you would start. And in fact, I think you have to start as an EMT to go on to the next level, which would be paramedic, right? For sure, yeah. So if you're a paramedic, you have about ten times the amount of coursework and schooling under your belt by the time you're a paramedic. And I think you do have to have about six months at least of prior, immediately prior EMT experience to start becoming a paramedic as well.

Which I'm sure is the way most people go, is you start out as an EMT and then you, you know, move on to the next level, which is paramedic. Yeah, which, like you said, 10 times. So that's about anywhere from 1200 to 1800 hours, depending on your state or your municipality to get certified. And this is where the real action can happen. You can give an IV. You can, if someone's having a heart attack,

you can deal with that. You can operate a defibrillator. Defibrillator? Fibrillator. Fibrillator? Matthew Fiesner Fibrillator. Matthew Fiesner Fibrillator. Matthew Fiesner It's fun to say once you master it. Matthew Fiesner They should have just called it the clear machine.

Matthew Fiesner Yeah, the bzz. Matthew Fiesner But it's a lot of work and a lot of hours and one of the people that they interviewed in this article said that, you know, it's really grueling and when you're in paramedic training and school and doing your coursework, basically for a year or two you can just say goodbye to your friends and family. Yeah, I saw that too. Yeah, that's tough stuff.

So the paramedic is actually, they operate under the license, not just like under the direction but under the license of a physician in their locale, right? There's a couple of ways that you can do it. And as you'll start to see, I saw a quote that said, if you've seen one emergency medical system, you've seen one emergency medical system. They're all just so different

and the whole thing is so patchwork. But there is a national standard, which I think is the National Emergency Medical Technician Registry Exam. That's like the national exam. And then you may have to pass like a state and or local exam too, depending on where you live. But there is like a national accreditation and national coursework. But then how the system functions and runs is what's the patchwork part of it. Yeah. And it'll cost you, I mean, it depends on where it is, of course, and what program.

But the example they used in our article is the UCLA Center for Pre-Hospital Care. And they quoted about 10 grand for just the tuition. And then, of course, like any college or coursework, you're going to have to pay for books and equipment and then of course like any college or coursework you're going to have to pay for books and equipment and uniforms and stuff like that. That's exactly where they get you. The plaid skirt. And then after that though, the good news is that you have a really good chance of getting work. I get the impression that if you have gone through all of your paramedic training, you're

not sitting around. Like, there's usually a job waiting for you somewhere. Yeah, I saw that as well. And actually, it doesn't necessarily pay super well. No. People, so if you ever see a paramedic, be extra nice to them. For sure. Because not only are they running around saving people's lives, they're not getting rich off

of it at all. They're doing it because it's something they care about. Yeah. But despite that, despite the mediocre pay, I saw it's going to be one of the most in-demand jobs over the next 10 to 15 years. I really wish I could remember the statistic exactly, but I think they're expecting another 53,000 EMT jobs or paramedic jobs to

be added to the American economy over the next like decade maybe. So it's definitely a growing career for sure, growing profession. Yeah. And you mentioned the pay if you go to the US Bureau of Labor Statistics to kind of find a mean salary or something. They do it, it's not really, they should separate it out, but they lump in EMTs and paramedics when, of course, EMTs don't make the kind of money their paramedic would, but they had a mean annual wage of about $31,000 a few years ago.

And if you're in the top 10%, it's about 54,000. And apparently the state of Washington is on the higher side. You can get as high as 71 grand in the state of Washington. But I mean, you know, that's a good living and a decent living, but it's not like, like you said, they don't go into this because like, oh man, you know, that 31 grand a year, it's sort of like being a school teacher. It's a, I feel like it's a calling in a lot of cases. For sure.

For sure. Um, as I was saying about the, uh, the license that they operate under, right? So if you're a certified paramedic, when you are, um, depending on the state you're in, you may be operating under the license of the state medical director, like that's where you have your license. Yeah. Or you could also be operating under the license

of a local physician, like that physician's license covers you, covers the physician's assistant, basically everything working for, everyone working for him or her. So you might be operating under that physician's license. Or, I didn't know this man, during an ambulance ride. So remember how just adding like a trained medical professional to the ride

from an accident scene to the hospital improves outcomes. And we've known that since 1966 at least. They figured out that if you can communicate with a doctor, an ER physician, en route, you could also improve outcomes even more. So during this transportation from an accident to the hospital, the paramedic is probably in touch with an ER doctor who is instructing and advising and consulting with the paramedic to figure out the best course of action, the

best course of treatment, and then how to carry that out. And from what I understand, at that time, the paramedic is operating under that physician's license in that state. Would that make you feel better or worse? What? That the paramedic was getting instruction from a physician? Yeah. Like if you hear this going on.

I don't know. I would say... Part of me is like, better, because it's a doctor telling you that, but the other part of me is like, don't you know? And you would hate to hear the doctor say, well, get the something something, and for the paramedic to say the what? You're right. I don't know what that is.

I've never seen this before ever. Have you ever had to take an ambulance ride for yourself? No. No, thank goodness. I didn't think I had either, but then I did remember when I was 13 or 14, my brother was 16 or 17, we were in a car wreck. There were eight people in a Jeep, in my brother's Jeep that was once my dad's Jeep. And that was definitely not safe to do to begin with. But we were going to a movie after church on a

Sunday night, bunch of kids in youth group. Matthew F. Kennedy- Raising hell. Matthew F. Kennedy- Piled in my brother's Jeep, wasted. No, just kidding. Completely sober. Matthew F. Kennedy- Wasted on the Lord. Matthew Feeney We were. And it was raining really hard and you know at Ponce de Leon Avenue here in Atlanta, everyone that doesn't live in Atlanta probably laughs that we pronounce it that way instead of Ponce de Leon. But on Ponce where it kind of, if you're leaving from Atlanta, it's that big curve where you

go over that large stone archway. Yes. Kind of headed toward Indicator. We were coming down that way, nowhere near Northlake Mall, where we were supposed to be headed. We were lost and my brother, we hydroplained, hit a curb and turned the Jeep over on its side and I ripped through the canvas ceiling,

or whatever it's made of. Oh man, you got thrown? Oh yeah, we were scattered all over the street. You were lucky. I know, it's the only time I think that I've been knocked unconscious. And I just remember waking up, you know, what would have been probably seconds later,

in the pouring rain and looking around and seeing my friends scattered within like, 20 feet of each other in various places. Wow. Man, that is scary stuff. It was scary. So, in the end, the good news is no one had like, I think the worst injury was like a broken collarbone.

I broke my finger. There were little cuts and scrapes, but nobody was hurt bad. But I do remember this. I hope my brother doesn't listen to this one. In the ambulance on the way, my brother was just sort of catatonic and they said they were trying to get information and they asked what his name was and he said, A-hole. He said A-hole. He said the real word.

Yeah. I think he was just sort of out of it and felt terrible. Poor Scott. What? He said a-hole. He said the real word. Because he felt so bad? Yeah. I think he was just sort of out of it and felt terrible. Poor Scott. And he didn't curse at all at the time. Still doesn't even curse much. But it was just weird that that is what stands out in my mind. I wonder if he remembers that actually.

Well, that's a big one, especially if you didn't curse, you know. So funny. Man, that's a, that's a, you are a great storyteller. Was that a good story? Yeah. I was like, I was seriously where you kept like going off on tangents. I'm like, no, we got to get back to the story. What happened to the cheek?

I know you looked a little nervous. Yeah. So, wow. Okay. Should we take a break? Oh yeah. And also I forgot to mention the one guy that was tragically killed. Right. You're like, but did I forgot to mention the one guy that was tragically killed. Right.

You're like, but did I mention I also broke my finger? No, nobody was hurt. Everybody was good. Too bad. Everybody was good. I think my brother broke his foot. Man. Yeah, it was just stuff like that.

Heck of a story, Chuck. Heck of a story. Thank you. Yeah, let's take a break and regroup, shall we? Yeah, let's do. Okay. Once again, we find ourselves in an unprecedented election. And with all that's happening in the lead up to the big day, a weekly podcast just won't cut it. Get a better grasp of

where we stand as a nation every weekday on the MPR Politics Podcast. Here are seasoned reporters dig into the issues that are shaping voters' decisions and understand how the latest updates play into the bigger picture. Listen to the NPR Politics Podcast on the iHeartRadio app or wherever you get your podcasts. This election season, the stakes are higher than ever. I think the choice is clear in this election. Join me, Charlamagne the God, for We the People, an audio town hall with Vice President Kamala Harris,

and you live from Detroit, Michigan, exclusively on iHeartRadio. They'll tackle the tough questions, depressing issues, and the future of our nation. We may not see eye to eye on every issue, but America, we are not going back. Don't miss this powerful conversation with Vice President Kamala Harris.

Tomorrow at 5 p.m. Eastern, 2 p.m. Pacific on the free iHeartRadio app's Hip Hop Beat station. Hey, I'm Jacquees Thomas, the host of a brand new Black Effect original series, Black Lit, the podcast for diving deep into the rich world of Black literature. I'm Jacquees Thomas, and I'm inviting you to join me and a vibrant community of literary enthusiasts dedicated to

protecting and celebrating our stories. Black Lit is for the page turners, for those who listen to audio books while commuting or running errands, for those who find themselves seeking solace, wisdom, and refuge between the chapters. From thought-provoking novels to powerful poetry, we'll explore the stories that shape our culture. Together, we'll dissect classics and contemporary works

while uncovering the stories of the brilliant writers behind them. Black Lit is here to amplify the voices of Black writers and to bring their words to life. Listen to Black Lit on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey friends, I'm Jessica Capshaw. And this is Camilla Luddington. And we have a new podcast.

Call it what it is. You may know us from Graceland Memorial, but did you know that we are actually besties in real life? And as all besties do, we navigate the highs and lows of life together. And what does that look like? A thousand pep talks. A million I've got yous. Some very urgent I'm coming up first. Because, I don't know, let's face it, life can get even crazier than a season finale of Grey's Anatomy. And now here we are, opening up the friendship circle. To you! Someone's cheating?

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Listen to Call It What It Is on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Okay, we're back. I'm not reeling quite as much as I was, but that was a good story again. I feel like we should mention, even though it's kind of silly, that emergency TV show. Oh, yeah, for sure. From the 70s because it seems like it definitely like actually played a part in ramping up ambulance services. Yeah, so this is I think 1971 or 72 when it premiered and remember the Emergency Medical Services Act wasn't passed until 1973. That white paper had come out in 1966.

So this idea of like this new type of medicine, this new type of like healthcare worker, was really on America's mind. But one of the ways it got there was from that TV show, Emergency. In part because it was shot like documentary style, people played themselves on it, like there were real dispatchers on the show,

acting as dispatchers. It just captured America's imagination. Yeah, I remember watching it. I don't think I ever saw an episode of it. Yeah, it was Emergency with an exclamation point. It ran until 77 and it was mainly two dudes, two firefighter characters is what the story centered on. And one of them was a young Kevin Tig, or Teague. He was, did you ever see Roadhouse? Yeah.

He was the owner, he's a character actor, he's been in many things. Oh yeah. He owned the double deuce. Yeah, he's great. Yeah. I can't remember what else I've seen of him. I've seen him young before. I wonder if it was emergency now that you mention it. Maybe. Huh. Maybe I have. I wonder if it was emergency now that you mention it. Maybe.

Huh. Maybe I have. I bet it ran in reruns. For sure it did. But I'm a Jack Webb fan and I think he produced or created it. Your big Jack Webb guy? Mm-hmm. Are you not?

I don't know. He's the dude from Drag Night. He's Sergeant Friday. Yeah. I guess I need to think about that. Yeah. He's awesome. I'll let you know. Man, if you go back and watch like old episodes of Drag Night, he's Sergeant Friday. Yeah, I guess I need to think about that. Yeah, he's awesome. I'll let you know. Man, if you go back and watch like old episodes

of Dragnet, oh my God. Yeah, that was a good show. Yes, it was. And I think Emergency, maybe Atom 12 is like the direct spinoff of Dragnet. Maybe that's what I'm thinking of. But I swear I know exactly what you're talking about with the Teague fella from Roadhouse.

And then, wasn't Dragnet Colonel Potter? Yes. Harry Morgan. Right. We had a, Emelina had a long conversation about M.A.S.H. the other day and how that was, I was a M.A.S.H. nut. And how that show was one of the few to survive like major cast changes. Oh yeah.

They had like three cast changes. Oh yeah. They had like three of them. Yeah, they certainly didn't like big stars, like co-stars. I think one of the few people who made it through was Alan Alda, right? He was there the whole time? Yeah, and like Hot Lips I think was the same and a few others, but they had like Radar and Klinger.

Yeah, they were there the whole time. Although they co-existed I think. But eventually Radar left and Klinger, although they coexisted I think. But eventually Radar left and Klinger took his job. Potter took over for what's-his-face, the original guy. I don't remember, but he wore the fishing hat. Yeah, he was, oh man, the saddest ending ever for that one. When he left? Yeah, remember he got his papers to go home and everyone's all excited and then he was

killed in a helicopter crash or a plane crash on his way out. And then of course Frank Burns left and was replaced by Winchester and then Trapper left and was replaced by Honeycutt. But it was still great. Well, it wasn't as great at the very end. I don't know, man. Goodbye, farewell, and amen was one of the all-time best last episodes ever. True, for sure.

But you're saying they pulled it together at the end of the last episode? I think I remember the last couple of seasons, it was a little bit like, you know, this, maybe it had run its course. But I was a very discerning 12-year-old viewer. Yeah, I guess so. Yeah, like they've really gone to the hooch gin joke too many times this episode. It is funny though that like little 12-year-old me thought like the funniest thing in the world was war surgeons, drunk war surgeons.

Right, drunk philandering war surgeons. All right, I really got off track there. Yeah. Maybe we should take a third break. No, I don't think so. I don't think we should either. So we're talking about paramedics today, believe it or not. And one of the things we talked about was the idea that paramedics, well, let's talk a little bit more about their job, right?

Okay. One of the things that paramedics are sometimes criticized for is that they don't run to the scene of an emergency. I've never thought about that once. You haven't, I really hadn't either, but then I started thinking about it, I'm like, yeah, I could totally see that. Apparently, for some people who are at an emergency scene

and see the paramedics just kind of walk up, they appear a little too casual, and they want to know, what are you doing? Why aren't you rushing to this scene? And paramedics, I think we saw a question answered on Quora or something like that. And a paramedic explains, there's actually a number of really good reasons why paramedics, why you don't see them running to the scene. First of all, they're going to park as close as they can. So that running is only going to shave a couple seconds off. But really the number one reason or one of the top reasons is that they're supposed to be,

they're supposed to bring with them to this scene of catastrophic panic basically, calm and professionalism and being in control. Yeah, I get that. Like I think it would be a little disconcerting if I was injured and I saw a paramedic burst into the room, like breathing heavy. Like, oh my God! What's going on? What's going on? Is everybody okay?

Yeah, plus they might get hurt running. That's another one. And they're usually, you know, or not usually, but I would say probably a lot of times it's not like they're walking through a perfectly laid pathway. Like they could be running upstairs or through a house of hoarders or through the woods. Like you don't know what's going on. You got to be careful on your way there. Yeah.

And you have to be going slow enough that you can assess what the risks you're walking into are as you're walking into them, rather than running into it and being like, oh, the guy who shot you is still here waiting for me. You know? Now that I've run into the scene, I know that, but it's terrible. It's also kind of hard to run from place to place depending on the equipment that they're carrying with them. The stretchers get heavy, the EKG machines get heavy, the defibrillators get heavy,

all that stuff gets heavy. So there's a number of reasons why you won't see a paramedic rushing to the scene. You will see him rushing to the scene in the ambulance though, and from what I understand, driving in the ambulance or riding in the ambulance is the most dangerous part of the entire job. Yeah. And here's another tip, aside from being nice to your EMT or paramedic, is don't call them

ambulance drivers. Yeah. Because that's part of their job. And it's a weird thing too that it's not like they hire a driver who's super skilled at that, and then they have other people in there that do the work. Like they do double duty. They have to learn to drive like that, I mean, while they're EMTs or paramedics. Yeah, and so, you know, if you've ever seen an ambulance going through an intersection, they're going to slow and maybe even stop and then proceed.

They still get broadsided very frequently by people going through the intersection because they have a green light and they're not paying attention. They'll hit an ambulance, like T-bone an ambulance, and the driver's probably okay, or I should say the paramedic driving is probably okay. But the paramedics in the back, they probably aren't lashed down in any way, shape or form because they're working on the patient. And so they're getting thrown around and can get injured and killed themselves that way.

So that's the most dangerous aspect of the job from what I've seen. Matthew Feeney Yeah. Another interesting thing that I saw from that list you sent was that if you're in a big city, a lot of times they even have divided up between EMT and paramedic for different cases. So like if there's a scene of trauma going on, like a car accident, then you're more likely to get an EMT, whereas if you're at home and you're like, my husband's having a heart attack or my child's having a seizure, then you're more likely to get a paramedic. Yeah.

Which is interesting. Yeah. And if in cities as well, if you're a paramedic, you probably, once you get into your ambulance, you're basically stationed at the ambulance for the rest of your 12-hour shift. You don't go back to like the firehouse or to the ambulance clubhouse or anything like that. The ambulance clubhouse or anything like that. You're on a designated street corner parked waiting for your next call. Probably killing time somehow, but there's not very much downtime in a city especially. The opposite is true for more rural EMTs and paramedics

and that there's a lot of downtime. So much so that this guy who's actually one of the consultants on that show, Emergency Years Back, he became a minister of health, I think in Nova Scotia. And he created this program for rural EMS workers to use their downtime in much the same way that like a country doctor would have made house calls. Yeah, so like wasn't the idea that they would go to places and sort of help train like regular citizens on how to avoid getting hurt and stuff to begin with?

Right, yeah, like doling out preventative medicine, like making sure that people are taking their medicines correctly, teaching CPR classes, teaching leading exercise classes for like seniors at a senior center, like doing all the stuff to reduce the number of calls that they have to go on anyway. So it cuts down on their downtime, which I think is actually very much appreciated by paramedics, because there's really nothing more boring than sitting around constantly. And then they're actually doing something and also making their community a healthier place.

Yeah, I thought it was funny when they were talking to some real on the ground paramedics about the downtime. They're like, well, HBO goes kind of awesome. Like, oh, well, I guess you got to pass the time. It's better than Nicolas Cage and bringing out the dead. Matthew Feeney What did he do? Because I remember that movie, but I don't remember all the details. Matthew Feeney Well, it wasn't that great.

Matthew Feeney I liked it. Matthew Feeney He did tons of drugs. Matthew Feeney Oh, okay. That's why he was on the truck. Matthew Feeney I think he was like a speed freak or something. Matthew Feeney I gotcha. Matthew Feeney Yeah. Oh, okay. That's why he was on the drugs. I think he was like a speed freak or something. I gotcha. Yeah.

Yeah, he kept begging to be fired, right? I don't remember it very well at all, actually. I think he did. Like, that was his schtick. He begged to be fired. Huh. So, one of the things about that downtime, the community preventative medicine initiatives that have kind of spread from Nova Scotia out through around the country.

When you see a paramedic doing that, they're not being paid or at the very least their unit or their county or their city is not being paid for that, which is a huge problem. Yeah. This is where I got a little confused. The way I was reading this was Medicaid and Medicare and stuff and insurance companies will reimburse only if they have transported someone to a hospital? Yes. So, in other words, if you go as an ambulance and a paramedic or EMT to a place and you actually can just help and treat someone there and they don't need to go to the hospital, then that's a freebie? Yes.

Or do they send a bill to the people? From what I understand, it's a freebie. Probably since it is such a patchwork of systems all around the country, I'm sure that you could live somewhere where you, the person, would get a bill for that. I think, as a matter of fact, you do, no matter where you live, but Medicaid and Medicare won't pay for it.

So there is a substantial reason to say keep working chest compressions on a person who is obviously dead all the way to the hospital. So that you can like bill Medicaid for that transport or getting somebody to go to the hospital even though they don't need to so that you can bill Medicaid for that as well. And the problem is that that leads to other problems as well. Like hospital ERs are very much overcrowded and understaffed and overworked, right? Yeah.

So when you show up with another person, that's one more person they have to deal with. And apparently it creates a bit of a... Conflict? Yeah, there's a cultural conflict between the people, the paramedics and those EMTs bringing people to the ER and the people who staff the ER and are accepting these people. So much so that it's become kind of common for ER rooms to issue ambulance diversions, saying, don't bring anybody to our ER, go somewhere else.

And on a really bad night in a really populated city, you might find every single ER room, like, with that diversion alert on, and you've got to take somebody out to, like, a country hospital that doesn't know anything about trauma, and it takes 45 minutes to get there, and they're not going to get the care they could receive at a good trauma center in the city. So that's a real problem.

Matthew Feeney Yeah, and this is, too, in terms of pay, and we need to hear from people on the ground because this, it's surprisingly confusing. We researched this on how it all works, and maybe that's the point, but it seems like it's also a fixed rate. There's no difference between I treated a kid for an allergic beasting reaction to I brought a guy back from the dead who had had a heart attack or heart failure. Is that right? Yeah. So long as you transport both of them to the hospital, you're going to get, I think I saw

as low as 25 bucks for Medicaid in some places. I don't understand this. The numbers just do not add up. I don't get it at all. I know that some places, some counties and cities fold their EMS workers under their fire departments so that they fall under the fire department's funding, which I think fire departments tend to be way better funded than any kind of EMS service. So I think that's one way that it happens, but I just don't get how this actually works money-wise because it doesn't add up.

It doesn't make sense. Matthew Feeney Yeah. I mean, it's not often that we're a little stymied. So we're going to follow up for sure with some emails, but I think it's also going to vary from place to place. Because the other thing that I got really confused about was the privatization of ambulance services. And as best as I can tell, is in the 70s and 80s, there were a lot of small private ambulance

companies, but then they merged into more regional things and that these days there's just a few like big multinational companies that are the most dominant in the industry. Right. But I don't get how that works. Like if they're private, are they like working with only private hospitals or can they go to a state hospital? I think that they can get a contract from the state.

They can be, they can have a license to operate within a state or a county or wherever. And I think they go wherever they're called to. I know that there can be like competition among them. So like multiple ambulances will show up at a scene sometimes. It's just, it's kind of a bit of a cluster as far as Competing with the local EMS services, and I think it's on the decline from what I've seen yeah, but when you call 9-1-1 Do you have a choice so what you can do? I think it's kind of like uber

we're like they the the 9- they the 911 dispatcher has a log of companies or services like public funded or private Services that it can be issued to and they send out the alarm and whoever takes the call goes and gets it Interesting. So the problem is is I saw a Las Vegas Review Journal article about this. Las Vegas was debating whether to just totally privatize their EMS services. Their EMS just like went berserk. They're like, no, like this doesn't work. The private companies are late. I think they were late like 10,000 plus times in one year in Las Vegas.

Their response time tends to be less than the actual fire department or EMSs. It's just not as preferable. And the reason why private ambulance services came about or became widespread is this idea that you should just privatize everything and then that competition will keep everything going. And that hasn't necessarily panned out to be the case. And from what I see, New York is actually scaling back on theirs, right? Yeah. I think Giuliani is one of the people that really tried, and of course, no surprise, given his politics, trying to privatize the industry. But apparently a lot of those had gone bankrupt basically. And during the housing boom, the financial collapse strangely or maybe not strangely

because I don't understand it, a lot of private equity firms started buying up ambulance services. Yeah, there you go. There's the downfall. It's just so interesting. I know that this is one of those where someone's going to knock our socks off with a great email. Yeah, I think also one more thing about the private ambulance services. It's not like they're just a bad idea all around.

Sure. In a locale that is underserved, if a company wants to come and set up ambulance services, that would be great for that area. Because they have a far, you know, they have, they can get places faster in an ambulance than they could have before. In a place where you've got your EMS overstretched and the county's like, no, we're not hiring a single additional EMS worker. The company that sets up shop can actually take up the slack. Like there are good aspects to it. Like it's not just like some terrible idea, but in practice, it hasn't worked out as well

as one would hope from what I understand. Yeah. Yeah. EMS workers, like email us, like explain this because I really, like you, I do not get who's footing the bill. It has to be insurance companies. And if you don't have insurance, it has to be just the person, the individual. Yeah, and I think we have, we waded into the waters of doing a 911 podcast once and didn't.

Isn't that correct? Because it was, I mean, we'll do it at some point, but I remember thinking, oh, that's a good easy-ish one. And it ended up like being super convoluted. Yeah, I think we should do that. We should also do just ERs in general too. Yeah So that's a bit about paramedics sounds like there's way more to it, right? Yeah But you got anything else for now? No, sir. Okay. Well since Chuck said no, sir. It's time for listening to me

All right, I'm gonna call this we helped a dude win something Yeah, I love this one. Hey guys, been listening to your show for about four years and always wanted to write in, but now I have a great reason. A local store was doing a giveaway a few days ago and they posted that the first people to show up and answer correctly would win a prize. The question was, bacon and eggs was not always a breakfast food and what year did it become so and who was the man behind the marketing idea? So this guy sounded super excited because he knew the answer Immediately I thought of your show and the uncanny ability of mr. Edward Bernays to pop up in seemingly strange histories I remembered your PR episode and knew it was sometime in the 20s

So I hopped in my car took off for the business when I got there I told him the answer with a startled look they told me I'd won a huge case of meat And not just junky stuff either this place sells to restaurants and businesses all across the country I love that I was super stoked good meat. He's like I won meat and not just like terrible meat like good stuff, too When they asked if I had to look it up I told them no that I listen to stuff you should know and they retained it in the back of my mind They asked for the name of the show And they said they were going to play it for all the workers there during the day

So now they can get more difficult and random questions. That's awesome. And he said it doesn't in there I went back later in the week and the same girl I'd spoken to recognized me. So they had two other people come in that had known the answer from stuff You should know as well. All right, even though we live in super rural Utah you apparently have a large following and that is from John Robeson. Thanks John Robeson. I hope you have a healthy EMS service out there to come find you after you eat that box of meat. Yeah, and you know what? Let's hear from Salt Lake City, because we have debated a live show there, and just didn't know if we had the support, so I want to hear it. Okay, so we want to hear from Utahans and EMS workers.

Yeah, if we get 10 people that email us and say to come to Salt Lake City, we'll come. I think we should set the bar higher than that. Oh, okay. Okay. Well, if you want to let us know that you're from Utah and you want us to come or you're an EMS worker and you got some good stories for us,

you can send us an email, it's probably easiest, to stuffpodcasts at howstuffworks.com. As always, join us at our home on the web, stuffyoushouldknow.com. Stuff You Should Know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, Apple podcasts, or wherever you listen to your favorite shows. goes. Once again, we find ourselves in an unprecedented election. And with all that's happening in the lead up to the big day, a weekly podcast just won't

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