# Man down in shul



## bstone (Aug 13, 2008)

Sunday evening I was at my local synagogue (shul) for a service. While we were doing the evening service in the lower level sanctuary I heard a *thud* which came from the first floor sanctuary, where a parallel service was occurring. Thinking someone had dropped a prayer book I just ignored it. A few moments later a friend comes rushing downstairs with a look of fear/concern on his face. "Stone, we need you. Someone has fainted." I put down my prayerbook and rush upstairs. I find a man laying on one of the bench/pews on his right side and a friend, an EMT-B, just beginning to make patient contact. I ask if he hit his head and I am told affirmative. I then initiate full spine and head measures, we carefully move him onto his back and hold c-spine for 30 minutes until local EMS arrives (they were called just as I entered the room). He's breathing, pulse is fine, pupils pinpoint and unreactive. Turns out the fellow had syncope as he was sitting and hit his head on the way down.

When local EMS arrived I turned over care to them, helped them collar and board the PT and move him to the bus.

The end.


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## karaya (Aug 13, 2008)

30 minutes for EMS to arrive? Wow. Is this normal in your area? Where did this incident occur?

Bus?  I thought you called for an ambulance?


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## bstone (Aug 13, 2008)

karaya said:


> 30 minutes for EMS to arrive? Wow. Is this normal in your area? Where did this incident occur?
> 
> Bus?  I thought you called for an ambulance?



Is it normal for EMS to arrive in 30 minutes while in a major metropolitan area like Boston? I don't think so. Perhaps this is just how bad it is.

This occurred in my synagogue, which is in Cambridge, MA. Less than a mile away from Harvard and MIT. I guess I now know why MIT has their own volunteer ambulance service.


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## emtphil (Aug 22, 2008)

bstone said:


> This occurred in my synagogue, which is in Cambridge, MA. Less than a mile away from Harvard and MIT. I guess I now know why MIT has their own volunteer ambulance service.



Was it Professional EMS (the private ambulance co. in Cambridge) that showed up, or was it CFD?


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## bstone (Aug 22, 2008)

emtphil said:


> Was it Professional EMS (the private ambulance co. in Cambridge) that showed up, or was it CFD?



Armstrong showed up. I was expecting Pro.


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## medicdan (Aug 23, 2008)

Pro was completely overwhelmed on the 9th-- the ended up going to their second or third mutual aid to cover Cambridge calls, and its not entirely clear why. My company sent one of our BLS trucks to post closer to cambridge if we needed to pick up any calls. 
One last thing, did BLS or ALS show after 30 min?


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## Airwaygoddess (Aug 23, 2008)

*Patient care....*

Stone, you were in the right place at the right time!!  Great job!


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## bstone (Aug 25, 2008)

emt-student said:


> Pro was completely overwhelmed on the 9th-- the ended up going to their second or third mutual aid to cover Cambridge calls, and its not entirely clear why. My company sent one of our BLS trucks to post closer to cambridge if we needed to pick up any calls.
> One last thing, did BLS or ALS show after 30 min?



BLS. Which was fine as his was breathing fine, talking, stable pulse, etc. If I had ALS gear there I would have started a line but kept it at KVO and done a NC at like 2 lpm. Also the monitor, but just for posterity.


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## bstone (Aug 25, 2008)

Airwaygoddess said:


> Stone, you were in the right place at the right time!!  Great job!



Thank you, madam. :blush:


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## mikie (Aug 25, 2008)

Commendable job indeed! 

 At my synagogue, there is a 'crash kit.'  Other than the AED, there is O2, BVM, NSS w/ IV equipment (just one bag and I believe two catheters).  

I believe it is one of the member's 'equipment' (not the AED), as he is an MD. 

There is also a first aid kit w/ two epi-pens, ASA, Glucose tablets and a few other things that are slipping my mind.  

It makes sense, a lot of older people (not saying it couldn't happen to anyone) do attend services and are more than likely to have a syncopal (is that a word?) episode, AMI or just drop dead!


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## bstone (Aug 25, 2008)

mikie333 said:


> Commendable job indeed!
> 
> At my synagogue, there is a 'crash kit.'  Other than the AED, there is O2, BVM, NSS w/ IV equipment (just one bag and I believe two catheters).
> 
> ...




Thanks for the accolades. I did feel rather frustrated by the lack of any equipment. In response to this I am going to put together a BLS bag, including a BP, steth, BVM and airways. If I can swing it financially, an AED and O2 with NC and NRBs as well. We have enough EMTs in the shul that we know how to use them and based on the ambulance response time it seems we might just have to.


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## mikie (Aug 25, 2008)

bstone said:


> Thanks for the accolades. I did feel rather frustrated by the lack of any equipment. In response to this I am going to put together a BLS bag, including a BP, steth, BVM and airways. If I can swing it financially, an AED and O2 with NC and NRBs as well. We have enough EMTs in the shul that we know how to use them and based on the ambulance response time it seems we might just have to.



Can you get the AED through some sort of medical grant for your facility?  I don't know too much about how to acquisition one, but perhaps because it is a religious organization with many members, there is need for one?


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## bstone (Aug 25, 2008)

mikie333 said:


> Can you get the AED through some sort of medical grant for your facility?  I don't know too much about how to acquisition one, but perhaps because it is a religious organization with many members, there is need for one?



Really good question. The synagogue isn't rich. The budget breaks about even every year. Sometimes a little less. So I feel a plea to the board might be turned down with great lament on their part (some of them were there and witnessed this event). 

Perhaps someone here knows of a resource which gives grants for these sorts of institutions? I know AEDs are going around $1500 or so today. Suggestions welcome.


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## Jon (Aug 25, 2008)

Stone,

What about the city EMS folks? they might have a source for grant money, and/or have an "older" AED they aren't using.


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## bstone (Aug 26, 2008)

Jon said:


> Stone,
> 
> What about the city EMS folks? they might have a source for grant money, and/or have an "older" AED they aren't using.



City EMS folks kinda don't exist here. It's all private. I will however start with the local and state health depts. Perhaps they have resources.


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## p3medic (Aug 26, 2008)

CFD runs an ALS rescue, and responds in a first responder role to all EMS calls in Cambridge, I have no idea why it would have taken 30 minutes for an ambulance.  Did fire show up?  If not, perhaps the call was made to a number other than 911?  I know Pro does the transport there, and have very good response times, seems like an anomaly.  As for public access defibrillators for  the synagogue, contact Pro, you might be surprised.


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## bstone (Aug 26, 2008)

p3medic said:


> CFD runs an ALS rescue, and responds in a first responder role to all EMS calls in Cambridge, I have no idea why it would have taken 30 minutes for an ambulance.  Did fire show up?  If not, perhaps the call was made to a number other than 911?  I know Pro does the transport there, and have very good response times, seems like an anomaly.  As for public access defibrillators for  the synagogue, contact Pro, you might be surprised.



I'll contact Pro about the AED. The call was made to 911 but Cambridge FD never showed up, only pro. From earlier posts it seems Cambridge was very very busy that night. I just hate to think if the fellow was stroking or having a CVA. Those 30 minutes would mean a lot. We were only *maybe* a 3 minute drive to the Cambridge Hospital ER.


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## Jon (Aug 26, 2008)

Doesn't CFD have a huge, "custom chassis" ambulance/rescue? WTF? (what's that for), if they don't transport?

Talk with CFD... they might have an idea about grants. Also - talk with your state representatives.


Also... I know Philadelphia has had times where the MFR engine companies have transported patients in engines when the system is overloaded... and Philly PD also has a habit of grabbing shooting/stabbing patients and taking them in in a "wagon" (van), if EMS isn't onscene "fast enough". In fact, many of the wagons have a reeves in them. Part of this is a throwback to the days before the FD provided EMS - if you were sick, PD took you in in the back of one of the wagons. PD also will use wagons to transport bodies if the ME isn't available to pick them up.


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## bstone (Aug 26, 2008)

Jon said:


> Doesn't CFD have a huge, "custom chassis" ambulance/rescue? WTF? (what's that for), if they don't transport?
> 
> Talk with CFD... they might have an idea about grants. Also - talk with your state representatives.
> 
> ...



Yeah the custom chassis beast is quite the sight to see. I always double take when it passes me and I see it quite often. I even asked them once what it was as after 6 years in EMS I had never seen anything like it. They just smiled.

I'll start digging into AED grants and resources. Thanks for the ideas.


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## fshguy (Aug 27, 2008)

Please let us know if you find anything.  I've also been asked to look into acquireing an AED for our church.

Thanks


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## bstone (Aug 27, 2008)

Well you're not going to believe this! (a good thing!)

I sent an email this morning to Professional Ambulance here in Cambridge telling them about the call, the delayed response and lack of any equipment. I asked could they possibly help with a BLS bag. I got a call about 30 minutes ago from the CEO of Pro, Bill Mergendahl. He pulled up the call on his computer, confirmed it was an extremely busy night in the area and said he'd look into the exact time of the call and response. He was shocked that we got no FD response as they respond to over 90% of 911 EMS calls.

On the topic of medical equipment he asked about the size of my synagogue, how many people attend, how old it is. I told him we are perhaps the oldest and largest Synagogue in the area with an average Sabbath attendance of 100+. He seemed impressed enough to then offer a BLS bag and Zoll AED!!!!!!! Free~~~!!! I AM REALLY IMPRESSED BY THIS FELLOW!!! He made a few suggestions for getting our congregants trained. One of the EMTs there on the night of this call is an AHA CPR instructor, so no issues there.

So, I guess it never hurts to ask! I am really impressed, again. The fellow said we'd be in touch over the next several days. I am sure we'll make a big deal out of this, with a press release and all as they are donating $2-3k of equipment to us. I invited him to come to the Synagogue and meet everyone and give us a little speech so we can get to know him and his company. 

Wow...just wow.


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## mikie (Aug 27, 2008)

well, as we say...

Mazel Tov!:beerchug:


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## Jon (Aug 28, 2008)

Mazel Tov... See... never hurts to ask.

Then again, Devils advocate says that this might be an attempt to butter you folks up so you don't go complain that it took WAY too long for an EMS response... and/or he saw an opportunity for easy PR.

But don't look a gift horse in the mouth, right!


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## bstone (Aug 28, 2008)

My friends at shul are also really impressed. I still am speechless about it. He was just such a nice guy who really does seem to have not gone "corporate", despite being the CEO.

Well, lchaims all around!


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## mikie (Aug 28, 2008)

bstone said:


> Well, lchaims all around!



I'll drink Manachevetz to that!


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## jordanfstop (Aug 28, 2008)

must be some hashgacha pratis 

maybe it's time to start your own hatzolah...


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## silvercat354726 (Aug 29, 2008)

Job done well!  Glad to hear your getting a helping hand on equipment.  I live in NY and I know during the summer Hatzolah is all around and is still here even in the winter but not as many.  Have you looked into Hatzolah?


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