THUNDER BAY — No evening is ever truly typical for paramedics with Superior North EMS.
On Wednesday night, Dougall Media was granted special access to tag along with two Superior North EMS paramedics for part of their shift to see a snapshot of what goes on during their downtime and on the city's busy streets.
Meeting at the main EMS base on Junot Avenue, acting superintendent Nolan Raynak described what the new priority dispatch system has been like since its launch on Jan. 24.
A colour-coded graph shows how many ambulances are available, with green indicating a lot of ambulance availability.
"Then yellow is like getting to a critical mass where we're starting to lose ambulances. Red is when we have one or two trucks available, and then black, that's when we don't have any ambulances available for the city."
The new system started last month, which will help prioritize calls and their severity, alleviate congestion during hospital off-load wait times, and will also help ensure paramedics get breaks and mealtimes during their shifts.
After a short time on Junot Avenue, paramedics Dawn Martyniuk and Colin Cuconato were dispatched to the Vickers Street fire hall as a mobile unit to be in the neighbourhood in the event a call for service occurred.
Typically, on arrival to Vickers Street, paramedics are often dispatched right away.
However, Wednesday night proved to be an anomaly.
Martyniuk has been a paramedic in the city for 21 years, and in the last three years of covering the 11 am to 11 pm shift, she's noted multiple times where they often don't get out of their ambulance, known as a rig, as a call for service pulls them back onto the road because of how busy the Vickers Street station can be.
With 12 years on the job, Colin Cuconato talked about the students who attend ride-along with them and that not everyone who starts the paramedic program is cut out for the job.
"You can be book smart - you can know your directives inside and out. But I think the biggest thing is that if you don't know how to talk to people and if you don't want to talk to people and apply your training with that, then it's not for you."
Cuconato was roughly 19 years old when he started in the field. He said having a bedside manner and being confident on the job are both beneficial in succeeding in this work.
"It was the biggest thing for me - being 19, 20 years old when I first started. I'm talking to a grown man, you know what I mean? That was the biggest thing for me."
Cuconato added having life experience helps in this kind of job. "It's definitely easier for someone to come in with life experience versus starting as a kid."
In an effort to see what the job as a paramedic in the City of Thunder Bay is like, both Cuconato and Martyniuk decided to go "mobile."
This means they can drive the ambulance around their designated zone and respond to calls for service if they come in or assist individuals they come across during their time on the road.
Shortly after leaving the Vickers Street base, a call for service came in - a VSA, meaning "vital signs absent" - with the dispatcher adding it could be a possible drug overdose based on information received on the scene.
Driving to the scene, Cuconato initiates lights and sirens on the ambulance and heads to an address in Westfort.
It's to be noted that riding in the back of an ambulance is not for the comfort of a bystander. Instead, it is outfitted for safety and efficiency in treating patients.
There are many well-placed storage and cargo spaces, cupboards, drawers and surfaces designed to hold various medical supplies, equipment, ventilation and tethers to keep paramedics and patients safe.
Once at the scene, both paramedics jump into action and unload their kits and the gurney.
Tailing in a supervisor car, Raynak arrives since he is trained as an advanced care paramedic - specifically for cardiovascular and respiratory ailments and he can provide pre-hospital life support.
This higher level of paramedicine also allows trained workers to administer upwards of 20 types of medications before arriving at the hospital.
Arriving at the scene within seconds is a secondary ambulance, a fire truck and later a second police car.
The additional individuals file into the home, where the scene is accessed and only the original three paramedics are needed. The extra EMS and firefighters are dismissed back to their respective bases.
After some time inside the residence, a patient is brought outside on the gurney, where they are wrapped in a blanket and loaded into the ambulance.
On the way to the hospital, the lights and sirens on the ambulance were not activated because the patient was stable - as well as out of safety for the paramedics and other drivers on the roadways.
In the supervisor's car following the ambulance to the regional hospital, Raynak spoke about the steep increase he's seen in drug use over his career, even before the pandemic.
"Prior to COVID, mental health everywhere was terrible. But, in the last five years, the opioid overdoses in the city have been unbelievable," he said.
"In the previous 10 years before that, I did one overdose, and it was an old person who took the wrong long-acting medication. And now there's one or two every single shift."
He's also noticed there are more deaths of young adults happening because of suspected overdoses.
"The biggest change I think you see is the amount of young adult deaths now," he said.
"It's actually surprising - you'd hear a 28-year-old cardiac arrest before, and you'd be like, 'ok, that seems really weird.' Now, that's commonplace because of overdoses. It's unbelievable."
Paramedics also see a lot of the city's violence firsthand, something that Raynak has seen an increase in during his 15 years on the job.
"I had never been to a shooting in the first 12-13 years of my career," he said.
But then, all of a sudden, he had attended four shootings in a year.
"It sounds crazy, but it's so obvious when you're going to more than one gunshot call in a year, and you're like, 'Oh yeah, I've never actually thought I would see that.' I've seen three people that have been shot five times, and those are people that survived. It's crazy."
Raynak called it a concerning trend and said it does affect how he does his job.
"When you are newer, you have a hard time grasping at other things in your environment just because you're so hyper-focused and you're so green, and you're so focused on what you're doing.
"But after some time, you start to really take in what's happening around you, which is good."
When attending a violence-based call and treating a patient, paramedics must be cognizant of their surroundings for their own safety as well as for the safety of the patient.
The paramedic recalled a time he was responding to a stabbing call earlier in his career.
"Me and my partner, a couple of years ago, went to a guy that was stabbed - he was VSA. We were the first ones there, and I found out after that the guy who stabbed him was right behind the door in front of us. It's a concerning trend."
Once at the hospital, paramedics prepare to offload the patient so they can be triaged by hospital staff.
A nurse takes the critical but minimal information available on the patient and attempts to speak with them, but is unable to because the previous doses of Narcan that were administered at the scene are now taking effect.
Once the patient is brought into the hospital, the paramedics' role is wrapping up and becoming more administrative.
They'll fill out various shift reports and paperwork at the hospital and EMS base - restock any needed supplies, clean up the back of the ambulance and get ready to return to the road before the end of their shift.
Paramedics are on the clock up until the second their shift ends. However, oftentimes a call will come in near the end of their day and put them into overtime.
While the short period of time spent in the ambulance wasn't completely filled with lights and sirens, it was an opportunity to see who some of the city's paramedics are as community members and how they help people. It was also a chance to see what happens inside the ambulance bay and the rigs.
