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- <text id=90TT1394>
- <title>
- May 28, 1990: A Hard Day's Night In L.A.
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1990
- May 28, 1990 Emergency!
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- MEDICINE, Page 62
- A Hard Day's Night in L.A.
- </hdr>
- <body>
- <p> Frantic family members and blinking squad-car lights
- surrounded Antonio Ramirez. Knocked down by a passing pickup
- truck, the six-year-old boy screamed in pain as he lay on a
- curbside patch of grass in a south Los Angeles County barrio.
- For paramedics Edwin St. Andrew, 27, and Walter Tayenaka, 32,
- summoned to an "unknown T.C." (traffic collision), the moment
- was routine yet unnerving. The boy briefly lost consciousness
- and appeared to have broken bones. They had to move him quickly
- to a hospital. "You never know about kids," explained St.
- Andrew. "They seem to be doing well, and suddenly they just
- drop."
- </p>
- <p> St. Andrew and Tayenaka work for Paramedic Squadron 39 of
- the Los Angeles County Fire Department, a unit that serves a
- working-class white and Hispanic area within comfortable reach
- of five hospital emergency rooms. But as time passes each day,
- one E.R. after another claims saturation and closes down.
- Paramedics with life-and-death cases must sometimes beg or
- bluff their way in. Equally frustrating, trauma-care capability
- gets entangled with the community's demand for street medicine.
- High-speed runs for "unknown rescue" all too often involve
- nothing more than cut fingers, headaches and family hysteria.
- </p>
- <p> Little Tony Ramirez seemed to be in serious trouble.
- Wrapping the boy in head-to-knee flexible braces to keep his
- spine straight, technicians gingerly placed him in the
- ambulance. It left the scene at 7:05 p.m., just 13 minutes
- after St. Andrew and Tayenaka got the call. St. Andrew
- monitored Tony's blood pressure while he cradled a portable
- phone and asked a county trauma center for permission to bring
- in the case. He tried to insert an IV needle, but the boy, who
- spoke no English, cried and resisted. "No moveas," St. Andrew
- cajoled in semi-Spanish. An impatient nurse on the phone
- demanded a blood-pressure reading. Suddenly Tony stopped
- crying. St. Andrew shook him gently: "Antonio, Antonio!" The
- boy began to wail again. Everything was chaotically routine.
- Hospital tests eventually showed that Tony had neither head
- injuries nor broken bones.
- </p>
- <p> The radio barked again while St. Andrew and Tayenaka were
- still in the parking lot, and they took off at top speed.
- Arriving with the siren blaring, they found a man who had cut
- his hand in a minor traffic accident and wanted hospital care.
- A county-contracted private ambulance took the case. "He'll get
- a bill," said Tayenaka, "but nobody pays." Later a drunken
- partygoer fell and cut his head slightly; he wanted an
- ambulance too.
- </p>
- <p> At 8:05 p.m., retired landscape gardener Robert McKinney,
- 76, sat shaky and pale in a room full of firemen. As paramedics
- attached red EKG clips to his chest, McKinney explained in a
- raspy voice that he had got out of bed at 1 a.m.--19 hours
- earlier--and had been struggling to breathe ever since. His
- blood pressure was an alarming 200 over 140 (120 over 80 is
- normal). Such severe hypertension can impair lung function and
- lead to congestive heart failure. McKinney's EKG showed an
- irregular, rapid heartbeat.
- </p>
- <p> In the ambulance St. Andrew turned on oxygen, spritzed
- nitroglycerin under McKinney's tongue to relieve the
- hypertension and potential heart problems, and briefed a
- hospital over the phone. He warned McKinney to be ready for "a
- stick," then put in the IV needle to administer the diuretic
- drug Lasix, which dilates blood vessels. McKinney rallied as
- his pressure slipped down to 164 over 120. "I was scared," he
- admitted hoarsely. "I didn't think I'd make it." He did.
- </p>
- <p> "I'm so sick! I'm so sick!" wailed Mona Aguayo as the
- paramedics entered her tiny bedroom at 1:30 a.m. Observed St.
- Andrew: "She's 96 years old, maybe senile, hurts all over. But
- basically she's healthy." Carried out by burly firemen, Aguayo
- seemed like a wounded bird with her thin, angular features,
- frightened eyes and short silver hair. "My hands! My hands!"
- she cried. She began to vomit as the ambulance sped toward
- Santa Marta Hospital, the last "open" emergency room of the
- night. But her pain and terror were apparently caused by
- hysteria. The woman was sent home within hours.
- </p>
- <p> St. Andrew and Tayenaka remember the night they forced a
- local community hospital to admit a man who was gushing blood
- from a bullet wound to the neck. The sophisticated county
- trauma centers were closed; a less-equipped emergency room at
- Downey Community Hospital, six minutes away, was full. The
- paramedics were ordered to St. Francis Medical Center, twice
- the distance. They went instead to Downey, and the man survived
- the night. "I know the situation," said St. Andrew. "I'd pay
- extra taxes to keep the trauma centers open. I want one
- available if my kid is hurt."
- </p>
- <p>By James Willwerth/Los Angeles.
- </p>
-
- </body>
- </article>
- </text>
-
-