MERRILLVILLE — Regionites are no strangers to wailing sirens and red flashing lights zipping through well-traveled roadways. But what is it like to be behind the wheel of an ambulance?
Superior Ambulance's Tristan DeFord, 911 contract manager, has walked into countless life-and-death situations in his career in the emergency medicine field. From gunshot victims to overdose calls, DeFord and his colleagues are ready for anything.
Superior Ambulance's staff in Merrillville have a unique dynamic. On top of being one of the most busy communities for Superior Ambulance, the paramedics and EMTs are housed in the Merrillville Fire Department. They work, eat, sleep and live alongside Merrillville firefighters in 24-hour shifts.
Their workplace has beds, showers, a kitchen and more to act as a home away from home while keeping watch for their next call.
The latest installment of Riding Shotgun with NWI Cops takes a different turn this episode by focusing on Northwest Indiana's EMTs and paramedics.
How long have you been in the emergency medical services field and how old were you when you started?
Just under 10 years. I was 20 years old.
Where did you start out at?
I actually started by doing an EMT program at Hobart High School, when I was still in high school. I went ahead and got my EMT certification shortly after that. Then I got a job at Superior in 2012 and worked as an EMT for four years and then became a paramedic. Becoming a paramedic is an additional 80 plus hours of training between the classroom, hospital and the ambulance. Passed that to become a paramedic and worked my way up to management in about a year and a half after that.
What sparked that initial interest to get into the field?
I just always had a want to help people, which drove my inspiration from a young age. I had a stepfather who was a paramedic. Growing up and seeing him out and about doing stuff, it made me want to do the same thing. I like the idea of helping people and getting to work on an ambulance and do something different. Every day it's different calls, different patients and you never really know what you’re going to get.
What was the first experience you had that lit a fire in you for this job?
That’s a tough one. Trying to think of some of the early 911 calls I had. I remember from a young age I was quiet, I never talked a lot and that’s what people kind of associated me with, as being that shy person. So trying to transition into a more authority role, like being in an ambulance and going into someone’s house to talk to them — that was really difficult for me.
Do you remember your first real day on the job?
It's funny because we have an EMT and a paramedic on the truck and the paramedic is the person in charge. So if you’re an EMT, you can stand by a little bit — you have the paramedic to tell you what to do. Transitioning into that paramedic role, you're in charge and you don’t have that safety net anymore. They're looking to you for that guidance and all of a sudden you’re in the hot seat. That was a big change for me to be the one in charge. I remember for the first few months; you're on your way to a 911 call for chest pain or difficulty breathing, and in my head, I'm going through every possible outcome because I don’t want to be caught off guard. So it's kind of nerve-wracking.
What's it like walking into life-and-death situations on a daily basis?
It sounds cliché but you get used to the job. You get used to seeing people at their worst unfortunately, or on their worst day, to put it better. A lot of 911 isn't the crazy stuff you see in television or in movies. A lot of it anymore is stuff that people can handle with a primary care physician but we still help them and direct them where they can go or how they can get better assistance, so it's not always that chaotic scene. It could be as simple as talking to someone about their medications or helping someone off the floor.
What does a day in your life look like?
As a contract manager, it's basically making sure all the ambulances and all of the crews have everything they need. So whether it's getting them equipment, answering their questions or helping them with their reports, I'm there basically to make their job easier.
What are some of the more major things you have dealt with in your career?
We've had multiple bad car accidents and those could be where there’s multiple different fire departments on scene and multiple ambulances, depending on the amount of patients. I've been at the scene of shootings like homicide scenes in the past, so that’s an example of some of the larger instances we have.
What’s it like going into a chaotic scene where there’s a lot of blood, or there’s a lot of things going on?
It can be a little nerve-wracking walking into intense situations. I think a lot of what gets us through it is that initial adrenaline rush. You're not really thinking about the emotional aspect right away or really whats going on. You're walking in with, “I got a job to do. I have to how many patients there are. I need to see how critical these patients are. How can I help them and get this situation more under control?" And then after the call is over, you get to start to decompress and think about it.
Do you guys have different jurisdictions like cops have?
Yeah, so we have different towns we have contracts with. But within those towns and those fire agencies, they have mutual aid agreements. For Merrillville, for instance, we have three ambulances serving Merrillville, and wherever those ambulances get dispatched per the fire department and per the Lake County dispatch center, then those ambulances go there. It's up to Lake County dispatch and Merrillville Fire Department to decide how to use them.
How would you describe what it's like, NWI being an amalgamation of all of these communities, working with everyone?
So NWI has a lot of different agencies, a lot of different fire services, police services, private ambulance services and various public entities. For the most part I think we have a good relationship working with all of them, when we get to the scene, whether it's another police agency on scene, never had any issues. Everyone is there to do the same job and help the public and I think that is what keeps our relationship good with everybody.
How would you describe working in Merrillville compared to the rest of the region?
I think Merrillville is our busiest contract, next to East Chicago. They’re very comparable as far as the call volume. Merrillville is a very diverse and dynamic community and it's growing. There’s a lot of businesses, there are a lot of car accidents because of the highway. Its just a wide variety of different calls while working out here.
What are some more interesting call types that come in?
So potential drug overdoses can be interesting, like people eating too many edibles. They’re not used to the feeling or they’ve taken too much. They're not prepared for how they're going to feel afterwards.
Have those kind of calls increased, with marijuana being legal in Illinois and Michigan?
So those calls have definitely increased as far as edibles and drug overdoses in the last few years. All of the different things coming in from across state lines.
What is it like dealing with people who are in a very altered state like that? Do they do strange things?
Oh goodness, yeah. So people that are on those drugs, they definitely have a different state of mind. They're hallucinating, they're taking to people that aren’t there. They're seeing things that aren’t there. Still a medically emergency, but can also be a little comical.
Are there any people who you repeatedly make contact with that you’ve been able to form a bond with?
Those tend to be our frequent lift assist patients. Someone will move into the neighborhood new and they'll have a hard time walking around or someone falls a lot and its not uncommon for us to go there two, three times a week, sometimes two or three times a day. So our folks get used to seeing these people very routinely. They know the code to their house to get in without having to look it up. They know their name and date of birth without having to ask them because they're there so often. So we definitely establish relationships with these people.
What’s it like building that relationship with people, especially the elderly population who may need help on a regular basis and almost being extended family?
I’d say you described it perfectly. We are extended family to some of these people who we are going to their house pretty routinely. We know them by name and we do see them more often than even their family members, especially with the pandemic. A lot of these people haven’t seen close family in over a year with everything going on.
How often do you hear of the outcomes of the patients you help and do they ever reach out after the fact?
We have means of being able to follow up to see how a patient is doing. We can reach out and contact the hospital. In particular, we like to do that a lot with severe car accidents, or traumatic injury calls where a patient might be flown out by helicopter or when it involves kids. Then we make sure to reach out to see what was the final outcome.
It helps resolve things with our crews to be able to tell them what ultimately transpired.
What is it like after your shift is done, do those things stick with you?
Every call is different and everyone processes every call different, so there's not necessarily one call that'll hit you harder than another. Because it's different for everybody. I would say something in general that is getting taken seriously in EMS as a whole is something called critical incident stress management. So anytime we have a severe call or a call that is a lot harder than normal, like a bad call involving a kid, it's something we are taking seriously and talk about as a group afterwards. We even have professionals come in to lead a group session and getting those feelings out. Because it doesn’t do anyone good to keep those things bottled in.
When did critical incident stress management start?
I’d say in the last 20 years it's become a lot more prominent than it used to. There used to be a mentality in EMS to suck it up and keep going. That this a job and this is what you're here to do, so get over it. But now we’ve learned we have to take better care of ourselves to take better care of everyone else. So it's something we take serious.
How would you describe what that self-care looks like with everybody here?
I’d say that a lot of our crews work 24-hour shifts — you really get to know the other people around you. So whether it's your partner or it’s a setting like this, where you are in the fire department and you have the fire guys here as well, you really get to know each other. And what that does is really creates a family dynamic. So if you have a bad call or something bad happens, you can tell if one of your family members is off or not doing well. I think we are all very good at reaching out or talking about it when we have an issue or something is going on.
What is it like being housed in a fire station? Because it's just East Chicago and here where Superior Ambulance is housed at a fire department.
It's only here where we have the fire guys with us. In East Chicago, we just have the fire department to ourselves. It's different but pretty cool, actually. Like I said, it's very much a family dynamic. With the fire department crew here and our Superior Ambulance crew, I don’t think they look at each other differently. They’re here to do the same job everyday.