Not just a stretcher-bearer

Henriette Lamprecht - As a flight paramedic she’s undertaken flights to many parts of Namibia, as well as to Botswana, Angola and South Africa. She’s also had to relocate patients to France, Switzerland, Germany and Belgium.

This saw her dealing with patients with a wide range of conditions: broken legs, arms and feet, heart attacks, breathing difficulties and more.

There is a general lack of understanding and knowledge about the role and abilities of paramedics among traditional medical staff (i.e doctors, nurses etc.) in Namibia, says Tara-Leigh Ciolek.

“We’re not just ambulance drivers or stretcher-bearers. As a young female Advanced Life Support Paramedic, I sometimes find it very hard to convince the medical professionals of my level of training and abilities, as they underestimate the capabilities of paramedics,” she says.

There is also the trauma of “very tragic or disturbing calls” she’s had to deal with.

“Sometimes things I’ve seen can be very hard to deal with after the call is done and I’m off duty,” she admits.

The best part of her job is the difference she makes in patients' lives.

“Successfully treating a patient is the best feeling ever – especially when the case is a difficult one.”

Tara-Leigh explains paramedics have their roots in the military where the need for fast on-site medical treatment was realised to save the lives of wounded servicemen. This role was later transferred to civilian services.

“Modern paramedics are trained to respond to emergencies in order to provide medical treatment to injured, sick or ill people and to stabilise them for safe transport to medical facilities.”

As paramedics work in the field away from normal medical facilities, they are forced to work with the bare minimum in terms of equipment, says Tara-Leigh.

“All of which has to be portable and carried to and from the patient by the paramedic team. We are trained to diagnose and treat emergency life-threatening injuries and conditions with the goal of ensuring the patient is stabilised enough to be safely loaded and transported to a hospital. The wish of every paramedic is to deliver their patient to a hospital alive no matter the circumstances.”

There are a number of different paramedic qualifications, each trained to different levels of care with different skills and levels of advancements. This includes Basic Life Support, Intermediate Life Support, Emergency Care Technician, Advanced Life Support and ultimately a Paramedic Doctor.

“It is important to remember many of the skills or techniques used by advanced paramedics include being fast and efficient. This differs from the way a doctor would treat a patient in hospital.

“In a pre-hospital emergency setting, we often don’t have the luxury of time, space or fancy equipment.”

A flight paramedic differs from other paramedics, says Tara-Leigh.

“Flight paramedics respond to their patients by air, using either aeroplanes or helicopters. This means they have to consider extra conditions such as changes in air pressure and density, the longer distances or transfer periods, as well as the noise and vibration of the aircraft – all of which could affect a patient.”

Many paramedics fly and do ambulance calls “on road" as well, she explains.

“I have tried to specialise in being a flight paramedic only, as there is a need for this in Namibia.”

Tara-Leigh’s job involves transporting patients by private air ambulance - either fetching them directly from an accident scene or a remote location, and being the first medical care for the patient, alternatively transporting patients in need of advanced care from small hospitals and clinics to bigger hospitals with specialist facilities.

“Flight paramedics also transport patients on commercial airlines, usually done for intercontinental flights. However, this depends on the condition of the patient, the treatment required and the rules of the various airlines.”

Currently Namibia and South Africa do not have specialised courses for flight paramedics yet, although the basics of emergency flight medicine are covered in the Bachelor EMC course at the Namibia University of Science and Technology (NUST).

“In addition to this, I also did some of my training in South Africa, which even included jumping into the sea from a helicopter hovering at 30 m and being lifted from the sea and taken ashore in a sling under the aircraft! I’ve also done helicopter underwater escape training.”

A lot of a flight paramedic’s training happens after one qualifies as an ALS (Advanced Life Support) paramedic, with aircraft safety sessions for the different aircraft types and the different operating procedures of the aircraft operators, says Tara-Leigh.

While treating a patient in flight one is generally focused on providing the best possible care and treatment, which can keep one very busy, leaving no time for nerves, she says.

“I love flying so I’m less nervous about that aspect than some people, and I think that helps.”

Paramedics generally work in teams of two or three, with one medic monitoring and assessing the patient while the other prepares and administers treatment, explains Tara-Leigh.

“Teamwork is a vital part of the job and you have to be able to rely on the other members of the team. Pilots also form part of the team and as a flight paramedic you have to be able to trust and rely on them to handle the aircraft.”

Tara-Leigh studied for five years and has now been working as a paramedic for two and a half years, doing more and more flights having chosen to specialise in this underdeveloped section of emergency transport. She recalls her most difficult case as a patient with a severe head injury, who was completely disorientated and confused.

“I was on my own on that flight and it was pretty stressful continuously having to try and calm the patient while at the same time monitoring his condition and keeping him stabilised.”

According to Tara-Leigh a flight paramedic needs to be adaptable, as one never knows what scene one will be called out to.

“A patient’s condition can change rapidly once in the air. You always have to be willing to learn and to keep up with new methods and practices.”

Paramedics should have a strong belief in their abilities and have self-confidence, Tara-Leigh emphasises.

“The ability to work in small, noisy spaces and remain focused is also high on the list. A love of flying helps as you will spend hours in the back of planes. Having patience is also definitely a virtue, as a good paramedic spends many hours waiting!”

Tara-Leigh’s dream for the future is the existence of a 24-hour specialised air ambulance service in Namibia, doing more than just basic air transfers.

“To be more of a first, rapid response medical service to make sure patients are reached and treated quickly and then transported to a hospital safely.

“With huge distances in Namibia and very few hospitals, this can only be properly done by air with flight paramedics in modern aircraft specifically equipped as air ambulances.”

Currently there are long delays in approving and arranging medical flights and not all the aircraft are fully equipped, says Tara-Leigh.

“As a result, it is sadly often quicker to transport patients by road, which is not ideal, as delays can adversely affect the outcome for patients. The loss of any patient is tragic.”