Working as an emergency medical technician in a Los Angeles suburb, Paula De La Cruz has encountered her share of drama on the job. On Christmas Eve 2018, for example, De La Cruz and her partner treated four people in cardiac arrest, an unusually high number for one shift. Thankfully, three of the four survived.
With the advent of the COVID-19 pandemic, once-routine tasks are now fraught with life-threatening danger.
Case in point: In April, a few weeks into the crisis, De La Cruz and her partner had to “hold a wall” at a hospital for a COVID-19 patient. In EMT-hospital parlance, that meant they had to take care of their patient inside their ambulance until a bed was available. This patient was an older person with dementia. The patient wore an oxygen mask — technically a nasal cannula — but was confused and kept taking it off. That meant De La Cruz needed to lean in close repeatedly to replace it — putting herself at risk of being infected by the novel coronavirus that causes COVID-19.
“The patient had a lot of questions and did not understand the need to keep the mask on,” she says. “I had to keep putting it back on. The patient needed to spit up phlegm, and I needed to help clean it up. I must have gone through a whole box of gloves.”
[Read: Unsung Heroes Fight the COVID-19 Pandemic.]
Aside from brief breaks to get fresh air, De La Cruz stayed inside the ambulance’s patient compartment with the ailing person for about five hours, until a hospital bed became available.
“It was very difficult,” she says. “The pandemic’s made everything more stressful.”
De La Cruz, 44, has been working as an EMT for a private ambulance company for two-and-a-half years. She lives and works in Covina, a suburban community she grew up in, about 22 miles east of Los Angeles. In her 20s and 30s, De La Cruz worked a series of bartending and waitressing jobs, which allowed her to have flexible hours so she could be with her three kids during the day. Her husband, the kids’ father, worked during the day and took care of their kids at night.
Once her kids were were old enough to not need her constant daytime presence, De La Cruz decided to launch a career as an EMT. Her late father had been a firefighter, and she admired first responders. The blend of excitement and the opportunity to jump into different situations to assist people attracted her to the job.
“I really was drawn to helping people and the dynamic nature of emergency medical services,” De La Cruz says. “It’s different every day.”
Before the pandemic, De La Cruz and her partner responded to a wide array of cases. “We’d run basic calls, ranging from helping people with tummy aches and flu-like symptoms to more serious calls like cardiac arrests and diabetic incidents,” she says. “We’d respond to psychiatric calls, in which people are ordered held for 72 hours if they’re determined to be a danger to themselves or others.”
In March, De La Cruz and her colleagues received online training on how to respond to COVID-19 patients. They were provided personal protective equipment, including N95 masks and full gowns.
De La Cruz and her co-workers prepared mentally to rush to the front lines of the crisis. But for a couple of weeks, there was little to do. Most residents followed California Gov. Gavin Newsom’s shelter-in-place order, leaving De La Cruz and her co-workers with few calls to answer initially.
“The traffic on the freeways and on the streets was gone,” she says. “Nobody was on the road. It was kind of nice, but eerie at the same time. Everybody was staying home. We weren’t getting trivial calls.”
By late April, things started to pick up, and De La Cruz and her partner routinely responded to calls for help from people who had or were suspected of having COVID-19.
While California initially had success in slowing the rate of infections, the state has become a hot spot in recent weeks as cases have spiked. In response, Newsom has re-closed some businesses that he’d allowed to reopen.
De La Cruz typically works a 24-hour shift, during which she and her partner will typically respond to seven to 14 calls. De La Cruz estimates that more than half are for COVID-19 patients.
The COVID-19 pandemic has prompted EMTs and the Los Angeles County firefighters who typically respond to calls for medical assistance to improvise.
For example, many of the calls to assist COVID-19 cases have come from a convalescent home, where older people, many of whom have underlying health problems, are recuperating from being hospitalized. Beginning in about late April, firefighters began calling hospital staff to have them roll COVID-19 patients in their beds outdoors, to cut down the risk that first responders would be exposed to the novel coronavirus.
Staff members wheel these patients to the front of the convalescent facility, where De La Cruz and her colleagues quickly pick them up and put them onto a gurney, which they place into the patient compartment of the ambulance.
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“It was weird at first having them bring the patients outside, but it was very much appreciated because it prevents us from having to go inside and breathe the air that infected people have been breathing,” she says. It’s also better for patients, because they aren’t exposed to emergency first responders who may have been exposed to the virus.
De La Cruz and her colleagues would sometimes have to work quickly. For example, if a patient was on a ventilator, the EMTs would have to unplug the device and quickly hook up a device known as a bag valve mask, which provides oxygen, to the trache, or tube, the patient has in his or her windpipe. EMTs complete such a maneuver in seconds, De La Cruz says.
One patient, who De La Cruz and her partner picked up at a private home, stands out. The patient was about 40 — about the same age as De La Cruz — with no underlying health conditions. The person “had a hard time breathing,” she says. “The patient had a fever and body aches, we were pretty sure it was COVID-19. When you see it firsthand, someone very similar to yourself, you realize, ‘Oh, there’s a chance I can get it.'”
That’s what happened just after Fourth of July.
On July 6, De La Cruz began suffering from body aches, a cough, congestion and a probable fever (she couldn’t find a thermometer at home). She, her husband and her oldest son went to a county testing site, and the three tested positive for COVID-19.
“My son got it first, he started coughing on a Saturday,” she says. “I came down with symptoms the following Monday. Did I bring the virus home to my family? There’s no way of knowing. With my job, I might have been exposed.”
Since she fell ill, De La Cruz has been on leave from her job. Her symptoms have remained mild, but she still feels tired and has a dull headache. During a recent telehealth appointment her physician advised her to take a few more days off, she says.
Knowing she’s infected raises new questions: How long will her antibodies provide her protection from reinfection? When can she be around other people without posing a threat to infecting them?
“I’m trying to stay on the positive side,” she says. “I try not to watch too much news. I think there are still so many unknowns, and a lot of disinformation is possible. I try to stay as positive as possible. This is a mild illness for most people but it’s serious for some. I take it seriously and try to be as careful as I can be.”
[See: Coronavirus Prevention Steps That Do or Do Not Work.]
Her bout with COVID-19 hasn’t dampened De La Cruz’s resolve to get back to work.
“We choose to be in this profession to help others,” she says. “We know there’s a need out there. We also have to take care of ourselves first, we’re not useful to anyone else if we’re not well. I have a sense of urgency to get back to work because I know I’m needed.”
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EMT in COVID-19 Hot Zone: ‘I Know I’m Needed’ originally appeared on usnews.com
