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Ambulances see a lot of action in Isla Vista

Jack Crosbie

Ambulances see a lot of action in Isla Vista


You Drink, They’ll Drive

Inside Isla Vista’s Emergency Health-Care System


Saturday, November 16, 2013

“I’ve given up trying to predict when it’s going to be busy or not. When the call comes, we go out,” said Captain Mike Dalcerri.

It was just after 8:00 on Saturday night, and Capt. Dalcerri, a clean-shaven guy with a silvery-gray crew-cut and an encyclopedic knowledge of football trivia, was sitting in an armchair in the lounge area of Santa Barbara Country Fire Department’s Station 17, watching the final minutes of the Stanford-Northwestern game with the rest of A-shift. Station 17 is on Mesa Road, right next door to the UCPD complex behind Harder Stadium on UCSB’s campus. Despite Dalcerri’s lack of predictions, A-shift — Capt. Dalcerri, paramedic Al, student EMT Liam, and firemen/EMTs Fred, Hugh, and Alex — were fully aware they had a busy night ahead of them. Northwestern failed to convert on their last drive, and as Stanford took a knee to run out the clock, the room cleared out, with every man hitting their bunk for about an hour of sleep before the first alarm went off.

A paramedic gets ready for the next call-out
Click to enlarge photo

Jack Crosbie

A paramedic gets ready for the next call-out

Isla Vista’s reputation for alcohol abuse isn’t a secret — and neither are the all-too-often tragic consequences of student behavior. But night after night, weekend after weekend, shifts of firefighters, private paramedic crews with American Medical Response (AMR), and the nurses and doctors on call in the Goleta Valley and Santa Barbara Cottage hospitals do their best to pick up the slack and keep students safe from harm.

A-shift got about 45 minutes of sleep before the first alarm went off — two long pitches, then a four-note descending tone and the crackle of a 9-1-1 dispatcher reading out the call and location. The first call was early, preempting the typical weekend flood that begins at 11:00 or 11:15 p.m., so consistently “you can almost set your watch to it,” according to an off-duty captain relaxing in the lounge before his shift the following morning.

The engine went out and was met on-scene by an AMR ambulance, one of several that cover all calls in the Isla Vista area. Station 17’s two ambulances usually only go to on-campus calls, but all three firefighters on the engine are certified EMTs, and Al, who rode in the back seat with me behind the captain, is a full paramedic. “We’re kinda the ground floor, doing our best to package and support [the patient], but the ultimate goal is to get someone to the hospital,” said Dalcerri. “But we’re still able to do some top-of-the-line medicine.” The first call was routine, with an ETOH — medical shorthand for ethanol intoxication or overdose — patient in the back of an AMR ambulance and on their way to Goleta Valley within about 15 minutes.

The engine drove back, and Fred, who’s on his third 24-hour shift in as many days, reversed the semi-trailer-size vehicle into the garage effortlessly. The men slipped out of their ready-ups, and went straight back to bed. They repeated this process 10 more times over the course of the night.

Other calls weren’t as smooth. The engine’s second trip into I.V. had to go deep, all the way to the 6600 block of Del Playa Drive, and was slowed down by crowds of students, one of whom deliberately stalled the engine, dancing in front of it and blocking its progress. Fred and the captain, up front, spotted a couple of cops and cheered them on as they chased down the obstructing dancer and slapped cuffs on him. “It’s getting really bad — the respect is just gone,” Dalcerri remarked later.

A peek inside the emergency room before patients start rolling in
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Jack Crosbie

A peek inside the emergency room before patients start rolling in

On scene, there was pandemonium. Law enforcement officers responded first, talking to residents of the house that the call came from. The firefighters headed upstairs with their gear and returned in a few minutes, carrying a patient — by which time the cops downstairs had broken up a fight and were trying to make room for the AMR team to get a gurney through.

As the first patient was loaded in the AMR van, Al came downstairs with a second patient, who also went in the ambulance. Friends of one of the patients protested, saying that she didn’t need to go, that she was fine. But it was completely impossible to discern who the original call referred to, and neither patient could pass the firefighters basic tests of mental status — usually simple questions like name, location, and birthday — which Al said is “really what’s going to determine whether we take them to the hospital or not.”

“At that point, we’re bound by law,” Dalcerri said. “We can’t leave anyone alone that can’t care for themselves … they say, ‘Well, she’s gonna get in trouble with her mom.’ Well, she shoulda thought about that before she took 20 shots.” On the street, people were yelling, and two more kids got cuffed when they tried to push past the cops surrounding the ambulance and get to their friend. Dalcerri and the firefighters just walked away. “We usually don’t take that much flak,” he said.

The ambulance ride to Goleta Valley doesn’t take long — depending on how busy the Emergency Department (ED) is, the wait for a bed can be longer. On particularly busy nights, especially during Halloween weekend or “Deltopia” (the latter of which resulted in 75 calls for assistance in a single 12-hour period last April — Engine 17 took 17 calls, and Engine 18 came all the way down from Gaviota to assist), an extra room outside the ED is opened up, where groups of patients can be monitored en masse once the nine regular beds fill up. Though the line of waiting gurneys sometimes stacks up two or three deep at the door, the inpatients eventually find beds. Care for the standard ETOH cases is pretty simple — usually just administering water and monitoring vital signs, including making sure that if patients vomit, they do so in a safe position that keeps the airway clear. “We pride ourselves on being able to take care of the UCSB kids,” said Michael Coombs, a clinical nurse in the ED.

On the streets, a high volume of calls brings engines 11 and 14 — and sometimes even the department’s full-size ladder truck, an ungainly vehicle in I.V.’s crowds — out of their coverage area to cope with the students. “That’s the bummer: All these kids aren’t taxpayers,” Dalcerri said, “so all the people in Goleta are out of service.”

Physicians strategize for the long night ahead
Click to enlarge photo

Jack Crosbie

Physicians strategize for the long night ahead

Back in the ED, staff kept an eye on flat-screen monitors mounted on the walls that display patient details and conditions color-coded by severity and urgency. While specific patient statistics, like the number of ETOH cases, are confidential, Goleta Valley’s ED took in 58 and 75 patients September 27 and 28, respectively, the first full weekend UCSB was in session. On last Spring’s “Deltopia” weekend, April 6 and 7, the ED handled 92 and 89 patients, respectively.

“Yep, we’re getting pretty saturated … been like that all day,” said Dr. James Mitchell, the physician in charge for the night. [Note: Reporting at Goleta Valley Cottage Hospital took place one week prior to reporter Jack Crosbie’s ride-along with SBCFD.] It was still before midnight, and the nine ED beds were full, mostly from fresh admits from I.V. Mitchell, a 20-year veteran of Santa Barbara’s Emergency Departments, has the cheerfully sarcastic nonchalance of someone who’s seen everything in front of him before. “This I don’t mind,” he said, referring to his current lineup of mostly ETOH cases.

Later, night supervisor Mary Jo Terrill echoed his sentiment. “It’s only bad when they start spitting and swearing and trying to hit you,” she said. “We have a great staff here, every single person is dedicated and hardworking and even-tempered. They don’t complain; they just keep meeting each patient and getting the job done.”

When asked how she gets through the bad nights, Terrill whispered, “Coca-Cola.” Sometime during the night, a scribe puts a Coke on Dr. Mitchell’s desk. He doesn’t manage to get to it before I leave. On my way out, at just after 12:30 a.m., I saw Coombs holding a bedpan in front of a vomiting patient.

“Don’t leave now!” He said. “You’ll miss all the fun!”

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