On rescue missions through the snow Teamwork, ingenuity get hundreds of patients to dialysis treatments

Blizzard Of 1996

January 11, 1996|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

With the wind whipping flecks of wet snow against their faces, the paramedics slowly edged down the narrow stairs of the Northwest Baltimore rowhouse, carrying Ruth Bond in a portable stretcher.

The ambulance sat a block away, down a street covered in almost 3 feet of untouched snow. After several failed attempts to get the ambulance closer to Mrs. Bond's house in the 2800 block of Woodbrook Ave., a futile try to get her out of the house in a chair, and finally, a summons for another crew to help carry her out, the journey was about to begin.

It was one of many tough trips this week for those trying to get hundreds of dialysis patients to the treatment that keeps them alive.

"Got your hat on tight, Mom?" Paula Bond called to her 67-year-old mother. "Pretend you're going camping!"

The street was quiet. The paramedics' blue jackets and the stretcher's orange vinyl were bright against the new snow. Emergency medical technician Charles Klump kept repeating, "Take it easy," as they negotiated knee-deep drifts that twice tripped up one of the medics. The others picked up the slack in time to prevent the stretcher carrying Mrs. Bond from plunging into the snow.

Neighbors on their stoops watched the strange procession.

"It might be scary, but we're not going to let you fall," Mr. Klump told Mrs. Bond, who is paralyzed and has diabetes and rheumatoid arthritis.

She needs dialysis, a process that cleanses her blood of toxins and other fluids, since her kidneys no longer do the job. Without dialysis, the body's waste products build up and systems start to fail. Patients get confused. Their bodies swell. They can die.

One Baltimore woman was comatose when drivers arrived yesterday morning to bring her to dialysis. A city health staff member had to explain to her son how to keep her airway open, and then he carried her to one of the cars hired by the city to transport patients. That driver got her to the corner, where the ambulance waited. The woman was hospitalized in critical condition.

Setting priorities

To handle the mounting backlog of patients, local officials Tuesday night drew up their priority lists. The plan: The sickest would get dialysis first, but only an abbreviated, two-hour treatment, to make room for all the other patients, dozens of whom were terrified, frantic they wouldn't get the treatment in time.

Many of these patients, who are typically older and often have complicating conditions, regularly need transportation to the nearly 30 Baltimore-area dialysis centers. Getting them there this week has required teamwork and ingenuity.

Henry Foertschbeck, 76, wanted to get to dialysis so badly Monday that he hitchhiked through the blizzard from his Highlandtown home to downtown. He managed to get the treatment and then got a lift with a pizza deliveryman -- going along for several deliveries. When he was dropped off at home, eight hours after he had started out, he tried to pay his benefactor.

"He shook my hand and said, 'Merry Christmas,' " Mr. Foertschbeck said, crying. "It was sort of a miracle on a day like that."

Another patient, a woman, rode in on a firetruck.

The Baltimore City Health Department's Field Health Services unit coordinates the transportation of about 900 Medicaid patients a day to dialysis, chemotherapy and other medical treatments. But with the storm, the department also has been offering free services to at least 150 people with other health insurance who couldn't get to the dialysis centers on their own.

"We will just keep on trucking," said Irene Lumpkins, who oversees the city's medical transportation. On Tuesday, her staff, along with subcontractor Yellow Transportation Services, got 300 patients to dialysis and back.

Yesterday, armed with a thick computer printout listing dialysis patients, their addresses and the nearest major intersections, Ms. Lumpkins directed the traffic.

"Hello Storm Central, I need Mikey," she demanded, telling the Department of Public Works which streets needed to be plowed immediately because of patients in life-threatening situations.

Singing "Jingle Bells" in a rare spare moment, tapping out phone numbers with her long fingernails by memory, she rapidly answered questions, often in her own slang. "Ambo" means ambulance. A call of "Toyota!" means "You want it, you got it."

"I have a woman crashing. I need you now," she said firmly.

From 8 a.m. yesterday, all seven lines into the command center rang continually. By 9:30 a.m., paramedic Charles Dwyer, who had to put people on hold just so he could take a moment to sneeze, had already assured dozens of worried and sometimes angry patients. Hanging up the phone, he pushed back his cap. "Holy moly. Who has the Anacin today?"

Ms. Lumpkins calmed patients, calling one at home late Tuesday because the woman was devastated that she wasn't going to get to treatment until yesterday. When crews did arrive to pick her up, the ambulance slid into a utility truck, but they soon managed to get her to the clinic.

"Their biggest concern is that they'll be forgotten," Ms. Lumpkins said.

Complicating her job is the fact that many of the patients she oversees are elderly and weak, so their sidewalks and steps are rarely shoveled. Some, such as Mrs. Bond, are bedridden or in wheelchairs, so crews have to carry them by stretcher.

Mrs. Bond's rescue mission took two hours.

'It's terrible'

"It's terrible. It's taking three to four times the amount of time for this call alone," said Molly Gardner, one of the emergency medical technicians.

When the huffing paramedics took a short break, lowering the stretcher to the ice, Mrs. Bond looked up and told Mr. Klump: "Boy, you are so tall."

Finally, they loaded her into the back of the ambulance.

That's when the driver discovered the battery was dead.

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