National Night Out is a good opportunity to get to know the people providing community services such as fire, police, and rescue. In our town, the police have a squad car for examination, plus a table touting the DARE program (with simulated examples of illegal drugs), a fire-department truck (this year, a ladder truck), a Rescue Squad ambulance, a vehicle or two from the county SWAT team, and free burgers and hot dogs. It's one of the rare occasions for which our residents come out in full force.
Last year I asked the police and the rescue squad about their training regarding people with diabetes -- specifically, people going hypoglycemic. The first-responder protocol for our state (New Jersey) starts with a call to 911, at which time either the local fire department or the local (volunteer) Rescue Squad is dispatched (locality, availability, and time of day determine which). These folk have "basic EMT" training -- which means they can handle most wound emergencies and perform basic life support (CPR, portable AED, etc.). They are NOT licensed to handle diabetes-related emergencies -- they are not allowed to help you test your blood glucose, or to give you any sort of emergency sugar if you're low (if you are sufficiently responsive, though, they are allowed to help you to get to your own stash). If the first responders encounter an emergency beyond their training, they must call to the nearest hospital for the (professional) paramedics.
Please note that this is what I've been told is the response protocol for Somerset County, New Jersey. Your state, or your locality, may have a different protocol. Please take the time to become familiar with the emergency-response protocols for your area.
About this time last year, after many community protests, the most-local hospital to us (one town over) closed. The next-nearest hospitals are each three or four towns away. While asking one of our firemen about some of the specialty saws in the ladder truck, I asked how the closure of the local hospital affected their medical-emergency response. The short story is that there is still (thankfully!) a paramedic unit based out of the now-closed hospital, but that transfer to an appropriate emergency room now takes about twice as long as it previously did. The longer story is that in New Jersey, only paramedics can treat people who need emergency glucagon or -- even worse -- emergency epinephrine (e.g. to treat an anaphylactic peanut allergy). And if -- as we were taught in high school -- brain function starts to die within four minutes of lack of air, even a five-minute delay is significant. This is one reason why both Fireman Rob and I believe that Basic EMT training should include certification to use glucometers, epi pens, and glucagon when a patient has them available.
There's a longer story here, too. Fireman Rob mentioned that when a 911 call comes in and the caller states explicitly that the person needing assistance has diabetes, severe allergies, or any other condition that is likely to need the advanced certifications of a paramedic, a paramedic unit will be dispatched at the same time as the rescue squad. While this is not as ideal a situation as having someone on site who can work an epi-pen or glucagon kit, or a first responder who is qualified to do that, it's much better than having the rescue squad arrive first, determine that one of these conditions is involved, and then first call for paramedic back-up.
The bottom line here is, always tell 911 you have diabetes. Train the people most likely to be near you in an emergency to tell 911 that you have diabetes. (Or, if you have one, an anaphylactic allergy). Where seconds and minutes count, it could be a matter of life and death.
