Cool head under pressure

Ian Santee stays focused and calm when responding to medical-emergency calls

Ian Santee Title: Paramedic, college instructor Job: Provides pre-hospital life-support care to patients in need, and teaches medical skills to paramedics students and ocean life guards

Ian Santee makes a point of keeping his head on straight while almost everyone around him is losing theirs. Santee is a paramedic with the Honolulu Emergency Medical Services Division. Based at St. Francis Medical Center in Liliha, he and his ambulance partner tend to patients whose often-dire situations cover the spectrum from birth to death -- yet he maintains an objectivity about his job and claims he doesn't dwell on any of it when he goes home after work. He also is an instructor at Kapiolani Community College, where he teaches others how to be paramedics and provides medical training to county lifeguards. A graduate of Maryknoll High School, Santee also has a master's degree in public administration and a bachelor's degree in sociology from the University of Hawaii. In 2002, he was named county employee of the year and statewide paramedic of the year. He is single and lives in Makiki.

Question: What is your job description?

Answer: I'm a paramedic that provides prehospital life-support care to the island of Oahu.

Q: How long have you been doing it?

A: This is my eighth year as a paramedic.

Q: What were you doing before?

A: I was a Nuuanu YMCA aquatic specialist. I was the guy in charge of running the water programs -- the swimming lessons, being a lifeguard, all of those things.

Q: How did you get into being a paramedic?

A: I guess the YMCA has a lot to do with this, in that I was teaching CPR and first aid over there. And one of my advisers introduced me to a paramedic, and that sparked my interest.

Q: Who was that?

A: That was Brian Shimabukuro. He's still a paramedic with the city.

Q: What kind of training did you have to have to get this job?

A: Well, the first step is you have to go through the Emergency Medical Technician basic program, and that's held at Kapiolani Community College. It's a six-month program that teaches you basic life-support skills. And then you have the prerequisites of anatomy, physiology and medical terminology. They're all college courses. Then after you complete that, you're eligible for state and national certification.

By the way, I also work for the college part time.

A: At KCC?

Q: Yes. I'm a full-time paramedic for the City & County and I have a master's degree in public administration and a bachelor's in sociology -- both from the University of Hawaii at Manoa.

A: Is that kind of background typical for a paramedic?

Q: No. (Laughter). Not really. In my part-time job, in conjunction with City & County of Honolulu Ocean Safety Division, I'm also responsible for every beach life guard's medical training.

Q: But you still are an active paramedic?

A: Oh yeah. I work at the Charlie I ambulance station, located at St. Francis-Liliha hospital.

Q: Then you go out every day?

A: I work night shift, from 3 in the afternoon until 11 at night. We are the busiest ambulance in the entire state.

Q: How do you define that?

A: Our monthly call volume is close to 600 calls a month.

Q: How many people in a crew?

A: On a normal ambulance there are only two people.

Q: A driver and a paramedic and that's it?

A: Yes, but actually there's no driver because we're both drivers.

Q: How do you deal with the stress of coming upon people at an accident scene who are seriously injured?

A: Knowing that there is an opportunity to make a difference with my focus on my job is what allows me to handle that.

Q: Is your job heartbreaking sometimes?

A: You know, we do everything to help bring you into the world, and also when you leave the world, because we do everything from delivering babies to doing pronouncements.

Q: You mean proclaiming somebody dead?

A: Yes. So from beginning to end, it's the full circle.

Q: What about people who call the ambulance who don't really need it? Does that upset you?

A: You gotta be prepared for whatever may happen. It can be something extreme, in the sense of a shooting or a stabbing, or it just might be somebody who's lonely or has a behavioral condition. But if you let that get to you, you'll burn out that much faster.

Q: Do you ever fear for your own safety while you're racing to or from an accident scene?

A: No. Because we follow proper laws. You're not worrying about your safety as much as worrying about defensive driving. We go through a defensive course, which teaches us how to be safe while driving to an emergency.

Q: Do you ever get upset with people in traffic who don't seem to notice you or won't get out of your way?

A: You do. You get upset with it, but I guess you can never let that get to you because if you took all the little things that get to you, when you get to the big thing, the emergency, it could cloud your thoughts, and you don't want to have that happen. You want to deal with the emergency at hand.

Q: What's the worst type of case you have to work on?

A: Probably when the family is trying to get more involved in the case.

Q: So the families sometimes get in the way?

A: Yeah, I guess the public is not educated about what our skills and capabilities are. They think we're there just to pick up 'em up and take them to the hospital. That's not what we're there for. We're there to make an assessment, do some treatment if necessary, and then provide the hospitals some information on what type of patient is coming in.

Q: How do you deal with all the blood and all that?

A: Wash my hands? (Laughter) I guess the best way is you know there are a lot of diseases out there, but as long as you wear the proper protective clothing -- our gloves, for example -- and being aware of what we're doing, then that's how we deal with the blood, the vomit.

Q: What's the most interesting piece of equipment on the ambulance? Or maybe the most useful?

A: Well, the piece of equipment that we use the most would be our cervical spine immobilization, which consists of a backboard, three straps, a head bed and tape. The reason that's used the most is for people who fall down or in accident situations, where they think they might have hurt their back or neck. So they're immobilized on the back board.

The most interesting piece of equipment, I would say, is our cardiac monitor. It allows us to look at a lot of different views of the electrical activity of the heart. It's the most challenging piece of equipment. It keeps us on our toes, and comes in very handy when somebody's having a true heart attack.

Q: What kind of emergencies do you have to respond to that might be considered uniquely Hawaiian?

A: I guess it would be anything in the ocean. People do drown elsewhere in the United States, but we're surrounded by ocean. So maybe getting wana (sea urchin) stuck in your foot? Or the box jellyfish or the Portuguese man-o wars. Those would be my top three unique Hawaii emergencies.

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