Nodaway County farmer and paramedic Brandy Gast never questioned her career path as a first responder.
“My family has always been involved in the volunteer fire department,” she said. “My dad is an emergency medical technician (EMT). I think I was 13 or 14 when I started going on fire calls and then became a junior firefighter at 16. As soon as I graduated from high school I took the EMT course.”
Now in her 15th year of service, Gast’s dedication to working in the emergency response field has not wavered.
In rural areas, first responders, whether volunteer or paid, are the backbone of the medical community. As the first to the scene of any accident, rural first responders all have, at minimum, basic level medical skills, Gast said. They provide initial condition assessment, can request life flight and administer CPR until additional support arrives.
Serving Nodaway and Buchanan counties in Missouri as well as the city of Clarinda, Iowa, Gast works as a PRN paramedic, meaning that she works where and when needed.
“Being a PRN paramedic works really well with farming,” she said. “…When we are going into harvest or planting, I can choose to stay home and farm and then pick up more shifts when we are done. That’s also why I work out of three different locations — I have the opportunity to pick-up more hours when I need to.”
On average, Gast said her team fields between five and seven calls per day, ranging from stomach aches and minor car accidents to more serious shootings and stabbings.
In rural areas, each ambulance team consists of at least one EMT and one paramedic, with each crew covering two 24-hour shifts per week.
“One crew comes in at 6 a.m. and provides a shift change for a team that has already been on-call for 24 hours. The fresh crew will be first-up for any calls for the first 12 hours of their shift,” Gast said. “Depending on where I am working, the city or the county may dispatch our team for a call. The dispatchers will also be the ones who determine if the fire department or law enforcement are needed in addition to our response.”
For a normal, weekday 24-hour shift, two crews are always on-site and ready to be dispatched. On weekends, a third crew is on-duty from 12 p.m. until 10 p.m. to field the higher call volumes. All first response providers also carry pagers and will report in the case of a call when all other crews are dispatched.
Gast said that proximity and the level of care a facility can provide determine the ambulance’s route once the patient is on-board.
“We will always go to the nearest health care facility, as long as they can provide what a patient needs, but in rural areas sometimes they can’t,” she said. “If we have a patient that is having a heart attack, we always transport to St. Joe because they have a cath-lab.
“In extreme situations, we may also have to call in Life Net and have a patient transported by air to the nearest facility, but the response time is typically 30 minutes to an hour, so we always have to make the call of which will benefit the patient more.”
The Nodaway County team Gast works with consists of 20 full-time EMT paramedic professionals, three office staff and 10 PRN EMT and paramedic professionals.
Gast said that, for the most part, turnover is low, crediting the dedication of those who serve rural areas.
“I have been very fortunate to work alongside and learn from some really great and dedicated individuals. No matter how bad the call was, I have never doubted that our teams have done everything that could be done,” she said.