The needle’s on EMT: Trained medical technicians waiting to help at area casinos

Wednesday, April 10, 2002 | 8:29 a.m.

As Stratosphere security officer Nickie Burns walks among the crowd of tourists she is alert to the ever-present possibility of trouble.

Thieves, belligerent drunks and hustlers may be waiting to pounce on the unsuspecting.

But the unsuspecting may also be susceptible to other dangers heart attacks, heat strokes, dehydration or countless other medical emergencies.

Burns is ready for those dangers, as well. She is one of about 10 Stratosphere officers at who are also trained as emergency medical technicians (EMTs).

"Today, someone had a heart attack," Burns said one afternoon last week. "He didn't become unconscious, but he was in a lot of pain. We administered oxygen and monitored his blood pressure until (the ambulance) came."

She spoke calmly, with a matter-of-fact tone, as if saving a life were all in a day's work.

For her, it often is.

"I've helped with everything from the common cold to heart attacks," said Burns, who first received her EMT training in California, then took a refresher course when she moved to Nevada and went to work for the casino. Burns has worked at Stratosphere for about three years.

A hotel the size of Stratosphere, which may be filled with as many as 10,000 guests at a given time, is similar to a small city, and medical emergencies are a fact of life.

"We've had four emergencies today," Anthony Catletti, the hotel's safety coordinator, said. "That's just one shift.

"We have about 2,500 rooms, plus we have our day guests, plus our own employees and also we have responsibility for anyone who steps on the property. All of the major hotels are faced with the same situation."

Catletti said the Stratosphere has about 100 security officers, 10 to 15 percent of whom have EMT training.

"But we don't call them EMTs," Catletti said. "We call them FARs first-aid responders. This is a kind of weird area. They are trained at the basic EMT level, but they aren't allowed to do all the things EMTs are allowed to do.

"It's a fine line, but we don't allow any intrusive work," such as administering medicine, he said.

"The reason for the distinction involves a lot of legal issues," he said. "We just provide first aid. As long as we don't reach the level of EMT status we are protected by the Good Samaritan Law," which protects those providing assistance to injury victims from lawsuits.

Catletti said being a trained EMT has its benefits, even when an officer doesn't put his or her entire training to use.

"When Nickie reports to the scene of an emergency, she has a better ability to understand the symptoms and she can diagnose better and relay the information to the dispatcher, who calls in the emergency folks," he said.

While only a handful of officers have EMT training, all are trained in basic first aid, cardiopulmonary resuscitation (CPR) and the use of the automatic external defibrillator (AED), a portable machine used to revive victims of a heart attack.

There are four AEDs placed at strategic points around Stratosphere for quick access.

"Every minute you don't get to the unconscious person with the AED, they lose 10 percent of their chance of survival," Catletti said.

But heart attacks aren't the only ailments. There are bottles of oxygen and bags of medical supplies stashed at different locations to meet those and other emergencies.

"When a first-aid responder hits the scene of an emergency there is usually someone coming behind him with a wheelchair, a bottle of oxygen, a medical bag and an AED," Catletti said. "It looks like a mobile medical clinic."

Emergency situations

Common emergencies among patrons include choking and dehydration.

"People are used to sweating on the East Coast and they don't realize that in the desert they don't sweat -- the sun drys the sweat and they can get dehydrated without realizing it and the next thing you know they kiss the floor," Catletti said.

Some people get into trouble because they forget to take their medicine.

"There's the excitement of the city," Catletti said. "A lot of things they would never forget to do where they are from, they forget to do here because they don't know if it's daytime or nighttime. They lose track of time."

Catletti calls the most common emergency "the Las Vegas syndrome."

"Tourists come into town and have spent a lot of time getting hassled at the airport and they're stressed out," he said. "They want to start their vacation, so they get to the hotel and drop their stuff off in the rooms and hit the tables.

"The forget to eat. They forget they're in the desert and forget to pump fluids into their body, and they forget that water is the best fluid, and Johnny Walker Red isn't. Then if they have a streak of luck, they're going forget to eat again and they don't sleep."

Emergency personnel can't do anything without a victim's consent, unless the victim is unconscious and then the law presumes the person would have granted permission if he or she was awake.

One of the most important services the staffers provide is keeping the victim calm while help is on the way.

"Bedside manner is everything," Catletti said.

Lifesaver

EMT Robin Marler, 48, has used an AED to save the lives of six heart-attack victims at The Orleans since going to work for the hotel more than five years ago.

"A few nights ago a gentleman came up and shook my hand," Marler, a night supervisor on the hotel's security force, said. "The next time I saw him he was lying outside, dead."

Marler is the only trained EMT at The Orleans, but all of the property's nearly 100 security personnel have basic medical training, can administer CPR and use an AED.

While heart attacks are among the most dramatic medical emergencies the staff faces, there are others.

"There are not a lot of things I have dealt with," Marler said. "I was working (in Jean) when they were building Buffalo Bill's, and this electrician grabbed a high-power wire and it (the force of the electrical power) blew a hole in his foot. It was pretty nasty."

The most common ailment? "Las Vegas syndrome," or, as Marler calls it, "Las Vegas-itis."

Marler has also had to deal with scorpion bites, heroin overdoses and diabetes-related health issues. He said most of the medical emergencies on the graveyard shift are related to alcohol.

"They get drunk and fall down and split their heads open," he said. "On the day shift and swing shift, there are medical problems with older people."

It's difficult to predict when an emergency will happen.

"Sometimes we go for days without any, and then you have five or six," Marler said.

Help at MGM

EMTs started to become a part of Las Vegas resort properties in the late '70s. Back then MGM Grand Vice President of Security Dave Austin was working at the Las Vegas Hilton.

"We were quickly realizing that there are a lot of people in these buildings, and that we were going to see heart attacks and medical problems," Austin said. "That's a lot of lives in our hands."

MGM Grand employs 12 security guards who are also trained EMTs, who supervise the treatment of medical emergencies.

Michael Whitson, who has worked as an EMT at MGM Grand for five years, says he never knows what's going to happen when he goes to work.

"You really could be responding to anything from a heart attack to a cut finger," Whitson said. "I'd say about a third of the calls are cardiac, a third are dehydration and everything else makes up a third."

The resort runs its own dispatch, and when a call comes in Whitson is off and running.

"We do the wheelchair run," Whitson said. "We keep complete medical supplies, including oxygen and Automated External Defibrillators, at locations throughout the casino.

"That stuff weighs about 50 pounds, so we usually throw it in a wheelchair and run to the scene. Sometimes you have to make your own siren."

When a medical emergency occurs MGM Grand personnel are normally attending to the victim in less than two minutes. Security personnel swoop in to handle crowd control, and EMTs work to keep the patient alive until paramedics with American Medical Response or Clark County Fire Department arrive.

It usually takes paramedics about 10 minutes to make their way to medical situations inside huge resorts such as MGM Grand, Austin said.

"We give the fire department and AMR maps with all the entrances to the property, but it's still a big place," Austin said. "Getting there as quickly as possible can mean the difference in saving someone's life."

Once on the scene EMTs evaluate the patient and give a report to the paramedics when they arrive.

While Whitson can handle heart attacks, he is not allowed to pluck a splinter from a guest's finger.

"It's kind of funny, but Nevada Revised Statutes say using tweezers to pull out a splinter is surgery, and we can't do that," Whitson said. "If someone has a splinter I can wrap it for them or they can go to the clinic." (MGM Grand has a clinic facility on property for guests and employees.)

Despite sore muscles and tired feet after busy nights of crisscrossing the property, Whitson said he enjoys his job.

"I've always wanted to help people, and this allows me to do that," he said. "It's very rewarding.

Sun reporter Jace Radke contributed to this story.

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