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Delivering twins on the CTE

Delivering babies and tending to victims of heart attacks are part of the job for these everyday heroes

There is never a dull day in the life of a paramedic, but delivering a pair of twins in the centre of the Central Expressway (CTE) during rush hour? That should count as a good story even for the most seasoned professional.

This was exactly what happened to paramedic Rahah Mohamed, 40, about 10 years ago.

She and her team at Paya Lebar Fire Station responded to a call about a woman having labour pains in the Ubi area. The team rushed down in an ambulance. But halfway through the ride to the hospital, the woman's water bag burst.

Ms Rahah, who has worked for 19 years as a paramedic, says: "There was no time to filter to the road shoulder, so the ambulance stopped where it was, in the first lane."

It was past 7am and the CTE was packed. Ignoring the jam her stationary vehicle caused, as well as the angry honking from cars from behind, she delivered the baby with two other male colleagues.

  • What to do in common medical emergencies

    STROKE

    A stroke occurs when blood supply to the brain is disrupted and it may lead to long-term disability. It is therefore important to seek medical help as soon as possible when someone suffers from stroke.

    These are some signs to look out for if you suspect someone of having a stroke:

    • Speech - Patient mumbles or is unable to speak clearly.

    •Arms - Patient cannot raise both arms upright or has weakness in one or both arms.

    •Face - Patient cannot smile and his eye or mouth may be droopy.

    Dial 995 for an ambulance immediately if you notice one or more of these symptoms.

    BLEEDING

    To stop the bleeding:

    1. Put on protective gloves.

    2. Check if there are any foreign objects (for example, glass fragments) in the wound.

    3. If there are no foreign objects in the wound:

    •Elevate the injured arm or leg above the heart level to slow down or stop the bleeding.

    •Place a sterile gauze pad over it.

    •Apply firm direct pressure on the wound using your gloved palm or with a towel, cloth or handkerchief.

    •Secure it with a bandage. If there are foreign objects in the wound, avoid applying direct pressure on the object by adding padding around it before bandaging.

    BURNS AND SCALDS

    A burn is severe if it affects more than 5 per cent of the patient's body surface - an area more than five times the size of the patient's palm - or if it affects his mouth, throat, eyes, ears or genitals.

    Apply the four Cs: cool, constrict, cover and consult.

    •Cool the affected part under cold running water or immerse it in cold water for at least 10 minutes. For chemical burns, wash off the chemicals.

    •Constricting accessories such as bracelets, rings, watches or clothing are to be gently removed from the injured area before it starts to swell.

    •Cover the burnt or scalded area with sterile dressing.

    • Consult a doctor if the burn or scald is not severe. Otherwise, dial 995 for an ambulance.

    Other things to note:

    •Do not apply toothpaste, lotion, ointment or a fatty substance to the affected area as it may cause contamination and infection.

    •Do not cover the affected area with cotton wool.

    •Do not break any blisters or remove anything that is sticking to a burn.

    The SCDF conducts free courses on what to do during an emergency under its Community Emergency Preparedness Programme. Areas covered include basic first aid and how to do CPR. For more information, go to www.scdf.gov.sg

Just when she thought it was over, the woman said she felt another contraction. Then Ms Rahah saw the crown of another head - there was a second baby on the way.

She says: "The mother had not gone for medical check-ups and did not know she was expecting twins."

Despite the stress, she finished the job. "I was just happy that everything turned out well and the babies came out fine."

Often dealing with births, deaths and all kinds of emergencies in between, paramedics are usually the first line response to medical crises. They are trained to provide pre-hospital care. They also ride with the patient in the ambulance to the hospital.

These everyday heroes came under the spotlight recently for their professional response when Finance Minister Heng Swee Kiat collapsed from a stroke during a Cabinet meeting last month.

Their "highly responsible" action won praise from Prime Minister Lee Hsien Loong.

There is at least one paramedic attached to each of the 55 or so ambulances in the Singapore Civil Defence Force (SCDF). They attend to emergency cases within minutes after a 995 call.

The profession was introduced here in 1996. Previously, nurses from hospitals, who were called "ambulance officers", filled the role.

The starting pay ranges from $1,916 to $2,480, with opportunities for upgrading, including being sponsored for a degree or master's degree.

Ms Rahah, who has a diploma in engineering, is pursuing a degree in sociology with a minor in security studies at UniSim. She is married to an emergency medical technician, also with the SCDF, and is now division paramedic with more than 50 staff, including paramedics, under her charge.

Contrary to popular belief, you do not need a medical-related education to be a paramedic. People usually join the force for a sense of adventure and altriusm, although hours are long and the job can get stressful.

In the SCDF, a standard shift is 11 to 13 hours. The minimum educational level is A level, higher Nitec or a polytechnic diploma. To become a paramedic, you need to undergo 14 months of training.

Take Ms Xu Xiuling, 31, who has a mechanical engineering degree from Nanyang Technological University. She has been working as a paramedic for the SCDF for eight years and holds the rank of staff sergeant.

She says: "I love helping people and I love being outdoors. So being a paramedic seems a good option."

While her older siblings - her sister is a financial adviser and her brother, a chef - encouraged her to pursue her passion, her parents were initially "not supportive".

"They thought I should have chosen something that was more related to what I studied. They also felt the job as a paramedic would be too tough for me."

But they soon came around when they saw how devoted she was to her job and how she would "come home happy every day". In the course of her work, she has delivered babies, treated heart- attack victims and attended to survivors of traffic accidents and fires.

Similarly, another paramedic Jonathan Wang, 33, also has a non-medical-related diploma in interior design. Eleven years ago, he joined the SCDF after he completed a stint as a medic during national service and found he liked the job.

He cut umbilical cords and delivered babies even before he had his own. The father of a 17-month- old boy has done six deliveries: one in a taxi, one in a hotel and two each in an ambulance and a house.

The highlights of his career were the two occasions when he helped revive cardiac-arrest victims and for which he received the Survivor Awards, given by Singapore General Hospital to those who have helped save such victims.

He says survival rates of cardiac- arrest cases tend to be low because of the missing "link": the lack of bystanders willing or able to do CPR, or cardiopulmonary resuscitation.

More than 1,800 Singaporeans suffer from cardiac arrest every year and only 3 per cent survive. Bystander CPR can increase survival rate by 2.2 times.

Mr Wang's most memorable case happened earlier this year, when the boss of a beef noodle shop suffered a cardiac arrest at work.

When he and his team arrived at the scene within seven minutes, a bystander was already doing CPR with the help of the SCDF operations centre. The team took over and the man's pulse returned.

On the way to the hospital in the ambulance, he started breathing on his own. "It was just awesome to see his chest rise up and down," Mr Wang says.

Doctors found that the man had three blocked arteries in his heart.

While the paramedics love their job, they admit that it comes with challenges. People still call up 995 for non-emergency cases such as insomnia, toothaches and even family disputes. Some treat the paramedics as drivers and ask them to take them for medical appointments.

Mr Wang and Ms Rahal say it is not uncommon to have vulgarities hurled at them when they encounter aggressive, drunk, mentally unstable or simply rude people.

Ms Xu was once slapped so hard on the face by a disoriented woman that her glasses almost fell off. The woman had run away from a road traffic accident and Ms Xu was trying to calm her down and get her back to the accident scene.

But she takes all this in her stride. "It's part of our job. We cannot control who we meet. They are not in their right mind and we need to have compassion for them."

A version of this article appeared in the print edition of The Sunday Times on June 19, 2016, with the headline 'Delivering twins on the CTE'. Print Edition | Subscribe