Life in the GOM: Paramedicine in the Gulf of Mexico
About 200 miles south of New Orleans, situated in 4,500 feet or so of water, sits an oil platform manned by roughly 120 people. It is active 24/7/365 producing oil to keep America running, downtime leads to lost profits, and higher gas prices for you and I. As you can imagine, safety is paramount this far at sea. That is where Boston comes in.
Harold “Boston” Wright has been in EMS since 1995. Love brought him into the profession. Engaged at the time, his fiancé’s dad wouldn’t let him marry his daughter as a McDonald’s manager, even though he was on the fast track to being a general manager and getting his own store. Boston opened the “Standard Times” and saw an ad for EMT-MAST school in Fall River, Massachusetts. His fiancé’s dad was okay with that choice. After getting his EMT and working for the City of New Bedford, Boston realized he wanted to be a paramedic. While a paramedic for the City of New Bedford, Boston also became an EMT, CPR, ACLS and PALS instructor for South Coast EMS in Fairhaven, Massachusetts. In 2008, Boston needed a change. He was suffering from PTSD, and decided to visit a childhood friend in North Carolina for a week. While there, his friend tried to convince him to apply for a job with Harnett County, NC. Boston decided to make the move, and before he left, he had the job. Covering a county of about 135,000 people over 600 square miles, Harnett County EMS runs 10 ambulances and 4 QRVs. Boston quickly became an RSI medic on one of the QRVs and was an FTO. By 2018, Boston felt the need for a change again.
Now, every twenty-one days, Boston packs his bags and heads to the airport, where he flies to Louisiana to catch his next flight, a helicopter to his office for the next three weeks. Once on board, he is the only medical provider for 120 people. He says it takes about a day to reacclimate to life on the platform, check equipment and review “turnover notes” from the off-going medic who left earlier that day. His shifts are 6a-6p, but he is available 24 hours a day for emergencies.
Flying to work
To get this job, Boston submitted his resume, participated in a panel interview, and met with his medical director. Once hired by his agency, a client such as BP or Shell or Chevron, conducted their own screening process and selected who they wanted. After being selected, Boston spent two weeks onboarding with his medical director. This included training in suturing, I&D, antibiotics, and dental work, such as fixing chipped teeth and repairing crowns. He also needed to get a Transportation Worker Identification Credential (TWIC), which is required to access secure areas of America’s maritime facilities and vessels. Once off shore, he trained with another paramedic for two weeks.
Found a friend
Boston describes the culture on board as being like a big firehouse. Theres’s camaraderie in the uniqueness and danger of their jobs on board the platform that brings them together, and they look out for one another. He is lucky, he has a private room that is decent sized, not a luxury afforded to all on board. There is a gym and theater, and the cafeteria has really good food. When Boston has downtime, he walks the platform, does safety checks, and checks in with the various team leads to stay on top of any upcoming issues.
Home sweet home
Not only is Boston responsible for emergencies and the healthcare of the people on board, he is also responsible for the overall safety of those on board as well. He conducts cleanliness and hygiene inspections, weekly ServSafe inspections of the kitchen, potable water testing and outdoor temperature monitoring for crew safety in the heat. He also conducts safety orientations for new employees onboard for the first time including where muster points are and where key safety equipment is located. All employees on board are required to have CPR and basic first aid, which Boston teaches yearly.
The company that Boston works for does mandate an emergency response team that is available to assist in the event of an emergency. This is a team of 6 people, trained to the first responder level who are mainly there to assist in the movement of the patient from the accident or incident site, to the onboard hospital. The onboard hospital is only a single bed, but can handle everything from a headache to suturing, I&D and any other emergency that occurs. It doesn’t have x-ray, and only limited labs, but will hopefully soon have ultrasound. Boston will see 3 to 4 patients a day, and can consult with medical direction if antibiotics or steroids are needed.
HEN bone removal left tonsil
When an emergency happens, it could be anything from a medical situation, to a serious traumatic injury. The alert is activated by phone, which prompts the emergency response team to report to the hospital to gather equipment. This is typically a jump bag, a Lifepak monitor, and oxygen. Once the patient is brought back to the hospital, they are stabilized, and a decision is made. Can they be managed on board and return to work, do they need to be airlifted emergently back to New Orleans, or can they wait to be transferred when the next crew change occurs, called a medi-move. Emergent airlift is a relative term, as it can take 3-4 hours or days to be airlifted depending on weather.
Speaking of weather, hurricanes are obviously a threat to those on board. Preparation starts early for these storms, and movement of people starts with the nonessential workers being sent home. This puts the platform down about a third of their workforce. That’s not Boston, he’s still onboard. Once the storm is confirmed to be coming for the platform, essential employees are evacuated. Boston doesn’t get to leave yet. At the last minute before the storm hits, they put the last 19 people on a chopper, and shut the platform down. Boston has heard of people that have gotten stranded during a storm, but thankfully it hasn’t happened to him yet. When the storm passes, the medic is with the first helicopter back on board. The chopper stays on board while they do a habitability inspection, once deemed safe, they can return to normal operations. While talking, Boston said it is very eerie walking on the platform after a storm, a once buzzing, busy place is empty, with no power.
Despite the risks and the long days in the middle of the Gulf, Boston loves what he does. Providing emergency care in a unique and challenging, but rewarding, environment with a pretty decent view.
