Fodor's Travel Talk Forums - St. Thomas EMS is dangerous

My family and I recently visited St. Thomas for a wedding. On June 20, 2016 we were visiting Coki Beach. As we were resting on the sand we noticed a swimmer, about 50 yards out. We initially thought the man was playing. He then appeared to be struggling. It was hard to tell at first if he was legitimately drowning, as the top of his head kept coming out of the water. Approximately 15-20 seconds later, he went completely under. At this time, my boyfriend jumped up and ran to the water. He swam out to the man, who was now at the bottom of about 8 feet of water. My boyfriend was able to drag him to the surface, and with the help of another tourist, bring him to shore. EMS had been notified by this time. I should mention, I am an certified emergency department registered nurse, with over ten years of experience, who holds advanced certifications in acute trauma and cardiac care. My boyfriend is a fire department captain and an EMT in a large city with 25 years of experience. His sister is a retired registered nurse. We, along with a few other tourists, immediately cleared this man’s airway, and performed CPR for 15-20 minutes as we waited for EMS to arrive.

EMS arrived carrying a defribrillator, but it was chaos from the start. There was no sense of urgency in their demeanor or actions. My boyfriend attempted to relay pertinent information as they approached the patient, but he was essentially ignored. No one from EMS seemed concerned with performing CPR. The patient was placed on their long board, but they then proceeded to argue whether or not the patient was facing the “wrong” direction on the long board. There was no logical reason, yet they insisted “we must turn him around”. One of the EMT crew members asked if she should insert an airway, but was told “no” by another EMT. A pulse oximetry reading was never obtained, and no rescue breathing or supplemental oxygen was ever administered. After much precious time was wasted the man was placed on their cardiac monitor and he was alive and in ventricular fibrillation. After what seemed an unnecessarily long delay, one shock was finally given. I resumed CPR (as per American Heart Association protocols) but was told to stop, by an EMT who appeared to be in charge. He rapidly proceeded to give a second shock, without any additional medical intervention. The young man then appeared to be in asystole. I pleaded with the EMTs to start an IV and give this young man epinephrine. Not only was I ignored, I was shoved out of the way by a large male EMT, who proceeded to step on my bare foot, with his boot, fracturing one of my toes! They then carried this young man away to the ambulance. Again, I attempted to perform CPR as they were carrying him (AHA recommendations), but was told to stop. My boyfriend followed the EMTs hoping to lend his assistance, but was turned away. We later learned the young man had died shortly thereafter. I am outraged over this entire situation! The EMTs flaunted their authority, yet showed no expertise; going so far as to hinder any outside care. We turned over a viable human life to the EMTs. I believe with prompt and appropriate pre-hospital medical care this young man would have survived.

The locals who own and manage Coki Beach never even acknowledged that a drowning took place mere feet from where they sat. They even joked as I was leaving their beach approximately 30 minutes after the event, saying I needed to “chill ma’am it’s island time”. There are two lifeguard chairs on Coki Beach. They were empty, and apparently always are. Two local scuba instructors tried to help, but they were unfamiliar with their own oxygen equipment and didn’t even know how to operate it!

I’ve since learned that EMS on St. Thomas is known for their slow response times, poor management and training, and antiquated standard of care. It is also my understanding that Carnival Cruise Lines has, in the past, halted shore excursions to Coki Beach due to violence. In that case, a deadly shooting, the ambulance was called but NEVER even arrived on the scene.

We recognize that any EMS crew can have a bad call. However, our own personal research indicates this was not an isolated incident, and is an ongoing problem. With the help of an island journalist I contacted I was able to obtain the official reports. The drowning and death were curiously never even made public. The young man who drowned was a 34 year old passenger from the Carnival Fantastic. There are blatant inaccuracies within the police and the Health Department reports for this case. The reports state a lifeguard was present and assisted in the resuscitation efforts, which is NOT true. The reports also state that the EMS personnel followed "life saving protocols", this is also a lie. No one from EMS ever performed CPR or rescue breathing on the young man. We’ve had difficulty locating island officials, and emails and phone calls are never returned. A case for cover-up, or at least systemic apathy within St. Thomas emergency medical services, could be made.