Chapter 10Portability

“Why is there a machete in this ambulance?!”

Not “Do you guys carry epinephrine?” or “Where is the bag valve mask?” No, my first question after jumping in the back of the ambulance as we raced to a call for suspected anaphylaxis was to question the legitimacy of the machete tucked precariously inside the sliding door.

If you're a firefighter, one of your first stops in any city—especially overseas—is the local firehouse. While it's not uncommon for a drop-in to become a half-day of riding calls, somehow I found myself volunteering at the Bomberos Voluntarios (volunteer fire department) in Antigua, Guatemala, not even a week after moving to the city. So much for relaxing after Afghanistan…

The predominantly Spanish-speaking crews welcomed me, given that Antigua is rife with tourists, and Americans were especially elated when an English speaker showed up after a stabbing or tuc-tuc accident. While I didn't always expect to understand my crew or patients, I did expect emergency medical training to be relatively universal in tools, techniques, and protocols. This wasn't always the case.

Climbing into the back of the minivan—oh, yeah, the ambulance was a converted Chrysler minivan—the glint of the machete blade first caught my eye, but the amazement didn't end there.

The hatchback had neither latch nor lock, so a seatbelt had been tied to the metal hasp on the floor (where the door originally would have locked) and also the hatchback—such that the rear door ...

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