Reprinted from The San Diego Union Tribune

Smoothing out the bumps
Emergency medical team stands by at special events

By Leonard Novarro
SPECIAL TO THE UNION-TRIBUNE

Whether it's a convention of 60,000 or a street fair of 600, it's almost inevitable that someone will fall, bump a head, scrape a shin, burn a hand or, in the very least, get a headache.

And that's when planners turn to Sheila Goldfarb and First Aid Services of San Diego, the only locally based provider of medical services for special events.

First Aid Services' nearest competitor, according to Gwen Jones, Emergency Medical Services coordinator for the county, is Event Medical Services of Orange County.

Goldfarb has carved out a niche here with a roster of 50 nurses, paramedics, firefighters and emergency medical technicians (EMTs) usually employed by area hospitals, clinics, doctors' offices and fire departments.

They can be found at circuses, rock concerts, conventions, corporate get-togethers, softball games, volleyball contests, golf tournaments and on movie and television sets. At the San Diego Sports Arena alone, they watch out for the welfare of about a million people a year.

The assignment may be as simple as having a nurse on hand or as involved as a 1995 Alcoholics Anonymous Convention of 60,000 in which eight EMTs and two nurses manned three first aid stations inside and outside the San Diego Convention Center.

According to state law, medical personnel at these events are allowed to perform every first aid or emergency function, including CPR and administering oxygen. However, unless they are paramedics assigned to an ambulance, they may not administer drugs or intravenous solutions or perform tracheotomies. First Aid Services will supply standby ambulances if a client requests it, but that's rare, said Goldfarb.

"More and more people are realizing the value of this type of service," said Goldfarb, 56, who founded the company 20 years ago. "We are the medical presence. We afford a client the beauty of knowing a medical person will be there at all times to evaluate all situations."

Those situations might include sewing a button on Pavarotti's shirt -- which Goldfarb once volunteered to do -- or treating migraine sufferers like Linda Evans and Kathie Lee Gifford -- part of EMT Jim Wright's repertoire. Goldfarb has also supplied her share of oxygen to rock musicians.

Most often, however, it's taking care of minor injuries, such as those suffered by some 360 weekend warriors during Super Bowl Week's NFL Experience. For Goldfarb's team of eight medical personnel on hand, the order of the day, except for one fracture, was bruises, sprains and abrasions. Five cases ended up in the hospital.

Sometimes an assignment calls for creativity. During a 1994 Grateful Dead concert at the Sports Arena, Goldfarb set up a special room for concert goers in the throes of a bad drug experience. Complete with posters and black lights, it was designed to help them come down from a bad trip.

"It was amazing how she handled that situation," said Mark Neiber, vice president of operations for the Sports Arena. "Most people would freak out and not know what to do. But she was knowledgeable, and she was compassionate toward her patients."

Goldfarb, who taught nursing at Loyola University in Chicago and Lehman College in New York City, was hired for a $20-a-day part-time nursing job at the Sports Arena shortly after moving here in 1978. When the nurse who hired her left, Goldfarb stayed on to work events single-handedly and has remained the medical provider there ever since.

It wasn't until she got divorced in 1986, however, when "necessity became the mother of invention," as she put it, that she decided to build a one-woman service into a company. Growing a little each year, the business began taking off two years ago. Last year, it brought in more than $100,000 in contracts.

It means no worries

Typically, Barbara Scarantino, 55, who joined the company 2-1/2 years ago as marketing director, will take to the phone with a list of conventions coming to town.

"Every month you start again, establishing phone rapport, writing letters," said Scarantino, who joined First Aid Services part time after being downsized out of a job with a Santa Cruz computer firm in 1994. "As I've watched this service grow, it's been a rewarding kind of telemarketing experience because the service Sheila provides is a valuable one."

Scott Kessler, executive director of the Adams Avenue Business Association, has used First Aid Services for September's Adams Avenue Street Fair for the last five years. "It's a real high-quality service at an affordable price, and having an organization like this relieves organizers of having to worry," he said.

The State Bar of California, which uses the company for its annual conventions, promotes the free first aid during its meetings. "The greatest benefit as a meeting planner is peace of mind," said Mary Wannarka, the bar's manager of convention services.

With First Aid Services on hand, companies can avoid the expense of flying in their own medical personnel for a conference or the time it takes to go through the Yellow Pages in search of a physician if one is needed. Goldfarb has even arranged for sign language interpreters for the hearing impaired.

The presence of First Aid Services also discourages lawsuits, Goldfarb said. "We document everything, from how an accident occurred to the medical relief offered to a detailed description of the injury," she explained. Medical personnel also will note the condition of floors and stairs and even the condition of shoes someone is wearing in event of a fall.

"The first question when something happens is for someone to ask, 'Who can I sue?' So it's incumbent for us to document everything," said Goldfarb. "We're a patient advocate, but we're always protecting the client."

The bottom line

In addition to being a nurse, Goldfarb has functioned as a baby sitter, adviser, counselor and lost-and-found expert. What she didn't count on was being a business person.

"As nurses, it's not something we're trained to do," she said. "So I had to learn on my own and come through the back door."

That included learning things the hard way. In 1988, after spending weeks putting together a proposal for the convention center, the City Council awarded a contract to Mercy Hospital, which agreed to work free in exchange for patient referrals, according to Goldfarb.

"It was meaningful. I was disappointed, but that was OK. I learned," she said.

The annual contract with the Sports Arena provided a backbone for the business as Goldfarb slowly added regular clients, including Qualcomm, the San Diego Beauty and Trade Show, the West Coast Souvenir Gift Show, Harley Davidson, IBM and the Miller Brewing Co. In 1992, First Aid Services began providing medics to the sets of movies and TV shows being filmed in and around San Diego, which have since included "The Rock," "Beastmaster II," "Fast Money," "Free Willy II," "Renegade" and "Silk Stalkings," among others.

The chief overhead for the company is its equipment, paid for by Goldfarb out of her own savings and ranging from wheelchairs, gurneys and oxygen tanks to backboards, cervical collars and airway management bags. The company also keeps on hand a wide assortment of ice packs, dressings, splints, tweezers, swabs, creams, lotions, bandages, insect repellent, tongue depressors, eye wash, eye cups, eye patches and eye drops. And, of course, an ample supply of aspirin, Tylenol, antihistamines and cold remedies.

The company soon will add a defibrillator to its regular equipment. Because heart attack victims are not treated on the spot but stabilized until they can be transported to the hospital, "it can be the difference between life and death," said Scarantino. "And it expands what we can do with the makeup of our company."

Added Goldfarb: "People have higher expectations today about the level of care they should get -- anywhere."



Saturday, February 21, 1998