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Monday, December 28, 2009

Stupid Is As Stupid Does

As we pulled into the parking lot we were able to see several police officers surrounding our patient. Before we could even stop the rig we watched as one of the larger police officers grabbed a sweatshirt or jacket and tossed it far over his shoulder while yelling at the 30 year old male. As we approached the patient we noticed that he was being detained by PD but had yet to be handcuffed. That quickly changed as he started verbally engaging us. It was obvious that the guy was under the influence of, at the very least, alcohol. As we tried to examine the patient to determine if he needed to go to the hospital we did our best to distinguish ourselves from the cops. This usually makes it so that the patient will be cooperative with us even though they are fighting with the cops. As we tried to get vitals one of the officers said something to anger the patient. The patient was quickly placed in an arm hold and, in a not so round about way, told that he better behave or he would need to go to the hospital.

During our assessment we determined that the patient was indeed altered and that his heart rate was trucking along just a little too fast (about 140). Once AMR was on scene we filled them in on the situation. The AMR medic told the patient that he better be nice because if he wasn't she would simply knock him out, and not violently. The patient agreed and stood, without the cops permission, to get on the gurney. He was swiftly tackled back to the ground and ordered to stay there until told otherwise. After the gurney was brought out the large PD officer picked up the patient and attempted to slam him down on the gurney. Unfortunately, none of the EMS personnel were aware of the cops intentions. the gurney was not being held and it slid out from the force of the impact. The gurney stopped when it collided with the knee of another firefighter and the patient came to a stop when he smacked into the pavement. Eventually the patient was restrained to the gurney and he laughed maniacally as he was loaded into the ambulance.

It always amazes me when a guy that weighs 150 pounds refuses to be intimidated by a 230 pounds, muscular, angry cop with several other cops there to back him up. Sometimes you just got to love stupid people.

Friday, December 25, 2009

Merry Christmas

Just remember, while you're celebrating with your family, there are those that are at work today (thankfully not me this year) just in case the worst happens. Many people around my station have stopped by to say thank you and drop off a treat (even the burnt cookies). We really appreciate it. Be safe and have a merry Christmas!

Thursday, December 24, 2009

Going Above And Beyond

A few weeks ago one of the other crews at my station got a call for a victim of a fall. When they arrived on scene they found an 80 year old woman laying on the floor covered in blood. Her house looked like a scene from a horror movie with blood trails leading to the front door. Towards the rear part of her house she had fallen and hit her head on the door jam. This split her forehead open almost from ear to ear. She also broke her neck. She had crawled from where she hit her head to the phone but couldn't reach it. She finally crawled over to the front door to try and open it to get help. There was blood everywhere.

Eventually neighbor came over and found her. She called 911. The engine crew bandaged her up and placed her in a cervical collar and on a backboard. Then they sent her on her way to the hospital.

What makes my department stand out from others is what the crew did next. After the patient had been transported to the hospital they started to clean up. They used towels and mopped up the floor. They went through and cleaned every surface up to and including the jewelry that was bloody. After getting it mostly clean they used paper towels and a little bit of bleach to make sure it was all clean. Then they took the towels they had used, and a rug that had been soaked in blood and put them in the wash before the blood could dry and ruin them.

I'm proud that I work for a department that would do the extra stuff. When questioned they said that they didn't want to make their patient come home from this traumatic event just to have to clean the house and relive it.

A week later I ran a call on the same lady. She had stitches all across her forehead and had to wear a neck brace because of the cracked vertebrae. This time she was weak and unable to stand. It was a tough assessment since all she wanted to do was thank us for the last time we were there. Today she's doing fine.

Wednesday, December 23, 2009

Lucid Altered Patient

We got called out just before the end of the shift. On of the things that made this call interesting is that our patient had no idea that we were coming. Our patient's son had received a call from his father at about 0730 on a Monday. His father wanted to know why he couldn't find the football game on TV. Since his father seemed confused he thought it was best to call 911.

We arrived on scene and were greeted by our patient at the door. He was a male in his late 60's and looked it. AS he sat in the chair in the front room I started to question him. He was able to answer almost all of my questions without hesitation or problems. He thought it was Tuesday morning but then said that he could be wrong and it might be Monday. I can't tell you what day of the week it is without looking at my watch first. During the questioning we noticed a full wine glass on the table.

He explained that he had poured it last night and forgotten about it. Not likely. Then my captain found several empty wine bottles in the kitchen. We asked if he had had a party recently and he said no. I asked him about his medical history to which he replied, "You name it, I got it." Not a great answer so I started to ask more pointed questions.

Do you have heart problems? No. Breathing problems? No. High blood pressure? No. History of strokes? No. Diabetes? Diet controlled. Thyroid issues? No. Anything else? No. So much for having everything.

Next I asked about his current medications to which he responded, "I take lots of meds." We were instructed to go over to the kitchen counter to retrieve the bottles of medication. He took Tylenol and Ibuprofen.

We checked his sugar which was fine. The little voice in the back of my mind kept yelling at me that there was something wrong. Something just wasn't adding up. My patient eventually said that he didn't know what was wrong but he was confused so I started a line on him and sent him to the hospital. The son arrived at the house just as we were about to leave and explained that his father has a alcohol abuse issue and that when he drinks he doesn't eat. Quite often they have to take him into the hospital because of malnutrition. I wonder if it was the alcohol/malnutrition or if he had early onset of dementia. It seemed more like the latter to me.

Tuesday, December 22, 2009

I Pinch. I Pinch.

We were toned out for an allergic reaction to crab. As we jumped on the rig I was thinking that it had been a while since I had a good allergic reaction call. They are pretty straight forward to treat but ti's a call where we can make a big difference with medications we carry. As we were responding dispatch came through with more information. We were responding to one of our local markets for someone that had been pinched by a crab.

As we entered the store we were greeted by the manager. He escorted us to the front counter where the patient was sitting on some boxes. She had been trying to bag her own groceries when the incident occurred. The crab, while the victim was trying to bag him and take him home for dinner, saw his opportunity to strike and he took it. I can't blame him! He managed to catch the victim's left pinky in the meaty part of the flesh closest to the palm of the hand. It took a sizable chunk of flesh and flayed it open but there was no bleeding. My patient complained that the wound burned and was numb. Interesting combo. There wasn't even any bleeding to control. After a quick assessment we placed a band aid on her finger. Since her husband was right there I asked if she would like her husband to take her to the hospital to see if she needed stitches. She said no, and that she wanted an ambulance to take her. While this seems to me to be a complete waste of resources, no amount of prodding was going to get her to change her mind. When AMR showed up we gave them a quick run down on the situation. The patient walked to the ambulance and climbed in.

The entire call I couldn't get the commercial for the Honda Element out of my head that has a crab in it that wants to pinch.

Sunday, December 20, 2009

Full Response, Structure Fire

At 0530, the tones went off, "Full response, structure fire." Such a fun phrase (at least to firefighters). Even better, it was in my district! I quickly put on my socks and shook the sleep out of my head, then headed for the apparatus bay. I quickly donned my turnouts and jumped into the seat with the SCBA. At this point I have a chance to relax, double check all my gear, and enjoy the ride.

I knew that the house in question was close so I as a little disappointed not to hear a smoke showing call from my captain. I figured it was just another false alarm.
This is what I wanted to see.

As we pulled up there was nothing showing (no fire or smoke). Just a couple of cops (really wishing they were firefighters) pointing to the house. As we dismounted we were met by the residents. I heard them explain to my captain that the fire was in the bedroom on the second floor. Before my captain could tell me I was on the way to the engine to grab a line. I pulled 200 feet of 1 3/4 line to the front door. There my captain and I masked up and called for water. As we opened the door we realized a couple of things. First, that it was partially blocked and the door wouldn't open all the way. That could be a problem if we had to make a hasty exit. Second, we noticed that the entire house was charged with smoke. Visibility was down to nothing.

My captain decided to go in first with the TIC to see if he could quickly find the fire. Once inside we could tell that the place was completely covered in trash. As we ascended the stairs we had to be very careful of our footing. My captain soon realized that the TIC wasn't working. Everything was coming up the same temperature. While we weren't able to see anything we were able to feel heat. It was warm but nothing like a good roaring structure fire. We also couldn't hear it. If you don't know, fires make a lot of noise. Next time you're near a wood fire, listen to it. Once my captain realized that the TIC wasn't going to be of much help he let me go first. I moved along the right wall of the stairs. As I got to the top of the stairs I found that there was some obstacle about the size of a small file cabinet blocking the top. I climbed over it and continued my search. I found what I thought was a closest on the right at the top of the stairs. Through the doorway straight ahead I was able to feel tile flooring, a bath tub and a sink. I kept going along the same wall (a right hand search). As I entered the bedroom I tripped on a step ladder. I ended up picking it up and tossing it across the room. It was warmer in this room but there was still no fire. I turned off my light in hopes of seeing the orange glow of the fire but nothing.
Fire crew doing vertical ventilation.

Finally a crew outside went around and busted out the window in the bedroom. The smoke poured out and fresh air came rushing in. This cleared things up and gave the fire the precious oxygen it needed to flare up. I was almost standing on top of it. I moved a couple of small book cases and asked for more hose. My captain gave me a couple more feet of hose and I extinguished the small fire. At this point my captain was low on air so we headed out to switch our bottles.

After the smoke had cleared I was amazed at what I found inside. Picture everything in the photo below spread around in the living room.

I couldn't see the floor except on the stairs where we had cleared the area. The front door was partially blocked with trash. The upstairs closet that I had found actually was open. The door from the closet was blocking the doorway to the second bedroom and had 3 feet of debris in front of it. It's no wonder it felt like a wall. The door was wedged open with garbage. We had to use several shovels and rubbish hooks just to clear the area and start on overhaul. Lots of stuff went out the second story window. I'm glad that the windows didn't crack because of the heat or else we would have had a hard time stopping it from taking the neighbors house as it went up in smoke. I found out later that my captain had moved whatever was blocking the top of the stairs. While he was doing this he slid down the stairs on his butt on all the trash. Luckily he was uninjured. The frustrating thing is that people that live like this have no idea that they are literally putting my life at risk.

Saturday, December 19, 2009

Job Diversity

This is a video I found about CalFire but it shows the amazing amount of job diversity within the fire service. I love this job!

Friday, December 18, 2009

Close Call...A Little Too Close

Firefighter Will Gregory exits the home with his PPE on fire. Photo by Brian Haney, The Daily Record.
Photo by Brian Haney.

You can read the full story and get more photos here: The Daily Record

Thursday, December 17, 2009

Baskin Robbins Fender (almost) Bender

So. Imagine yourself in a parking lot, say, at an ice cream shop. As you sit, waiting for someone to back out of a parking place, you notice that the person backing up isn't paying attention and that they're going to hit you. Now just think how much damage that would inflict on your 2002 Toyota Corolla. Not to mention the injuries, pain and suffering to which you would be subjected.
This is a call that we had a while ago. Two girls were in the car, both just under 20 years of age. I can understand calling the cops to get an accident report. But calling 911 for an injury accident? Really? Why not just call your lawyer directly? Thankfully, no one wanted to go to the hospital.

Wednesday, December 16, 2009

He Seemed Like He Couldn't Catch His Breath

We were toned out for a man with difficulty breathing. We arrive on scene and are greeted by the daughter of my patient. As we approached my patient I noted that he was about 70, thin build, good skins (not blue, pale...) and laying on the couch with no apparent distress. The daughter told me that her father only spoke Chinese but that she could translate. The daughter then informed us that my patient has cancer and is undergoing chemotherapy. While he was on the his way to his appointment yesterday he started feeling short of breath and ended up being seen at the ER. There he received a steroid shot and was sent home. After going through a thorough assessment AMR showed up. At this point, my patient asked if was going to the English! At that point the assessment took a radical turn. I was able to talk to my patient directly and found out that he had no medical complaint at all. He had just been laying on the couch taking a nap when we had shown up. When I confronted his daughter she simply said, "He seemed like he couldn't catch his breath." I got the distinct impression that they were just trying to get an evening off from taking care of their sick father. The father must have understood this. He said he would go to the hospital because his family wanted him to go. Now I understand that taking care of someone as their health is deteriorating is a daunting and overwhelming task but calling 911 for a "baby sitter"...that's not right.

AMR On Scene

I enjoy working with the AMR crews for the most part. They are competent and professional bunch (which was not my experience with private sector medics in another part of the state).
We were toned out for a fall with injuries at Home Depot. As we pulled in we saw that AMR was already on scene. I know I should be happy because it means that the patient was able to get care they needed faster but what really makes me happy is that I don't have to do the paperwork. Then the AMR crew cancelled us before even getting out of the rig. It's a little strange to be the one getting cancelled. Nice though.

Saturday, December 12, 2009

Daddy's Home!!

As I pull up to the house I hit the little clicker on my visor opening the garage door. After I park in the garage (a strange thing for a Californian to do) I get ready for one of the best moments of my day. As I enter the house I am almost always greeted by my two older kids screaming, "DADDA!!" They then will stop whatever they are doing and run up for a hug and a kiss. The moment usually only lasts a few seconds but I love it. Only then do I get to find my wife and give her her hug and kiss. Somewhere along the way my cat will start circling my legs and, with a twitching tail, wait for me to pet her.

The other day when I got home my daughter was a little extra excited. She told me that she had made a present for me. She hurriedly went and retrieved this:

My daughter knows that I love gum. So while she was going through her Halloween candy she discovered two pieces of bubble gum. She decided on her own that she was going to give them to me. She grabbed a sheet of paper and colored it (for wrapping paper) and then wrapped the present. It was one of the greatest gifts that I've ever received.

Thank you my Monkey (her nick name).

Friday, December 11, 2009

Seizures Of A Different Kind

To me, seizures are one of the more fun types of calls to go on. For the average person out there, a seizure has to look somewhat terrifying. Your family member (or friend) loses consciousness and starts shaking all over. From an EMS point of view, they really aren't that bad. There are a couple of serious complications for which you need to watch such as the patient seizing for too long (since breathing can be affected) or trauma from the patient hitting something. The other thing that I like about seizures is that I can actually do something about it. Most patients are not actively seizing by the time we get there but the ones that are get an anti-convulsant and it almost always stops the seizure activity.

We got a call at about 0230 for a woman having a seizure.When we arrived we found our patient (a 63 year old woman) laying in bed. The entire left side of her body was contracted and shaking.As we talked to her through an interpreter we found out that she had been convulsing like this for the last 10 minutes or so. She had a brain tumor which was evidently causing the seizures. She had experienced one other seizure in her life that was about a month ago. It was the strangest thing being able to talk with my patient while she was having a seizure. Looking back on it I would have loved to question her about the experience (if she had spoken English). I gave her some medication that almost always works to stop seizures and it didn't work. By this time AMR was on scene so we loaded her up in the ambulance. The medic on the ambulance was going to give a repeat dose of the medication if the seizure hadn't stopped by the time that the started heading toward the hospital.

Something tells me that I haven't seen the last of her. Maybe next time I'll ask her more about the experience.

Monday, December 7, 2009

We Danced With The Devil: One Firefighter’s Cancer Chronicles

This is a great article about some of the hidden dangers that firefighters face. It's long so I'm just going to post a link. If you're a firefighter or have a loved one that is a firefighter, you need to read this.

We Danced With The Devil: One Firefighter’s Cancer Chronicles

Sunday, December 6, 2009

Stopping By Your Local Fire Station

Sometimes it's the simple things that make this job great. One of my favorite things to do is wash the fire engine. I love having a sparkling shiny rig. The other day, while washing our engine, a grandpa and grandson walked up. The grandson is ten years old and has Savant syndrome. He quickly came over to us and started rattling off questions almost faster than we could answer them. While Grandpa stopped and talked to my captain, my engineer and I showed the boy our engine. He climbed into each seat and tried all of our headsets on. He pretended to be the captain ordering up additional resources for an apartment fire. I let him wear my turnout jacket which fit like a tent. In short, the kid was in heaven. After having thoroughly inspected our equipment (and us) he told his grandpa that he was ready to go. As he was leaving he asked if he could come back and visit some other time. We told him that we are always here.

Later on, talking with my captain, I found out that this young boy was an introvert in social situations. Whenever he is in a public setting, like school, he will sit by himself, silently, off to one side. Hard to believe. The boy's grandfather said that he trust us (because we're fireman) just as much as he trusts his own family. That was the only reason he was willing to come see and talk to us.

About 15 minutes later as we were drying off the engine a mother and her 8 year old daughter rode up to the front of the station on their bicycles. The mom encouraged her daughter to ask her question. I quickly knelt down in my turnout pants to get down on her level. She asked in a very quiet voice if we had a black and white spotted dog. I had to explain to her that we didn't have a dog at this fire station. Her reaction was great. She asked why not in a way as if to say, "Why wouldn't you have a Dalmatian? That's just silly"
After trying to explain why we wouldn't have a dog at the station the mom asked if there was someone working on Christmas day. I guess it's just something that most people don't even think about. The fact that there are always firefighters waiting to come help you, even on holidays. She was surprised that there would be a crew on duty that day and decided that she was going to bake them something to say thank you. Hopefully it's good. This year, I get Christmas off.

Friday, December 4, 2009

Honorable Mention

This story was related to me by one of the Captains at my department. It is too good not to tell. The Captain was helping to make dinner which involved slicing up some habañero peppers.
After he finished preparing dinner he went and used the bathroom. He then sat in the recliner while the chili slow cooked. After a couple of minutes he felt a burning sensation his crotch. And it started to get worse. Soon he was writhing in pain as the capsaicin soaked into a very sensitive place. With the other firefighters laughing at him he started dancing around in pain. One of the firefighters told him that soaking the affected body part in milk would help. Desperate for a cure the Captain grabbed a mug, filled it with milk, and headed for the shower. Evidently it worked, at least well enough for him to function. He then had to call the owner of the mug (it said something like worlds greatest coach) and let him know that he would probably want to throw it out.

When the story was related to me I thought the captain should have just posted a note on the board explaining what had happened and that he didn't remember which mug it was.

Thursday, December 3, 2009

Be Careful With Your Christmas Tree

Make sure your tree stays moist. Give it lots of water and use LED lights. If it gets dry, toss it.

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