Not That Festive

Christmas came a couple days early to my house. This is because I picked up some overtime and worked Christmas Eve. I worked at station 42 which has an engine and truck company and a BC.

No. We were not this festive.

The morning was low key. We were on mandated holiday mode (yes, the fire chief actually put out an email saying that the crews were not to be doing projects or inspections or training....we were to be relaxing and enjoying the holiday). We ran a few calls and made a last minute trip to the grocery store. Thankfully the truck went and braved the crowds.

Early in the afternoon we started cooking. We were having a ton of food. Turkey and roast, potatoes (we peeled an entire 10 lb bag) and almost anything else you can think of for a holiday dinner. At 1500 hours family members started to show up. They would be trickling in over the next two hours. My wife and kids showed up just in time to see us tearing out of the station on a call.

We had 8 kids under the age of 7 running around the station. Luckily our station has a circular hallway and the kids were able to chase each other around and around. They also got to crawl all around, over and through the engine and the truck. My kids even got a ride with lights and sirens around the station (out the apparatus bay and then to the back of the station). That may not seem like much but to little kids it was awesome!

After dinner and cleaning up we grabbed some presents that had been bought by the regular crew there at the station. They had "adopted" a couple of low income families that didn't have much to give their kids for Christmas. We headed out and made a couple of deliveries hopefully brightening Christmas for a few kids and their parents.

To top it all off we slept through most of the night.

It was a good day to be a firefighter.


Merry (belated) Christmas.

An Ounce...

'An ounce of prevention is worth a pound of cure.' -Benjamin Franklin

One of the things I was asked about during my interview with the fire chief was my thoughts on prevention. I rattled off some different ways that fire departments are involved in fire prevention and how that has helped the community. I also talked about the future and how we may be part of the front line of prevention in EMS. A year later we were vaccinating people for the H1N1 virus.

The other day (ok....week) it was raining a lot. My captain noticed on his way in that there were several small boulders, each about 100 pounds, that had slid into the roadway. Fortunately it was Sunday and traffic was light. The other firefighter and I jumped into the Type 4 and headed up the road. We spent the next 30 minutes clearing the roadway.

I know that, except for the couple of people that passed us while we were working, no one knew what we were doing. There was no 911 call or complaint. It was just the fire department trying to make use of that ounce of prevention. Although I have to admit that the 'prevention' is a lot more boring than the 'cure.'

Ice Cream

In the fire service (and I'm sure in a lot of ambulance services as well) we have a weak spot for sugar. You know? Just like cops and their donuts. Our weakness is ice cream. Of all flavors and brands.

But it's more than just that. When a new firefighter has his first structure fire, he owes ice cream. For that matter, any time he has a first, he will owe ice cream. I remember one firefighter trying to get out of owing ice cream when his crew picked the flavor by saying that it was not his first. While this may have been true his crew had, by this point, decided on a flavor and were looking forward to it. You may as well stop a raging river with your bare hands as change their mind. The newbie was reminded that it was his first fire on that date with that crew. In other words, he owed ice cream.

Another time you owe ice cream is when you get your picture in the paper or if you're on the news. The problem here is, depending on how strict your agency follows this rule, you owe ice cream to every one that sees you. Luckily, in practice, this is usually contained to the one or two crews with whom you are closest. Everyone else just stays quiet about it.

There's another time you buy ice cream. Whenever you screw up. If you break a lamp while moving an unconscious patient, or run the wheels of the engine along the curb or anything of that nature, you owe ice cream.

The nice thing about this unwritten rule is that it applies to everyone. When a captain gets promoted to BC and has his first structure fire, he owes ice cream to all the crews there.

Anyways. I just thought you'd like to know one of the reasons that firefighters are often struggling with their waistline.

How To Become A Firefighter Part 6: The Chiefs Interview And Beyond

No Stress, right?

Deep breath. Remember. You've done this before and they liked you enough to pass you. Now you just have to sell yourself to the chief.

The same general principals apply to this interview as with any other. Remember to tailor your answers to your audience. If you're being interviewed by BC's remember that they are still line personnel. If you're being interviewed by anyone higher up than that they are paper pushers and number crunchers. They will want to know what you are going to bring to the organization. They may ask about community involvement or prevention programs. You need to be able to think a little bit deeper than just what a firefighter does on a day to day basis.

Have a good closing statement prepared. Remember to thank them when you're done.

Now that that is out of the way you're not done. When you get home you need to start getting everything together for a background check. You'll need names, addresses and phone numbers for family, friends, roommates, landlords and former employers. You need to have your work history down without any missing time periods. You will also need official copies of your birth certificate (otherwise how would they know that you were born?) and marriage certificate. Once you've done this for one department, make a copy of it all. That way you have all the information in one easy place.

Hopefully now you're on your way to being in the next fire academy. I hope that you're staying in great shape. One great way to prepare physically is to actually pull hose and swing an axe while in turnouts. If you don't have that ability, get a weighted vest.

Another thing. Most municipal departments run EMS calls. A lot of them. If they require you to have an EMT or medic license to apply expect a medical assessment exam. It's usually just a national registry skill so if you download the paperwork and practice going through each step you should have no problem. When I did my medic assessment while going through the process with my department we had several stations we had to go through. We had to assess and treat a pediatric patient for anaphylaxis, including drawing up and administering medications. We also had to intubate a mannequin and talk about everything we knew about Glucagon. Every department does theirs a little different.


For those of you that have the job, what did I miss? What tips/tricks helped you get hired?

Previously, More Station Visits

How To Become A Firefighter Part 5: More Station Visits

Congratulations, you've passed the initial interview.

Now you need to shift gears and do a little more research. The initial interview is usually conducted by line personnel. In other words, the guys with whom you'll hopefully be working. They want to get to know you and see if you are the type of person that would fit in with their crew.

The interview with the chief is different. He's not going to be working with you on a daily basis. Because of this will want to get a different vibe from you. Will you be good for the department and the citizens that it serves? Are you worth the thousands, if not tens of thousands of dollars that they will have to invest in you to make you one of their firefighters?

So now you need to visit some more fire stations. Preferably stations with a BC. All the same guidelines that I talked about before apply here too. Talk to them about where the department is headed in the next 5-10 years. What major changes, if any, are going on. Talk about funding for the department. This is the time to get into the nuts and bolts of how the department is run and where it is going. Just like before, the more you know, the better.

If you can find a copy of the departments strategic plan, read it. It will let you know where the chief would like to take his organization over the next 5 years. If your applying to a municipal department, learn about the city. The elected officials, economics of the city, local cultures, annual city events etc. If you're applying to a county or state department you should do the same thing. At least as best you can.

Something else I forgot to mention before. Know the capabilities of the department. Find out if they have a HAZMAT, USAR, heavy rescue, boats, swift water team, technical rescue team, dive team, ice rescue team, air ops.....you get the picture. Most department are pretty proud of their specialties. Stroke their egos. Learn target hazards. Those places that would be very bad if they were to go up in smoke. You know, oil refineries, hospitals and the like.

Again, if you know some chief officers at any department, active or retired, see if you can set up some mock interviews. Perfect practice makes perfect.

Next, The Chief's Interview And Beyond
Previously, The Interview

How To Become A Firefighter Part 4: The Interview

The day of the interview.

Show up early. Bring a resume, letters of recommendations, and copies of all certificates and licenses. Get a nice case to carry them all. They may not want any of it but it's better to have them and not need them than to have them ask if you have a copy of something and not to have it. Wear a dark suit and have the tie tied correctly.

This is the time for you to shine. Eye contact is a good thing. Sit up straight. If you can, remember the names of the members of your interview panel and use them. Remember to answer the question. In an interview that I had (it was a group interview with the fire chief) we were all asked which is more important for a career as a firefighter. to have a bachelor's degree or to have the ability to take apart a car engine and put it back together? Several candidates failed to simply answer the question. They said both were important. The problem is, that's not what was asked. They just wanted us to pick one side or the other and make a stand. I picked one and backed it up with my reasons. I got the job (although I'm sure that wasn't the only reason).

Remember that the panel is trying to get a good picture of who you are and how well you will fit into their organization. Be confident, but not cocky, and tell them why you'd be great for their department. This is a great time for you to show them how much you have learned about them from your research.

We recently had a young candidate come through our interview boards and when he was asked what he knew about our department he covered it all. Somehow he had even gone over our strategic plan for the next several years (which isn't online) and memorized points from there. He did very well on his interview. You could tell that he really wanted to job.

At the end of the interview make sure that you shake the hands of all the members of the interview panel and thank them for the opportunity. At some departments a couple of points will be added to your score if you do this.

Now go home and analyze what you said in your answers. Is there something that you could have said that would have been better? Remember, if it went well, you still have another interview. If not, you will have more interviews with other departments. Critique yourself and make improvements.

One last thing. Go back to the stations (and shift) that you visited previously (no need to make an appointment) and drop off some ice cream to say thank you for their help. Very few people do this but it makes a great impression.


Next, More Station Visits
Previously, Research

How To Become A Firefighter Part 3: Research

Congratulations. You've passed the written examination and have been invited to participate in the oral boards. Your interview is.....

Now what? Time to do some research. Firefighters are an opinionated bunch and we all think that our department is the best. We expect you to know why it is the best. We want to know why you want to work with us more than any other department. Now you and I know that this is complete BS. You want to work for a fire department. At this point, getting hired anywhere is better than working for the low wages on the box or worse. We know that you are applying everywhere but we want to know that you are willing to put in the time and energy to find out things about our department.

So how do you do this? First thing is to go to the department web page. Figure out all the information you can from there. It's not a bad idea to memorize some statistics before you meet anyone. Online forums (such as the ones found on firecareers, firejobs, or firefighter-jobs) are a good source too.

Once you've gathered all the information you can from the web schedule an appointment with one of the fire stations. When you visit, don't show up empty handed. Ice cream is a great idea. Make a list of information you would like to know and bring it with you. Write down their answers. If they offer you a meal, kindly refuse. If there is a project that they have to do while you're there, offer to help. Roll up your sleeves (go in a shirt and tie) and help. They will tell you not to bother but doing things like this make a very good impression. Don't just hang out at the station. Your visit has a purpose. Once it's done, move on. The more stations you visit, the better. Double houses and BC houses get you more exposure. You want to make a great impression so that when you see them on the interview panel they already have a positive outlook towards you.

That being said, it can also have the opposite effect. If the visit leaves a bad taste in the mouths of the guys at the station you've more or less shot your chances. We had a guy this last week just pop in to the station. We were off training until dinner time. So we came back to the station to find this candidate waiting for us. We were cordial and answered his questions. He just talked while we dried the rig (it was raining) and cooked dinner. My captain was nice enough to offer him dinner so he stayed and ate with us. We didn't plan on him being there and he didn't help cook/clean and didn't offer to pay for his portion. He knew almost nothing about our department and was overly confident. I don't know for a fact how he did on his interview but I know the story of his visit spread through at least our battalion faster than a wind driven wildfire.

Another thing to do is to have mock interviews with company/chief officers of a fire department. If you can do it with officers of the department for which you are testing so much the better.

In general, the more information you have on your prospective department, the better.

Next, The Interview
Previous, The Written Exam

How To Become A Firefighter Part 2: The Written Exam

The next step is written exam.

How to prepare for the written exam. If you're not a good test taker get some help. Get a tutor, get an account with one of the online testing sites and practice. If you know that you have a weak spot, such as math, get help in that area as well. Take lots of tests. This means applying to a lot of departments. Maybe even some where you don't want to work. The written exam I took when I got hired was the exact same test that I had taken 3 previous time in the 6 preceding weeks. When I saw that it was the same test not only did I know exactly what to expect but I remembered most of the answers. It allowed me to take the test and then go over it a second time.

Things to remember on the day of the test. Be early and bring a couple of #2 pencils. I've never taken an exam where the department didn't have some extras but it would suck if that happened to you. Leave your cell phone in your car. One last thing on the written exam. Watch your time. Skip the answers you don't know and come back to them. Don't forget. If you do run out of time, guess. You miss 100% of those questions you fail to answer.

Next, Researching your department.
Previously, Whose Hiring

How To Become A Firefighter Part 1: Who's Hiring

My department is currently looking to hire new firefighters. This process, for the candidates, is usually long and full of opportunities to fail. Less than 1/3 of 1% of all wannabe career firefighters make it to their dream jobs (the rest become cops....kidding....sort of). I'm going to take you through each step of the process and give some of the pointers that I've picked up. I don't claim to be an expert but I did get the job.

The hiring process starts with the job announcement.

Get an account with one of the many websites, such as firecareers, that will let you know when departments are hiring. It's much easier to figure out which departments in your area are hiring and their minimum qualifications for applying.

As long as we're on the subject of minimum qualifications, figure out what type of department you want to work for and start getting yourself prepared. If you want to work for a department that does mostly wildland, focus on that. If you're trying to get hired on a department that does not have medics going through medic school is a waste of time. For the most part, departments in my area want you to have an EMT license and a firefighter 1 academy.

Now that you know a department is accepting applications, get one and fill it out. If it's not online than make sure you fill it out legibly. There are a lot of applications for HR to go through and if something is not legible they will usually just toss it out. If they require photocopies of any documents (make a check list so you don't forget to mail something in) be sure the copies are readable. I recommend going to Kinkos (sorry, it's now FedEx Office) and spending the money for a nice color copy. It's an investment. While you're there make more than one copy of each since you will probably need to do this again for the next department you apply to. Once it is all filled out send it in on time.

Next, The Written Exam.

Man Of Steel

My wife just couldn't help herself when she saw the shape of the log in the fireplace. What's funnier is she recorded it!

Double House

A double house in fire nomenclature is a fire station with two crews and two apparatus on duty at a time. The most common variation (but by no means the only one) of a double house is an engine and truck company.

Being stationed at a double house adds a different flavor to the job. Picture a family with 9 boys at home. There's a lot of energy, practical jokes, laughter, competition and of course, food. A lot of  food. Every once in a while tempers flare as well but that's a story for another post.

I was stationed at station 55, a double house. I was on the engine. One of my buddies (we were in the same academy class) was on the truck. We've always been at each other like brothers. We get along great but love giving each other a hard time. I've been fortunate enough in my career to have had a lot of fires. He, however, has not.

Recently I came back after working an OT shift at a station where I had a small structure fire. When I saw my friend I was sure to give him a hard time about getting another fire. So late in the morning when the tones went off dispatching the truck to a structure fire in the neighboring city he laughed at me as he donned his turnouts.

He got back about 3 hours later. He gave me a full report on his actions. They ventilated vertically and then pulled a lot of ceiling. He never actually was inside a burning structure. This distinction would be very important later on. While I was very happy that he got a fire I was a little jealous too. Fires don't happen every day, at least not where I work, and I always want to be on the next one. He had his moment just as I had had mine a couple of weeks before.

That evening the engine was toned out for a vehicle fire. While not a structure fire, a fire is a fire. I'd take it. I jumped into my bunker gear and climbed in the engine. Once in the rig I slipped into the shoulder straps of my SCBA. I grabbed the headset to let my engineer know that I was strapped in and ready to go. Just as we pulled up we were canceled by CHP. The car was not on fire. When we pulled back into the station my buddy was waiting to twist the knife that he had had a real fire and not a false alarm.

At 0210 the tones woke me up. We were being dispatched for another "vehicle fire" on the freeway. I repeated the process that I had done only a few short hours earlier. This fire was supposedly on the far edge of our area, over the hill.

As we rounded one of the corners headed down the back side of the hill my captain spotted the tell tale orange glow of a fire. All of the sudden having been awakened at 2 in the morning was worth it.

The next morning I was ready for some ribbing of my own. When I found my partner in crime I told him I had a question. I then proceeded to ask him why, after he had had a structure fire and I had just had a car fire, did my turnouts smell like smoke and his just smelled like sweat? He didn't think that was too funny. I then let him know about a guy with whom I worked at my last department. He had a similar problem of never being on shift when the fires happened. So we came up with a new title, which I passed on to my buddy, EMS fighter. You're only a firefighter if you actually fight fire, right? I just have to see if I can get a badge or a patch made up for him.

Seizure

For me, the worst time to get a call is around 0500.

The tones went off just after 5 in the morning. As I headed toward the engine I glanced at my watch. My heart sank a little as I realized that I was up for the day.

We headed to an apartment complex just a half block down from the station. The city streets were empty this early on a Sunday morning. When we arrived at the front door we found it open. I called out "fire department" and heard someone yell that they were upstairs.

On the second floor of the two bedroom apartment things were a little crowded. There were two families living here. My patient was on the floor in the kids room between the full size bed and the bunk bed.

Two of the kids awoke when they heard the 10 year old thrashing about. They woke mom up who then woke a dispatcher up (ok, she probably wasn't totally asleep) who in turn woke us up.

By the time that I knelt at his side my patient had stopped seizing. One of the older kids said that he shook for about 2 minutes (which means it was actually about 30 seconds). My patient had no injuries or oral trauma from the seizure. He wasn't feverish, and, per the mother, had no history of seizures, didn't use drugs and hasn't had a head injury recently.

We placed him on some oxygen to help bring him out of his postictal state and then check his sugar. By the time AMR arrived he was opening his eyes and looking around in confusion. After a couple of minutes he was able to walk down the stairs.

Finally we head back to the station to start the morning routine: pot of coffee on, grab the paper, check staffing to see who is coming in this morning, take a shower and grab breakfast. Once all that is done we hand over the reins to the next crew.

Time to go home.

I'm My Own Patient

We responded to a call a couple of blocks from the station. We always have AMR right on our heals since the our station is in the shadows of the trauma center.

Over the growl of the siren we heard from dispatch that we were responding for a fall victim. These calls are usually fairly vanilla. An old person falls, is bruised and a little battered but is fine. Every once in a while you get someone that falls and smacks their head causing a cerebral bleed. I knew an AMR crew that once responded for a "fall victim" only to find that their patient was actually a skydiver whose parachute failed to open. Splat.

We arrived on scene to find an old lady being helped by several bystanders. The 90 year old woman had been walking to the hospital, where she volunteers a couple of times a week, when the sidewalk reached up and tripped her. She managed to stop her fall with her forehead.

The entire time we were there my patient kept making jokes. She thought it was hilarious that she was going to be her own patient. It was good to have a patient that happy. She had split her head open just below the hairline above her right eye. She would probably need a couple of stitches. She was worried that she might be late for her shift. I assured her that when she showed up in our white chariot they would forgive any tardiness.

Epistaxis

I showed up at the station a little early. I was working an OT shift and hoping to get something good. The tones went off right at 0800. Welcome to station 3. The call was forgettable. Just another ill elderly person that was feeling a bit weaker than normal.

Less than 20 minutes after we arrived back at the station we found ourselves again splitting the sea of cars on their morning rush hour commute headed for another medical aid. Most of the drivers tried to wedge their cars into whatever space they could find to get out of our way.

Arriving on scene we found a 45 year old woman with a bloody nose. She said that it had been bleeding for the last 2 hours and nothing helped. She had had this happen once before about a year before and she had her left nostril cauterized. This time it was the right one. She also admitted that she had a history of hypertension but wasn't taking her medication. And what a shocker, her BP was high.

I used a nose clamp and an ice pack to try to stem the blood flow and gave my report to the AMR medic that had just come in the door. Another life saved.

Fast forward 12 hours. 2123 hours.

The tones were going off for the 13 time that day. This time we were being dispatched for another medical aid. As we responded with our lights reflecting off the exterior walls and windows of the buildings along our path dispatched advised us to stage. PD was en route to a fight outside of Home Depot. The victim had been hit with a pipe and the assailant was thought to still be in the area.

While we waited down the street the AMR crew decided to stage on the far side of the parking lot. The patient spotted the ambulance and walked right over, arriving before PD. The 45 year old male had been struck by a lead pipe right in the face. He had am avulsion that started about an inch above his left eye and traveled down at a 45 degree angle across his nose to a point about an inch below his right eye. We tried to stop the bleeding with direct pressure but that was only slowing it down a bit. Despite being drunk, which no doubt helped with the pain, the human pinata was amazingly alert and oriented.

One of the cops asked the patient if he knew who hit him. When he named his assailant the officer then asked if that wasn't the guy that the victim had stabbed in the hand the previous week. I guess these guys have a history. Maybe next time I work an OT shift at station 3 they'll have upped the ante a little. Medics love trauma.

Vacation

At my department (and I'm sure most have this ability) we can trade shifts. Instead of using up our vacation time we can have someone else work our shift. We then have to work for them on another occasion. Having someone work 2 days for me allows me to have 10 days off in a row.

I guess what I'm trying to say is, I'm on vacation!

What We Do When Not Running Calls

Firefighters work all types of different schedules. Some work every third day, for 24 hours. Some work what is called a 3's and 4's schedule. They work every other day for 5 days (3 days working) and then have 4 days off in a row. I did this for a while. Other departments work 3 days straight but then get 4 days off. I think I have it the best. I work for 48 hours then get 4 days off. The down side to my schedule is that 48 hours is a long time to be awake if you happened to get slammed with calls.

My shift officially starts at 0800.  Although the crews try to get there a little early, that way the off going crew can bail right at 0800. The oncoming crew talks with the guys getting off duty. They find out if there were any issues, rumors, good calls, stories, etc. Quite often this is done over a cup of coffee or while setting up your turnouts and other personal equipment. It really depends on how fast the guy getting off needs to get out of there.

The first order of business in the morning is to check out our equipment. We make sure that everything is there and in order. The engineer will do a complete check on the apparatus. The medic will check all of the EMS gear. The captain does......captain stuff (I think he just drinks coffee and checks eBay.....kidding). The crew then gets together, eat breakfast and talk about the day (and drink still more coffee).

Topics normally covered in the morning include any training scheduled for that day, tasks that need to be accomplished that day and most importantly....dinner.

In the morning we get in a workout. the number on cause of firefighter fatalities is heart attacks. Most departments (including mine) encourage us to work out every shift. Sometimes we have training that the department schedules in the morning hours so we have to work out later.

The morning time is when we do most of our training. Sometimes it's set up by the department and several companies will get together at one time to do it (such as an EMS class). Other times, it's just the crew getting together and working on something that they haven't done in a while. Recently my crew decided to contact one of the local towing companies to see if they had any 'spare' vehicles laying around. We ended up tearing apart a 1994 Ford Explorer for practice.

After lunch we take care of any business that's left. Sometimes we go out and do company level business inspections. Most of the time we do company level training. In the afternoon we also take care of our grocery shopping. Let me just take a moment to set something straight. We pay for our own food. It's not payed for by you, the tax paying public. So if we want to have steak and lobster, don't freak out. We're buying it with out own money.

Sometime around 4 in the afternoon we start cooking. Who cooks depends on each crew. At the double houses (one with an engine company and another company like a truck or rescue) dice are rolled to assign jobs. Dishes are usually the last to get picked. Most stations have at least one 'skate' spot where you don't have to do anything. We try to have dinner sometime around 1730.

After dinner a lot of crews watch TV. Either sports or a movie. Then, usually around 2300, everyone goes to bed. In theory, we sleep until about 0700 and then do it all over again.

Now at any point during the day we can be interrupted by the tones. Usually this happens at meal times, at a critical moment in a ball game, just after stepping into the shower or when we just fell asleep. At least that's how it seems. Sower station may only get one or two calls a day. At the busier stations the tones can go off more than a couple dozen times in 24 hours.

Eventually, your shift ends, the talk to the guys coming in to relieve you and you get to go home. One of the reasons why I love my schedule so much is that my 'weekend' is always 4 days long.

Breaking....Your Fall?

The tones go off yet again. It's been a busy day, 7 calls in 7 hours. This time we were being dispatched to the local junior high school.

When we pulled up we were greeted by a bunch of students that were as excited as little kids to see the firemen pull up in the firetruck with their lights and siren. A bunch of them said hi as I jumped out and grabbed my gear.

My patient was standing in the parking lot talking to a teacher and to his mother. His mom was worried and trying to hold it together.

The young man was holding his left arm and trying hard not to cry. Crying would only be added insult to injury. He told us that a couple of other kids had come up from behind and pushed him to the ground. He instinctively reached his hands out to break his fall and broke his arm instead.

While we talked the swelling in his arm continued to worsen. We grabbed an icepack and splinted the arm. Since getting any morphine would mean getting stuck with a needle he declined.

Poor Mother

Engine 51, respond for a possible OD, PD on scene....

We pulled up into the cul-de-sac in the upscale suburban neighborhood. There were two squad cars out front, one with its blue and red LED lights blinding all that looked at it.

Walking into the nice entry way I found two police officers, a frustrated mom and my patient, a 20 year old female that was handcuffed and laying on the tile floor. One of the officers briefly explained that they were a frequent visitor to my patient and that she has a history of drug abuse. This time she decided to fight the officers, upset that her mother had called them.

Still not happy, my patient spent her time yelling and swearing at us stopping only to vomit. She refused to admit that she was on anything at all. We knew better. Having been around the block a time or two we knew what someone stoned looked like. That and she smelled like a brewery. She was drunk and on some kind of stimulant. Probably meth. Maybe coke.

By the time that AMR showed up we had calmed the patient down. She was still throwing up but had finally reasoned that it was better to go to the hospital with the nice medics than to go with the cops.

After AMR left we found out from PD that the poor mother had been dealing with this for some time. The daughter had a boyfriend/drug supplier that was in his late 40's. He had been abusive and now there was a restraining order that wasn't doing much.

Hopefully the system won't totally fail them and the daughter can turn her life around. If not, we'll be back. Some day for something a lot more serious.

For more information on Methamphetamine visit The Anti-Meth site

The Last Thing I Heard

...Truck 105, respond for a report of a fire.....

It was the third or fourth false alarm this shift. It was getting old. I was itching for another fire (I shouldn't really be complaining because I get a lot more of them than some of the other guys on the department). After we pulled into the station went through my routine of doffing my turnouts and hooking up the plymovent to the exhaust. While doing this I informed my captain that I had reached my quota of false alarms and I would not be responding to any more without first have a structure fire. He assured me that the next on was going to be good.

About two hours later the structure tones went off again. Despite what I said earlier I was still excited to get dressed, dive into the quint and head out to a possible structure fire. As we headed out of the barn dispatch informed us that we were headed to a commercial kitchen fire with smoke and flames showing. Music to my ears. Better still, it was in my district.

My heart sank a little as I looked out my left window towards the call and didn't see any smoke. I was sure someone had extinguished it themselves. Then we turned towards it and my view was obscured.

 About a block out my captain said those magical words, smoke showing.

As we pulled into the parking lot of the banquet hall I noticed a group of people standing and watching. It would be a fun show for them, assuming they weren't the owners of the building.

The quint came to a stop and I hopped off. My boots were on the asphalt before the air breaks released the air in their system signifying that they were locked. I rounded the front of the apparatus and got my first look at the building. There were a set of double doors leading into the structure that had thick black smoke rolling out of it. There were also a couple of windows mimicking the door.

I grabbed the 1 3/4" crosslay and headed first away and then toward the door, hose paying out behind me. My captain was doing his size up of the situation and establishing IC while I masked up. Just as I finished masking up I turned to see my captain realize that I was ready and he was not.

While he masked up I decided to go on air and take a step into the enveloping black smoke. The double doors from the outside led to an anteroom. There I found a set of open double doors straight ahead which led to the hall and a set of open double doors to my right leading to the kitchen, and the fire. The smoke was down to about waist level so I bent down to look under it. I could see that the entire back half of the kitchen was aflame.

With my captain behind me I made my way into the kitchen. Just as I stepped inside I heard my engineer yell that there were propane tanks inside. The flames on the back wall were from floor to ceiling. I moved around the left of the large table in the center of the kitchen toward the seat of the fire. A few moments later the fire was out. There on the ground was a propane tank, charred black. I cooled it off and then turned it off. Moving around the other side of the table looking for hot spots I found a second propane tank which I also cooled and shut off.

Other crews had set up horizontal ventilation, giant fans at the doorway to blow out the smoke and heat. With better visibility we could now see what had happened. Someone had decided to use a pair of deep fat fryers inside. Something caught fire and it quickly spread. During overhaul we found a third propane tank. Thankfully none of them bleved. The two with direct flame impingement were open and able to off gas which probably helped.

By the time we were done with overhaul and reloading our rig there was just enough time to shower and get dinner. I'm ready for another one.

Low Sugar

I assume the tones went off. This was probably what woke me up. Or maybe it was the lights suddenly turning on. Either way, my body has the same reaction. Get up and head to the app bay. Jump into my bunker pants and hope by that time I've figured out if I can just go like that (in the case of a medical aid), toss on my turnout jacket (for a vehicle accident) or get "Scotted up" and ready to fight a fire.

This time, about 0130, it was for a medical aid. The engine company in the neighboring district was already on a call so we headed there. This meant a longer response time (my wife laughed at me when I mentioned this to her since our response time was just over 7 minutes....nothing compared to the response times of some more rural jurisdictions).

We were met at the door by the son of the patient. He led us upstairs to the master bedroom where his father lay on the floor, unconscious. He told me that his dad is a diabetic. The son had come home from work to find him laying on the floor. I inquired what his most recent blood sugar was and he had no clue. They hadn't tested it.

I grabbed the glucometer and prepped a finger for a stick. While I was applying the drop of blood to the test strip AMR showed up. The old man's blood sugar was in the low 20's. Now that the problem had been correctly determined it was time to solve it.

I started an IV in the mans right arm. He jerked slightly as I plunged in the needle. Once it was taped down the AMR medic, who had already fished out my glucose and set it up, pushed an amp of D50W. Within moments our patient was awake but confused. After about a minute you could see the internal light switch turn on. He knew what must have happened and why we were there.

We asked him if he wanted to go to the ER. He rather emphatically said no. It was the right decision. I discontinued the IV and had him sign the CYA paperwork. I talked to the son about making sure his father had something to eat before going back to sleep.

45 minutes after waking up in confusion I was back in bed, now unable to sleep. I pulled out the laptop and watched an episode of Deadwood. As I drifted off my last thought was that my alarm was going to go off way too soon.

Wrong Target

I read this at BackstepFirefighter's blog.

Two guys in Boston decided to steal something. They decided to steal a helmet....from a fire truck. I think they failed to realize that there is almost never just one firefighter and, as a general rule, are in decent shape. They are used to lugging around a lot of weight.

The truck company retrieved their property and subdued the would be thieves. The report from "witnesses" makes it sound a lot worse than what the video shows. Either way, not the greatest thing in the world for public relations. I hope that the people of Boston understand.

Patient Advocacy Even In Death

 We responded to a board and care home for a 90 year old man feeling lethargic. My first thought on hearing the nature of the call was, "Really? A 90 year old not feeling well, what are the odds?"

As we walked into the house my captain, who was really on the ball, asked the caregiver if the patient had a DNR. I love it when my captains are thinking ahead like that. The caregiver said yes and directed us to the back bedroom. As soon as we saw our patient my captain turned around and went to find the DNR. We were going to need it.

My patient was laying in a hospital bed sitting up slightly. He was guppy breathing. As my captain headed out of the room I quickly checked for a radial pulse. Not finding one I searched for a carotid pulse. He had a weak one but it was there.

As my engineer walked in the room I turned to him to explain what I had going on with the patient. I turned back and watched the old man take his last breath. Not wanting to do anything contrary to the mans wishes I loudly asked my captain if he had found the DNR. In the absence of a valid DNR we have no choice but to work up the full arrest. 

Because the staff were unorganized we had to start compressions. Thankfully, after about 30 seconds my captain found the DNR. Once it was determined that it was valid resuscitation efforts stopped. We then replaced the covers on the body and left him so that he appeared to be sleeping.

I'm glad we found that DNR.

Genetic Predisposition?

While I was upstairs I heard my daughter (who is 6) scream for Daddy. When I asked what was going on she said there was a bug! And it was on the couch.

Not 5 seconds later my oldest son (who is 4) loudly proclaimed, "I got it Daddy!"

Even at this young age the boys are the ones taking care of the creepy crawlies.

Breaking And Not Entering

At 0115 the tones went off. The lights on my room slowly started to brighten. I could hear the automated voice starting to dispatch us. "Truck 71......"

When we arrived on scene we could see several PD officers standing on the grass next to an apartment building. We could also hear music loudly thumping away. The officers explained that they were responding to a noise complaint but there had been no answer at the door. They could tell that the window to the second story apartment was open. That's where we came in.

I grabbed the 16' ladder and laddered the trellis under the window. I climbed up and called out loudly, "FIRE DEPARTMENT!" The last thing I want to happen is scaring some guy with a knife or a gun. No one appeared to be home. The computer was on and playing loud music. The officer in charge told me not to enter the residence.I climbed down the ladder and then put it away. The poor neighbors were going to have to put up with the noise all night. I was headed back to bed (but I wouldn't stay there long).

Bar Fight Turned Ugly

It was just after 2 in the morning. As we started out of the barn the radio crackled to life. Dispatch was talking to another unit about a first alarm assignment. There seemed to be some confusion about who was responding where. Then we heard that Truck 71 (which is station in the neighboring district) was also responding to the call. It seemed that something big was going on and we were in the dark. Dispatch informed us that we were responding to a different location around the corner from their incident. Truck 71 then asked that the next due engine be dispatched as well. Whatever was going on had a lot of resources moving.

We soon figured out that another city that uses our dispatch was working a structure fire and we caught their radio traffic before they switched to a tactical channel. As we turned the last corner we saw several PD units. Dispatch finally came through with an update as well. We were responding to a stabbing with multiple victims. We had the truck and another engine on the way, which meant a BC as well.

I jumped out of the rig and grabbed my gear. As we approached the scene we could see one victim laying in the street in handcuffs bleeding from the hands. An officer could be heard, almost screaming with urgency, that the other one had his guts hanging out. Since patient #1 wasn't so bad off we kept going.

On the side of the street we found patient #2. He was laying under a tree in the weeds. A police officer knelt beside him holding a trauma dressing down on the victim's abdomen as if his life depended on it. As I approached the cop started to move. I'm sure he was hoping to escape but I told him to stay right where he was. I did a quick 360 of the scene to look for any other patients and didn't see any. I also knew the truck should be pulling up any second so if there was another patient out of sight they would help him.

Patient #2 was covered in blood from his head to his knees. His shirt had been pulled up around his chest to expose wounds. I knelt beside him and asked his name. He was very lethargic. Not a good sign. Soon my engineer showed up and relieved the officer of his duties. I pulled out my trauma shears and started removing all the patient's clothes, looking for every injury. By now the external bleeding had stopped. I think this was more due to a lack of blood than anything we did.

I found 6 stab wounds in my patient. Two were to the side of the chest but appeared superficial. He had two more shallow wounds the left side of his abdomen near his hip. Another one was just to the left of his navel. The one that I was worried about was just under his rib cage on his left side. It was more than 2" wide and deep. I checked lung sounds to make sure he didn't have a pneumothorax. His lungs were okay.

We quickly strapped the young man to the backboard. Once he was secure we moved him to the ambulance. As soon as I jumped in the back with the AMR medic he directed his partner to drive. We would be taking care of everything while racing to the trauma center.

We both started IVs at the same time, one in each arm. While we were doing this our patient became unresponsive. Now that we had IV access we poured in the fluids. We wouldn't normally do this but our patient had no blood pressure. We were losing him. After a couple of minutes he perked right up. His blood pressure was 70/P, not good but better than it was.The victim actually tried to argue with us as to where we were taking him. We informed him that he was going to a trauma center because his hospital of choice was not capable of handling wounds of this nature.

Arriving at the ER we found several ambulance crews lining the hall. Word had spread that we had a good trauma patient and everyone wanted to get a look. As I helped to slide the patient over to the hospital bed, I gave my report to the MD. I could see that victim #3 (the one I never saw) was in the neighboring trauma bay already intubated. The RT was waiting on a ventilator breathing for the patient by hand.

That was the last I saw of my patient. I headed back to the station where I checked my gear for blood. Thankfully I had managed to not get any on me. I helped finish restocking our rig then went back to bed, 2 hours after the call came in.

---Follow Up---

I found out that my patient was in the ER for about 3 hours before taking a turn for the worse. While being stitched up he coded. The ER doc cracked the guy's chest to try to save him. When he did the doctor discovered that the stab wound had actually punctured the heart. He died there on the table. There is an ongoing police investigation.

Does Not Play Well With Others

One of the major reasons that I became a paramedic is that I love helping people. I'm good at it. I don't fluster easily in emergency situations. One of the reasons I became a firefighter is I love to help people. Shocking huh?! I take my position as a civil servant very seriously. As a medic I am a staunch patient advocate. As a firefighter, I try to do what is best for the citizen that I am serving.

I was once naive enough to think that that was the way all fire departments work. It's been a while since I thought this way but I still get angry when I see the way some cities/departments provide emergency care.

Let me give you an example of what I think is a better way of doing things (maybe not the best but better). I grew up in Southern California. There are many largish fire departments (between 6 and 10 stations each) in the area that I called home. These departments all started using one dispatch center, reducing response times because you don't have to transfer the call to another dispatch center.

Another way they improved service was to drop all borders. Each unit has a GPS tracker. When a call comes in the computer tells the dispatcher which is the closest unit to the call, regardless of the jurisdiction. The cities and fire departments (and I would think PD as well but I'm not sure) mutually decided that getting help to the citizen in need was of more importance than who provided the help.

We'd love to help you but you're on the wrong side of the dotted line on the map.

This is not always the case. There are several departments with which we share borders. For various reasons (in some cases noses of some politicians have been bent out of shape, another case, the members of the FD act as if they are better than us) these smaller departments feel that they do not need to have the closest unit respond to an emergency instead electing to have their own unit respond.

In one of the cities my department has a station within their city limits. Yet, if the person that lives next door to our station calls 911, he will have the engine from almost 2 miles away respond. The captain on that engine may or may not request that we be dispatched since we're closer.

One day, while working overtime at that station, we had one of the residents from a half block down stop by with his son for a station visit. The dad was telling his son that if they had an emergency we would come help. I stopped him and explained that we would probably not get dispatched to the call even though we are the closest unit.

It's frustrating and childish to me. I would love to be able to sit the people in charge down and ask them if they think they are really trying to provide better care to the people. Stop getting into pissing contests like you're 13 and start doing what's right for your communities.

Progress is coming but it's slow.

Death And Dignity

 The call came in just after 9 in the morning. A possible DOA.

As we pulled up to the house there was no one to greet us, no one outside in a panic, no one screaming in panic.

Inside, the body of a nearly 90 year old man lay in a hospital bed. He had died sometime during the night. His wife and daughters were solemn but not openly crying. His death had been expected. This was why he had come home.

As I went through the motions of checking for signs of life the family explained that he had had severe respiratory problems. He had been on hospice care and had recently come home from the hospital. Rigor had set in, there was nothing we could do for him.

After verifying that he had died we switched gears and turned to the family. We asked if there was anything that we could do for them. If there was someone we could call. The oldest daughter explained that they had already contacted hospice. His wife explained that they were one week shy of their 69th anniversary.

The widow did have one request. They had tried to get her husbands wedding band off of his finger but were unable to do it. I bent over the body, reaching for the far hand. I found the ring, and with some struggle, removed it for her. This started the tears.

As we were leaving I couldn't help but notice the wall in the front room. It was covered with photographs of different sizes documenting almost 70 years of marriage.

At least he had come home to die on his own terms, surrounded by those he loved. A little more dignity in death than dying at the hospital.

Dazed And Confused

I wake up and look around. Very confused. It's 0328 hours.

Where am I?

It takes my brain about 2 seconds to come up with the answer. I'm at station 72 (working an overtime shift).

Why are the lights on?

About half way through this question my brain burns through the mental fog. I must have a call.

I get up and groggily stumble towards the apparatus bay. Time to go help someone. Hopefully by the time I get there I will be mostly awake.

Live Fire Demonstration

This is a couple of videos of a night time fire demonstration. I thought it was a fun to watch and decided to "borrow" it from Firefighterspot.com. It makes me want to have my department put on a demo of our own.





Notice that the cop was the first one racing to the scene? Even during demonstrations there's evidence that all police officers want to be firefighters (I hope my buds in blue know that I'm kidding).

Being able to do stuff like this makes up for the vomit.

Not On The....Boots

Engine 551, respond to the clock tower for a woman in and out of consciousness.

Once again someone decided to do a little too much at the fair. We pulled up to find the patient sitting in those chairs that have the foot massage (for something like $45 dollars per foot I'm sure). Her family was a little anxious. To be more blunt, they were annoying and were more in the way than anything else.

My patient was weak and dizzy. She looked pale. Mid assessment she passed out. This really set her family off. They were screaming for us to do something. Little did they know that we had switched gears and were now making sure that she was still breathing and that she had a pulse. I held her up while the rest of the crew grabbed the gurney. She started to come around just before we moved her. When she did regain consciousness she first looked around, confused. That look morphed into another, very recognizable facial expression. The one that people get right before the vomit.

The rest of my crew had seen it as well and jumped away faster than a rat off of a sinking ship. I was holding her up so I had no where to run. All I could think, just as she started to throw up was not on the....vomit splatters all over my boots....boots.

We loaded her up and took her back to the aid station to wait for the AMR unit. One of the other medics was kind enough to take over for me while I went and decontaminated my boots.

Have I mentioned lately that I love my job?

The Lighter Side Of Medicine

After the last couple of serious posts I think a little more humor is called for. I found this video in the comment section of another blog. It's hilarious. More so if you have ever treated a patient like this!

Email From The Man

This is an email that was sent by one of my readers to Kenneth Stokes (click on his name if you would like to email him as well) in response to his criticism of the way the paramedics did their job. Read the original post here.

Mr. Stokes,

I am befuddled and appalled by your criticism of the Paramedics in Jackson.  This of course is in regards to your press conference where you lambasted the company AMR and stated that the paramedics needed to, "...take the risk, you can't let citizens die, or sit here wounded because you're sayin' 'I'm not safe.'"

I applaud your camera-op heroics, because I assume that if you were on scene at the Pleasant Oaks Apartments you would do all in your power to help that young man.  Even if it meant you getting shot yourself, right?  

I ask you this, what good is a downed paramedic going to do for you?  In recent years we've all heard the news reports of gun violence.  Now think with me, if someone took the initiative to shoot this young man, don't you think that person would use the gun again.

Now continue to think with me, if only there were a force that was highly trained on how to deal with gun violence.  Maybe a group that had protection and guns of their own.  Maybe we could call them the Police.  

The Police have a job to do, and from what I've seen and read they did it effectively, allowing medics to treat the young man within 8 minutes after receiving the call.  NOT the 21 minutes you claim. 

You see everyone has a job to do.  The Police secure the scene.  The Medics treat the victim(s).  The City Council member then has the job of placing blame on a group to make themselves look more important.  Or maybe, just maybe, the City Councilman should instead make the city safer by curbing the violence which ravishes the city they serve.

The Man

To "The Man," I loved the letter. Hopefully more people are writing this jackhole (a term a good friend used to describe Mr Stokes).

Watch It Burn

                                

It's a sad story when ever someone loses their home, no matter what the cause. But this story has caused some heated emotions. Understandably so.

But, sad as it is, the situation was brought on because of several factors. The South Fulton City Fire Department is a pay for service fire department for citizens in the local rural area outside of their jurisdiction. They charge an annual fee of $75 for the contract. If someone lives in the area and doesn't pay for the services, they don't get them.

I know that a lot of smaller departments will charge for services rendered to people that don't live and pay taxes in the area. Such as when someone passing through on the highway has an accident. It's a way for them to recoup the costs of helping someone out that hasn't paid for services.

I'm glad that the local citizens reportedly aren't upset at the firefighters. I know that firefighters want to fight fires. Period. We don't care where, when, whose it is, who paid....we just want to fight fire. The issue is with those in power above us.

So the question is was the city of South Fulton justified in refusing service. I think that they were. Let me explain why I believe this way.

To start with, it is a service offered for a fee. If you don't pay the fee, you don't get the service. So why not let Gene Cranick pay the fee now that he has a need for the fire department. In order to answer this question you have to be able to look at the situation from a large scale perspective. The fire department uses the money generated from these fees to help pay for training, upkeep and equipment.

So why not let Mr. Cranick pay the $75 fee as his house is burning down? If the department allowed that then the only people that would pay money into the system would be those actually having the fires. This would dramatically increase the service fee. Also, according to the Onion County statistics, there are several departments that do just this. That is bill for services rendered. They are only paid 50% of the time.

I think that the bigger issue here is that the people of Obion County have decided that they are happy with this type of fire protection. Sure, there are some that don't but they are in the minority. In 2008 the county did a feasibility study seeing if they could form a county wide department instead of having 8 separate departments covering most of the county. Here's a list of those departments:

• Hornbeak Fire Department
• Kenton Fire Department
• Obion Fire Department
• Rives Fire Department
• Samburg Fire Department
• South Fulton Fire Department
• Troy Fire Department
• Union City Fire Department


Of the 8 departments only Union City Fire has career firefighters, 42 of them. The rest of the county is covered by 144 volunteers.

The study showed that with a 0.13 cent property tax the county would be able to provide fire department coverage to the entire county and improve response times. For reason that I was not able to find, this consolidation did not occur. That means the elected officials of the individual communities must have turned it down. So the issue goes back on the voters. They chose their elected officials. Maybe it's time for a change.

Furthermore, Gene Cranick chose to live in an area with sparse fire protection. That is a risk you assume when deciding to live in a rural area. It's like living in California and deciding not to get earthquake insurance on your house. Sure, you may not need it. But if you do and you don't have it you're screwed.

Basically I feel that this is a problem that the people of those communities have allowed to happen. They need to elect people that will make the changes that are needed for better coverage. Maybe they need to be willing to pay a little more in taxes as well.

A little side note. In the news story the homeowner said that the fire started in a pair of 55 gallon drums and then moved to a shed before getting to the house two hours later. I know I'm not getting the full story here. Was someone there when it started? A garden hose should be plenty to stop a fire like this in the early stages. Something doesn't seem right to me with the way the story has been told.

As for the firefighters. I understand why they followed orders and didn't attack that fire. But, as I understand it, those firefighters are all vollies. I would have stepped away from the IC and said that as long as I'm not needed by the department I'm going to go help my neighbor. I may not have had an engine and hose but I would have done what I could. At least I'd like to think that's what I'd do. It's tough to say since I wasn't there in the situation. It's always easy to armchair quarterback things like this.

Is The Scene Safe?

Ask any EMT just out of school to walk through a scenerio with you and it will always start out the same. Is the scene safe?

This is something that is drilled into EMS personnel from day one. In any emergency situation, we need to make sure that we don't add patients to the problem. Another way of looking at it is if I get injured/killed, who is going to take care of the initial problem? No offense to the general public, but my highest priority is going home at the end of my shift. I think most people would understand this position. Not everyone.

There has recently been a mild uproar in the EMS blogging community about the comments made by Kenneth Stokes. Mr Stokes is upset because of the apparent inaction of an ambulance crew in his community. The AMR unit was dispatched to a shooting and were "staging" or waiting until the police officers cleared the scene. Roughly 20 minutes elapsed from the time of the call to the time that the patient was seen. Stokes asserts that the medics had a responsibility to go into harms way to treat the patient.  

Read the news story here.

My question to Mr Stokes is this: Why would you send someone into an emergency situation for which they have not been trained or equipped? Medics (there are exceptions to this) are not trained in police tactics. They aren't issued body armour and a gun. No where in their job description does it say that they are expected to perform under gun fire. Do you ask your police officers to go into a hazardous materials release to get a victim? I bet you wouldn't. And you'd be right not to do that. Without the training and equipment you would just be sending in another body for the FD to drag out. And trust me, the cop would come out before the civilian.

Mr Stokes, our job is dangerous. We do it anyways. We deal with the dangers for which we have been trained. We work on streets, freeways, highways, in upside down vehicles, with blood borne diseases, fires (in the case of fire/medics), electrical hazards, HAZMAT situations and do it all as carefully as we can. We know those risks and do what we can to mitigate them. The way we mitigate a potential violent scene is by calling PD and letting them do what they have been trained to do.

If you agree or especially if you disagree, I'd love to hear from you.

Money Troubles

I've worked in areas where my crew and I were fairly isolated. It regularly took 30 minutes for any additional help to arrive....but we knew they were coming.

For those of you that don't know the city of Detroit is having an EMS crisis. They have very few ambulances that are functioning. Recently there have been several stories in the news and in the blogosphere showing just how bad it is. The city does not have the money to repair the rigs. It's so bad that there have been accidents involving emergency vehicles that may have been caused by brake failure and bald tires.

I'm not going to say that we, the voting public, need to raise taxes to pay for emergency services. I am going to say that we need to look a little closer at the budgets (on a local, state and federal levels) and figure out what needs to be done in order to keep basic needs met. I for one don't want to have to wait for 30 minutes for a paramedic in the middle of a city.

Monkey See, Monkey Do

1423 hours

Truck 51, respond with engine 57 for a motorcyclist down....

The truck was canceled by engine 57 while en route to the call, but they were already committed to the canyon. They passed the accident and saw that the rider had laid his bike down but had not gone over the edge.

1712 hours.

Engine 51, rescue 42, battalion 5, respond for a motorcycle down, possibly over the side....

As we started up the canyon we verified with dispatch that an engine and ambulance were responding from the city on the far side of the canyon, just in case they were closer.

As we wound our way up the narrow road a CHP unit came up behind us. Since he was able to take the road at a lot faster pace, we let him go by. A couple of minutes later we came up on him again. He was stopped behind a group of motorcycles and cars where one guy lay out on the ground. We immediately reported what we had and the responding BC canceled the balance of the assignment.

My patient had been traveling up the canyon when he hit some gravel and spilled. He didn't lose consciousness but was experiencing neck and back pain and also pain to his left scapula. We quickly did a "strip and flip" (a quick trauma assessment where we cut the clothes off the patient and check head to toe for injuries) then strapped him to a backboard.

It was about this time that we started to wonder about our ambulance. My captain called dispatch and found out that when all of the responding units were canceled, the ambulance was inadvertently canceled as well. Dispatch then informed us that there was still an AMR unit coming from the far side of the hill. We then asked for an ETA only to find out that that unit had gotten lost and was 30 minutes out. We had another unit sent from our side of the hill.

Meanwhile, we had time to do everything we needed with our patient. We had a complete history and physical. I started an IV and offered some medication for pain management, which was refused. We still had time to kill. We started making small talk. That's when we found out that he had traveled down to our trauma center to visit a friend in the ER. His friend had been in a motorcycle accident several hours ago, about 100 yards from where he was now strapped to a backboard. He had been unable to see his friend (because he didn't know his friend's last name) and had been on his way back home.

Almost an hour after he hit the asphalt my patient was loaded into the back of an ambulance. He was headed back to the trauma center where he had tried to get in to see his friend. Maybe they shared a room.