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Wednesday, January 30, 2013

Progress

Some say the fire service is 200 years of tradition unimpeded by progress.


Sometimes, I agree.

Sunday, January 20, 2013

Someone Hit My Station?

The tones went off at oh dark thirty. I must have been still in my sleepy daze because I thought I heard the tones for a traffic accident and my station address. Did someone really hit my station?!


I jumped into my bunker pants and grabbed my jacket. I looked out the windows on the apparatus bay doors to look and see if there was anything right out front. Nothing. My captain had checked the front door on his way to the rig. Again, nothing.

We pulled out of the station and saw a vehicle that had crashed into building down the block. I guess the 911 caller used our station as the reference when reporting the location of the accident.

The car had crossed oncoming traffic lanes, hit a power pole and then went head long into a cinder block building, oddly enough, an auto repair shop. The woman that had been driving (term used loosely) was just about the legal drinking age. And she was drunk. Plastered.

She was still wearing her seatbelt and the front airbags had deployed. My engineer immediately went for the car battery (disconnecting it helps to reduce the chance of another airbag going off and injuring us). I poked my head in the car and turned off the vehicle. I also placed it into park and set the emergency brake.

While trying to stay out of the airbag deployment zones as much as possible I did a quick assessment. I noted that the patient had a fractured right arm and that she was bleeding on her right leg. AMR was on scene and getting the backboard ready. Their EMT grabbed c-spine and I applied the collar. Once she was out of the car and onto the backboard we were able to do a strip and flip (this is where all of the patients clothes are removed to look for any injuries that may not have been so obvious). We found that the young woman had managed to break the bones in her lower leg and now they were protruding through the skin. This was the source of the blood I found earlier.

With the patient packaged and on her way to the ER we were free to make sure the vehicle wasn't leaking any fluids. Since we had already disconnected the battery there wasn't anything else for us to do. We headed back to the barn to try and get some more shut eye.

No sooner had we stripped out of our turnouts then the phone rang. It was dispatch saying that PD was requesting are presence on the scene of the accident we just left. Evidently the car was pinned against a power box of some sort.

We walked back over and looked. The car wasn't against a box. In fact, it had bounced back off of the wall and wasn't touching anything. And PD said that they didn't ask for us. Maybe dispatch was bored.

Friday, January 18, 2013

Save A Life

Take a minute to learn Hands Only CPR. For more information go to Heart.org.

No Good Deed

No good deed goes unpunished.....


So assuming that there was an actual need to place the patients in C-Spine (which I highly doubt) you're trying to tell me that the paramedics there couldn't find a way to extricate the victims from a perfectly good car? If they can't remove someone from a perfectly intact car does this mean they do a full auto-extrication on every traffic accident? What a fun job for the firefighters!

All I can say is if the insurance company doesn't cover the cost of the vehicle the ambulance company should.

Thursday, January 17, 2013

Time Of Birth

Some calls are good calls. Few of what many of us in emergency services would call a 'good call' are good for the person calling 911. Good calls to us tend to be on the more serious side. Ones where we may actually make a difference between life and death or one where we use some of the technical skills that we have developed to mitigate the negative circumstances. But every once in a while you get a really good call.


We pulled onto the street with lights blinking and siren wailing. Dispatch informed us that we were responding for a 25 year old woman in active labor. A minute before we pulled up to the house the radio crackled again, "Truck 51, Medic 422, the baby has been born. Time of birth, 0857 hours."

We walked in the house which was bustling with activity. Grandma was there trying to keep the two siblings out from under our feet. There was another woman there who may have been the sister of the mother.

We found mom laying on the bloody bathroom floor with her baby in her arms. The newborn was wrapped in a receiving blanket and a couple of towels. I check of the baby found him to be in good shape. His initial APGAR was 8 with the repeat 5 minutes later being a 10.

We clamped the umbilical cord and cut it. My partner then took the baby into the next room while I helped the AMR crew get the mom onto the gurney. Once she was settled in the baby was again given back to her.

The mom was going to call the father (who was at work) to let him know of the birth from the back of the ambulance. That would have been a fun conversation on which to eavesdrop....Hey honey, guess what.....

Monday, January 14, 2013

Schedule Your Emergency

If you live in Tacoma, Washington and you live near fire stations 13 or 15 you may want to plan your emergency for sometime during the day. And it better not involve a fire.

Photo Credit: King TV

Recently the Tacoma city council decided that in order to save money they would replace the fire engines at two of their city's fire stations with pick-up trucks (news story here). These pick-ups would have some medical gear and two firefighters and one would only be staffed from 7 in the morning to 7 in the evening.

Just 49 minutes into the first day of this staffing there was a structure fire in District 13. In this instance it didn't matter that the new Squad 13 has no fire suppression capabilities since they were on another call. But for the forseeable future, anytime there's a fire in districts 13 or 15 all the guys on "Not So Big Red" will be able to do is point and say, "Yep, your house is on fire."


In reality they would be able to do a search of the building to make sure people were out of danger but they won't be able to put the fire out.

How much do you want to bet that none of the city councilmen live in either of the aforementioned districts?

If You Don't Care....

We have another frequent flyer (read about some others here, here and here). Shocking I know. It seems that when one disappears (dies, moves, is sent to jail) another one appears. Some houses just generate a lot of calls throughout the years. The people living there are in poor health so we go a lot. This was the case for our new frequent flyers. Except they've moved on from calling once every few months to calling 6 times in the last week.


In the last 4 days I've worked this lady had called four times. One time each day. Each time she had complained of pain around her kidneys. The first time we started our assessment but AMR showed up before we got too far into it. We got her on the way to the hospital quickly and I assume the medic on the ambulance took care of pain management.

The next day she called again. I asked if she felt the same as the day before and she said yes. I asked what had been done in the ER and she didn't know. All she knew was they sent her to get her blood drawn at the lab and now she was waiting for the results and she had a script for Vocodin. AMR was Johnny on the spot this time as well and we shipped her off to the hospital rather quickly.

While I was off for the next 4 days she called twice.

Then I came back and started my shift with a call from her. This time the pain was the same. All the answers to the pertinent questions were the same. She still didn't know what was going on. This time she did have her lab results and she said that she was waiting for her Dr. appointment to go over the results with him/her.

The last time she called was the most interesting. This time her son was there. He, assuming I didn't speak Spanish, proceeded to tell me what was wrong with his mom. He said she had a seizure. She denied this. He said she was throwing up. She denied this too. She did say that her lungs hurt in addition to the kidney pain.

Before I could get any further the son said that his mom had had surgery on her stomach last week.

HUH!?!

I asked my patient and she confirmed it. So I asked what type of surgery. No one knew. I asked what it was on and no one knew. I asked if they took something out and again, no one knew. The patient now said that her incision site was bothering her.

And in walked the AMR medic. Thankfully it was one that had been here before. I asked her if she knew about the surgery. She didn't. So I wasn't the only one kept out of the loop on that one. So we loaded her up and sent her off to hospital again. We'll see what happens this time.

My question is how do you let someone slice you open without knowing the reason. How was this surgery going to fix whatever problem she had? I mean if you don't care enough to know what the MD is doing to your body who will?

Wednesday, January 9, 2013

The Fire Station

I think I have an awesome fire station. It's newish, it's big and it's mine (at least I claim ownership while I'm assigned there). But there are some cool fire stations out there.

Station in Cologne, Germany.
Station in Mexico City, Mexico
Station in New York, New York
Station in Ponce, Puerto Rico
Station in Saxony, Germany
Station in Sinningen, Germany
Station in Heidelburg, Germany
Station in Leipzig, Germany
I guess what I'm trying to say is that there are some really amazing fire stations out there in the world. But I'm still proud to call mine home.

Monday, January 7, 2013

Pre Omniscient?

We were standing outside the station talking to a couple of the local PD officers when one of them said that we were getting a call. He gave us a location and said there was a mattress on fire. We jogged back into the station and jumped on the rig passing a very confused battalion chief on the way.


The air brakes released and we started rolling. Then the tones went off. Then the battalion chief stood there wondering how we knew of the call instead of where we were going.

On scene we found several people outside of a wood fence. On the other side of the fence there was a decent size fire going. My captain went over the the fence to clear the people out of the way and to open the gate. Fortunately there wasn't a lock or he would have had to break the fence.

I grabbed the bumper line and chose a path between all of the parked cars. I was careful to lay out my line in such a way that it wouldn't get kinked when there was water in it. The fire was consuming what was left of a queen size mattress. The wood fence and the house were both smoldering as well. Within second the fire was out. I then completely flooded the entire area to make sure there wouldn't be a rekindle.

After my engineer and I drained the hose and stowed it we joined my captain who was talking to the renter of the house. He said that he had found the mattress out in front of his house. The man had left it at the curb next to his trash bins for the garbageman but when he returned from work the mattress was still there.

That's when genius struck and the guy decided to torch the bed. It was obvious he never anticipated how big the fire would get. He had the mattress on the side of his house where it was touching a wood fence on two sides and the house on another. We got the call because a police officer had been driving by on the way to another call and saw flames licking the eves.

Job security.

Wednesday, January 2, 2013

Cancer Wins Again

When calls come in around 6 in the morning I always think the same thing. Someone woke up to find so and so dead.


While I shook the cobwebs out of my brain dispatch informed us that we were responding for a possible DOA. In situations like this my mind used to wander through ACLS protocols but not any more. After a while things become automatic, like riding a bicycle or driving a car.

We silently (well, as silently as an 80,000 pound truck with a powerful diesel motor gets) moved through the predawn streets with our emergency lights on. There was no need to wake anyone if we didn't have to.

At the house we were directed by a somber couple to the back bedroom. They said they had found her this morning and called immediately. They also provided us with a DNR.

In bed I found what was to have been my patient. The body of a woman in her mid 30's lying motionless and lifeless. I first checked for a pulse knowing that I wouldn't find one. I then checked for one of the obvious signs of death (more out of habit than anything else. The DNR meant that there were to be no resuscitation efforts) I then placed the electrodes on the body and checked 2 leads to make sure the patient was in asystole.

Afterwards we removed the electrodes and covered the body. We found out that the woman was a niece of the couple that let us in. She had been staying with them while she fought cancer. Then, when she knew the battle had been lost, had decided to stay with them until the end.

We asked if we could call someone. The aunt and uncle had already contacted hospice care. A few minutes later we were on our way to Starbucks. As long as we were already up.....
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