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Thursday, May 15, 2014

Going, Going......Gone

We got dispatched for a medical aid just after lunch. We were told that we were responding for a 95 year old male who was ill and unresponsive.

We arrived and were met at the front door by the family. The house was a mess. It was another hoarder house. Trails leading throughout the house. The family had slid their father/grandfather to the front door on a chair. As I walked up I asked what was going on while in my head I did a quick visual assessment of my patient. I could tell just by looking that this wasn't going to go well.

The family told me that the man had been unresponsive since the night before. His mouth was filled with crumbs because someone had decided to "feed" him while he was unconscious. He was breathing, but just barely. I reached out and checked for a radial pulse and found nothing. I did find a carotid pulse but it was slow and weak at about 45 beats a minute.

Something didn't seem right with the story so I asked again how long the patient had been down. I was told this time that their father had stopped responding to them this morning.

I little later on I asked a third time and was told that the old guy had only been unresponsive since lunch time.

I love it when stories change.

AMR showed up and started getting their gurney ready. I checked a BP (105/52) and a sugar (182). I also through the patient on the heart monitor (sinus bradycardia, no ectopy).

At this point, rather than staying on scene and pretending to be a doctor we scooped and ran. At the back of the ambulance I asked the medic if he wanted me to come along.....just in case.

He declined (you got to love young inexperienced medics that think they can handle everything by themselves).

I looked at the patient again and told the young medic that I was coming along for the ride.

As I walked around to the side of the ambulance the little voice in the back of my head told me to grab our Autopulse. I told the ambulance crew to wait for just a couple of seconds as I went to the truck to get the equipment. As I returned to the ambulance I could hear the medic remark that he hadn't seen the old man take a breath in a while.

Great. Just great.

I checked for a carotid pulse. Nothing. The old guy had coded.

I had the young medic help me get the patient onto the CPR device and told the driver to go. While en-route to the hospital the two of us would do everything we could to get the patient back. I was at the head of the patient so I took over on airway. I sank in an OPA and had good compliance with the BVM. In between breaths I flooded the IV line, grabbed the medications, put the patient on the StatPadz and checked the patients underlying heart rhythm.

The young medic attempted an IO but his drill died. He then got an IV established and administered the medications.

We rolled into the ER with the now dead patient. The ER quickly went to work continuing our resuscitation attempt. After 20 more minutes of CPR the MD finally called it.

Time of death 1406 hours.

Thursday, May 8, 2014

Water Flow Alarm

The tones went off just about 10 in the evening. There was a water flow alarm at one of the warehouses in our district.

A water flow alarm goes off when there is a water moving inside the pipes of a buildings sprinkler system. In a monitored system when the alarm sounds we also get toned out.That way if there is an actual fire we can get there in a timely manner.

This time however was like most times. Someone in the warehouse accidentally broke a pipe.

We arrived on scene and were met by one of the supervisors. She said that one of her employees had dropped a box on a pipe and cracked it. They had already contacted the alarm company who said they would be out there first thing in the morning. Meanwhile there was a lot of water spraying everywhere.

Our game plan was to shut off the water to the sprinkler system and then just to let the entire system drain. To do this we had to find the "risers." Pipes through which water is pumped up the side of the wall to the ceiling where the piped then form a grid to provide adequate coverage in case of a fire. The problem was in a building this size (about 500,000 sq ft) there are multiple risers.

Near each riser is a shut off valve. In this case they had a shut off valve on the riser itself (about 7 feet off the ground) and a PIV (Post Indicator Valve) at ground level.

While my engineer and I did some recon to find out just how many valves we were going to have to shut off my captain looked a little closer at the pipe. He noticed that the pipe had been bent upwards causing the crack. He decided to apply a little downward pressure to see if he could stem some of the flow. Nothing happened. So he decided to apply a little more pressure. He found that he could greatly reduce the amount of water leaking.

Most of you can probably see where this is heading.

My captain then decided that if a little pressure was working so well that a little more pressure would be even better. I don't think he consulted with Murphy on this one. The pipe cracked again. This time causing even more water to cascade to the floor.


While we went around turning off all of the PIV's we were followed by the assistant might manager. He kept offering little quips and asinine suggestions. At one point he muttered to my engineer that all firemen do is break s**t. He's lucky I didn't hear that one. I don't think I would have been able to stop myself from saying, "You're right. We'll leave." One of his suggestions was for us to shut  down the water main in the street. We had to remind him that he wasn't the only customer that the water company had.

Eventually we got all the valves shut off. The water flow slowed as the entire system drained. Neither the manager nor her assistant offered a thank you.

Oh well.

Thursday, May 1, 2014

A Hug

The tones got us up just before 3 a.m. Someone in our district needed our help.....or at least they think they do. After donning my bunker pants I slipped into the firefighters seat and put on my headset. With little more than a grunt I let my engineer know that I was on board and ready to go. I was still trying to shake loose the cobwebs in my mind.

Dispatch let us know that we were just going out for a lift assist. Usually not a big deal and this one proved to be routine.

We got to the house and an elderly woman met us at the door. She walked us into her beautifully kept home back to the bathroom where her husband had fallen. His health had been deteriorating over the last couple of months to the point where he really wasn't able to walk. Once he fell he didn't have the strength to get back up.

We helped the gentleman up and into the bathroom. While he did his business we stayed and talked with the wife. We learned about the 40 years that they had been in the home. All about their successful kids that were now all around the country. A couple of times they tried to get us to leave insisting that we didn't need to waste our time waiting. We gently encouraged both of them to let us stay and make sure the husband could get back to his bed. Finally they acquiesced.

We were glad we stayed. The old man was able to use his walker and get about halfway down the hallway before his legs gave out. We caught him and carefully carried him to his bed. After assuring that everything was as good as it could be we bid our farewell.

13 hours later we were just clearing a call on the far side of our district when dispatch asked if we were able to take another call. It was at the same house we had been to for the lift assist. Thankfully Engine 110 from the next district over was close to where our call was. They said they'd take it for us.

Then dispatch updated Engine 110 saying that the patient was unconscious. Knowing who it was and their medical problems we were concerned that the old guy wasn't just unconscious but dead. We decided to head over and see if Engine 110 needed assistance.

Upon arriving we found the ambulance had already made it there too. I walked in just in time to hear my patient asking the crew from 110 where we were. I popped my head around the corner and said we were right there. I explained that we had been out of position for the call so this crew stepped in for us. Both the husband and wife were happy we stopped by.

Turns out the husband had had his BP drop significantly. He was even weaker now. His wife looked as if she was barely keeping it together. Clearly she was worried about where this downturn in health was headed. After making sure the patient was in good hands I quietly approached the grandmother of 7. I told her she looked like someone that needed a hug. She simply nodded her head and gave me a big hug.

While there isn't much we can do long term for her husband I hope that a simple hug and some kind words let her know she isn't alone in all this.

I'm sure we'll be back again.
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