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.