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.

Oops.

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.

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.

Why Does The Fire Department Respond?

One of the questions we get quite often is why we send "big red" on medical calls. After all, isn't that what ambulances are for? Isn't that a waste of fuel/time/resources for a simple medical call?

Before I answer these questions let me just say that fire engines don't respond to medical calls all around the country. Every area has a slightly different system in place. I am going to talk about my system (since it's what I know best).

Where I work we have a private ambulance company that responds to and transports patients to the hospital a la AMR/Westmed/Rural Metro.. They are usually staffed with one paramedic and one EMT. They have, under their company's contract with the county, between 8 and 10 minutes to respond to critical EMS calls depending on where the call is (more rural locations have longer time allowances).

So why does the fire department respond to medical calls?

First off, state law in California requires two paramedics to respond to medical emergencies. Some places do that by staffing two medics on the ambulance. We do it by staffing one on the ambulance and one of the fire engine/truck. Every engine and truck in the county in which I work is staffed with at least one paramedic.

So why do we choose this method instead of staffing the ambulance with two medics and letting just the private ambulance respond?

Ambulances, especially those belonging to private ambulance companies, are spread pretty thin. Private companies are in this game to make a profit so the fewer ambulances and crews they need to staff to get the job done the better. However this can mean longer response times. Fire stations and crews are more plentiful and usually closer to any given incident (at least with career departments) allowing for faster response times.

An example of why this isn't in the best interest of some patients. There was a call in my district (on the other shift) a couple of days ago. The call came in as a lift assist. This is usually for your stereotypical "I've fallen and I can't get up" scenario. No big deal.

While on their way to the call the woman that called 911 for her husband noticed that her spouse was no longer breathing. The firefighters were on scene within a minute or so and were able to render life saving care (yes, he made it). The ambulance on the other hand took 8 minutes to get to the scene. According to Wikipedia "Without special treatment after circulation is restarted, full recovery of the brain after more than 3 minutes of clinical death at normal body temperature is rare."

Who would you want responding to your spouses untimely death?

Another reason the fire department responds is manpower. On most calls you only need a couple of people. But often you need more. CPR in progress, vehicle accidents with multiple patients, obese patients and other similar calls require more manpower than the ambulance crew can provide.

So if the fire department is going to respond why send the big fire truck and not just a small vehicle with EMS gear?

We respond with the big fire engine/truck is that we are always ready to respond to an emergency. If we were just clearing the scene of a medical call and we had responded in a small pick up truck only we wouldn't have the correct tools with us to respond to a structure fire. We would have to go back to the station and change vehicle. In a job where time matters we have to always be able to respond. No matter the emergency.

There are other methods out there such as the Squads LA County Fire use but those require more personnel. I know LA City Fire has used firefighter/Paramedics riding on motorcycles to get through traffic. But again, that requires special staffing unless you want an engine or truck crew to be without their medic for a while.

Our system may not be the best but it's better than any other EMS system I've worked under so far. I'm curious to see how we adapt to future needs of our citizens.

Ending It

I'll warn you now, this post may be a bit graphic. But it represents a part of my job and I post it so that others who may be interested in a job in the fire service or EMS can better understand what they are in for.

At the very beginning of the shift the tones went off. At times like that you hope that all your equipment was left in good shape by the preceding crew.  Especially on calls like this one.

We were responding for a full arrest. PD had received a 911 call stating that a person had hung themselves. The call was in the neighboring district (engine 110 was out on another call) so we had a longer response time than usual.

We pulled up and parked behind a couple of police cars. The officers in our city are great. They have no problem responding to critical medical calls and getting in and helping where they can. One of the officers came out and met us. He informed us that only I, the medic, needed to go in. This told us that I was simply determining death and that there was no need for everyone to go in and disturb a potential crime scene.

Inside I found another officer taking photos for his investigation. On the floor was the body of a man in his late 30's. Rigor mortis had set in and it didn't allow his body to lay completely flat on the floor. Because he was in rigor determination of death was made, 0752 hours.

Looking closer at the face of the man I could see that it was distorted. The officer stopped taking pictures for a second to explain that he had walked in and found the man hanging from the pull up bar in the doorway to his bedroom. He had used a leather belt to do it. The belt had slid up around the cheeks and the face "froze" in that position after death. The bar was to low for the man to hang completely so his legs seemed to be dragging on the floor behind him.

The worst part of this entire call was that the dead man's mother was the one to find him. She walked out in the morning and there he was. We contacted a clergyman from a local church to come and comfort the old lady. We then cleared ourselves from the call in case we were needed for another emergency but stayed with the mom until the clergyman arrived.

No Relaxing

All of the chairs were pushed back out of the way and the table had been moved near the wall. In the middle of the conference room was our patient. He was sitting on a chair cradling his left arm. 

I introduced myself and asked him what had happened. He said that during a meeting he had leaned back in his chair and stretched both of his arms toward the ceiling (I guess is was a boring meeting). During mid stretch his left arm popped out of its socket.

I asked if he had ever dislocated his shoulder before. He hadn't. He had no medical history and wasn't taking any medications. But he was in a lot of pain.

After starting an IV I gave him some morphine. My patient felt much better after that. So much so that he started cracking jokes. Hr started asking if I would write a note to his wife stating that his injury would preclude him from changing any diapers for the next 6-8 weeks.

Good luck with that one.