Lung Cancer

The call came out for difficulty breathing at about 9 in the morning. When we arrived on scene we were met by the patients brother who explained (as we walked) that his brother was recently diagnosed with lung cancer. I found my patient laying in bed almost gasping for air. I immediately had him put on high flow oxygen. My patient told me that he has been short of breath ever since he started his chemotherapy but that in the last two days it has been getting worse. He finally decided to call us when he started coughing up blood. His lung sounds were clear and the rest of his vital were OK. I started an IV and then checked on how his breathing was going with the oxygen. He told me that he felt like he had finally caught his breath. We left him on the high flow oxygen and sent him down the hill. Sometimes is the simple treatments that make the difference in your patients.

SOB, blood in sputum, o2 made better

Auto Ex. Take Two

We got together with the guys from CalFire engines 3560 and 3586 to do some auto extrication training.



The Geo Metro about to be eaten by Truckzilla.




This shot is entitled "Pull Over!"



This is the view from my seat in the cab of Medic Engine 462. I promise that the Geo Metro is still in front of us. You just can't see it.



CalFire Captain starting his lecture.




Our "tool cache." This is the area we set up with everything that we may need to get someone out of the car.




This was the first time for this firefighter to cut up a car.

Ashley manning the power unit.

This was a race to see who could cut off their half of the roof faster. The team with the sawsall, or the team with the hydraulic cutters.

I think it's obvious who won.

Rolling to dash forward to make access to the patient a little easier.

September 11

September 11 is a day that means a little more to firefighters (and to be fair, other emergency personnel as well) than I think it does to the general public. Here in Morongo Valley our local elementary school put together a ceremony to honor those that died in the terrorist attacks on September 11, 2001 and to honor their "local heroes." They invited members of the San Bernardino Sheriffs Department, the California Highway Patrol, Marines from 29 Palms military base and firefighters from the Morongo Valley Fire Department to a ceremony. the honored those lost with a moment of silence and had the Marines lower the American Flag to half staff while playing taps. They then honored us by having a child (one child per person being honored) give us each a medal and a certificate while our names and titles were read off. We often get people thanking us for what we do when we are out in public. It's not often thought that we get stood in front of a crowd and called heroes. This experience was more than a little humbling for me. Some of us ended up getting our picture in the local newspaper. Yes, I bought ice cream for that.

Rodeo

On my shift one of the things we train on is called the "rodeo" (a term used by us). This simulates everything that a fireman may have to do here in Morongo Valley on a structure fire before help gets to him. This is roughly what we do. We first have the fireman (this time it was Grant) get dressed in his turnouts and SCBA and "click in" (this means he is using his air bottle to breath and not regular air). He then has to tag the fire hydrant (connect the hose from the engine to the hydrant and turn on the water). The fireman then runs to the engine and grabs one of the preconnected 1 3/4" hoses and drags it to the objective and flows water. This time there were some neighborhood kids at the park which enjoyed getting soaked by the training fireman. The fireman then has to run back to the engine to grab the "irons." He then has to return to the nozzle to flow some more water. He then makes the trip a several more time for different tools and flows water in between each trip. The last tool that he is instructed to grab is the 8 pound sledge hammer. He then has to swing it over his head and hit the target (the dirt or a tree stump) 50 times. About this time is where the firefighter is about to drop from exhaustion. The last time that we did this we had just started getting all the equipment back on the engine when we got a call for a vehicle over the side on the Morongo grade. We quickly loaded everything but the hose on the engine and ran the call. It turned out to be nothing. After clearing the call we headed back to the park to rebed our hose.

Smoke Investigation

We got a call for an illegal burn. the citizens of Morongo Valley are a little skittish when it comes to fires since they have had two major fires in the last three years or so. The RP (reporting party) stated that there was smoke and flames visible. Little did we know that as we were responding so was almost half of the deputy sheriffs in San Bernardino county. We ended up with 5 or 6 SO vehicles running around with us looking for this fire. At one point one of the deputies got in the way of us in Medic Engine 462. As we approached he realized that the lower part of our bumper was about equal to the roof of his squad car. Needless to say, he quickly got out of our way. We could almost hear him say, "AAAHHH! I'm going to get eaten by truckzilla!!!" We finally found a couple of kids that started a bonfire in their back yard. They were chewed out by our fire marshal, a sergeant from the sheriffs department, and a captain from CDF that Craig called in. There was a lot of man power for a couple of kids. As the last SO was leaving I asked him why the large showing of deputies. He said that they were bored and the call sounded like it might be good. Further proof that all cops wish they could be fireman!

Trying to Get Dinner

A couple of weeks ago we sent Eric and Grant up to the store while I stayed at the station with Craig in the brush engine. We just put all of the ALS equipment into the brush engine. As Eric approached the top of the Yucca grade we got a call for a person possibly having a stroke. Craig and I were done with everything that we needed to do by the time that Eric made it on scene. After we shipped the patient off with MBA we sent Eric to the store again.

This time Eric made it all the way to the parking lot of the store in Yucca when we got toned out for another call. this time it was another "stroke" victim. It was really a daughter that was worried about her mom. The mom wasn't happy to see us and signed out AMA. Eric made it back just in time to help us to the rig with our bags. Again, we sent him to the store.

This time he was just about done shopping when we got toned out for the third call. This was the unresponsive patient in the previous post. MBA was loading this patient by the time he got on scene. At least this time he had bought everything we needed for dinner.

Overdose

The call came in for a person down and possibly not breathing. We responded over to the trailer park and found an 83 year old woman sitting in a chair on her porch. Her domestic partner (that is a direct quote) stated that my patient had been sitting and talking when she just passed out. When she didn't wake back up we were called. My EMT quickly got a set of vitals and placed the patient on some oxygen. I asked the domestic partner to get get any medications that the patient might be taking. I checked the blood sugar and it was 147. The patients vitals were all within normal limits. She just wasn't conscious. I checked her pupils and they were pinpoint which can indicate the use of narcotics. Even though her respiratory rate was fine I decided to push some Narcan to see if I could reverse some of the nervous system depression. She started to come around after I gave her some Narcan. She didn't have any narcotics in her prescription medication which makes me wonder where the 83 year old was obtaining her recreational pharmaceutical substances. Hhhmmmm.

Allergic Reaction

A couple of weeks ago I took the brush engine to station 2. Just as I was turning into the station I heard Chris (now an acting engineer) come on the radio informing dispatch that we had a walk in medical aid, a possible allergic reaction, at station 1. I quickly turned around and headed back for station 1. By the time I got there Chris and Ben (a new firefighter on Monday - Wednesday shift) had already preformed a decent assessment, got me vitals, and placed the patient on oxygen. At this point I did a once over on my patient and saw that he was in severe respiratory distress. He could only speak in one word gasps. He is allergic to bees and was stung about 10 minutes earlier. I got my epinephrine and drew up the appropriate amount. About that time the patient's eyes started to go wide because he could no longer get enough air past his constricting throat. I gave him a subcutaneous shot of epinephrine and within a few moments he was able to breath again. I then started an IV and gave him some Benadryl. Right about then MBA showed up and he was transported.

Changing Gears

We got toned out for an ill woman (just the type of call we all love to get) at about one in the afternoon. When we arrived on scene we were met by the woman's caretaker (loosely termed, nurse). The caretaker stated that she had been driving through the area on her day off and decided to call her client. She stated that her client wasn't feeling well so she decided to stop by and check in on her. The patient had been drinking for the last two days and was now throwing up partially digested blood. She also was not alert and oriented. While Grant started to get me vitals I started asking her questions. I also tried to get her bottle of alcohol from her which she grabbed onto tightly. As I put her on the monitor I continued my questioning. In the background I heard a fast beep, beep, beep, beep. It took me a second to realize that it was a her heart rate. It was trucking along at a rate of almost 200!

At that point I changed gears from treating a patient that had a drinking problem and a small GI bleed to treating a patient that had a severe cardiac problem. I quickly had Grant get her on oxygen, got an IV started and had her do a valsalva maneuver. When that didn't work I pushed 6 milligrams of adenosine, which is supposed to be like hitting control, alt, delete on windows 95 (if you are too young to know what this does...Google it). This took her heart rate from mid 190's to about 120. After a few seconds it went back up to about 160. At this point MBA showed up and loaded the patient up. I assume that they pushed some more adenosine to further slow the heart rate.



Her EKG strip.

Respiratory Distress?

We got toned out for a person with shortness of breath (notice I didn't use SOB for all you dirty minded people). We arrived to find a friend of the patient standing outside waiting for us. We went inside to find the patient sitting on a chair in her room. The patient was stating that she was feeling short of breath. She had a history of anxiety and was breathing pretty fast. She was also "taching out" at about 120. After some oxygen and some calm words she was not only feeling better but her heart rate had also coming down. The easiest part of being a decent medic (at least for me) is being able to listen to the patient and calming them down.

Portable Monitor

We invited CalFire enigines 3586 and 3560 down to train with us. We showed them how to set up the portable monitor which is used for defensive firefighting.





Firefighter Grant helped me show the state guys how we set up our monitor.



This is one of our Reserve Engineers. He works full time for CalFire and part time at MVFD.





Eric making sure that we showed them everything.



CDF Captain watching his crews work.



A couple of hundred feet of 4" and 2 1/2" hose on the ground. Medic Engine 462 is facing away from us and Brush Engine 461 is in front of Engines 3586 and 3560.



CDF Captain giving us some fine tuning tips. He really isn't standing that close to the master stream.

Cold Pie

This is the new medic, or more appropriately nicknamed, MedicMaybe AKA Casey. We call him MedicMaybe because he wasn't able to pass his ICEMA accreditation test. Here he is struggling (poorly) to get his turnouts and SCBA on in less then 2 minutes. He is one of the reasons that I'm working almost every day for all of September and most of October.

His second shift one of the other firefighters had brought in apple pie and ice cream. That night I served everyone. MedicMaybe had the audacity to complain that I hadn't warmed up the pie. Since he complained I grabbed his plate and microwaved it for two minutes...with his ice cream. He was smart enough not to complain about that.

Boredom....Boredom....Boredom....BOOM!

We were watching TV when the power went out for about 3 seconds and then it came back on. We immediately started joking about the inevitable (OK, wishful thinking) call for a vehicle into a power pole. Our banter was interrupted by a telephone call. The biggest target hazard (business or location that has the potential for things to go bad really fast), in this case a furniture manufacture that is the only two story business in our district and it has hazardous/explosive materials on the premises, was calling to inform us that they had just had a big explosion and they were trying to figure out what blew up. We very quickly got into our turnouts (there were only two of us that day) and started responding. The engineer got on the radio, "San Bernardino, Medic Engine 461, we have reports of an explosion at a two story wood framed business. Start a structure response to stage at Highway 62 and Park, we'll get you the correct address when we are on scene." Dispatch came back to inform us that they had a separate report just coming in of a vehicle into a power pole at Highway 62 and Elm. They wanted to know if it was the same thing. We let them know that those were two different locations and that they needed to start an additional unit for the TC.


When we arrived at the business there was nothing showing but all of the employees were outside. They told us that one of the power poles had exploded. We did a rapid check of the area and there was no smoke, fire, or danger. We quickly cancelled the incoming units and started responding to the TC. When we were coming up on scene we saw a power pole being supported by its power lines hanging over the highway. About 20 feet beyond the pole was the smashed up car that had taken it down. The driver was now sitting in the back of a pick up on the other side of the highway. We checked him out and signed him out AMA. He had some bruising to the left ribs and an avulsion to the right elbow, which I bandaged. We had CHP shut down half of the highway just in case.


So what happened is that the car hit the power pole and knocked the power out for 3 seconds. The power company, realizing that the power flow was interrupted, sent a larger charge of electricity through the lines to try to burn off whatever bird that had just been zapped (a frequent cause of short term power outages) This clears the line and all is well, if it was an actual bird that caused the short. This time the power spike blew up some of the porcelain thingies (I can't remember the technical names) and sent porcelain flying for a couple hundred feet in all directions. Some of the debris busted windshields, skylights and dinged up vehicle paint jobs.


While we were on scene of the TC dispatch asked if we were able to run a medical aid. We got toned out for an ill female. She was an old frail woman that had been throwing up for 3 days. She was also having a little bit of trouble breathing. While we were working her up MBA arrived. As they walked in they commented something along the lines of WOW! Been busy lately?!!? It's just like what a British cop once said, "It's hours and hours of boredom with about 20 seconds of excitement and then hours and hours of boredom." He wanted to remain anonymous.



This is the car that took out the power pole. The driver walked away.



The scene of the second call after we finished our third call in 25 minutes.



The car was sitting in the dirt here in the fore ground.



The power pole that "exploded"

The windshield of a brand new PT Cruiser that was broken by a falling piece of porcelain.

New Relief Engineer

One of my new relief engineers stumbled on my blog. He wanted to know why I had failed to mention him. So....his name is Ralph Villegas, nick named Ralphy. Hi Ralphy. Photos coming.

Fail

I couldn't resist putting this on the blog. May this is why no one calls 911 for us in Morongo Valley?!

"Extended Family" Dinner

Last Sunday Eric and I invited our "extended" family over for dinner. I had Katie bring up the kids and Eric invited on of the crews from MBA. We try to keep a very close relationship with the members of the other emergency services in the area. While we were getting ready for dinner one of our local CHP officers stopped by and we invited him to stay as well. It must have looked funny to people driving by the station. We had our rigs in the apparatus bay with the bay door open, and we had a CHP unit and an ambulance parked out front. Had a TC happened then we would have been one giant responding caravan. Fortunately the citizens of Morongo Valley cooperated and we had a great meal. For those that are interested, we had carne asada tacos.

Engine 462

We are now in "The Beast." Engine 461 went in for maintanance so we asitched out into engine 462. This is an older taller engine. We have to scale it just to get in and out. It's also slower than most tricycles with 3 year olds on them. It's an adventure to say the least.

The firefighter in this shot is 6'3" tall for comparison.

Three Minutes Too Late

As I came into the Morongo Valley at the start of my shift I was greeted by the sight of Medic Engine 461 on the scene of a good (which is bad) wreck. A woman driving what was once a small Honda pulled out in front of a full size van doing over 60 mph. Sorry for the lack of photos but I think your imagination is doing justice to the scene. The biggest bummer for me was that I was not on the call.

I continued on to the station where I grabbed my turnouts and jumped in the Brush Engine. 'Click' It had a dead battery! About this time I heard the Mercy Air chopper coming in to land on the highway. Figuring that the guys had the patient all packaged and waiting for the chopper I decided to go ahead and get the morning routine going (raise the flag, brew some coffee, lay out the paper). About this time Curtis showed up (in the water tender since the Brush Engine was dead) and asked if we had the spare cutter there at station 1 because the cutter on scene had broken. I told him that it was at station 2. He told me to grab my gear and that they could use me on scene. By the time we got back on scene Engine 3560 was there helping out. Using hand tools they managed to get enough of the vehicle out from around the patient to get her out. We quickly got her onto the backboard and into the chopper. Later that day we found out that she had broken her pelvis in three places and had broken her arm and collarbone. She should make a full recovery.

Ill Person in a White Car

We were toned out for an ill person in a white car on the side of the highway. While we were headed in that direction I told Grant that this was his call. I like to let the Firefighter/EMTs get in there and do patient assessments so that they can hone their skills. I usually get the deer in the headlights look when I tell them that they are in charge.

When we arrived on scene Grant jumped out and grabbed the EMS gear. He quickly went to the driver and started asking what was going on. As I approached the car I got a good look at the driver. I stepped in and asked Grant to go to the other side of the car and start getting me some vitals. The patient was white as a ghost and looked mostly like death warmed over. He was barely talking. He just had a pacemaker put in 5 weeks ago and was given Nitroglycerin for any chest pain. He started having some chest pain while driving so he took the Nitroglycerin, which did it's job and opened up all his blood vessels, and lowered his blood pressure. By the time that we got to him he was no longer in chest pain but was extremely weak from his low blood pressure. We leaned him back in his car and I started an IV. As soon as MBA arrived on scene we loaded him up and sent them on his way.

I think that Grant was glad to not have to be in charge on this one.