Breaks Over

I've been off now for three weeks because of my gall bladder. I'm going back to work tomorrow. I'm ready for a gnarly call.

Something like this will do.

Free Time

Isn't it comforting to know that while not on a call your local firefighters are always doing something constructive with their free time.

Double Take

As seen in our local grocery store. The fine print says there's no meat added. I thought it was funny.

"Now They Will Tremble Again - At The Sound Of Our Silence."

There are some things in my job that I have never considered. I'm still relatively new to the profession and know that I have a lot to learn but there are certain things that I'm not sure most of us pick up on.

We worked a full arrest a while back. It was the kind of call where you walk in and look at the guy and know that he is dead. I thought that there was going to be some lividity or rigor but no, there wasn't. As we worked on the frail old body, my captain started talking to the family preparing them for the worst. Unfortunately, there was nothing that we could do. He had been down for too long.

Afterward, back at the station, we talked about the call. We went over the things that we did and tried to find things that we could improve upon for the next time. During our discussion, my captain brought up an interesting point. While working a code, there's quite a bit of noise. The Autopulse rhythmically thumping away on the chest. The sound of the BVM being squeezed and refilling with precious oxygen. The sound of the defibrillator charging and shocking the victim. The body itself making noises (I'll spare you the details here but if you want to know send me an email). On top of all the ambient noise you have medics asking for medications, talking about H's and T's, reporting sugar levels, clearing people away from the body prior to a shock. There's a lot of noise. This didn't surprise me. What did is when my captain pointed out that when we stop resuscitation efforts, all the noises, all the talking, comes to a very abrupt stop. He explained that the silence can be overwhelming for the families.

Just food for thought.

Bonus points for naming the movie the title of this post is quoting.

Papers Please

There are some lessons in life that I enjoy watching others learn. For example, no matter how big of a fish you think you are in your little pond, there is always a bigger one.

We got a call right in the middle of our workout. Several of the local elementary schools in our city were all complaining of a strange odor. 911 operators were also getting inundated by calls from homes in the area. As soon as we pulled within a block of the first school we could smell it. It was not a pleasant smell to say the least.

Once we made contact with school security we advised them to shelter in place until we could determine the source of the smell. We also had dispatch call all of the other schools and advise them to do the same thing.

We then drove upwind a couple of blocks to a construction zone. The construction crews there were installing a new sewer pipe inside the existing one. When we first pulled up there was no smell. I thought for sure that our wild goose chase was going to continue. Then, as we walked towards the project foreman, the smell hit us like a ton of bricks.

I'm still a little vague on the process. To re-pipe they line the existing pipes with a liner that turns into a hard plastic. They then inject hot water and an activating agent into the pipes which causes the liner to harden. The activating agent is what smells. It's supposedly harmless.

In order to do any kind of work like this the construction company has to file the proper paperwork with the city to obtain permits. One of the things they need to file and keep with them on site is an MSDS on all the chemicals being used so the city can be sure that it's citizens are safe. When the foreman was asked by my captain about his MSDS  he started to have an attitude. Generally not the brightest of ideas. Evidently the foreman was used to getting his way all the time and thought that he should get it now. Turns out the MSDS was not on site and now we had to wait for the fax.

In the mean time, our BC showed up along with someone from our city permit office. The foreman continued with his attitude. Once the MSDS showed up it was mysteriously lacking any information on the chemical in question. And, on the permit, the company did not disclose that it would be using this chemical. The foreman went into a rant about how he does this for a living all over the state and how fire departments everywhere have the same problem.

If this is true, wouldn't you be better prepared for us when we show up?

The foreman finally said that he was going to finish the project because he needed to get his equipment to another job site the next day. My BC shut him down. The foreman was told that he could do whatever he wanted as long as it didn't include the activating agent until such time as a proper permit and MSDS could be obtained. Hehehe. I can't help but laugh when someone with an attitude problem gets put in their place.

In this situation, I think had the foreman acted differently, there would have been a better outcome for him. I understand that he is used to being the boss but when dealing with people that have control over you, a little humility can go a long ways.

I did save the day on this call. My engineer needed a bathroom early on into this call. The call ended up being over 3 hours long. About two hours into the incident (after having traveled back to the elementary school once but not stopping for more than 30 seconds) I happened to spot the port-a-potty at the construction site. It was behind some of the construction equipment and hard to see from where we were standing. My engineer was grateful. The funny thing is we had parked just on the opposite side of the trench from the kybo. We just didn't see it at the time.

People Trapped On The Roof

Just after two in the morning the tones jolted me awake, again. The last time had been for a crack addict that had been beat by "her man" but insisted that she had had a seizure and fallen into a dumpster, smashing her face. Unfortunately she was alert, oriented and being a pain in the butt. She finally refused medical treatment and allowed us to go back to bed. So when the tones went off again, my first conscious thought was, "It had better not be Michelle again." My dispatcher quickly allayed my fears. We were responding into a neighboring city for a water heater that had exploded with 6 people trapped on the roof. Fun!
My next thought was of a Mythbusters episode on exploding water heaters.


If they truly blew like that, what roof were the people on? How were they even alive. There had to be some misinformation somewhere. As we checked in with the dispatch center for our neighboring city they gave us some better information. We were responding for a two story apartment building with the second floor well involved.

As we pulled up we could see flames shooting out the windows on the A and D sides of the building (the A side is the front, B side is on the left of that, C side is in the rear and D is to the right of the front). We were immediately assigned as ventilation group. While I have been through extensive training in vertical ventilation, and practiced many times, I have never had the opportunity to do it until now. Saying that I was very excited would be an understatement.

We grabbed the 35 foot extension ladder and set it up on the A/B corner. It was literally the only place we could set it up. There was only a couple of feet separating the burning building and the apartment building next to it. The ladder was very steep. I masked up and started my climb. I had only gone a couple of rungs when my SCBA bottle hit the eaves of the buildings next door. As I contorted myself around the obstacle I kept thinking how great my job is.

Once on the roof my captain led me sounding the roof with a rubbish hook. He used the hood to direct me where he wanted a hole cut but as he did so the hook went right through the roof. He proceeded to make a 4' by 4' hole just by smashing in the roof. At this point I grew a little disappointed figuring that the roof wasn't stable enough for us to do much and that we would be heading back down the ladder. Not so much. My captain led us up the ridge line to the middle of the roof. There he told me where he wanted the hole. I cut a beautiful 4' square. Smoke was coming out of the kerf cut as I went along. As soon as I was done I stepped aside. My captain and my engineer louvered the cut on a rafter and then punched through the ceiling. As soon as the billowing smoke started to clear we could see the flashlights from the interior attack team.

Later on we talked to the hose team and they said that the hole was perfect. Within seconds there was visibility in the room and they were able to make short work of the fire. Coordinated teamwork does wonders.

Here's a glimpse at what vertical ventilation is like.

Oops

I borrowed this from another blogger.

It's always the little things that get you.

Feel The Love

During my recent incarceration in the hospital (that's what it felt like....except when they gave me Dilaudid) I got several glimpses at how much my family loves me. It was the little things like my daughter almost breaking into tears as my wife explained to her where I was and why I was there. And how she drew a bouquet of roses on a piece of paper that said get well soon. It was evident in all the trouble my wife took to get the kids to various friends and family members (and them taking the time and energy to watch the kids) so that she would be able to spend a little time with me. How she would drag all three kids through the parking garage and across the hospital to see me. How, when hearing that I was on my way home, my daughter quickly ran to the front door and hung a welcome home banner and then pulled a kitchen chair up to the window and stood there looking for the exact moment when I arrived.

It's even evident in my cat, who after being left home alone for a week, cannot be removed from my lap as I write this post. I blame any typos on her.

I am loved.

Pain Management

I have always been a firm believer in in pain management for my patients. Even more so now that I've been on the other side.

This last weekend my family and I decided to visit friends and family. Early Sunday morning I woke up with some abdominal pain. Like any medical professional I started to try to diagnose myself. It was a sharp pain in center of my abdomen just below the rib cage. It wasn't radiating any where and there was no nausea or diarrhea. My first thought was a gas bubble, but the pain wasn't quite right for that. I then started thinking that it may have food poisoning, but the lack of nausea made me think that wasn't it. After about 30 minutes I woke my wife. I then spent the next hour trying different things to stop the pain. Tossing and turning in bed. I tried Ibuprofen and Tums. Nothing worked. Finally about three in the morning I decided that I better go to the ER. By this point the pain had started radiating to the right upper quadrant and had increased to a point where it was difficult to stand up straight.

Once I arrived at the ER I paced the waiting room while my wife checked me in. I know I was getting strange looks from the other people there but I didn't care. All I could think about was getting the pain to stop. As soon as my wife finished the paperwork I was seen by the triage nurse. When you're in excruciating pain this process takes forever. Thankfully I was immediately led to a bed. My poor wife had to watch me try to cope with the pain. I vacillated between pacing and rolling around on the bed. I figured out how to look on the computer and tell not only how busy they were in the ER but it kept a timer on how long I had been waiting. 28 long minutes later the ER doc came in and asked a few questions. Ten minutes after that the nurse came in and started my IV. I asked her what I was going to be getting for the pain. She said that the MD had originally ordered 4mg of Morphine. The nurse had seen me walk back to my bed and knew that Morphine wasn't going to cut it. She talked the doc into ordering 2 mg of Dilaudid. That was about the point at which I told the RN that I loved her. The first milligram lessened the pain from a 10/10 on the pain scale to 8. The second one almost eliminated my pain.

By this point I had surmised that I had gallstones. The rest of the day was spent getting more dilaudid and going through tests. Between the ultrasound, the x-rays and the contrast photos the conclusion was reached that my gall bladder had to come out.

It's now the day after the surgery and a lot of the pain has subsided. This entire experience has reaffirmed my belief in pain management. Speaking of which, it's time for my meds.

I Love YouTube

This is a video of the structure fire that I was on in a neighboring city. If you look carefully, I'm one of the guys in yellow turnouts standing by the stairs below the fire.