M&M's

The fire service is full of jokers. You need to have a pretty tough skin if you're going to survive.

The crew from the neighboring station stopped by to pick something up. We all sat around a chatted for a while. The crew from the visiting engine company related how their captain had, the tour before, been a little bit of a micro manager. He of course denied this. So this tour someone on his crew got him a bag of M&M's (for Micro Manager). The captain took it all in stride. If the fire service, if you aren't a target for practical jokes, you probably aren't liked.

Later in the day we were out running errands and getting some driver training (I'm working on being able to upgrade to engineer when the need arises). While we were out we were unable to resist the urge to buy some M&M's. We then drove over the the other station, as stealthily as you can in a big fire truck. I snuck into the apparatus bay and placed the bag of candy on the captains seat in the rig and made a clean escape.

I found out later that night that the captain, when he found the treats, gave his crew hell. After denying it for a while they figured out who the culprits were. We're waiting for payback.

Tunnel Vision

We got yet another call for a fall victim. As I walked into the apartment I announced our presence.A man from the back bedroom said that that we should come on back. The old man had tried to get up to go the the bathroom and had fallen down at the foot of his bed. His right ankle was going in angles that should not be possible.

My patient didn't appear to be in much pain so I asked. He said that it was hurting real bad. I told him that we'd try and do something about that and then started asking other questions while my engineer got some vitals. I found out that the guy didn't trip and fall like we first suspected. He had felt dizzy and then passed out. That changed the entire call. Now we were investigating why he passed out instead of focusing on a broken bone.

My thoughts immediately went to his blood pressure. My guess was that it would be low. His heart rate was good. A little high but that would probably be from the pain. His EKG was normal too. And the winner was his BP. It was a touch low, 88/60. I asked the patient if he had taken his medications that day, among which were his meds for his hypertension. He said that he had. I then inquired if it was possible that he took more than one dose. He thought about it for a while and eventually realized that he had taken all his pills twice that morning.

About that time AMR showed up. This time they had with them a shiny new intern that was just realizing that paramedic school taught you the bare basics and that dealing with real patients was more challenging. I gave the intern a quick synopsis, "Male,75, fall victim, broken ankle." This forces the intern to do his own assessment instead of relying on mine. It also allows the preceptor to see how his intern is doing. While the intern went to work on his assessment I told the preceptor everything that I had found out. We then sat back and let the intern run the show.

After an 'exhaustive' 30 second assessment the student asked his EMT to go get a splint (which was in the ambulance down 3 stories and on the other side of the apartment complex). He said that his plan was simply to splint the ankle and take the patient the hospital. I kept my mouth shut hoping that his preceptor would correct his so called plan. Once the EMT arrived with the splint I had to step in. I asked the intern if he wanted to start the IV or if I should. He hadn't considered an IV. At this point his preceptor stepped in as he should have trying to get in between his student and a rapidly angering fire medic. The preceptor said that they would do the IV en route to the hospital.

At this point I went from trying to let them run the show so the intern could get some experience to patient advocate. This was my patient. I told them that we were starting an IV up here so that we could do a fluid challenge on the way to the bus. Once at the ambulance they could recheck his BP and see if they might be able to give a little bit of MS for pain relief. While the intern started the IV I told the EMT to get an ice pack on the ankle before splinting it. Once all this was done I let them take my patient.

I'm sure the preceptor thought I was totally out of line. I know a lot of medics don't feel pain management is something that they need to look at seriously. Because of my preceptor and my life experiences I am a staunch advocate for pain relief. And studies show that it's better for patient healing as well. Hopefully the intern learned something.

9/11 First Responders Told To Stay Home

Because of possible overcrowding rescuers from September 11th have been asked not to attend the ten year anniversary memorial to be held at ground zero. Instead there will be one held for them at a later date.

Read the story here as reported by CBS.

I understand that there were more people killed that day than 1st responders. But how many of those were rushing in to help? That's what I thought. Maybe they should un-invite the politicians (Obama, Bush, and Giuliani to name a few) with their associated massive security details and make room for some of the guys that were there. Not to mention the politicians attending with the government paying the way. Invite the political talking heads to the ceremony to be held at a later date.

I guess we rescuers are yesterday's news to the politicians. Now to get in the spot light you have to be a part of a ceremony. I'd be way more impressed if a politician that was slated to attend gave up his spot to a cop or a firefighter.

Fire....Again

After the last fire and following investigation we got back to the station a little before 11 at night. We then had to clean up the rig, our dishes from dinner and ourselves. It was after midnight before we were all done.

Time for bed.

The lights clicked on. The structure tones go off. I glanced at my watch as I headed for the apparatus bay. It's just after 0230. I couldn't help but think that this was going to be another false alarm. Then the address hit me. 1234 5th Street. Wasn't that where our last fire was at....a few hours ago? I asked my captain to make sure I was remembering things correctly. Sure enough.

While on our way to the house dispatch told us that smoke and flames were seen coming from the rear of the residence. We all thought SH**! It rekindled. A fire that rekindles is kind of like a slap in the face. It means that we didn't do our job right the first time.

As we turned the corner and headed in the direction of the house we could see the column of black smoke in the dark sky blotting out the stars. We were going to work again.

We were soon parked in the exact same spot we were earlier in the shift. Now there were flames shooting up through the skylights that had been broken to ventilate the last fire. This time time the ventilation just served to feed the beast.

Knowing what the layout and condition of a house is prior to a fire is amazing. We knew that our best chance of fighting this fire and keeping it small was to pull the cross lay to the rear of the residence and to attack the fire from the sliding glass door there. There was too much junk all over the house to be able to make a fast attack through the hallways.

I grabbed the hose and started to stretch it out toward the back. While moving along the side I noticed one of the smaller bedroom windows was completely black and there was charged smoke pouring out of a small hole in the glass.

In the back yard I stopped about 5 feet short and off to one side of what was a sliding glass door and masked up. Once I was relatively safe in my protective gear I called for water. I moved up to the doorway. There I could see that the entire master bedroom was engulfed. I had flames rolling out over my head and into the night air. I opened the bail on the nozzle and started pouring in 150 gallons of water a minute. Within a minute or two I was able to darken down the fire in that room. While I was doing this I noticed the next bedroom over flashed.

It was about this time when the most dangerous part of the fire happened. One of the firefighters from another crew came rapidly around the rear corner of the house only to realize that the small space between the structure and the pool was occupied by several firefighters. In order to keep from bowling us all over he made a quick step to his left. He immediately realized his mistake and started swimming before he hit the water. Hearing the splash and knowing what must have happened caused quite the adrenaline rush. How long can you swim in 70 pounds of gear? Luckily we were able to drag him to the side where he yelled at us to move back so he could get out. Once he was safe a safety message went out over the radio about the pool and we continued suppression efforts.

While this was going on my captain had another crew stretch a line to the front door with instructions to let us know when they were about to enter. We didn't want to be flowing water into the room that they were entering.

Once the master bedroom was knocked down a bit I moved over to the side of the house where the smoke had been puffing out of the window. By that point there was no window at all and the smoke and turned into flames. I got in there with my nozzle and started flowing water again. About 30 seconds later I heard on my radio that the engine crew at the front door was ready to go. Knowing that they would get to that bedroom first I moved back to my original position the keep the fire in the back of the house in check. I few minutes later the active fire was out.

A little while later we were the only ones there, once again with the investigator. While walking through the house we noticed that there was a little more smoke than there should have been in the back of the house. We looked around but could find the smouldering material so we (my captain) decided that we (me) had to go up in the attic and look around. Once the ladder was in place I scurried up. Being careful to walk only on the rafters I noticed one 2x4 was still smoking. I asked my captain to grab the hose so I cold douse it. While my captain was fetching the line the small glowing embers erupted into a thin two foot tall flame. It was really cool to watch. But it only lasted about a minute until I got some water.

Finally, around 0730, we made it back to the station. That day I got to go back to work with my regular crew. Coincidentally, my engineer was the one that went 'swimming.' For the rest of the day he received phone calls asking for Aquaman or asking if we found Nemo or one time, there was simply the theme song to Flipper playing. I love the fire service.

Karma Isn't Always A B****

The night before I started my shift my phone rang. It was one of the guys from work calling to ask if I'd be willing to leave my regular station/crew and move to a neighboring station. The next station over needed a medic and they would have to force someone to work there unless I was willing to move (my engineer is a medic as well). I decided that it was worth the hassle of moving stations for a day if it meant that someone didn't get mandoed. Besides, it was with another great crew.

The day was moving along at a leisurely pace. We had a call in the morning for an odor investigation which turned out to be nothing. Later on we went to the new discount store in town and did a walk through just to see how it was laid out.

That afternoon we were discussing the most important thing of the day (dinner) and my engineer let us know that he had a feeling we were going to get a fire that night. We chuckled and thought that would be nice. We were over due for a good fire but it usually happens on some other shift or station. But I had done something nice for someone else, maybe karma would be nice to me.

That evening we had take out from our favorite local Mexican dive. It was great. We were sitting at the table having just finished the meal when the tones went off. The dispatcher chimed in and started down the list of responding units, "Engine 51, engine 53, engine 62, truck 52, rescue 3, battalion 15....residential structure fire."

As we left the station the dispatcher informed us that we were responding for the smell of smoke coming from a house. That usually means someone is having a bbq and the neighbors are upset that they weren't invited.

As we pulled up to the house we could smell it. The unmistakable smell of a structure fire. It was faint, but it was there. There was no smoke at all showing from the house. I knocked on the door and checked the delta side of the house (if you're looking at the front of the house that's the alpha side....then go in a clockwise direction naming the sides of the house, alpha, bravo....). My captain, over on the bravo side said that he could see a little bit of smoke coming from an attic vent.

That was all I needed. I went back to the engine and grabbed the #2 cross lay and headed for the door. My engineer had already thought ahead and placed my irons at the door just in case I needed them.

Just before the front porch I stopped and masked up. Then I checked the door again to make sure it wasn't unlocked (try before you pry) and then I turned around and gave the door a good donkey kick ("Check that door for heat, Tim?"). I immediately noticed that the entire house was charged with smoke and it was already banking all the way to the floor.

As my captain and I entered the house we were blind. The house was warm but not hot. The Thermal Imager was unable to see anything because the smoke was all one uniform temperature. We tried ducking low to see better but the home owners were pack rats and there were piles of junk every where. We stumbled down two steps into the family room only to find that our way was impassable. We back tracked and worked our way to the kitchen.

There we found the smoldering fire. It had burned through some of the cabinetry and some of the trash on the counter but it had snuffed itself out. All that was left were some red hot coals that looked like what's left after a campfire. The "blaze" was doused with a couple of gallons of water.

The truck company had gone up on the roof and busted out the skylights for ventilation. Now they went around and opened up all the windows and set up a blower to evacuate the smoke.

Soon, everyone else had been cleared from the scene and we waited for the fire investigator. Finally, we were cleared to head home. Once there we cleaned up the rig and then took showers. By the time we got to bed it was well after midnight.

And the night was just getting started....

Railroad Fire

While working an overtime shift at the station one district over from mine we were toned out for an apartment fire. The address given placed it just about equidistant from all three stations in the city so the race was on to see who would get there first.

The first in apparatus gave a report on conditions as they came on scene. They reported that there was a small grass fire next to the railroad tracks and that the best access would be from the bridge we were about to cross. We pulled up to the edge of the bridge where we could see small wisps of smoke and went nose to nose with the engine from the other district in town.

I jumped off the engine and looked over the railing. There was a steep hill with a half acre of grass burning. "Great," I thought to myself, "wildland firefighting in turnouts." I grabbed our bumper line and started stretching it out toward the end of the railing so I wouldn't have to hop it. I called for water (so the engineer knows when to charge the hose line) even before I was totally ready knowing that I'd still have 15 seconds or so before the water got to me.

Fifteen seconds came, and went. Then 30. Then a minute (this may not seem like a long time but standing on the edge of an uncontrolled fire, even a small one, it seems like an eternity). Something wasn't right but I was now below the level of the bridge so I couldn't see what was going on. Finally I got water. Turns out another hose line had been stretched out and accidentally charged over top of mine preventing the water from getting to me.

Now armed with water I charged/repelled down the hill extinguishing the fire as I went. The fire was out in under a minute. At least on our side of the double tracks. Apparently there was another spot fire just on the other side of the railroad, about 75 feet away. Up on the bridge the guys shut off the water and added in a 100 foot section of hose. Then, with look outs posted in each direction, I drug the hose line across and put out the smoldering fire.

While I don't normally advocate leaving anything on train tracks I think it was the right thing to do in this situation. Once both spots of blackened earth had been turned into dark mud we picked up our hose and headed back to the station.

At the station we replaced the hose that we used, since it was really dirty. We then went out back and washed the hose and then strung it up on the hose rack to dry. The next day the hose was taken down and rolled up, ready for use.

The cause of the fire was undetermined.

Dead On Arrival

The tones jolted me out of bed sometime around 0330. Sometimes waking up for a call can be so disorienting it's funny. I've walked the wrong way down the hall and then out the side door of the station only to realize there wasn't an engine there. I've made it to the apparatus bay and had to stand dumbfounded because I didn't know what type of call we were going on so I didn't know if I needed to put on my full turnouts. This time wasn't that bad.

As we pulled out of the station with our red and white lights casting strange reflections of the surrounding buildings dispatch informed us that we were going to a possible full arrest. They also said that the family was unwilling to do CPR and that PD would be responding (the police are dispatched in case they can get there quicker).

As we pulled around to the back of the apartment complex we could see a police car. At least on officer had made it in before us. I jumped off the rig and grabbed the monitor and the drug box. Walking in the front door I saw 3 family members crying and hugging. They knew this wasn't good. I made my way to the back bedroom where I found a cop trying to assess weather or not the 80 year old man was breathing. The officer was more than happy to get out of my way so that I could do my job.

I found the man laying on the floor next to the bed. I assume that the officer move him to the floor so that we could do CPR but I'm not certain. As I approached the patient I could tell he wasn't breathing. I felt his neck where the carotid artery should have been pulsating but it wasn't. I told my engineer (another medic) that it was a full arrest. I quickly checked the body for any signs of obvious death but found none. My captain immediately asked the family if there was a DNR. While I started chest compressions my engineer put the patient on the monitor. Asystole, flatline.

At this point my engineer and I gave a knowing look at each other. This patient was gone, but we still had to go through the steps...just in case. My engineer started a line and took charge of the drug administration. My captain came back in and took over chest compressions. I grabbed the airway bag and set up the intubation equipment. Once I was set up we did another check on the patient. He was still apneic and pulseless with asystole on the monitor. We resume CPR. I inserted the ET tube into the patients airway and attached the ResQPod.

The AMR crew walked in and asked if there was anything they could do. At that point we had everything under control. We gave them a run down on what we had found and done. After going through our H's and T's to make sure we didn't miss anything we terminated resuscitation efforts. My captain then had the job of informing the family and seeing if there was anything we could do for them.

We packed up the gear, cleaned up our trash and covered the body with a sheet. We left the body in the custody of PD until it was determined if this death was going to be a coroners case. I'm sure it wasn't.

Street Cred

So our dinner was once again interrupted. I think the local cops get a kick out of it whenever they can either call us during a meal or wake us up.

When we pulled up on scene we could see several police cars. One of the officers flagged us down and pointed to the back of his cruiser indicating that our patient was in his custody.

As I approached he told me that he had a 18 year old guy that had been doing a little B&E in the neighborhood. He was well known to the cops and had been arrested several times before.

I readily admit that I don't know much about criminals. A lot of what I do know is from shows on TV like Cops and Gangland. As I seem to understand it, if you're a criminal you get more prestige or "street cred" if you do more hard core crimes. I don't think that this is what was motivating the young man in the back of the patrol car but if it was he failed. You see, he had broken into the house of a young woman that was 8 months pregnant. Not only did she call the cops but she chased him down the street until they showed up. Somehow I think getting caught by an angry pregnant woman isn't going to do much for his image.

His only medical complaint, being thirsty. He went to jail instead of the hospital. We also checked on supermom-to-be and she was just fine.

Check your "Street Cred" here.