Truck 51, Responding.

The tones chime around 21:30. A medical aid. I've picked up an overtime shift and am driving at my own station. Always a plus. I listened to the address and go to the map. I knew the street but I want to check exactly which house it was. As I stepped into the rig my captain said in a tense voice, "Get us there!"

In the dispatch notes my captain had read that we were headed to a pediatric full arrest. In plain English we were headed out for a baby that no longer was breathing or had a beating heart. 

Normally when driving a fire truck with lights and sirens there's a lot of caution involved. A 70,000 pound vehicle rolling through red lights can be dangerous. On the way to this call the limits were pushed. Seconds counted. We listened above the growl of the siren to the dispatcher rattle off all the units that were responding. Truck 51, PD, AMR, AMR Supervisor and at our request, Engine 52. Dispatch informed all responding units that CPR instructions were being given and that this was for an 8 month old boy. 

One police officer made it to the scene before us, He had just enough time to go in and grab the lifeless kid and bring him out to us. I started chest compressions while my firefighter set up the BLS airway. After a minute of CPR the AMR unit pulled up. Without hesitation we moved. As a cohesive unit we transferred the entire operation from the front of the house to the back of the ambulance.

On our way to the hospital, in the back of the ambulance, there were three medics and an EMT. My firefighter continued with compressions gently forcing the child's heart to pump blood. I inserted an intubation tube into the airway of my patient. With that in I then connected the end tidal CO2 tubing and continued to breath for the baby. The AMR supervisor used a drill gun to sink in an IO needle for vascular access. He then was able to administer what we hoped would be life saving drugs. The AMR medic watched the heart monitor for a rhythm and kept track of time for us. It's remarkable easy to lose track of time on a full arrest.

By the time that we reached the hospital the RNs were waiting for us at the door. Our ACLS protocols had been followed perfectly. Even better than they would have been in the hospital. This is what we do.

Inside the ER the staff takes over continuing with ACLS. Another 20 minutes go by and there's been no change. The family has arrived. Mom and dad stand in the hallway looking for a miracle. As I come out of the room they look to me for answers. The hospital staff hasn't had time to talk to them yet and I'm the one the parents remember rushing their baby away giving them hope. The father asked what his vitals were in a way that told me they had heard that on a medical show on TV and were sure their boy was supposed to have some sort of vitals.

I take my time with the family explaining what was going on. I prepared them for the worst because I knew it's coming. Years of experience told me what the end result of this call would be. After a few questions another ER doc came by and took over for me. As he was talking I slipped away.

I headed back out to the ambulance bay and helped my firefighter put all of our gear back together. Just as we were leaving the AMR supervisor came out, caught my eye, and shook his head. Nothing more needed to be said.

The ride back to our station was quiet. Somber. None of the usual banter and at times dark humor that usually follows a serious call. None of us talk about it but we're all fathers. This one hit close to home. As we approached the station the radio beeped and the dispatcher came on.

"Truck 51, medical response...." I knew where were headed. I reached up and flipped on our lights. My foot stepped on the floor button that winds up the siren. Over its high pitched scream I hit the air horn.

Truck 51, responding.

Neither Snow Nor Rain.....

We pulled up on scene to find a mail jeep and an SUV in the intersection. It was pretty clear that the jeep had pulled out and into the other vehicle. PD was already there. The officer said that there were 3 possible patients. The mailman, the guy driving the SUV and his grandson.

My engineer headed over to the grandfather and my captain started assessing the mailman. I went over to the police cruiser where a frightened 8 year old boy quietly sat. Pulling off my helmet I opened the door and knelt next to him. I got his name and age. I asked him if he was wearing his seat belt and what hurt. He said that he was and that nothing hurt any more. He said that the bag hurt the side of his head a little bit but he was better now. And he wanted to know why we had airbags.

I continued my assessment and answered questions. He was very curious. How did we know to come? Who called 911? What going to happen to the car? But most of all he was worried about his grandfather. I told him that he looked ok and that another firefighter was looking after him. Finishing my assessment I headed over to my engineer to find out about the old man. I then headed back to tell the boy that they didn't need to go to the hospital and that his grandfather was well.

Once that was done I headed back to the rig and grabbed a sticker. I knew I had hit the jackpot when I handed it to the 8 year old and he exclaimed "COOL!"

The mailman was ok too.

Start The Helo

"Engine 59, medic 149, you're responding for a 2 year old female with hot oil in her eyes."

Oh crap! In my district we are about a 30 minute drive from a couple different hospitals that are capable of handling a critically burned pediatric patient. That's 30 minutes, if there's no traffic (did I mention that I work in California, in a major metropolitan area? We practically invented traffic). And of course it was 4:30 in the afternoon on a Friday. How bad could traffic be?

I had an overtime captain that day that wasn't familiar with the area. I suggested to him that we start a helo. He called dispatch and asked for Life Flight to be dispatched and for another engine crew to land the bird.

While we were responding to the call I was trying to envision how bad this kid could be and possible treatments that would be needed. I would find out later that the medics at AMR were busy looking at patient destinations and treatment protocols. I guess we all react in a similar way to dispatches like that.

As we walked up to the door there wasn't the feeling of panic that I expected to see/feel. Through the screen door I found the patient's mother crouching down and crying next to her child. The little girl was just standing there. Her eyes were a little red and looked as if she had been crying. But she was no longer crying. I was a bit confused.

The mom, through her tears, explained that her daughter had put an ointment (similar to Tiger Balm) used for sore muscle in her eyes. The mom had called 911 and then thoroughly rinsed out her daughter's eyes.

We canceled the helicopter but still transported the girl to the hospital just in case there was some more permanent damage done. Afterward we all agreed that this call could have been a lot worse.

One Year Old, Not Breathing

"Engine 51, Medic 143, you're responding for a 1 year old unconsciousness and not breathing. PD is also en route."

In my city PD will respond to potentially critical pediatric calls and to full arrests (and any time we might need them to....ah....correct some bad behavior). As we drove down the dark residential streets dispatch informed us that PD had arrived on scene to find the patient breathing and alert. Now we could continue on in in a more conservative manner instead of like a bat out of hell.

Arriving on scene we found 3 police vehicles parked along the street. In front of the house were about 20 people, all wearing 49ers clothing (it was just minutes after the 49ers blew their Super Bowl chances). One of the officers held a small child, wrapped up in warm blankets, in his arms. Mom and dad held each other next to him. Mom was borderline hysterical.

I walked up and took a quick look at the kid. She was crying. Music to my ears. AMR had just pulled up behind us so I let them, along with my captain and engineer (who were both medics) take care of the kid. I went to the parents to find out the story.

Mom said, in between sobs, that her daughter was dancing in the kitchen when she collapsed, stopped breathing, and turned purple. Pretty much all not good things. She said that her baby didn't breath for about a minute than she started again.

Since little kids generally don't just stop breathing and collapse for no reason I probed some more. Mom said that the night before her daughter had fallen and hit her head on the couch, leaving a small goose egg. She also reported that her daughter had recently spiked a fever but they had treated that with Motrin.

After gathering all of that information I went and talked with the AMR medic. Turned out that the goose egg from "last night" was still getting larger. something about the story just didn't seem to fit right. So we didn't know if the kid had received some kind of cerebral trauma the night before and was just becoming symptomatic, if she had a febrile seizure, or had some other medical condition that was yet to be diagnosed.

Once we had the girl all ready to be transported we made sure that mom had a ride to the hospital. We let dad ride in the ambulance since he was the calm and collected parent.

Man Up

I understand that kids whine and cry. Hey, I just went through a PALS course. That means I'm a trained professional, right?! Ok. Not quite. But I am really good with kids. And I have 3 of the little rug rats of my own. So that's where I'm coming from when I tell this next story.

We were dispatched to a child down in the street. We expected the kid to be gone by the time that we arrived on scene. When we pulled up we could see a small knot of people standing and kneeling by a kid in the street. There was an ER RN at the head of the patient holding c-spine. It really looked as if we had a critical kid.

As I walked up I noticed the 10 year old boy was laying prone with his left leg and arm slightly bent in a normal fashion. I also noted that the kid was screaming bloody murder.The story was that the victim had been racing hes scooter down the hill and lost control. Luckily he was wearing a helmet and he wasn't on a busy street.

He was complaining that he had severe pain to his left hip. We exposed his hip and found that he had road rash. During the head to toe assessment I found that he also had some road rash on his left elbow. When the kid discovered this he forgot all about the hip and started wailing like our siren. Keep in mind, there is no blood. It's a large scratch. Band aid worthy.

I know road rash can be painful. But it's not that painful. My six year old daughter wouldn't have cried that much if she had broken an arm along with the road rash. I really felt like saying 'man up' to the kid. I guess I wasn't feeling to sympathetic that day.