No 'signs' of life.

I took basic and intermediate sign languages courses in college and really wish I had kept it up. I've had only a handful of calls where I could have used it (here's one I was on from a fellow fire bloggers site) but when you need it you need it.

On this particular occasion we were called out for a possible DOA. I was met outside the house by a woman who immediately told me that she was deaf and waved for me to follow her in. Inside I found our patient deceased in a recliner in the living room. She was very much dead but still warm and had no rigor which means I would have to work her up anyway unless there was paperwork to support a request for no resuscitative efforts. I put the ekg leads on her (asystole) and my captain wrote a note to the woman who'd met me at the door asking about advanced directives. The woman ran off and returned with paperwork stating exactly what I needed to know: no cpr, no machines, etc. This woman was not family but had power of attorney and the paperwork was all in good order (you don't know how important that is, really I can't stress this enough). While she was retrieving the paperwork a man came out of the bedroom and I turned to him to ask him a question and he smiled and gave me the universal "I'm deaf" sign of pointing to his ear and shaking his head.

Neither the man nor the woman seemed overly distraught and were really very pleasant to us. Turns out they were husband and wife and the dead woman was a friend who lived with them (who also happened to be 90 years old). We cancelled the ambulance and called for PD. I think it must have been shift change or something because it took a long time to get an officer out there. In the meantime we conversed the best we could and passed the notepad back and forth when we couldn't understand each other, basically letting the couple know what would happen, answering questions, and really just chatting. We were asked about our families, how many kids, etc. I remembered enough to sign the number of kids I had as well as their genders and ages which earned me a little applause from the woman. We found out where they were from and where their daughter lived. Despite the dead woman on the floor and the barriers to communication it was really very nice. I wish I knew more sign language just so I could have talked more with this lovely couple.

Right Before My Eyes

We were responding for an elderly female with breathing problems just before eight o'clock in the morning.  When we arrived we were led to a room in the back of the house where my patient was sitting in a chair unresponsive. She was moving her lips a little, drooling (her dentures were still on the dresser), and had pretty shallow respirations with no palpable radial pulse.  I asked the first obvious question of "Is she diabetic?" and was told by the family that yes she was.  Bingo, no problem. I quickly took a blood sugar reading and it came back well into the normal range. Oh, okay, time to start thinking and acting quickly. My firefighter had obtained vitals and had the patient on oxygen by this time. Her blood pressure was quite low and we weren't getting a very good reading off of the pulse oximeter (to read pulse and blood oxygen saturation).  She was completely unresponsive but was still breathing and had some purposeful movement. I checked her pupils which were smallish and not very reactive. The ambulance arrived and I gave them a quick rundown and suggested that we not muck around on scene getting the IV and 12 lead ekg but instead move straight to the ambulance and work there on the way to the hospital - I didn't like the way this was going. The ambulance crew went to ready the gurney and my firefighter and I picked the woman up and carried her outside to the waiting gurney and in so doing apparently killed her.

By 'we killed her' what I mean is, when we set her down on the gurney I noticed that she was no longer breathing and after a quick pulse check discovered that she was also pulseless.  She must have coded right in our arms. My firefighter had immediately headed back into the house to gather up our gear and clean up. I called after him to get the Lucas (CPR) Device but he didn't hear me. I sent the captain off to the rig to retrieve it while we started chest compressions and quickly loaded the gurney in the ambulance.

The captain and I climbed aboard the ambulance and put the Lucas on the patient and fired it up. At this point my firefighter arrived back from getting our gear and, not seeing us anywhere by the fire engine, popped his head in the open door of the ambulance. He of course had no idea that any of this was going on and was quite surprised to see that we were now working a full code in the back of the ambulance. He merely said, "Oh" and got to work helping us out. I wasn't able to get an IV so went quickly to the IO, easily screwing the needle into her tibia and got the line flowing. The ambulance medic got us a good ET tube and we were off to the races. I administered one round each of Epinephrine and Atropine and after circulating the drugs for a couple of minutes we stopped CPR for a rhythm check and found our patient to be in a sinus tachycardia (rapid heart rate) with a corresponding carotid pulse. A quick blood pressure check yielded results of almost 200 over 100 and her capnography (CO2) numbers were dead on - no pun intended. She still wasn't breathing on her own so we continued with the assisted ventilations but stopped the IV fluids and chest compressions. The hospital was only about five to ten minutes away so it was a pretty short trip. The ambulance had rung down the ER and told them what we had and the staff was waiting for us when we arrived.

When we moved the patient to the ER bed, the ambulance medic gave a rundown of the call, and before I left the room I heard the ER doctor saying something to the effect of "they did an excellent job" - rare praise from an ER doc. Five minutes later we were deconning our equipment outside by the ambulance when my captain came out and told us that our patient was now breathing on her own and had a BP of about 140 over 80.

This call definitely demonstrates the truth and importance of the Chain Of Survival:

This woman had no down time since she coded right in front of us, had immediate and proficient CPR, an advanced airway, IO access, and medications all within a matter of minutes after she coded.
I still don't know what the underlying cause was, although the ambulance medic said it sounded like she had fluid in her lungs, and I don't know if she will leave the hospital neurologically intact or if she will leave the hospital at all. But, leaving the scene with a dead patient and arriving at the hospital with a live one is a pretty good run for us.

Hello? Fire Department!

We had two distinctly different Life Alert calls this tour.  Most of the time these calls are accidental activations, requests for lift assist only, or minor injuries. Rarely are they serious medical calls.

Often people who have these monitors know enough to leave a hide-a-key for us or have a KnoxBox on their house.  A KnoxBox is a small box like a little safe requiring a fire department specific key to open it. They are usually mounted near the front door and contain a key to the house or business or what have you.

Dispatch will give us the key info on our update: "the key is located under the ceramic turtle on the porch" or "the code is 2742" or "the knox box is on the delta side of the building". Without these keys we would most likely be forcing entry into the house and doing damage.

This time it was the ceramic turtle kind. We found the key, knocked loudly and called out "Fire Department. Hello?" We got no response so we unlocked the door and headed in, again calling out loudly as we went. Still no response. We had worked our way back to the bedroom with the captain leading the way. From the doorway of the bedroom we saw a 90 year old woman wearing nothing but a shower cap, her back to us, inching her way extremely slowly out of the bathroom which was still steamy from the shower. We had been calling out the entire time and did so again from the doorway. Still no response. At this point we knew we were likely to terrify this woman when she finally turned around and saw us, so myself and my equally brave firefighter began backpedaling our way out of the room leaving my poor captain to confront the naked woman alone.

(But...you know...90. And with no towel.)

We retreated to the living room but heard no cries of alarm or objects being hurled - a good sign. This woman, though startled, responded rather calmly to appearing naked before a strange man who had entered her home without her knowledge. It was confirmed that it was an accidental activation of the panic button and we went on our way with only a sarcastic, "Thanks a lot guys" from our abandoned captain.


The second call ran much the same way but with the addition of the captain ordering us not to leave him alone this time. We got no response to our calls initially but found our patient down on the floor in the hallway pretty quickly. She was very out of it and was definitely having a medical emergency of some kind (possibly a seizure or a stroke). The ambulance had arrived right behind us and by the time we had made entry and found the woman they were on our heels. Although her eyes were open and she did not appear to have any obvious fall related injuries she could not respond to us appropriately and we got her going off to the hospital pretty rapidly. I never followed up to find out what had actually happened to her. In any case, we turned her lights off and locked her doors and returned the key to the KnoxBox.

I have run a lot more medical monitoring calls that turned out to be false alarms than actual emergencies. But when it is a true emergency those things are definitely life savers.

EMS With Staging

My firefighter was off on vacation and we got toned out for his favorite type of call:  EMS with staging.  Usually, this means that the police need to secure the scene before we can enter and do our jobs.  Sometimes, it involves a larger police action.  This time it was the latter.

We were called down to the waterfront, where we usually launch our boat, for a person with a gun.  We staged about a block away from the location they gave us and tuned into the police radio frequency to listen in.  An off duty officer had spotted this guy sitting on the rocks by the water with a pistol.  Turns out that where I parked the rig (facing a T-intersection) was dead ahead of where the guy was sitting on the other side of the water.  I busted out the binoculars and got a good view of him.  He was sitting down and not doing much of anything, at least from my view.  The police had a fixed wing in the air with a high powered camera on the guy and they could see that he also had a knife and was cutting at his arms and bleeding.

It took a while to discreetly evacuate the park next to where he was sitting and call in the police rapid response team.  That's when it got exciting.  An armored vehicle (BearCat), K-9 unit, and SWAT team arrived.  Suddenly there were armed men belly crawling over grassy knolls and taking up sniper positions.

We heard over the police band that they were calling for a PD boat from a neighboring jurisdiction to come to the Marina in case he went into the water.  There was no way we were going to have another agency pull someone out of the water in our Marina so we called for our boat which was literally just down the street.  They were suited up and in launch position in no time.

We got a report that this was a missing, at risk, young man who had posted a farewell/apology on facebook and was known to carry a BB gun.  The police action was in full swing and we moved our rig down to the command post, closer to where we could move in to help if someone got hurt.  Now that the park was clear, the BearCat and the K-9 unit started moving in.  The suspect started shuffling down the path towards them shifting the gun from one hand to the other and in and out of his pocket.  We were standing in a parking lot watching through the binocs as this all went down.  From behind the BearCat they told him to drop the gun.  I couldn't tell exactly what happened next but I saw him stagger back a couple of steps, flinch a couple of times, double over and then stand still.  They had shot him a few times with plastic projectiles (picture a solid nerf dart shot from a real shotgun).

They ordered him to remove his jacket and lay down which he did.  He was then cuffed and we were called in with the ambulance.

When we went to bandage him up, I expected to see some superficial, 'cry for help' type cuts on his arm (which there were) but he had also done a legit job of slashing his wrist.  That is, he cut deep and he cut up his arm, not across his wrist. That explains why he was shuffling, he had probably lost a decent amount of blood.  He also had some damn good welts from the non-lethal bullets they shot him with.  All in all the whole thing took about three hours and was pretty damn interesting to watch.

One of the most interesting things to come out of it, though, was what I learned later.  The K-9 officer is a friend and he comes by our station frequently with his dog.  The next day we asked him a practical question, "If you get hurt or shot on a call and we have to help you, will the dog let us?"  The answer was, of course, "No."  The dog will most likely be very protective and won't respond to commands.  If the officer can talk he might be able to get the dog to obey, otherwise, this is what he said we should do:  Go to his patrol car and grab the leash, then pop the trunk and grab the 'sleeve'.  One person holds the leash and gets ready to clip into the dogs collar.  The other person puts on the sleeve and gets attacked by the dog!!!

Yes, that is the plan. Now, as I said, this guy is a friend so if his life is in danger then that is what we are going to do, especially since the alternative is shooting the dog.  I'm just not sure how we will decide who gets which job, Rho-sham-bo? I'm the medic and will have to go treat the officer afterwards, so, maybe I shouldn't be the one to be eaten by the dog, just sayin'. Although, if it worked, that would be one awesome story.

If It Weren't For The Courage Of The Fearless Crew or Why You Should Always Monitor The Radio

                  

At my station we not only hear the departments fire dispatch radio for my battalion but, since we are one of the two rescue boat houses, we also monitor the Coast Guard hailing frequency.  I was on the front office computer placing an ems order when I heard traffic over the CG radio.  Now, most of what we hear over that channel are mariner notifications, vessels overdue, and other non emergency traffic as well as info for distant locales that aren't in our response area at all.  This time what I heard was an unexpected Mayday distress call, not from the CG, but from a capsized boat with people in the water.  A man and his kid in the water!  In the water in our part of the bay!!  My captain was walking by at the same time and as I started writing down the info he jumped on the phone to the BC to tell him we needed to respond.  We got the go ahead and quickly loaded the boat and took off for the marina.

We launched the boat and I came up on step, speeding down the channel.  I was able to do about 32-34 knots even though the water was pretty choppy.  As I drove, the captain worked the radios, and my firefighter got suited up to go in the water.  I was very grateful to have one of the regular water rescue captains that day since he had to listen to, monitor, and talk on three different channels: the fire radio (main channel and tactical channel) as well as the Coast Guard radio, responding to the BC, the CG, and the other responding rescue boat; very confusing.  We got such a jump on this call that CG was way behind us in their response plus they were coming from farther away.  The capsized vessel was reportedly a mile South of the bridge and it took us about 15 minutes to get there.  The waters really changed on me as I got closer to the bridge.  The swells dramatically increased to about 4 feet, the wind had picked up, and the tide was going out.  It was like being in a washing machine there for a bit.  

I was just slowing down to pass under the bridge when suddenly the CG helo flew over us and out past the bridge to try to get an eye on the vessel.

(Okay, maybe, it wasn't that dramatic, but it felt kind of like it.)  

I passed under the bridge and the captain grabbed the binoculars to search for the victims.  The CG helo was nowhere to be seen.  After driving on a bit further we spotted the capsized boat off to our 11 o'clock.

( Kind of like this but way more 'sinky'.)

A second later we spotted the pair in the water about 200 feet off of our 2 o'clock.  There was an adult male and a teenage female in the water.  They both had life jackets on and were clinging to each other and just bobbing in the swells.  I moved the boat toward them cautiously.  The swells were big enough that they couldn't even see our boat until we were almost right to them.  I stopped a short distance away and threw both motors into neutral and my firefighter went into action, "Swimmer in the water".  

He swam out and made contact with the pair and had both of them hang on to our flotation tube.  His plan was to swim them back to the boat but the current was just taking them all farther away and he couldn't swim against it.  I had to power the motors back up and circle around to where we could throw a rescue rope to him.  I put the engines in neutral again, we threw the rope and hauled them to the side of the boat.  The captain and I pulled the two castaways aboard and our swimmer climbed in after them.  The man and his daughter had been in the water for just about an hour, but other than being a little hypothermic they were fine.

We put them down in the cabin, gave them towels and blankets and water and cranked up the heater for them.  Before leaving to bring them ashore I drove us up to the capsized boat and marked it's lat and long position.  The captain radioed this info to the CG who would be able to come out with Vessel Assist and retrieve the boat.

Now, the title of this entry does not refer to my crew (though they did an outstanding job) but to the crew of the capsized boat.  The father, in this case, made a very difficult but excellent decision that probably saved both of their lives.  The seas got too rough for their tiny boat and they were heading home when they got caught in the swells.  Their boat began to dolphin, nose diving into the waves, and took on water faster than they could bail.  Eventually the whole thing went over sideways and they were tossed.  They were able to hang onto the boat initially but all their gear was jettisoned and was now at the mercy of the current, including the small bag containing their marine radio.  

They made the decision to abandon the boat and swim out together to get to the bag and the radio.  There was no one out on the bay that day and if they had not retrieved that radio they would have been doomed.  The other smart thing was that they stayed together.  If the father had swam for the radio there was no way he could have made it back to the boat against the current and they would have been separated.  So, I applaud him for not only being prepared but for making the right calls.

We delivered them to a dock across the bay, warmer and in good spirits (considering), where we were met by a fire crew from that city, two ambulances, a fire chief, a couple of cops, and a very friendly brown pelican who decided to join the circle of conversation.

                    

We said our goodbyes and headed back home at a slightly less hurried pace.  Once back in quarters we washed the boat, readied all the gear for the next call, and ordered ourselves a pizza.  Needless to say I was pretty excited to get my first real legit water rescue out on the boat and that it all ended well.  Makes for a great day at work.

Just Another Day - Typical But Good

So, here's just a slice of life in the fire service.  Nothing particularly dramatic or hilarious, but I had a good time.

I was working with a newly promoted captain who hadn't worked in my district before.  Right out of the gate at about 09:00 we got a medical call.  It was for a sixty something year old male with abdominal pain.  From the smell of the apartment his "medical" marijuana wasn't helping with the pain.  He was not in major distress in any case.  The ambulance was right on our heels so I pretty much got all the pertinent info and vitals taken care of and that was about it.  Once we got him sent off to the hospital, we began discussing amongst ourselves the layout of this apartment complex.  It had some pretty unique features and we spent some time planning out what we would do in the event of a fire in different areas of the complex.

We returned to the station, cleaned up the breakfast dishes,  and then I got my workout in.  Just before lunchtime the structure tones went off and I recognized the address as the same complex from the morning medical call.  The report was of black smoke coming from under the door of one of the units.  It sounded pretty legit and we had it all planned out from this morning so we were pretty excited.  There was no visible smoke when we arrived but you could smell it clearly.  It had the distinct smell of a 'pot on the stove'.  Now, a 'pot on the stove' doesn't necessarily mean that the kitchen isn't on fire, but it's usually not.  The captain and firefighter headed over to the unit with tools and an extinguisher.  There was no one home but the apartment manager was on hand with a key which meant they didn't get to break down the door (err...I mean 'have to' break it down).  I had my rig angled for an easy hose pull and had the pump running just in case when the captain confirmed 'pot on the stove' and that only smoke removal was needed.

 

This meant that the IC could keep the truck on scene for positive pressure ventilation and release the balance of the assignment.  It was a great dry run for us though, and really shows the importance of preplanning.

There was one minor medical issue from a neighbor who had hurt his arm hopping over the back fence to open the unit's patio slider.  I'm not sure if he was making sure no one was home or just letting smoke out.  In any case he refused service.  We talked for a bit with the neighbors and the apartment manager and passed out fire helmets to the kids (and some of the adults).  One of the neighbors brought out a bag of homemade chocolate chip cookies and gave it to the truck guys.  For as much ice cream and desserts there are at some firehouses it's funny to watch guys try so hard to get rid of sweets.  The truck guys passed the bag off to the second engine who then stuffed it into the jacket of my firefighter who wound up giving it back to the truck guys.  When the other crews had left and I was putting my gear away I found the bag of cookies sitting in my jumpseat on the engine.  Sneaky bastards.

The afternoon was spent catching up with the new captain and studying up on building construction.  We also went out on a medical alarm called in by a remote monitoring company - you know - I've fallen and I can't get up.  Turns out that's exactly what it was.  Our patient didn't have any medical issues he just couldn't get back up from the toilet to his wheelchair.  The firefighter and I each took an arm and helped him to his feet and hoisted his pants up for him and got him situated in his wheelchair again.  We wheeled him out to the living room and repeated the process to get him set up in his recliner in front of the tv.  Some people find the lift assist thing a pain but sometimes they are the best calls because the folks just need a hand and are usually very grateful and friendly.  Often those are the people we get to chat with and joke with and learn more about because we're not treating an emergency situation.

 A little before dinner time we got toned out for another medical call.  The dispatch was for a 'sick person'.  Can't get much more vague than that so I really had no idea what we were going on.  When we arrived we were met by a young Asian woman who led us to the kitchen where the family had apparently just sat down to dinner.  Still sitting at the table and looking distressed was an elderly man who was Cantonese speaking only and wasn't saying anything anyway.  The language barrier and the fact that the family didn't know anything about his medical history or meds or pretty much anything about him made the assessment a little challenging.  Most of his meds (that we found anyway) were cardiac drugs and I got enough info to determine that he might be having chest pain.  He was quite hypotensive and bradycardic.  I had my firefighter spike an IV bag and we were about to move him to the floor when the ambulance showed up and we decided to just move him straight to the gurney and treat him in the ambulance.  When we picked him up he began dry heaving and I thought for sure he was going to puke on us.  The good news was the nausea led credence to my diagnosis of a cardiac issue.  The ambulance requested a rider (a fire medic to ride along in case the patient codes en route).  As I hopped in the ambulance the medic was telling his partner that he was going to have to go for an EJ (that's an IV in the external jugular vein in the neck).  That's usually a last resort if there is no peripheral access.  I looked at the patients arm and even without a tourniquet on I could see a vein worth trying for.  I told him to hold off and let me try first.  I squeezed in beside the gurney, slapped a tourniquet on his arm, and slid the catheter into the vein.  With the patients legs up and some fluids going in his pressure and pulse rate improved.  The ambulance medic decided he was comfortable without the rider and I got to go back to my engine and home to the station.

We picked up Thai food for dinner and settled down with a DVD I had brought in on adventure travel by motorcycle.  We had one more medical call that night for a man with back pain and constipation as well as one more lift assist which came in around midnight (this time from the floor to the bed, a little bit tougher).  After that we went to bed and slept  until 7a.m.  Then it was time to get up and start day two of the 48 hour tour.  Like I said, it wasn't very dramatic, but it was a good day and pretty typical of a lot of our shifts.

P.S. - Just to continue with the day in the life theme:

I went home after a quieter day two on the job and arrived home about 09:30.  I normally have four days off after a two day tour but I was scheduled to work overtime on the last day of my four.  I was looking forward to my 72 hours off before 72 hours back on.  After putting kids to bed that night I got a phone call at about 8:30 pm.  It was work saying that an engineer at Station 51 had gone home sick and they had to mando me back in for the rest of the shift.  I made the mistake of answering the phone so there was no getting out of it.  Fortunately my gear was all packed in my car already in anticipation of my overtime shift.  I was out the door in about 5 minutes and on my way back to work.

The Terra' From Unda'!

The welcome and unique, though infrequent, tones for a water rescue sounded at about 11pm.  There was a vessel in distress with 9 people on board just a couple of miles outside of our marina and the water was too shallow for the Coast Guard to approach.  We jumped into our foul weather gear, loaded up Rescue Boat 41 and took off for the marina.  Rescue Boat 40 (smaller and equipped for towing if need be) and the BC were responding as well.


We arrived just before RB40 and prepped our boat for launch.  Details were still coming in from the Coast Guard as to the nature of the problem and the vessels position.  We got the lat and long coordinates and were advised that the vessel was now taking on water and there were no life jackets on board.  RB40 has a shallower draft and could tow the boat in if needed so they launched first.  We launched right after in case we needed to offload the people onto our boat or possibly pull them from the water.

 

We headed out of the channel right towards the CG vessel.  The vessel in distress was a couple hundred yards south of us and were heading towards the rocky shore.  They had been headed out fishing and had lost engine power.  I'm not sure how long they were out there because I don't believe they had a radio either.  They were woefully unequipped to be out on the bay.  The only thing they appeared to have had in abundance was beer.

RB40 made contact with them and determined that they were not taking on water or at least not much and would attempt to tow them in.  RB40 had their navigation electronics go out on them in the middle of the operation so we came along side and had them follow us back to the channel and into the marina.  As we came up to them and my spot lights lit up the rescued vessel it looked like we were about to assist a group of refugees enter our country illegally.  There were nine guys stuffed into a boat built for four or maybe five max.  They were so packed in there I don't see how they even thought they would be able to fish.  And if they caught something, where would they put it?  As I said, they had no business being out on the bay.  It did make for a great night drill on boat ops for us, so no complaints from my end.

And speaking of pretending to be nautical.  The most humorous part of this call actually did come from our end.  Our BC was on scene for the operation in the capacity of Incident Commander (from the shore).  This is good because he can help communicate and coordinate with the Coast Guard or assist in getting extra resources if needed.  However, he is not water rescue personnel and the operation is pretty much left up to the crews of RB40 and RB41 who have trained for this.  Even at that, when talking on the radio we use simple terms and plain text and don't try to get too nautical as it can just be confusing.  Once RB40 had the boat in tow and we were all headed back in, the BCs voice came over the radio, "Rescue Boat 40 - what's your tera frumunda?"  Myself and my crew all just stared at one another in disbelief saying simultaneously, "What did he say?"  Meanwhile the captain aboard RB40 came back with, "I have no idea what that means so I'm just going to use plain text.  We have the vessel in tow, no medical, and we are in the channel at Channel Marker 14."  It took a minute or two of discussion amongst ourselves to figure out that what the BC must have wanted to know was their ETA to Terra Firma.  Now, I don't know if this was meant to be a joke on his part, but it certainly became one.  It would have been confusing regardless since he left off the ETA part of the question, (Hey good buddy, what's your terra firma?  Uhhh...I don't know...Earth?) but we don't even use terra firma in our terminology anyway.  I couldn't stop myself from laughing when my Captain went on the radio and reported that the vessel was secure at the dock and we would be Tera Frumunda in about thirty seconds.  Hopefully the Chief didn't hear me in the background.

All Hands Working

 
My captain for the day (there is currently a vacancy at my station) was in the shower when a call came in for the neighboring district.  I was working in the apparatus bay and didn't hear what the call was for.  The captain came out wrapped in a towel then headed quickly towards his dorm while calling out, "You guys want to go help them out?"  We asked what was going on and he said there was a code blue in the next district over, pretty close to the border.  As a medic, I usually appreciate an extra set of hands so we suited up and headed over to the address.

When we got there the first in engine, an ambulance, and a paramedic supervisor from AMR were on scene.  I kind of figured there wouldn't be any work for us or even room in the house for more people.  We made our way inside to find out if we could help anyway.  CPR was in progress, manually, and the Lucas device was still being set up.  The patient had an OPA in and was being bagged with a BVM.  There was still space in the room so I moved in and took up a position at the drug box and asked if an IV was in progress.  It wasn't but I was down at the patients feet and wasn't in a good place to try for one.  I gave my firefighter the IV bag and he flooded the line while my captain picked up the clipboard and started scribing.  I started setting up for an IO just in case and got some meds ready.  The ambulance medic made one attempt at an IV in the arm but the vein was blown.  I immediately drilled in the IO and started passing meds to the other ambulance medic.  While we were establishing the IO the original engine crew was getting the patient intubated and securing the tube.  We pushed a couple rounds of drugs, shocked the patient two or three times, and packaged him for transport.  I started gathering trash and managing the pile of sharps (IV needles, glucometer lancet, medication vials, etc) as they got the patient on a backboard and out to the ambulance.

I can't believe that we fit all nine emergency personnel and one patient (and one family member who wouldn't leave) in one bedroom and kept all hands busy and productive without getting in eachother's way.  Amazing.

 

I don't know the patient outcome or circumstances leading to the cardiac arrest but, as for me, I got to do an infrequently used skill and the best part of all was I didn't have to do any paperwork.  Success.

Something here is not quite right.

I'm sure you all know that feeling where things just aren't adding up and you can just tell that something about the situation is not quite right.  We get that quite often actually, and this recent call was no exception.

We were responding to a call for a man in his mid to late 60's who had fallen and possibly had a head injury.  This is pretty much the typical in my district so I really wasn't in the mindset of expecting what we actually got.  But from the moment we pulled up on scene it became apparent that this was not going to be typical.  As I pulled the engine up to the address I saw a young woman crouched in the driveway who appeared to be (or at least had been) crying and who was just staring out at the street.  I stopped the rig, turned off the lights, got out, opened the back door and grabbed some medical gear and she had not moved or spoken to us.  Tip #1 something is not quite right. We often get incorrect patient ages or genders on dispatch so my first thought was wondering if she was the injured party.  As I grabbed some additional gear from another compartment I called out to her, "What happened?".  She said, "I don't know".  Tip #2.  As we approached her she got up and started leading us around the back of the house to a small guest room addition in the backyard.  She stopped short of going in, pointed, and said what I thought was, "He's in the bedroom".  She didn't lead the way or go a step further.  Big Tip #3.  There was obviously something going on here besides an elderly slip and fall.

As I, cautiously, entered the room I looked around for where the bedroom might be and off to the side I saw, in the 'bathroom', my patient.  Much like my previous code blue, he was slumped on the floor having fallen forward from off the toilet with a pool of blood around his head.  He was not moving in the slightest and I knew right away what all those signs had been pointing to.  He was face down but it was obvious he was not breathing and when I touched him he was cool and had pronounced rigor mortis.  He had been there for awhile.  I notified the captain that this would be a coroners case and got out my monitor.  I documented that the patient was asystolic (flat line) in all three leads, covered the body, and marked a time of death.

My captain had had the same sense that things were off when we arrived and had stayed with the young woman which was a good thing because she was, rightfully, distraught.  We made the proper notifications and did our best to console the family, more had shown up by that time.  PD arrived and we turned the scene over to them and went home to do the paperwork.

Intuition is a pretty powerful thing and should probably be listened to a lot more than we do.  Fortunately there was no danger to us in this situation but it is a good lesson in paying attention to your environment, the people around you, and trusting your instincts.

I Hate Having To Do That

There is a very fine line between respecting a person's wishes and getting them the help they need. Sometimes it can be very difficult to walk that line, especially in our overly litigious society.

We recently responded for an elderly male who really put us to the test. Apparently he had been seen the night before for a possible stroke, refused service, and had been AMA'd by the ambulance crew. When we arrived, the family told us he had not been interacting with them as he usually does and after the episode the night before they were very concerned. Unfortunately the patient was very stubborn and was still refusing to be seen at the hospital.

There are only a few circumstances in which we can make a patients decision for them and send them to the hospital without their consent: if they are altered in any way, heavily intoxicated, or a danger to themselves (that is, wanting to hurt themselves). Our patient was able to answer all of our questions appropriately and was not drinking so that ruled out the first couple. However, he was not making decisions that were in his best self interest.

In addition to the possible stroke symptoms the night before and a pretty distinct one-sided weakness, he had a new onset irregular heart beat and rectal bleeding. He was not in major distress right now but he should really be seen at the hospital. We just couldn't force him to go. His family was very upset and pleading with him to go, but he wouldn't listen to any of us. We had spent the better part of a half hour trying to convince him and finally my captain told him that the decisions he was making were going to cause him harm. The patient said he understood, so the captain said, "So you do want to hurt yourself?" The patient said yes. He said yes in front of the ambulance crew and us, which is all we needed. We called the police to put him on a 5150 hold and allow us to take him to the hospital. It felt almost deceptive, like we tricked him with logic, but it was ultimately in his best interest. I just hate doing that.

I really feel that, for the most part, if someone wants to refuse service (even at the detriment of their health) they should have the right to do so. Unfortunately, that's not the world we live in; especially when so many have been sued by someone who refused help and then they or their family claim we should have done more.

Usually, when our patients are put in a situation where they have no choices left or have to choose the lesser of two evils, they cooperate. For example, patients who have a choice of going to jail or to the hospital, usually choose the hospital. Our patient was told that he was now going with the ambulance no matter what, so why wait for the police to come and fill out the paperwork? We could just get in the ambulance and go now. He still refused. He completely understood what was to happen and was stubborn enough to ride it out and make us jump through all the hoops.

I had been in and out of the room, talking to the patient and to the family and had missed some of the conversation. Somewhere along the way, my crew had been told that the patient had some weapons in the room. I didn't know this until the police arrived and said they wanted to clear the weapons before we proceeded. They ended up taking two pistols from the nightstand and a Rambo style commando knife from the dresser. I don't think he would have, or was in any condition to use them but I wish I'd known they were there.

After the paperwork was done, the patient got on the gurney and went to the hospital. The family was tearful and very grateful and understanding which made it a little easier. But, man, I still hate having to do that.

Why didn't you say that to start with.

We were toned out for a medical call for a 67 year old male who had a syncopal episode at one of our local businesses.  The business was right by the station and this call really didn't sound like it would amount to much.  Syncopal episodes happen all the time and they usually aren't a big deal unless the person actually falls and gets hurt.  That is the kind of information I like to know when I'm going into the scene:  is the patient conscious?, did they fall or hit their head?, are they talking?, etc.

We were met by some wavers directing us through the parking lot to the entrance.  As I gathered up my gear I asked what was going on and was told, "I don't know, he passed out in the bathroom."  We headed into the building and were met by the next set of escorts who started us down a long hall.  Each step of the way the people we saw seemed more and more tense and hurried.  I asked this new escort if the patient was talking and he responded, "No, they're doing CPR on him."  Well, shit, why didn't somebody mention this rather important fact from the get-go.  I immediately sent my firefighter back to the rig to get the Lucas Device (our automatic CPR machine) and headed into the bathroom to see my patient.

I found an adult male on the floor of the bathroom stall, the big one fortunately, and another employee standing over him doing compression-only CPR.  I think he was very happy to see me arrive and started to step out of the way.  My firefighter wasn't back yet so I told him to just keep doing what he was doing.  He probably doesn't like me anymore.  I cut the patients shirt off and put the defibrillator pads on him as my firefighter came in with the Lucas.  We quickly got that set up and went to work getting an airway and oxygen into him as well as establishing IV access.  He had surprisingly good veins for pretty much being dead (thanks probably to the Lucas device) and I quickly had my line in and flowing like a champ.  The ambulance arrived and put a King tube in him (it was a tight space and not very conducive to trying to put an endotracheal tube in).  I did a heart rhythm check and he was in asystole.  I then found out that the last time he had been seen was an hour prior to someone discovering him on the floor of the bathroom.  That didn't sound promising.  I pushed three rounds of epinephrine and atropine into his IV and he never changed from that initial asystolic heart rhythm.  We made a declaration of death in the field, stopped resuscitation efforts, notified PD and the coroner, and began cleaning up.

It's weird, sometimes, to realize how different your perspective can be when your job is dealing with this kind of thing.  For me, I was mostly thinking about how smoothly the code ran and that it was relatively clean.  Not only was there only a minor amount of blood (from falling forward off the toilet) but there was no vomit and even the amount of garbage and debris we usually produce during a code was kept to a minimum.  I headed out to the rig to get some cleaning supplies to decon our equipment when the receptionist asked me, "Is he okay?".  I can't legally discuss any confidential patient information and everyone there was going to know he was dead in a minute anyway, but I couldn't really stop and politely explain the situation in a grief support kind of way.  I simply said, "No.  They are making some notifications right now."  A few minutes later a manager asked me how long it usually takes for the coroner to arrive so she could decide what to do with her work force.  I told her I couldn't really estimate because it just depended on how busy they are and how many people they had working that day.  It struck me as an odd question though.  My first reaction was: close off the bathroom, inform the staff, and go about your business if possible.  But I do realize that while I see this often, most people rarely have people die during their work day and it is liable to be upsetting.  What I don't get is how that changes depending on how quick the coroner comes?  If they move the body quickly everyone can stay at work but if they don't then everyone goes home?  No matter what, while we go back to our station and have lunch and move on with our day waiting for the next call, they are stuck with the aftermath of a traumatic event and a dead co-worker or friend.  It really is just two entirely different worlds.

We are not uncompassionate in any way.  On the contrary most people who do this job are here because we are compassionate and we want to help and make things better.  But we also enjoy what we do and like using our skills, even if it doesn't always work out in the end.  My firefighter even commented that, as morbid as it sounds, since codes are going to happen anyway, he's glad he gets to work them because it keeps up his skills and keeps his hands on the equipment.  In this case, even though there was nothing we could have done for this man and it is quite sad, as a crew we did an excellent job and that feels good.  We can't always control the outcome but we can be happy and proud that we did the best we possibly could for our patients.

Caution: Children At Work

I really like chemistry and I have sometimes thought that it might be fun to go to HazMat school.  But, more often than not, exceedingly more often, Hazmat calls are long and boring and uninteresting and don't involve much chemistry.

As a general rule, it's not a good idea to keep a group of adult 12 year olds (AKA firemen) bored and uninterested.

This time we got called out for a hazmat involving a rail car full of dry carbon powder, the stuff that goes into computer ink cartridges.  The product was somehow smoldering or having some form of reaction inside the container car.  It had actually melted the vacuum tube that was being used to offload the stuff into the warehouse.  We took some temperature readings with our TIC from the outside and it was definitely heating up in there, plus the car itself was warm to the touch.  That's not good.  As a precautionary measure we got some hoselines in place.  The hydrant was about 200 feet away so we stretched 225 feet of 5" large diameter supply hose and then pulled 150 feet of 1 3/4 inch attack hose to one side of the car and 250 feet of 2 1/2 inch hose to the other side. 

The hazmat team arrived, suited up and went up on top of the car, popped the hatches and took some readings of the product itself.  It was over 700 degrees inside.  There was no smoke, flames, or gasses present though.  It was essentially acting like a giant powdered charcoal briquette.  After much deliberation and contacting of subject matter experts it was decided that the rail car should first be moved to a more open space away from the building before taking any action.  This involved moving two other cars first.  The only means of moving the cars was to push them on down the track using forklifts.  And since firefighters live in a state of suspended adolescence and we'd been standing around with nothing to do for far too long we started rifling through our turnout pockets for loose change to put on the tracks as the cars rolled slowly past.  Yes, we are children and yes we get bored easily.

 

To steal a line from a fellow fire blogger: A child stopped a firefighter in the store and told him, "I want to be a fireman when I grow up".  The firefighter responded, "Sorry son, you can't do both".

In the end the car was moved, the hazmat team sent home, and an employee was sent to get four to five hundred pounds of dry ice to put in the car and create a CO2 blanket to cool and smother the product.  That part I actually wish I could have seen.  Instead, we reloaded our hundreds of feet of unused hose and went back to the station.

We were on scene for a little over five hours and had to return a few hours later to make sure the clean up company showed and that they had posted a fire watch.  I think I'll skip Hazmat school after all..

Did She Just Say What I Thought She Said?

 This is one of those stories that sounds funny at first but really wasn't.  It turned serious real quick.

I was working at one of our outlying stations with a captain I'd never worked with and a probie firefighter I'd only met once.  This station is in a district with a lot of wildland interface, hilly roads, freeway responses, and a long canyon road leading out of town.  We had had a pretty slow day but then started running calls about 4 a.m.  After unsuccessfully trying to get to sleep for the third time we got dispatched to a traffic accident on the canyon road.  It was about 5:30 in the morning now.

I hopped into my turnout gear and was ready to jump on the rig when the dispatcher stated we were responding for a motorcycle vs. cow.  Seriously?  Where the hell am I?  Motorcycle vs. cow???

The location of the accident was mid-way between us and the neighboring department so they sent a rig down the canyon road and we went up.  We reached the reported location and found no cow, no motorcycle, no anything.  Dispatch reported that the other department's rig was on scene of the accident (further up the road) and needed us to continue in for traffic control and manpower. In reality, I knew from the initial dispatch that this would probably be a bad scene.  If a motorcycle hits anything it is usually bad, but if one hits a cow then it is certainly bad news for the rider (and probably the cow).  The fact that the other department still wanted our help for just one patient did not bode well.

I drove on up the canyon until we found the scene of the accident. I positioned my engine to block the area from traffic and headed over to the rider.  I still didn't see a cow, but I did see a motorcycle on the ground, a helmet on the ground, and a busy fire crew working on the unconscious rider.  I glanced over at the helmet to assess the level of damage.  Thankfully it looked in good shape, no big dents or cracks....but...it was full of blood.  We joined the other crew who had just extricated the rider from under the guard rail and cut his shirt and jacket off.  He, like the helmet, looked physically undamaged...but...he had a large amount of bubbling blood pouring out of his mouth as he struggled to breathe.  He was definitely bleeding into his lungs, at a minimum.  We finished stripping and stabilizing him and got him into the ambulance.  My paramedic firefighter jumped on board also and the ambulance crew still wanted another rider.  I jumped in too and my captain said he would drive the engine to the hospital to pick us up.

En route I tried to get an IV in his arm and couldn't find any good access.  I wound up putting an IO in his leg (drilling a large bore IV into the bone).  The ambulance medic got him tubed and, combined with the fluids going in the IO, we got a passable blood pressure and good capnography numbers.  We were constantly suctioning blood from his mouth though.

 It was a seriously bloody mess.  My gloves were covered in blood, but my firefighter (who was doing the suctioning and bvm) had to put his turnout coat in a hazmat bag just to get it back to the station to be cleaned.  I truly have no idea how the rider is going to fair.  If it is just chest trauma and they got him to surgery quick enough, he could be fine.  If he has multiple organ or system injuries, spinal damage, or a head injury it could be seriously bad news.  Hopefully we'll get a follow up and find out how he did.


So, did you forget about the cow?


I bet you're still wondering about the cow, right?  I thought so.  Well, it turns out there was no cow.  There was a fawn.  Now, after reading what the rider went through, let's don't be all, awwwwww the poor fawn.  The fawn was dead but intact (no blood) and knocked clear across the roadway onto the shoulder with what appeared to be (at a quick glance) a broken neck.  My guess is that the fawn was killed instantly.

What I want to know is who the hell reported this accident and mistook a fawn for a cow???

Can you spot the difference?

A Shocking Tale

The lights and tones woke me up at about half past midnight for a medical call.  It was for a 28 year old female complaining of a heart problem.  As I pulled on my gear and found the address on the wall map I thought to myself, this is either some ridiculous panic or drug/alcohol induced nonsense or someone with a congenital abnormality or other serious cardiac issue.  Because it was the witching hour and I had been asleep I was grumbling and leaning toward the former. 

En route dispatch updated us that the patient had a cardiac defibrillator and it had fired about ten times in the last fifteen minutes.  Okay, so I was wrong...it's the latter.  We arrived at the apartment and found a young woman lying in bed with her arms crossed around her chest and her eyes  closed.  She told me she was just trying to be still and relaxed so the defib wouldn't fire again.  She said she has had an AICD (Automatic Implantable Cardiac Defibrillator) for thirteen years and has never had it fire.  This was her second AICD (which she's had for the last five years) and as it turns out this particular model has a recall notice for some possibly faulty wiring.  That had to be disconcerting.

I assessed vitals, ekg, and got some additional history from her.  She was awoken from sleep by the fist shock but had no prior symptoms, stress, or unusual activity. Her ekg actually looked fine although we would have to wait for the ambulance to get a more definitive 12 lead ekg.  This is a little frustrating because I am a 12 lead trained medic but we don't yet have the cables on our monitors to allow us to do them.  My department is currently training all of our medics in 12 lead acquisition which is excellent.  But, until that's done I have to wait to use my training.  In any case, the scene was calm and my patient was cardiac symptom free: no pain other than residual pain from being repeatedly electrocuted, good BP, good pulse and rhythm.  It was certainly looking like she got one of the defective defibrillators.  Unfortunately there wasn't much I could do for her.  Her chest pain was only a three out of ten and only caused by the shocks, she couldn't have morphine and my other pain management drug wouldn't do much in this situation.

The ambulance arrived and we were disconnecting our equipment from her when she suddenly screamed and sat bolt upright.  The AICD had fired again.  I was at her side and my firefighter had his back turned to her and was trying to coil up the long ekg wires when she screamed.  In my peripheral vision on one side I saw my patient clutching her chest and rising up and on the other side I saw a tangle of wires flying into the air as my firefighter jumped like a startled cartoon cat.

 

It would have been funny except my patient was now crying and scared to move.  This means she didn't want to get up and onto the waiting ambulance gurney.  This means we have to pick her up and carry her to the gurney.  Which means I have to get behind my patient and wrap my arms around her holding onto her wrists and pulling her arms into her chest while another firefighter holds her legs under the knees and we take her down the hall this way.  She was young and light and I wasn't worried about the lift.  I also wasn't too worried about the defib, it shouldn't really be strong enough to hurt me even if it fires while I'm carrying her (at least I hoped it wouldn't - I didn't really know how powerful the thing was).  I just didn't want either of us to drop her if she suddenly screamed and jerked again with the sudden shock.  Fortunately we made it to the gurney and the ambulance took off without any more shocks.

All The King's Horses

"Engine 41: Respond for a 22 year old female with an eye injury".

This call was pretty close to the station and we arrived very quickly. So quick, in fact, as to not get the update that the eye injury was caused by an egg. Yes, an egg.

Don't worry if you're feeling confused, I was too. All will be made clear.

We arrived and were greeted at the door by a young woman holding a wet cloth to her eye. I led her into the nearest room and had her take a seat. The nearest room happened to be the kitchen where she proceeded to tell us that she had been microwaving an egg and when she set it on the counter it exploded in her face. And yes, I realize there are numerous jokes and puns to be made here, like "I guess the yolk is on her", etc, but I'm not going to stoop that low. I glanced around the kitchen and saw bits of egg shrapnel everywhere. There was exploded egg all over the ceiling and the counters.

She didn't say so and I wasn't going to make her feel worse by asking if she had actually placed a raw egg in the microwave to hard-boil it, but that is obviously what had happened. The same principle behind popcorn popping and tanker truck explosions is at work here: it is called a BLEVE or Boiling Liquid Expanding Vapor Explosion. Simply put, the liquid inside a closed container vaporizes and expands thereby increasing the pressure inside and causing a failure of the container and a subsequent explosion. She had somehow nuked this egg for the perfect amount of time so as to not explode harmlessly in the microwave but to delay detonation until she had crossed the kitchen with it and set it down on the counter. The flash-bang of egg grenades if you will.

I removed the cloth to see the extent of her injury and found her eye to be completely swollen shut. I could just barely get it open enough for a cursory examination. It was bloodshot and irritated but I couldn't see any actual shrapnel. We spiked an I.V. bag and tilted her head to the side and just used the tubing to run cool saline into her eye to her great relief. She had already done a pretty good job of flushing it with cool water when it first happened but she was still in pain.

By the time the ambulance arrived she could almost open her eye all the way, although only briefly. We passed off our irrigation contraption to the ambulance medics so they could keep flushing her eye en route to the hospital. I got back in my engine, shook my head, and headed back home.


Here's a link to an exploding egg video on youtube. Just imagine looking right at the egg in a bowl when it blows:
http://www.youtube.com/watch?v=xCT039Pdrag

I'm Feeling Much Better Now

We responded to a call for a 65 year old male, "conscious, breathing, not alert". This could be a hundred different things but from the dispatch it didn't sound too bad and I wasn't too worried about it. When we arrived the patient's wife said something about a seizure but I didn't quite get the full story because we got busy fast. My captain gathered info from the wife while the firefighter and I assessed the patient. He was sitting up on the couch with his eyes closed and appeared to be barely breathing. Uh-oh.

We laid him down and for a minute it looked like he had stopped breathing entirely and had probably just coded. He had agonal respirations and a carotid pulse (fortunately). My firefighter quickly dropped an OPA into his mouth and I cut open his shirts and put the ECG pads on. The firefighter started bagging our patient and after about three breaths our guy started pushing the OPA out of his mouth and opening his eyes. It was at this point that he looked at my firefighter, shrieked, and took a swing at him. The firefighter grabbed his arm before he made contact and I leaned down on his legs to keep him from kicking.

Now, I've never been in this situation, but I have seen it many times and can pretty much imagine how unbelievably bizarre it must be. Can you imagine having some medical event that messes with your body and or brain enough to knock you unconscious and when you come to you are half naked and three men you've never seen before are leaning over you attaching wires to your body and shoving things down your throat? Seriously, he must have thought he'd been abducted by aliens and the probing was about to begin. I don't blame him one bit for screaming.


Well, we got him calmed down and quietly and carefully explained what was happening. He was oriented to where he was, who he was, and what day it was but couldn't explain what had happened to him. What became humorous (later anyway) was that even once he was calm enough to answer questions he would occasionally look at one of us in surprise and give a shriek, "Ahhhhh". I asked him what was wrong and he said, "I'm scared". Well I kind of figured that. He denied any pain but had a very abnormal heart rate and rhythm. He had an internal cardiac defibrillator but said he had not felt it fire.

The ambulance arrived and I rode along with them to the hospital just in case it happened again. His wife said he had just gone rigid and then unconscious, come around and out of it, and then did it again (which is when we showed up). Well, he just got better and better as we rode to the hospital. His color improved, his BP settled down, he remained calm. His heart rhythm was still funky but he was doing much better, especially considering he had gone from pretty much dead to awake and fighting in about ten seconds. I thought for sure we were going to be working a code blue when we first saw him, but when we dropped him off in the E.R. he just looked mildly put out. So, I guess that's a good thing.

Watch Your Step

We responded on a second alarm fire a couple of districts over. We were the second in truck to this two story residential structure. Most of the truck work was already done so I helped another engineer get some lighting set up while the rest of my crew went to back up the upstairs hose team. It was pretty much mop up work at this point but still very smoky. I masked up and went upstairs to help out my crew. I found my firefighter in the middle of the large upstairs bedroom. He had the hoseline now and was still soaking down hotspots. Visibility was still pretty low. A fact I discovered when I walked past my firefighter and almost fell out of the house and down to the driveway.

You see, the house was built with a second story balcony over the garage (not uncommon).


This balcony had burned up pretty good in the fire (spread from the garage to the upstairs) and had actually been pulled down by one of the crews earlier in the fire so it wouldn't fall on anyone. The sliding glass door was open (for ventilation) and it was just smoky enough that I didn't realize there wasn't anything out there to step onto until I had walked right up to the edge. Only the wind clearing the smoke around outside the slider kept me from walking right out into open space.


Assuming the fall wouldn't have crippled or killed me, I would have had a hard time living that one down. Although, I later learned that my Captain almost stepped out of the same slider when he came upstairs.

Lessons learned: don't take anything for granted and never let your guard down, even during mop-up and overhaul.

Y? Because we loathe you.

One of the things I love about this job, since my very first calls as a work experience student, is getting a glimpse into situations, places, and lives I would otherwise never have any occasion or business being privy too. There is never a shortage of things to shock, amaze, wonder, admire, and/or shake your head at. I know that had I gone any other sheltered/suburban route with my life I would have no clue as to what goes on around me and its prevalence in even the most serene looking places.

I was a pretty new firefighter when I got this call and was 'riding backwards' because I wasn't signed off to drive yet. The house we were going to was on a corner in one of the nicer areas of town and our route took us in so that the house was on the drivers' side of the street. I didn't get to see the house or the fire until I actually stepped off the rig to get to work, but the engineer and captain both had some colorful exclamations as we rounded the corner.

I jumped off the rig and ran around to the back to pull the live-line when the engineer went running past me stretching the cross-lay. OK, I guess we're using that line. I got my first look at the house now. The garage was fully involved and just cranking out fire. Either the garage door had been open or it had completely burned through.

I grabbed the nozzle and my captain told me to take the driveway and start hitting the garage. I was kind of disappointed that we weren't going in the front door to make an interior attack but it was still a lot of fire and we were the only rig there at the time. I knelt down in the middle of the driveway next to a parked car and started hitting the flames while the engineer hooked up to the hydrant on the corner behind us. Through the flames I could just make out two motorcycles amongst the mass of stuff burning in the garage. It was pretty hot but I didn't think it was that bad until I noticed that the car I was kneeling next to was starting to catch fire. The next due engine had arrived and that crew was preparing to go interior but somebody from another company stopped and popped the hood of the car and put some water on it for me.

I had the fire pretty well darkened down in the garage but of course the motorcycle tires and rafters kept wanting to reignite so I kept having to come back and train the hose stream on them for awhile and then move it around. The other crew went in the front door and made sure there was no extension into the house. There was some minimal damage to the kitchen but it was pretty much contained to the garage. It took just a few minutes more with both hoses on the fire
to knock it all down.

With the fire out now and no extension, we ditched our bottles, fired up a couple of blowers, and got ready for what looked like a lot of overhaul. That's when I got a chance to look around some.

The door from the garage to the kitchen (open now) gave a clear view into the living room of the house, now clear of any smoke. And there, proudly and prominently displayed on the wall (and visible now from the street) was a large nazi flag. It was in perfect condition thanks to the great stop we made on the fire.

Yaaay fire department, protecting life and property.

Your welcome.

As we were checking the rest of the house I came across a curio cabinet with a couple of Disneyland license plates (awww), figurines (cute), a bayonet (huh?), and two SS Officer knives with swastikas on the handles (umm?).


The video cabinet next to the TV contained a bunch of Disney animated movies on the first shelf and a collection of Jerry Springer: Too Hot For TV and COPS videos on the second shelf. All in all, a pretty odd juxtaposition of collectibles.

The rest of the place was a marvel of whiskey-tango engineering. There was no power to the house but at least a dozen or more extension cords ran daisy-chained all through the place powered by (what else?) a string of car batteries bolted to a 2x6 laying on the garage floor. Coleman lanterns and camp stoves rounded out the decor.

How this place possibly caught fire we may never know.

I spent the next hour helping shovel out the debris from the garage and hosing it down. As I worked, I marveled at the amount of small auto parts, beer cans, and porn we were scooping up.

Within a month we were called back there again. This time it was to shut down an illegal backyard burn. These folks had set up a tent in the backyard and just moved the whole operation outside. They were having a little bonfire which we politely put out for them.

The occupants are gone now, the place leveled, and that address is now home to one of the largest and by far the nicest house in the neighborhood.

Neighborhood beautification, one structure fire at a time.