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.