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.