Paging Dr. Google

Ohhh, the internet. You gotta love it.

We responded at about 8:30 pm for a 23 year old male having a panic attack. When we arrived at the house the rest of my crew remembered that they had been on this guy before a couple months back.

We found him sitting on the couch complaining of rapid heart rate and some hyperventilation. He did not appear to be in any distress at all. He said he had been practicing the relaxation tips the doctor had told him to use but it wasn't working. He was speaking normally and his pulse was barely over 100. He had no tingling in his hands or chest pain or any other symptom that we would worry about so we really weren't too concerned. Nor were any of his family, as evidenced by the fact that his sister (?) appeared in the hallway, glanced back into the living room, saw a crew of firefighters, turned and went on her way without a word.

Our patient decided that he didn't want to go to the hospital by ambulance after all, because he didn't want to "waste our time". I'm sure we all mentally said, "Too late". So we cancelled the ambulance and he signed out AMA. As we got back on the rig the firefighter said, "He's gonna call us back you know that, right?"

Fast forward eight hours...yes, at just after four in the morning, thank you very much, we got toned out for the same address. When we walked in this time the first words out of his mouth were, "I'm going to the hospital this time." Oh, we already knew that. Again, he was in no apparent distress and in fact his heart rate was in the high 80's and his pressure was fine and his ekg normal.

He, however, had spent his time between our visits cruising the web for information on all the things that could be wrong with him (which probably triggered the second event).

As we waited for the ambulance to arrive he peppered us with questions. Could it be tachycardia? Well, tachycardia just means a heart rate greater than 100 beats per minute and you don't even have that right now. What about palpitations? Well, a palpitation is just a sensation in which a person is aware of an irregular, hard, or rapid heartbeat, which...again...you don't have. And so on.

In defense of his research, he stated that he had a lot of time on his hands, which I took to mean that he was jobless. He also stated at one point that this was his grandmother's house. So, I thought to myself, you're 23 years old with no job and living free at grandmas house.

If that's the case, what are you so stressed about?

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Halloween

I signed up to work overtime at my old station with my old captain. The engineer on duty the next day was working overtime at a station right by my current one so he asked if we could swap. No big deal, I still had a good crew to work with and would be closer to my home station in the morning.

Unfortunately that station can get busy, especially at night. They had actually been shut out the day before (no calls) which is pretty unheard of for them so we kind of knew we were going to pay for that. We drilled and ran a couple calls during the day. As predicted, we wound up being up all night (four calls after midnight). Our first night call was for a diabetic who is one of their regulars. His blood sugar was in the teens and we started an IV and gave dextrose. He came around and of course didn't want to go with the ambulance. This sometimes happens and we just make sure the patient has some real food (longer lasting sugar) and someone to watch over them. We have to make sure they eat and are mentating well enough before we can leave. In this case we were on scene for an hour getting this guy to eat and stabilize. We probably should have just pulled the plug and made him go to the hospital but we were being excessively nice. After that we got up at 2 o'clock for back to back calls and again at 5 o'clock a.m. It was one of those nights where the calls are spaced just far enough apart to never get back to sleep again.

I went from that station to my regular house for my regular 48 hour shift. My house is supposed to be the slow one, but once again we ran a couple calls in the day and 2 more after midnight. I think I got 3 hours sleep on the overtime and maybe 4-4 1/2 on my first shift. The second shift wasn't as bad until the next morning when I was getting ready to come home.

At 7:30ish that morning I got a call from the BC telling me to stay put at my station because I might get mandatoried. They had one person to call before me but he was out on a medical call and they had to wait for him to get back to the station.

Did I mention this was Halloween?

Well, the guy ahead of me claimed Family Care issues (which is the only thing that can get you out of a mandatory) and so I got stuck with it. The mandatory was at my old station with my old firefighter so at least that part was good, but it meant that I would miss going out with my kids and that my wife would be stuck dealing with them for an additional 24 hours (now 96) by herself.

The firefighter had also been mandatoried and was as unhappy as I was about it. He made a good point that Halloween was the one holiday we can't do on a different day. If we work Christmas or Thanksgiving, we celebrate the day before or day after, no big deal. He asked if I though his neighbors would look at him funny when he took his kids trick or treating on November 1st.

We had an overtime captain with us for the first 12 hours and the regular captain was coming in at 8 that night. We kept the day low-key and did our regular engine and tool service and decided to just go pick up burritos instead of shopping and cooking. There is a small taqueria right across the street and down a couple so we decided to just walk over there and get dinner. So, at about 5:30 we put on our uniforms, grabbed radios, and headed across the street. We had just reached the door of the place when the radios went off: "Engine 56, Truck 57, Engine 57, Engine 40, Rescue 19 respond for a structure fire residential".

Well we took off running back to the station pulling off our uniform shirts as we went. I must admit, I always think of the scene in the Superman movie where he is running and pulls his shirt open to reveal the iconic S whenever we do that. In any case, as I put my turnouts on and checked the map for hydrant locations I knew that it was going to be a race to see who got there first. The house was in the next district over, but pretty close to the border of our district. As we flew down the street towards the address I commented that I couldn't see any smoke. Just as I said that though we could all smell it. We saw the other engine coming towards us from the opposite direction. We pretty much met at the intersection but they made the turn first and took command. We swung in after them and went to assess the structure for ventilation. There was a decent amount of light colored smoke coming from the garage as we made our way around the house. We could see in almost every window and most of the way through the house and it was all clear of smoke so we were pretty confident that whatever fire there was would be confined to the garage. A crew went upstairs to confirm there was no fire or people inside: all clear. The initial engine crew made there way into the garage by way of a side door and were able to move through the cluttered and smoky garage to unlatch the garage door which allowed us to open it up from the outside.

There was a smoldering fire in the middle of the packed garage which was quickly and easily extinguished. It really didn't classify as a 'structure fire' but it gave us something to do and added a little excitement to my day. We helped pick up and load all the hose for the attack engine and went back to our station. I realized on the way back that we didn't have anything to hand out to trick-or-treaters if we got any. We stopped at the little market on the corner and the firefighter ran in and got a bag of blow pops.

If we weren't hungry before we certainly were now, so we put our uniforms back on and went back to the taqueria. This time we got our food and ate without interruption. We only had one small group of kids come to the door but at least we were prepared.

That night, the engineer due to relieve me called in sick and I almost got mandoed again. There was only one guy ahead of me on the list with the proper qualifications and if he had cried Family Care, I would have been hit again. Fortunately he accepted the mando and I was able to go home.

Coward

Normally, I try to keep these posts relatively light but this was messed up.

The tones went off and we were dispatched to a motor vehicle crash. En route we were given the update that it was a vehicle versus pedestrian with multiple patients. We were the second rig on scene and the first paramedic had already done a quick triage. I was split off from my crew and told by the IC to grab my monitor and go confirm the death of one of the patients. Over by some bushes at the base of a light pole there was a yellow highway blanket covering a body. I started to head over when somebody, I can't even remember who - a cop I think, stopped me and said, "Just so you know, it's a kid."

I later found out that what had happened was that two twenty-something idiots decided to peel out while leaving a gas station. They started to fishtail, lost control, and over-corrected sending them onto the sidewalk and right into two pre-teen skateboarders. The first kid tried to jump out of the way and was just grazed by the car. The other took the full force of the car and was sent flying.


I lifted the blanket and saw a twelve year old boy with his obviously lifeless eyes staring straight up at the sky. He had been thrown through the air and into the pole. He must have hit hard enough and in just the right position for it to immediately stop all his momentum because he seemed to have dropped like a stone right to the base of the pole. I thought to myself that normal physics would have had him bounce off or spin around the pole. I still don't get how he landed where he did. In any case, everything conspired against this kid that day, because if the car and hitting the pole alone didn't kill him, the four inch bolt sticking up from the bottom of the pole that went through the base of his skull certainly did. Of course, I didn't learn about the bolt until later when the coroner went to remove the body, but it didn't matter, there was no question he was dead. He had been triaged correctly. I still had to follow the protocol and hook him up to my monitor and run a strip showing him to be asystolic. I did so, and covered him back up then went to help in the extrication and treatment of the idiots in the car.

The driver of the car turned out to be a Mexican national without a driver's license who wound up leaving the hospital, fleeing the country, and supposedly returned to Mexico. I don't know how much more unlucky this kid's family can get.

Please, teach your children to respect the lives of other people, respect the power and force of a moving car and don't screw around with either. That way, maybe they won't wind up killing somebody else's kid. But if they do, I hope they are noble enough to stand up and face the consequences. I don't know how that driver can can live with himself and I can only hope that he is tortured every day by what he did.

Moonlight Serenade

You never know what lies in store when you respond to a neighborhood park for a man down at 10:30 at night. Could be an assault victim, an overdose, or anything under the sun...er, moon. But most often it is just a drunk, or I should say an allegedly intoxicated person. In any case it is always a little touchy and you have to be on your guard because altered people are always unpredictable.

The guy we went on tonight was no exception. We arrived to find him sitting on the ground and the PD sitting (very relaxed) on the picnic bench in front of him. Apparently he is well known to them, but my crew is all new to this district and we had never met him. He was surrounded by empty vodka bottles and was slurring his words. He jumped with a start when my firefighter approached him but calmed down quickly. I took up a position at his side in anticipation of taking his vitals (pulse and blood pressure). He somewhat answered some of the questions my firefighter/medic was asking him and then he paused and stopped talking. I then spoke up to tell him I wanted to take his blood pressure. I guess he hadn't noticed me before then because he jumped and started crawling backwards away until we convinced him I was just another one of the firemen. Of course, we had just come from a report of a car fire and I was dressed in my full turnout gear which should have been a tip off but, as I said, the altered are unpredictable.

I took his pulse, checked his blood sugar, and got the automatic blood pressure cuff going when our patient suddenly broke into song. "I see trees of green, (mumble mumble) too". My firefighter perked up with recognition and looked over at me smiling. I looked back at him and said, "Hey man, it's a wonderful world". We had been out on the water boat training earlier in the day and had been running a few calls in the evening and we were all feeling pretty good so it was a pretty true statement. Our patient continued to attempt the song as we got him loaded up for the ambulance, "I see blue...jeans, and more trees too". Being drunk and homeless he even had a bit of that raspy, gravely quality to his voice that old Louis had.

When's the last time someone sang to you at work?

Sounds Good On Paper & The Dangers Of Code 3 Driving

I worked a trade for the engineer at my old station the other day. The captain was an overtime captain and the firefighter was one of our new probies and we had a reserve firefighter riding along for the first eight hours. We did some rescue training during the day but the ride along curse was in full effect and we were shut out for calls...until bedtime.

I was just turning in for the night knowing that the odds of us getting up later was pretty good. Then in the space of a couple of hours we responded to a series of calls that all sounded very exciting and dramatic.

The first came in as an unknown medical with staging required, which means police are on the way and it is not safe for us to enter until police have secured the scene. Our update stated we were responding for a possible stabbing/shooting/penetrating trauma. When we arrived on scene at the gated apartment complex, the police were trying to punch in the code to activate the gate. I have a remote for the gate on my rig so I opened it for them as we pulled up and followed them into the complex where a man came running up towards us waving and directing us in.

As we rolled in the radio dispatched a call for the next district over that we would have gone to if we weren't already engaged: "Enging 59, Truck 41 respond to a vehicle accident with rescue - police car on its roof". I thought, damn, I'd much rather be going to that call, although I do have a pretty good trauma waiting for me just ahead. Dispatch immediately updated that the officer is fine and no medical needed, all units can cancel.

We were waved in by the cops in front of us and we approached the patient and the small crowd around her. She was a 20 year old girl who was bleeding from her........pinky.


Apparently she got in an argument with her boyfriend who grabbed her keychain out of her hands. Her keychain has a very small knife on it and her finger got cut. This happened approximately a half hour ago several cities away. She got her keys back and drove home and then called 9-1-1. And, in responding code 3 to this dangerous stabbing, a police car flipped over. We wrapped her finger with guaze and sent her away with the ambulance.

We decided to drive by the police accident scene to check it out and go over vehicle stabilization with our probie. The officer was fine, though covered in coffee. The car looked terrible. The right front end was pushed in and it was still upside down with the lights on and airbags deployed.

The funny thing is that the car was by itself in an empty school parking lot. Turns out that the officer was patroling by the school when the stabbing call came in and when he went to turn on his lights, he hit his radio instead. He momentarily looked down to correct it and when he looked up he was running into a stanchion pole. He was only going about 15 mph because he hadn't hit the gas yet but the impact caused his foot, hovering over the gas pedal, to "punch it" which sent him flying off the stanchion and on to his roof. We waited until we got back to our rig before we started laughing.

We got back to the station and headed for bed. I was pulling my sweatshirt off over my head when the lights and tones went off again. I slid back down the pole and we responded to a man having a heart attack at the gas station. This could be another good call for the probie. Of course, when we arrived on scene we found one of our new regular drunks sitting on the planter. He does have a cardiac history but by his own admission he was drunk and not all of his symptoms were jiving with a real cardiac event. I did a 12 lead ekg to be sure, shaving enough hair off his chest to cover a small animal in the process, and there was nothing glaring or alarming at all on the printout. The ambulance was right on our heels so we let them have the patient and headed home.

Of course, the next morning during shift change, my report to the oncoming medic just said that we had a busy night with a stabbing, a heart attack, and a code 3 police rollover. They don't need to know the details.

New Digs

Well, I decided to put in my bid for a new station. After my 3 station department joined the county department I have worked at about ten new (to me) stations. Some were places I knew I didn't really want to work and others were fine but didn't present an overwhelming reason to leave my comfort zone of the station and town I'd been in for so many years. The one that did intrigue me was the station that houses the rescue boat. I figured that was something so different than what I've done so far in my career that it could be worth the move. The station is in another city which is about 20-25 minutes closer to home for me, so it will improve my commute a bit as well.


A spot opened up at that station and the firefighter there was already someone I knew from my old department so it would make the transition even easier. I was awarded the bid and had my first tour at the new station. The boat was in the shop so I didn't get to check it out but the engine there is pretty good. It's old and has some problems but it's not bad. It is nice to be back on an engine after the cramped/crowded Quint I've been driving. The rumor is that the department will be getting 2-4 new engines and one of them may be slated for my new station.

I fear this blog may suffer a bit though. The district is small, pretty well kept, and has a predominately older population. It is also pretty slow. We had one call in the next district over for a kid on a special needs bus who got punched by another kid on the first day and one in our district the next day for an elderly woman with back pain. We are, however, surrounded by some busier stations and could get their overflow and respond in to any structure fire in those districts, so here's hoping.

Once the boat comes back and I get to start training on it, there should be enough to occupy my time but I think the volume and variety of calls I will be going on will be quite diminished from what I'm used to.

The firefighter is two spots away from a promotion so he will probably be gone by mid-next-year and there is a temporary captain there right now. So, I don't really know who my crew will end up being, but however it works out, hopefully the boat will make it worthwhile.