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.

Breaking In

I was working overtime at a station that I've only been to once before when we got toned out for a medical. Fortunately, it was on a major cross street and I knew how to get there without relying on the captain to navigate for me.

The call came in for an elderly female fall victim. It was also reported that PD was on the way as well. This didn't make sense to any of us. It sounded like a straight forward trip and fall. So, why was PD responding? We arrived right behind the police officer and made our way to the apartment where we found the apartment manager trying several different keys to unlock the metal security door. The woman inside was calling for help and scratching at the door.

So, that explained the cops being there.

The manager didn't seem to have the right key so we went back to the rig and grabbed "the irons" to force our way in.
While the firefighter and I went to the rig for the tools, the cop decided he would give the door a try. I don't know if he was trying to make a point that they didn't need to rely on the fire department and our forcible entry skills or if he just legitimately thought he could pry a metal security door open with his bare hands. In any case, when we returned from the rig we found him hanging from the top of the door with his feet up on the wall and yanking on the door like a monkey trying to escape it's cage.

He stopped doing that as we approached and the captain and firefighter forced the door with the irons then went to work on the apartment door.
The manager quickly spoke up that her keys might work on that door. The single minded firemen who really wanted to force another door had to stop and concede that we should probably try that first. This time her key worked and we made our way inside to the patient. She had fallen in her kitchen and had possibly broken her arm. Otherwise she was in good shape. The ambulance came in pretty close behind us, so other than a spinal assessment, history, and cursory exam of the arm I passed off patient care and treatment to them.

The crew did a great job on forcing the door too. The screen had a couple scrapes and a small dent but was still fully functional. Nothing like getting to break stuff without actually breaking it.