From Drain To Crane

There's a man made lake in my old district that is home to a million geese and ducks. The little ducklings occasionally follow their parents right across the sewer grate and drop right down. They can't fly and so they end up trapped. Inevitably someone will call us to rescue the ducks. Most of the time it is a pretty simple operation: we lift up the sewer grate, drop a small ladder in, climb down, block off the other exit with a shovel so they don't run away and scoop up the ducklings. It's a happy ending, feel-good, positive PR kind of call. Unless, that is, you're the B-shift crew that this happened to:

The lake is also home to an annual fishing derby for kids. The city pays to stock the lake with hundreds of fish and hundreds of kids come out to the park to drop their lines in and pluck the unwary suckers out of the water.

It happened to be a beautiful day and there was a big turnout. Of course, with so many people around the avian residents were on the move and one little guy, as expected, dropped into the storm drain. The call went out and Engine 52 came to the rescue. With all the kids gathered around them they descended into the storm drain and heroically re-emerged with the duckling. The mama duck had retreated to the waters edge due to all the commotion. Amidst a chorus of cheering, the duckling was brought to the water and released, quickly falling in behind its mother and swimming out into the lake.

That is when, according to the crew, the shadow appeared and time slowed down. From somewhere in the trees behind them a crane took flight and passed right over their heads. It bore down on the rescued duckling, snatched it from the water, and flew off with it in its talons into the trees above the crowd. There it proceeded to eat the duckling as the shocked and horrified children drew silent. "Hey kids, how many of you have seen The Lion King? Circle of life remember? Right kids? Kids?" Of course, the actual exclamation from the firefighter was, I believe, "Oh my god! Did you see that god-damn vulture?"

 

The next morning I was on duty and this whole story was relaid to us with much laughing and teasing. Later that day we responded to a grass fire in an open field. After extinguishing the flames we traced the fire back to its starting point and found a very dead KFC (Kentucky Fried Crane). It had apparently landed on the power pole and spread its wings out contacting the wires and electrocuting itself. It must have caught fire and fell dead into the tall dry grass by the power pole. We all agreed that this must be the crane from the fishing derby and that karma is, indeed, a bitch. Lion King.

Tennis Anyone? or People of Walmart

We were returning from picking up some equipment and happened to be in another station's district when a call came in just a few blocks from us. We radioed dispatch and told them we would take it for the other engine. The call was for an assault in the WalMart parking lot with one suspect still inside the WalMart. Police were on scene with the victim as we rolled into the parking lot.

Our victim/combatant was pacing around with some cuts and bruising to his face and neck when I introduced myself. He explained that he was in his car leaving the parking lot when another guy started hitting him (through the open window) with a tennis racquet. I looked over at the other police car and saw two tennis racquets on the hood that were completely bent up and destroyed.

 

 My patient told me that he then stopped his car and got out to fight, naturally. Since there were two destroyed tennis racquets on the hood, I like to think that he got out, reached into his coat, and pulled out his own racquet, Highlander style, and the two began to duel.

 

I believe the truth is something closer to him leaping out of the car and charging a guy wielding two tennis rackets and getting beaten down windmill style. Either way, I bet it was a site to see.

Other than being very angry and quite bruised up my patient didn't have any serious injuries and declined ambulance transport. I have a feeling, though, that tomorrow he is going to look and feel like he was in a racquet fight.  "Jesus, man, what happened to you?"  "I got in a tennis racquet fight."  "Oh. Yeah, that looks about right."

The police came out shortly with the Andy Roddick of the WalMart parking lot. Instead of some wild eyed crazy random attacker he turned out to be a guy in his early 20s who looked pretty normal. He stated that the guy in the car ran in to him in the parking lot and didn't stop, which led to the beating. He was unharmed in the melee and needed no medical attention.  What a shock - the guy with two tennis racquets and the element of surprise won the fist fight.

What never ceases to amaze me is how surprised people are when they get arrested for the most obvious things. It seems they honestly don't understand why the cops are even talking to them. This kid was getting the bracelets hooked up as the officer explained that he was being charged with assault. He looked at her, aghast, saying "But he ran into me. Why am I in trouble?"

(should say, I Served Time)

The capper to this whole fiasco, though, was all the other drivers in the vast WalMart parking lot who could not figure out for the life of them how to deal with one aisle full of emergency vehicles and still go about their day. A whole line of cars pulled out and instead of going the opposite direction, headed straight down the aisle towards a fire engine, an ambulance, and two cop cars. They proceeded to just stack up in the aisle until I finally went and moved a bunch of shopping carts and started directing traffic away from us and into the next aisle. Meanwhile, a car parked right by one of the cop cars decided to back up and leave. They began backing up and my firefighter was directing them away from the cop car but they wouldn't turn. They just kept backing up towards the cop car, where incidentally the kid was getting cuffed. One of the officers went up to the passenger window and began telling the driver to turn the wheel. They turned the wrong way. He pointed and told them louder to turn the other way. They straightened the wheel. He opened the door and pointed again and said, "Turn the wheel that way and slowly back up!" They finally got turned the right direction and proceeded to back up at about 1/8th of a mile per hour. I didn't know cars could actually go that slowly and still be moving. The cop actually looked up at all of us, threw his hands in the air and said, "I did say slowly didn't I?"

This Just Pissed Me Off

The vast majority of ambulance crews who respond to our calls are good ones. On occasion you get the burnouts and it sucks. I hate being the caring professional who treats my patient with respect and then have to hand them over to some uncaring idiots. Normally it doesn't stick with me or bother me for long but for some reason I was fuming over these dipwads all four day.

Our patient was an elderly man who just went on hospice care a few days ago. He was having some difficulty breathing and really needed supportive care. We set him up with some increased O2 and did our best to comfort his wife as well. He was pretty much ready to go when the ambulance arrived.

This ambulance crew happened to have an intern with them. Now, I was an intern once and I know what it is like so I try to let them do their thing and kind of help them out. However, the regular ambulance crew came in and didn't say a word. Not one word to me, my crew, or their intern. I usually look to the preceptor to get an idea of what he expects out of the intern and how the guy is doing. I got nothing from this guy. So, I gave the intern a complete rundown and told him we would have to carry the patient out to the gurney. The intern asked if the patient had a DNR which was an excellent question although it was most likely not going to be needed on this call. The patient's wife said yes, but was obviously not prepared for this to come up so soon and was very flustered by the thought of him needing it. I tried to reassure her that we just needed to know what kind of directives he had but would not even be going lights and sirens to the hospital. She could not seem to locate the DNR and this seemed to be hanging up the intern. The other two "medical professionals" still had not said a word and were standing shoulder to shoulder in the doorway of the bedroom blocking any access or egress.

 

I went outside to see where the gurney was and which way it was facing so I could plan how to take the patient out. When I arrived back inside the scene was unchanged. Our patient needed to get to the hospital and this crew was still standing there doing nothing. My firefighter, probably reading the expression on my face, had taken up position behind the patient ready to help lift and carry him. My way was blocked by the ambulance tools so I merely looked my firefighter in the eye and said, quite loudly, "Are you ready?" and pushed my way unceremoniously into the room between them. I took the patient's legs and my firefighter took his upper body and we took him out to the gurney and started bringing the gurney to the ambulance.

Now, my firefighter and I do a lot of lifting and carrying of patients in our district and we don't mind it at all. But, when the ambulance crew doesn't even feign assistance and behave like these bozos did it really bothers me. Normally, I am able to just shake my head, talk smack and berate them when I get back in the engine, then move on and forget about it. But, for some reason, these clowns really got to me and every time I thought about it over the next few days it made me angry all over again.

Happy Windsday!

It was a very blustery day....

The day started off nice and sunny and we decided it would be a good day to get our new captain some practice at launching and recovering the rescue boat from the trailer (which he hadn't done yet). We were all set to go after lunch. However, all through the morning the wind continued to pick up and by the time we got to the marina there were waves and little white caps at the boat launch which is pretty unheard of. We, stupidly, decided to give it a try anyway. Based on the conditions I offered to try it out first to see how tough the recovery was going to be but the captain decided to give it a shot.  We figured if you can succeed in the worst conditions then all other attempts will be a piece of cake, right?

As soon as he backed the boat off the trailer the wind started pushing us back into the dock and towards the rocks. My captain struggled to get us straightened out and turned around for a run at the trailer. We were in a substantial crosswind and the cabin of our boat basically turns the middle and ass-end of the boat into a giant sail. 

The wind was coming from our left and as we made the approach to the trailer things were actually looking good. Then things started to go sideways...literally. The wind was pushing us sideways past the trailer and towards the starboard side dock. We have bumpers out to protect the boat and the firefighter at the trailer ran over to push the bow of the boat away while I leaned out and pushed against the dock from inside the boat. The firefighter suggested that we reposition the trailer and just pull the boat onto it by hand, a simple and practical solution. However, being a firefighter faced with a challenge and slipping into single-minded, "this thing isn't going to beat me" mode I said I wanted to give it one shot before we resorted to towing it in. I figured the worst that would happen is that we wind up in the same spot and go with the firefighters plan.

I backed the boat up and fought the wind to loop around for my run at the trailer. Now, normally in recovering the boat I only use one motor and only power it up to make steering adjustments with small on/off bursts. The expression we use is, "Slow is pro". This day, I found myself using both motors just to get lined up into position. I aimed for the corner of the port side dock to hopefully give myself some wiggle room and came in under power, though with only one motor. The rear of the boat immediately started swinging out to the right as I approached. I wound up coming in almost completely sideways to the trailer and under power, scary. Just before I got to the trailer I turned the bow hard right toward the trailer and killed the power. I got a thumbs up from the firefighter at the trailer and as the boat came up on the rollers and centered itself I popped it back into gear and drove up onto the trailer. The firefighter secured the bow hooks and  brought us out of the water. It was probably a one in a thousand lucky shot and I doubt I could possibly repeat it, but damn it felt good. That recovery alone made me happy all day.

We weren't the only ones battling the wind that day, though.

Our next call, after giving up on further boat ops and getting back to the station, was for a woman in the trailer park whose carport was being ripped apart by the wind and threatening to fly away. When we arrived we saw that two of the supports had already been pulled loose and the roof itself had buckled. The entire carport was about 40 feet long and made of corrugated metal.

My firefighter grabbed a pike pole and hooked it over the roof where it had buckled and pulled down to bring the roof back down to the sheared supports. He wrapped his legs around the pole like he was flying on a broomstick and even with that when a gust came along he was lifted off the ground about six inches. I threw a ladder for the captain and handed him tools while he tried to reattach the supports with some metal strapping. We soon discovered that the strapping was not going to hold and decided to try securing the whole thing with rope.  I found myself lying on my back on top of a shed under the carport with a sawzall cutting holes in the metal as the roof blew up away from me and bounced back down within a foot of my face. We fed ropes through the holes I had cut and tied them off to secure anchors on the ground. Of course the next gust that came along caused the rope to rip through the corrugated metal like butter.

Okay, that did it, this thing had to come down. We decided just to cut the damaged section of roof off entirely, a section about twenty feet long. I took over duty on the pike pole trying to keep the roof pinned down while my firefighter sat on the roof of the mobile home with the sawzall cutting the carport away from the home. The sheets of corrugated metal were pulling loose from the gutter/flashing I had hooked with the pike pole so every once in awhile when the firefighter cut a sheet loose it would whip back at him like he was holding onto an airplane wing. It's amazing none of us got hurt. But, it worked. We even went back the next day to check on it and make sure everything was okay and all was in order.

We rounded out the shift with an overdose, a combative woman with encephalopathy, and a DOA early the next morning.

Priorities

My last post mentioned priorities and how often, at least in our eyes as first responders, they can be quite skewed. Here's a good example:

We responded for a 55 year old male who was bleeding from a recent surgery site. When we arrived we were met outside by someone who told us the patient had undergone hernia surgery that same morning and must have popped a stitch getting in and out of the car when they went to run errands. We went inside and found that our patient was sitting in his kitchen typing on a laptop computer with no bleeding control measures in place at all. His jeans were saturated with blood from his waist to his knees.

 I wish I had taken the time to look at the screen to see what was so important that kept him sitting up, typing, and bleeding (maybe he was blogging about his experience). I asked him what was going on and the first thing he tells me is that he is feeling lightheaded and nauseous. Really? I can't imagine why. I told him to lay down immediately. His blood pressure laying down was 87 over 50.

I went to kneel down next to him and almost knelt right in a puddle of blood. I grabbed a nearby towel and laid it over the blood. His pants were undone and I lifted his shirt to see a completely clean surgical incision site. Weird. I told him I needed to remove his pants to examine the wound. He said okay but asked that I cover him with something, modesty I guess, but again - priorities, after all we were alone in his living room not in the mall. Turns out he was going commando but I barely had to move his pants down to see that the lower abdominal incision site was the one that was bleeding. I covered it with a trauma dressing and applied some pressure. I asked how long ago this happened and he said, "About an hour." An hour?!?! What have you been doing for the past hour? "Well, we just came back home from the store." A word of advice here, if you have surgery in the morning, don't go shopping in the afternoon. If you pop a stitch at the store and are soaking your jeans with blood, stay there and call an ambulance.

Next, I asked if he had any medical problems and he said he was diabetic. I asked if he took insulin or pills. He responded, "Oh god I take so many pills it's like a meal." Oh, okay, what for? "I'm HIV+." Oh. Now, I can understand not wanting to shout out to everyone who comes into your house your HIV status, but when you are covered in blood and the medical personnel ask if you have any medical problems, it might be the first one you mention. In fact, you might want to mention it in the very beginning. Of course we always wear gloves and take precautions against body fluid contact but it is still one of those things that makes you a little nervous and you like to know about as early as possible.

An I.V., some fluids, and an ambulance ride back to the hospital and this patient would be fine. I just really wish I knew what he was doing on that computer that was so important.

Can You Call Me A Cab

We had just pulled into the parking lot at the grocery store to shop for dinner when a man on a bicycle rode up to the engine. I stepped out of the rig to see what he wanted and in a very thick Phillipines accent he said, "Can you call me a cab?". Really? Who exactly does he think we are? I responded incredulously, "Can we call you a cab???". He said, "No. Can you call me a cob?" "A cob?...I don't understand. Cob? Wait, call you a cop?". "Yes. I been chot?"  "You've been shot?!!!"

Once again, I am always amazed by what people tend to think is important. Personally, if I'd been shot and was talking to a paramedic I would probably lead with the fact that I had been shot and worry about the police later.

I told him to sit down on the tailstep of the engine and tell me what had happened while I examined him. His story was as follows: He had been out for a bike ride and was going over the overpass from the neighboring town into ours when a car drove by, someone leaned out of the window, and shot at him. He felt a hot, sharp pain on his right side but kept riding. I found a small hole in his t-shirt and a small red mark on his side. It looked like it was just a pellet gun but it had enough force to go through his shirt and he easily could have crashed in the roadway. He declined an ambulance and we called the cops to take a statement from him.

He told us that in the Phillipines he had been a resistance fighter for many, many years and was never injured. It took coming to The United States and going on a pleasant sunny-day bike ride for him to get shot. 'Murica.

First Days

First days rarely go well. I've heard a lot of horror stories of peoples first days on various jobs. So, here are the stories of the first day of my EMT hospital time,  my first day working on an ambulance, and my first day on shift with the fire department.

Hospital time:

Becoming an EMT or a paramedic requires you to do clinical time in an ER before being certified. It pretty much immediately follows the didactic portion of the class and serves as your first real encounter with patients and all that you've been learning about. Bear in mind, I had zero experience at this point.

On the first day of my EMT basic clinical rotation I walked through the doors of the ER about 15 minutes before my shift was due to start. One of the nurses was heading toward a drawn curtain when she spotted me in my student/intern uniform. She stopped and asked if I was reporting in. I said yes and she immediately sighed and said, "Great! Go help Doug in Bed 2." I looked around the ER and saw that Bed 2 was the one with the drawn curtain and that the nurse had returned to the nurse's station. Eager to help but a little unsure of protocol, I quietly stepped around the curtain and there was Doug. To be more precise, there was Doug, a large opaque plastic sheet in his hands, and the naked corpse of a thin 90 year old man. He told me to come over and roll the body towards me so he could get the sheet under him. Now, I'd never even seen a dead body before, let alone handled one, but I did as instructed. We completely wrapped him in the plastic and taped it shut. Surprisingly none of it really bothered me. The part I found strange and a bit irreverent was when it came time to secure the extra plastic. The plastic was longer than the body and if it were a tootsie roll you would just twist the ends and leave it at that. In the case of this man, not being a tootsie roll, the extra plastic at the end was folded back over his face and secured by taping it repeatedly around his neck. Being dead, it didn't matter, but it was a strange sensation putting plastic over someones head and taping it around their neck. It seemed a little serial killer-y.

Well, having gotten the 'first corpse' thing out of the way, I reported back to the nurse's station. I was given a few random assignments but nothing too eventful until a patient came in with a bleeding arterial dialysis shunt. This is the implanted port used to remove blood, filter it, and put it back into the body during dialysis treatments.

The patient was a large African-American woman and the blood was under quite a bit of pressure since it was from the arterial side. I was assigned to hold direct pressure on the site with some gauze pads. Every once in a while the doctor would come in to see if the bleeding had stopped. He would ask me to relieve some pressure and fold down a corner of the bandage so he could see. At this point the blood would squirt out about 2-3 feet and he would say, "Not yet. Keep pressure on it." and then leave again. This went on for quite awhile with me just sitting in a chair next to this woman with both my hands wrapped around her large forearm and squeezing the best I could. They finally had to put a blood pressure cuff on her arm as a tourniquet to slow the bleeding. It was my job to sit there and watch the time and monitor the cuff. The cuff had to stay on for ten minutes at a time. It was pumped up very high in order to achieve the tourniquet effect and it was obviously painful to the patient. I could feel her hand getting cooler and see the color change in her skin. At the two minute mark she started asking if it was time to take it off yet. I had to do the, "Not much longer. Hang in there." dance with her to make it through the time. We did that dance at least two more times. All in all, that incident lasted almost three hours and pretty much took up my entire first shift in the ER.

Ambulance:

I worked part time on a BLS ambulance for awhile while going to paramedic school. We did mostly inter-facility transports, that is, taking elderly people from nursing homes to their doctors appointments or to the hospital. This pretty much just entails transferring the patient from the bed to the gurney and taking vital signs. Rarely do we travel lights and sirens and we don't respond to 9-1-1 calls. It is usually pretty uneventful.

I showed up at the barn and met my partner for the day. He informed me that he was a huge Eagles fan and that is what we will be listening to in the ambulance and if I didn't like it then that was too bad. Okay, good start. We left the barn and headed immediately to the gas station to fill up. I was the new guy, so I pumped the gas. I had no idea how low the tank was or what it even held because I wasn't driving. It was obvious it was full however, when the pump burped and gasoline came sloshing back out of the tank and all over my thigh.

Strike one.

My partner then informed me that, "Oh yeah, that can happen. Sorry I should have mentioned that." He was sincere, he hadn't set me up, however I had no other pants and now I reeked of gasoline. My partner told me he had some pants I could use and we went back to get them. His waist was about four inches bigger than mine and I'm sure I looked ridiculous in his oversize pants but I didn't really have any other option.

With a change into the clown pants we headed off to our first call. When we arrived at the house we found out that this patient was on a ventilator. Being only EMTs and not paramedics or nurses, we are not allowed to transport patients on ventilators and we had to explain that to the family and then hang around and wait for the ALS ambulance to show up. It's very awkward standing around with nothing to do and not much to say. It wasn't our fault we were the wrong ambulance, but we were the ones there and the family wasn't thrilled about it.

Strike two.

We ran a couple of nursing home transfers and then got a call to respond to a house. Most of our calls were to hospitals or nursing homes and usually not to private residences. When we arrived we found that our patient had been changing his catheter and encountered a problem. (Here comes the pitch.)
This was causing him to bleed from the site and the bleeding was not stopping. (Anyone else, sensing a pattern here?) Once again, as the new guy, it was up to me to deal with the bleeding while my partner drove. (He can't hit, he can't hit, he can't hit. Sssawing batta'.) So, yes, I got to hold direct pressure on a patient's penis all the way to the hospital. At least this time I didn't have to break out the blood pressure cuff.

Swing and a miss. Strike three.


Fire Department:

On your first day on shift in the firehouse everything is a test and everyone is watching you. How well do you do your job? Do you step up and do the chores and all the work in the station without being asked? Are you entertaining and do you tell good stories? Do you seem lost or at home? You are under a microscope and walking on eggshells. There are many firehouse rules or etiquette that should be followed and hopefully someone has clued you in ahead of time and not steered you wrong. One of these rules is never show up empty handed. On the fireground it means you always have a tool of some kind with you so you can do some work. On your first day it means you bring ice cream. This is where I was steered wrong.

The last week of my academy, just before starting on shift a particularly particular captain advised me that I need to show up with ice cream on the first day (and probably every day after that for awhile). Okay, thanks, good to know. He then informed me that I should bring something particularly good like Butter Pecan and none of that "mint chip shit". Okay, thanks, good tip. I of course didn't take into account that I would not be working for this captain or his crew and that bit me in the ass. More on that later.

 

I did all the cleaning and the chores and all that I was supposed to so there was no fodder for the cannon there. The getting to know you period, or third degree grilling as it turned out, was another matter. I am vegetarian, a relatively rare thing in the fire service, at least in that small department twelve years ago. There were many questions about why I chose vegetarianism and a million what-about-this-situation hypotheticals. I knew I was in trouble when I stated, "Look we can go over this for hours and it isn't going to change anything" and the answer I received was, "Oh no, no, no. We have 20 years to go over this."

It was somewhere around this time that the Butter Pecan was discovered. I knew this because I heard from the kitchen behind me, "Who brought in this shit?". I fessed up and told the story of the captain who had led me astray. At this point, the lead investigator in the vegetarian 'grilling' went to the blackboard to educate me. He drew a large C on the board. "Now pay attention. This is C shift, okay? C is for Chocolate. C is for Carnivore. C is for Catch and DON'T release." He wrote these all on the board; there were more but I probably blocked them out at this point. It reminded me of Mr. Hand from Fast Times At Ridgemont High putting Spicoli's "I don't know" on the board for all future classes to see.

I was then grilled about my cooking ability and it was determined before I'd ever made anything for them that I couldn't cook but merely heated things up. Then they informed me that I would be cooking tonight. There were six of us altogether at this station and I had never cooked for that many people, and honestly I didn't really have much of a repertoire anyway. So, I decided to go safe and make build your own burritos. I got a lot of food because the other rule is it is better to have too much than too little. I had prepped all the ingredients, made the guac, and set everything out. I was at the stove finishing the meat when the crew took their seats at the table. I had laid out the tortillas on the table already. The next thing I knew one of the other firefighters was standing next to me at the stove heating up his tortilla over one of the gas burners. He had no shirt on.

 

I did a little double take, said nothing, and went back to cooking. This firefighter was a little hyperactive and I figured that he was probably changing and decided midstream to get his tortilla ready first so it didn't really phase me. The meat was finally ready and I turned from the stove to put it on the table and found the entire crew waiting patiently at the table, shirtless. Their shirts were hung neatly over the back of their chairs and they eyed me expressionlessly. As I said, everything is a test. What I had to figure out quickly was what was the answer? Was it, am I stupid enough to fall for this, or was I supposed to join in? I decided, as ridiculous as it was, that it was the latter. I set the food on the table, looked at each one of them, peeled off my shirt and set it over the back of my chair and sat down.

Everyone dug in and we ate that way for about five long, silent minutes until the lead investigator broke and said, "I can't take this anymore. I can not eat and stare at you flabby, pasty, bare-chested fuckers." Everyone started laughing and I was high-fived by my captain. I had gotten it right. The funniest part was that they actually believed that they could convince me that this was the normal firehouse way of having dinner so that the first time I worked at another station or with another crew I would whip my shirt off at the table and embarrass myself.

And for the record, everyone ate the ice cream.