They See Me Rollin'

We do a lot of lift assists in my district. Elderly folks who just slipped out of a chair or the bed or whatever and don't have the strength to get up again. For the most part we just pick them back up and put them to bed or wherever they would like to be. Usually they are pretty quick and easy unless the patient is very heavy or in an awkward position. This most recent one was easy but not quick.

When we arrived we were met by our patient's daughter, who turned out to be no help at all. She directed us to the bedroom where our patient was on the floor between the bed and the dresser. She had grabbed some pillows and propped herself up a bit but she had been on the floor for a couple of hours. She is 98 years old and very open and chatty. We got to hear all about the virtues of her 'underwear with pillows' (Depends diapers) and many details of her past few weeks and other completely unrelated subjects in between me trying to ask pertinent medical questions.

It turns out that she had been trying to get out of bed to go to the bathroom and slid down to the floor. We checked her for injuries and then lifted her up and back onto the bed. We suggested she go use the bathroom now so this doesn't happen again later. At first she said she would just rest first and that she would be fine to go later. We really didn't want to have to come back in a few hours so we again suggested that she go now. She agreed and we grabbed her wheeled walker for her. Meanwhile she somehow wriggled out of her diaper and kicked it off. We mentioned it to the daughter who did nothing. So, we began to help our patient down to the bathroom.

This is where it got funny. The bathroom is directly down the hall from the bedroom about 25 feet. Our patient began moving with the walker in that direction so unbelievably slowly I felt like I was  listening to a 45 rpm recording of Andy Griffith speaking played back at 33 and a 1/3. All I had to do to keep pace with her down the hall was lean forward slightly. All the while she was chatting on about this and that. It was frustratingly amusing, but I'm glad that I have a crew that just laughed it off and stuck with it to help this woman out. When we got to the bathroom we knew she might need some help. Again, the patients daughter was just standing there doing nothing. We asked her to please come up here and help her mother out. Our patient used the bathroom and began the long trek back down the hall to the bedroom where we put her back to bed and covered her up.

And speaking of rolling along:

Our next lift assist happened to be a 400 pound man who slipped in the shower. We were able to dry him off enough to get a carry-all behind him and lift him to standing. The funny part about this one was this couple's ingenuity. The wife was not as large as her husband but on her way. She was in a rolling desk chair and seemed to use that as her primary conveyance. She was also on home O2 with about a 50' tube. She had installed little hanger hooks all down the hallway and around the house to rest the tubing on so it didn't get tangled up as she scooted around the house. We were able to move our patient to a similar chair which I'm assuming he uses all the time as well. As we said goodbye and left the couple rolling around their house I noticed that everywhere you looked around the house were a variety of tongs strategically placed for reaching things from a sitting position.

That's just how they roll in my district.

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.