Lost & Found

A little over a year ago, my small town, three station department merged with the County Department (now 28 stations big). When that happened, of course, all of our uniforms changed. Our badges, patches, t shirts, jackets, hats, etc. had to have the County name and logo instead of the old City name. The one uniform piece that the County FD didn't have that the City FD did was a Tilly or Boonie style shade hat. As a balding guy, I viewed my City FD Tilly hat as a piece of safety equipment and even though I'm not technically allowed to wear it, I held on to it. I carry it in my wildland bag and I will use it around my station if I'm out in the sun detailing the rig or doing yard work.
Today, I was out doing the weekly service of our reserve rig and wearing my shade hat. My captain told me we had to go out to a station a couple of districts over and retrieve some equipment left by the previous shift. I must have set my hat and gloves down on the sideboard of the front line rig while getting ready to go and forgotten about them. We headed out to the other station and just before getting there we got a call for an auto accident one district over from where we started but in the opposite direction. I put the Code 3 lights on and we drove all the way back to the accident. After treating one of the patients on scene we were released and set off back to retrieve the equipment. When we got to that station I noticed my gloves were on the sideboard and put them away. It didn't occur to me that my hat was missing. When we got back to our station I needed to finish up with the reserve rig and couldn't find my hat. I then put two and two together and realized what I had done and that the hat must have blown off somewhere while we were driving around. It's amazing to me that the gloves stayed put that whole time. We had gone all over and in and out of other districts so we couldn't just go retrace our steps to go look for it. I was pretty much resigned to the fact that I had lost my hat. I used that hat for camping and other things too and although I could always get another one of that style, it wouldn't have the fire department logo on it and it had sentimental value.

Later that night we responded to a small house fire and after going to the roof and raking shingles and checking for extension I decided it would be worth mentioning to the other crews in case someone turned in my hat to another station. Unfortunately, I don't think the hat had my name in it. Although, there were really only two of us who wore that style hat in my old department and the other guy is now retired. Well, as we were cleaning up I stopped the other engineer and told him what had happened. He started laughing and called his firefighter over. He then told me to tell the firefighter my story, which I did, and he started laughing and shaking his head.

They then told me the story of their day:

They had started off responding to the corner at the freeway offramp for the homeless guy in the wheelchair I have written about previously (see blog entry 'They Just Keep Rolling Along'). He refused ambulance transport and they went on their way. After that they responded to the next city over for an apartment fire. It turned out to be nothing and they were released to go back to quarters. They took the freeway back and as they came down the offramp they saw our wheelchair bound homeless regular giving them a big smile and a thumbs up while pointing at his head with the other hand. He was, of course, pointing at the fire department shade hat he was wearing. My hat! They knew it must have been mine but didn't know the story until I told them what happened while at the fire that night.

Now I'm very conflicted. I really like that hat and would love to have it back, but, knowing what I know about the person wearing it now, I wonder if there is any amount of washing and sterilizing that would make me comfortable about putting it on my head again. Plus, they said he looked so happy about having it I would almost feel bad about reclaiming it. However, this is not exactly the advertisement or endorsement I think is best for our department, now defunct or not. And who knows, maybe it does have my name in it.

The Dead Walk Among Us

"It is alive!"

I found out recently there is a guy in the next district over who is living without a pulse.

Here's how:

An artificial heart has been developed that involves the use of centrifugal pumps instead of relying on a pulsatile form of pumping. This results in a constant blood flow instead of the high and low pressures of a heartbeat.

If you listened to the patient's chest with a stethoscope, you wouldn't hear a heartbeat. If you examined the arteries, there's no pulse. If you hooked him up to an EKG, he'd be flat-lined. It's the strangest thing.

(Edited from the article):

The doctors who created the pump did not start totally from scratch. They took two medical implants known as ventricular assist devices and hooked them together. A ventricular assist device has a screwlike rotor of blades, which pushes the blood forward in a continuous flow. Thousands of people have these implanted in their hearts. By using two, the doctors replaced both the right and left ventricles — the entire heart.

The doctors say the continuous-flow pump should last longer than other artificial hearts and cause fewer problems. That's because each side has just one moving part: the constantly whirling rotor. But Cohn says they will still have to convince the world that you don't need a pulse to live because by every metric we have to analyze patients, they're not living.

"We look at all the animals, insects, fish, reptiles and certainly all mammals, and see a pulsatile circulation," he says. "And so all the early research and all the early efforts were directed at making pulsatile pumps."

However, the only reason blood must be pumped rhythmically instead of continuously is the heart tissue itself.

"The pulsatility of the flow is essential for the heart, because it can only get nourishment in between heartbeats," Cohn says. "If you remove that from the system, none of the other organs seem to care much."

The only thing I'm wondering is what we're going to do if the thing stops working. CPR won't do anything for him, he has no heart. Neither will any of the medications we use as most of them are designed to work on the heart itself. Maybe it's got a hand crank or something.

The times they are a-changing.

"Let Go Of My Eye!"

Head injuries are interesting. I can do without the secondary projectile vomiting that comes with some of them, but watching people's change in behavior is a curious phenomenon. I guess it's just a primal fight or flight thing but the universal reaction seems to be violence and combativeness.

We were second in on an auto vs. bicyclist (I drive the "truck" in my district so we respond to all auto accidents). In this case it was actually a bicycle vs auto since the guy on the bike was riding against traffic and ran into the side of the car waiting to make a right turn. He went right over the hood of the car and onto the ground.

The accident occurred at the exit of a housing development with one way in and one way out. I parked just inside the entrance and as we left the rig the engine captain came over waving us off. He said they only had the one patient and that they could handle it. We were free to leave but the accident was blocking the way out and cop cars were blocking the way we came in. We were stuck on scene so we walked over to see if we could help anyway.

The bicyclist was sitting up in the street with a bystander holding c-spine and the engine crew trying to talk to him. I put on my medical gloves and took over c-spine from the civilian. I'm glad I did because it was at this point that he started fighting us. I'll say this: people who are altered or scared are STRONG. I once had to hold down a 7 year old in the hospital who was getting stitches right next to his eye and it took everything I had to keep him still. This healthy twenty-something male took all of us (ambulance crew included). We put a collar on his neck and I tried my best to keep his head still while he cursed and screamed at phantom women who had taken his money and of course at us. He only had a little road rash to the side of his face (no helmet) but he obviously got his bell rung because he was completely delusional. While the firemen held him down the ambulance crew put the leather restraints on him, securing his wrists and ankles to the backboard.

He kept yelling, "Let go of my eye!" I looked down at him and told him I was holding his head still because he got hit by a car and that no one was touching his eye. He raised his right hand the best he could, spread his fingers, and yelled at me, "This IS my eye! Pay attention!"
Okaaaay, I'll put that down as altered level of consciousness.

Once fully restrained we tried again to explain to him that he had been hit by a car to which he responded "No, I wasn't". With that we put him into the ambulance and got out of the way in case the vomiting was coming next. His ranting makes me wonder what his mental state was like before the accident. Was he already a little nuts or was this all purely head injury related?

Wear your helmets kids and be safe out there.

A Comedy Of Errors

I'm sure it wasn't viewed as hilarious by the patient or by the restaurant owners but this was one of those calls that kept us laughing all day long.

We were called to a restaurant for a waitress with abdominal pain. The restaurant was a steak house in an old converted ranch style house. We were taken upstairs to what I guess was the employee lounge where we found our patient. She was in her twenties, very thin, and curled up on a couch. The cause of the abdominal pain was unknown, but her pregnancy status was in question as was her possible history of drug use. Since we were upstairs, the ambulance couldn't bring the gurney up to us so we had to carry the patient down to the gurney. Because she was so light and it would have been harder to move her down the stairs with two people. I decided to just carry her myself. I scooped her off the couch and moved toward the stairs. She wasn't heavy but I didn't have the best grip on her so I tried to readjust. Without even thinking I automatically did what anyone does when holding a child in their arms, I bounced her up to move my grip further underneath her. This is usually fun for the child but not so good for the patient with abdominal pain as evidenced by her groan and the "what the hell are you doing" look the firefighter gave me.

Meanwhile, my captain was making room for me at the bottom of the stairs so I could get the girl to the ambulance crew. There was a cluster of restaurant supplies and an assortment of maintenance odds and ends being stored there. As I descended the staircase, the captain moved the first piece from the pile, a metal shelf. What followed was straight out of a Ben Stiller movie. The piece he moved was apparently tenuously supporting a crate of glassware which then crashed to the floor. In an effort to stop the cascade of falling glasses he dropped the metal shelf which loudly clanged to the floor and continued to resonate as it wobbled around. This is when the rest of the pile began to give way and we watched as he helplessly turned from one piece to the next, unable to stop a single one from crashing to the floor. As he frantically turned in circles, clutching at falling objects, I stood on the stairs holding our patient in my arms trying desperately not to laugh out loud and listening to the 'crash, crash, clang, (pause) crash, (pause) clang, (longer pause) crash, crash, crash, clang (pause) crash' that seemed to go on for about five minutes. My captain finally had to just step away as anxious busboys rushed in and tried unsuccessfully to salvage the situation.
I carefully made my way through the debris field and delivered the patient, gently, to the gurney. We then returned to quarters where, over the course of the shift, my captain's face eventually returned to a normal color and the firefighter and I continued to laugh every time we looked at each other.

Our Good Deed For "D" Day

We do some interesting public assistance calls from time to time. There are some things that the fire department is uniquely equipped for that no one else can really handle. It is not an emergency in any way, but 'who you gonna call'?

Today (D-Day) we brought our ladder truck out to repair an 80 foot tall flag pole for the Masons. The wire that runs inside the pole and to which the flag is attached had gotten caught and they were unable to put their flag up. They had no way of getting up to the top of the pole without renting a crane. So, in the interest of good will and PR, we went out with our reserve ladder truck which has a 105' aerial ladder to see if we could fix it.

It was a steep angle but we were able to reach the top easily and the firefighter went up to free the wire. He had quite a view from up there.

He was able to unhook the wire and send it back down without a hitch. We stuck around to help raise the flag which was huge (20' x 30') and get a tour of the place before returning to quarters.

Hand Holding

A lot of times my job amounts to hand holding and reassuring. It's not dramatic, daring, or exciting but it needs to be done and I think it is important to do it with true compassion and professionalism. I found myself doing this a few times this past tour.

We responded out to the same address twice in the same day for a "lift assist". The 80-something year old female who lives there has very little use of her legs and gets around in a motorized wheelchair. She can usually get herself from the bed to the commode by her bed and back as well as into her wheelchair and back. Today her feet slipped out from under her while trying to get to her chair and she slid off the bed to the floor. She lives with a couple of forty-something year old males, at least one of whom I believe is related to her. The other gentleman has a bad back and cannot assist in lifting her and it truly is more than a one man job. So, we go out and help her up and into her wheelchair.

The first time we went out there the woman was quite embarrassed and apologetic. We assured her that it was no problem and we were glad to help. The second time we went out she was just despondent over the situation and crying (not from pain but from frustration at her situation and inability to handle it without calling us). This time it took a bit more talking and reassuring on our part. I hope we left her feeling a little better about the situation and that there is nothing to be embarrassed or ashamed of. I hope she understands that this is indeed one of the things we are here to do and that we will gladly help whenever needed.

The second situation of that shift came in the form of a very upset 17 year old girl. The call came in as a report of a 17 year old female with difficulty breathing. When we arrived we were told the girl had asthma and they had given her albuterol (which would have been fine if this had actually been an asthma attack). The girl was on the couch crying and hyperventilating and complaining of chest pain, headache, and low back pain. We went immediately into calm and reassure mode and set to work getting her to slow her breathing down and relax. I listened to her lungs and they were clear, definitely not asthma. I never even found out why she was upset but spent a good twenty minutes holding her hand, supporting her back and coaching her breathing until she slowed down enough to talk in full sentences again.


Once she was able to talk normally I asked some of our standard medical history questions and found out she also has a history of stress induced ulcers (at seventeen). I wasn't about to get into what had triggered this whole episode and risk her getting worked up again so I avoided that whole line of questioning. We were in an upstairs unit and when we tried to get the girl to stand she felt too weak so the firefighter and I picked her up and carried her to the ambulance gurney downstairs.

Now, I'll admit, our whole crew was probably picturing the scene from Airplane where Leslie Nielsen was slapping the hysterical woman while a line of passengers waited with a variety of weapons for their turn, but we never showed it.


She was still upset when we loaded her onto the gurney and embarrassed to be seen like that by the neighbors but she was breathing at a much more reasonable rate and her hands had stopped tingling. It was definitely going to take a lot longer for that headache to go away but she'd be OK.

Of course the next day, I got to wrestle in the street with a combative bicyclist who had been hit by a car and was seriously altered and fighting us, so I guess it all balances out.

Something Different Every Day

You really do learn new things all the time in this job. For instance, I didn't know that lumberyards and sawmills simply packed semi trailers completely full of sawdust to get rid of the stuff.

I suppose that seems obvious now that I think about it, but it hadn't occurred to me before.

I know this now because one of them caught fire.

We had started our day off with a code blue first thing after breakfast. The rest of the day had been training, exercising, and a couple more medical calls. About 8:30 that night the structure fire tones went off and we responded to a "commercial structure with a roof on fire" in the next district over. We were second on scene and were initially assigned water supply, which is not a great assignment for our particular rig. Fortunately another rig got there right behind us and took the hydrant for us which left us free to do truck work. We followed the first engine into a pallet yard where one of these sawdust trailers was sitting inside a covered structure of some sort. There must have been some sort of spontaneous combustion or else something got in the sawdust and smoldered until it broke through the top of the pile. There was active fire out the roof of the structure when we arrived.

The trailer itself is open at the top and so the flames had gone straight up and started burning through the roof. I put the aerial ladder up to the roof and the rest of my crew climbed up to start pulling the plywood roof sheeting off and then try to extinguish the fire from above. I set off to help the first engine with the water supply and connecting hoses. Pretty quickly it became apparent that we weren't going to be able to do much more than knock down the initial flames until someone could come and tow the trailer to someplace where we could access it better. It was just so packed full that the hoselines couldn't really penetrate. Parts of the side of the trailer had burned through and if we just tried to flood the thing with water, the weight would probably have caused the trailer to fail and burst open.

After awhile someone from the business showed up and moved the trailer out into the open. Our crew was assigned to overhaul the structure and extinguish any remaining fire there. When we finished that we went to see what was happening with the trailer. We found the other crew using a circular saw to cut open the panels on the side of the truck and attempting to poke at the sawdust with pike poles and roof rakes to get it to spill out. They were then hosing down what spilled out. It was like fighting a fire in the worlds largest hamster cage and it was not very effective. We decided to put a ladder up to the trailer and a couple of guys went inside with a hoseline flowing foam and just doused the thing. It made a hell of a mess but it worked. The foam helped the water penetrate deep enough to get the smoldering stuff and they'd pulled out enough sawdust to give the guys room to work and move around inside.

The whole thing took about three hours. By the time we got back to the station, cleaned all of our equipment, and showered it was after midnight. I laid down in bed at 12:13 and we responded to a medical at 12:23. We got back from that one about 01:00 and got up for the next one at 01:30. I think I fell asleep about 02:30 and slept until 07:00 when we got up to start day two of the tour.

But, hey...I learned something new.