Persevere, Improvise, Adapt, and Overcome

Sometimes I’m amazed we all stuck with it.  

I got hired in a group of three.  Of the two other guys one was my age (30) and the other a year or two older.  Our orientation was plagued with incidents, injuries, and ill advised training practices.  Looking back, I understand what they were trying to accomplish, but almost nothing worked out like it was supposed to.

The first day we reported to training we were met by the newly appointed training chief who was holding three brightly colored tie dyed t-shirts.  Wait, let me go back a step.  The normal uniform for PT is a blue t-shirt and shorts with the department logo on them.  As a means of instilling a goal in us, we were not allowed to wear a department t-shirt during orientation - we had to earn it. Instead we wore plain white tees and department shorts.  The Chief passed out the tie dyed shirts to us and told us to put them on.  He then took us on a three mile run around the city.  

                  

Now, we were firefighter recruits in pretty good shape, but not one of us was a “runner”.  This would prove important as the training wore on.  Apparently, the point of the tie dyed shirts was to instill in us the fact that everything we do is in the public eye and that they are watching our every move - we’d better get used to it and respect it.  Toe the line, someone is always watching.  

It really was not a big deal to us.  No one felt stupid wearing the shirts, we just didn’t really get it immediately.  But the message was driven home much more forcefully when the Chief got called on the carpet by his bosses for subjecting the new recruits to what someone else viewed as “hazing”.  So it was true, someone is always watching.

We were told that every morning, before 8 a.m. (the official start of training) we were to run this course together (the three of us) in less than 30 minutes.  So, taking three non-runners and having them run three miles a day on hard city streets before a day of puling hose and throwing ladders, etc. eventually took its toll on one of my classmate's knees and he had to stop running.  That left just two of us to do the run which would later become known as the “Bataan Death March” by the other line personnel.

                 

Shortly after the knee injury we got our first day of live fire training.  We would take turns advancing a hoseline into the burn room, feeling the heat, staying low, putting just enough water on the fire to darken it down and then let it build up again.  As we went in time and time again our gear and our gloves became wetter and wetter.  On the final pass, my, as yet uninjured, classmate felt his hand really heating up inside his glove but he wasn’t about to say anything and be dubbed the weakest link.  He was the last one to go through so the Chief told him to advance all the way in to the burn room and put the fire out completely. In the process of doing that, so much heat was generated that the water in his glove turned to steam and literally boiled his hand inside his glove.  He came out of the burn room and pulled off his glove along with a pretty decent amount of skin.  It looked something like this:

                       

The paramedic on the crew we were with that day treated the burn immediately and the Chief threw him in his car and drove him off to the hospital.  He didn't get pain meds until they reached the hospital and it was not a pleasant ride. Needless to say, the Chief heard quite a bit about that one too.

With one hand and nearly one knee out of commission the chiefs had to rearrange the entire training schedule and do anything and everything that wasn’t manipulative first.  With the burn to the hand, my classmate wasn’t even supposed to sweat so he couldn’t do the morning run either.  I asked the Chief if I was supposed to report early and still run by myself.  In a frustrated and somewhat defeated tone he said no.  It was supposed to have been a team building exercise and it wouldn’t serve any purpose for me to run alone.  So the morning run became a thing of the past.

In the long run, we all passed and moved on without permanent injury. Although, the rest of our orientation was not without further incident. But that will be a story for another day.

Well, that sucked.

When we get dispatched to a call we have 90 seconds from the time the alert tones go off to get dressed, get on the engine, and get going.  From that point we have four minutes to arrive at our destination.  The ambulance company doesn't have the same rules.  For one, the ambulance could be coming from anywhere: a staging location, the hospital, another city.  It all depends on how many units are available at the time of the call.  They also have a priority dispatching system which means an ambulance responding to a lower priority call may get diverted to a higher priority call and a new ambulance dispatched to the original one.  We always go Code 3, lights and siren, but the ambulance may only be coming Code 2, following all normal traffic rules.  Unfortunately I wasn't paying enough attention to the priority level of my ambulance when this call came down.

We were responding for an elderly female with abdominal pain.  Abdominal pain can mean a million different things and the severity of the pain makes all the difference in how quickly and aggressively we treat it.  My patient was in a lot of pain.  Also, it was new onset pain so something was definitely going on.

 

I knew I had to give this woman some pain relief. She already had a fentanyl pain patch on and had taken a percocet and she was still hurting.  I set about trying to get an IV established but this woman had extremely papery skin and only the tiniest of spider veins.  She apologized and said she knew that they always have a hard time getting a vein with her.  I guess I was pretty focused on finding a suitable site for access (mostly by braille) and wasn't paying attention to the radio traffic.  I felt what I thought might be a good enough vein, though I couldn't see it, and went for it.  Miraculously, I got the welcome flash of blood in the chamber that meant I was in the vein but it collapsed immediately and I could not advance the catheter even the slightest amount.

At this point I heard my captain say, "Oh wonderful".  I asked what happened and he said that our second ambulance had just been diverted. Damn, I hadn't realized they weren't coming code 3.  I told my captain to upgrade the new ambulance.  That's when I found out that my new ambulance was coming from over twenty miles away.

I wound up having to give this woman a morphine injection into the muscle which unfortunately takes much longer to take effect than if it were administered into the bloodstream.  She was also a diabetic with horrible circulation, so really I knew that this was almost pointless. I fished around on her other arm for IV access with no luck. I gave her another injection before the ambulance arrived forty minutes after the initial dispatch.

I knew it wasn't their fault and I was just mad at myself for not thinking about the response code from the get-go.  If I could have gotten the IV it might not have been so bad, but overall I just felt pretty useless.

Sucks when that happens.

Nice Save

My captain's wife and kids were out on a campout while he was at work with us. A little while into the shift he got a message from his wife that they couldn't find his youngest kids stuffed rabbit. It turned out it got left in the car that he took to the station. This was a very sentimental and important bunny and instead of just calling back that it got left behind he decided to go a different route.

We proceeded to take a series of pictures of the stuffed bunny helping out at the firehouse and taking part in all of our activities. The bunny in the gym lifting weights, sitting on the engine going to a call, wearing eye protection and holding wrenches while laying on the creeper to work on the engine. Best of all, we cut the fingertips off of a medical glove and put them on the bunny's hands so he could scrub toilets like a good firefighter. We even got a picture of the bunny flowing the big deck gun during one of our drills.

All these pictures were sent with a message to his kid, from the bunny, saying that the bunny forgot to say he was spending the tour at the firehouse with daddy during the campout. It was a big hit, the kid was no longer worried about the bunny and they anxiously awaited what pictures would be sent the next day.

Nice save Cap.

The Outskirts

There is a station in the farthest outlying area of my department that I got to work at for the first time recently. They respond mostly to auto wrecks on the one lane road that leads out there and grass fires. It is literally out in the middle of nowhere. There's is no cell reception, wifi, or anything else.  Well, I can't say nothing else. There are plenty of scorpions and rattlesnakes and other assorted critters. At this station you are not supposed to leave your gear on the floor of the apparatus bay because you never know what might end up inside them. In the kitchen, hanging next to the fly swatter, is a snake stick. Yeah, they keep it in the kitchen.

From the apparatus bay into the station you pass through sort of an airlock. One door leads into a little antechamber with sticky bug traps in all four corners. There is no shortage of crickets and other
bugs stuck there. You then pass through another door that leads into the dormitory hallway. By each dorm is another sticky trap (with, fortunately, considerably less guests stuck to them).

I saw no snakes or scorpions during my shift. I did, however, see a deer about fifty feet away at the station fence line and in the evening we had an after dinner visitor. A raccoon appeared at the kitchen slider. He is apparently a regular guest because, instead of shooing him away, the crew went to the fridge and got an egg, opened the slider, and left it for him. He tentatively approached, picked up the egg, trotted back a few feet and ate it. They then grabbed a piece of bread and laid it down right outside the slider. The raccoon again came right up grabbed the slice of bread, held it in his mouth and went trotting off.

It was a slow weekend day so nothing much happened as far as calls went but it was a different experience none the less.

Right Man At The Right Time

For the last month we have been running on a nuisance false alarm at a manufacturing warehouse in our district. Our shift alone has gone there ten times this month. The worst part about it for us is that we usually get the calls at about 9pm, 11pm, 1am, and 3am. And that's in the same shift. Spaced just perfectly enough to allow for almost zero sleep.

The place is open with workers inside until between 2-3am so at least there is usually someone there to let us in. We go in, we silence the alarm and reset the system and go back to the station. After 3am there is a security guard who sits in his personal car in the parking lot watching the building. He does not, however, have access to the building (I don't know if he even has a radio) and there is no fire department lock box for us.

It is only because we know this is a false alarm and that we are trying not to make the situation worse that we have not broken the door down when we go there after 3am. Nothing gets a business owners attention and lights a fire under them (so to speak) like property damage.

After our first call of the tour to this business we contacted the alarm company ourselves and were told that they required someone on the official contact list with a password to take the alarm offline. No one working in the plant had this info. The fire alarm rep was very honest in explaining that he was not surprised they had not received a repair order since that costs money and we were resetting the alarm for free. Unfortunately we can't just not go to the alarm so we decided that this would be the day that we break in if no one was there to let us in. The captain also sent the info off to Fire Prevention so the business would start being fined every time we went out there. We were done messing around.

We got our second call of the shift to the business around 9pm and we were silencing the alarm with our usual contact, the floor production manager, when a stern looking man with a clipboard and a camera appeared from the warehouse and followed us to the alarm panel.

He stated that he was the corporate safety inspector and just happened to be down here from Kansas City doing an audit of the facility. Without prompting, he informed us that, in his words, "They're failing by the way. This place is a shithole." We told him the whole saga of the month long alarms and he was not a happy camper. No one outside of the plant had been informed and he was pretty upset that this was the first he was hearing of it. He told us he would be calling corporate right away. Considering it would be 1am where he was calling I got the feeling he was going to get some attention and some action. He asked if he could get a picture of us as proof that we were here. I though it odd that they wouldn't believe him but we obliged and he snapped a picture of our big smiling crew with the floor manager.

We haven't been back since.

Will this be for pick-up or delivery?

I've seen a lot of people abuse the EMS system and use the ambulance as their personal taxi but this was a new one.

 

The call came in for a medical in the next district over. That engine was out on another call so we took it. On the way we got an update from dispatch that this was for someone who was in a car accident earlier and now wanted an ambulance. Already I felt that this would be a waste of time as this type of call usually is, but there's always a chance it's legit. We arrived at the address and knocked on the door. No answer. I rang the bell and knocked louder while announcing, "Fire Department"! I didn't see it, but the firefighter said someone peeked out of the blinds at us and then disappeared. Well somebody was obviously home. I knocked and called out again. Nothing.

We went around to the back of the unit and before I could even knock on the back door it opened and a woman (the same one who had peered out) stepped out. We told her someone had called 9-1-1 from here. She then told us that the person who had called had been in an auto accident and went to the hospital but had been waiting in the ER for a "long time" so they called an ambulance. Okay...well, let's take a look, where are they? She responded, "Oh, they're on their way back now".

Are you serious?

They left the hospital to come home to get an ambulance ride to the hospital?  And they pre-ordered the ambulance?!?!?! 

Oh, my captain was pissed. To his credit he was polite and we returned to the engine. He said we're giving this guy two minutes and then we are out of here. A few minutes came and went, the captain radioed dispatch that no one was here, and we returned to quarters. Just as I was pulling back in to the station the call came in for the same address. This time the in-district engine was available and they got the call but we wanted to let them know what went down and give these folks a little "education" so we headed back.

The other engine was on scene and into their assessment (no obvious injury or problem that anyone could find, by the way) when we arrived. We gave them the rundown of how this had all gone down. The ambulance arrived and got the rundown as well. The ambulance, of course, was taking them right back to the hospital they had left. The beauty of this was that they probably would have been seen within the hour they wasted coming home and going back in the ambulance. Now they would be starting the process all over again and adding an ambulance bill on top of it.

 

Here's the "education" part for those that don't know. For some reason, people think that arriving by ambulance to the hospital means you are seen quicker. This is not at all true. Everyone who comes in to the ER is triaged according to the severity of their condition or injury compared to everyone else in the ER. Those who are stable are going to wait longer, that's just the way it is; it doesn't matter how you get to the hospital. And I can guarantee that the triage nurse who had already triaged this guy, probably called his name while he was gone, and then sees him arrive again by ambulance is not going to put him at the front of the line. Just the opposite I suspect.

 

Hopefully he learned an expensive lesson about the EMS system today. You don't call 9-1-1 for take out.

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.