A Good Line

Just got back from a cardiac arrest call. At least that is what we were dispatched for. As we were getting into the engine, knowing that we were going to a care facility, we were discussing which of the two possible scenarios we would face. In these cases, we expect a very deceased person, or a person sitting up and talking.

Turns out, it was the latter. The old guy fainted, fell down, and the very excited staff began CPR right up to the point when he started complaining about it. After we arrived, it was apparent that he was doing OK, but had a rather slow heart rate and was speaking slowly due to his Parkinson's. During the our exam, he closed his eyes for a moment. The Paramedic, who is a real clown, blurts out, "don't close your eyes Bill, or someone might start pushing on your chest!"

Desperate People

It never ceases to amaze me. People pick up the phone, call 911, and expect...well, they just expect weird things sometimes. For example, a couple day ago, an apparently normal adult female called at about midnight. With her willing accomplices in the 911 center, she managed to get 3 highly trained (and paid) professionals at her door within minutes of her call. Her problem? A tiny sliver in her foot which she got from walking on barkdust. She was somewhat mystified that we were something less than willing to do on-demand exploratory surgery for something that that could not be seen with a naked eye.

In a similar oddity, although occurring several years ago, an adult female called to have her toilet seat removed. Since she lived in an apartment complex, the maintenance man had done some upgrades and replaced the toilet seat. Now, since it was new, it smelled like plastic (go figure) and that was making her nauseous. That, my friend is why we have firefighters...to deal with these desperate situations that are so vexing.

The Things We Do...

Had an unusual string of events last shift. We caught a respiratory distress call at about 0530. Turns out that it was an actual respiratory distress call with real distress. Since the man did not respond to treatment, it continued to be a serious call. In these cases, we often put an extra Paramedic or two in the ambulance for transport and we follow with the engine to pick up our firefighter/paramedic at the hospital. At this point, I became the designated ambulance driver for the code 3 trip back to the hospital. Usually, this in not a big deal, since I have been doing this for years. Only this time, we just took delivery of a fleet of new, very large ambulances. So, having never sat inside one, I need to drive in the dark code 3 with a critical patient. Once I figured out where the key, the brakes, and the lights were, we were off... Good news is, my maiden voyage did not result in any damage to anything and I did not have to spend the rest of the day filling out paperwork.

After arriving at the hospital, I get a radio call for me to contact dispatch via phone. I was told there was a man who fell out of his wheelchair on the other side of town, and he was needing some lift assistance. Before I could ask, "Why not send an engine in that area?", they continued with the details that included the door being locked and the keys being with the wife who was currently trying to hatch a baby at the hospital. So, off to Labor and Delivery for the keys, back to the other side of town to pick the man off the floor, and finally back to the station, just in time to finish up the reports and go home.

Just another day when you need to expect the unexpected!

This is NOT What it Looks Like

We were recounting our stories of how much effort it took to be hired as a firefighter. It is not uncommon for firefighters to spend 2-5 years testing all over the country. When I was hired, there were about 600 applicants for 12 positions. Now days, the numbers are much more in favor of the applicant, but still it is a competitive process.

My engineer Roger, who is one of the more senior members of the department, told the story of how he once tested for a department near Portland, Oregon. As he is a rather meticulous character, he traveled to the area the night before, checked the location, and was all set for the test in the morning. The application included a warning that at the appointed time, the doors would be locked and no late-comers would be allowed to test. As he was driving to the test, he had a flat tire. With no taxis, cell phones (in that era), and no one willing to pick up a stranger, he was resigned to missing the test.

Suddenly, a local police officer arrived and asked if he could help. He then graciously offered a ride to the testing location. Here is where the story takes a dark turn. Although the police officer was more than willing to help, he had rules to follow. So in order to carry someone in the police car, it required a pat down check for weapons, and the customary handcuffs. At this point, Roger had no other choice but to accept the inconveniences in order to make it to the test on time. They rushed off to the test place, just in time to see the officials locking the doors and starting to turn the late-comers away. The police officer graciously dashed up to explain the situationand returned to uncuff Roger in front of the somewhat confused small crowd that was gathering. Roger bolted for the door and was allowed to take the test. For some reason, they never did call poor Roger back for an interview.

Did I Actually Say THAT?

Every once in a while, we forget about the public that tends to notice everything we do and say. In particular, it is common to say something on an emergency scene that is badly misunderstood or taken offensively. A classic example of this is when a paramedic says to "bag 'em". We in the know, understand that to mean "get a bag-valve mask and assist the patient with ventilation." The family nearby interprets, "time for one of those body bags" and their loved one is dead. Like I said, this one has happened on more than one occasion.

On a medical call in a elderly couple's home recently, it was apparent that the gentleman with some slight chest pain, also had some dementia. After he answered the same question several times and was confused about his date of birth, we had a bit of discussion about his dementia and whether it was getting worse. As we were chatting with the couple, their family, and a few neighbors that stopped by for the entertainment, it was determined that perhaps we should call the patient's doctor. The wife says, "sure, use this phone" and hands a tv remote to our young paramedic. After a brief look of confusion on his face, be blurts..."I thought he was the one with dementia..." As the rest of the crew stared at him stunned, the wife quickly laughed and we all got a good chuckle out of that one.

How to Avoid Accidents

A common theme when it come to accident investigation is the concept of "chain of events". This concept is based on the premise that a sequence of events occurs in such a way that anytime a link is broken the accident is prevented.

For example, say a "fender bender" happens in a busy intersection. When investigating, it would be common to say that the chain of events includes a cell phone call, speeding, a dirty windshield, heavy traffic, and early morning sun glare. If you consider all of these factors as a chain, breaking or removing any of the links would have prevented the accident.

So with that concept in mind, a totally "preventable" fire call happened late last night. The call came in as a house fire and a total of 18 firefighters and one tired district chief were all rolled out of their bunks at about 1 AM. This exciting yet inconvenient little exercise could have been prevented:

• Life Flight helicopter had not landed on the hospital roof.
• if the wind had been blowing a different direction or a window had been close.
• had the lady on the third floor not been medicated very heavily.
• if the telephone in her room had not allowed outside calls.
• by dispatch realizing the person they had on the line was not sure what direction was "up".

So by putting this chain all together, you get a large of amounts of sirens, lights, and sleepy firefighters tromping all over a house out in the suburbs, disturbing the neighbors, just for grins...

A Career First

Having been in the business for a lot of years, it is not very often that a total new experience hits me like what happened last night...

Engine 6 was dispatched to a car fire at about 3 AM. We just got on the road when we were diverted to a chest pain call. So far, this is pretty normal - but then, it became apparent that the chest pain call was two doors down from the car fire. Technically, the car fire which was spreading to the garage, was a lower priority than someone dying from a heart attack. But, as you may have gathered, dispatch information is rarely accurate, and always assumes the worst when it comes to medical conditions.

Now 5 blocks out from the call, we see a glow in the sky, a plume of smoke, and know that we have a real problem on our hands. From two blocks out, it is obvious that this is a ripping fire, in a cul-de-sac, all the neighbors were awake, and we had multiple people directing us into the fire. To bad we were supposed to park the fire truck, ignore the fire, and go check on the little old lady with chest pain.

There is something about selling confidence to the public and managing your PR that dictated what we actually did. I had the engineer put the pump in gear and by himself, keep the fire out of the garage. While he was doing that, the firefighter and I went to check on the lady. As it turns out, she was actually having indigestion/heartburn and did not want to go to the hospital. She simply had read the signs and symptoms chart on her refrigerator, determined that it said to call 911 if you had chest pain, and the rest is history.

Another engine arrived shortly, finished putting out the fire, and we all went back to quarters.

Lifestyles

In this profession, we touch down with all types of people from all walks of life. For example, a few shifts ago, we were dispatched to a "respiratory distress" call at about midnight. Since 95% of all "respiratory distress" calls are anything but that, it was no surprise for us to find a 20 something guy with his leg in a cast. It was obvious that this was not an emergency so we dug deeper into the story. He had been riding in a cab and had asked the cab driver to call. When questioned, he explained..."I just needed someplace to spend the night." He had recently undergone some fairly minor ankle surgery at the local hospital, but was on his way to Texas after spending a few months in Hawaii. Now, considering that he did not work, had no money, no possessions, and not even enough money for cab fair, I decided he was the modern rendition of the hobo. He was able to travel at will, had no money, yet it was obvious that not only was he doing pretty well, but in these modern times, he had the best of medical care and was able to get 5 firefighters to look after even the most basic need of a place to sleep for the night. In the end, the Red Lyon motel had a shuttle running towards the mission and offered to take him there for the night. A true "King of the Road!"

Random Dialing of 911

I have come to the conclusion that some people have nothing better to do than to call 911 and try to create some excitement in their day. So far today, we have run the following calls (in order with NO embelishment):

• 58 year old female backing out of her driveway, hit the mailbox and scratched her car. She then was so upset, she basically had a panic attack and someone (not sure who) called 911 and we were dispatched to a respiratory emergency - code 3 of course.
• Fuel spill on the on-ramp to the freeway. Multiple calls with description of a major spill and some confusion as to whether it was diesel or gas. On our arrival, we found a small wet area of about 6 square feet and it was rapidly evaporating. Traffic was now backed up for at least a mile.
• Motor vehicle accident on another freeway ramp. Because of the various directions of travel associated with freeway intersections, we had total dispatch of 2 trucks, an engine, and a medic unit all dispatched code 3. There was a chief in the area who also responded, giving the total personnel dispatched to 12. On our arrival, the one vehicle had already exchanged information and left. The other vehicle had no damage other than a slight mark in the dust on the rear bumper. The only reason that 911 was contacted, according to the people in the car, was to make sure there was some documentation done by the police. Which in fact, does not occur unless there is injury or some significant legal violation.

They call us heroes...I think that is because we can still smile and act gracious in situations like this!

Strange Things DO Happen

With some significant time being passed since my last entry, I have collected a few interesting yet unrelated tidbits of oddness.

Downtown last week, a middle-aged woman was driving down the street in a late model SUV. At some point, she drifted over the curb and struck the guywire for a power pole. This caused the vehicle to flip over on its side. We we arrived, the lady was dead. It was reported in the newspaper pretty much just like that. One would naturally assume that she died in the accident. Me, being skeptical by nature and with several years of experience with such accidents, came to the conclusion that we did not have the whole story. A few days later, the autopsy showed that she had died of a heart attack and the low speed motor vehicle accident was a secondary result.

Late one night we were sent out to "check out" a 25 year old guy with leg pain after walking across the street. Since this was 3 o'clock in the morning and both the guy and his buddy reeked of alcohol, our approach was rather straight forward. It went something like, "So what happened?" "Pain?" "OK, you want to hop on the stretcher and we will give you a ride to the hospital..." At that point, since the guy wasn't moving much, we prepared to unceremoniously lift him to the stretcher. For some reason, one of us decided to check the leg to see why there was the ambiguous "pain". Much to our chagrin, it was obvious that the guy had a broken leg...from walking???

Mid morning last shift we were dispatched with the medic unit to an unconscious female. Almost as soon as we went en route, the details were updated to include the fact that the patient was no longer breathing. Arriving at the address, we noted the address numbers posted at the mailbox and knew we were at the right location. After turning into the lane, we were confronted by a very disconcerting situation; there were two houses and a large motorhome, all locked, and none with any indication of address or any other indication of where the patient was. I scattered my crew to the various possible locations and then went to knock on doors and hopefully locate the patient. I finally found an open back door and made entry into one of the houses. After calling out and getting no answer, I called the crew on the radio to say that I had found an open door and was still searching for the patient. I then took a few steps down the hall, discovered the patient, and the husband. The husband was standing so still, it took me a moment to realize he was there. I still do not know what he was thinking or if he was simply not mentally processing. It turned out that the woman had just had a heart pacemaker installed the day before and likely it had lost a wire or something else had malfunctioned. I was very frustrated because the patient died and I truly believe that the delay was a major contribution to the negative outcome. Since the couple was 80+ (although in apparent good health and living independently) it is not likely that the husband's actions will be scrutinized too closely.

Fire Fighter Food

I picked up an overtime shift today and got to work with a couple of old salty types that are both less than a year from retirement. We just got back from a "line down" call in an alley. Usually we get called when a powerline comes down, just to keep people back and safe until the power company comes to fix the problem. In this case, it was just TV cable lines and the distraught homeowner had called for anybody that would listen and it just so happened that 911 was willing to answer the phone AND send us out to pull the lines out of the way so he could drive on down the alley.

On our return, one of the old guys says to the other, "I see the window on that restaurant is still boarded up from when you crawled through it." Of course, that raised my question of why he had crawled through the window. Turns out, there was a pretty good fire that had broke out in the apartment above the restaurant.

"We did save the restaurant..." says one guy.

"Yah, they were pretty happy about that. They sent us a bunch of lasagna to eat. We had our families come in to share and it was really great," says the other.

After a slight pause..."yah, next time we are a going to burn a Chinese joint..."

As always, it is mostly about the food!

Pack Rats with Only Two Legs

Occasionally we find human pack rats. I have never quite understood this behavior, but it not real uncommon. Today, we went to a house in an older, but upscale neighborhood for an elderly female that could not get up from the floor. As we entered the large single-story house, it was apparent that we were not going to be able to get our gurney in at all. There was a collection of household goods, furniture, books, and general debris that occupied basically every inch of the house. There was a very narrow trail that ran from the kitchen to the bedrooms, with little side trails to the bathroom and front door. There were entire rooms and sections of the house that could not be reached without climbing over things piled about 4-6 feet high. Surprisingly enough, the house was relatively odor and dirt free. There was food in the kitchen and obviously they were able to cook and eat. We first wondered if they ever sat down, but then we discovered two chairs (his and hers) near what would be the dining area, just off the kitchen.

Having fought fires in a few of these houses, it is amazing that more don't die in the clutter and the mess. We did refer them to social services and hopefully they will get some help. In chatting with the elderly man, some of the behavior might be explained by the death of their only living relative, a daughter. In looking around, it was conceivable that they simply emptied all of the contents of her house into their house when she died.