101 Things the Fire Department wishes you knew



Wednesday, December 31

New Year Resolutions

This year I resolve to:

  • Stop trying to convince people that, "This is my first time in an ambulance. How about you?"
  • Cut back on bad jokes on long transports. Heard the one about the one armed fisherman?
  • Read the protocol updates when they come out, not when the training starts.
  • Make sure everyone is wearing a seat belt.
  • Cut dispatch a little slack when I ask for more info on a code 3 run and they say, "We'll do a call back."
  • Get in at least an hour early and hope the idea catches on.
  • Read my Firehouse Magazine front to back, not just Sirenhead cartoon to ads.
  • Take a water rescue class. Maybe Scuba? OK, maybe just go swimming.
  • Spend less time on the computer and more time with the family.
  • Update this blog more often.
Happy New Year!

Monday, December 29

My Kind of Lawyer

Anyone who has been visiting knows Happy Medic is not a fan of lawyers in EMS and the Fire Service, they seem to add so many headaches and not make it any better to do our jobs.
So imagine my surprise when I heard a lawyer read a patient the riot act.

It was a couple of years ago and we had a few regulars that would get drop down drunk, get transported, then wander away before we even got back in service. You see, the lawyers were worried EMS would leave drunks in the street and someone would die.
More than once we would take a certain individual to the hospital multiple times to the point nurses would see him coming and put a bed near the door so he wouldn't stumble into anyone else on his escape attempt.
On this evening, however, the local hospital had finally had enough. When I radioed ahead, as is standard practice, the hospital responded asking if the patient's name was "Bob." I responded in the affirmative and they cleared the air. Odd, I thought, the nurses often give a sigh of recognition, but never ask to confirm the name.
As we arrived at the hospital and began to back in, I saw we had a welcoming party. I opened the doors to the Attending Physician, Charge Nurse, Hospital Administrator and the Lead Council of the Hospital's "lawyer brigade."
The lawyer asked if the Physician and charge nurse recognized the man, they stated yes and went back into the hospital. I asked the charge nurse what was happening and she just smiled. the administrator, who identified himself as a medical doctor, stated HE would be taking the report on this patient.
I gave my little rundown and he stated, very professionally, that he accepted the patient under his care. We were reloading the cot when the lawyer began reciting what I can only assume was a prepared statement.
In a nutshell it was informing our regular that he had been transported to the hospital over 25 times in the last 2 weeks and never stayed long enough to be seen by the physicians and that this blatant abuse of the hospital will stop. He then did something I wish more hospitals had the guts to do: They denied him care. Seems like a horrible thing to do, but the lawyer said they were within their rights since the man had refused care for the same complaint more than 2 dozen times. The regular was then offered a chair in the waiting room, if he chose to wait his turn to be evaluated. The Administrator offered an arm and led the man towards the door in, only to have the regular push him away and wander towards the bus stop.
In a week's time I didn't see our regular and later found out he had sought out treatment for dependency. Later in the month a memo came out advising units in the field to notify a supervisor if they encounter a regular more than once in a day.

Two years or so later, it's working.

...for the unknown medical aid...3:13


Dispatch and their quick alert protocol. As soon as someone calls and says "I need an ambulance" they ring us out. It saves 30 seconds on their end but costs me 2-3 minutes on my end. Looks great on paper, bad for patient care. Speaking of patient care, seen any good cartoons lately?

THE EMERGENCY
The man we meet says someone has fallen off a ladder and leads us UPstairs.

THE ACTION
We're led to a man lying in bed, fully clothed, holding his hands over his genitals. The house full of family says he was hanging christmas lights and fell off the ladder. Looking out the bedroom window we see the ladder leaning against a 5 foot fence in the backyard below. After doing our thing we find only one place he's hurt. You know where.
Turns out he leaned out half way up the ladder (about 8 feet up) and lost his balance. He tried to reach out and grab the fence with his foot and missed. Then his other parts found the fence. It wasn't so much a fall off a ladder, but an encounter with a fence.
He asked if we could take a look and just make sure everything was where it was supposed to be. We did and they were. He then took a deep breath, smiled and thanked us.
His brother offered to take him in to the local clinic and we suggested taking an ice pack along as well.
My question is, did the brother not have the basic training to identify missing man parts?

Sunday, December 28

...for the not alert...2:13


Trying to honor the wishes of someone who has been told they are dying can be difficult on this job, especially when the lawyers want us doing so much in conflict with people's wishes. But when the public takes our sympathy too far, what do we do?

THE EMERGENCY
A woman has called 911 stating her mother is not alert.

THE ACTION
Mother has been diagnosed with a painful form of cancer and is deteriorating quickly. She has signed a Do Not Recuscitate order with her doctor and asked that no more chemotherapy be administered. She has, ultimately, chosen to die at home. Trying to honor the spirit of that decision, we're tip-toeing around the situation trying to get all the facts before acting. The patient, it turns out, has a low blood sugar level, which is a quick and easy fix.
After administering the medication of choice our patient is able to communicate clearly with us. Usually this is where people ask for a ride to a doctor who will likely bill them $600 to tell them to eat something and watch their sugar more closely. Since it's never about the money, we offer our standard service and the patient's eyes glow red.
"I'm not leaving this house son, not if you drag me." I like that kind of resolve.
"Your sugar was very low, you need to have something to eat."
"I'm not hungry." She tells us as the daughter begins to get upset that she wasn't tracking her mother's blood sugar closely enough.
"Well, you just need to sign our form if you don't want to go, but call your doctor in the morning, they may want to see you in the office tomorrow." I offer the pen and she looks up at me and asks one of the oddest questions of my career , "Will you stay and watch me eat?"
30 minutes of discussion and near argument later, and after using the tactics usually reserved for children, she was able to finish a sandwich and some cheese.
She thanked us for coming and hoped not to have to bother us again. I was almost losing my cheerful disposition when she said, "I'll probably be dead before I need you again anyways," and she smiled.
I realized we were going to be the last non-family members she ever sees and we made her smile.

Saturday, December 27

A Happy Medic Christmas

Hope all had a wonderful Solstice, Christmas, Hanukkah, Quanza, December 25th or whatever you celebrate.

The Happy Medic got 2 fantastic gifts I just had to pass along. The first is a navy blue T-shirt (I have none of those) with a big Maltese Cross on it (still nothing like that in my closet) and a nifty slogan on it.
It says "FIREFIGHTER - Our job is to save your ass, not kiss it." Best. Gift. Ever.

In a close second was a little toy ambulance my father mocked up with stickers. At first glance it looks like he's simply added my municipality's name to personalize it, but looking closer it reads **FD Courtesy Van on the sides, Happy Medic on the hood and the license plate? It reads FREERIDE.

Do these folks know me or what?

The Happy Medic

You Make the Call...Code Blue

YOU MAKE THE CALL
Read the following story, then post a comment. After a few days, I will post what happened.

I am on an ALS transport ambulance rung out for a code blue recuscitation. On arrival at the address we are met with a large amount of grieving family, not causing a problem in any way, but clearly this event was expected.
I enter the living room which has been converted into a hospice/visiting room and find the patient supine in the bed, appearing aepnic.
No one is crying, wailing, screaming for me to do something, they all appear calm, but sadened. Being the thoughtful person that I am I first ask for any advanced directives or Do Not Recuscitate orders. The family states that there is a DNR on the way over, ETA 20 minutes.
It is then that my partner informs me he detects a faint pulse at the carotid, maybe at a rate of 30, but weak. You then notice an agonal breath by the patient. Your partner asks you if he should start CPR and call for a Paramedic Supervisor.
We are about 20 minutes from a hospital.
Protocols in this situation require all efforts be taken.

What should I do? You Make the Call.

Friday, December 26

A new topic coming soon

My favorite part of watching football games used to be the segment, "You make the call." They presented a situation and a brief clip, then asked the audience to be the referee and make the call. Then they went to commercial and you had a chance to discuss it before they came back, explained the rules , then the call made in the situation and whether it was 'right' or not.

Often at the dinner table or at shift change we exchange tales of odd situations that are not covered in the medical protocols or fire manuals and share our thoughts and actions in an attempt to educate one another.

So I'll be starting a new type of post here as these topics come up called, you guessed it, "You make the call." I'll look for your comments and input about what you would do, would have done, what you think etc. I don't expect a flood of comments, but it looks like at least 3 of us come here on a regular basis, let's see what happens.

Wednesday, December 24

...for the abdominal pain...1:13


Actually call 11, but we'll start with the good stuff.

THE EMERGENCY
A young lady has called complaining of abdominal pain.

THE ACTION
It's early in the morning and we're playing a game I call Holistic Detective where we compile a patient profile, chief complaint and actual complaint, then see who was closest in all 3 categories. I guessed, female 16-30 years old, on the porch, thin build, flat shoes and one of those parka jackets with the fur around the hood and her cell phone on in her left hand. I must be slipping, it was in her right.

I start with my usual "You reported a life or death emergency?"
"Yeah my stomach hurts."
"What did your doctor say?"
"Huh?"
"Surely you called your doctor's office or a clinic earlier today when it began to hurt right?"
"No."
"Then what makes it an emergency now?"
"It hurts. My solaplex hurts. How can you make it feel better?"
"You mean your solar plexus? Well, that's not near where you're touching. Who's car is this?" I ask pointing to the nice sedan parked in the driveway.
"My brother's. He's sleeping, I didn't want to wake him up."
"Well then let's go. If you're willing to wake us up and not him it must really be a life or death emergency. Oh, that reminds me I need your billing information."
"My what...wait why?" She asks sitting back down without even a wince.
"Because we have to bill you for the ambulance ride to the hospital. So let's go."
"I don't have to pay, I have food stamps, I can't pay."
"Regardless of how you eat, the ambulance is not a taxi. If you have an emergency I am more than happy to take you to the waiting room at the hospital of your choice, but there is a fee involved, I won't lie. You're even required to sign a form stating that you are responsible for the charges."
"I'm going to wake up my brother then." Her phone rings and she answers, "I'm on my way but I have to get another ride."
I take a peek at my partner who is standing on the sidewalk in the cold dark and he fumes.
"Want to go?" I ask pointing at the ambulance,
"Thanks for nothin' jerk" she says as she gets back on the phone and walks back inside.
I smiled. She really expected an actual taxi ride to a hospital near a friend's house is my guess. And yes, we actually are required to get that form signed. Nothing gets between you and medical care better than lawyers.

Monday, December 22

We're a-movin' soon

Due to complications we at emsfun blog don't exactly understand (at least the wife won't tell) we'll be moving to a new apartment here in the Blogspot building. The new location is slotted to be yourhappymedic.blogspot.com . This move will in no way increase the validity of the calls we receive, nor will the public suddenly understand the difference between an emergency and a routine eval.

We will, however, continue to bring you what we think is fun an funny as well as links to all the sites you love including Firegeezer, Motorcop, Tanga and woot!.

Sorry for the switch, I'm having to change my bookmarks as well.

See you there soon,
Happy Medic

Hey, you found us!

1 and 14, what a way to spend a day

I love my job. I love my career. I love that my trade is on the verge of being recognized as a legitimate professional skill. I hate that no one outside the service knows that.
Last shift on the ambulance brought us 15 bells. Not entirely out of line these days, but busy. Not busy in the "Breaking hearts and saving lives" sense but in the "My brother is sleeping" and "Will you stay and watch me eat" way of busy.
Of the 15 bells we received, 2 were for reported fires, both of which were people cooking and neighbors called. The remaining 13 medical bells were a variety of shortness of breaths, abdominal pains and literally, I couldn't make this up, a "pain in the neck."
We did have a legitimate medical emergency, however, and another instance of people who don't speak English recognizing a massive stroke and calling 911. Time from onset of symptoms to CT scan was under 30 minutes. I love my job.
For the others, I was disappointed such educated people had no idea what to do when their nose begins to run or their tummy hurts for more than 15 minutes.
We need a revamping of emergency care in this country and we need it fast. Too many are unable to see a doctor so they call 911. Forget taking themselves to the ER, they've already figured out our ride is free and the billing service can send letters all they want, these folks will just ignore it. And this is not a "rant" against the poor, in fact it's mainly against folks like me, plodding along somewhere between not going broke and doing just fine.
I'll have more about my new friends in coming posts, so check back. I'll mark them with a number like this 1:13 so you know that's call 1 of 13 ridiculous wastes of tax payer dollars in a 24 hour period.

I'll take Jingle Bells over these bells,
Happy Medic

Sunday, December 21

Attention all units in the field

The forced overtime list has been published.

For most of my years (Dad, roll your eyes) I have been scheduled to work Christmas or Christmas Eve. On occasion I have accepted 2 for 1 trades to get one of them off. Last year I was injured over the holiday, but for the first time I can remember I'm not scheduled to work the 24th or 25th.

Then the forced overtime list came out. They publish 2 lists, one for the 24th populated by people working the 23rd and one list for the 25th populated by folks working the 26th. Makes sense, right? So what happens when you're scheduled to work both the 23rd and the 26th? Make one list sure, but how did I make BOTH lists? There is a possibility that I will work my regular shift tuesday, get forced wednesday, get forced thursday, then work my regular shift friday. That makes perfect sense, right?
In the past we simply didn't answer the phone on Christmas morning, then the folks got smart and started thinking ahead.

So send your positive vibes my way friends, I may need them.

Chasing the bells,
The Happy Medic

Saturday, December 20

Station 31 EXP

One of my earliest memories is of my father opening a garage door for me at our house when I was maybe 2 years old. It was dark in the garage and I was waiting for him to open the door. As soon as the light came in and he pulled the door up, I went racing out on my big wheel making the most realistic siren noise I could. In my mind I was pulling out of the busiest fire station in the biggest fire truck. I turned up the street and rode to the end of the block and stopped.
I remember wondering what I should do now that I was out. It wasn’t until about 10 years later that I discovered what it was firemen do after they pull out of the garage, siren blaring. But for the moment I was happy taking my nap in the back room with my boots placed neatly next to the bed, waiting for my mother to wake me. When she did, I would race down the hall into the garage and be off in the other direction.
I wish it were as simple as it seemed then. I had no idea there was more involved than simply driving away.

Many years later I find myself concerned that it may not be enough to be an educated and dedicated fireman. Since my humble beginnings as a Big Wheel Fireman I have striven to not only do well, but try to learn where the service would be in the time it took me to reach my goals. Would Paramedics rise and control a good portion of the rank structure or would private ambulances corner the market making Fire based Paramedics obsolete? Should I specialize in airport, rescue, scuba, collapse rescue…There seemed so many options, too many options and maybe the simplest solution was the best: Just a fireman. A simple fireman. Smoke Eater…etc. Why would I need to specialize when I could get an assignment anywhere as a fireman.

It seemed like a great idea and was all I had on my mind when I joined the local Fire Explorers out of Station 31.

My favorite part of being an explorer was when we had our turnouts on and participated in a drill. It really makes you feel like a real fireman when the boots, pants, jacket and helmet match the on duty firemen. We would meet once a week, on Wednesdays, and start each meeting with physical exercise, followed by a uniform inspection and a drill. I remember there were a variety of drills from ladders to extinguishers to medical assessments. There were other scouts that spoke of working for a local ambulance company or studying to get on a wildland crew. Sounded like a good idea, but I was only 16 years old.

Bunker drills were often and I prided myself on being the fastest in my group to dress in full turnouts each week. My gloves were always clean and my coat neatly folded when not in use, a habit I learned from my father. “Take care of your equipment and it will take care of you.”
Explorers, after completing every drill in a cycle, were permitted to sit for a test to become ride-a-long certified, which would allow me to go on calls and assist when appropriate.

Uniform neatly pressed and safety equipment checked, I reported for my first day at Station 31. The Captain was a friend of my father’s, and explained the day’s activities to me as well as what was expected of me. I kept hearing what I thought was the alarm and got very excited. I vividly remember the first call we went on, a traffic accident. The alarm went off, we all ran to the engine and away we went. Door up, siren blaring. My Heart was leaping out of my chest, red lights were flashing and reflecting off of the cars that pulled over to let us by. We were racing to someone in need. We arrived to find a minor accident with no injuries. No injuries, no fire, no emergency. It reminds me now of when I was at the corner on my big wheel, wondering what to do next. The Captain informed me later in the day that I shouldn’t be discouraged, but thankful that I only had one call and that it turned out to be nothing. He told me one day I’ll hope all the calls are false alarms.


My next ride at Station 31 solidified my resolve to become a paramedic. During our morning exercise the alarm sounded for a medical aid call. Again the door was up, siren roaring and we headed to the scene. Walking in the door carrying our standard medical equipment, I expected an old woman sick or maybe a man with stomach pain. What I didn’t expect was the Captain, who entered ahead of us, emerging from the rear bedroom carrying a lifeless body. Our patient, an elderly man, was in full cardiac arrest. The Fireman and Engineer calmly entered the room, moved the coffee table and the Captain placed the man on the living room floor. His skin was a shade of gray/blue that I have only seen since on persons who are dead. We cut open the man’s shirt and began CPR. I had only received my CPR card a few weeks prior and was scared I would do it wrong. The AED was applied and before I knew it, Medic 22 was at the scene.

Paramedics.

Like I’d seen on TV as a child. They had the tools to save lives. Everything seemed urgent in my mind from starting the IV to transporting to the hospital. Part of out training included preparing the IV bag, so I spiked it. Hands shaking, I could barely insert the drip chamber into the saline bag. The Paramedics from Medic 22 seemed relaxed, almost bored. They discussed treatment options I didn’t understand and administered drugs I had never heard of. When the ambulance arrived, the driver was a member of my explorer post and we made a quiet nod of recognition. the Firefighter would be needed to drive the Medic unit to the hospital as both Paramedics tended to the patient.

The engine followed the ambulance and the medic van to the hospital. By the time we arrived he had been "pronounced" dead. I know now he was dead the whole time, but that kid wanted to believe what we did worked.

I was permitted to see the man one last time to "say goodbye" and that was the first time I saw an actually dead body. All the training, all the drugs, equipment, sirens, flashing lights...all of it made no difference whatsoever. He was dead.

Not long after that day, while practicing knot tying behind the station, one of the Captains counseled me in what it would take to be a firefighter and paramedic in the coming years. “Jump through every hoop they put in front of you.”

I still agree with that and feel like I'm still jumping even today. Only I'm the one lifting the hoops higher and higher.

I'm going to punch someone in the face

I will, I've been saying it for almost a year now and I'm finally resolved that in the coming year, the next person to say the phrase, "I gots the Asthma" will get punched in the face. Unprofessional, absolutely. Wrong, you bet. Possibly license ending, likely. But I'm going to feel REALLY good about it. I can't seem to get through to my regulars that the path to wellness begins with quitting smoking, quitting drugs, cutting WAY back on the alcohol and get enough sleep. Then you'll have the energy to learn the English language.
They don't "gots the asthma" because of some government conspiracy or strange chemical in their homes, they need to simply dust a few times a year.
Go into a smoker's home and slightly move a hanging picture? If you can see where the picture used to be you have asthma because your lungs are sick of ingesting crap.
Yet I still smile, offer a free ride to free healthcare and know my problems are tiny in comparison.
But I can't complain really, I guess. Without cigarettes and alcohol I'd be out of a job.

Cracking my knuckles and waiting for a bell,
The Happy Medic

Friday, December 19

...for the 9 year old unconscious...


Something about kids in this business really gets the public freaked. And when your call takers and dispatchers are mostly new to the business, it can make for some very interesting calls. Like this one a few days ago:

THE EMERGENCY
A call has come in that a 9 year old girl is unconscious in a Doctor's office.

THE ACTION
The engine has arrived just before us and they're running into the building. They only seem to run for kids and fires, never to help carry the flea ridden regulars(Not a phrase, an actual description of 2 of our regulars). Weird.
In we go to find a hysterical mother in a chair holding a fit looking 9 year old girl with her eyes partially open. As I brush past the open office door I decide to take a peek at what kind of Doctor we're dealing with and I find one of the eight words I HATE to see pre-hospital - Chiropractor. My first impression is that the quack gave a spinal adjustment to a minor on the mother's instructions but this Chiro is calm and helpful, a clear sign he isn't a part of the drama.
We lay her down and she begins to speak clearly, isn't posictal (lethargy and disorientation common after a seizure) nor is she presenting hyperthermic (fever). Mom on the other hand is a bag of hysteria, pacing around the waiting room just over our shoulder screaming for someone named Jesus to "Help my baby!" Maybe he was on the last ambulance that came to her aid. the daughter appears to be suffering from a heavy load. that's actually LOAD for Lack of Attention Disorder.
As the engine crew helps Mom to the ambulance the daughter and I are having a wonderful conversation about how mom pulls her out of school twice a week to visit the chiropractor and the daughter just sits in the office and waits for mom to be finished. She also tells me the staff is nice and on occasion will give her something to eat.
When I asked why mom went to the chiropractor's so often she informed me mom used to drive a bus, but hurt her back climbing in one day and now she can't drive. So that's how to get the disability pension!
I hear mom outisde the side door of the ambulance crying and suddenly interrupting herself with, "Hello? Hey let me call you back." Then right back into the hysterics.
Hysterical indeed.

Thursday, December 18

I hope they never report an emergency

Tis the season all the songs on the radio are telling me and the smell of a fresh Douglas Fir in the house inspires the Christmas Spirit. But how do you know when it's gone too far? How can one tell when an idea about Christmas has overshadowed what Christmastime really is all about?

Just watch this:


Not only must their neighbors LOVE them setting this up probably since August, but they cram so much into such a small area, how can it be enjoyable?

I only hope they never call reporting something smoking, "Near Simba, but behind the Dalmations..." Great.

Waiting for the bells to ring,
The Happy Medic

...large outside fire...


Here's another blast from the past, when Happy Medic worked in a Public Safety system. On paper there were 20 firefighters on duty everyday. In actuality there were 5 of us and 15 cops with turnouts. Works great so long as all the cops are available to help, which they rarely were.

THE EMERGENCY
A large outside fire, sparked by down power lines, is racing through a large wooded area approx 40 feet wide with houses on both sides.

THE ACTION
I arrive in the first engine and the brush truck is close behind. We both (there are only 2 paid firemen there)suit up and make a quick attack from a paved road serving as our anchor point. The line is 200' and getting snagged up as the first officers arrive, remove their firearms, vests and gear to suit up in wildland gear. We make a great stop before a single home is damaged and are mopping up with hand tools when I almost got shot.
Let me go back a minute. This was a few years ago when the movie Babe was big. In that movie, about a talking pig, the owner uses the pig as a sheep dog and says to him, "That'll do Pig." It became almost a standard line instead of saying "yes" or "OK." Now imagine what I said when the officer, assisting to mop up the fire, looked up and said, "Think we're about done?"

The look on his face was priceless, his hand going for where his weapon usually is was even more hilarious.
We joked about that for years after. Mainly he joked about it and I avoided him.

Monday, December 15

A Letter in the File of Lannie Haszard


A Letter in the File to the bad apples in the barrel. Amid all the stories about EMS and Fire having to cut budgets, the last thing I wanted to read this morning was the following online article:

"In Portland, paramedic Lannie Haszard was sentenced to five years in prison in August after pleading guilty to five counts of attempted sexual abuse. Haszard, 62, was charged with inappropriately touching four female patients while they were being taken by ambulance to hospitals." more here

Just because Larry Hagman's character in Mother Juggs and Speed tried it out doesn't give you permission to abuse your position of trust. I can only hope my next female patient having an MI didn't read this. I'd really like to get leads 3-6 placed for the 12-lead, but Brain Dead there might have ruined it.

I have never witnessed such horrible behavior and would not stand for it if I did/do. Are these fellas really so lonely and feel so worthless that they have to take advantage, not only of the women in peril, but of the trade so close to being recognized as a profession?

The public gave you its trust and you molested it. There is a special place where you just might get a taste of what you've been doling out.

Enjoy prison. If it was up to me I'd leave you in a room with those peoples family and call an ambulance when they were done with you. And the Paramedic in charge of your treatment? Well, do onto others...

And the headline: 'Paramedic dream job for sex offender' "It's a dream job for a sexual predator," said Greg Kafoury, a Portland, Ore., lawyer who represents three women who were groped by a paramedic." Nice. I hope he never calls. We all know how the Happy Medic LOVES lawyers in EMS.

A letter in the file to Lannie Haszard, your pink slip is right underneath it.

Sunday, December 14

...for the seizure...


Dang, 15 minutes before change of shift and my relief calls in sick. I have to take a late run and in this part of town, it's a long ride to the nearest hospital.

THE EMERGENCY
A local house has been converted into a home for persons with mental disabilities and they've called stating one of their residents is having a seizure.

THE ACTION
We're on scene shortly after the first responders and are led to the second floor and into a bedroom. Although it is almost 8 AM, this place is quiet. Our patient, the staff tells us, had a seizure as he awoke this morning. Nothing about this patient or the story we're being told looks, smells or even hints at a seizure. All vitals check out and we're not seeing anything wrong so I delve deeper into the history.
After interrogation the staff admits that the seizure did look similar to some shaking he's been doing as he wakes up in the mornings. "But the moaning was so loud!" the caretaker tells me. "Moaning? He was moaning while seizing? That's quite unusual" I tell her as we all downshift our response.
"What kind of moaning?" I ask and almost like he was cued another guest in another room begins to moan. Not a sick moan or a hurt moan, but kind of a 'Where is everybody?' moan. I smile and confirm with them that he has been having nightmares lately and this morning was likely a man waking from a bad dream.
"So he's not going to die?" She asks.
"We're all going to die." I deadpan and wish them a happy morning as we wander out. When I got back my relief was still not there. I moaned.

Saturday, December 13

Happy Medic has a brother from another mother

I nearly pissed myself (I know...again) after clicking on a link a friend sent. motorcop.blogspot.com
Seems the boys in blue (Sheriffs wear brown?) get the same ridiculous responses and situations we get. I kind of knew all along, but the brash honest style Motorcop uses really lets you feel the frustration.

So wander on over and read a few of the hilarious stories, but look out, they're up there in reverse order. The blog started in April of 2008 but I recommend starting with December.

Fantasy #4 on the list...crossed off

Everyone has that list of things...A bucket list, fantasy list, a list of things you always wanted to do.

Last night I crossed off trying to evade the cops in a high speed pursuit.

OK not really, but let me indulge for a bit.
Code 3 return to the hospital with a person who the police wanted to speak to regarding her crashing her car while intoxicated. Well they chose to follow us in instead of simply meeting us there and it was on like Donkey Kong. I told my partner to hang on (more as a joke, this was all safe people) and went for it. I took a couple of turns wide, opposed traffic in a few places and they stayed right on us, sirens blaring and lights flashing. I would accelerate when safe and imagine I was being chased after some really cool cyber crime from the movies.
But alas, we arrived at the hospital and they let me go.

Wondering what fantasies #1, #2 and #3 are? That's on a whole different blog my friends.

Disconnecting the bells,
The Happy Medic

Thursday, December 11

...for the chest pain...

It seems most of the interesting folks are awake between 2 and 4 AM. This morning was no different.

THE EMERGENCY
A fellow called 911 at 430 AM stating he was having cardiac chest pain. He is 29 years old.

THE ACTION
We are first to arrive and the ambulance is coming from a distance. The front porch light is on and we see our new friend sitting on a chair, cigarette recently extinguished, with no shoes on. He dives into a prepared speech about a number of medical afflictions he claims to be suffering from. We do our thing and find nothing. I'm noting throughout this entire exchange he never looks directly into my eyes no matter where I stand. His crossed arms are only moving to scratch his arm almost like a compulsive action. He is playing the stereotypical meth user with his actions so I decide to delve deeper into his "medical history."
The following are his definitions for his conditions, I kid you not.
Endocytosis - Painful joints
Pericardial Bacteria - His heart is eating itself away
Diabetic Myopia - He needs his marijuana for that or he can't see
3 heart attacks - He claims NEVER brought on by elicit drug use

Those are only the ones I recall prior to the ambulance arriving. He has forgotten, after my questioning, what his chief complaint was. When asked by the ambulance crew what was bothering him the most he says his joints. They asked "Which ones?" He responds with, "You mean, like, weed?"

Wednesday, December 10

...for the legitimate medical emergency...


A local teaching center has called reporting a man down. The dispatch has no further information stating only that their is a language barrier.

THE EMERGENCY
A teacher collapsed while addressing his English as a Second Language class. We are met at the doorway of the classroom by a number of folks, few of whom are able to communicate with us at all.

THE ACTION
We do our job assessing and treating while trying to gather information from the class. They're unable to understand my questions and I can't understand their questions to me. I decide to grab a dry erase pen and try to describe in pictures my questions when I see what they're trying to tell me. The instructor's writing on the board is incomplete. The last word written ends in a small scribble and trails off down to where our patient is on the ground. Based on that and our assessment, these students witnessed a massive stroke and IMMEDIATELY called 911.
There was no hesitation, no confusion and no drama on what they needed to do. Most of the folks in the room not only spoke no English but likely have never had access to advanced EMS services.
Because of their quick reactions we were able to get this man to the stroke center, and into the scanner in under 30 minutes from the onset of symptoms. If only every emergency could go this smoothly.
I don't know the outcome, but this center is renowned for their teaching stroke center. If only HIPPA laws allowed me to follow up on his condition.

Tuesday, December 9

What do you mean I'm supposed to work today?

Leave it to firemen to loose track of their schedules. Detroit 3-4, ABC Platoon, 31 Day Cycle, Kelly Day, who can keep track? If only there was a way to keep track. Sure you can carry a paper calendar, but that is so 2007.

In swoop the folks over at Gasda Software with an application for your Blackberry device that will adapt to your fire schedule. I was excited until I realized that the Happy Medic has no blackberry and, sadly, they don't support my schedule. Don't see yours? Drop them an email from the site and I think they can accommodate you.

Tell them Happy Medic sent you for absolutely no discount whatsoever. On second thought, they might charge extra. Pretend you don't know me.

You're not happy, you're bitter

I've gotten some feedback here at EMSfun Blog that the Happy Medic seems to be rather bitter. Quite the contrary my friends. I share these moments because no matter how crazy some of these folks make me I always make work on time. I always cut the triage nurse slack if we have to wait to get a bed. I always give a blanket to the little old lady who woke us up at 3 AM for her sneezing.

I really am happy to be where I am and worked darn hard to get there. This job requires us to use humor and distraction to get over what we see and what we feel. I find it best to hold the jokes until after the run, whenever possible, and remember that no matter how bad my shift is going it will always end at the same time.
Some of my dialogue here on the 911 page seems 'bitter' I'm told. I don't see it, really. The role of EMS and the fire Service has changed dramatically in just the last 10 years and the public knows it. We're now the catch all end all, one call service. The dial a nurse should just be replaced with a recording stating "We are now transferring you to 911 since we'll recommend you call them anyway." But when we arrive we take a deep breath and sigh knowing that this is just the way it is.

I got the name "Happy Medic" from a nurse at the local Trauma Center after a rather difficult run. I can't recall the particulars of that one but not 20 minutes later we had another customer with us, one of our regulars, and I was whistling the whistle while you work song while taking his triage vitals. the nurse came around the corner and said, "Why are you so happy?" I looked around and said, "On my worst days, when I feel like I can't get through, I think about all these folks and remind myself that my worst day is like some folks best day. That helps me relax. when I'm relaxed I whistle. Whistling makes you happy."
"Ok Happy Medic" and she wandered off. My partner that day said the name was perfect and now when they see me coming in they know all the drama will be from the patients, not from me.

Saturday, December 6

...for the MVA with injuries...


There is a policy in my jurisdiction that if you are in a traffic collision without injuries there will be no police report. Well guess what people say when they hear that.

THE EMERGENCY
A caller reports a 2 vehicle accident with injuries on a rather busy roadway.

THE ACTION
Units arrive on the scene in the parking lot of the convenience store where 3 adults are standing exchanging information. I use my standard "are you kidding me?" intro of "Did you report a life or death emergency?"
The driver of one of the cars with no discernible damage wanders over and launches into his story.
"I left work early today to get home for my mother's birthday and was driving the speed limit..."
I cut him off "Skip to the part where it's an emergency"
"This guy pulled in front of me and I had no choice but to swerve and clipped this car in the other lane."
"and the emergency part is..."
"I want a report taken."
"Sir if you have no injuries and the other car has no injuries," My EMT on the engine, who is with the other occupants, gives me a thumbs up that no one is hurt,"then we're going to go now."
"But who will take a report?"
I ask if he has a camera phone and of course he produces one of those fancy $400 phones that can take video. I instruct him to take video of the cars, the intersection and all parties involved as well as still photos of all the other driver's information and call his insurance company if he finds any damage.
The blank look he sends at me almost creates a vortex and sucks me into his world.
I smile and ask if there is anything else we can do for him and I get nothing but that blank look.

Thursday, December 4

A Letter in the File


Complacency kills.

Don't get tunnel vision.

Fire in a type 5, 2 story residential. Heavy smoke and fire pushing from the entryway on first company arrival. You are assigned as an engine on the second alarm struck 10 minutes into the event.
As you are monitoring the radio enroute you ascertain that folks on the roof are reporting heavy fire in the second floor kitchen and need a hose line there. You also hear the transmission that a primary search is clear, and soon after that a secondary search is clear.
You arrive 18 minutes into the event and are assigned to ventilate the fire floor. As you arrive at the top of the stairs and decide to make a left to enter the rooms you saw from the street, who's windows were still closed. You find 3 closed doors, burnt through with debris on the inside. It is clear as you enter the rooms, pushing doors open, that these rooms have not been entered since the fire started. You do your job opening windows and begin to pull ceilings. Out in the hallway you notice a bookshelf in front of another door. Moving it, you enter another room, untouched by fire. It appears the folks on the roof have cut their ventilation hole here. The one room without smoke or fire.
With your job completed you return to the command post and find that you were the fifth group of people into the building, including the group that "completed" the primary and secondary search. 2 of those rooms were bedrooms. This fire was early in the evening.

It is inexcusable to call a primary or secondary search clear without actually searching the area in question. We also found that every group into the building went straight to the seat of the fire and clogged the hallway.

Complacency kills my friends. If you are assigned to complete a search - DO IT. If your job is to knock down the fire - DO IT.
We were the only group that actually confirmed half of the building was clear of victims and fire spread. 18 minutes and 5 groups into the event.

Letters in the file of the members of those 5 groups who went right past were they were supposed to be and went for the "glory" of putting the fire out. The glory in this job is working as a team to save lives and minimize damage to property.
I need to grab a shower. When I cool off, the Happy Medic will be back.

Wednesday, December 3

...for the Residential Building Alarm...


Alarm companies these days afford all kinds of security and the ability of one button summoning of emergency services. Similar to ringing a bell to have your butler run into the room.

THE EMERGENCY
An alarm company has called stating that a resident has activated the "fire" panic button and there is no answer on call back.

THE ACTION
Companies arrive to the swanky neighborhood noting no smoke and no fire showing. On investigation they are met by the homeowner, who is in her day robe, and find the source of the alarm. It's not fire. It's not smoke. It's not burnt food or a strange odor. She leads the first in engine to the basement where a smoke detector is chirping, indicating it needs a new 9 volt battery.
"You change these, right?"
We're floored. The glances to each other speak volumes and then the boss, an almost 30 year veteran began to giggle. Giggling, as you know, is contagious and we were all soon giggling while walking back out.
The resident was convinced that the button on the alarm panel with the little flame on it was to summon the fire department for any reason.
"Who is going to change the battery? I don't know how to do that?"
Not one of use could face her for the fear of bursting into complete laughter, which we did shortly after clearing the scene.

Saturday, November 29

...Alert for the Mass Casualty Incident...


Oooh, now this could be good. An MCI reported at a major department store could mean a lot of work...or not.

THE EMERGENCY
While men were working on the holiday window displays, an employee passed by an open door and dust wafted out causing her to wave her hands infront of her face. Her supervisors want her evaluated since she is pregnant.

THE ACTION
You may be asking yourself, "I thought this was an MCI. Where are all the victims?" Oh just wait and see.
We assess the young lady who has nothing wrong and no complaints, she just wants to get back to work. She signs our refusal and we're clearing the scene when the MCI call comes in. Radio dispatches it as multiple persons exposed to an unknown dust, initial reports of dozens injured. We tell them to hold on the calvalry for now and let us go back and see what is happening now. We were just there where the open construction door was and no one came out asking for help.
As we pull back around the corner, there they are. About a dozen employees are on the sidewalk holding their mouths watching all the pre-holiday shoppers going by.
I look at my partner who sighs and asks, "Are we really going to do this?"
"Absolutely we are. Let's think of it as a drill." I say.
I order up a Hazmat repsonse and an alert for the local hospitals of a situation with multiple patients. We exit a half block away and use the PA to tell the employees to remain where they are. Another ambulance has approached from the other side of the street and they're blocking pedestrian traffic. We know the "dust" is just that but want to see if the plan from HQ can actually be deployed in a busy situation.
We don our flashy vests and grab the triage kit and away we go.
As the Hazmat and Chiefs arrive they quickly learn that none of the construction workers are involved, it appears to only be employees. As we question them as to their symptoms, they never got their stories straight while waiting for us. Some have abdominal pain, others a soar throat, I remember one being faint, but all say they were exposed to the dust and want to goto the hospital.
Corporate folks are now appearing on the sidewalk demanding to know why people who work on the other side of the store are here saying they're injured.
Turns out the rumor spread that the first girl got to go home because of the dust (not true) and they all wanted to go home.
We cut 35 charts that morning and learned that the plan really does work if you start from the very beginning. It is true what they say that the first 5 minutes of an MCI will dictate how the next 5 hours go. My last 4 hours was writing charts.

Thursday, November 27

Show your support

I was wandering the internets recently and have come across every kind of logo and representation of Fire Departments from all over the country. I'm starting to wonder what it is about the East vs. West undercurrent out there.

So chime in visitors, what is it that makes your Department fit into a regional mold? Are you all volunteer and always have been? Yellow helmets vs black? Turnout gear vs bunker gear? Tender shuttle vs hydrants? Tell me what it is that makes your service different!

Wednesday, November 26

Working the holidays?

A tip of the helmet to the brothers and sisters away from their families over the holiday. Even though most firehouses will open their doors, bring in more chairs and get through the awkward tradition of not staring at the Captain's wife, you're still away from home.
Everyone the Happy Medic meets smiles when they hear the schedule we work. "Wow, only every 3rd day?! That's awesome!" Until birthdays, anniversaries and holidays come along.
We really are a family and even though many folks outside the service joke that we must all know each other, we almost do. A quick story about family:

Not long ago two firefighters in the area were killed in a residential house fire. Firefighters came from all over the world to participate in the memorial ceremonies. So many in fact that the local hotels and motels were swamped. A group of Canadian Firefighters made it to town thinking they would just grab a room when they arrived. Late at night after the service and memorial, they sought refuge at a local firehouse. They were welcomed, offered coffee and a place to rest the night. The next morning the visitors woke early, shopped and cooked breakfast for the house, then left their home phone numbers and open offers to stay with their families should anyone there ever need a place to stay. And all of it seemed as natural as breathing.

And a very special thank you to those who go out of their way to work on the holiday so others may enjoy it with their family. If someone offered to pick up a trade on a holiday for you, do the right thing and offer back. At the very least sneak some cash towards the meal on behalf of the person doing you the favor.

So stay safe, my extended family, and Happy Thanksgiving. Be thankful for your health and your family, may the trauma gods keep you quiet.

The Happy Medic

Tuesday, November 25

...for the PD eval...


HE'S BACK!

THE EMERGENCY
Our special friend from a previous call has decided to pass out in front of the local drug store after reloading on his favorite poison. PD won't take him in...paper work and all...so in swoops EMS.

THE ACTION
As we pull in I recognize this fellow from days earlier and disembark shouting his name on the busy street corner. He looks up at me with a big sloppy smile and says, "Do I like you?"
"No, no you don't like me."
He's amazed I know everything about him before he tells me. The officers who called us in are amazed as well since I already knew asking them to do their jobs was out of the question. We could spend 20 minutes taking him in or 30 minutes arguing with PD, then taking him in anyway. After refusing to stand on his feet even like my 4 month old does, he's in and we're on our way. On the cot he looks over to my boots which are near his head since I'm partially reclined on the bench, report finished.
"You have nice shoes." He tells me, rocking his head back and forth like the dog from the Victorola ads.
"Thanks, you bought them for me. Well, tax payers did. Come to think of it, are you even from here?"
"I moved here from far far away..."
"Well let's get you one step closer shall we?" We continue out of our regular area to a hospital rarely visited, well outside our area.
The staff is less than thrilled we're 'dumping' this fellow here until they run his info and, sure enough, he's supposed to be there. That's where his doctor is.
It should take him at least 3 days to walk back into our first due area. Good thing I have 4 days off.

Saturday, November 22

...for the unknown medical...Part III


You need to read Parts I and II for this to be any good...really.

The night that just won't end continues and the sun comes up in a little less than an hour and a half. Earlier in the shift my partner and I commented that there was a nifty looking complex neither had been to before and we wondered what it looked like on the inside. Mistake number one.

THE EMERGENCY
A man has called stating there is a man across the hall beating on a door screaming that his grandmother won't answer and may be ill.

THE ACTION
Sure enough we're pulling into the building we were wondering about, cursing under our breath why we said anything to begin with. The manager meets us at the door stating there is a man upstairs trying to break into his grandmother's apartment screaming she is ill. We ask him for the key and he says he has none. When I ask the engine crew to grab an axe to force the door, the manager suddenly produces a key and upstairs we go.
At the end of the hall (It's never the first door, always the last) is a fellow in pajamas (It is 4 AM), dirty socks and a sweatshirt and he's got the top and the bottom of the metal entry door bent open. As we ask him what's wrong we notice his right hand is wedged between the door and the frame and he can't get away. Separated from the door we note his face is pale and covered in what looks like wet coffee grounds. He's crying that his grandmother won't answer the door and may be dead.
The key opens the door and we find grandma asleep in the back room, perfectly fine. Our focus shifts to our new friend in the hallway and he is now altered and combative. He tells us he went out to smoke a cigarette and got worried his grandmother was sick because she wouldn't answer the door.
Just because it was late I asked, "What else did you smoke and goodness friend what is all over your face?"
"I ate some mud."
"Why?"
"I was hungry."
"And what else did you smoke down there?"
"Meth..." is his answer and now all the pieces of the puzzle start to fit together. We wrangle him into the ambulance and enroute to the hospital he perks up and tells me all about how he hallucinated that his grandmother was sick.
I told him he'll want to be hallucinating when he returns to grandma's and has to pay to fix the door.
2 lessons learned on this run. First, always take your keys with you when you smoke methamphetamines and, second, never comment out loud that you've never been a certain place for a call.

Friday, November 21

...for the unknown medical...Part II


Catch up on Part I below first.

The night that just won't end has only just begun. Just after our heads hit the pillows after the last run, this one comes in at the Police station.

THE EMERGENCY
A gentleman...well, he's in for domestic battery so let's call him 'guy'...A guy has told the arresting officer that he needs medicine for a chronic condition and needs to be seen at the hospital.

THE ACTION
'Guy' starts by stating he is having pain in his face where his spouse struck him earlier. I see nothing apparent and there are no signs of distress when he slows his breathing and looks at me. "Do you hear that?" he asks. "Hear what?" "My wheezing, listen" and he begins this whistling sound similar to air escaping a tire.
"Impressive, you can wheeze on command. Do you have an emergency or are you just trying to get out of going to jail? Because as soon as I take you in, they'll let you go and right back into jail you are."
He then begins to describe the 'serious' condition he has that requires his medical marijuana and needs to see the doctor to get more.
I explain that the ER doesn't dispense marijuana, nor do they dispense medications at all. He can get a prescription from the Jail pharmacy if needed.
I turn to the arresting officer, who is holding back a laugh, and say, "If he's in custody he can stay that way."
I didn't notice until we were leaving he was wearing a "Local 420" T-shirt.

Thursday, November 20

...for the unknown medical...Part I


You know its a rough night on the medic van when every engine you meet is bright eyed and wide awake on every run you go on. Last night was one of those nights and I'd be in a bad mood but there was a cosmic connection between the hilarity of the calls and the teamwork on behalf of my partner and I this particular eve. This shift yields not 1, not 2, but 3 examples of how mainstream society has lost their way and EMS is there to sort out the mess and pick up the pieces.

First, we'll start with a riddle:
What's red and white and hasn't slept all night?

Now on with the dispatch...

Unknown medical aid is the administration's way of showing an ambulance responded quickly, mainly because when you call and say I need an ambulance, they send one, no questions asked and call it "unknown."

THE EMERGENCY
Local campus police have reported a need for a code 3 eval at one of the dormitories. It's a weeknight, around midnight so we're not expecting anything too elaborate.

THE ACTION
The campus police have detained two young ladies, recently 18 who have over indulged in the fire water and become sick in the bathroom. By the time we arrive, 1 is in the hallway embarrassed and not intoxicated while the other is expressing her desire never to drink tequila ever again. We do our Medic thing and try repeatedly to convince the engine crew to leave the girl's dorm as their assistance was no longer needed. We determine the girls have been drinking but are not intoxicated and are of age to refuse our services, which they refuse in a number of ways. Campus Police, however, will remove the young lady who is sick to her stomach because, "We can't just leave her here." I'm not sure about the rest of you college graduates, but I had at least 1 night a month like this and sometimes worse. Oh I hope Happy Medic's Mom hasn't found this to read that.
At the end of it all we were leaving the dorm and wondered who would call campus police for 2 girls getting sick in the bathroom at midnight? And who, when arriving to find them no longer drinking, but suffering as a result, would burden them with our exams and embarrassing questions?

Wednesday, November 19

...for the seizure...


So many in western culture view a person suffering from alcohol withdrawal as having 'withdrawal seizures'. Could it be their body is reacting to living off only grain alcohol and not food? The medical community has yet to decide. Our new friend, however, has made up his mind.

THE EMERGENCY

An elderly man's grown son has broken into his apartment, again, in search of liquor money. The police have refused to respond since this appears to happen on a weekly basis. So again the only agency legally REQUIRED to respond is EMS, and away we go.

THE ACTION

We arrive on the scene and the engine crew is upstairs already and my driver not only knows where we're going in the building, but has already started filling in the chart with this person's information. Into the apartment we find the elderly man asking that we take his son into custody, not noticing we have no guns, and the son sitting on the couch chatting with rescuers.
"Did you have a seizure today?" I ask him.
"Yeah, withdrawal seizures, nasty ones." He answers, odor of cheap wine spreading throughout the room.
"Have you eaten recently?" I inquire as the engine crew leaves.
"No."
"Do you think that is the reason you have this condition?"
"I want detox." He shouts at us suddenly realizing the reason for this call. We find through the course of our conversation that repeated trips to various detox programs have done little to change the habits of our friend on account of his 'inability to go cold turkey.'
On the way down the stairs he begins flirting with my female driver and any other female that passes by. Down to the lobby and I step out to make some phone calls to find our new friend some help. When I return not 5 minutes later, he's gone. He told my partner he didn't want someone else telling him how to live and he walked away. No doubt we'll likely see him next shift, when I'll be able to fill in his info early.

Saturday, November 15

Attention all units in the field

Attention all companies...

Southern California is getting hit and hit hard. From reports all over the internets, fire companies assigned to the Tea fire are struggling to get a hand on the fast moving fire. No reports of serious injuries on the working side have been noted, fingers crossed.

This is one of the more interesting photos I found:


And it reminded me that in this job, hidden in all the bureaucratic crap, training drills and BS calls, are events that require us to take a calculated risk with our own lives. There are hundreds of firefighters right now putting their lives on the line to save someone's stuff. Not their lives, but their stuff. I saw on TV that Oprah's vacation house might have already burned down. How many task forces were assigned to that neighborhood I wonder? How many firefighters were asked to defend someone's vacation house with their lives?
A firefighter's duty is to protect life and (then) property. When the first task is met, let's all remember to take a breather and remember, it's just stuff.

My thoughts are with the firefighters on the line and in the interface working their butts off so someone's life isn't completely erased with the destruction of their home.

Be safe brothers and sisters. Keep hydrated, change your socks and keep your gloves dry.
That is all.

Wednesday, November 12

...for the code 3 transfer...


A smaller ER in a quieter part of town has hit the panic button when a patient walks in with injuries they are unable to handle. The law says a patient must be "stable" and meet certain other criteria before they can officially be "transferred" between facilities. Or, the doctor can just call 911 and run and end around the entire system.

THE EMERGENCY
A man was struck by a car on his bicycle and the driver has been kind enough to drive the rider to the nearest ER for evaluation. The rider walked in, registered and took a seat to be seen. When the physician, who is doing his mandatory ER time away from his pediatric practice, got worried this was out of his league, he calls us.

THE ACTION
We arrive with only the information regarding a transfer so we're getting our things together when a nurse comes running out and tells us to hurry. Hurry? Isn't there a doctor in there with all that high tech equipment, bright lights and staff? We hustle in to find the bike rider, lying flat and our physician friend pale and sweating.
"He's a trauma patient, he needs to be seen at the trauma center immediately."
"What happened?"
"I told you he needs to goto the trauma center!"
I took a breath, looked at the patient who was smiling in the hospital bed with nurses scrambling to start IVs and take further tests.
"Are you hurt?" I asked the rider noting here was no blood, no missing limbs, not even an abrasion on his elbows. "I'm fine, I just want to get checked out so the guy in the car feels better."
I motioned the doctor into the hallway and my partner starts a more thorough assessment. I inform the Doc that since he activated us under 911 protocols, we're in charge of patient care unless he accompanies us to the hospital. If this is a transfer, the patient seems stable enough to maybe not need the trauma center. I ask what of the certain criteria in our system qualify the rider for a trauma center visit and am told, "His heart rate is 48."
I poke my head in, "You bike a lot friend?"
"300 miles a week."
"That explains the heart rate, Doc."
"He still needs a trauma center!"
We agree to take the rider and the rider is happy to comply, just to get to another physician. If that seems embarrassing you should have seen me trying to explain the situation to the trauma team as we arrived with a patient telling bad jokes. The physician from the first hospital had called ahead and told a wild story that had no less than 15 professionals awaiting our arrival.

Monday, November 10

PANIC button installed

Chief coming down the hall? Need to look busy, or at least not wandering the internets?
Is that the wife opening the door? Embarrassed to be looking at our blog? Well now you can keep it under wraps from those who wouldn't understand.

On the bar to the right, (not that kind of bar...firemen...) the side bar,just above Mother's sweet rig, is a bright yellow PANIC button that will link you to the MDA Summer Camp information site. Now when the chief turns the corner and says, "What are you doing on the computer?" you can respond, "I was thinking of volunteering at the MDA summer camp, you should join me!"
You will be left alone in no time. Not that this isn't a worthy cause, far from it, just that folks with something else to do will do it.

Now back to work all of you! I called dispatch and put you in service to cover our runs for the night. Thanks!

Avoiding the bells,
The Happy Medic

Sunday, November 9

...to evaluate the pneumonia...


Another case of a physician on scene correctly identifying a condition or another citizen up late, bored and feeling bad? For the last 15 years.

THE EMERGENCY
A fellow has waited until the wee hours of the morning to decide his last few years of poor health is as a result of "pneumonia" and can't seem to get a doctor on the phone to confirm it so he reaches out to the only section of American health care that is legally REQUIRED to help, EMS.

THE CHANGING ROLE OF EMS
More and more journals are talking about EMS being the first line of offense in an attempt to bring a public health message out of the office and into the homes of the public, changing the role of the rescuer to that of the social worker. I'm a big supporter of this idea if only medical directors would have the spine to let us tell folks who don't need us that they don't need us and leave it at that. But for now we have to do whatever they say or we get sued, the Department gets sued and the Medical Director gets sued. What a system!

THE ACTION
Answering the door in the upscale building, the unit is in a state of disrepair. He answers, clearly winded, and the stink of alcohol and cigarettes flow at us like an airlock opening. He goes into broken sentences about how he can't get a doctor to talk to him on the phone about his self diagnosed pneumonia and we gather our information and a thorough assessment. He is on dialysis, as evidenced by the shunt, and heroin, as evidenced by the spoons, lighter and needles. He is also heavily medicated by the tobacco industry, clearly causing most if not all of his health concerns. He doesn't want an ambulance to take him to the hospital, he wants a doctor to give him something for his pneumonia. I hold the overflowing ash tray before him and say, in my monotoned Night Medic voice, "This is your pneumonia. Every puff on this is another 5 minutes off your life. You will not get better until you quit smoking. That is what the doctors will tell you and that is what the doctors have already told you, I'm sure." "But you're not... a doctor how... would you know?" The '...' are for the pauses he takes. This man clearly needed routine care about 15 years ago and now, whithering away at home, smoking himself literally to death he refuses to listen to our message that a change in habit can be the beginning of a better life ahead.
As the ambulance arrives to take over I give my report and the EMT smiles. "We were here yesterday," he tells me pokes his head inside the door. "Still pneumonia today John (Not his real name) or did you quit smoking like we told you to?" I patted our friend on the back and reminded myself to tell the Engine boss he needs to quit smoking too.

Saturday, November 8

Same questionable calls, new look

After learning how to alter the internets, we here at EMSfun blog decided to make the site look a little different in the hopes some of you stopping by will hang out a bit longer and get an extra chuckle or two before the Chief catches you online instead of mopping floors.
We're also looking into PANIC buttons along the page so in case the hubby or supervisor is closing in you can quick link to IFSTA manuals or something instead of explaining why laughing at other people's "emergencies" is actually therapeutic.
Hate the new layout? Let us know by responding to this thread. Like the new layout? Visit a sponsor, take a class, a new job, buy a dress, whatever.


Waiting for the bells to ring,
The Happy Medic

Friday, November 7

...for the working fire...


Well alright an initial report of a 10-75 can only mean we have an experienced set of eyes on this fire and they confirm it is a working job.

THE EMERGENCY
The call comes in with report of smoke in a hallway, alarms activated, building being evacuated. It's a medium sized unit for the area, maybe 10-15 apartments. First engine reports smoke from the second floor, building being evacuated. Ladder companies arrive and have access to the roof where some confused occupants have sought shelter. We arrive as the glorious, always brave heroes of The Truck are removing them via ladder to shouts from across the street.

THE ACTION
Up the entry stairs, over the first 2 attack lines to the second floor where there is a familiar smell, but hard to place. The search team has forcibly opened a few doors on this level (likely unlocked) and nothing looks burned, smoky or anything resembling a fire. We note the empty fire extinguisher in the stairwell and assume it was to attack a growing fire and the occupants dropped it as they ran.
5 minutes in and we've found no smoke, no fire, no scorched kitchen, not even a warm candle and there is one door left to open. As we discuss options (different techniques are used on each door for training purposes) the door opens to what looks like the left overs of quite the college party. Droopy eyelids and college sweatshirts are mingling and we see why we're here.
The dry chemical extinguisher has been discharged at the front door, spraying a clear delta pattern on the floor and the apartment is full of a heavy cloud of acrid chemical.
Pranksters, likely rejected or removed from the party, grabbed the extinguisher from the wall, held it down near the door thresh hold and discharged it. Not expecting the bulk of the chemical to come back at them, they likely fled, confused and dropped the extinguisher where we noted it. The chemical cloud was thick enough to set off the alarms and our colleague who phoned in the working job got to keep the extinguisher.
Suspects are still at large.

Thursday, November 6

...a guy wandering in a tunnel...

OK, from across the internets comes a classic tale of why we should ALWAYS lock the ambulance doors from the inside while transporting.


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Judging by the vehicle styles and the type of Medic unit, I'm guessing Western Europe.
I can't find much else about this fellow, but just be assured, he doesn't get hit, although he would have in the US I'm sure.

And another from Turkey:

A nod to LiveLeaks for the footage

Let's pay attention people! Maybe securing the cot and closing the doors will be the next daily drill. Accidents are one thing, but if it happens again, perhaps a Letter in the File

...for kidney stones...


CRINGE! I can't imagine the pain folks go through when solidified crystals try to pass through...well...you know. So it always amuses me when: A. A diagnosis has been made prior to our arrival and B. A course of treatment has already been decided upon.

THE EMERGENCY
A middle aged gentleman is experiencing extreme pain in his retroperitoneal (lower back on the sides) area and is immobilized on the couch in pain. His adoring spouse decided to call 911 when she couldn't take his agony any longer. Well, that's the picture they painted over the telephone to the dispatchers anyway.

THE ACTION
First responders have the man on high flow oxygen and the EMT from the fire engine is actually pale and sweating. "What do you have?" I ask him, known to be a caring responsible EMT, and he replies, "This guy is hurting BAD." The patient looks up at me, shakes his head ever so slightly, looks up at his wife and sighs. It was then I realized what was happening. Before I could open my mouth to speak to her, I discovered why our dispatch information had included a field diagnosis.
"He needs morphine for his kidney stones. He can't sit still and its driving him crazy. I think 5 will do for now and another 5 in the ambulance." Wow, she knows our dosing which means she's either a nurse, physician or they've been through this before. "Are you a doctor or nurse ma'am?" "No, but I know what you're supposed to do in this situation, that's why I called last night too. They gave him the medicine and he felt better."
I looked to our patient who appeared a shade redder now. "What is it?" I asked. "Her. the doctors last night gave me some medication for the pain but she won't leave to go get the prescription so I'm stuck." I stood up and walked over to where she stood for a little Medic on Fam discussion. She told me all about how the doctors told her he would feel better and to get him seen if it got worse. I explained how the medicine can't work unless he puts it in his body first and she got upset. "Take him or I will!" On that our patient stood up, took off the mask and asked for a hand to steady him as he walked out to the family car parked between the door and the ambulance. We assisted him into the passenger side as the wife came running out following asking what we thought we were doing. "Take me to get my pills already!" he shouted and told us he was sorry she called, he didn't want us, just his pills and some quiet.

Tuesday, November 4

...for the man down...


Have I mentioned how much I love cell phones and how they make reporting an emergency so simple? Especially on a major through way when folks from out of town call as they're driving by.

THE EMERGENCY
Someone driving past a bus stop notices a man lying partially in the street with his legs in the bus zone. Instead of honking or even stopping to render aid, they have called 911 reporting the situation and, unable to confirm the man is alive, dispatchers have sent the calvary. What the caller leaves out is that there are easily a dozen people standing near the man at the bus stop. An engine, ambulance and even a Paramedic Supervisor are racing to the scene.

THE ACTION
Rescuers arrive to find a gentleman who looks familiar lying, as reported, partially in the bus zone. As we approach on foot he glances up at us and the idling fire engine. "This for me?" he asks as he begins to get up. The half dozen locals at the bus stop saw no need to call and they filled us in to why. At this particular stop the bus often passes by when a fellow of this man's nature (and odor) is seen in the bus stop shelter. Right or wrong, it happens. By laying partially in the bus zone, the bus must stop in order to avoid hitting his legs and merge into the other busy lanes. As the bus stops, the locals get on and the man sleeps half in the road. When he heard more sirens he spooked, got up and casually wandered off, politely leaving his odor behind for the others.

Monday, November 3

Misleading Advertisers

A letter in the file to the political advertisers using Google's Adsense to advertise on blogs across the internets. Even here at the EMSfun blog we hold certain "standards" even if they be as simple as upholding the constitution of the state and country in which we reside. Some of you I'm sure took an oath to that affect.

Certain advertisers disguised the intent of their messages by renaming the url of the sponsor to elude ad filters at google. Long story short, someone lied about an ad to get it onto pages that strictly requested the opposite. Most times we giggle at the content of the ads here at EMSfun, women's clothing and nursing schools, but some recent ads just prior to election day were not appropriate for this site and, by the method they were placed, were not appropriate to be shown at all. Much the same way an internet predator slinks around pretending to be something they are not, political ads pretending to support basic rights prove deceitful and take up valuable (OK not here but other places I'm sure) space that could be used to remind folks to change their smoke detector batteries or warn citizens of weather conditions in their area.

So a letter in the file of political advertisers, and this will reflect on your promotional opportunities in the future.
If it was up to me you'd be busted back to the Tower to run PT drills for the Cadets.
That is all.

Friday, October 31

...fore the pediatric difficulty breathing...


Kids can scare a lot of rescuers and a lot can go wrong if you're not careful. Many times the parents are helpful, other times a hindrance, but one I met recently was downright rude and the universe let her know it.

THE EMERGENCY
Our young patient has had a cough for 4 days, ever since he got his flu shot, and has been keeping Mom and Dad awake tonight. Instead of trying a humidifier or a gentle cough medicine (as directed) she has decided to dose Jr with his brothers asthma medicine in the hopes it will quiet him down. 911 was called when the medicine wasn't doing the trick. A quick aside here, she absolutely should have called, its what happens in the end that I love so much!

THE ACTION
Anyone in the field will tell you kids are tough cookies and will go on breathing strong a lot longer than adults, but will also tire out suddenly and need help fast. With this in mind we convince mom to let us take Jr in so we can monitor him. She tells us what hospital to go to and we begin the walk downstairs to the ambulance when she tells us, "Let me get my shoes." Not unreasonable, he's not too heavy and is comfortable watching the fire engine drive away. Minutes pass with no sign of mom. Now I've had mothers jump in the ambulance in bath robes and one slipper to accompany their ill child, others scramble for a favorite toy or bear to make the child comfortable, this mom was looking for a proper scarf for the ride. This was a first for me.
She's got the scarf, shoes, bag, all accessories except, "I need my phone." It was then the decision was made we were leaving with the child and they could follow whenever she was ready. As we left the house mom comes running after demanding we wait. She climbs into the back of the ambulance where we've arranged for Jr to sit in her lap, in her arms so as not to be scared of the ambulance. She gave us a look of disgust much like Paris Hilton might give you if you offered her a ride in your '88 Trans Am. Putting the phone to her ear to argue with the husband not 30 feet away, my partner took over care as it was my turn to drive.
This story would not be as good if I was in the back because I was able to concentrate on the phone conversation she was having the ENTIRE drive in. Raising her voice about how it should be him in the ambulance, not her and how she'll likely get sick as as result. All the while our patient is quiet and doing just fine. We arrive at the hospital and into an exam room, phone still pasted to the ear against hospital staff requests to the contrary and that's when the universe stepped in. 'Call it fate, call it luck call it Karma.' We see Jr's body tense up a bit in mom's lap and I make a bee-line for the emisis basins, but not in time. The asthma medication has an interesting side effect we learned, as did mom's beloved scarf, now covered in vomit. Did she comfort the child? Did she try to help us clean him up? Nope, she was examining the scarf, then back on the phone.

Wednesday, October 29

...for the chocking...

Look again. This call is not for a choking, but for a chocking. How can I trust what the dispatchers tell us when they can't spell? Mistyped you say? Look at how far away the 'c' is from the 'k' and the 'o.' What have I been dispatched to? Will I be placing a wheel chock behind this person?
Here's just the recent ones I can recall...

...respond for the psychic...(psychotic or psych eval maybe?)
...aboniminal pain...(ab pain or a large white hairy guy?)
...elderly nabor...(a type of bird?)
...bicicle accdnt...(icicles? Really?)
...2th hurts...(took me a minute too - Tooth hurts) More on her later
...cs flms fm blcny...(Sees flames from balcony - I let this one slide)

We all make mistakes, sure, but some are just so much fun.

Tuesday, October 28

As seen on FireGeezer.com

The very first Tip of the Helmet to the folks over at Fire Geezer for a quick line about us on October 28th. If you haven't been over there yet, they've got great items related to EMS and Fire from all over the world as well as hilarious news reports. I like to read about the fire engines repurposed as beer dispensers, but that's just me.

This is part of a new feature here where we'll break up the monotony of dispatches with notes from around the internets. Stuff we like will be given a "Tip of the Helmet" while things that get us mad will get a "Letter in the file."

So welcome, fellow Firegeezer readers, and hope you enjoy the stories!

...for a 9E1...


Ah the old/new days of the coded dispatch system. A 9E1 is a severe diabetic emergency and as usual with these folks, the address is familiar. A special tip of the helmet to my old medic "Beemer" on this one, this tale never gets old.

THE EMERGENCY
A man with uncontrolled insulin dependent diabetes has been found by his family unconscious, again. Rescuers recognize the address as the call is sent over the radio and the conversation starts about who has to convince him to get seen at the hospital this time.

THE ACTION
A proper assessment clears the way for the medication of choice and our friend is soon returning to "normal" when he sits bolt upright and surveys the room slowly. He is not panicked, he is not worried or scared, but is almost inquisitive in his eyeballing of the people around him. It is not uncommon for a person in this situation to be slightly disoriented or even confused, but he seems completely awake. He then looks from Beemer (the medic) to me and I ask him, "How do you feel?" He looks at me, almost leaning in to look into my eyes and speaks the single most memorable line of my career, "Who are you people and how do you know my language?"
"You're fine" Beemer says and we spend the next 30 minutes convincing him to take his medication. To this day I always think of him when I'm in this situation.

Monday, October 27

...for the large outside fire...


This one falls under the "You should have known better" category since you should always technically call 911 when you see a tee-pee on fire.

THE EMERGENCY
Some local, self described, "Free living" types were having a party and decided it would be nifty to build a tee-pee in the back yard. It appeared well constructed, was in a large flat area and measured about 10 feet across and almost 12 feet high where the posts came together. Plenty of room to keep some candles burning near the stacks of magazines and close to the 100% cotton sheets serving as as skin for the tee-pee. Neighbors have called advising our dispatchers that there is now a large fire where the tee-pee once stood. Our dispatchers advise us enroute, "Multiple 911 calls," which usually means its the real deal.

THE ACTION
The first engines on the scene see no smoke because of a common weather condition where we are. We're met at the front door by the previously mentioned "free living" folks who tell us their tee-pee burnt down. It was a little before 1 AM so I just shook my head and tried to imagine what he really meant to say. Then into the back yard and there it was in all its charred glory. Lightly smoking with only the poles marking the dead skeleton of once had been a happy place to burn candles un-attended. It reminded me of the charred christmas tree in the Christmas Vacation movie. They were a little confused when we grabbed their garden hose and nearby rake to break apart what was left and make sure the fire could not spread. Little jokes were made around the remains of the tee-pee, mainly about what the native people of North America would say if they were here to see this. We concluded they would smile, turn their backs and walk away, so we did the same.

Thursday, October 23

...for the unconscious...


Well it is 5:30 in the morning, perhaps they're sleeping?

THE EMERGENCY
We're tapped out an hour before sun up by a cell phone caller in front of the fire house stating there is an unconscious person in a car. It isn't uncommon for people to sleep in their cars in this area, so we proceed to drive up and down the block looking for the person in the car when we're waved down by someone in the middle of the street. The car nearby is in the middle of the intersection and we're wondering why this person chose to stop there and call 911. Turns out he's calling about the fellow IN the car in the middle of the intersection who, sure enough, is asleep at the wheel.

THE ACTION
"Did you try to wake him up?" I asked the caller, expecting the answer of "No" which seems odd since I tapped on the half rolled down window to which the driver awoke, looked around and said, "Oh shoot. I fell asleep. Sorry." And drove away. Our job is not to chase people so we made sure he drove safely as his brake lights disappeared into the pre-dawn morning. The caller simply looked at us with a blank expression, clearly let down that we weren't going to give pursuit. "Anything else we can do for you today Sir?" I asked as I climbed back into the ambulance. We didn't hear a response, I was already on the radio, "Put (this ambulance) back in service, citizen is now awake and driving away." Just in time to get 2 hours sleep before shift change.