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.

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.

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...


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 in swoops EMS.

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.

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.

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."
"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.

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.

'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."

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 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.


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.


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.
"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.

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.

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 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.

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.

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!

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 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.

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.

ParamedicTV is powered by

Thanks to ParamedicTV, one of our advertisers

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 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.

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.

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.

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.

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.