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.