101 Things the Fire Department wishes you knew



Thursday, October 15

We've moved

We've moved.

I told you update your address bars, right? Well, happymedic.com is up and running with thehappymedic.com on the way soon.

Same content, different look, new home.

happymedic.com

Wednesday, October 14

Hoseline Placement or How Not to Impress the Public

Trying to keep up with the flood of industry news that is Statter911 can be daunting and I missed this story not once, but twice.

On October 7th DC Fire & EMS put on a demonstration of the effectiveness of fire sprinklers. It also ended up showing the ineffectiveness of modern firefighting.

One of our brothers was hurt in this exercise and I hope he makes a full recovery. I've been hurt at fires and I've been burned, neither experience do I wish to repeat. Our thoughts are with our injured brother.

This is not a Monday Morning Quarterbacking of the event, but instead some great video that will show you what happens when you are unfamiliar with how to use your equipment to its full potential.

This first video is from farther back than the second and is a better opportunity to read the smoke and see possible flashes. As you watch it, imagine you are in the hallway of a dorm approaching this room. Heavy smoke in the hallway, intense heat and that flame dancing out of the top of the prop will be spreading in all directions along the hallway ceiling. Now, as it flashes, imagine where you will place your team and where you will shoot first.


This is another video from head on that better shows the incipient, free burning and flash periods of this particular fire, as well as our brothers placing their line. I can't help but notice the fog nozzle.


A smooth bore at 60 psi could have knocked the seat of this fire from the imagined hallway in my earlier example, even banking it off the wall if the heat was too much. Many news outlets talk about the lack of a backup line. Huh? Don't need one. Smooth bore from 20 feet makes short work of this fire without even having to go on air.

Putting ourselves in a dangerous situation in public only makes me wonder what we're doing in the dark hallways at working fires. Let's use our equipment to our advantage. Take that fog nozzle and put it in your pocket, get smooth bore nozzles on your pre-connects so you can put the fires out. HMHQ is a firm believer in the power of water applied from a safe distance in order to make a safer environment for extinguishment.

Another quick word on the Culture of Extinguishment. Lt McCormack, in his "controversial" remarks before the FDIC in April 2009, fought for the idea that "If you put out the fire, safety is accomplished for everyone on the fireground." I agree with that 100%. Unfortunately, I don't think Lt McCormack's message is getting to firefighters as intended. The Lt wants you to safely put out the fire, not go running in without using your tools and training to your advantage.

I speak with many firefighters in my service who heard about the speech, but never read excerpts. They make it into a call for safety to be thrown out the window when there is a fire or a rescue. Not at all, friends, not at all.
WAKE UP! Pay less attention to which Chief or Union Leader blames who and look at what gets our people hurt and don't do that. Don't go somewhere your water can go instead.

Placing a hoseline is not a simple task and I, on the nozzle, have been dragged by my airpack to a different location by my officer who had a better view of the situation. Each and every time I have them walk me through where I was, where they moved me to and why. Then I apply that next time.

Are we all perfect first try? No. But this first try got someone hurt.

Tuesday, October 13

If you get stopped...

The Po-po with the Mo-mo, the Po-po a Go-go is back on the streets after welcoming Baby MC and starts off in a car due to pouring rain. Poor guy didn't even get to fire up the Honda and bust some fools on his first day back? We at HMHQ think that is just a travesty.

Welcome back Motor Cop, we missed you and your matter of fact style. We always enjoy reading from our Law Enforcement friends, but you are after all our brother from another mother here in blogger land.

Stay Safe MC and see you in the report room for cocktails.

HM

(Oh yeah I did)

My 5 hour day

I was confronted by a citizen recently about how I was paid to sit around and play pool and sleep and that I was robbing the City. She stopped me while we were out doing our weekly hydrant checks, which I explained to her, but she refused to listen.

It got me thinking though, that many of you not in the business may think us 24 hour guys have it pretty good. I'm the first to tell you we do, but not because of the reasons you may think. When I stopped to think about it, I really do have a weekend everyday I go home. But I also work 5 distinct "days" within my 24 hour shift. Since I try to arrive an hour early, this makes my day 25 hours. Allow me to explain.

Monday - 7 AM to noon
Back to work, just like you folks on your Mondays. Getting into the swing of things, seeing your work friends, and remembering what working is like. Check all the gear, clean the house and get the shopping done. It's all routine on Monday.

Tuesday - Noon to 5 PM
The week drags on, but the morning is finished. After lunch it's usually a drill and a class, then maybe a workout before getting ready to fix dinner. This is by far my favorite part of the day.

Wednesday - 5 PM to 10 PM
Hump day. Making dinner, eating dinner and the wind down following the meal can be good, but you're reminded that your shift is only half way finished. Sometimes you have time for a full movie, other times you're lucky if you get dinner on Wednesday.

Thursday - 10 PM to 3 AM
Isn't it Friday yet? On my Thursday I'm up in the dorm looking for a good place to sleep, wondering how many more times I will have to climb the three flights of stairs before Friday is over. When busy it goes fast, but when the calls are spaced about an hour apart and bells ring just as you enter REM sleep it can exhaust you just thinking about it. I HATE THURSDAYS.

Friday - 3 AM to 8 AM
But those who know my writings here know I'm a fan of my Friday. When I awake and see we're heading out and it's after three I relax and realize it is officially morning instead of night. then it's a downhill slide to the sunrise and end of shift at 8 AM, my Friday night.

So there you have it my 9-5 friends, my 5 day week within a day. Then I get a weekend, just like you, except mine can't start until I get home after the shift.

Monday, October 12

Attention all Companies

The mandatory reading assignment for this week is waiting for you at Ambulance Driver's in response to another excellent post by Rogue Medic and the comments that followed.

Another example of the need to restart this trade as a Profession and lift ourselves out of this "patch and tan box" mentality so many of us are still stuck in. Reboot the entire system. EMS 2.0.

You Make the Call...Line Up...What Happened

This was a giant Duh moment really. We later discovered the officer was doing his final day of FTO before getting out on his own and we were being used as a partial prank.
The Sergeant stuck his head in the back door a few moments later laughing, apologizing for the seriousness of the request, they expected him to smile and laugh instead of actually ask us about the line up. The superiors had intentionally waited until both men were on the boards before telling the rookie about the suspect in custody.

Seems they realized our clients were far to inebriated to make a reliable ID.

If you said "You're kidding right?" You made the right call.

Sunday, October 11

Sunday Fun - If you build it...

There is always talk around the dinner table at the firehouse that the house was clearly not designed by anyone who had ever even seen a firehouse before.
"The locker room is too small!"
"This kitchen sucks"
"Can't we have a toilet on the ground floor?"

The usual complaints.

So this Sunday we're heading out of HMHQ and over to the architect's office with a copy of Gerry Souder's book and the following demands.

#1 - Humidor Cabinet
The guys are having an occasional cigar, but why have the engine parked infront of the smoke shop every weekend? With this cabinet, each member can purchase and store quality cigars to enjoy 50 feet from the closest door, per policy. If your organization prohibits the use of tobacco products while on duty, install this in the basement. Cigars.com has a lovely selection.







#2 - Commercial Dishwasher
At a busy triple company house, feeding and cleaning up after 14 people can be a chore. But if you use a commercial strength dishwasher, you can wash an entire load of dishes in 90 seconds. That is not a typo. 90 seconds. I work at a big house that has one of these and it is awesome. Pile in the silverware, press on, wait a minute and a half and POW, clean forks.
It takes a few more cycles since there is only one tray, but the water heats up to 170 degrees and cleans those things like no one's business. The folks at ArchiExpo can tell you more.








#3 - 3 Burner Bunn-o-Matic Coffee Maker
Forget those fancy fru-fru drinks for $3 a pop at the local coffee shop. Save those for heading home. That's your reward for staying safe and going home again. Until then, we need 3 piping hot supplies of delicious coffee. Some may tell you the 4 burner is the way to go, maybe if you're having a lot of meetings at your house, but if you're all career, 3 should do fine. And while you're at it, stop buying the crappy coffee at the warehouse store and spend the extra $2 a pound for some quality coffee from a local vendor. Chances are he'll be glad to brag that you buy his coffee to drink in your house. No gifts, buy the coffee.







#4 - Wireless
Do I even need to include this in our dream house? What house these days doesn't have wireless yet? Get a private phone line installed and collect the $5 a month from the members and get a network set up. You'll likely want two routers, one on each side or end of the house so that the computer up front gets as strong of a signal as the dorms. We'll also need a communal computer for research and checking for updates on firegeezer. That brings up another thing, networking the network. That fancy TV you spent all the money on last year you currently use to watch Dancing With the Stars has a video input on the back. Run a cable from the computer to the TV and watch training videos, fireground close calls, and post important information. We recently had a boss do this to the giant TV to give a ventilation drill. he fired up the video on the communal computer and everyone actually wanted to try it and was involved. We watched, we learned, then we went and did it. And add in the free printer, make it wireless so all the laptop guys can use it too.


#5 Truck Turntable
Too many folks are getting hurt and some have even died while the apparatus is backing up. Why? Why are we even "spotting" these things, only putting ourselves in danger to protect someone's investment. Let's install a truck turntable. Pull in, press the button and just like Batman did, we're turned around and ready for the next attack from the Riddler. I can hear some of you groaning about how elaborate, expensive, problem prone this might be but it can never fail. It simply becomes a floor if it stops rotating. Not sure how the tillers will do with this, we'll look into something. And for those of you singing the praises of drive through bays...I don't want to hear your bragging anymore.



#6 Slidepole
No slide. Slide Pole.

Friday, October 9

You Make the Call...Line Up

Nighttime is always good for a few fights and you've caught a decent one.

A couple of guys from out of town got mugged and attacked with a knife. Nothing major, but the report in your mind already has the phrase "copious ETOH odor" so both are getting full c-spine precautions with various bruises forming on their faces and some superficial lacerations to their faces, necks and torsos.

Nothing worth screaming towards the trauma center for, but certainly taking your time for a full secondary assessment.

As you're completing C-spine precautions on the man on the bench seat and indicate your driver to go, a police officer jumps in the back and begins asking the men questions. Completely understandable, so you get a head start on your charting in the few moments he takes to finish up getting different descriptions from your patients, who are clearly intoxicated beyond remembering.

You exchange your professional courtesies and the officer climbs out and closes the door. As you begin to pull away from the curb, he opens the door and asks you to divert over 4 blocks for a lineup, they think they have the suspect in custody.

Both men are in full C-spine precautions.

Divert oven and have your patients ID the suspect or not?

You make the call.

Thursday, October 8

Oh No. Not Again

In The Hitchhiker's Guide to the Galaxy by Douglas Adams, two missiles are improbably transformed into a suprised whale and a bowl of petunias. The whale embraces his new identity, while the bowl of petunias, while falling to the ground from space says, "Oh, no. Not again." Adams then tells us that had we understood what the bowl of petunias meant we may have a better understanding of the nature of the universe.

I recently discovered that just saying that phrase, "Oh no. Not again" means your night is about to get interesting.

THE FIRST EMERGENCY

Automatic fire alarm activation

THE FIRST ACTION

The engine arrives on the scene just before 3 AM to find no alarm bell ringing and no strobes flashing. The building is secure and we prepare to pack up as a small man dragging a shopping cart makes a mad dash across four lanes of decently busy road to reach us.
He waves and waves and I lean out the window to ask him his trouble.
"I am out of medication." he tells me, not even a hint of a wheeze or shortness of breath. There he is, no distress whatsoever, apparently he thinks we have a pharmacist behind the hydrant jumper lead in the hose bed.
"We don't have medication refills here, do you have an emergency Sir?" I ask wondering if I;m really having this conversation.
"I need more medicine, I need 911." He tells me, refusing to get onto the sidewalk, preferring to stand in the street.
"Do you want an ambulance, Sir, you seem OK."
"No ambulance, no hospital, I need medication from 911." He tells us, looking from my jump seat to the ladders on the side of the engine, still waiting for the pharmacist to pop out.
"We have no medicine refills on the fire engine, so if you don't have an emergency and don't want an ambulance, we're going to go, OK?"
"OK, but where is 911?" And he grabs the dirty cart and scurries (Yes, he altered route and speed at random) back across the street and around the corner.
"We're going to see him again, I can feel it" I said into the headset as we pulled away and back to the house.

Just as I got my turnout pants unbuttoned, the lights are on and the bells are ringing.

Oh no. Not again.

THE SECOND EMERGENCY

A cell phone caller reports a man short of breath at the doughnut shop.

THE SECOND ACTION

The doughnut shop in question is not the high quality place mentioned in other posts, but the 24 hour place on the other end of town.

Off the engine I can see only two customers in the shop. One on the phone and drinking coffee, the other remarkably familiar and scurrying again, this time out the door towards me, not away.
"No, no" He's waving, "I no need firemans, I need 911 for medications,"
"What medicine do you need Sir? I have medicines for sick people...are you...sick?" I ask trying to chase him through the parking lot.
"My brain pills are gone. GONE! I am needing more." he tells me over his shoulder, zig-zagging through the lot. There's no way I'm letting him get away just to call us back all night long, so I'm in pursuit.

The only thing that slows him down is the sound of the approaching ambulance from at least 5 blocks away.
"My medicine is coming!" He tells me.

Good Grief.

The ambulance crew gets my "Don't kill the messenger speech" to which they sigh and wave us off. I pay careful attention to the radio traffic when I hear the ambulance report that their patient has disappeared down an alley and they are going back in service.

Not ten minutes later, we're backing into the barn when the bells ring.

Oh no. Not again.

Wednesday, October 7

Boo!

Halloween. All Hallow's Eve. Samhain. Whether you practice the ancient Celtic holiday or just dress up on October 31st, there are certain things you should not do when decorating your home for the fall holiday.

THE EMERGENCY

Cell phone caller reports flames in the window of a residential building.

THE ACTION

4:30 AM. We should have had 3-4 calls since I crawled into my sleeping bag and am rather well rested when the dorm came to life for a full box alarm. The Engine, Truck and Chief are all first due and only blocks away.

We're barely dressed when we pull up to the intersection and see flames in a window box outside a window on the fourth floor.

Airpacks go on as we see the truck get set to head for the roof and to the window in question when I see my boss do that head movement that can only be described as the RCA Dog tilt. His body language changed right then to a relaxed stance as he motioned for us to come to his side with one hand and began waving down the rising aerial ladder with the other.

As we looked, I mean really read the flames, we noticed...no smoke and the flames are neither growing nor receding, meaning the fire is not growing, moving or giving off gasses. Hmmm...

Then we looked closer at the window, noting not only no discoloration, but there are multiple paper Halloween decorations on the outside, slowly waving in the soft breeze of the early morning.

By this time the entire first alarm compliment had arrived and we can now see it is a small electric cauldron. A small fan is blowing fabric above a light, causing the appearance of fire.

Outside. In a planter box. At night. We get planter box fires often, what with discarded cigarettes and all. I just never expected someone so excited about modern Halloween celebration to put such an element outside a wooden frame building.

Monday, October 5

A reminder on uniforms...

I like to think I am a Professional. When summoned to headquarters or even stopping by to see the clerks at payroll, I'm in a new uniform shirt, cap and tie because you never know when you'll bump into the Chief of Department.

So imagine my surprise when we responded to our Headquarters on a medical call and I found myself without my button-up shirt.

Not really listening to the guys calling out jokingly "Grab your shirts!" I donned my navy blue, collared job shirt, zipped it up and climbed into the fire engine to respond.

20 minutes later I was doing a walk of shame.

Lessons I've learned from this event:
1. Always have your shirt at the ready. Whether you are anywhere near HQ or not, if you're not wearing it, put it on the engine anyways.

2. If you find yourself without it and out in public, don your safety coat instead of wearing just your shirtsleeves. You shouldn't be wearing your shirtsleeves out anyways.

3. When you see your engine mates donning their safety coats OVER their uniform shirts, follow suite and do the same, even if the call is a possible cardiac.

4. While assessing the patient and the Chief walks in, focus on patient care, there is time for chit chat later.

5. When the Chief says "Nice Sweatshirt" in the same tone one might say "Hey you cut me off in traffic," do not say "Thank you, Sir" while taking the blood pressure.

6. And by all means, when important papers still have to pass through that Chief's office for certain blog related issues, avoid this situation entirely.


D'oH!

Yeah, you better run!

Summoned for refresher training, I was into my own car and out and about the fair City one sunny morning. Still in my uniform, as required when still on duty, I happened to be passing the infamous coffee shop and had the urge to stop in for a cup of caffeinated goodness before the 3 hour protocol update lecture.

I parked my car in the first metered spot, fed it some coins and was walking to the corner when a man sleeping in a doorway peeked out from behind a number of dirty blankets to see who was passing.

I paused at the corner, empty mug in hand, and glanced back to the eyes in the doorway. He was visibly startled when he recognized my uniform and he began to gather his things.

"I don't want to go to the shelter! I don't want a hospital! Leave me alone! Leave me alone!" And he began to run down the street.

I was amazed. Every time I pull up in an ambulance, they never run. And now this man is fearful of my uniform, so much so he'll abandon a clean, warm doorway to get away from me.

That cup of coffee was extra delicious.

Sunday, October 4

Sunday Fun - Kids + Fire Trucks = Blog?

While wandering the interwebs for a completely unrelated post on robots (Just go with me here) I came across something fun.

Kids Firefighter Blog was started by a family who had trouble finding a single site as a resource for kid friendly toys, information and activities related to the fire service. They cover coloring books, regional activities, lego, you name it, if it relates to kids and fire trucks, chances are it's in there.
I especially enjoyed this photo series of classic fire apparatus built with Legos. So close to my 900 series, I had to post a pic.

With so much going on around the Project, I've been neglecting my traditional Sunday Fun stories of the tradition of our Profession. Until I get my piece on red lights finished, visit our new 2nd Alarm Company firedaily.com.

Saturday, October 3

The power of the Blog

Mark has chimed in about an update to the Project, the Trans-Atlantic Paramedic exchange I'm always reminding you of. Pop over and read his post, answer his question, then come back for my thoughts on whether blogs are bad.

It seems that the powers that be on both sides of the pond are still nervous about the reality of patient confidentiality laws, and rightly so. It is understandable to be worried about litigation if one of your people is blogging, facebooking/Myspacing or tweeting the address of a patient, a patient's name, history, likeness or scene photo, but what about those of us trying to make an impact on the Profession of EMS?

These same supervisors who are nervous about Mark's blog being perceived as NHS driven and my supervisors to even allow me to tell you my name, surely sit down with other professionals and share tales of "the big one" or "the call that went wrong." Are those violations of privacy rights?

What about ACLS scenarios? Each time we enter the classroom we are encouraged to share stories of patient outcomes and interventions. Are those violations of privacy rights?

Many of you may be shaking your heads and saying, "That's different, it's not in the public realm," I say sure it is. I go home, tell the wife about a rough call or scenario in class, she tells a friend, etc etc.

We share information all the time, and mostly even more details than have even been shared in this arena. Privacy is so private that people will scream for help on a busy sidewalk, then refuse to give their name because they don't want a bill. Will rail on and on about their medical history, in front of dozens of strangers, then I have to get a form signed saying I promise not to share their information with anyone outside of our billing system. That's makes sense, right?

I took this opportunity to re-read the Health Insurance Privacy and Portability Act (HIPPA) and find out once and for all if what I've been doing is allowed. Here's a shocker...yes.

From the text of HIPPA:

What Information is Protected

Protected Health Information. The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."12

“Individually identifiable health information” is information, including demographic data, that relates to:

  • the individual’s past, present or future physical or mental health or condition,
  • the provision of health care to the individual, or
  • the past, present, or future payment for the provision of health care to the individual,

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.13 Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

The Privacy Rule excludes from protected health information employment records that a covered entity maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act, 20 U.S.C. §1232g.

De-Identified Health Information. There are no restrictions on the use or disclosure of de-identified health information.14 De-identified health information neither identifies nor provides a reasonable basis to identify an individual. There are two ways to de-identify information; either: (1) a formal determination by a qualified statistician; or (2) the removal of specified identifiers of the individual and of the individual’s relatives, household members, and employers is required, and is adequate only if the covered entity has no actual knowledge that the remaining information could be used to identify the individual.15


Take note of the "and" following the bullet points under Protected Health Information. If I post about someone who, even if I change all the information, can still be identified by someone not there at the time, it becomes questionable.

I understand the reason for privacy rights, believe me, but I also understand how sharing information of a non-sensitive manner can help move our understanding of this Profession forward by leaps and bounds.

I don't know what privacy laws are relevant in the UK, but I'm sure Mark is well aware of his limitations, as evidenced in his post.

Blogging can do harm Mark, when done recklessly and without respect to our patients, clients, employers and co-workers.
But when done following the intent AND letter of the law, it can only help.

I'll explain more when you pick me up from the airport in Newcastle during our blog born EMS exchange to advance patient care. But keep that private, OK?

Friday, October 2

You Make the Call...Brain Attack

Brain Attack is the new stroke. Did you not get the memo? In an effort to expand on our similarities, not just our differences, I thought a straight forward medical scenario would do the trick.

You are assigned to your regular response unit and dispatched just after 10 am for a reported altered mental status. You response time is 6 minutes and you are the first care giver on scene.

Family states the late 60s male in the hospital bed in the family living room has an extensive cancer history and has been having difficulty getting up and walking around in recent weeks. This morning he awoke around 530 and had his linens changed, at which time he used a walker to move around the room.

Just a few minutes ago family returned to awake him from his nap and find him unresponsive, left extremeties in a state of contraction and a noted facial droop with drooling, also left sided.

You complete a full assessment finding him actually responding to painful stimuli with a grimace from the non drooping side, no voluntary movement from the contracted left extremeties and faint squeezing on command on the right. Blood sugar is in normal range, EKG and secondary exam all come back normal, previous notations excluded.

Pupils are equal and tracking together, no fixed gaze.
There is no past history of stroke or CVA.

The nearest hospital is 10 minutes away. Another 10 minutes is the regional trauma center, with scanner.

What is your agency's policy for this patient? Is he in the window for stroke center care in your jurisdiction? Does your system offer any in field treatments for this patient? You Make the Call.

Wednesday, September 30

Social Media in EMS - A Tip of the Helmet

A Tip of the Helmet to online EMS educator Greg Friese and his extensive research into how EMS agencies need to embrace social media before it gets past them and starts to cause problems. In his September 2009 article, he mentions our efforts here at HMHQ to use this media for positive change in our profession.

Not sure what social networking can do for EMS? Have you ever used a tip you learned online, on twitter or even done a google search for something related to your role as an emergency care giver?

Then you are using social media to advance our Profession. Learn more in the article here,and at the EMS Expo in Atlanta Georgia, where it looks like Greg will be expanding on his article in person. I would attend, but will be recovering from my CO-Op Refresher in New Mexico and preparing for the Project, which starts in less than 6 weeks.

A Tip of the Helmet to Greg Friese. On twitter and facebook and everything. I'm sure he'd have it no other way.

Facebook updates now rolling

Hey Facebook friends and followers, it's your cartoon fireman friend the Happy Medic here, now linking directly to Facebook. Used to be I'd have to log out, log back in as Steph Frolin, navigate over to HM's fan page, grab a link...you get the idea.

And since we have been auto piping posts into twitter, and getting a good response, we decided to follow Fire Critic's lead and use an application called Networked Blogs in Facebook to crawl the blog and feed you updates without me having to do it all he time. This means you can follow the blog from the comfort of your Facebook status and make comments, like it or share it.

If you click on the image in the Facebook post you will be magically transported to HMHQ here at thehappymedic.com and have a chance to scroll through the 2nd alarm and mutual aid boards for the best fire and EMS bloggers on the interwebs machine, not to mention click an ad or two.

All this is in anticipation of making it easier for you to follow the Project, my and Medicblog999's adventures trading places and riding along to experience patient care across the pond.

Now you can hear about it on twitter, facebook and the blog readers, since the BBC will likely not be making our adventures into a program. We'll just have to change the world from right here on our computers.

For those of you not on facebook, who still have something called "free time," I'll try not to mention it much more after this, but I make no guarantees.

Tuesday, September 29

EMS FAIL or Client FAIL?

Our Pal CK had a rough night recently, not just with some hellish weather and unsound sleep, but encountered one of the glaring issues of modern Emergency Care, the frequent flier.

For those of you not in the industry, frequent flier refers to clients who activate 911 for non-emergent conditions or situations that the normal responsible person would simply take some tylenol or decongestant. These persons call 911 when they run out or lose their albuterol inhaler, have their seizure medication "stolen" or didn't listen when the pharmacist told them not to drink alcohol when ingesting these medications.

Another kind of frequent flier is the basic care seeker. These clients call 911 and use code words like "chest pain" and "seizure" and "difficulty breathing" to get their response bumped up to a priority dispatch. Then, when the crews arrive and find no life threat, they know the law and demand a transport to the ER, which they know we can not refuse.

You see, the laws were written back when companies would refuse to take those who could not pay, or, for whatever reason, the attendants didn't want to take in. That was back when we were a trade.

Now those laws tie the hands of professional care givers who care not only about the patient at the scene, but the next patient who may actually need that ambulance, instead of the client demanding care they do not need.

These folks are not responsible citizens. They demand others care for them, even when there is no care needed. It goes without saying that we treat those who need it, right? So why can't we be honest with those who don't need it? If she calls 911 3 times in 24 hours and got transported, seen, released and brought home twice, why the hell are we there a third time? This issue needs to be solved at EVERY level of the health care ladder, from the patient all the way up to the CEO of the insurance company she may or may not have. So let's break down where the system fails our friend CK, respecting that I don't know the specifics of his system model, so I'll try to be generic in my solutions.

The "patient," or client as I like to call them, is the single biggest share holder in their own health care decision making. The patient needs to seek out information about their medical history, health care options and basic interventions. This can be as simple as listening to the tylenol ads on TV in between episodes of Walker: Texas Ranger and as complex as making an appointment to see their doctor to discuss different interventions. Most folks can't take the time out of their busy schedule of sitting to be bothered with caring for themselves, besides, "Isn't that your job?" No, Ma'am, that's your job as a responsible citizen and proactive member of your community. Not every person can step back and see how their personal life effects their community, we are in the middle of the most selfish generation of people who don't care what happens to their neighbor, only to them.
In CK's example, the client was the first part of the system to fail. She refused to listen to the care takers already put in her path from the prior transports and thinks the ambulance is her personal taxi. PATIENT FAIL.

The family needs to be informed decision makers and understand the conditions which their family suffers from, if at all. Don't tell me she has seizures but you don't know how often, or why, or if she takes meds for them, or if it's just "DTs" (Which I am observing less and less, I think even the alcohol abusers are getting too lazy to fake seizures). If you care for your family, then CARE for them. If they fall and hurt their elbow, maybe take them to a clinic or their doctor's office. Don't call 911, demand a transport, then follow in your car. Tell you what, you get in with her and I'll drive your car, how's that? The family needs to also recognize abuse and nip it in the bud. Huh, third ambulance ride today? Maybe nothing is wrong if they keep sending her home. FAMILY FAIL

The General Practitioner who was called and defaulted to a 911 response is playing CYA with local resources. I am not your insurance policy Doctor, I am a Paramedic. My profession is not your car service and can not respond to cover you should you decide to actually see your patient. I know you are overbooked and understaffed, but that nice Audi I saw in the parking lot is coming from somewhere. Get off the phone and get in the Audi and tend to YOUR patients. House calls are a thing of the past? How about a thing of the future? If there was a component of your practice that allowed this patient to access you or your staff at all hours, she would not be calling 911 3 times in 24 hours and bothering you at all hours. If she is healthy she doesn't need to call you and you actually have more free time for cruising in the Audi. And if you think that simply activating us gets you off the hook and we can do a better job, then let's see you put your credentials where your mouth is and step up as a Medical Director and give your Paramedics authority to refuse care to folks who don't need it. DOCTOR FAIL

The 911 EMS system. You fall, they call, we haul is funny, yet true. Why can't our friend CK take in all the facts, do a professional assessment, determine no need for the ambulance transport and call the doctor back, informing them of the situation? Why? Lawsuits. Our services are afraid someone will actually be refused a transport because of their nationality, sexual orientation or ability to pay, but they ignore the fact that if I wanted to stick it to people I didn't like I would simply not treat them properly. Well, I think it's obvious we're past that part of EMS history, let's get up and actually move past it. Medical Directors need to be proactive in giving their systems tools to guide people out of the water slide that is defaulting to ALS to a hospital. Why was an entire town's EMS system activated 3 times for this client? EMS RESPONSE FAIL.

Does this woman have medical insurance? Is she on disability or perhaps in the VA system? If she is in a private system, has she called the nurse advice line and if we reached that far, did the dial-a-nurse default to telling her to call 911? In my experience with the dial-a-nurse lines, they should be replaced with a recording that says, "Hang up and call 911." In the rare instances where the information is valuable and followed, the clients calling are honest about their symptoms and are clearly responsible citizens, proactively trying to stay healthy. In this situation, again assuming she has some sort of policy, the company must now reimburse the ambulance service, the ER docs and whatever specialists may be activated, instead of spending $100 to get this person into the office sooner. INSURANCE FAIL

The emergency room is the most expensive form of preventative care. I once transported a woman who demanded a pregnancy test. When I offered her the $12 to buy one she refused and told me to do my job and take her in to get the test. "That's what my insurance is for." she told me. No, Ma'am, it's not. And even worse, I know for a fact that the Docs that night gave her that test and anything else she wanted simply to avoid the possibility of legal action should our client decide she didn't get what she wanted. We give these Physicians powers to save lives and end them but tie their hands when it comes to rationing (ooooh buzz word) treatments they know, from being doctors, clients do not require. Let Doctors practice medicine, not constantly defend themselves from what could, possibly, maybe, one day, be a law suit. ER FAIL

So there we have it, CK's situation broken down and the failure found. That's the easy part, unfortunately. The difficult part is finding the solution that fits to make sure our client, remember her, is healthy. That is what this whole giant medicine thing is about, healthy people.

So do we ditch the whole for profit thing and go single payer socialized medicine? It might change a few aspects fo the system, but it will not make our client responsible for her own care. It will give doctors and paramedics more options for diverting her away from the ER, but in he end, CK is still right there in the middle of the night for the third time.

Can we tweak the way insurance companies bill, maybe have everyone pay a little? Still not changing our client's desire to be proactive and there is CK, sleepy and at her home.

Tort reform will surely change the way physicians treat, right? Maybe, but how can solving the problems in the penthouse fix the problems in the foundations? Insurance for the Docs will cost less, but will they pass along the savings back into the system or will there be His and Hers Audis? Not to mention our client is still calling the first time, even if we can convince her no to call the second and third times.

Advanced Care Paramedics and ability to refuse transport could help, right HM? That's only part of the picture and we're still going out there for the initial call and, likely having to return multiple times if they don't get what they want. How many times have you had someone wave you down demand meds and when you refuse they call 911 thinking someone else will return for them. Refusing transport only works if there is a framework we can plug people into instead of the ER.

The solution has to be wide ranging, sweeping and take into account every single aspect of health care from inoculations and birth control to advanced surgery and experimental treatments for advanced conditions.
There is no solution that solves all our troubles, but there is one solution that goes the farthest towards helping to take the pressure off the rest of the system.

Personal Responsibility. Taking control of our own lives and inspiring others to do the same. Get in the faces of your clients and impress upon them how they impact the system. Follow your protocols, do what is right, but point out to your clients the truth about what they are doing and remind them of ways they can access healthcare that isn't running red lights, putting lives on the line for a hurt foot. Be honest about the cost of your response, that if someone nearby is actually sick or actually hurt, they will suffer as a result of this abuse of the system. Nothing in the laws says you can't tell the truth. When people say "Sorry to bother you with this, but I didn't know who to call" take the extra 5 minutes, grab a phone book and show them who to call, where to go and how to get help. Then do what the law requires. Be nice, be supportive, but be honest.

Next time, if we can get people proactive about their care and encourage them to do the same for their neighbors, maybe our call volume starts to go down.

Lofty dreams of an overly optimistic Paramedic, sure. Ramblings of an EMS blogger, certainly. A simple first step towards positive changes in our profession...if no one else will, then I will.

Will you?

Hope you have a better night CK, and if it gets to busy, I'll bring 99 over and we'll cover in. I'd love to have a little chat with your client.
This post started as a simple response...sorry I got long winded. And Medic999 and my UK friends, I'd love to get your responses to CK's situation.

Monday, September 28

Are you already intubating TRAUMA?

The Crew of Medic 77 - Kevin Rankin as Tyler, Derek Luke as Boone in NBC's TRAUMA

The buzz is alive! NBC's "new hit" TRAUMA premieres tonight, as I'm sure anyone who visits these pages and others already knows.

Thing is I'm already hearing from my co-workers and others that the show is doomed to fail.
"Looks so fake." I was told by a fellow watching The Terminator.
"It isn't like that at all, that's not an accurate picture of what we do." Said the woman who adores CSI:Las Vegas.

My point here is that this is not a documentary about EMS, that Project got knocked down, this is TV. A TV show not unlike the one with the yellow family that hasn't aged in 20 years, or the genius doctor and his merry group of physicians treating the exotic, or perhaps my favorite show about spaceships and people that talk funny.

It's TV. This is not the Emergency! of our generation, we know that, so lower the bar of expectations a bit my friends.

TV Paramedics never seem to do well for two main reasons.
1. No one wants to watch a show about what we ACTUALLY do. There is no good TV value in watching me help a 45 year old man claiming to have an asthma attack scream about how much I abuse him every week, without a single wheeze. Boring. Funny in the moment, but boring. The magic we on occasion create, when a patient actually responds to a complex treatment is rare and over quickly, mainly because we tend to move quickly to definitive care.

2. They follow the characters home. In my exhaustive 10 minute research on the subject of TV Paramedics, I've found that each had a really good chance of succeeding until the story followed them home.

Case in point:
Paramedic Wyatt Cole from TNT's Saved was a great example of a Paramedic of the 21st Century. Apart from the whole "I graduated Medical School but I hate my father so I work on an ambulance" story line, he was a true caregiver who they showed actually caring. The show was clearly written by someone who worked in the field, since they had smelly regulars and a rival ambulance company pushing unwanted vagrants into their roll area. It was a fun medical show, but the home lives of the characters began to take up more of the show and before you knew it it was less of a Paramedic show and more of a show about a guy who happens to work in EMS.

Law & Order does so well because you know exactly what is going to happen every week. 30 minutes of Police doing amazing police things, a twist, an arrest, and then 30 minutes of lawyering. No homelife BS, no diversions, plain and simple. In the rare cases they do wander home, it's part of the case.

TV isn't meant to be real, guys and gals, it is meant to be entertaining. Tonight, when you're angry that someone did something WAY outside their scope of practice, or says something like, "Don't you die on me now!" take a deep breath and imagine Motorcop watching reruns of Chips, or Firegeezer watching Rescue Me, don't get upset if it's not an accurate portrayal of EMS in the US, heck from what I can tell it's not even an accurate portrayal of EMS in San Francisco.

TRAUMA is a TV show about Paramedics, not FOR Paramedics. If it was, it would be on the BBC or Discovery Channel and actually ride along with Paramedics. Wait a minute, I swear I've seen such a program...

I will be watching it here at the Angry Captain's place with an open mind and a hope for entertaining television. And even if it fails to make me cheer, I'll keep watching it because it has helicopters and explosions, which are never a bad thing.

112

One Hundred and Twelve degrees farenheit. 112. Last I checked cell walls break down around 107, but our caller swears her son's temperature has broken the land heat record. At 1 AM, of course.

THE EMERGENCY

A mother states her son is lethargic with a temperature of 112.

THE ACTION

The bells are loud at this station and I seem to have chosen a bunk directly under the speaker. I wander into my turnout pants and down the slide pole before I completely comprehend the dispatch information.

"Did they say 112?" the Officer asks as we climb in the $450,000 fire engine staffed by 1 highly trained firefighter, 1 highly trained driver, 1 new Officer and yours truly.

"Impossible," I say clicking my seat belt, "107 is as high as you go while alive. Maybe she's reading it upside down?"

Enroute dispatch advises the child is unconscious and they add a Paramedic Supervisor to the run. This town panics when kids are involved. As we arrive at the address we see the standard teenage girl flailing her arms in the street as if the houses weren't numbered in ascending order. Off the engine and bags in hand we're led to the third floor, past a woman screaming a foreign language into the phone and into a back bedroom where I see our young fire child.

Awake. And dressed, shoes and all.

"Is this the boy with the fever?" I asked as the firefighter checked the boy's skin.
"His fever is 112, I had to call you, I don't know what else to do!" Mom is crying to us as young "Danny" is curled up at the edge of the bed asking why my pants look funny.
"These are my fire pants. We brought our fire engine, want to see it?" simply wanting to see if he comprehends the facts in front of him, kind of a level of consciousness test.

"YEAH!" He shouts and is off to the races and down the stairs nearly knocking down the ambulance crew running up the stairs, Pedi bags in hand.
"How much Tylenol have you given him?" was the last question I heard as the ambulance crew pushed us out the door and back in service.
"None" was mom's response.

Danny was excited to see the engine, lights flashing in the early morning hours, even though he should have been fast asleep, tylenol doing its thing on his mild fever.

You Make the Call...Smoke Showing...What Happened

Seems every time we put a fresh pot of coffee on, something comes in.

In this scenario I was actually the eager young fellow out in front of the station reading the smoke in the early morning hours. I was beside myself when the boss looked over to me and told me we were out of service and there are other companies to cover it. But, the red stuff, it's...red and burning and hot and stuff. Huff.

My jaw was on the floor. I wanted to throw the radios back in our coats and head over there. I don't need my ALS kits at a working fire, that's what ambulances are for.

If you said hang back, you made his call.
However,
If I was in the seat that morning we'd be right back in service on the air and responding if we were due. I think most of us work in a place where if you can see the smoke, chances are you're due.

If you said get off your butt, there's a fire, you made my call.



A quick note on our You Make the Call series. There are often comments about not knowing my situation or my SOPs, etc, etc. The point of these situations is to get us thinking about what WE would do in our own districts with our own SOPs, staffing, equipment, etc. Don't wonder what I did, tell me what YOU would do. Hence the "YOU" Make the Call.

Sunday, September 27

Saturday, September 26

Rules for Covering-In

Different places might call it different things, but here when one company is called to respond for another, it is called Covering-In. Our dispatch system already knows who will cover for who depending on the severity of the incident. Most commonly used when greater alarm fires are transmitted, this system puts companies into the effected area to maintain basic coverage.

We are dispatched as follows: "This is a directed cover for Engine 99 to the quarters of Engine 77, Engine 99 you are now first due in place of Engine 77." And we head over to Station 77.

There are rules you should follow when covering-in.

1. Get the map book from the office and put it on your rig, after looking it over. Maybe you're lucky enough to come from a nearby area and know the neighborhood you're covering, but if not, become best friends with that book if you're the driver.

2. Cover the food. If they were in the middle of a meal when the bells rang, cover their plates and tend to the food left out. Do not eat the food, they're expecting it to be there when they return, so go out and get your own food.

3. Make up a hose pack. If your department has a standard strapped hose load, make a new one so the company can go back in service faster when they return. Make it up or ensure there is enough line to restock their pre-connects and get it ready.

4. Don't sleep in their beds. If you're stuck there overnight, you get to sleep in a chair. Do you want some stranger sleeping in your bunk? Didn't think so.

5. Secure the house and the yard. Make sure all the doors are closed and locked (and that you can get back in) and cars in the lot are secure. Goodness only knows what they were doing when the call came in.

6. Make a fresh pot of coffee. Also check for bottled water and put some in the fridge.

7. Post a night watch. This person will be pre-selected to answer the phone, front door and monitor the radio to wake the crew when the home company is returning. That way they return to lights on, fresh coffee and extra hands to help get back in service.

8. Check the washing machine and dishwasher. Do basic chores to make less work for your co-workers when they return, likely exhausted.

9. Keep a log of any supplies you use while gone, from coffee to medical supplies.

10. Before leaving, make sure there is nothing else you can do for that company including chores, dishes, cooking, anything. Pay it forward. Do onto others, etc etc.

Friday, September 25

A Tip of the Helmet - HIPPA Mad Libs

A tip of the helmet to Mack505 at Notes From Mosquito Hill.

The recent post joking about how a HIPPA approved EMS blog entry would look sparked a nifty idea over at his home blog.

Mack505 copied the [bracketed] items and sent them to friends as an actual EMS Mad Lib.

The first one came back and it is indeed funny. Give it a shot, here is the list of brackets.

[a location]
[medical condition]
[possible relative]
[partaking in a household task]
[he and/or she]
[mechanism of injury]
[an injury and/or illness]
[municipal service]
[a/an approved medical device]
[conveyance]
[patient care procedure]
[medical device]
[medical device]
[an approved setting]
[the appropriate button]
[a body part]
[patient care procedure]
[approved pharmacological interventions]
[Physician and/or Physician's Group]
[a secular receiving medical facility]
[an approved pharmacological intervention]

Replace your words into the text of the original post and send it to Mack505. Neat idea Mack, I like it and we might just do this again some time.

You Make the Call...Smoke Showing

Congratulations on making it through your first shift as the Engine Boss. Yesterday went well and here you are at 6 AM stripping the radios and whatnot from the engine as she is due at the yard for an oil change.

Just as you finish removing the ALS bags, defib, radios and headsets, a call comes over the radio for a reported working fire in the next district over. You are out of service for the yard, made the call not 5 minutes ago.

Not thinking much of it at first you go back to your morning paper. The first engine to go enroute on the air reports heavy smoke showing as they pull out of quarters. One of your firefighters has come running back in as you take your first sip of coffee and tells you it looks to be on the border of your two jurisdictions, maybe even closer to you.

"Are we going on this or what?" He has his pants and coat on.

You make the call.

Thursday, September 24

the Handover - 8th Edition

The Handover is alive! And for the next 12 hours my link bar will likely have all links to this edition, hosted over at Life Under the Lights.

CK has put together the funniest. calls. ever. and did a fantastic job. Anything with a one armed fisherman joke, sign offering a free cat and stories about human urination can't go wrong. Right?

Attention all Companies

In case you were unaware, you can also access the Happy Medic blog from thehappymedic.com, or happymedic.com.

If you currently access HMHQ from a bookmark in your browser, please take a moment to update the exhausting yourhappymedic.blogspot.com with a quick happymedic.com.

This will make it easy for you to follow along seamlessly should I finally decide to expand the blog into a full fledged site. Yes, that was a threat.

Also, keep watching for details on the England Paramedic Exchange "the Project" and dates for EMS and Fire Bloggers meetups both in the UK and the US. They will be in November, exact dates and locations TBD. Want to join us? Drop me an email at thehappymedic@gmail.com and I'll update you personally. Or at least my secretary will, if Mrs HM will let me hire Scarlett. *sigh*

In addition, HMHQ was linked by a publication for our advice on Disaster Planning recently, so that will continue early next week with tips on how to plan for an evacuation. Remember, this is all adding to our binder we started after agreeing to finally get that living will sorted out, so just keep adding to that binder and before long you'll be prepared for anything.

That is all.

Wednesday, September 23

A HIPPA Friendly Post

I was joking with a friend that instead of changing facts in these posts to make them safe and legal and such, I could just omit the information. I joked it would look like a horrible MAD LIBS. Sounded like a challenge. So here is a HIPPA approved EMS Blogger Post:

THE EMERGENCY

[There is no way to confirm or deny the existence of a medical emergency]

THE ACTION

We arrived at [a location] for a reported [medical condition]. The reporting party said their [possible relative] was [partaking in a household task] when [he and/or she] lost their balance, resulting in a [mechanism of injury] that caused [an injury and/or illness].

The [municipal service] moved quickly to apply [a/an approved medical device] and extricated the patient to the awaiting [conveyance]. In the back I started a [patient care procedure] and rapidly shifted gears to the [medical device]. I charged the [medical device] to [an approved setting] and pressed [the appropriate button]. The smell was intense. [a body part] had caught fire, literally, as a result of the [patient care procedure] despite my use of [approved pharmacological interventions].

Needless to say the accepting [Physician and/or Physician's Group] at [a secular receiving medical facility] was not at all amused at our predicament and immediately started [an approved pharmacological intervention].

Two Houses

Two households, both alike in dignity,
In fair Verona, where we lay our scene,
From ancient grudge break to new mutiny,
Where civil blood makes civil hands unclean.
From forth the fatal loins of these two foes
A pair of star-cross'd lovers take their life;
Whose misadventur'd piteous overthrows
Doth with their death bury their parents' strife.
The fearful passage of their death-mark'd love,
And the continuance of their parents' rage,
Which, but their children's end, naught could remove,
Is now the two hours' traffic of our stage;
The which if you with patient ears attend,
What here shall miss, our toil shall strive to mend.
Shakespeare's Romeo & Juliet, Prologue

Two Houses.
EpiJunky

Capt. Schmoe


I do believe an ancient grudge is boiling to a head.
A grudge born from a time when what we do was still a mystery, a trade, an idea whose time was overdue. The fact that this new idea took root in a large municipal agency has led to many today misunderstanding why it was put there. Some have seen the big red machine have little effect on their company's ability to provide excellent service to their community over decades.

There is a battle raging in some systems between these two houses that has no winner, no finish line and no perfect solution.

We are the children of a time of confusion and reaction. The machine struggled to defend their size and mission. In no way am I suggesting that the children of the two systems will unite and die to finally get the parents to stop quarreling, as Shakespeare tells, but I now believe that my current role may in fact be that relationship. A combination of the two houses that was not properly vetted or thought through and was doomed from the beginning.

The meeting of fire and EMS for me is a natural fit. I don't see things in the contrast of Montague and Capulet but shades of Verona Citizenry. Fire based EMS makes sense to a point, but I've seen it taken so far past that point in some places, we're starting to finally turn on one another.
To quote James Andrews from PCU - "It used to be the Administration's job to make the rules. It used to be us against them, now its us against us."

The cousins of both families are at war because we take the least of each and apply it as the rule.

We're better than that. Those we make example of may not be "us", but the folks that take the time to even type EMS in the google search bar are miles ahead of those bringing the meaning of what we do into the gutter.

Fire engine, ambulance, squad, pick-up truck, volunteer, whatever capacity you provide you service, we should all be striving towards the same goal of providing the best possible service to our clients and patients, leaving all the political BS, name calling and ancient grudges outside. It doesn't belong at the scene, it belongs here, in the channels of communication we have opened when others failed.

It is here, in this new medium, we can have an International discussion about what to do next, instead of raising our voices in front of the people who call for help, not caring what color uniform walks in the door, or who pays the salary, just that help comes.

So vent my friends, get it out. Write a post out of frustration, erase it and start over again. Each version calming your anger and settling your frustrations.

Share your experiences so that those new in the business can learn what a true caregiver looks like and those who may be slipping can catch themselves before they fall.

Tuesday, September 22

Losing Independence

Not a political post, I assure you. This is about a section of the population that needs to come to terms with their limited abilities. And to remind PAs that I am in charge of patient care at a scene.

THE EMERGENCY

Caller states there has been a car accident and one person appears shaken up.

THE ACTION

Shaken up. OK. Out the doors and a few blocks down we see a large SUV into a light pole, newspaper machines and trash cans in the sidewalk, 2 parking meters down for the count and a little old lady seated behind the wheel of a little hatchback behind the SUV.

Blink. Blink.

The SUV was empty and parked, our little friend is alert and oriented, sitting behind the wheel, clearly upset at what has happened. I think she would likely get out of the car and be fine if it weren't for the half dozen samaritans encouraging her to go and get "checked out."

I introduce myself to the group and they all start to tell the story, each pointing different directions and saying different things. Quickly, I duck down and make contact, she is not injured and has no complaints. She describes not having parallel parked in years, let alone on a hill like this, and hit the gas a little to hard backing up (she points over her shoulder to the uphill parking meter). Then she gunned the gas a little too much instead of letting the car roll forward. (She points forward towards the mess down the hill). When she realized what was happening, she tried to hit the brakes, but her foot was still on the gas. She pushed that SUV right up off the street and onto what is usually a crowded sidewalk.

As I completed my assessment and she blushingly refuses an ambulance, a man approaches to ask me if she had a TIA.
"I don't think it appropriate to discuss her condition with strangers, do you know this man?" I asked her seeing her shaking her head.
"I'm a PA," he advises, removing his sun glasses, "Are you OK Dear?" He asked her as if talking to a three year old.
"Sir, I have this scene under control, and she has a name if you'd care to ask." Was my smart ass response that got his attention off of her and onto me, as planned.

"You guys sure have a lot of attitude," he observed looking me up and down, perhaps looking for my Registry Certificate, State and County Licenses, 48 hours of continuing education, Bachelor's Degree, instructor's certificate and years of assessments. I keep them in my other pants.

"I would have her checked out if I was you." And away he went, placing his sunglasses back on as if nothing was wrong.

"Who was that man?" my client asked looking up at me from the seat of the car, holding her insurance information and license.
It was then that all the BS around that man faded away and I saw what was going to happen to my friend. There is no way her insurance rates will stay affordable, likely resulting in her losing the car. The freedom she has known for close to 70 years of driving will be gone. Then she'll have to walk to the market, that is until her knees give out. Then she'll be stuck at home. And the PA so concerned for 80 seconds will never stop by to lend a hand.

Monday, September 21

Milk dripping from my nose

We added a new CE source awhile back and they recently earned a permanent spot in the CE group.

Take a big sip of milk and click on this link to the most recent post at Ugly Things for Sale entitled, "There is nothing about this post I don't like"

I haven't laughed like that since they tried to convince me the King tube is better than the combitube.

This is good for 48 CEs for the author of that blog.

LATE EDIT -

Speaking of CEs, I've added Rogue Medic to the Mutual Aid Board, but will also give CEs for his insightful posts and unyielding desire to CITE HIS SOURCES when making an argument. I find people who make claims they can back up fun to read and great to learn from.

By the way, your CEs are only good for your Happy Medic refresher, so no more emails asking for the certificate provider number for your National Registry. Even though I'm sure they were a joke, I just wanted to set some ground rules for you new folks. Both of you.

Last call for the Handover

CK at Life Under the Lights has sent out the last call for submissions to the Handover. This month's theme is "Funniest. Call. Ever." Grab a link to your funniest call and send it to him for inclusion, but hurry, today is the deadline.

You Make the Call...Advertising...What Happened

Well, well, well, your flirting has finally caught up with you, eh? (Thrown in for Little Girl)

This situation called for either disregard and hiding or coming out into the open. Or blaming someone else... Where is MC when you need him?

I chose to come forward and tell the brass about the situation, in person. When I walked into headquarters and into the Chief's office I was met by a familiar coffee cup on the desk and knew everything was cool. We talked about how parking in front of the shops we frequent can send the wrong signal and that we were of course allowed to patronize appropriate businesses.

In the end it could have gone either way with the same result, I think there was some pressure from City Hall as to why one of "their" rigs was in an ad without their permission.

There was no such outcry when a local insurance group used a shot of one of our rigs in their ads proclaiming quality care by their services.

If you said be honest and get out in front of this thing, you made the right call.

Sunday, September 20

Sunday Fun - Dinner, dinner, dinner

Three of my favorite words in the firehouse are:

Jumped - You are relieved, I'll jump a call if you get one.
Box - A reported fire.
Dinner - No explanation needed.

Stuck for a recipe for tonight? Try this site, FireHouse Chef dot com. Each recipe gives the member who submitted it and there are a large number.

Even something for my bacon loving friends:

Border Bullets - For Those Who Like it "HOT"

  • 12 large jalapenos or how ever many you want to make.
  • Cut the tip or small end off of the jalapenos leaving the stem on the other end.
  • hollow the jalapenos. ( we use a potato peeler )
  • Fill jalapenos with cream cheese.
  • wrap jalapenos with bacon holding bacon in place with toothpicks.
  • Broil in oven until bacon is to your liking.
  • remove, let cool and eat.

Recipe by Firefighter: Phil Burrow - Alva Fire Department, Alva Oklahoma

Do you have a favorite recipe? Post it in the comments and you'll have another place to look for recipes.
And don't forget to stop by our friend Mrs Fuzz over on Fuzz Food for other ideas.

Saturday, September 19

Onstar?

I was asked by a client recently if this Onstar really works. The idea is that the sensors in the car send signals to the company who calls 911 in the area and relays the information.




I was wondering if anyone out there has responded to one of these automated calls and how it came in. Was the information accurate? Did it make a difference?

Friday, September 18

You Make the Call...Advertising

A couple weeks ago you were at one of your local coffee spots enjoying a fresh, brewed just for you, cup of caffeine when you commented to the clerk, whom you fancy, how much you love the coffee there.

"These keep me awake to save lives" you half joked, half hoped she was single.

The bells rang over the radio and away you went on a call, not giving it a second thought. You've been back every shift, so has half the fleet.

Yesterday morning the newspaper has a new ad running showing your ambulance parked in front of the coffee shop with your quote in large block letters. Medic 99 clearly visible on the side.

This morning a memo is out asking those responsible to come forward. Your Department's policy on endorsing products in uniform is clear: No.

After sipping the last of your coffee, your partner asks why you turned red. You make the call.

Wednesday, September 16

No one wins

The dispatch is for an unknown medical aid.

I press the button for the rickety elevator, wondering how long the trip up to the fifth floor will be.

"Mid 40s female...overdose," the Fireman says.

I pause

"Early 60s male, respiratory issues," is my reply.

"Lunch and dinner?" He asks, hand outstretched.
"Lunch and dinner," and we shake hands as the elevator opens and we pile in.
The ride is shorter than we expected, and we made it all the way up.

As the door rumbles open there is a distinct odor of urine and an open door just down the hall.
"In here!" a tired male voice calls. I turn to enter the little room and see, on the bed, a man in his 60s having trouble breathing, holding onto a woman in her 40s with an altered mental status.

"Well that was anti-climactic" the boss says and we go to work.

Later that night we bought each other's meals just to keep the spirit of the game going.

Tuesday, September 15

Holy anhydrous ammonia Batman!

You need to stop what you are doing right now and click over to Life Under the Lights.

This is not a drill.

Disaster Plan - Supplies

I've gotten a couple of supportive emails about the Family Disaster Plan we've been slowly building, so I'll try to add a section or two every couple of weeks.

This new section is about supplies. Not necessarily MREs and climbing gear, but re-purposing some basic household items to be used in case of a disaster.

We'll need some bins. Buy your supplies first, stack the items together, then buy bins that will fit your stuff. Don't try to cram stuff into bins after the fact.

First, let's talk water. You will need one gallon of water per person, per day. That means at least 12 gallons for my family. When you get the water home look at howe much space it take up not only in the house, but in the parking lot at the store. Keep this space usage in mind since if you need to evacuate you'll need to bring it along. (Water does not go in the bins)

Next, let's talk food. I recommend one can of food per person, per meal. This means a family of four could share 2 cans of chili a vegetable and a fruit as an evening meal. Include canned foods, nothing that needs to be refrigerated, and things your family will actually eat. The side of the road in the middle of the night is a bad place to try to introduce spaghetti Os to a finicky 3 year old. Check the expiration date on the cans and make sure they'll make it to next year around Christmastime. When they near expiration, replace them and donate them to one of the many canned food drives. Instant karma.

In addition to the cans, we'll need some variety. Add in a box of unsalted crackers, a package of juice popsicles unfrozen (Like OtterPop Brand) and a handful of candies. This will keep the sugar level up and add some yummy flavor for the kiddos. At the store, find some 12oz V8 cans and add 3 per person. This is your breakfast and is also a great source of vitamins.

Avoid pasta, ramen, anything that requires water to cook. You need that water for drinking.

Now, onto the cooking of the food and the sheltering while away. We'll cover how and when to evacuate later, let's get our supplies together first.
Do you go camping? Do you have a tent, camp stove, flashlights, candles and a decent little stockpile of utensils and the like? Then great, you have a disaster kit almost ready to go. Move all you camping things together and into a place that can be easily accessed in a hurry. This will be your home if you need to evacuate. Especially if you are leaving with your pets since many shelters will not accept persons with animals, camping allows you to chose who you bunk with. Re-read the instructions and cautions on your cooking stove to ensure you always use it in an open area.

Just a few more things for our bins. Each bin now gets a can opener, 2 large trash bags, a small box of ziplock bags, a roll of duct tape, a package of baby wipes and an emergency radio/flashlight. You can find a variety of models to choose from, but I recommend one that can run on batteries, solar and dynamo power. It should include a flashlight and radio and some even offer adapters to charge a cell phone. Each bin gets one along with an old cell phone with charger cable. As long as you can transfer your card into the old phone, you're good to go.

If you have really little ones, add formula and a bottle set up to each bin and remember to update the food choices according to age.

There, the basic bins are ready to go. Whether it fits in 2 or 3 or 4 bins, be sure that the supply can be split if needed, one group taking enough for them while leaving enough for others. Store the bins so they are easily accessible, maybe with the camping gear and you'll have everything you need in the same place.

Write down what items are in each bin with their expiration dates and place it in the binder in the back. Update it every year before the holidays along with the photos on the front page.
Not sure what I'm talking about? See where this all started at our first adventure into Disaster Planning HERE, ans follow up HERE to learn even more.

Next time we'll talk about when and why to evacuate. Until then, be prepared.

Monday, September 14

It's a funny squeaky sound

You need only watch the first 20-30 seconds of this for the following dispatch to make sense.



Aunt Bethany from National Lampoon's Christmas Vacation is a favorite at HMHQ. It isn't Christmas until Clark W. Griswald and family go through their annual disaster. I was temped to hold this post until the Christmas season approaches but I had to share this remarkably appropriate use of resources.

THE EMERGENCY

The caller states she hears a "Loud squeaking sound" from her basement.

THE ACTION

Did I mention that I am so creative I have imagined every single one of these posts? None of them is rooted in any reality whatsoever, I'm that good.
Oh I wish I made this up.

The engine and truck companies arrive on the scene, code 3 I might add, to the large apartment complex where we are led to the unit of the reporting party.
"It's a loud squeaking sound" she tells us, causing me to smile recalling Aunt Bethany.

We head to the basement where we find a hot water circulator pump with what sounds like fried bearings. We explain that we can turn it off, but folks up on the upper floors may have to wait a while for hot water.

"I can't sleep with that sound, turn it off." she tells us and turn it off we did.

It was back on the sidewalk out front as the ladder came down (why not have a quick drill?) when a passerby asked me what the trouble was. When I told him what we had found he stopped dead in his tracks.
"Are you [expletive, deleted] kidding me? They called 911 for a noise? Are they retarded?"
"Sir I can make no statements as to the mental well being of our clients, what with privacy concerns and all."

He smiled and went along his way. I, unfortunately, had 14 more calls to run before that shift was over.