Thursday, December 29

Happy Awards 2011 - Best Gear

Easy.  Rip Shears.

Tell me you got a set of Rip Shears after my glowing review.  If you carry a pen (2 actually) you should be carrying a set of Rip Shears.

I still carry and will always carry a Rip Shear when in the field.  Sadly, it seems out of place at my desk now that I have a staff job.  But it makes IT think twice about questioning my format on the RCSQL server reports.  What?...

Wednesday, December 28

Using Siren Doppler

Near the ramp that leads to the Golden Gate Bridge is a National Park area under construction.

No, that's not the right term.

It's torn up in 50 different ways in 50 different places by no less than...wait for it...50 different contractors.

Late one night we got a call for a hiker down.  I too heard Mike Myers character from So I Married an Axe Murderer..."We've got a piper down" but I digress.  Since it was a cell phone call it was routed through the Highway Patrol to the National Park Police, then finally to the rescuers with the SFFD, meaning e very detail from the caller has made it to us, the rescuer.  I'll give you a moment to stop laughing.

The location was given as follows:

"Near the base of the bridge, fell down, near a fence."  Oh, well there you go then.

That literally describes the 1/2 mile leading up to the bridge in all directions, including water.  When we asked dispatch for more information they obliged by reading back to us what was on our screen.

A quick aside for our dispatcher friends:  If you have nothing further and do not still have the lost hiker on the line, don't read us back what we already know.  Simply tell us you have nothing further and are trying a call back.  That's all we really need.

With police, us and an ambulance searching roadways near the bridge I realized we had the caller's cell phone number on our screen so I pulled out my phone and called.  When the hiker answered I could hear our siren in the background.

Then as the ambulance approached from another direction I was able to gauge proximity to the rigs.  I'm sure you remember this skill from Paramedic School.  It was after Cardiology but before pediatrics.  Our federal Q was closer than the ambulance's electric siren, so we had them slow and approach our location.With our knowledge of the construction area and the vague description of the hiker's surroundings "rocks and a fence" we were able to roughly estimate where they were.  A few minutes later, there we were, face to bloodied face.

The hiker thanked us and mentioned, "I was wondering if anyone was going to call me back or not."


Sunday, December 25

Happy Awards 2011 - Best Conference Event

A few years ago a couple of guys net up for a trans Atlantic EMS exchange. Maybe you heard about it. A big reason that happened was the early support of ZOLL Medical.

As part of their sponsorship in what Mark, Ted and I were trying to do they invited us to their booth in Baltimore, where we began to expand the #CoEMS family face to face. However, few realize, that the night before the conference we met for drinks with Charlotte and Blake from ZOLL to discuss what we all hoped to accomplish.

Being the social media whores devotees we are, we both tweeted our status and checking in on Facebook.  Literally minutes later we were joined by a few bloggers who happened to be in another part of the restaurant, saw our update and came over to say hello.

And that is how the ZOLL Pre Conference Blogger Bash was born.

Each year Charlotte and the folks from ZOLL but together a little event to recognize the power social media has in bringing EMS providers together and the sharing of best practices.  It is by far the best event at the conferences, even though it's smaller and less flashy than some of the other fare put on when thousands of EMTs descend on these poor cities.

And in case you were wondering WHICH blogger bash I am referring to, it was a tie for Baltimore and Las Vegas.  And in 2012 I suspect yet another tie.


Thanks for making me smile ZOLL!  See you in Baltimore!

Saturday, December 24

Magnum Boots needs you to LIKE them

No, seriously.

Click that big image. LIKE Magnum Boots on Facebook (why haven't you already?), then LIKE their status update about the 12th Day of Christmas. Total time: less than 30 seconds. Impact: $1 to a worthy charity.

After you LIKE it I expect you to share it on facebook and twitter. They should reach this goal by lunch.

Merry Christmas from HMHQ!

Wednesday, December 21

Happy Awards 2011 - Best Small Business

When Motorcop and I dreamed up Kilted to Kick Cancer over a Guinness 2 years ago we never knew the impact it could have, we were just looking for a reason to wear our kilts more often.  Then TOTW informed me of the risks of prostate cancer and we were off to the races.

Along the way we sought out sponsors to help us spread the word.  Some were less than receptive, telling us they were too small a company and that the economy was too slow for them to help out in any way.

Enter Alt Kilt.

The definition of a small family company, they make a product that isn't exactly flying off the shelves.  Especially since each kilt is hand made.

But their own story with cancer explains everything.  September is also Childrens' Cancer Awareness Month and Alt Kilt is a big supporter of any effort to find a cure and spread awareness.  But that wasn't enough.

Alt Kilt's enthusiasm continued with discount codes, gift certificates and kilts for MC and me as well as rush orders for many many others.  They could have very easily said no for the same reason other larger companies did, but there was a connection that went beyond the bottom line.

I think it's obvious by now that the Kilted to Kick Cancer effort made me happy this year, but it was the support of people who believed we could do it that made it all possible.

Alt Kilt, you made me happy in 2011!

Sunday, December 18

Happy Awards 2011 - Best New Blog

EMS blogs pop up all the time, write a few posts, then suddenly nothing.  Maybe they got caught, maybe they got bored, maybe they forgot.  One day I read a post from a new blogger calling their site Captain Chair Confessions.  The style was right up my alley and the stories were so familiar I felt an immediate connection with the author.

The frustration, the angst, the sheer hair pulling insanity that can only come from being in EMS for more than 20 minutes in a system or with a partner or in a place that just doesn't get it.  It's there.

Also there, if you read carefully, is the withdrawing of a burn out in progress.

I think CCC, as they call themselves for short, has been saved by this amazing therapy experiment called blogging.  Even though the political stuff can get heavy from time to time, it is CCC's forum and I can skip a post from time to time, but rarely do.

CCC, thanks for making me smile this year and good luck in the future!  I'll be reading!

Friday, December 16

Tip of the Helmet to Radio

Every single time I have been sent on a wild goose chase by radio based on a cell phone caller's brief description of something fanciful has been erased from my memory ( OK, most of them. Well, some. Alright, the last 2 dozen)because of something they did recently.

Something that got them a phone call from me to say thanks.

I'm in the Captain's buggy for the night and having a decent string of interesting calls when my screen comes alive steering my towards a reported suicide.

The text of this run reads like a teenager's text message both in content and presentation.

In part shorthand is a scenario describing a person who's son was online with another person who told another person they were going to kill themself and that a fourth party had supplied certain pharmaceuticals to make that request a reality.  Did you follow that?  Imagine your kid comes in and tells you Bobby saw on facebook that Jimmy said Ed was going to kill himself.  Now imagine you're telling 911 that.

On scene with half the police watch (with beanbag gun!), an engine and one of my favorite ambulance crews, we're wandering the laberynthine apartment complex looking for the unit in question.  Radio shoots back with a corrected unit number which sends us in the other direction.  For those of you not in the business, this is one of the first giveaways of a BS call.  Radio advises us they're on the line with the cell phone prodiver who is actively pinging the phone and is giving a 91% probability the phone is currently inside the billing address.  They can do that?  Yup, they can do that.  Whether or not the owner of said phone is there they're still in Beta testing on I'm told.

We finally find the unit in question and wake the occupants only to find they did not request us.  As PD turns to go the medic asks an important question:

"Are your children at home?"

They look at each other and then back into the unit. After a brief pause they answer with a question, "yes? why?"

PD's ears are up and they're in the unit faster than you can say exigent circumstances.  They search the unit and find our patient semi-conscious, deep under the influence of medications supplied by a friend.

He had snuck out, ingested the medications, then snuck back in to drift into the ether, but not before sending out a cryptic message on social media that was seen by someone who cared.

That person told their friend who told their parents who took it serious enough to call 911.

And my dispatchers took it serious enough to dig around and find out where the patient was and get us there as fast as they could.  And it made all the difference in the world for this family.

I tip my helmet to the voices...


Way to go, Radio!

Tuesday, December 13

Happy Awards 2011 - Best "Yes!"

Those of you who were around for the Kilted to Kick Cancer events know what a huge role Magnum Boots played.  Motorcop and I went to their factory one day and sat down with their team and simply pitched the idea of a few medics, cops and firemen wearing kilts to raise awareness about prostate cancer.

Before we had a chance to get nervous, they responded "yes!" and followed with "What do you need from us?"

We were just hoping for someone with a wider social media reach to help us spread the word.  Next thing we know Magnum has their marketing/social media Goddess Alexis in T-shirts and with hand outs in Las Vegas for the launch a mere 30 days later.

It would have been very easy for Magnum to squirm in their chairs and tell us the economy isn't looking good or that they were too small a company, but they jumped in with both feet and were instrumental in helping educate hundreds if not thousands of men about their own risks for cancer, and had a hand in helping to raise over $11,000 for the cause.

Magnum Boots made me Happy in 2011.

Sunday, December 11

Coming Soon - Happy Medic Awards 2011

Last year I awarded Rescuing Providence  my Blog of the Year Award.

2011 was filled with so many things that made me happy I have decided to expand the award from just a single blog to cover my entire year.

I considered letting you vote in each category, but then it would be your award, not mine, so I've kept the balloting secret.

As December marches on you'll see random postings of awards for events/products/companies/blogs, there is no restriction on who or what is included.


Coming soon - Things that made me Happy 2011!


Winners receive my heartfelt thanks for making my year better by putting a smile on my face.  I have no prizes, no sponsors, no begs for votes, just a thank you and a little golden Happy icon.  And of course bragging rights.  That's a big deal where I come from you know.

If you have something that made you happy this year, share that experience with your friends and social media circles!

Friday, December 9

Meeting the parents

I have been told by many a patient and parent that our mere arrival at a scene calms folk.  As if we were the reinforcements sent for by the last surviving members of a forward squadron, pinned down by enemy fire.  They hear our horns and calls and smile, because we've arrived to make everything better.

But what do we do when our reinforcements fail to turn the tide of the battle?

I've written before about dealing with parents when their children are under your care and we've also discussed the proper way to deal with death notifications, but what do we do when the two situations are the same incident?

A widow is someone who loses a husband, an orphan has lost their parents but there is no term for a parent that loses a child.  And for good reason.  It is one of the things we don't talk about at dinner parties or at the water cooler.  Losing a child is unimaginable.  There are no words that a Paramedic could tell me that would make me come to terms if my own children had died, so finding the words to tell a perfect stranger may leave us stuttering and stammering.

Falling back into the old comfort zone of "They've passed" or "They're gone" will only get us into more trouble, as we all know, so be ready for the moment when all your efforts have failed.  It's nice in PALS when every kid's rhythm changes, you got IV access on the first try and other difficult situations are handled on a prop or verbally, but we end it there.  When was the last time your instructor played the part of the distraught parent?

During an emotionally charged call as the paramedic supervisor I contacted the mother of our patient in the next room to ask about past medical history and a lot of other things she didn't want to talk about.  As she just began to calm I told her our standard "We're doing everything we can right now..." when she hit me with a whopper I wasn't ready for:

"Everything is going to be OK because you're here now right?" the pure desperation in her voice was outdone only in her cold grip on my arms as she turned me square to her and looked into my face.

It is very important to be completely honest and leave no room for parents to begin to interpret your statement to mean something it does not.  If they ask you what you're doing, don't answer with the gauge of needle, but instead simple terms they can understand like, "we're giving (the child) medicine and fluids and carefully monitoring their reaction to it."

This mother asked me 2 questions I had received in various forms, but never this clearly.  Just as she asked "Is her heart beating?" my mind began to say "no" just as my mouth uttered "We're beating it for her."  "Is she breathing?" was met quickly with "we're breathing for her." and the rest of the conversation revolved around everything we were doing FOR her...not TO her.

Focus on what you're doing to help, not procedures you have done to them.  Take the clinical edge off of your interventions and make it easy for a frightened mind to begin to understand and a breaking heart to come to terms with.



Wednesday, December 7

the Crossover Episode 18 - Where's your car dude?

The boys are back in what can only be described as their Christmas Show.  They discuss how to stay safe when out shopping, what a cassette tape and a pencil will never show our children and why the Elf on the Shelf might just make up for it.


Motorcop from joins me for another 45 minutes of the internet's only Police/EMS/Fire podcast!


The show is now barely legal.  That alone should get you to click play!


Friday, December 2


I never thought it would happen to me.

Her hair was the deep brown of the earth after a summer rain, her perfume completing the vision of a forest in bloom.  The dress she wore, orange and yellow patterns accentuating her curves, hiked up her legs as she arched her back slightly.  Eyes closed and head turned away, her hair covered part of her face which exposed her neck.  I approached slowly, her high heeled shoes nearby a prefect color match to her dress, and I am suddenly excited when I see her take a deep breath and slowly moan.

I lean down, my lips near hers and turn my head.  Eyes still closed she's moaning quietly as if scared to make too loud a sound while we're together.  If her parents hear us, she could get in a lot of trouble.  She's not supposed to be here with me, but right now neither of us cares.

Sitting back up next to her I move my hand along her jaw to her neck, then brush the hair away from her soft face.  A quiet moan escapes her lips as I reach to see her eyes, those brown eyes.  Her eyes are closed as I beg for her to open them like a child wishing to open a present on Christmas Eve.  Alas, she would not give me the satisfaction.


She's not from the area and came running up the block waving her arms swearing to anyone who will listen that she was having a seizure.  She is one of the rare few who have likely seen a seizure before since a neighbor familiar with the conditions that cause it swears it wasn't a fake.

I have my own opinion.

As we approached her breathing was shallow and for a few moments I was afraid she had stopped breathing completely.  My thoughts were on the road of CMS Depressant/Narcotic and I was about to reach for the ambu bag when the moan escaped.  Not the moan of deep inspiration and awkward exhilation as heard with postictal and hypoglycemic patients, but an attention getting moan seen on late night cable TV.

The other rescuers and I shared a glance of confusion.  I reached down to listen to her breathing and smell for alcohol or keytones and felt a pulse.

She pulled away ever so slightly when I leaned in, clearly awake and the decision was made to check her pupils.

And she held her eyelids shut.

I have never met an unconscious person able to do so and I leaned in and whispered this information to my new friend and almost like magic, she was awake and talking.


Almost had me fooled.  Almost.

Sunday, November 27

Internal Affairs

As part of my new role, I also wear the hat of Risk Management.  This means that all complaints and reports of medical errors come through my office.  It also means that I get all the "He said, she said" crap that comes with EMS not being accepted as part of the patient care team.

Surprisingly I have received more than one report of a crew "not giving notification via radio" from a hospital.  This often happens when the person who answered the radio was unhappy with the report, lost the triage slip and is in trouble or that the crew simply didn't make the call.  It happens.  Sometimes we're busy with a little thing called patient care and our partners driving should not be distracted by talking on the radio while driving if we're that busy.


Now for the best part: The investigation.


I go over to the computer and pull up the crew, date and time, review the chart and get a feel for what was going on during the call.  Most importantly I look through the timeline of interventions to see if there was time to make a call, and then I script what my report would have sounded like.

Then I go over to the fax machine and pull out a Request for Radio Traffic Form and pull the tape.

Much like politicians, I think some people forget that everything is recorded these days and simply saying "No they didn't" can be proven wrong in as little as 24 hours.

When that CD arrives and I listen to a pretty good radio report matching the patient I just read about, then hear a voice aknowlege it I feel great.  My guys did the right thing and I get to play that sound clip to the hospital.

Of course it's also a drag when I get an email from radio that states "No traffic exists for specified date/time, please check."  Then I can't confirm what really happened and have to be the bad guy.

When your CQI calls you on the phone or into the office, it's not because of some sadistic desire to torture you (despite how much that seems to be the purpose), but because we can no longer find evidence to support your version of events.  I have already been able to deal with most of the complaints that come in by reviewing your documentation, your previous documentation to ensure it wasn't a fluke, and everything else available to defend your care and demeanor.

Sometimes you just plain screwed up.

Make it easy for me:

Do what's right, write down what you did, tell the right person when you get there.


They'll still complain, but at least I'll have the ammo to defend you.

Thursday, November 24

Black Friday Ambulance Deals?

An Ambulance company in Fort Worth, Texas is taking advantage of the black Friday mentality and offering discounts in ambulance services early on Friday morning.

"It's a chance to break into a section of the population that might not normally think of us" said Bill Lockheart, Manager of Forth Worth's seventh largest ambulance service provider, Fort Worth Ambulance Group or FWAG. "If they need us, we're there. But if they need us between 4am and 10 am Friday morning, it's going to save them 25%."

Mr Lockheart is not alone in his thinking that savings on goods and services should not be limited to the big box stores and items manufactured in China.

"I call them every week for my asthma," says 33 year old mother of 8 Stephanie Johnson, "If I can get a discount on Friday morning, that means less Medicare I have to pay." Ms Johnson was unable to provide documentation to that effect.

Bryan Stevens, a 66 year old diabetic from Galveston was visiting Fort Worth when he heard of the discounts. "Well by golly, have they no shame.  It's a service for emergencies, not for profit.  I remember my early days as a lad in the..." We cut him off because we saw 40 year old Ted Remmit, an unemployed employment expert who called the Forth Worth Ambulance Group at 4:15 this morning with a sore thumb.

"I pay taxes, this is a service I 'm entitled to.  You can quote me on that."

Wednesday, November 16

Report from the Trenches

Only on the front lines can you tell where the bullets are coming from.




To say I might be in over my head is an understatement.  To say I thought it would be worse is also an understatement.

This is an entirely different world.  My commute is twice as long as it was 6 months ago when I first tested it, or maybe since it's an everyday thing now it just seemed half the time before.

I wake at 5 to make the train by 6 so I can do research till 7 and make the office by 8.  Then I have to time my departure to make the train right before the tens of thousands of others exiting the City at closing time.  It's different than wandering into the fire house after an hour and 20 minute drive.

That's the only drawback so far.


I realized on my first morning of reviewing charts and advanced interventions that I am now responsible for more than my own patients.

To borrow from the meme, "I get ALL the patients!"

Seriously. I am able to act in the best interests of each and every patient this system comes into contact with.  Sometimes that will mean counseling a provider or defending them from an MD unclear on the concepts of EMS.  Other times it will be discovering where we're not doing enough and finding the evidence to show it, then provide solutions to the command staff.

Some they will embrace, others they will reject.

I am not here to change the world for myself or even EMS, but for each and every person in my City who calls for help.  That is my new goal.  Not a 20 minute intervention, but a 20 week analysis of their experience and outcome.


Bring it.

Sunday, November 13

Overheard on vacation - the Barber

A cop walks into a barber shop looking for a haircut.  As they discuss the news of the day and the weather, the topic turns to his line of work.

"What do you do?" the barber asks.

"I'm a cop."

"I admire what you men do, I'd like to give you this haircut for free." the barber says and the cop reluctantly agrees.


The next morning the barber can't get into his shop because there is a large box of donuts and a card from the cop.


As he walks in another man takes a seat for a haircut.  As they discuss the news of the day the topic once again turns to his line of work.

"I'm a paramedic." the man replies.

"I admire the work you do and I'd like to give you a free haircut as a thank you." the barber says and the Paramedic agrees after the barber refuses his money a third time.

The next morning the barber can't get inot his shop because there is a box of bandages and pamphlets about staying healthy.

Soon after another man walk in and takes a seat.

As the topic turns once again to his work the man replies, "I'm a fireman."

"I admire the work you do, I'd like to give you a free haircut."  And just like the others he reluctantly agrees.

The next morning the barber can't get into his shop because there is a line of fireman around the block.



Told to me by a retired fireman who served not 30 miles from me growing up.  Met him on a cruise ship in Canada.  Go figure.

Thursday, November 10

A Whole New World

On a summer day back in 1996 I walked into the trailer at the Isleta EMS and Fire Station and began my paid career helping people.  I have worked a variation of a 24 hour schedule ever since and it has become second nature to be away from my family for long stretches in exchange for a few days in between.


That will make Monday all that much more interesting.


On Monday I hang up my turnouts and late nights without sleep in exchange for a promotion and a reassignment downtown.  That also means giving up that ever so comfortable and vacation friendly schedule.


I was bummed at first until I realized that now the HMjrs are in school and we can't just pick up and go somewhere whenever we feel like it anymore.  When this job at headquarters opened up it seemed too perfect a fit.


Monday I will take over the vacant CQI position that has been retooled ever so slightly to now officially include research.  Talk about a perfect chance to mine the data to see what is really going on out there.  I have lofty goals for my service, but it's going to be a long while of playing catch up and learning the new job before I can start going forward with new ideas.  I also have a new political landscape to consider and will be in direct contact and communication with the regulatory agencies, budget writers and vendors that all have a stake in patient care in my jurisdiction.


It's an amazing opportunity for me both professionally and personally and I am beyond excited to get started.


About the blog...

There will be a slow tapering off of 911 stories, I've got quite a few more half written and half anonymized just waiting in the wings, but there will likely be a shift in what I share.  My EMS 2.0 rants may well turn into updates about what I'm dealing with in that little office downtown.  I won't be changing the name of the blog to Happy Captain (or Happy Cappy as MC suggested) since this is about my therapy, not necessarily an accurate mirror to my own life.

I now join the ranks of Sparrow, Morgan, Crunch and Stubing, to name a few.


Thanks for all your supportive messages on FB and Twitter.


-Captain HM  ;)

Monday, November 7


Rogue Medic is in a great mood as of late and this article about the complete joke that is Mechanism of Injury (MOI) hits the nail on the head.  I recently had to triage a car over a patient because of strict trauma guidelines, luckily finding the always available "Paramedic Judgement" to wiggle my way out of it.


The simple point is this: Mechanism needs to be a symbol on a map, not the destination.  With cars designed to crumple around our patients, what if it does take 30 minutes to get them out but they are unharmed?  And the pedestrian clipped by the mirror on the arm by a passing car at 40MPH?  Why are they on a board and in a collar?


Because 30 years ago when this Profession was still trying to figure itself out we bought into some crazy ideas, that's why.  Now that we're actually starting to study some of these ideas and finding them hurting more patients than they are supposed to help, we need to start revamping a number of our "standards of care" which actually should read "That's what everyone else does..."

Whenever I have to document damage to a vehicle (mainly for my recollection of the run later on, just in case) I try to use some basic terms that at least remain consistent in my own description of vehicles.  Those are:

Light truck, truck, large truck, coupe, sedan, wagon, van and commercial vehicle.

Then I go and describe the damage using 3 terms, light, moderate and considerable.

Those are mine and can be widely interpreted.  Maybe I'll get Motorcop to jump in on this but...A coupe hitting a brick wall at 40MPH will look differently than a van that hits another van at 25MPH.  One is a trauma, the other not by protocol, even though one may indeed have carried far more force.

And even if I do mention light damage to the front of the vehicle, what does that mean? What kind of car? What kind of impact? Against what? Did the vehicle's protection systems discharge properly?  If the driver was able to self extricate and has no chief complaint, why am I chasing him down with a C-Collar? Because the folks who wrote the policy are in a committee long ago and far away.

MOI is important as far as it gives us an idea of POSSIBLE injuries to consider.  I consider it as a part of the Past Medical History and weigh it just as heavily.  If it does not apply to the patient's presentation it will be considered, but not relied upon.

One rollover will have a 17 year old girl sitting on the curb completely unharmed while a minor damage collision could yield significant injuries to the passengers.  We won't know until we assess them.

I remember long ago in far off new Mexico, some medics would launch the helicopter just based on dispatch information of the reported damage.  And we're back to the telephone game of one person's "Oh my God! They're trapped!" and another's "She's just not getting out, but looks fine."

Assess.  Use MOI as a tool, not a guide.  We always look inside the passenger compartment for deformity, blood, marks, bent steering column etc, but we should not be basing a transport on the vehicle.


Then again, try documenting that you let a driver refuse transport who had moderate damage after a head on collision into a guardrail, deploying front airbags with a non-complete recollection of events.

Now if I tell you they hit the guardrail head on after sideswiping another vehicle at 40MPH and spinning around, coming to rest in the slow lane and is avoiding telling the police they cut across 6 lanes of traffic to make an can I let them go home?  Or should I be chasing him down with a collar?  We all know the answer to that one.


Looking forward to more, Rogue!

Sunday, November 6

Man Up NFL - Ditch the helmets


I'm talking American Football.  The game where almost 50 men complete against one another 11 at a time with plenty of breaks in the action to catch their breath.  They are strong, large men, many of them obese and wear enormous pads and helmets to protect them not from the other men, but from the other men's pads and helmets.  Why do I care? Well, I always have, but watching a college game yesterday made me want to comment on it.

Chris Owusu, a wide receiver for the Stanford college team was removed from the field Saturday after being struck in the helmet by...another helmet.  This was his fourth concussion and reports have him being taken off the field unconscious.

This phenomenon is nothing new in the world of American Football and has been studied for decades.  A simple google search returns studies that talk about ensuring the players hit each other less, or not head to head.  Good luck.


The entire motivating factor in American Football is to hit the other guy hard, yet there is no stat for hits.  So if the culture of the sport is encouraging dangerous play, shouldn't we protect the players?  Surely stronger pads and helmets will protect them right?  Sadly no, it just adds a harder hit from the other guy.  It's a lot like arguing that car accidents will be safer if we all had bigger heavier cars.  Foolish, yet that is what the NFL, NCAA and youth programs are doing.  They add more pads and stronger helmets, all the while seeing more injuries and more serious injuries to boot.


I'm not a huge fan of American Football and have a number of ways to make it more interesting to watch, but none of them is "HIT HIM HARDER!"

My first order of business is to remove the helmets in use now and replace them with nothing.  Yes, nothing.  It'll take a little while for the game to adapt but far less people will be getting concussions if they have to go skull to skull against the other guy.  It might actually require them to learn how to tackle, not just hit.  Look at rugby and Australian Rules Football, both requiring more strategy, fitness and contact to tackle a person as opposed to simply hitting him so hard he passes out.  Imagine an NFL lineman who can run farther than 40

But American Football fans don't want to watch men who can play an entire game.  They live for the hard hit across the middle, knocking the player who caught the ball on his face in some form of ancient battle.

Removing the helmets, the radio transmitters and making the players actually play the whole game with limited substitutions (imagine that!) will greatly increase the pace of the game as well as the entertainment factor for those of us interested in a competition, not a battle.  Not to mention, less career ending injuries.


Lose the helmets NFL, what do you think you are? Hockey?  As far as I can see the only hazard on the field is the other team and the only reason is because they're heavily fortified as well.

Saturday, November 5

A Tip of the Helmet - San Francisco Police

You may have seen in recent updates that your pal HM had a rough call not long ago.  While I can't discuss the particulars, possibly ever, I did want to give some credit to a few folks who made it so much easier to focus on patient care: the police.


Not only did they deal with family and nosy neighbors as we worked, but they did a lot of the behind the scenes stuff.  For example, one officer retrieved additional O2 bottles without being prompted, calling out to us that they were in the hallway if we needed them, and we did.


When we were ready for a backboard they grabbed it and handed it through into the room, AFTER asking which end needed to be handed in first.

As we moved through the small hallways, I noticed a Sergeant moving items off the cluttered stairway and calling out how many steps there were.

Down on the street they had taped off the sidewalk giving us a clear path to the ambulance.

At the hospital they managed family and served as a story teller when the hospital asked questions we had no answers for.


It may seem like simple things or something that should have come naturally, but they have different priorities at the scene than we do.  It is possible that it was simply the nature of this call that got them involved to this extent, but judging by their ability to anticipate our needs, they've done it before.


A tip of the helmet to our boys in blue on this one.  Thank you.

Wednesday, November 2

I'm no expert...

...oh wait, um, I am.



Automatic alarm activation. Smoke detector, first floor hallway.



Even though it's dinner time and our own dinner will be pushed back at least an hour now we're loaded on the engine and out the door in less than a minute.  The first due engine is out of service so our response time will give a small fire more chance to grow.


More often than not the alarm company calls to advise a resident on site reports a faulty alarm and we often cancel the truck company and Battalion Chief also assigned to the alarm.  As the engine, we always continue until we get eyes on the detector.  We get no such advisement.

On scene to the 3 story type 5 residential we have nothing showing and a person on the front steps, phone to her ear waving us down.  Airpack on, axe in belt, lamp on shoulder and a pump can in hand I'm met by the person who tells us she can't understand why the alarm won't stop going off.  We aren't hearing a fire alarm, but a smoke detector shrieking it's triple beeps from the building behind her.  Some may take a deep breath and pack down, but I love a good chance for free exercise so I head for the sound.

And that's when I see it.


From behind me I hear the occupant telling the officer, who suddenly sees my pace change, that "I'm no expert but that thing is broken..."


The house is charged with the light to moderate smoke of burnt food, the smoke detector faithfully discharging it's duty and working perfectly.

The pan on the stove is...wait for it...still on and we turn it off and remove it from the house, now surrounded by curious neighbors coming out to see what is going on.

A quick side note, I love going into a building without hearing sirens, only to return a minute later to the truck on scene and the stick coming out of the bed.  Those guys are fast.


As we open windows we note the occupants clear confusion with how a smoke detector functions almost as if she was never taught in school.  Oh...

"But it wasn't a fire, just's only supposed to go off when there's a fire" To say the Chief did a face palm would be great, but being the professional he is he took her under his arm and slowly walked back into the building.  The last thing I heard him saying was:

"These things happen to people sometimes.  Some more than others..."

Monday, October 31

You Make the Call - Still Hanging Around?

PD often asks us to preserve their crime scenes before we can get in and do our work, but this situation seems unique indeed.


While the particulars have been decently obscured, there was no hesitation on my part when faced with this situation.  We have a "reported" hanging and judging from the past medical experience of my callers it could actually be a car accident out on the lake.  We're loading up the boat and making our way out there.

Until we can assess and determine a clinical plan other agencies will have to work with us, not delay us, in completing our task.  If we wait for PD dockside a viable patient could deteriorate making our interventions more complex and leading to a poor outcome.


So, on the boat we go.

10 minutes later, after listening to PD screaming for us to wait, we come around the bend in the lake to a cove where we see a small sailing boat with a person clearly hanging from the mast, motionless except for when the boat slowly rocks as our wake disrupts it.

His feet are about 6 feet off the deck and it's been awhile since you were a Sea Scout but the rope tied around his neck does not appear to be there accidentally.  A jacket is hanging on the same mast and his shoes are neatly arranged below him on the deck.


Your primary assessment as the boat approaches includes the notation that the patient's neck is deformed and elongated in such a manner that suggests internal decapitation.  The fingers are flexed into the palm and the arms appear rigid as the body slowly rocks on the boat.  The entire body moves as one.  Do to his dark skin color, no pooling of blood is noted, cyanosis and bruising are also difficult to distinguish.  Judging from the marks measuring the mast the length from his mandible to his clavicle is almost 12 inches with the possibly 3/8" rope hidden withing the skin behind the mandible, taught.


The dock manager feels now is a good time to tell you that the person who found him was in a kayak and first noted him an hour ago.

PD seem to have been able to find another boat and have radioed for you to not enter the crime scene if the person is deceased.


Well, is he?

You make the call, based on your local protocols and policies.

Friday, October 28

You Make the Call - Hanging around

The title is a bad pun, but has a dual meaning, trust me.

You have been dispatched in your first response vehicle to a boat yard for a reported hanging. The location is about a 10 minute drive from your posting spot and no other rescuers are responding with you.

About half way there dispatch advises the reporting party states the victim is in a boat out on the lake and will take rescuers to it when they arrive. The local Sheriffs used to have a boat but budget cuts have it on a trailer in a parking lot.

Arriving at the scene, or at least the closest your rig can get, a man identifies himself as the boat yard manager and motions you to a well kept vessel dockside with 2 other men staffing it. It is larger than a house boat and has plenty of room for all your gear, even the gurney!

Local PD radios you and states they are 10 minutes out with a field investigator and camera and request you do not board the boat until they arrive.

The man on the boat is adamant that you hurry and come with him immediately. It is a 10-12 minute ride to the boat anchored around a corner.


What do you do?

You make the call.

Sunday, October 23

ring ring

We've been here at Station 51, the San Francisco Fire Department's newest fire house, for just over a year.  As you may recall we took over for the Federal Firefighter's who were no longer going to be staffing the Presidio of San Francisco.

We moved into the almost 100 years young firehouse and began to make it our home.

Funny thing about old houses though, is that they have quirks and this house is no exception.


My absolute favorite thing is the incredible number of phone jacks here.  There are dozens of all shapes and ages.  In the old apparatus garage, now a make shift gym we plugged in a phone to answer when exercising.  Makes sense, but it never rang.  You can make calls on it just fine, but it never rang when the other 2 house lines would.  We dismissed it as a broken ringer since all of our phones are hand me downs.

Then one morning I heard a faint ringing coming from he gym.  Curious, I went to investigate.


It was ringing.


I think we have Rod Serling's old phone because the people that call that number are the most interesting people I have ever spoken to.  They often have no idea they have called a fire house, or are using a telephone to begin with.

One woman was calling to ask if I would give her $5 to get home to her dog.  When I asked where she was she admitted she wasn't sure and hung up.

Another woman called and after I answered "firehouse" which is how we answer the non official phone, she asked "Is this AT&T?". "Uh, no, this is a San Francisco Firehouse." "Are you sure?" "Quite sure."

Sometimes we get butt dialed and I try to listen to hear if I can figure out where these people are.

Could they all be in one place?  Could it be a prank?  If it is it is the most well thought through prank I've ever been hit with since the calls keep getting weirder and weirder.

Just the other morning I was on my way out when it rang and I ran to answer it.


"I'm trying to find out about a fire extinguisher?"

"OK, how can I help?"

"It's gone off the wall.  Did you guys take it or what?"

A semi-fair question, not the first time I've heard it.

"Where are you right now?" Thinking the answer 'home' or 'at work' would come next...

"I'm in a bathroom and there's a sign that says fire extinguisher but no hook or anything."

"Sir, what City are you in?"

"Why do you need to know?" *click*


The pace of speech and accent would have caused anyone on the other line to crack up laughing if it was a prank.


I love that phone.

Friday, October 21

Did anyone notice the rolling boil?

What happened to us? I woke up this morning and it seemed that suddenly we're all at each other's throats. Disagreement has turned into pure hatred and there is very little discussion anymore. Pundits spout half truths and opinions to achieve a political goal while those of us out here trying to live our lives do our best to navigate a minefield designed to enrage us.

Did you get that email from your brother about Obama's secret camps for Tea Party supporters? What about the one years ago about Bush instituting a draft to cover the war in Afghanistan and the coming war in Iraq? How Pelosi is ruining America, or Boehner or who ever?

We used to keep our political leanings more or less to ourselves until it became easy to have a one sided conversation. TV interview shows and the internet have allowed opinions and beliefs to evolve without any connection to fact whatsoever, drawing instead on the writings of whoever agrees with them. Whether it's the 9/11 truth movement or Obamacare we now see the world in strong shades of red and blue and it's making me sick.

Sick to think that it's only going to get worse. That an armed Tea Party group will confront an Occupy ____ crowd and someone will say something stupid and before you know it we're at war. Civil War.

Taking it too far you say? Think back to when we got along. Sure we all had our differences, but it was subtler, we all made decisions based on the facts at hand. Some more than others, but there was always a back and forth, a sharing of ideas.

Now we have two groups locked in a fight that can never end without BOTH of them backing away. Abortion, healthcare, finance reform, banking regulations, job creation...these are not things any one party has figured out. Our current situation is not the result of our current administration, Congress or Court, but a continuous failure of all three for decades. The offices are inundated by monied interests looking to have the path cleared for their project, drug trials, regulations to the point that law makers have no choice but to take the easy way out and simply do what they say.

Our system fell apart and we all picked up our red and blue glasses and looked for someone to blame. We were told by new voices to hate the right wing gun loving nut job neocons or the leftist commie hippie liberals, each of us told what we wanted to hear.

And the voices only got louder and told us more half truths about who we were supposed to hate.

Then one day we looked around and instead of having a discussion with our neighbors and learning about WHY they feel the way they do, we just hate them.

We hate them because of a bumper sticker, T-shirt or slogan, for an avatar on facebook or a picture they linked to they believe in. We hate them because we're not sure who we're supposed to hate so we take the easy way out and just do what they say.

No one is without blame these days, we've all taken things way too far. Wire taps, healthcare mandates, war for oil, protecting some stupid salamander, we take something we dislike and assign an evil doer to it and nothing we read, hear or feel will dissuade us from even thinking, "Hmmm...I wonder if I might have this all wrong after all?"

The melting pot of America has had the heat turned up slowly for decades, most noticeably in the last 10 years. Choose your bogey man, blame whoever, but look in the mirror first. Hate the banks, but look at what you're doing in relation to them first. Hate immigrants or food stamp recipients but examine your own life for things you can do about it.

99%, 53%, 1%...
...100% of Americans believe something is wrong on some level. Perhaps instead of looking for a trigger in this current administration, Court or Congress, or the one before that, or the one before that, we should take a look at the only thing that has been a constant throughout it all:


The American people.

The same people currently loathing half of our Countrymen and Women and for what? Why do we all hate each other? Skin color? Religion? Cheeseburger or plain? Kids or no kids? Booze or no booze? Last I checked all the things I disagree with had little to no impact on my day to day life with only minute changes to behavior.
"But (insert politician here) wants to take away my (thing you think is going to be taken away)!"

And we're back to hating each other instead of looking around for the cause to our troubles. Maybe they want it this way. James Andrews, the character from the film PCU summed it up nicely when he said "It used to be us against them, now it's us against us."

US against US.

I'm so tired of trying to figure out why so many people are so insanely upset at things they may know nothing about, but simply need to hate something.

We're all like toddlers who will spend more time crying about cleaning our room and how our sister never cleans hers than just getting the job done, being proud of it and moving on to other more interesting things.
There will always to a part of every society who doesn't carry their weight. The young, the old, the crippled, the sick, the just plain lazy...but should we hate them? There will always be those who excel at what they do and rise above us to higher position and stature...but should we hate them?

Depending on your bumper stickers I can guess which side you come down on because I've been conditioned to draw assumptions and build barricades. Just because I disagree does not make you wrong. We seem so quick to destroy someone else's opinion just because it clashes with our own preconceived beliefs.


We're all fools to have let it get this bad.

Wednesday, October 19

the Crossover Episode 17 - We raised how much?

Kilted to Kick Cancer was organized to raise awareness about male specific cancers.  Thanks to Kelly "the Blogfather" Greyson, it turned into a massive fund raising effort that raised...well...have a listen to the show to find out.  And your guess is way too low.


This is also the first episode of the show where we invited not one live guest but 2!  Alex from Unkilted stopped by to discuss his part in making the kilted to kick cancer .org site actually look nice allowing us to bring so many people together from so many different places.


I also throw out my target fund raising goal for KTKC 2012.  Who's with us?


Tuesday, October 18

Common Spelling

I always knew San Francisco was filled with the rich and famous, but I never thought I'd meet them in the course of my duties as often as I do.  Worst part is I can't tell you which comedian's neighbor I've been to and looked into his living room or which movie actor almost choked on a fish bone.  Oh well, until I can figure out how to clearly hide the events in details and time passed, I wait.  However, one night on the ambulance I had a run in with a very rich old woman who...well...let's just say we had a good laugh.



Code three for the fall.



Again we're upgraded to meet a stopwatch, and arrive on scene of the swanky apartment building to the usual cadre of managers waving for us to quiet down.  Odd how they want us there immediately, but demand we keep the noise down because "this is a quiet neighborhood."  Whatever dude...

After explaining very clearly that we will not be parking around the back, then walking back around the front to the elevators, we are led to the top floor.  You know the one, where the elevator requires a key and opens directly into the apartment.  No, that's not the right word. Palace.  The top three floors of this building belong to one person and it looks like it was redesigned sometime in the early 70's then left for us to find.  Almost like a time capsule except for the giant flat screen TV and staff scurrying around on cell phones advising someone of the impending transport of their elderly boss.

In the staff kitchen on the interior of the space (yes, there is a staff kitchen separate from the main kitchen) sits a woman in her late 80's dressed for a party sitting in a chair at a small table.  Half a dozen folks in black shirts and ties are explaining what happened, not one of them starting at the same point in the events so I distract them by telling my partner was in charge and they shifted their attention to him.

Crouching down to say hello I'm met with an embarrassed smile and an introduction.  Her name is Mable and she stumbled over a rug in the hallway helping the staff clean up from this evening's fund raiser.  At her age she shouldn't be getting her own coffee, let alone clearing dishes especially with a hired staff on hand but "'s my house and I can do what I want..." she reminds me as if we've had this discussion before.

There is no injury, she has no complaint, she simply stumbled coming down the hallway and dropped a tray of glasses.  Everyone panicked and we got involved.  They carried her to the staff kitchen and told her to sit tight until we arrived.

She asked to stand and go have a martini and I was obliged to allow it, but only after I finished my chart.  As I confirmed her name my pen stopped and I said "How do you spell your last name?"


"Oh, Levi*, like the jeans."

"Yes, like the jeans."

Holy crap.  I looked around.  Not like the jeans.  The jeans.  She laughed and so did I.  Unfortunately I had to decline the offer of the martini.  No gifts you know...


*not her real name, but the real one was just as bitchin', I assure you!

Friday, October 14

Overheard in the Fire Engine

From the resident Irishman in full brogue:


"I'm so hungry I could eat the hind leg of the lamb of God."


I made sandwiches instead.

Thursday, October 13

On Not Liking People

New EMS Blogs writer CCC from Captain Chair Confessional posted recently that he does not like people and the post got me thinking.

Have a read for yourself.


I left a brief comment but wanted to expand on it here.  I too hate people.  We all do to a certain extent.  There are those who would like us to believe that having a large circle of friends somehow makes us better, or that loving everyone equally is the norm.  Some think that my political leanings dictate I love everyone no matter what.  The truth could not be farther from the truth.  That doesn't sound bad out loud.  Try it.

CCC's post is more about hating the BS floating around these days and I have to agree there is plenty.

There is an order to things.  When this order is disrupted it causes after effects, ripples.  That is why there is traffic on a road where everyone is going the same direction.  Someone who does not understand this order or who can not see it in their lives is doomed to disrupt it.  As I said in my comment over at CCC's place, this isn't some kind of "God's plan" order, or some other deity of choice, or even some love-in touchy feely new age crap.

I'm talking about the beams.

I read Steven King's Dark Tower series when going through an interesting part of my life: My OCD.

OCD is not just washing your hands 30 times or touching every lamp post, but has many manifestations.  OCD had penetrated my life and lifestyle to the point that when I got frustrated that I could not manipulate my environment to make things work better anxiety and depressions were not far behind.  When confronted by a stack of magazines at the dentist's office, I had to straighten the pile.  HAD to.  No matter what else was happening.  Crooked pictures got straightened, things out of center got centered.  Water rings on tables at restaurants had to either overlap to create only one or make a pattern.  Salt shakers, chairs, store displays anything and everything that was out of it's optimal place HAD to be manipulated to meet my specifications.  Funny thing was, I had no idea I was doing it.

This irrational behaviour (miss you Mark) led to a deep disgust of people who did not understand the way things were supposed to go.  People who cut in line without thinking about those now behind them, all inconvenienced because of one person.  The guy at Costco who clogs the main isle getting a sample of pulled pork salsa, then gives you a dirty look when you move his cart out of the way.  I disliked more people than I liked.  When it came time for a shift at work however, everything seemed to change.  It wasn't until later on, with the help of therapy to understand what I was doing and why, I learned that EMS is a form of OCD all it's own.

Not to say that CCC's not liking people is obviously a nervous disorder, or even maybe, just that reading that post was like looking into my own past.

Not liking people is not a bad thing.  I hate some people.  I have said on multiple occasions I do not carry a firearm because of my opinion of many person's driving abilities.  Liking people or not liking people, I think, means you need to find some new people.

Many of you in the business of helping others will relate to CCC's post and likely agree that you too hate people.

But I would ask each of you to stop and think WHY you have these emotions towards certain people and if, perhaps, there is something in your past or present that is filtering what you see.

As was mentioned above, for years I had no idea that what I was experiencing was any different than anyone else until someone commented how funny it was that I was arranging the colored sugar packets at the table while inside I was hating whoever had left them that way.

The things that bothered me before that I was compelled to fix still catch my eye and I can control the impulses to alter my environment but it took a long time to realize my own hatred for most people was because they did not jive with my path.


Sunday, October 2

From the Archives Oct 2 2008 - Assist a Citizen

It doesn't get more vague than this. When nothing fits, they call it "assist a citizen." Well, on this day I happen to be assigned to a very specialized unit, a Ladder Truck that specializes in forcible entry and ventilation at fires, not to mention search and rescue. For those with no fire service background...The truck with the big ladder and the steering wheel in the back.

Someone at City Hall has called asking for help at an address in a questionable neighborhood. Upon arrival the very large and heavily equipped unit finds a man and woman looking into a storm grate near a van...wait for this is good...parked in a red zone. They dropped their keys and can't move the van.

We establish that yes, they are in fact calling for help for lost keys and the van is in the red zone, "Just real quick while I checked in on a friend." This neighborhood is famous for drug use and I was pretty sure I saw a person using this grate as a toilet earlier in the day so I advised the man that the auto club may be the best way to go in this situation. "But the Mayor said you would get the keys for us." "Oh really?" We asked. Gloved up and wondering how to get this old grate off the odor was indescribable. Just as we figured a winching system to pull the heavy grate up and look for the keys we heard from the man behind us, "Don't worry Hon, this is what these men are trained for."
I took a deep breath, nearly gagged, and sighed. It reminded me of those credit card ads. You know: 5 Firefighters for 1.5 hours $750, 1 Ladder Truck $375,000, 1 damaged storm grate $500, watching the Fire Department recover your urine soaked keys while you were parked in a red zone, priceless.

Friday, September 30

Kilted to Kick Cancer draws to a close

Well done for the month folks.  Our awareness campaign about male specific cancers during September can only be categorized as a success!

I'm out of the banner for a few weeks on a well earned vacation with Mrs Happy Medic and won't know the details of the fundraising efforts, but if we raised more than $1 I'm happy.


Kilted will continue, just in an abbreviated form, meeting whenever we feel like strapping on the kilts and drawing some stares.  The message will continue, of course, and plans are already in the works for a bigger and better KTKC 2012!


To those who wore kilts, well done.  To those who donated, thank you.  And to those bloggers that took up Kelly's fund raising challenge, thank you for turning your readers' attention towards a worthy cause.  At the end of all of this a special thank you to Too Old to Work who opened my eyes to my own risk factors and to Russel Stine who continues to scare the living shit out of me as he shares his cancer experience with us on his blog.

Inspiration comes from many places, the trick is spotting it.

Get your kilt ordered now for next year!


Tuesday, September 27

I'll be back

I'm on my way to the airport for a nice long trip away from everything with the Mrs to celebrate our anniversary.  I may or may not have internet access, so I'm pulling HM out of the sidebar until I get back.


There are a few posts pre-done and scheduled to go up, but I'll let you know when I get back.


Happy Travels,


It's burning my retinas!

We have all trained, at one time or another, to respond to a chemical release at a local swimming pool.  They keep enough chemicals on hand to cause quite the trouble, but how can I explain that to a mother who feels wronged?  By writing...a lot.



Dispatchers have hit the panic button on a full HazMat response to the local indoor pool.



My ambulance is the first of 3 responding as well as a complete first alarm assignment, HazMat, etc etc.  We arrive first and are met in the street by a number of lifeguards waving their arms.  In their little red shorts they look almost like valet parking attendants having a really slow night.

As I roll down the window ever so slightly we are given the initial report of the situation:

"It's only a couple of kids, there is no chemical release, their eyes sting after a swim lesson is all, the mom wants them to..."

and then he said it.  He said the line that gets my blood boiling.  The line I hear from the bulk of my clients and patients alike.  A line so innocent, but when taken to it's logical conclusion is never followed through with.  The line I hope to actually act on in the near future.

"...get checked out."


I cancel the bulk of the alarm, keeping the HazMat Battalion coming, just in case, and enter the pool where close to 100 people are still swimming and playing without problem.  In the back office a mother is sitting with her 2 children and their friends.

"They got out of the pool and were screaming and rubbing their eyes, I want it documented that this facility is using dangerous chemicals in the pool water."

I introduced myself and went about my assessments while casually mentioning to the Manager to bring me the MSDS.  For those not in the know, anywhere there are chemicals known to possibly cause harm, there are Material Safety Data Sheets (MSDS) which describe the chemicals, how to treat a person exposed to them and who to call for more information.  It's that giant binder crammed onto the top shelf in the janitor's closet.

As he returns with the binder we flip to the chemicals used in the pool.  I have Mom read, partially as a distraction, while I talk more with the assorted children who are more interested with my partner's phone than their "burning eyes."

I already knew, as you do, why their eyes sting.  We all learn that lesson early on.

As Mom refused to accept the reality that the chlorine in the pool actually belongs there, she reminded me I am not a Doctor and that she wanted her children...

and this is where the encounter should end.  Me informing the Mom of exactly what is happening, her digesting the information and making an informed decision, based on my professional medical opinion and diagnosis.  But, who am I kidding...

"...checked out."

My reminders that I had just completed the exam she had requested and that if further evaluation is requested a private vehicle would be more than appropriate went unheard, even unlooked at. She has turned her face away from me like one of her children would do. Then she reminded me I am there for her.  She never mentioned the kids.

We loaded up all 6 in seatbelts with Mom on the cot holding the youngest.  Then I documented all 6 patient encounters since she was convinced her lawsuit against the pool was a winner.

Good luck with that.  I'd love the get called to the stand on that one.  Too bad no lawyer will stop laughing long enough to file it.


Saturday, September 24

I am the Paramedics

In all the discussion, bickering and complaining about what EMS providers should be called (EMT, Paramedic, Ambulance Attendant, Steward etc etc) I got to thinking about the first part of my current title:



Walk into a room in most places on the planet, say you are a firefighter and I think it safe to say everyone knows what you do.  It has something to do with a big red truck and water and red stuff.  The specifics aren't important and where you work isn't important.  Or is it?

If I walk into that room as my 18 year old self I am a Firefighter following a 40 hour volunteer firefighter academy.  40 measly hours, yet I carry the same title as my counterparts in San Francisco, New York, Seattle, Los Angeles, Boston who have spent upwards of 18 weeks on the material.  They have more hands on training, more book time and a greater ability to do the job, but our titles are the same.  2 completely different skill sets and levels of education, same title.  No one who calls the Fire Department wonders how many IFSTA Certified, NFA FireFighter Level II's are coming.  They care about how many firefighters are coming because what they need are people who can do the job.

At a car accident, no one has ever turned to a friend and said "Quick, call the EMT-99s this person is injured!"  No one holding a cyanotic child screams "Help! I need 2 Nationally Registered EMT-Basics trained to the new curriculum!"

They shout one of 2 things:

"Call the ambulance"

"Call the Paramedics"

The Paramedics

I say we run with it.

I am in favor of calling pre-hospital care providers Paramedics even though there is a large gap in the training, experience and capabilities of the many levels from sea to shining sea.  They don't see the shiny patch on your shoulder is different than your EMT partner, nor do they notice you only inserted an OPA as an EMT instead of an ET.

They need help. We are it.  They call us what we are.

The  Paramedics.

Heck even most of us in the job are unsure exactly what a Paramedic should be, so what a great time to come together as one for once.

To those who will immediately back off and claim, falsely, that they earned a different title than the EMT when they completed their 2 year Paramedic program, come back when you've completed your Bachelor's in EMS and tell me if you feel the same way.


My name is Justin Schorr and I am a Paramedic.  I have been a Paramedic in my patients' eyes for almost 20 years, even though my little slip of paper says only 10.

Thursday, September 22

I got stopped...

...and I deserved it. Man I hate it when Motorcop is right.


I was driving through the City when my phone rang and it was work.  Sometimes I forget to take the radio out of my jacket pocket, sometimes it's the keys...etc etc, so I answered it.

Then they put me on hold for a minute, and that's when me and the Motor passing the other direction made eye contact.

I hung up, he swung around and I pulled over and waited.

I knew it was wrong, time to drink the tea.


CityMC - "Do you know why I turned around?"

HM - "I was on the phone.  Shouldn't have been.  No excuse."

CityMC - "License please. I'm going to cite you, this isn't safe."

He wandered back to the motor and began to scratch out the cite and my phone is ringing again.  No way in Hell am I answering it now.

He returns to the car where I'm patiently waiting, hands on the wheel.

CityMC - "Your license and your insurance have different addresses, which is correct?"


HM - "My insurance, Sir."

CityMC - "You need to get to the DMV immediately and get that remedied."

HM - "Yes, Sir."

He went back to the bike and was on the what is he doing? He's on the phone.  I make eye contact in the rearview mirror of him laughing and smiling on the phone and he turns away from me.

A few moments later he approaches the window and offers me the complete cite and asks me to sign.

I signed, no argument, no stupid excuse, no denying the obvious.

Then he gave me back my license and told me it was my lucky morning, he had just gotten good news.  This would only be a warning.  I should take what I would have paid in the cite and go buy a new hands free set, or 2, and use them.

And I will.


It just goes to show that if you are honest and respectful, and if he gets a lucky phone call, maybe you'll just get a warning.

Now if only medics could have the same kind of power in transport decisions...

Saturday, September 17

yeah, yeah...ok, ok

The brain works in amazing ways.  Our understanding of what is happening around us can be completely distorted by chemicals we ingest or otherwise introduce into our bodies for a variety of reasons.  Be it medicinal or recreational, habitual or experimental, the brain interprets it's surroundings as best it can and adapts actions based on those signals it receives.  The signals, however, are often changed by the substances we have ingested.

Case in point:

"Scooter Dude."



I've been special called as the Paramedic Captain to a "Major MVA" involving a cycle.



As I arrive first on scene, since this occurred not far from my favorite coffee shop (MC would be proud), I find a man slumped over the remains of the windshield of the scooter in the middle of traffic on a rather busy 2 lane road.  The engine is not far behind and we approach the scooter, which is still running to assess what has happened.

I've been to more than my fair share of "man slumped over steering wheel" calls but this is a first.  I have to pull my sunglasses down my nose just to be sure what I'm seeing isn't a reflection or other distortion from my $25 Target glasses.

Sure enough, he's balancing the scooter and unresponsive over the shattered windscreen, helmet on the ground nearby.  The front of the scooter is also smashed and the engine driver has discovered a few nearby cars with damage consistent with a run away scooter.

Our initial interventions were obvious, get him off the scooter, but as we grabbed under his arms he suddenly awoke.

Confused and clearly under the influence of something you would find on a pool table, his 6'2" 225lb frame is rigid and mimicking trying to start a motorcycle.

Our calm introductions are met with a diaphoretic face, lip licking and a simple phrase repeated over and over again, "Yeah, yeah, ok, ok," all the while his brain is convinced he is trying to make an escape on a motorcycle.

As the police arrive our friend is convinced he will remain on the cycle and even our basic interventions to lift him away are putting us in danger of not only a physical altercation we would surely lose, but the concern the scooter will drive off or fall over onto us during his extrication.

Seeing no visible trauma I instruct the officers, who are allowed to fight back when needed and have training in forcibly moving people, to move him to the ground.

That's when his brain suddenly realized he was not on  a Harley, but in hand cuffs on the pavement.


It takes 6 of us to restrain him and apply a spit sock since he has taken to trying to show his displeasure with saliva mixed in with creative verbage regarding my mother and a slew of other relations.

As the ambulance arrived my hero leaped out with a dose of  IM Versed that brought our new friend back into the realm of the moderately co-operative.

It was an interesting presentation that later allowed us to discover, from witnesses, that he seemed to be confused and riding the scooter in circles in the narrow street, crashing into a number of cars before inexplicably stopping in the middle of the street, looking all around as if he was hidden, then slumped over the handle bars, seemingly asleep.

It was also a reminder to work carefully and clearly with law enforcement since their end game is a person unable to fight back and ours is being able to treat them safely.  Talking through your plan ahead of time with the officers to ensure your plan matches their concerns is key to making sure a handcuffed recumbent patient becomes a properly restrained supine patient with no injury to any party.

And although chemical sedation was indicated and used, be sure to follow your local protocols when encountering agitated people who could mop the floor with you on any given day.

Friday, September 16

Tip of the Helmet - Lady in the Flip Flops

It's easy to see an accident and keep on walking, but something in some people kicks in to make them want to learn more. At a recent accident we've all seen on video by now a motorcyclist collided with a car and, surprisingly, they caught fire.
As random folks come to the car and look inside a woman in flip flops does what EVERY rescuer needs to do at EVERY roadway incident:

She looks under the car.

Seeing the unconscious body of the motorcycle rider she tries to lift the car off of him. Others seem interested and when she confirms again "there's someone under there" the troops are flocking to the scene to lift the car.

You can give credit to the worker who pulled the rider out of harms way, the cops and their interesting fire attack or even the firefighters and paramedics who magically appear, but the real credit goes to flip flop lady and her desire to answer the burning question she had inside: "Where is the rider?"

From NPR: According to the Salt Lake Tribune, Wright suffered a "broken leg, a shattered pelvis, bruised lungs and burned skin," when he and his motorcycle collided with a car. But, thankfully, he is "well on his way to recovery, his doctors said."


Thursday, September 15

Custom Kilt from Alt Kilt...Name your price

The gang at Alt Kilt are currently running an auction for a custom kilt to raise money for Kids' Cancer.


What kind of kilt?  Well, that's where the great part lies in all this:  You decide.  This is a 100% CUSTOM kilt from your mind to their tables to your waist.


I fully expect to see this won by a Kilted to Kick Cancer participant or supporter.  Anything less would be a disappointment.  If that is the case I'll add in a washed, but never worn Magnum RD Shirt embroidered with the Kilted to Kick Cancer logo.  So let's go folks, make it happen.

If you didn't have a kilt this year, here's a chance to get one custom made for next year.  No excuses.


I've bid and will bid again.  I have my eye on some of their steam punk inspired kilts and may take this opportunity to get one while supporting Kids' Cancer.

Think about it for a second.  You can get a kilt supporting Kids' Cancer, then wear it to support male cancers, then again to support any damn thing you want.

Efficiency on multiple levels.

BID!  The auction ends Sept 20th 6:25 am PST.


And I'll check with Magnum, but if supplies last I'll get you a KTKC T-shirt as well since all proceeds go to cancer research.

Wednesday, September 14

Smoke Conditions

I came across this video for a neat looking product for fighting high rise fires from the floor below.

During the video we see how water can be applied through the device in either straight stream or via a remote controlled combination nozzle.

I have no opinion about the product positive or negative, that is not the reason for my sharing the video.  As you watch, pay careful attention to the changes in smoke conditions between straight stream and fog.

Just in case you always wondered why there is more smoke when you use the fog nozzle as opposed to putting the fire out with the straight stream.


More reach, more water, less fire, less smoke.

Monday, September 12

KTKC T-Shirts and why you need

In case some of you were under the illusion that Magnum Boots has an open print order on Kilted to Kick Cancer T-Shirts, think again.

The first, and possibly ONLY Kilted to Kick Cancer T-Shirt is now available solely through Magnum Boots USA.

The cost:  $0.

Seriously, Magnum Boots is charging zero to get a shirt.  All you have to do is email them confirmation that you donated at least $40 to Prostate Cancer Research and let them know your size and POOF - Free Limited Edition T-Shirt.

I honestly thought that we'd run out of shirts in Las Vegas at EMS World Expo so didn't give much thought to it, but a recent communique from Magnum Boots confirms the mail order amount is starting to slow.

To slow?

I thought we were blazing the trail here guys and gals.  We have roughly a half a month left, barely over 2 weeks to get as much fundraising and awareness done about male cancers before everything turns pink in October.  Everyone's attention will be shifted to the noble fight against breast cancer and pink shirts will fill the TV, the workplace and people will empty their pockets for the effort as well they should.

But what about the male specific cancer that is set to overtake breast cancer next year if current trends hold?  Think about that for a minute while you fill out the $40 donation to the walk athon or arrange to go see the pink fire engine.

Next year more men will die of prostate cancer than women will die of breast cancer.


Next month most people will go back to not talking about it.  Get a T-Shirt so that you can wear it to the walk a thon and to see the pink fire engine and tell every man you see about their risks.  We're not going away but your chance to share this important message is.

I don't usually take this tone in this forum, but after the morning I've had somebody has to stand up and start talking.

Please make a donation and send your proof to Magnum to get a free shirt so that your donation can be the starting point of a conversation that could save more lives than any walk a thon or pink fire engine.  Cancer needs to be stopped and that takes research and research takes money.  To get the money we must raise awareness and me wearing this kilt all month and having these conversations may have already saved someone...who knows.  But a simple giggle from a T-shirt could start a conversation that could save a life.

If unsure of where to send your donation, Magnum Boots can help:

To get yours, donate $40 or more to, then email us your size and proof of donation to You can also send us a check, made to Prostate Cancer Foundation, to:

Magnum USA

Attn. Marketing

4801 Stoddard Rd

Modesto, CA


Don't let what we started die here and don't give just to help a blogger win a contest.  Give because you know it's the right thing to do.



Saturday, September 10

10 House "Still Standing"

Each year I choose 1 story to share in an effort to keep alive the memory of those who died. Buying a sticker or a T-shirt that says "Never Forget" isn't enough, heck it's nothing. Learning about the lives of those who went into that morning not knowing if they would be coming out and sharing their stories with others is the only way to remember and keep them alive in our hearts.
I used to think the ancient Egyptians were foolish for claiming they were going to live forever, yet we still speak their names and honor their traditions in our museums and textbooks. They truly did accomplish living forever and if we want these men to be remembered in the same way we must continue to share their stories and speak their names aloud.
In my search for a story to share about those who died on September 11th, I kept coming back to a number: 10.  10 years, 10 Engine, Ladder 10...10 House...

A firehouse is much like a family and when a member of a family dies it can have an impact on the survivors. But what if more than 1 dies? Or 2. What about 6?

This year I share the memories of 10 House and the day she lost 6 of her children.


10 House is the quarters of Engine 10 and Ladder 10 who, in 1984, adopted the logo of a firefighter straddling the tops of the twin towers on fire reading "First due at the big one." And they were.  Reports from survivors say that even as they rolled out the door there were already bodies in the street.
The firehouse is on Liberty Street directly across the street from the World Trade Center. The house survived the collapse and was re-opened after getting fixed up, but her family is still healing.
Both companies were established in 1865, later moving to the same house.  It is one of the few houses where the engine and ladder companies happen to have the same numbers. For almost 150 years she saw only 3 deaths in the line of duty, on that September morning the number would triple.

Lt. Gregg Arthur Atlas - Aged 44 years, Lieutenant Engine 10

Firefighter Paul Pansini - Father of 3 children, Firefighter Engine 10

Lt. Stephen Gary Harrell - Age 44, Member of 10 House assigned to Battalion 7

Sean Patrick Tallon - 26, Marine Reservist and only weeks away from completing Probationary status on Ladder 10.

Jeffrey James Olsen - Age 31, Firefighter Ladder 10

James J. Corrigan - Retired Captain from 10 House, oversaw Fire and Safety Operation for the WTC complex


The house was a gathering point for those wishing to visit the FDNY to offer their condolences.  Like many houses it was covered with patches and shirts from visiting firefighters, letting the members know they were in others' thoughts.  A beautiful memorial was erected inside dedicated to the 6 members who died and included was a newer plaque honoring the 3 that had fallen between 1867 and 2000.

10 House became the site of a 56 foot bronze relief sculpture donated by Holland & Knight , a Law Office, who lost  employee Glenn J. Winuk, also a volunteer firefighter, when 10 House lost her children.  The relief was dedicated in 2006 and is the only 9/11 related site on my list of things to see when I visit New York later in the month.

I don't want to see where 10 House lost, I want to see where she lives on.

You can learn more about 10 House on their excellent website.

2009's memory

2010's memory

Wednesday, September 7

What's Under my Kilt

Kilted to Kick Cancer continues to turn heads and open conversations with total strangers about male specific cancers.  More so than either myself, Motocop or the starter of all this TOTWTYTR could have imagined I'm sure.

A random woman in her "early 60's" (had I seen her at work I would have guessed 70's) asked about the kilt in an airport food vendor line.  I mentioned the campaign and our intent for men to get checked.  Suddenly, after having known me for less than 60 seconds, has mentioned her husband sometimes has blood in his semen.  He told her it happens to "men of a certain age."  NEGATIVE GHOSTRIDER!  I told her to call her husband from the airport to schedule an appointment with his doctor ASAP.


This is the exact mindset that likely has this man past the intervention stage if he does in fact have prostate issues.  If only she could have bumped into a kilted man 30 years ago.


And that is the point here folks.  We need to raise awareness so that when the generation staring at facebook is old enough they know what needs to get checked.  Heck, how many folks go overdue on their oil change on the car, let alone keeping up with their own health and that of those around them.


Visit the links, share them with important men in your life and if you can spare a few bucks to help research, click the links below the Kilted to Kick Cancer logo there in the sidebar.  Next month everything will turn pink for breast cancer and the kilts will go back on the hangers (not for too long though, details on that soon), but the fact remains that this cancer is killing almost as many men as breast cancer kills women and we've only scratched the surface on even researching it.  Like Motorcop says, cancer is like a giant domino game.  Once one falls, the rest are sure to follow.

Kilt up, and if you don't have a kilt, support a blogger who does!