Friday, January 24

All Stop! Quick Quiet!

It's been a while since I took one of those famous blogger breaks and considering the time between posts these days you may not have noticed me stepping away from the keyboard for a bit, but I need to do so for a little while. I'll leave it vaguely there.

-HM

Thursday, January 23

Up to and including death

This is a phrase I see a lot in my line of work.  There are a number of variations including another favorite "seizure, coma, death" that are designed to cover the hind quarters of the author in some half cracked attempt at documentation.

For you folks out there who will swear up one side and down the other that you were told by an EMS Anchor that if that phrase isn't included you'll goto court and get sued for malpractice, just take a deep breath and relax, Sparky.

Your local policy likely includes guidelines for patients to be eligible to refuse transport, care or a combination of both in certain circumstances.  For example, the patient must be alert, oriented and not under the influence of alcohol, understand the risks involved with refusing an assessment or transport and sign acknowledging that they understand...you know, the basic stuff.  When I see so many less than EMT-Basic calls being completed and the risks of refusing transport for a hand abrasion include "patient advised of all risks including seizure, coma, death" I have to shake my head and laugh.

Funny part is that this blanket statement calls into question the rest of your document most times.  Do you really believe the hand abrasion will lead to death?  In what fashion?  If it is such a risk, why isn't the patient being transported?

A more accurate statement could be "patient advised of risks of infection and advised how to avoid repeat injury."  BAM!  That simple statement covers you far more than the giant heavy blanket of death.

So dial back the drama and have an honest discussion with your patients, otherwise get ready to explain to me or someone like me why you were worried this was a possibly mortal wound.

Sunday, January 12

Top 5 Things Suburban and Rural Firefighters Take for Granted

As a rural firefighter and later a firefighter in a suburban setting there were a number of things I didn't even realize I had, and as the old song goes, you don't know what you've got til its gone.

This list is a result of my 12 years in the urban setting and constantly wishing I could have these things back:

5.  Pull through bays.

There is indeed a certain romance to backing back into the station each and every time, but late at night on a busy street, standing there blocking traffic so the engine can get back in...wears on you.  I miss the days of simply pulling around back, opening the door and pulling right through, staying nice and warm in my jump seat.

4. Large Apron

As part of my morning checks long ago, we'd pull the engine and ambulance out onto the giant apron in front of the station, fire up the generator, test the pump, give the rigs a wash, all completely pulled out of the bay and with still dozens of feet between the engine  and the sidewalk.  Here in the City we can barely get the driver's door out of the station before it's in the street, completely blocking the sidewalk in the process.  We conduct engine tests either double parked out front or down at the corner at a hydrant.

3.  Drive Time

When responding to a building alarm or report of fire getting dressed in full turnouts can be a challenging thing.  In my rural days I was driving alone so I just got dressed before I left.  Suburban firefighting meant I was sometimes in the passenger seat and got dressed on the way to the call.  In the City we're lucky if we can get our coats on in time, much less full hood and gloves.  If you've ever seen a video of urban firefighters partially dressed in safety gear when they arrive it's not because they're lazy or not safety conscious but simply because they were so close there was no time to get dressed.

2.  Dinner alternatives

When we were not in the mood to cook at the fire station the suburbs had dozens upon dozens of options for the crew to wander in, radios in tow, and sit down for a meal at the Outback Steakhouse, Applebees or Waffle House.  A part of this ability was the slower call volume, being somewhat certain that your 2 hour dinner would not be interrupted.  Urban firefighters consider it an insult not to cook in the firehouse and besides, where would we park the Engine and Truck and how long would it take to get that table for 9?

1.  Parking

For the first 9 years of my Fire Service career I never parked more than 30 feet from where I was assigned to work for the day.  There was always plenty of parking spaces in front of, along the side and around back of the station.  At most urban stations there is no parking lot, no parking spaces, nothing.  In the City we have to coordinate with off going crews and swap out street parking spots sometimes over a block away.  One of our stations even had to shuttle folks to a nearby decommissioned station 4 blocks away to swap out parking spots.  Yuck.

 

So if you've got a parking spot nearby, a chance to grab a restaurant dinner, a drive to the scene long enough to get dressed, a full apron to do your rig checks and a pull through bay back at the station, take a deep breath and enjoy it Brothers and Sisters, because you don't know how good you have it!

 

Coming soon: the Top 5 Things Urban Firefighters Take for Granted