Friday, May 29

Power Lifter

He was 9.

Or maybe 12.

I've likely forgotten on purpose.

The dispatch was for a child hanging.  My first such dispatch and there was only one thought in my head: "This is why I'm here."

In the 3-4 minutes I had to prepare myself for this situation I also had to drive a vehicle with lights and sirens, something anyone in the know can tell you is hard enough without being distracted by a hanging child.

The first engine in has only reported "CPR in progress."

Am I going the wrong direction?  Was that last turn supposed to be a left?

The ambulance has arrived and is pulling the yellow bag from their rig.  I can see it from afar as I make the final turn up the block.  Our adult bags are red, the pediatric bags are yellow.

I pull up around the corner near the three police cars.  So many blue, red and white LED lights were flashing that the entire corner was lit bright.

As I mounted the stairs, taking one last breath before what I assumed would be my worst day I heard a voice inside the apartment that sounded like the voice coming from the radio mic on my lapel, "Control this is 99, we have an adult in full arrest."

I have never been more relieved to hear that an adult was dead.  That sounds weird, I know.

Stepping into the room my Paramedic Captain eyes see the following, in this order:

1. Perfect CPR by an ALS Engine crew.

2. Perfect BVM by the same.

3. Ambulance Medic opening an IV kit and an EMT beginning to determine status of O2, CPR fatigue and the Medic's accessibility to meds.

The ballet we rehearse for has already started and my goals shift to support and oversight.  The crews are working like they always do, like a single machine with one purpose.  Ignore the fact that these 6 people don't even know the names of their coworkers.  From where I'm standing they have been trained together since childhood to perform this one task.

And that's when I suddenly realize he is watching.

The son.

I've seen the faces of brave men following harrowing tasks and can tell you that this young man aged decades that night.

Through an interpreter, the 911 operator was told that a child was found hanging.  Turns out that a child FOUND someone hanging.  His father.

When the first engine arrived the patient was on the floor with the boy trying to do mouth to mouth.  No chest compressions, just a son trying to breathe life back into his father.

He was unsuccessful, but my 6 well trained firefighters and Paramedics had better luck.

While the patient was loaded onto a board for extrication, cold saline running to aid in maintaining the pulse now pumping blood through his once dead body, I turned my attentions back to the family.

Long after bed time there was a loud "THUD" that awoke him.  In his pajamas he investigated and found his father's feet dangling above the chair now sideways on the floor.  Somehow this boy thought enough to begin screaming and grabbed his father's legs.  And lifted.

It was this single action that likely led to his father's positive reaction to the paramedic's interventions.

He weighed, maybe, 70 pounds and was able to lift almost 200 pounds until mom was able to cut the twine.

His power lifting that day is nothing compared to the emotions he'll have to carry the rest of his life.

I have purposefully avoided the outcome of this case because both outcomes frighten me.  Either the son must come to terms with his father's suicide or the father must come to terms with explaining to his son why suicide was more important than raising him.

I find neither outcome acceptable.

The Crossover Show Episode 5 - Memoirs



Get to know a bit more about your hosts, MC and HM. The guys talk about what their memoir would be about if it had to be written right now.

Their hope is that you ponder what your own memoir would be about. Would you read it? If not, why not? More importantly, if not, what steps can you take today to turn your personal ship around?

Click the link in the sidebar to listen or here and be sure to subscribe to get all the episodes downloaded to your feed reader (or itunes) every Friday morning and be the first of your friends to hear the shenanigans!


Friday, May 22

Just Like Riding a Rigged Bicycle

This video swam into my feed recently and the click bait was well written.

"See why no one can ride this bicycle!"

OK, internet, what's the catch?


Smarter Every Day

Not only is it fascinating that the welders threw this bike together, but watching the host try to ride it, and everyone else try to ride it, really hit home for me.  There is the old saying that you can't teach an old dog new tricks.  I've always hated that phrase but in many respects it is true.

Most times we are so engrained in the way we learned something that learning a new way of doing it is not only difficult, but could be impossible.

Training and education can challenge the old ways.  Heck it should, but we need to use caution in moving forward with new ideas that change the way we've operated in the past.  For whatever reason we think changing the system may be better, there will be those who will need time to adapt to the changes.

Indeed it is easier to change your ways when they are fresh in your head, hence why the child in the video was able to learn in a few days what took the adult 8 months.

While riding a bike is a great metaphor for EMS (We train, rehearse, drill and train again until we can't get it wrong) it is important to remember that there are those in our field who still ask for Lidocaine on an arrest, reach for the MAST or go for a pulse check after a shock.

They are still riding the way they were taught, wobbling unsteadily trying to adapt to the new settings in front of them.  Some things can't be unlearned, simply archived and new pathways used for new concepts.

However, just like in the video, when challenged we will revert back to what we have known the longest.


Hey, it happens.  Just be ready to admit when you're wobbling and don't be over confident in your ability to suddenly be able to adapt to change.

After all, it is just like riding a bike, right?

Friday, May 8

A Tale of Two Nurses

We get all manner of "medical" folks presenting on airplanes these days.  From the EMT student who manages a stroke to the PhD in Engineering more interested in free miles than the broken arm presented to them when the crew asked "Is there a Doctor on board?"

Recently we had a few runs that showed me the wide variety of medical training available to our nursing friends.

The first call was for a possible seizure on board the plane.  While responding we are told that a nurse is with the patient and will meet the medics at the door.  Well, gee, I hope so.

As the aircraft arrives we are met with a conscious, alert, oriented, ambulatory and very embarrassed patient.  The patient claims he awoke from a very intense nightmare and was shaking, but awake.  The nurse, who repeatedly made sure to tell us about her 24 years in the ED, proceeded to tell us about a "confirmed post ictal period" that included crying and wanting to get up and walk.

Of course the nurse denied this reasonable request.  Later, the patient told us he recalls the entire event and our assessment backed his version of events.  As he signed a refusal, the nurse did a double take and came running over to me.

"If he isn't transported, you're going to get sued you know.  He needs a Doctor."  Then she went back to the counter to see about a flight coupon for "helping."

Not uncommon unfortunately.

Second nurse encounters a child itching her foot.  The parents seem oblivious, but this nurse stops and mentions that the foot looks to be red and swollen.  Upon further assessment the child is, in fact, experiencing an allergic reaction from a bite of some kind.  She quickly pulled some of the Benadryl she carries and gave it to Mother to give to the teewn aged child.

As medics arrived at the scene they found a child with no complaint and a blue shape drawn on her calf encircling a small bite wound.  The nurse drew a line around the edema to track its progress, but it regressed before they arrived.

"Glad you're a nurse," my crew told her, "Do you work in the ED?"

"No," she said shyly, "I'm a home health nurse.  I take care of an older couple.  You know, cook, clean, help them out."

She got a high 5 from us, then simply walked away.


Friday, May 1

the Crossover Show - the Police Fire EMS Podcast is Back AND ALL NEW!

Your favorite (and only) triple threat podcast is back after a long hiatus that can only be explained with a 9 iron, Facts of Life Reruns and a life sized cut out of former Secretary of State Colin Powell.

Motorcop and yours truly are taking our first 51 shows and rebooting the franchise to bring you a more formatted show that will be perfect for your morning commute, the treadmill, or ignoring the kids for a good 40 minutes doing yard work.

The Link to MCPD for the show is here and after this you won't have to worry about following along here, you'll simply add us to itunes or your podcast player of choice.

To add us to your non-itunes player simply add the feed

We're recording regularly so every Friday you'll hear more topics important to those of us first in when things go bad.

Included in this new show are segments titled "Lineup/Briefing" "10-8" "BOLO" and "AIQ/7SAM."  We go through the show just like you go though a shift on the engine, cruiser or ambulance.

So click through, have a listen and subscribe to the show Good Morning America calls, "We do not review content."

If you like what you hear please give us some feedback in the form of a rating on itunes (One star means you hate puppies).  The more positive ratings we get the higher we are placed on the queue (list for you cop types) and the more folks can hear the show.

So here we go!

The boys are back in town!