Tuesday, July 28, 2009

Mr. Anderson

"This could be trouble" I told Cyndi as we pulled around the corner and saw our patient sitting in the parkway.

Our patient was a black male, somewhere between 55 and 75. I thought he could be trouble because he had given us the stink eye as we came around the corner and had then looked away in a manner that only a man with a lifetime of experience can. His stare in the distance served to tell us that to him, we did not exist.

His distant stare of denial changed the instant we spoke with him. "Hey man, how are you doing?" I asked him.

"I'm fine" he told us with a smile.

I survey the scene and note that the presence of the generic black backpack that all of the parolees and temporary shelter residents seem to have. Our pt. has shoes, though not on his feet and he is clean. He has his teeth, at least his front ones and he doesn't reek of alcohol. He is also holding a cell phone.

The call had come in as a man down at a location transients occasionally use to take a break from panhandling. Other than the backpack and the fact that he is laying down in the parkway, there is nothing that really tells us that this man doesn't have a place to stay.
"What's your name, partner?" we ask him.

"Davis Anderson" he replies, with a smile.
We ask him if he's OK, if he needs medical attention, how long he's been there, where is he is headed. All of the questions that tell us if he has his head on straight and if he is medically sound.

Mr. Anderson tells us that he had gotten off of the bus and had walked toward the shopping center and felt he needed to rest. He had picked this spot because it was cooler in the shade. He also tells us that is is fine and definitely does not need an ambulance to go to the hospital.

Mr. Anderson is conscious, alert and oriented to time, place and purpose. He denies any medical issue and the desire for treatment transport. He appears to be able to care for himself and has a method to communicate with someone, should his condition change.

This works for us. We cancel the ambulance as it pulls up to the curb, wish Mr. Anderson a good afternoon and return to the station. Pasta with a special marinara - al fredo sauce, a Caesar's salad and garlic bread await us back in the barn.

The evening passes at the station. Dinner, the daily paperwork and a false alarm fill the early hours; the news and some e-mails finish it off.

At thirty minutes past midnight, a computer generated voice tells me I am going to a medical aid. The station alert light casts enough of a red glow in my dorm, so that I don't trip over anything on my way out. We are being dispatched to a reported man down, at the same location where we met Mr. Anderson seven hours before.
We discuss the possibility of this call being related to the one earlier and agree that it could be. Two minutes later, we get canceled. Dispatch tells us that the RP (reporting party) has called back and doesn't need an ambulance.
I really want to go back to bed but am not quite sure. Cyndi thinks that we should drive by just to see if it is Mr. Anderson. I agree, despite my desire for my additional sleep. We go available, but head to the shopping complex where we were seven hours ago.

As we pull around the corner, we see Mr. Anderson seated in the parkway, talking on his cell phone. The street is nearly empty now, as all of the local businesses have been closed for several hours.

I hop off of the engine as it comes to a stop; Mr. Anderson is intently speaking into the phone. "Who are you talking to?" I ask him.

Without saying a word he hands me the phone. I take it and ask who it is. It is one of our dispatchers, a 911 call taker. She tells me that Mr. Anderson had called a third time and said that he needed a deputy because he was disoriented, but he didn't need an ambulance. I tell her that I will advise the fire dispatcher by radio if we need a deputy.

I hand the cell phone back to Mr. Anderson and note that his shoes are several feet away, his backpack is open, its contents spilling onto the grass. His wallet is on the ground as well, a few credit cards laying next to it. We also find a business card from a charitable organization with his name printed on it.

Mr. Anderson is even more pleasant than he was earlier. He still is trying to tell us that he doesn't want an ambulance or need to go to the hospital. I make up my mind that Mr. Anderson isn't staying here. I don't yet know whether we're going to take him, or if I'm going to have to convince a deputy to take him home. Frankly, I didn't think about checking his cell phone for contact numbers until later.

I begin the series of questions to determine whether he is mentally oriented. He knows where he is more or less, he knows his name and his address. He isn't too sure of the time, but then, neither am I. He knows what he was doing when he arrived at his current location and he knows who the current president is. We determine that he does not have any recollection of our earlier conversation.

"Mr. Anderson. You don't remember talking with me earlier this evening?" Mr. Anderson shakes his head no. I am shocked. I have a distinctive look. Kind of like Bigfoot has a distinctive look. Or Chupacabre. Only not as cute nor as charming. People always remember my face, it is etched into their memory like a bad root canal procedure. They try to forget, but can't.

The fact that Mr. Anderson does not remember us being there talking to him is enough for the two medics on my crew that evening to consider Mr. Anderson in a slightly altered mental state. Enough so that we can treat him, even if he really doesn't want it.

I request the ambulance to respond again. Vitals, an assessment and BGM reveal a hypertensive diabetic with a blood glucose level in the low 60's. Not critically low, but low enough to cause a problem. We give Mr. Anderson some oral glucose, a sickeningly sweet concoction that provides a quick blood sugar boost.

The ambulance arrives and we load Mr. Anderson into the back of the ambulance. The sugar seems to help Mr. Anderson a little, but some of his answers still seem a little off.

The boot and I are having a conversation at the back of the ambulance as the ambu crew sets Mr. Anderson up for the ride. Somehow he misinterprets what we are saying and thinks that we are going to leave him there. A look of genuine fear flashes across his face. I am startled by this look of fear and we instantly assure him that we are not leaving him. He accepts our assurance and relaxes as the paramedic student begins an IV on him.
I have seen a similar look of fear on a person's face before, on my mother in law at my house one evening. She was in the early stages of Alzheimer's disease and was visiting our home for a get-together. She was seated at the table and suddenly looked up at me with such an expression of fear on her face, as if she suddenly did not know where she was or who all of these people around her were. The look on Mr. Anderson's face reminded me of the fearful expression on hers. It was unsettling to me.

We double check the grassy parkway for any of Mr. Anderson's belongings that we might have missed. Finding none, we send the ambulance on it's way.

On the way back to the station, we talk about Mr. Anderson's plight. Of course we second guess ourselves about not being a little more assertive the first time we rolled on him. I am not sure what conclusions the other members of my crew came to, but I believe that we were within policy and that we met our moral obligation when we determined that he was in no danger and respected his wishes to be left alone.
I think we all agree that we made the right choice in going to the scene despite being cancelled.

Two shifts have passed since this call. We have driven by Mr. Anderson's resting spot several times, as it is near where we shop for chow. Each time I have looked for him and have been relieved not to see him.

I don't think he is homeless, I do think that he may be suffering from the early stages of some form of geriatric dementia. The low blood sugar didn't help matters either. Hopefully he has someone to look after him, so he doesn't have to run into the likes of us again.

Thanks for reading,
Schmoe

Another Joe, keeping the wolves from the door.

Sunday, July 26, 2009

Schmoe Snivels. Like a sissy.

I have been back to work now for a "cycle", which consists of 4 - 24 hour shifts with 24 hours off between each one.

A few items occurred last cycle which are worthy of a line or two. That sad thing is however, I won't be sharing them with you for a while as I am currently unable to focus on writing. You see, my domicile is currently in a state of chaos. This chaos is directly the result of my @#$%^& *(&%%^& air conditioner deciding to quit working last night.


I guess the $6000 I spent on a new unit 3 years, 1 month and 27 days ago was not enough. The compressor has catastrophically failed. It should be covered under warranty, but I will likely have to fork over another $500 or so for labor. Folks, a few hours ago it was 91 degrees in my house. MY HOUSE!!!! Thankfully the sun went down and it's only 88. That' s 31.11111 degrees for my metric readers.

Even the dogs are wilting. At least they aren't whining, like I am.

The Saint that I am married to is a kind, fair and merciful spouse. She upped my daily grog ration to three, so I will be able to survive. I think that was more for her benefit than mine.

I know that in the scope of things, my issue is trivial and insignificant. I know that some of you right now are suffering far worse than I. I am deeply sorry for your strife and sincerely hope that things improve for you. But on the bright side, now you all know what kind of sniveling little bitch I can be.

Thanks for reading,

A warm Schmoe.

Wednesday, July 22, 2009

Newby I.C.

There is a big difference between assigned to an incident and being in charge of an incident. As a firefighter or as an engineer, you are usually given an operational task, a certain level of direction and the resources necessary to complete your job. Should you fail to complete the task, you make the necessary changes to achieve your goal or modify the goal. You are responsible for your task, but the outcome for the entire incident is resting on the shoulders of the Incident Commander (I.C.)

Although we all take responsibility for our own safety and that of our teammates, ultimately, the I.C. is responsible for the safety for each and every member on the incident. This in an inherently dangerous environment.
Some people pin on the Captain's or D.C. badge and are immediately challenged by a large or difficult fire. Others, like me, do not. In the months following my promotion, I went to a lot of medical aids, rescues, traffic accidents and even a Mass Casualty Incident. I also responded to several fires. They were either extinguished before things got out of hand, or I was not the I.C.

In my agency, the first officer arriving at the scene of a fire has the option of keeping command or passing command to the next arriving officer. When command is kept, the rest of the crew is given an assignment such as fire attack and the officer then establishes command, sets up the command structure and begins making assignments for the other arriving units. In situations where there is a shortage of personnel at the beginning of an incident, the officer may opt to pass command to the next arriving officer and assist with the fire attack. There are advantages to both and the decision it is usually up to the first in officer.

It took six months after my promotion, for my opportunity to command a significant fire to occur.

The call came in the early morning hours for smoke seen coming from a local elementary school. Only one call was received, so I was thinking that maybe a dumpster had been torched somewhere at the school. We arrived on scene and could see a pretty good column of smoke and an orange glow coming from the center of the school. The size of the smoke column told me that the chances of this being a dumpster fire were small.

Where I was assigned at the time, school security was a big issue. Access to the schools were very limited, with six ft. high fences, locked gates and security posts in place to prevent criminal activity.

I had the additional responding units stand by at the street while my two firefighters and I grabbed tools and tried to enter the campus. The closest access point was a vehicular gate that was secured by a set up which prevented the padlock from being cut or forced. The gate was constructed in a way which would have made it difficult to cut the hinges and swing it as the device that prevented access to the locks would also prevent it from swinging.

The secured gate was throwing a monkey wrench into my plans. I sent the squad around to the other side of the campus to see if another gate was available, one easier to force. I hollered for my junior rookie (I had two) to get a roof ladder to scale the fence. I had been on scene for a couple of minutes and I had not yet seen the fire and did not know exactly what I was dealing with. Nor was that likely to change in the next few minutes.

Every once in a while, one arrives at a point when they realize they are not entirely in control of a situation. I work in a profession where I get paid to be in control of otherwise chaotic situations. It was disconcerting to realize that I was arriving at one of these points. My fear was, that I would be slow to recover from the challenges before me and that the incident would get worse as a result. I forced myself to take a deep breath and focus on my available options.

It was right then when I looked up and saw a man gate located in a dark corner about 10 feet away. I had somehow missed it when we arrived and even though we were using flashlights to look at our surroundings, all of us had missed it while messing with the gate.

The lock was easily cut and the three of us trotted down a narrow alleyway. We went in about 150 feet, turned a corner and we finally saw what our problem was. A portable classroom was fully involved with fire; a second was about half involved (exposure #1) and a third was steaming (exposure #2). Another portable was close enough to present an additional exposure problem. Of course, if either exposure #2 or #3 became well involved, there would be even more exposures.

I called for my crew to pull a 250 foot 2 1/2 inch diameter hose line and protect exposure #2. We would have to pull the line through the man gate. I had the second in engine lay us a supply line from the hydrant and then pull an additional line through the gate. The truck was tasked with forcing entry into two of the exposures and shutting down utilities.

I asked for an additional engine "just in case" and asked for the D.C. to be notified. All of this transpired in just a few moments. Then, the most wondrous thing happened.
Everybody did what they were assigned, some did more and the damn thing went out!!!
Quickly too I might add.

There is no feeling quite like that as when you have killed your dragon. You felt it's breath as you neared it, the heat passing around you, enveloping your mask and helmet with hot, black gasses. But now, after a short violent battle, your lance has pierced its chest and punctured its heart. The beasts lifeblood pours out of its wounds and covers your hands. This dragon is slain, nevermore to wreak its havoc upon our city.

Or, you're just glad the fire is out, no one got hurt and you didn't look like an idiot while attaining you objectives. Either way works for me.

This fire also served as an evaluation tool for me. My junior rookie was had been on about 7 months. This was the first time I got to see her actually fight fire. She performed well and I was encouraged to see her laying on her back, in the mud, overhauling the underside of the flooring in one of the exposures. I cannot stand working with someone who will not get dirty if necessary. This wasn't going to be an issue with her.

The fire turned out to be an arson fire, one of several school arsons that occurred in our district. The arsonist was never caught, at least by us. I am sure he is either dead, in prison or is still lighting fires somewhere.

I was glad to get this behind me. Looking back, this incident does not come close to others that I have commanded. I have to remember that at that time, it was the biggest fire I had ever called the shots on. I guess its a matter of perspective. It obviously still holds some significance with me, that's why I shared it with you.

Thanks for reading,

Joe,

Just another Schmoe keeping the wolves from the door.

Wednesday, July 15, 2009

Dispatch

This goes out to all of those dedicated people, who take great joy in waking me up and telling me where to go.

The agency I work for is pretty big. I have worked here a long time and I have seen a lot of changes, Some of the changes have been good, some not so good. One of the areas which is always up for discussion is dispatch.

When I first came to this agency, we had our own dedicated dispatch. They worked in a fire department building, worked the same 24 hour shift that we did and even wore the same uniform, although without badges and with slightly different patches on the sleeve.

Back then, we had 30% fewer units and probably half of the calls that we run now. There were always two dispatchers on duty. Each night, one of the dispatchers would be the "primary" and would be the one up most of the time to handle the routine calls for service. If things got really busy or a major call came in, the primary would holler for the secondary to come in and help out.

There were two beds in a room just off of the dispatch room. There was also a restroom and shower. They took turns being the primary, so the secondary usually got at least some sleep. I can assure you there were a lot of nights no one slept.

If things really got busy, one of the dispatchers could get on the phone to us, and we would send a firefighter next door to assist in taking calls, making notifications or supporting an incident.

There were many benefits to this system. We had a good working relationship with our dispatchers. We all knew each other, knew each others strengths and weaknesses and thus had reasonable expectations. The dispatchers had a thorough knowledge of the district and of our department. We had more respect for them and their jobs, as we often assisted them.

The dispatchers also typed our fire reports. The captains would phone the information in to them and they would type / transcribe it. Probably the best thing was the instant communication when there was an issue.

If a dispatcher made a boo boo and angered the District Commander, he would address the issue and it would be resolved. Conversely, if a Captain was rude, surly or stupid, especially with a dispatcher, he could count on a visit from the District Commander. Issue resolved.

In the mid eighties, my agency finally got on board with the 911 system. Prior to that, the Sheriff's department had a 7 digit number, as did the Fire Department. I grew up in an area that now is under the jurisdiction of my agency. I still remember both 7 digit numbers, and I recently tested them. They both still work and they ring a phone, down in our current dispatch.

When the 911 system was being spec'd out, they(they, them, those people) figured that money could be saved by eliminating our dispatch, combining with the Sheriff's dispatch and creating an independent communications department. The plan was to have the Sheriff run the newly formed communications department for 3 or 4 years, then appoint a new communications director and voila - a new independent communications department.

The independent communication department never happened. Twenty four years later, we are dispatched by people controlled by the Sheriff.

The dispatchers went to a 10 hour shift, were absorbed into the Sheriff's department and life changed as we all knew it. I have met a few dispatchers, but only once. They are in a building far away from my response zone.

The system also changed the way our jurisdiction receives and processes emergency calls. Our communications center is called a PCAP - Primary Call Acceptance Point. This means that when someone calls 911 the call actually is answered in our communications center. The caller obtains the information, then routes the call information via computer to to the S.D. consoles or to the F.D. console. The dispatchers at these consoles then dispatch the recommended units to handle the incident.

This is where I must say that our dispatchers, by and large, are dedicated, professional, well trained and very good dispatchers. I am guessing that most of them would be surprised to hear me say that. That is because at times I can be a little on the grumpy side. Plus I have been a little frustrated with the dispatch system that was created twenty four years ago.

Some of our dispatchers have won awards from their peers for performing very well under extremely difficult situations. I have never heard of any events where incompetence or a poor attitude has resulted in a tragedy.

They perform as well as they do despite the system they work in, not as a result of it. Staffing issues, working conditions and an unsympathetic management system contribute to a less that ideal workplace.

They are always short on people, and are forced to work a lot of overtime. They have lives, just as we do. Friend and family relationships suffer as a result.

The two primary reasons for staffing shortages are people burning out after a few years and leaving and people who don't cut it and fail to make it through probation. Both add to the problem and it's a vicious cycle. They work a ten hour shift, plus often they get held over for an additional five. For a while, they were required to work a set number of "holdovers" per month. I think the number was six. Those were just the scheduled holdovers, not the ones due to someone calling off sick or having to do to court.

Most fire department personnel feel that we take a back seat to the needs of the sheriff's department. I tend to agree. This is not the dispatchers fault, that lies with the S.D. administrators who oversee them.

I do think that most of the dispatchers prefer to work the phones or the S.D. consoles over the F.D. consoles. That is understandable as the work is at a more steady pace. The average fire incident is handled with minimal radio traffic. Computer Aided Dispatch, Mobile Data Computers and push button communication has reduced a lot of radio traffic.

The initial hopes for the automation of dispatch was that it reduce the "routine" radio traffic so that the dispatchers could focus on emergency radio traffic and the incredible workloads that major emergencies can bring.

In reality, the automation has had the opposite effect. Communications management figured out that they could use the fire console to take 911 calls when things were a little slow. What started out as an interim measure became a standard procedure. This usually doesn't present a problem, unless an urgent situation arises. Then, we have to wait while the 911 call is finished or placed on hold, before they can talk to us.

This does not occur on the Sheriff's consoles.

When an incident"goes big" and requires multiple alarms, multiple frequencies and multiple agencies, the demands on a dispatcher are enormous. These, by the way, are the times when we tend to become needy and demanding. Strangely, these are also the times when issues occur.

When we do have a legitimate issue, it goes up the chain of command, who in turn take it fifteen miles to the sheriff and then down the food chain over there. Except that it usually doesn't make it into dispatch unless it's so bad that someone is going to get time off. Or worse.

That isn't fair to us and it isn't fair to the dispatchers.

In an effort to improve things, a friend of mine was assigned to serve as a liaison with communications administration. He said that it was the most frustrating time of his career. He beat his head against a wall all day and accomplished little if anything. He said it was like David vs. Goliath. Except that David didn't have any sling. Or even rocks. The position was eliminated in FY07-08 for budgetary reasons. I am surprised it lasted as long as it did.

I like to think that if we controlled our system, we could incorporate modern technology along with the best dispatchers who would be dedicated to our mission. Not someone else's.

As time passes by, the memories of what dispatch was and the hopes of what it was supposed to be will fade. Old guys like me will be gone and will be replaced by people who know nothing else but the current system.

One thing for sure. Whatever form the system takes, it will be staffed by dedicated professionals who will manage to excel.

If any of my dispatcher readers have any issues with what I've typed, I am sorry as I have nothing but respect for you and the service that you perform. Please fell free to point out any errors that I've made or even to call me out.

Thanks for reading,
Schmoe

Sunday, July 12, 2009

MARS ATTACKS!!!!!

I've been doing a lot of driving this week. We had the drive home from Nebraska during the first part of the week and this weekend, we drove down South into Riverside County. While coming home from the Temecula area, I see this huge airplane flying low over Lake Elsinore.


I have been an aviation buff all of my life. I recognize it as a type of flying boat that has been modified for firefighting use. When it flies behind a hill and doesn't come back into view, I know that it has landed on the lake.

Although I know this is going to add to an already long drive, I exit the freeway and try to get a closer look. We work our way to the North end of the lake and we find the aircraft moored to a buoy, as well as various support equipment.


Whatever they are up to, they are here to stay. I grab my camera and mosey on down to the shore.There were quite a few locals as well as representatives from the print and broadcast media. Along with the airplane, a Sikorsky S-76 helicopter is parked on it's own pad nearby.


I was able to speak with one of the ground support people and obtained a little information.
This is a Martin Mars flying boat. There were five of these that were delivered to the U.S. Navy toward the end of the second world war. There are two left, and they are owned by Coulson Air Tankers, which is based in Port Alberni, British Columbia.

This aircraft, The Hawaii Mars, is contracted to the U.S. Forest Service for this fire season and will be based at Lake Elsinore until December 10th. It's biggest asset is it's large water capacity and it's ability to load water without completely landing. It holds up to 7200 gallons of a water and gel mixture.

The Forest Service will use the Mars Hawaii to augment existing aerial firefighting forces in California. The helicopter is used to support the Mars as it attacks the fire.

The Mars arrived in Lake Elsinore this afternoon after a 7.5 hour flight from British Columbia. The support equipment had been there for several days, waiting for the Mars.

It is a very large airplane. It's wingspan is 5 feet longer than a 747. Most of the photos do not adequately portray it's size.


Each of the four engines produces 2500 horsepower. I wish I could have heard them running up close.

The aircraft's arrival and landing generated quite a bit of local interest.

An operation such as this requires a lot of technical and logistical support. Apparently Lake Elsinore is a recreational lake and does not normally support seaplane operations. As a result, Coulson brought what they needed with them.

This boat is used for maintenance. The platform allows maintenance personnel to reach areas a little higher on the Mars.


A large semi-trailer stores equipment and spares. It reminds me of the transporters that auto racing teams use.

A Prevost Motor Coach allows at least some personnel to stay on site.


A crane does the heavy lifting.

This trailer contains the gel that is mixed with the water on board the aircraft. It is pumped on board before the aircraft departs.

Two tankers are on site. The larger one contains aviation gasoline for the Mars. It contains enough fuel to last the Mars for about a day and a half during steady operations.


A smaller tank trailer contains fuel for the turbine powered helicopter. They are parked on opposite ends of the site. You definitely wouldn't want to get them mixed up. Kind of like putting diesel in the chief's buggy.

As the Mars does not have landing gear, it stays on the water unless heavy maintenance is required. A boat is required to access the plane. Forgetting your sunglasses must be a pain.

This is a beautiful airplane and it is a piece of history. I wish these folks well. Maybe they will work their way up to my area and I will get to see them in action. Time will tell.

Saturday, July 11, 2009

Paranoia (just a little)



As you walk out of my kitchen door and into the garage, you will face the side of a large cabinet. Affixed to the cabinet are numerous mementos of my career. They are little things mostly. A manufacturers plate from the engine I drove as a newly promoted engineer; the “Captains office sign from a fire station long since torn down; several apparatus emblems, such as Crown Coach and Ward la France. Those are from engines that are now molten into something else. Little items that mean nothing to anybody but me.


The largest item affixed to the wall of the cabinet is placed in a manner that requires me to look at it every time I walk into the garage. Considering that I park my daily driver in the garage, it means that I have to look at it every time I go to work.


This item is not directly related to the fire service. It is the only item on that cabinet wall that is not. It is a souvenir from New Year’s Eve about 5 years ago.


I was working on that New Years Eve. I didn’t mind really. The saint that I am married to and I are not real “party animals”, we usually celebrate with family and friends on another day.


On that particular New Years Eve, I was working at one of our busier stations. It had been an abnormally slow day call wise and we were all a little strung out by the holiday season. I had gone to bed early and was not particularly happy when the tones went off at about 0130 I waited in bed, hoping the call was for the squad or for the truck company. A few seconds later, the voice on the other end of the wire told me that it was time to go to work.


“Engine 201 and AMR, respond with Eastvale Engine 4 to a reported traffic collision on the highway, eastbound highway 394 and Rincon Rd. Car is reported to be off of the highway. Respond on blue 6. Contact Eastvale on their TAC2.”


We were running a person short that night, someone was off on vacation. The three of us remaining dragon slayers tried to get our heads clear as we walked down the hallway and entered the apparatus floor.

I pressed the magic button as I walk by it. The apparatus bay door opened and a blast of frigid air chilled us as we donned our safety gear. As we pulled out onto the front ramp, we were greeted by a wet street and a light rain.


I became a little apprehensive. Darkness, wet pavement, highway speeds and a high drunk to sober driver ratio combined to increase the chances of a routine call going bad.

We hung a left and a short while later we entered the highway. The Eastvale engine entered right behind us; they must have been clearing another call.


We work with Eastvale Fire Protection District a lot. We share district boundaries, including the highway. We have their radios in our rig, they have ours in theirs. Depending where this call was located, this call could have been theirs or ours. I made contact with them on their frequency and made sure that we were working with the same information.


We drove down the highway, looking for signs of an accident. Although the rain had stopped, the spray from passing cars speeding down the wet highway coated our windshield, causing us to use the wipers.


As it was dark, and the pavement wet, the spotting of fresh skid marks was impossible. We were driving at a slower speed, using a spotlight to scan the shoulder for a vehicle or a victim. This was a double edged sword. The slower speed enabled us to search more thoroughly, but it also increased the chances that some drunk would plow into the back of our engine.


I leaned forward and looked into the side rear view mirror. I could see the Eastvale engine behind us, doing the same thing as we were. I felt a little better, as they were acting as a shield for us. The drunk would likely hit them before us.


Both units drove down the highway for several miles past the reported location. We found nothing. I checked with our dispatch to see how many calls had been received on this. I could hear the Eastvale engine do the same with his. Only one call was received and that was to our dispatch. No additional information was available. The call back number was to a cell phone, and was going to voicemail.

We drove to an off-ramp five miles down the road and turned around. I had Eastvale Engine 4 drive a mile further east to the next off-ramp, then turn westbound. I told them if they didn’t find anything, they could return to service. Our westbound search revealed no sign of an accident either.


We proceeded westbound until we reached the off-ramp where we entered the highway to begin with. As we reached the top of the ramp, I evaluated our options. The highway had been searched twice, once by each unit. The state troopers had been in the area and had found nothing as had AMR, our ambulance provider at that time. This information was countered by the recent headlines of an incident that occurred in California where a woman drove off of the road and the responding agencies did not find her. She was found by family members a week later, unfortunately dead.


I would like to say that I have superior decision making capabilities or that a superior level of logic, intellect and good judgment has kept me mostly out of trouble over the years. But that would not be entirely true. On several occasions, I have just been lucky when presented with difficult choices and made the right one. Other times, as in this case, just wanting to cover myself, in case something went wrong, has caused me to make the right choice.

“Babs, take another lap” I told my engineer “I just want to make sure”.


We headed eastbound again, driving slow, using the spotlight. Except this time we didn’t have the shield of the Eastvale engine behind us.


A few miles pass. Still no sign of an accident. No debris, no broken fence, no damaged landscaping. As we approached our turn around point, I heard Cindi over the intercom. “Stop. Stop, I think I see something”.

Babinski pulled the unit over and stopped. Cindi and I grabbed hand lights and got off of the engine for a closer look. The reflection that Cindi saw was a CD, leaning up against a bush.


Finding a CD along side the highway is not unusual. We live in a county of slobs, littering the roadsides with anything that is no longer wanted. The bush is located well off of the highway. It is amazing that Cindi spotted it. As we looked at it, we raised our hand lights and saw additional debris plus a spot where there appears to be an impact point.


We start moving farther from the road, now dropping into a small gully. A voice called to us from across the gully “Help me I’m over here!”


We shined our lights toward the voice and saw a male, walking in the bushes toward us. He appeared to be moving fairly well, though covered in moist earth. I advised dispatch that we had found the accident and asked her to advise the troopers and AMR where we were.


We then saw the car, which was on its roof, lying along side some railroad tracks. The tracks are a spur line and run along the bottom of the gully. They were not much of an issue, as they are only used two or three times a week and have a slow speed restriction on them.


The male pt. told us that he was looking for his girlfriend, who was in the car with him when it crashed. We looked in the car, then under it. She was not there. We found her in a few minutes, lying in the weeds. She was semi-conscious, but was breathing well.

AMR arrived and we got both patients assessed, treated and loaded for transport. As it turned out, the male patient was basically uninjured. The female had a broken arm. Her altered level of consciousness was primarily due to excessive alcohol in her bloodstream.


We made the appropriate notifications and checked the area one more time. Just in case.

All involved were lucky that night. Our patients were lucky as in they were not injured worse; we were lucky that I was a little paranoid and decided to check one more time. All were lucky that Cindi saw the CD and spoke up about it.


How does this tie in to the side of my garage cabinet? The one non-fire service item attached to it is a roadside marker that the above mentioned car took out as it left the highway. We found it as we cleared the scene. It had been thrown a hundred feet or so from where it belonged. I told the trooper I was taking it; he laughed and said that he wouldn’t arrest me for stealing state property.

It is on the side of my cabinet to remind me to be thorough, vigilant and maybe just a little paranoid. I see it every time I go to work.


Thanks for reading,

Joe

Just another Schmoe, keeping the wolves from the door.

Wednesday, July 8, 2009

Wounded Warrior

The call came in for chest pain, at a factory that we go to on a regular basis. They are pretty dialed is as far as businesses go. They have their own response team, which includes an EMT. They are pretty good about sending someone out to the gate to guide us in, usually someone in a golf cart.

We meet the golf cart at the gate and follow him into the facility, stopping at an assembly building. I grab my H.T. (handy-talkie), my clipboard, my EMS bag and step off of the engine. I ask the guy how far into the building we are going and if the patient is talking. He tells me that the patient is only in a few hundred feet and that the patient was conscious when they found him. The crew grabs the airway bag, drug box and monitor and we all follow our guide.

We walk into the building, make a few turns and find our patient. He is lying on the floor, with his head resting against the knees of a co-worker. The co-worker is kneeling on the cement floor at the head of the patient. Various supervisors are present, but standing out of the way at a respectful distance. The plant EMT is tending to the patient, administering 02 via mask and trying to get vitals for us.

The patient is a 35 yr. male. He has a shaved head, a goatee and has numerous tattoos. The patient is shaking heavily and initially isn’t responding to our questions. He is breathing at a rapid rate, respirations cranking along at about 60 per minute. A look at his hands reveals that they are cramped up into a claw like position.

Our patient mutters something about needing to see Sgt. Gomez and some other statements which I can’t make out.

We shut off the 02 and continue our assessment, leaving the mask in place. No obvious signs of trauma, no evidence of a fall. Witnesses said that they found him leaning against a pallet of aircraft parts and that they had assisted him to the floor. My medic is telling our pt. to slow his breathing down in calm, soothing voice.

About this time, one of the supervisors walks up and tells us that our pt. had a similar episode about a year ago and was diagnosed with an anxiety disorder, depression and a few other issues. Our patient is answering more of our questions now and tells us that he takes five medications. He doesn’t remember what they are, but tells us that they are for anxiety, depression, anger management and mood stabilization. He denies any other medical problems.

I have to be honest; sometimes it is hard to tell what the deal is with these types of calls. Sometimes we “get gamed” by people for any number of reasons. Other times it is just someone who is having difficulty dealing with life or someone who is juggling so many issues that any additional stress pushes them over the edge. Frankly, some people just handle stress or emotional trauma better than others. Then, there are all kinds of people that have legitimate mental / emotional issues which require medication and therapy to get it sorted out. As we are not E.M.P.s, (Emergency Medical Psychologists), we have no way of telling who is what.

The solution to this quandary is to assume they all fit into the latter category, treat whatever symptom that they are presenting to us and act like the professionals that we are. It’s best for the patient, best for the public and it keeps us out of trouble.

As I watched my crew continue their assessment, I wondered what the deal was with this guy and how he got this way. I also noticed that one of the many tattoos on his arm was an elaborate design incorporating the term “U.S. Army”. Another was designed around a unit insignia and had a Latin term attached to it.

A few more co-workers show up and one approaches me. He tells me that he is a friend of our patient and that our patient had served in Afghanistan. He adds that our patient had been a “designated marksman” in his unit and has been struggling with a lot of “issues” since coming home and leaving the army. The friend adds that our patient was shot while in Afghanistan but he doesn’t think that are any remaining problems from the wound. He also tells us that his friend learned recently he is eligible for VA benefits as he has become partially disabled as a result of his service.

A designated marksman is a specially trained soldier who is attached to a small infantry unit known as a squad. His job is to support the squad by taking out targets that are farther away than regular infantry can accurately hit, yet closer than those company snipers usually engage. Designated marksmen use a rifle with a telescopic sight on it. This “scope” gives them a good view of their target before the round is sent down range and often as the round hits the target. I imagine that some of those visual images are disturbing to say the least.

I don’t know what kind of shape our patient was in before his stint as a designated marksman. I can tell he isn’t doing so well right now.

Our assessment is complete and we turn him over to the ambulance crew for transport. As he is being wheeled out to the “box”, I think about how he appears to have recovered from his physical wounds, but how he continues to be ravaged by his emotional ones.

I hope that somehow, through treatment and counseling, our patient can conquer the demons that he battles with on a regular basis. Although his enlistment in the army is over, his war rages on.

Sunday, July 5, 2009

Independence Day

As noted in an earlier blog, #2 son and I are on the road for a family reunion. Our location is in a very small town in central Nebraska. This small town has about eleven hundred people. All of the local residents who I have met over the years have been friendly, helpful folks. It's the kind of place that you see on T.V, the kind of place that exemplifies small town America.
My relatives love this small town and are fiercely loyal to it. The vast majority of the adult cousins still live here. One left and returned, one left and stayed gone and the other lives on a ranch in the western part of the state. Their kids mostly stayed near as well.

I have spent seven or eight Independence Days in this small town. It is a geographically desirable location for my extended family to have a reunion. The relatives from the west and those from the east meet in the middle.

The first time I came here was in 1985. I was a newlywed with a brand new Toyota pick-up, the first new car I ever owned. We hit a deer on the way out, had to leave the truck in Denver for a month to get fixed. A rental car, an extra night on the road and a couple of airline tickets salvaged this trip.
My two sons were dedicated to God in this small town. My uncle, a minister who lives in Wisconsin comes out for these family reunions. He was happy to perform the service in the local Methodist church.


I have been to the reunion solo, with my wife (pre-kids), with my wife and one baby, with my wife and two babies and with #2 teenage son. All have been good trips, despite minor setbacks and issues.

This small town is primarily an agriculture town. The surrounding hills support cattle ranches; the flats usually grow corn or soybeans. Recreation also plays a part in this town’s economy. A huge reservoir lies a few miles to the west. Folks come from all over to fish and recreate in it. This town also hosts a huge rodeo, usually held at the end of July or in August.

Two (maybe more) cousins are on the local volunteer fire department. They train, maintain equipment, and respond emergencies that arise. Just like I do, except that they do it for free.
They do it because frankly, no one else is there to do it for them.


The Burwell Volunteer Fire Dept. responded when my second cousin’s husband suffered a heart attack and passed away. He was in town for the funeral of my great uncle who had passed away a week earlier. They also responded to a cousin’s auto repair shop when it burned and to another cousin’s house when it burned.


As today was Independence Day, the plan was to get up early, drive to see a cousin who works at a fire department ninety minutes away then return to Burwell at noon for the reunion. An afternoon of feasting, drinking (in moderation, of course) and visiting was to be followed up by a visit to the Burwell V.F.D, who was hosting their annual BBQ.


The department BBQ is one of several ways that the department raises money for new equipment, and operating expenses. I think it helps fund the local fireworks show as well. It is a group effort and they do a great job. The food is amazing and they give you lots of it. It is held at the firehouse, both on the apparatus floor and on the front ramp. The apparatus is on display and there are activities for the kids.

As I was so stuffed from all of the food at the reunion, my plan was to give a donation, then obtain a just a sample of the BBQ and “call it good”. Fireworks at the park, followed by more at the ranch were to wrap up the evening.


My plans were altered when #2 son (age 16) crashed a cousin’s four wheeler late in the afternoon. He and another kid were riding on it when my son lost control and rolled it. It happened in a pasture; the first I heard of it was when another kids ran up to us in the barn, informing us that #2 son and his younger cousin had crashed bad on the crossover road.


One of the B.V.F.D. cousins and I piled into my truck and drove the short way up into the pasture. I was relieved to see the two kids up off of the ground. Cousin Joel was standing, with an abrasion next to his eye, #2 son seated on the back of another four wheeler.

Both kids were alert, oriented and wide-eyed scared. Cousin Joel denied injury, #2 son complaining of severe ankle pain. #2 son gets a complete survey: Pt. denies LOC, neck/back pain. No visible trauma or deformity to spine. Abrasions and dirt visible to left side of face. No deformity observed to head, no blood or fluid in nose or ears. Pupils equal. No visible trauma to chest, no pain upon inhalation. No pain to pelvis, palpation reveals pelvis intact, no deformity or crepitus noted. Swelling observed at left knee and ankle. Paradoxical palpation on femur and shin reveal no additional pain or crepitus. Distal functions normal.

Two scared kids, a broken four wheeler and undetermined leg injuries. I can live with that. We load up #2 son and take him back to the motel. He can’t put weight on the ankle. I get him cleaned up, apply ice and administer 600 mg of Motrin.

We’ll see how this works out in the morning. The closest hospital with anything more than an x-ray machine is a two hour drive away. We have tickets for the Rockies game on Monday; we’ll have to see about that. I’m just glad #2 son and Cousin Joel weren’t hurt worse in this small town.

Update: X-rays taken today reveal a broken tibia 1" above the ankle. Bruised rib, possible torn ligamint in his right knee. It's going to be a long ride home for him. Cousin Joel went to church today, with no obvious ill effect. Heal fast little buddy.