Notes from Mosquito Hill » EMS

Pear shaped

mack505 — Tue, 27 Mar 2012 04:00:03 +0000

Just another Sunday afternoon. Average. We’d seen a few patients, none too sick; I can’t remember what was for dinner. The fire tones dropped for a box alarm at a high rise.

It was no big deal. The engines go there multiple times a week, usually for burnt food. The timing was right for a well-done dinner. Conversation resumed in the ambulance bay.

“Fire Alarm to responding companies, I have a report of smoke in the hallway.” It was still not a very big deal; likely still burnt food.

Companies signed on scene, command was established, elevators were secured, and then things began to go sideways. “Engine 68 to Command, we’re bringing down a victim.”

That got our attention. Four of us dove for our ambulances, clearing the doors before the EMS tones could drop. We never leave together, but tonight we executed a perfect synchronized turn leaving quarters as I fell in behind Ambulance 9. A remote part of my brain saw the opening credits of Emergency! with the engine falling into formation behind the squad. That small part has never grown up, but there was no time to indulge it.

Radio traffic was busy with the ongoing rescue and a developing fire attack. The short ride seemed to take forever. As we arrived, Command was calling for us to meet the engine at the elevator bank.

Most of the residents had yet to realize that there was actually a fire in the tower. Evacuation was ongoing at what seemed a leisurely pace. We swam upstream with our gear. One elevator stood open, blinking its fire alarm light. The other showed activity on the floors above. Residents exited the stairwell and stared at us as they strolled past.

We began to review and mentally prepare. Airway is the primary concern, followed by smoke inhalation and burns. We have oxygen & the intubation kit, there are burn dressings in the first-in bags. The supervisor is en route with the cyanokit if we need it. What’s the Parkland burn formula again? It doesn’t matter; we can see the hospital from here.

The elevator dinged. The doors rolled open with a crashing rattle, and everything went pear shaped. This was not burns or smoke inhalation. It was a whole new nightmare, one I will remember for the rest of my life. My thought process came to a crashing halt just like the elevator.

Only for a second, though. We reboot quickly. We have the tools. Airway, breathing, circulation. Everything else comes later. We can do this. Let’s get moving.

Birds

mack505 — Thu, 22 Mar 2012 04:07:12 +0000

Birds.

I usually don’t notice them. Spring has suddenly returned, though, and I hear them everywhere. Shore birds populate the trees and dunes behind me, the occasional gull swoops past, and a pair of cormorants bob peacefully in the channel.

Small waves lap gently at the shore while the river gurgles past the jetties. I have lived all my life virtually within sight of the ocean, yet I fail to appreciate it. I’m a mountain person; my solace is found in trails and trees.

Yet here this morning with the sun on my face and the breeze at my back, with the smell of salt in the air, facing the limitless expanse of the mighty Atlantic, I can steal a few moments of peace.

Salisbury Beach by Mack505 on Flickr

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I’ve written before of my first experience with critical incident stress. Tonight I had occasion to attend another debriefing. I felt pretty good going in. I knew we’d had an awful call, but I was still feeling OK. I feel I have a good support system. I rode the emotional roller coaster, learned a few things, had other things affirmed, and gained some insight into how the other side works.

The debriefing was a good experience, but I could still do without the triggering event.

It’s a beautiful night. Today was sunny and 82 degrees. As I was leaving the hospital, one of our units pulled up beside me in traffic. The sound of the Diesel, the warm night air, George hanging his bare arm out the driver’s window. Suddenly I wanted to be up there, in that seat. These are my people. We take care of each other as much as the city.

Summer nights have a magic in the city, and we are nocturnal. I’m in the middle of 4 days off, and suddenly all I wanted was to be back in that truck.

The light went green and they drove away before I could shout a hello. I’m sure the city will survive a few more days without me. I’m off to enjoy the night air and try my hand at photographing stars.

Don’t get intubated

mack505 — Mon, 05 Mar 2012 13:42:16 +0000

When you stop taking your Lasix because it makes you pee, you can’t breathe.

When you can’t breathe, your wife calls 911.

When your wife calls 911, the paramedics come.

When the paramedics come, they put you on CPAP.

When the paramedics put you on CPAP, you may get intubated in the Emergency Department.

Don’t get intubated in the emergency department. . .

(With apologies to DirecTV.)

Billboards

mack505 — Sat, 03 Mar 2012 21:57:03 +0000

My company stresses appearances.

This is not necessarily a bad thing. I drive a large ambulance with bright stripes, lots of flashing lights, and a two-foot high corporate logo on the side. It’s a rolling billboard. Everything I do in it reflects on me and my coworkers. No matter how pure our motives, if we look like idiots while doing our job there will be trouble. At best there may be a complaint; at worst we could be the next YouTube sensation and star in our own Firegeezer post.

This carries over into my personal life. I’m proud of who I am and what I do, but I don’t feel the need to broadcast it 24/7/365. Sometimes it’s good to be just another guy in the crowd. I have become very conscious of when and where I wear department apparel. My cars are subtle; while I do have red lights in my truck, they are hidden when not in use. I don’t drive around sporting a light bar or a bunch of extra antennas. The car wears a W6 decal and that’s it.

This all comes about because you never know who might be watching.

So if you are going to have a $4,000 light bar and 3 antennas on your personal vehicle, please don’t drive like an idiot on the way to your next call. What would ever possess you to add a distinctive vanity license plate like PARAGD, MEDIC9, ENGN51, or (God forbid) your unique county radio ID?!

I say again: if you insist on standing out from the crowd, be on your best behavior. DON’T BE AN IDIOT!!!

Because, you know, that guy in the non-descript gray pickup that you just cut off might know a thing or two about the right way to do your job. He might even know your chief.

No related posts.

Chickens, ambulances, and surreality

mack505 — Tue, 28 Feb 2012 01:50:47 +0000

2/23/12 – Look out below! The chickens love to roost on the screen door in the coop. They will ride it back and forth when you walk in.

2/24/12 – Cold, rain, streetlights. Another dose of surreality.

2/25 – Still in the camera, on film!

2/26/12 – Medic 9 and our BLS backup.

Heaven or hell?

mack505 — Thu, 23 Feb 2012 10:05:31 +0000

“Medic 9 respond, 10 High St for the unresponsive patient.”

My partner groans. It’s a Known Address; a rooming house. In fire inspector parlance it’s a Single Room Occupancy or SRO. Each ‘apartment’ consists of one room large enough for a bed, a television, and maybe a microwave. Everyone shares a kitchen at one end of the hall and a bathroom at the other.

Its denizens are a teeming mass of humanity one small step this side of homelessness, but that’s not why we know the address. Among all the stories and lives, the mundane and the desperate, two stand out.

Jefferson is an alcoholic. He hasn’t hit bottom yet; he still pays rent and has a roof over his head. We see him regularly both here and on the streets of our city. He’s a big, mean drunk, a danger to both himself and the people who respond to help him. We dread this address because of him.

Abe, on the other hand, is a small polite diabetic. He’s always friendly, even when his sugar is in the tank. He tries hard, but sometimes it gets away from him. He apologizes after we wake him up, and he always wants to walk himself down the stairs. You just have to like him.

Big, small; friendly, mean; diabetic, alcoholic. Heaven or hell, which will it be today?

Project 366 – week of 2/11

mack505 — Fri, 17 Feb 2012 02:35:08 +0000

2/11 – One for me, one for her. If you’ve been reading the blog for very long you know which is which.

2/12 – Going ‘commando’ at work. Sweater, that is. My sweater has been with me since my first winter in EMS those many years ago. I finally had paramedic and company patches installed on it this past week.

2/13 – coming later. It’s still in the FM2 right now.

2/14 – More on this later.

2/15 – It’s a miracle!! (seen randomly on the sidewalk)

Blue skies (P366 – 1/28)

mack505 — Sat, 04 Feb 2012 13:05:12 +0000

I’ve written in the past about my white cloud. I try not to be superstitious, but I went through a long dry spell at work. Slow days, ‘no-hitters’, cancellations; It was nice for a while, then it was boring.

Recently my cloud has evaporated. I haven’t developed a black cloud yet, but I see sick people. Chest pain, respiratory, head bleeds, STEMIs, even a fair bit of trauma have all come my way. I’ve been able to do my job and feel like people need me. It’s been nice.

I don’t need a cloud, white or black. The blue skies are treating me very well.

Duet

mack505 — Mon, 30 Jan 2012 14:05:57 +0000

Friends since high school, their lives have orbited and intertwined for decades. War, marriages, children, careers; all have come and gone yet friendship remains.

Upstairs we dance the ballet. Compressions, airway, breathing, electricity. Three paramedics, four firefighters, and an EMT all choreographed around one person on the floor.

Downstairs a lone EMT does the real work as the curtain closes on a duet.

Retro

mack505 — Sat, 28 Jan 2012 20:48:18 +0000

As mentioned previously, I’ve been shooting a bit on real film. I learned photography on a manual 35mm camera, shooting and developing my own film. Sometimes it’s fun to go back.

January 12 – At the firehouse. You don’t see folding controls very often, but even when folded these barely clear the doors.

January 13 – ALS

Shot on a Nikon FM2 with 50mm manual lens. Thanks to OldSchoolPhotoLab.com for developing and scanning for me. Not many folks can handle Tmax 400 any more.