Pear shaped

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.