Fighting Fires... and Other Things

Rarely a day goes by that I don't find myself wanting to journal on a subject or tell the world about my day. I just can't get to the computer.

I got moved to "B" shift after a year and a half and love it. Great folks. I've also still been reserving at two otrher depts for the extra $ and bagged some good calls here and there. Its now 3 am-ish and just got home for being called out because of a two alarm commercial assignment that exhausted the area's resources. Five different departments had apparatus there. Good stuff... so much for my six days off in a row but good stuff anyhow.

Last Friday also reserving at "the other place," we were called to a rollover MVA way out in BFE. The update on the radio was one patient with an elbow laceration... Cool... no biggie (or so I think). As we rolled up, the deputies are onscene and a few lookie- lous mingled about. Okayyyyyy I wonder who my patient is. The first deputy says "looks like its gonna require an extrication." Geez.... so much for an elbow lac. The SUV flipped three times crushing the roof over the edge of the doors. The engine was 30 seconds behind us with the tools to cut the car apart. I reached in the window (no glass left anywhere anyhow) and felt a carotid pulse but he won't answer. No reaction to a sternal rub. I told my partner to launch the helicopter. It wasn't long after that I heard my old "A" shift captain come up on the radio and offer their assistance with manpower for setting up a LZ for the help or whatever. Nahhh.. we got 'em. We are so far out in the sticks, they'd have a 15 minute response going code 3 anyhow. The SUV smells like a brewery and dude smells about the same. The twist top from his fourty-ouncer is still in his lap. Witnesses put him at over 65 mph and the vehicle rolled three complete times landing on wheels. No seatbelt. How dude managed to not get ejected is beyond me. By the time we got a collar on him, used the jaws on the door and got him on a board and in back of the ambulance, the helicopter was om the ground. Now dude is awake .... damnit.. why couldn't he just stay unconscious? Hes spitting on us.... trying to hit us .. lovely. As soon as the flight crew climbed in back I said "Joyce, you are prolly gonna want to RSI this gentleman."  Pilots get piussed when you put combative people in their aircraft... so its kills two birds with one stone. One, we use paralytics and secure his airway and... two, he is off to nappy-time and no problem in the air. To make a long story short, I got the IV just in time for the flight crew to secure this gentleman and we went back to quarters to decon and restock.

The pic of my white F350 was out on I-10... blew a front steer tire and did 3k in damage. The Geico sucks.

The "other" car up on a jack was a practical joke played on our "booter" new guy. While he was out on a call last tour, "somebody" took his tire off and slid it under the car. I honestly didn't do it but I sure did laugh about it.

More calls soon. Wear your seat belt so you'll be around to read it. Peace. 

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We buried a good man today. A scrote shot three cops June 2nd, two deputies and one TPD officer. The TPD guy didn't make it. The cop spent 20 years in the service and went into local law enforcement in 2004. Helluva guy. I did not have the honor of knowing this man but he has had a big impact lately on lots of folks here including many, like myself, that had never met him. 

The scrote will get lethal injection about a dozen years from now - after our tax dollars keep in fine health care, therapy and fine dental work. While I am quite fond of capital punishment, the thought of this asshole having to look at posters of Officer Hite's 1 year old daughter plastered on the roof of his 8 x 8 cell every day for 60 years sounds good too.

Thanks for everything you did, Erik. I'm glad the 11 mile procession through the streets was all about you and the things you did to make this place better.

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I had two great tours in a row. Tons of good calls and I'm home. This is again time where I'm supposed to have six days off in a row but picked up some reserve shifts at the other dept for some more ca$h so not as much time off as I'd like. Guess time will tell.

Yesterday was out of the twilight zone. Every time we got back, the tones went off before the computer report was done from the last call. On a couple of occasions, we never even made it out of the truck before the next call came out. On one of them, we were dispatched late for a domestic assault. The deputies had been there awhile and eventually cleared us to move in. I grabbed the jump bag and walked through the door. "Hellooooo.. FIRE department.."  Once past the entry way, I saw a young twenty-something brunette crumpled in the dining room floor. She is crying hysterically but I can't see any visible marks. Wow.. Damn domestics.. I'm thinking "how could some guy hit a gal like that?" Geez.. some people. I put my hand gently on her shouder. "Hi... my name is Karl.. I'm a paramedic... Where do you hurt?" No answer.  "Whats going on? I'm here to help you." The deputy ducks out from behind an adjoining doorway and says "your patient is in here."

Whoops. Ok.. I'm an idiot.

I turned the corner and here dude is sitting in handcuffs with his left eye swollen shut and miscellaneous cuts bleeding pretty good.

"Errrrr...Whats going on, sir?"

Seems she walloped his knoggin' a number of times with a closed fist..... then used a computer mouse like a geek nun-chuck and tore him a new ass.  I'll be damned.

There wasn't really a huge reason for dude to go to the hospital but he wanted to go. He was just prolonging the inevitable because he is going to jail afterwards anyhow but if they want to go, we still have to take 'em. She is going to jail also but the cops are waiting on cuffing her till the family shows up to care for the 18 month old toddler thats wandering around wondering wtf is going on. I dunno why they have a toddler up at 3 am anyhow much less letting the kid witness the violence. Some people have no business being parents. So.... I guess I need more practice in determining exactly who my patient is sometimes. <shrug>

More soon.

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The last couple shifts were preaty uneventfull... I'm ready for a few days off.

While on the ambulance one of the shifts, we were diapatched for a "fall injury." After getting enroute, the update included the fact that this guy was about "heavy ETOH onboard," meaning the guy was three sheets to the wind. I heard the engine come up responding to our call after a couple minutes... I have a history of being hit my drunk combative patients in the back of the ambulance so it made me curious if the engine self-dispatched to help assist me or if they were just hoping to see me get wapped. I found out later they were hoping for the latter.

The deputies showed up at about the same time. The guy was not being abusive but he was definitely feeling no pain. When we arrived, he was sitting in the bathroom after two bottles of empty vodka...holding a towel on his head... answering all questions without slurred speech and said he had no pain. Blood was everywhere... no... you may think there was alot of blood but I do mean everydamnwhere..... pooled on the floor.. on the walls.. drops on the ceiling... on the cabinets... and he remembers nothing. He keeps taking the towel off with his arms out at the sides in a questioning manner. He doesn't rememeber what happened. I kept asking him NOT to take the towel off anymore. <hint> Drunks do not listen. <hint> Paramedics should remember drunks don't listen or follow basic directions. Do I? Usually.. but I missed the boat tonight. On top of this, drunk-guy is touchy-feeley. Dude.. keep your bloody-ass hands away from me. I want to take you to the hospital. I don't want to make a poker-playing buddy or be pen pals. I'm glad you are thankfull but I don't want to shake your hands every two mintes.. gloves or otherwise. Most that read this journal know I care about people but jeezz... this guy is trying my patience. Drunk-guy has a full thickness lac the legnth of his anterior nose and another all the way up his forehead into his scalp line perfectly inline with the nose. Dang, I love trauma calls but I'm not having fun with this. He has no head, neck or back pain (no fooling?) so I made the decision to forego c-spine precautions.. no spine board, collar, etc. We walk dude to the gurney, toss a blankey on  and belt him down. Everytime the bleeding is about controlled, he takes the towel off and complains that he is still bleeding. No kidding, you rocket scientist. He whined about getting an IV... cried about the way he got oxygen and kept sniveling about the blood coming down his face. I finally had to take whats left of the towel, place some strategic 4 x 4s and cling-wrap his face like a mummy. he whined about that, too. Well, it ain't purty, he can breathe and the bleeding is stopped.

Time to go home yet?  

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I had a late call this morning two hours before we were supposed to go home. We were dispatched at 5:59 am. At first, I was tired. Damn, I have to pee. Then, because of the call we were dispatched to, I was apprehensive. Onscene, I'm inquisitive. Scared - he works for a neighboring brother department... I know him.. before we were both even in the fire service. After awhile - curious. Understanding. Soon, I'm balls to the wall with every stitch of knowledge/skill I might have. Relieved. Pissed off. Demanding. Humorous. Intelligent. Imformative. Sympathetic. Questioning. Enroute? I'm now apprehensive again. Game face, please. Lets do this. All about business. We talk.. conscious alert and oriented times four.. ABC's are intact... negative ETOH onboard... CMS intact times four...12 leads -- done.. IV-- done, labs -- done.. asperin --- done... nitro -- nope - his blood pressure sucks..Arriving at the hospital? Skillfull. Informative some more. Orator. Clerical. Relieved. High-fives.

I finished my paperwork and went back to quarters, put up my bedding, took bunker gear off the ambulance, did my computer report, stapled my hardcopies, signed my drug box sheet, told the ongoing medic what went down with the box that shift, filled out my overtime sheet and went home. Wow... we are bad-ass life-saving talented sons of bitches. woo hoo.

I got a call at home two hours later, he died at the hospital in the cath-lab.

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Be careful what you wish for. I enjoy trauma calls (more than the "my tummy hurts" taxi rides) so when we got called for a motorcycle accident in the National Park, I figured it would be good. I made a smart-assed comment that we would get a good trauma today. Its rare that a motorcycle accident happens in the Park without someone getting a ton of cactus thorns all over also. This call was no exception but it was the least of her problems. Today was another in our ongoing theme of "no motorcycle helmet(s)." This gal was on a Harley and everyone knows ya can't look cool on a Harley with a HELMET. It almost cost her life. The engine arrived with us (I was on the ambulance today) and our patient was off in the desert about 20 feet off the roadway. Her signifigant other, who was riding a different Harley was with her. She was going in and out on consciousness with a good head lac yada yada yada.

I thought about launching a helicopter for her but from where we were at, the time was about the same for us to take her in to the trauma center so I asked my Captain for an additional EMT to ride in with me because I needed another pair of hands. I got the IV fast and drew some blood. For a little petite gal, she had veins the size of garden hoses. She became unresponsive enroute so I had my partner upgrade to code 3 and get her there quickly. As we rolled into the trauma bay at the hospital, the senior attending casually walked over as several scrub-laden blue hospital type folks helped my partners get her to the hospital gurney. Several doogie howser looking residents peeked over the Doc's shoulders as I gave report on the little I knew about this gal's history, meds and allergies. I got my signature, finished my first round of paperwork and walked back to the ambulance so we could start back to the district.

Maybe we'll have a "change smoke detector batteries" call tomrrow.. Ya think? .  

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The first picture is my flatbed trailer after getting it to California last week. The trip had been pretty crappy up till that point [it breaking] and somehow, I lost part of an axle while driving down interstate 10. A minivan cut me off and started waving out the window. "Humnmm," I thought. "This IS California after all." <shrug> I looked back in the mirror and saw my ONE (not two) trailer tire tilted in and knew that my road rager was only trying to get my attention. Damn. I never felt the axle part and tire go bye-bye. Oh well. All I can do now is take the opposite tire off, chain up whats left of the axle and drive on it the last hundred miles. It worked. Now, to find a 10,000 lb mobile home axle in California on a Sunday. Piece of cake. I did (with a much lighter wallet), got 'er fixed, the trailer loaded and started back to Tucson uneventfully.

BEFORE the trailer broke, on the way TO California, the pickup caughed, snorted and belched black smoke just west of Phoenix. It sounded like a blew the engine. Luckily, it was just a hose for the turbo innercooler. I had no tools but I got on the CB and a "parking lot" (car hauler) stopped, loaned me a 1/2 wrench and got me going again. Makes me miss driving professionally sometimes. I got 1/2 mile before POOF and it blew again. THIS time, I exited the freeway and managed to stop right in front of one of the town's fire engines that was assigned a stand-by at a sky diving event there. They also helped me with tools and directed me to an auto parts store (after a third and fourth breakdown). I then bought a set of tools, fixed it right and the rest was ok.. until the trailer drama we've already gone over.

This Type 3 fire engine hasn't been used in a couple years to we had to get the pump going and some other TLC in case it gets called out on a wildland assignment this year. This truck isn't used for structural firefighting anymore for our department but makes a good wildland truck.

I'm sick of fixing things. I think my knee is broken.

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Approaching the fire (above) one mile out.

The fire (above) from 4 miles away. Some of Arizona's sahuaro cacti as we drive along. I wasnted to get more pics but our transport at the end put an end to my photography wishes.    

I've been home from work an hour or so. No sleep and need my beauty sleep soon but trying to keep it going.

The first shift of the tour was decent. I was supposed to be on the engine but due to some staffing issues, I was now on the ambulance and "toggling" between the ambulance and tender. SoooOOO.. if we get an EMS call, I'm all over it but if we pop a fire, my partner takes the ambulance and I'm responsible for bringing the tender. Like many times, this garage fire was just out of our district (our tones didn't even go off) but we were monitoring the radio and knew we could beat the responding units by several minutes so we called COM and told them to put us on the call. The engine was way ahead of me.. them myself in the tender followed up by my reserve EMT in the ambulance. The smoke was visible for several miles away as we drove in. Great adrenaline boost. The engine had a great knockdown on the fire as I pulled up and I prepared to hook up the engine's 3" "stinger" left for me at the entrance to the driveway (the engineer left a supply line on the ground for me as he entered the property).  After I hooked up to the discharge, I made eye contact with the engineer and he motioned for me to open 'er up and supply his engine. Radio contact was just too busy to do it on the handheld. I now finished bunkering out, donned my SCBA and my partner from the ambulance and I headed over to command for an assignment. We pulled a second attack line and the fire was out soon. In the middle of "overhaul" (pulling hot items out cheacking for smoldering items) 

I was directed by a bystander to one of the family members now experiencing trouble breathing. It tuns out, she was trying to put the fire out with a garden hose prior to our arrival and got the quite the dose of smoke inhallation.

We got her in the back of the ambulance.. turned up the airconditioning and put her on high flow oxygen. I was trashing the inside of the ambulance with my dirty bunker gear but oh well. Only so much we can do so off we went towards the hospital 40 minutes away. She also developed chest pain so I got the IV done, drew some labs and started her on asperin and nitro. She was delivered to the hospital in no time and we headed back to clean up the mess I made with my muddy bunker boots in the ambulance (the hospital was not pleased to see me that way, either).

I'm gonna sleep now.. more war stories soon. Ya' all be safe.    

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My last shift was pretty eventful. I wasn't normally supposed to be working but I had to pay back a "shift-swap" on B-shift for another medic that helped me with a day off not long ago. My partner and I had just got the truck-check done on the box... making sure we had enough of this.. enough of that... monitor batteries and charged... how much oxygen is in our main... reseal the drug-box.. yada yada..

Paramedic 121, paramedic 191, engine 191, batallion 191 ... bicylist struck elm and sycamore (not the real streets.. we were out in the sticks). Cool. This is also gonna be in a neighboring district's area but they diapatched us because we are going to be able to make it there faster. I put us responding and verified that we had a helo on standby. 

I like working with my EMT partner today - Danny. hes a good kid... wound up a little tight.. like a ping-pong ball in a hurricane but he is a good guy and very competent. More importantly, I trust his driving. Normally, the paramedic is on the passenger side and does the mapping and radio work and the EMT is responsible for the driving.

A National Park Police SUV lit-up as we rounded one corner - he is was also dispatched as the closest law-enforcement to this call. We got up the intersection in question - nothing. Okayyyyy... Park-cop went to investigate to the south.. we continued west. A mile or so further and I saw our gig. There were few stopped cars and lookie-lous meandering around hoping for a glimpse of some gore and twisted bodies. As we pulled up, a crotch-rocket (cafe-style motorcycle? I thought this was gonna be a bicycle struck?) was dumped in the ditch with the rider supine on the dirt shoulder. One lady bystander is holding his hand but nobody is holding c-spine precautions. Before I stepped out of the box, I told COM to launch the bird. 36 year old rider is now conscious with the typical head-injury symptoms. he'll answer questions and then forget he did and them answer them again. He hasn't been drinking but can't remember his phone number His biggest worry was they his wife was notified and they we told her that he loved her. Damn, you are killing me, man...  No helmet and it might cost him... What seems like acres of skin is gone off his head and he is bleeding like a stuck pig. I can't see any brain but there is a definite skull depression. Big lac-puncture over his right eye that is big enough to loose your pinkie in. After the c-collar was on, we log rolled him onto the spine-board and cleared his back as best we could. Good pedal pulses, he can wiggle his toes and follow multi-part commands. Sweet. We loaded him into the back of our box and one of the other EMT's had already spiked a couple bags for us and things went like clockwork. I started the IV on his left AC and drew labs while the other medic (he is normally on my regular shift but was actually filling in for the neighboring district today) started an IV also in his right arm. We had him on the monitor and were doing the secondary when the helicopter landed. I gave my report to the flight nurse and they [flight crew] made the decision to "RSI" this gentleman before we loaded him on the bird. RSI is a way of securing the airway by use of special paralytic drugs and then inserting an ET tube (to breathe). Its damned scarey. The nurse administered the additional drugs as the flight medic snapped open the laryngascope and got the tube inserted. He is now breathing better and stabilized. We now unloaded dude and rolled the gurney 100 yards or so down the asphalt to the waiting helo. Off they went and now we turned our attention back to our box. Looks like a hand-grenade hit it. We returned to the station after telling COM we are out-of-service for decon.

Restock this restock that, get a couple uh those.. and a couple 'o these.. wipe this... mop that.... the jump bag is back in order. Cool. Now there is just the paperwork on the firstcare form... asking the flight crew's dispatch to fax us some info... call the hospital and have them fax us some info... get the report number from the Sheriff's department.. and we can't forget the computer report. They might need to RSI ME before this call is over.

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I'll start with this morning and work backwards. Just about time to go home again and the tones go off. No medics from C-shift are in here yet. Lazy 7:59 bastards Oh well.. here we go.

"Paramedic 121, 59 year-old female...dog-bite.. amimal secured.. cleared to move in."

Once we get there, our gal is standing on the porch with her arm wrapped in a towel muttering stuff to us over the sound of the snarling pit bull that is chained to the porch wanting to tear me a new one. Animal is secure, my ass. I motion for the lady to step out to us at the ambulance. She mutters something else and walks back inside. I called our com-center and asked for cop-folks to respond. She finally walks out and we help her into the ambulance. Her left arm is wrapped in a towel and once a serious injury is wrapped, its not a good idea to expose it further until we are at the hospital but befiore I can finish explaining that, she tosses the towel on the floor and I'm looking at the various puncture wounds and pretty little pieces of bone sticking from the top of her hand. Kooolllllll. Look at THATTTtttt.. Bitchin'. Gal's husband is asking "is there gonna be a charge" to take her in the hospital. I explained that they keep financial dealings seperate from us folks in the trenches but I would imagine so. Hubby is insensed. "They don't charge for ambulances where they are from." So they walked to their POV to drive themselves to the hospital. I called our base hospital and documented the patient refusal. Turns out the dog that bit her was ANOTHER pit bull on the property that also killed their little Pomeranian this morning.

Anyone have Darwin's phone number?

Yesterday evening, a big jacked up 4 x 4 came sliding up in the front of the station horn blaring. Seems the gentleman has a lady-friend up front that has taken a whole bottle of clonazepam and another bottle of dalaudid and washed it down with something that makes her smell like a bar-fly. She is in her early thirties and one drop-dead gorgeous lady. Not all ODs are these high foreheaded toothless wonders that ya might think. Wow, this gal is gorked... not responding to a sternal rub right away and looking pretty bad. The engineer and I grabbed an end and we hauled her out of the truck and over to the gurney and plopped her in the ambulance. If you YELLED her first name, she'd open eyes for just a second and then she was gone again. She had an airway but barely. The other medic twisted an OPA in her mouth and she managed to reach up and pull it out herself. Thats a good sign kinda-sorta.. At least we won't have to intubate her --- yet. We need to get an IV to give her our drugs that reverse the actions of her drugs. The crap is still in her system but we buy her some time. I took my trauma shears and cut her shirt off (thats for you, Remo.. does "teal" mean anything to you?) so we could keep an eye on her breathing. The other medic was trying to get an IV in her left hand or AC and I was working on her right AC. Nothing.. nada.. zip. I asked my Captain to have a helicopter launched. Her blood pressure is roughly 80/50.. trust me.. those numbers aren't good. I finally gave up on the IV and pushed the first round of Naloxone intramuscular (a "shot") in her right arm. Yes, the drug is in.. but had we got it in her IV, it takes effect immediately. This way, its delayed awhile. I went back to trying the IV. With my Captain helping hold trraction on her neck-skin so the vein doesn't roll, I finally got an "EJ," external jugular IV catheter in. Sweet. I don't get to do EJs much. Shes so gorked, she doesn't care where I start the IV anyhow. Airevac was only coming from a close airport so they were on the ground shortly, I gave them a report, got my signature, loaded her in the bird and we went back to dinner.

Lots of other decent calls yesterday but I'll stop here. I'm on the engine tomorrow so might be able to take some pictures. We were up to our ass in alligators this pasty shift so no cool St Patty's Day pics... Woulddda been nice.

Y'all be safe. 

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