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Fire and Rescue, UK style

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My EMS adventures in Newcastle upon Tyne had come to an end and I had but one full day left in England.  Swalwell Station Manager Peter Mudie has arranged for me and Mark to take a bit of a tour of the capabilities of the Tyne and Wear Fire and Rescue Service, so we’re up early and he’s taken us for a road safety class.

Not for me, thank goodness, but for a group of young drivers to impress upon them the importance of not drinking and driving.

Many of us have been to these presentations before.  A middle aged expert prepares what to them appears to be a hip multi-media presentation and the attendees seem less than interested.  I was the same way at 16, we all were.

Enter the Happy Medic and UKMedic999 and the class is now wondering what just happened.

The presentation was actually one of the best I’ve seen including some racy videos that in the end have a message about driving safely.  The kids were really paying attention then.  Mark and I had a chance to impress upon the gathered youth the importance of seat belts and driving safely. I think my “accent” kept their attention more than my content.

Even the locals were cold. Mrs HM knit me two hats, so I shared.

Then it was off to the yard behind the station for an extrication drill to show the new drivers what happens when cars collide.

Set up down the hill were two cars and two students were chosen to be the victims.

To say it was “balls cold”, as one student put it, would be an understatement.  I’m a 6th generation Californian, 50 is cold for me.  This yard was cold.  Wind blowing, snow falling and me with no gloves.

The kids watched as their friends shivered in the cold while the fire appliances pulled up and began their task.  I mentioned in passing to the instructor that I would have let the kids go back inside and he suddenly had a point to make to the youth suddenly more interested in each other than the hydraulic tools freeing their friends.

“AYE!” He shouted to the huddled, hooded forms, “You’re here wearing your coats and gloves, hats and whatnot, but what if you were heading back from your mate’s place and were wearing only a shirt and crashed?” He was moving around in front of them, almost pacing like a drill sergeant, “Laying in the snow, cold, tired and hurt?  You wouldn’t last very long would you?”

He had their attention the rest of the morning.

The extrication was straight forward with the only difference being the use of the smaller ladders to brace the car on it’s side.

After a lunch cooked by the station’s french chef (Yes, the chef is not a firefighter) it was off to Tyne and Wear Fire Headquarters.

What an impressive building and training ground they have!

A grand foyer greets the visitor and many small groups of men are sitting in plain clothes discussing this and that.  One of them, the only one wearing a shirt and tie sees my SFFD Firefighter/Paramedic jacket and does a double take.

As I surveyed the enormous complex I would assume candidates are intimidated when they enter to get their employment packets.  Peter led Mark and I on a brief tour of the lower level and the man in the tie wandered over and said hello.  Just a casual greeting, he seemed like a regular guy in a sea of white embroidered uniforms and street clothes.

Chief Bathgate, Yours Truly, Peter Mudie

The man in the tie wandering the lobby is none other than Iain Bathgate – Chief Fire Officer for Tyne and Wear.

blink. blink.

He offered a hand and I shook it.  There I was in my uniform shirt, but buried under a sweatshirt and a jacket.  Had I known I was going to meet the Chief I would have at least donned my cap and tie to show respect.

Turns out he was more interested in the back of my jacket than what wasn’t around my neck.

“You do both then?” he asked me.

“Not often at once, but yes, I am proficient in both skills” I replied, wondering if I should go into further explanation.  As we spoke the other men were taking interest in the fellow with two titles on his jacket their Chief was talking to.  He immediately suggested a tour of the training grounds, something his face glowed about, he was proud of it.

Through the main lobby and out another set of large glass doors was their training facility, easily 5 acres and including a wide variety of props.

11towerThere was a standard training tower that, since once at the top one could peer over to the automobile manufacturer test track next door, was rotated and modified to keep wandering eyes away.

11highangle

Next to that was a high voltage power line tower prop for high angle rope drills.  Under construction nearby was a large two story collapse house that can be dropped and rebuilt quickly to simulate rescues.

A number of burn buildings stood ready for recruits and in service crews alike, one of which was in service when we visited.

But the piece of equipment that caught my eye as special was their train rig.  Over behind the airplane prop and the piles of wood was a full size train car half in a man made tunnel. 11tunnelI wish we had one.

Half way through my tour, Mr Bathgate dismissed himself and went back to running what appeared to be a well funded and well respected organization.

Mark, Peter and I finished the tour and the Department had a photographer come down and snap a few pictures of us in front of some of the appliances.  then a few minutes later she rushed out with a stack of nice photos for me and Mark to remember our visit.

The only comments Mr Bathgate made regarding the wording on my jacket was, “Oh, we’ll not be doing that here” which is something I’m not unused to hearing from the Big Red Machine.

Same System, Different Country.

I’ve got a few more posts worth of observations and anecdotes that I’ll be saving until after the Chronicles of EMS premiere on February 12th.

Posted by happymedic on February 5, 2010 • Filed under: Administrative, Command & Leadership, EMS Health & Safety, EMS Topics, Fire Prevention & Education, Fire Rescue Topics, Firefighter Safety & Health, Funding & Staffing, technology-communications-ems-topics • Tagged: ,

Shapes and Colors

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I often joke with folks outside the Profession that things need to be made “Firefighter Proof.”  This denotes the fact that my mother was right, I ended up with a job where they put my name on my shirt.  Another variation is that this job is all about shapes and colors.  Why else are the drugs in different color boxes, catheters as well, and we color code hydrants based on flow in some places?

But buried in all the jokes about how simple things need to be are some basic shapes and colors that are out in plain sight in the community that help us do our jobs better.

We visited a local cell phone company’s transfer station to train on a new system shutdown procedure.  it seems that if there is a fire in the server and transfer room, the system will handle it but there will be a need to shut down sections of the system, not the entire system.

Inside we saw reflective taping on the floor leading us to the breaker panel.  The tape said “FIRE DEPT SHUTOFF – THIS WAY —>” and it continued all the way to the panel.  At the panel, each switch had a colored reflective tape.  Each area served by that breaker was marked on the floor in front of it by the corresponding tape.  no more wondering which breaker to hit, just remember the color.

Loved it.

Shapes and colors really does work.

If you’re not really concerned about the switching station in your response area, let’s start with the simple ones found in elevators.

SOL_elevator Here is a shot I took at a local shopping mall.  Many places I go have these markings and few rescuers know what it means when a Star of Life is in the elevator well.  And why does this one have it but the one next to it does not?

Think you know?  Do you know?  Formulate your answer, then CLICK HERE to find out what makes this elevator so special.

star floor

Now that we’re in the elevator, we need to know how to get out at the ground level.  In the City, many buildings are on hills so they have more than one exit to street level.  In this elevator, which floor is the ground floor? This panel is pretty straight forward, being in a smaller building, CLICK HERE for a neat collection of photos of panels from around the world. Be glad we have a uniform building and elevator code. That star will get you out on the street level of the marked address. If the building is 123 Main street, that star will get you out on Main street.

All right, how about this reflective sticker on the electric meter at the street level?

What about the house next door with this sticker?

Find out from an article on FFN from Christopher J Naum.

Keep your eyes open out there.

HM

Posted by happymedic on January 25, 2010 • Filed under: Command & Leadership, Fire Prevention & Education, Fire Rescue Topics, Firefighter Safety & Health • Tagged:

That’s twice

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blog engineI’m walking through a busy shopping center looking for someone, not sure who, and it’s stressing me out.  Panic, confusion, anticipation.  Then a loud tone strikes me from my sleep, the shopping center nothing but a dream.  The lights are bright in the dorm of the firehouse, the time is just before 2 AM and the tones finish just as I sit up to the corner of the bed awaiting the inevitable magic voice telling me where the sick people are.

“Units standby for the box!” the voice says with a tone of excitement.

A fire.

The dorm springs to life, sleepy firemen now scrambling into their turnouts and heading for the pole hole as the dispatcher rattles off the companies due.  Downstairs we dress, the doors are coming up and the rainy night awaits our response.  The dispatcher finishes reading the first alarm assignment by telling us this is a report of smoke in a building and we take that very seriously.

The engine beats the truck out the door, as we should, but not by much and I can see them following from my rear facing jump seat.  The green light on the front gives away they are a truck company, letting our driver know to let them take the block ahead of us if we’re second due.  The MDT tells me that we are first due and by the address, we’re less than 3 blocks away.  I might just be ready by the time we get there.

Hands still tingling from waking suddenly we are on scene to the large apartment building with nothing showing but an audible alarm sounding and young people milling about in the lobby.

My walk around the engine to my airpack gives me a chance to size up the building.  If we’re going above the ground floor, we’ll need a bundle to extend a pre-connect.  The first door on the first floor (first above the garage level) has a smoke detector alarm sounding and an odor of burnt food.  Deadbolt secured, we’ll need to force the door, damaging it completely, to make entry to investigate.

The truck is laddering the fire escape when they see a haze through the window of the unit in question and the decision is quickly made to enter through the window.

From our position in the hallway outside the door, the haligan tool is just being placed in the door jamb when we hear the truck make entry through the window.  The old thick windows break loudly and we now hear our brother pushing the mini blinds aside.  Boots thunder to the floor and footsteps get louder as the lock on the door clicks and the smoke wafts out as he opens the door.

“I gave at the office,” he says as I grab the pump can and go in search of the source of the smoke.  As we converge in the kitchen we hear shouting from the back room.  Shouting about waking up.  Shouting only from our people.  Being the Paramedic, I peel away from the burning pizza making all the smoke and meet the truck in the back room with a man curled up on the couch, completely passed out asleep.

They’re shaking his feet, being polite as can be in an effort to let him know we’re there and his apartment is filled with smoke.  It’s amazing that the breaking window didn’t wake him.  The tillerman and I exchange a look and the politeness is gone as he shakes the man’s shoulders shouting “Wake up! Fire! Fire! Wake up!”

Nothing.

Down in his face. “WAKE UP!”

“Whoa! What?” He sits up defensive, most of the first alarm compliment standing in his living room.  Escorted to the hallway, he is still confused about what is happening and I make my way back to the kitchen to help remove the source of the smoke.  The pick end of the haligan has a number of uses, one of them being removing small pizzas from ovens, so out it comes onto a baking tray and it is carried outside into the rain.

Back upstairs one of the firemen from another company looked around, saw the man we awoke and cried out,

“Let me guess, pizza in the oven?”  He went to the man and held up two fingers, “That’s twice!”

Posted by happymedic on January 19, 2010 • Filed under: Fire, Fire Prevention & Education, Fire Rescue Topics, Firefighting Operations, Fires • Tagged:

You Make the Call…Chili Cookoff…What Happened

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You Make the CallAlas, Fireman88 from Buttasscold, Michigan (A false name I found out) never responded to my messages, nor in the comments, so what they did in this situation remains a mystery, but I know what I would have done.

First of all, I don’t think this needs to even be mentioned to the Chief, unless this department is so small that the Chief is the front line supervisor.  Secondly, I have a responsibility to report unsafe conditions to appropriate municipal agencies, it’s part of that whole swearing to support and defend the constitution part of what I do.

When I was faced with a similar situation I completed my preplan, as required, then returned to the station to INQUIRE about cleanliness standards in our area.  The agency responsible for enforcing food temperatures and the like was out of the office for the weekend but would follow up as soon as possible.  I didn’t make a big deal about it, but since I had enjoyed eating there a number of times, I felt it my civic duty to pass along what I had seen to folks in the know.

The fact that this business owner was involved in the chili cookoff doesn’t even enter into it in my opinion and it is not a Fire Department matter.  But I would also hope that should the Food Inspector see something that they believe is a fire hazard, they simply do their job and give us a call to make that determination.

If you said call someone who knows better, you made my call.  If you’re ignoring me, you made Fireman88’s call.

Anyone for some tater tots or a lime slushy? Is it me or does this photo seem wildly out of place?

Anyone for some tater tots or a lime slushy? Is it me or does this photo seem wildly out of place?

A bit of side business real quick, I’ve got a couple more You Make the Call situations in the pipeline, but a friend of mine is looking at forming a training specific program for them, so it may be a bit before I let them go.  Until then, you can read about my EMS exploits and other ramblings.

Posted by happymedic on January 4, 2010 • Filed under: Administration & Leadership, Command & Leadership, Fire Prevention & Education • Tagged:

New School, meet Old School

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I was sent this video by a friend on facebook and had to make sure it spreads as far and as wide as we can get it.  Maybe you’ve seen it before, maybe it’s been on other blogs or outlets, but this video from almost 80 years ago could be dubbed over modern video and be just as important.  It is about 12 minutes long and comes to us thanks to the folks over at flashovertv.com, a site I will spend most of the day wandering through and suggest you do the same. But first, a company film.

Please to enjoy the Los Angeles Fire Department training film “Company Response”

Posted by happymedic on December 15, 2009 • Filed under: Command & Leadership, Fire Prevention & Education, Firefighter Safety & Health, Firefighting Operations, Technology & Communications, Training & Development, Vehicle Operations & Apparatus, Videos • Tagged:

You Make the Call…Restaurant…What Happened

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You Make the Call...Line UpThis was the situation I gave you on friday, standing at the top of the stairs, no smoke, no fire, only an odor of burning paper.

We had all our PPE, including air of course, and multiple companies arriving behind us, so we took our pump can and went in search of the odor.  Back under the stairs in what likely passed for a store room 100 years ago, we found a small section of charred drywall at the floor level.  Opening up the wall led us to a large section of brick which likely went all the way up the inside of the building, but all the drywall was clear.  Oddly enough the other side of the brick wall had a large amount of trapped smoke so the Truck went to work opening it up.

In the end the conditions were such that having a charged line before going down there would have gotten us knotted up for sure.  Turns out the source of the smoke may have been above us, at the street level in an alley where a man was seen smoking prior to our arrival.

If you said have a look, but be safe, you made the right call.

Posted by happymedic on December 7, 2009 • Filed under: Command & Leadership, Fire Prevention & Education, Fire Rescue Topics, Firefighter Safety & Health, Firefighting Operations, Fires, Training & Development, Uncategorized, You Make the Call, training-fire-rescue-topics • Tagged:

Report from England – Part I

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I’m not sure how many parts this report will have.  I’ve been writing pages and pages of observations, recollections of discussions, talks with patients, staff, Doctors, other Paramedics, all in the hopes of learning something from the 23 days that I so hoped would open my eyes.  We can occasionally get caught up in the details of what we do without seeing the broader picture, the entire system, with all it’s players and pieces.  I found that visiting other systems around the US helped, but the same obstacles presented themselves.

When blogger Mark Glencorse an I dreamed up the Project, it was initially partially for fun.  Then we began to talk even more about what we did differently and I had to see it first hand.  And I did, for the most part.  Just as with Mark’s visit to San Francisco didn’t show him everything we do, I know I missed a lot of the problems with the NHS system.  That being said, I was able to burst many of the myths of socialized medicine and an ambulance service run by bureaucrats.

My experiences with Mark here and also in England taught me that there are all the same people in EMS no matter where you go.  There are the flirts, the nerds, the jerks, the dirty guy and the OCD fellow.  Some want to be there, others are on the way somewhere else, but for the most part people were genuinely curious as to what we might learn from the Project.

What did I learn, you might be wondering?  It boils down to this:

We are two countries separated by a common language.

Not sure who said it first, certainly not me, but it is true.  For example, in the North East of England a Chips Buttie is a nice afternoon snack.  Here it is called a french fry sandwich with butter.  There things are made with sugar, here High Fructose Corn Syrup.  There the EMS system is seamlessly joined to the hospital and clinic care, here it is a fight to get triaged in a timely manner.  In both places family means family, I now have a new one 9,000 km away.

Looking over my notes from this Project, I have a boat load to tell you about and a lot I hesitate to tell you about since it may appear my mind was made up before I went about socialized care.  I do have some suggestions how to make that system more efficient, but things there are so completely different when it comes to health care, it will never work here.  Not because of the administration, or government, or labor unions, but because Americans have come to expect instant gratification from their EMS systems.  They refuse to believe their sprained wrist can wait more than 4 minutes for a fire engine and ambulance.  It is this basic understanding of what EMS is that is lacking in America and I know who is at fault.

We are.  Anyone who has been in this business more than 2 years is responsible for the complete lack of understanding that grips the common American about their emergency medical systems.  It is time we recognized this fact and did something about it.  Exactly what that is will depend on those above us in this machine to recognize their part and help us educate our “customers” (I hate that term in this business).

For my short career I’ve been repeatedly discouraged by people using EMS as their free taxi service when more appropriate, far less expensive methods of treatment are available.  I did see, in my short time there, EMS abuse in England, but not nearly at the rate I see it here at home.  I believe it stems from the belief that people have a “right” to an ambulance whenever they want.  And not just the entitlement generation, but those who have paid into the system and want something, anything, back from it.  We need to show these people that they are entitled to help when they need it and an honest discussion about what is best for them.

I also learned from my experience that my system is not being as efficient as it could be, nor is Mark’s.  Believe me when I say that each of those statements could have their own volume, and likely will, since most of the things I want changed there, labor will never allow and the same here.

Before I start boring you with the countless posts about what I did, saw, learned and learned to avoid, I want to take a moment to thank a few people that made this trip everything it turned out to be.

To Mrs HM – The woman who sat next to a burnt out EMT on the tailgate of the rescue truck  in rural New Mexico and said, “You don’t belong here.”  She is the reason I got off my ass and got serious about going back to school full time.  I graduated 3 years later.  She’s been right here with me this entire time and made this whole thing work.

To Mrs 999 – Who I’m sure had just as many headaches as my Mrs while mark was away, you welcomed me into your home each night for tea and made me feel at home.

To Firegeezer – For noticing a little blog about the joys of 911 abuse.

To Lt Talmadge and her UK counterpart Fiona – Meetings, dinners, etc, all went to plan.

To anyone and everyone who donated to help make the Pilot episode of Chronicles of EMS.  Having the cameras along was unlike anything else I have ever done, I hope you all like it.  And I hope that Ted mentions I hit every IV first try with three witnesses and three cameras rolling.

And finally to Mark – Thanks for being so easy to get along with, bad jokes aside.  and sorry all the nurses liked my uniform and accent…wadda ya gonna do?

I’ll get more specific on my observations over the coming weeks, keep an eye out here and at Mark’s blog.  Thanks for following along.

Posted by happymedic on December 4, 2009 • Filed under: Administration & Leadership, Command & Leadership, EMS Topics, Fire Prevention & Education, News, Technology & Communications, Training & Development, technology-communications-ems-topics, the Project, training-fire-rescue-topics • Tagged:

You Make the Call…Restaurant

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You Make the Call...Line UpOK folks, back to the grind.

You are dispatched with your Department’s first alarm compliment to a report of smoke in a restaurant.  You are unfamiliar with the layout, since this is not your usual assignment and the building is in the oldest part of town.

On arrival you have nothing showing from the 4 story, mostly brick building, folks still seated at their tables as you arrive.  A quick inspection finds a labyrinth of hallways and stairwells behind the kitchen and a clear odor of burning paper.  No smoke is seen from the top of the stairs leading down to the storage area, which appears to have been retro-fitted into another kitchen area.

You have no charged line, only a pump can, but all your PPE.

Do you inspect the basement without a line or wait?  You make the call.

Posted by happymedic on December 4, 2009 • Filed under: Command & Leadership, Fire, Fire Prevention & Education, Firefighter Safety & Health, Firefighting Operations, You Make the Call

Hi…Fire Alarm

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blogengineIn the early 20th century most municipalities were encouraged by multiple fatality fires to take note of fire safety in public places.  Some of these ideas included not locking exit doors, marking said doors, building standpipes and installing high tech fire alarms.  But none of this matters if people ignore the bells and flashing lights when the alarms sound.

THE EMERGENCY

Automatic alarm activation at an elementary school

THE ACTION

I’ve only seen half a dozen actual fires in a school during the school day, one of those when I was a student.  Surprisingly, way back then, they didn’t activate the fire alarm evacuation, but instead chose to shelter the students in place.

Back to today.

I am  an imposing figure in full gear.  I have been known to scare small children visiting the firehouse when I am geared up.  When we arrive on the scene of a reported fire we take it seriously since most of our City is made of 100 year old wood and spaced 1/8″ apart.  The alarm bell is ringing and strobe lights flashing when the engine arrives.

The usual administrator, hand held radio to her ear, is meeting us at the alarm panel as our officer investigates the source of the alarm.  As he does that I hear the truck company arriving and grab another administrator, similar radio and stance and ask what I thought was an important question.

“Has the school been evacuated?”  All I was thinking about was back in 8th grade when they ignored the plan.

“Yes, it’s clear.” She tells me, and you already know where this story is going.

“General alarm, second floor” the officer calls out and I gather my tools and away I go.  I have my usual 40 lbs of turnout gear, helmet, 40 lb airpack, flat head axe and 10 gallon water can in hand.  My eyes are flying around the hallway looking for smoke, flames, a pulled hand alarm station or the tell tale red light on a smoke detector.  As my eyes are moving they come across a human form in the hallway who sees me and quickly turns away.

“Hi…Fire alarm, you need to evacuate the building.”  Maybe she didn’t hear me.

“Hi,” I reach her and look into the classroom directly in front of her. “Fire ala…Hi there, Fire Department, those lights and the alarm mean you need to leave the building,” I said to the half dozen adults and TWO CHILDREN sitting in the classroom.

“Oh, OK, we thought it was a false alarm, so-” she began, but I had no patience for the example they were setting.

“Now.  Down the steps to the front. Now, thank you.” I said with what I perceived as forceful, but kind.  Standing 6′3″, 6′8″ with helmet and all that gear, I hoped to put the fear of those trapped in the Triangle Shirtwaist Factory into them, but I likely only made them uneasy for a few minutes.

Back downstairs a few minutes later without signs of a fire, I inform the officer of the folks upstairs and he spun on a top to the administrators, radios still to their ears.

I didn’t hear the entire conversation, by choice, as I see people squirm enough in the ambulance, but I can only hope it was something out of an episode of Hell’s Kitchen.

Posted by happymedic on October 28, 2009 • Filed under: Fire, Fire Prevention & Education, Firefighting Operations • Tagged: ,

How I got into blogging

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Funny story actually…

“So that’s why your neck didn’t snap.” the Trauma Doctor told me as he set my helmet back down on the table and left the trauma room. I had confirmation of this statement from the nurse standing closer to the Doc since the ear closest to him was still screaming in pain.

 

Let’s go back a few hours.

 

It is just after 6 in the morning on December 17th, a cold morning for the City, but shorts weather for you in the North East. Ia m assigned to the Division Chief’s house which also staffs a Truck company and my engine. I had taken the night watch, as is tradition for the guy just in for the day, and was just awaking to make the coffee when the first report came in.

A full box alarm had been struck for reports of heavy fire from a window, by a passerby. 99 times out of 100 this is a false alarm, steam or something else non threatening. This was the 1 in 100.

 

The chief and his operator (Incident Support Specialist) are awakened and away, the rest of the house is not due. I check the card file used for decades to anticipate alarm assignments and see the Truck is due on the second alarm so I make an announcement to let the Truck folks know they may be going out if this is the real thing.

 

First units report heavy fog in the area, then the statement that gets the blood pumping:

“Control we have a working fire.”

 

A second alarm is struck in the first 10 minutes and the truck is away, smiling, while us engine folk remain back. In the City, the street fire alarm pull boxes are still functioning and account for a great deal of false alarms. In the event someone pulls the hook near a working incident a single engine responds to investigate. In our case, however, it was someone calling in heavy smoke 4 blocks from the fire that got us up and out the doors.

 

When we got near the reported address, the smoke was so thick, mixed with the December fog, that the busses had stopped moving and most traffic had given up trying to see the lights and simply stopped. Our driver weaved around and it was clear the report of smoke was associated to the fire up the block. What we noticed as we arrived was that not all the units from the second alarm had arrived yet, possibly due to the unusually heavy traffic.

 

Out front of the 3 story type 5 theater type building are two 20 foot tall 5 foot wide windows blowing fire 40 feet into the sky and lighting up almost the entire block. We check in and are assigned to the fire floor to assist companies already advancing lines.

 

Packed up and tools in hand, we make our way past the multiple wyed lines in the stairwell landing and to the fire floor. The smoke is thick and the visibility is about 5 feet. I can see blurs of yellow reflective in all directions and a diffuse orange glow from all around. I learned later this was the fire in the balcony seating.

 

After pulling a lot of paneling and knocking down the fire that was blowing out the windows, the first teams were back out for a bottle change while we directed lines out the windows to ventilate the large open area. We were then instructed to train the streams up and into the balconys since climbing up there was no longer safe.

 Keep in mind the location of the fellow in the red pants.

The other firefighter assigned to the engine that day tapped me on the shoulder and asked if she could have some nozzle time. I realized I had been a bit of a nozzle hog, the kind we all hate, so I apologized and gave her the pipe. When I stepped back 6-8 feet and picked up the hose, I suddenly noticed my chinstrap was hovering in front of my eyes. I thought it curious since last I saw the strap it was secured beneath my chin and, for the moment, was hovering in space.

 

“Are you OK?” “Hey! Is he OK?” I hear people beginning to shout.

 

“Are you OK, stand up!”

“I am standing. Just give me a minute.” I replied, not realizing my colleagues had just seen a section of ceiling, not roof, but ceiling fall 30 feet and knock me down.

Before I knew what was happening I was being pulled out of the building hearing shouts of “MAN DOWN! MAN DOWN!”

 

This part of my Close Call was recounted to me by some of the firefighters who pulled me out, since I have very little recollection of it.

 

We moved Justin to the hallway and into the stairway landing where the air was clean. He was grasping his right ear and his eyes were shut. His helmet and gear was covered in debris, as well as the gloves now holding the side of his face. He asked repeatedly what had happened, a clear sign of possible head injury so the decision was made to take full precautions from that point forward.

A back board was brought up and one of the other Paramedics on the engine teams attended to him pulling off his jacket.

Justin asked us if the building was still on fire. We we told him that yes, it was still on fire, he asked us to put his jacket back on. Not completely out of it.

 

Packaged and carried down the stairs to the ambulance, he was feeling dizzy and about to be sick.

 

 

I regained my wits looking up from the cot, hearing the sirens and feeling a 16g needle in my Left AC. I was emotional for sure, suddenly aware of the loud ringing in my right ear. When the Paramedic leaned over me I looked into the diaphoretic face of one of the medics I had precepted when he was hired.

“I’m not supposed to be here” I told him.

“I know.” He told me.

“Don’t call my wife.” I asked wondering if I even had my phone on me.

“I won’t” was his reply.

“Can I do my own radio report?” He told me no.

 

In the ER, my C-spine was cleared and the assembled team slowly made their way out of the room as the injuries I might have sustained were eliminated. One of the Docs grabbed my filthy helmet, gave it a turn in his hands and said,

“So that’s why your neck didn’t snap.”

 

The ratchet device so common on most helmets secures it to your occiput, theoretically holding it tight in case of impact. However, in this case, the ceiling fell at an angle, they believe, causing the load to hit one side first, causing it to tilt sideways. As it did, the helmet did it’s job, absorbing the force of the impact and directing it sideways, by turning slightly on my head. The inner rim was forced onto my right ear, causing all the pain and tennitus, which would continue for weeks. Had the ratchet strap been tight, the helmet would not have turned on my head, but the force would have turned on the next axis down, my cervical spine.

When I asked him to put that explanation in writing, he let out a small laugh and left the room. Darn it. Had I been hit in any other direction there was a fair chance the helmet would be dislodged, but my chin strap would keep it in place.

 

In the end, after spending Christmas with the inlaws and on head injury medication, which doesn’t allow caffeine or alcohol, I learned to trust your equipment and treat it properly.  So as a way to deal with what happened, they suggested I start a journal.  I started a blog.

Posted by happymedic on September 26, 2009 • Filed under: Administration & Leadership, EMS Health & Safety, EMS Topics, Fire Prevention & Education, Firefighter Safety & Health, In the Line of Duty, Line of Duty, Patient Management

Is that a fire engine or a fire truck?

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In response to my Sunday Fun about marking your gear, I received comments from across the pond asking the difference between our different units in the US, since I mentioned the need to tell us apart based on task.

So for my UK friends, and maybe my few readers not in the business, I give you the American Fire Department 101.

The Engine Company

The work horse of the American Fire Service is the Engine Company. Originally hand pulled pumps, then steam engines, these machines supply the water for the fire fight. The Engine Company carries three main elements that make it a stand alone team. A Pump, a tank and hose. The tank is often 500-1000 gallons, depending on the reliability of water supplies and can, if need be, draw water (draft) from a static source such as a pool or lake. The pump moves the water through the manifold and out one of many outlets to fight the fire. I can’t imagine this being much different than the UK Brigade units.

In some municipalities, the engines also offer EMS response at the Basic and Paramedic level as well as extrication using multiple power tools.

At a fire the engine company will usually arrive first, do their best to secure a water supply, deploy lines, find the seat of the fire and knock it down. Even though their mission may include other tasks, this is their main purpose, water on the fire.

“God Bless the Engine”


The Truck or Ladder Company

AKA the Hook and Ladder Company

The Truck Company has a completely separate set of tasks to accomplish at a fire or emergency scene. The truck, or ladder, carries, you guessed it, a variety of ladders and tools designed to gain access to the fire building for two main reasons, ventilation and search.

The truck company is often second or third to arrive at a fire and prefers to have access to the front in case the large ladder is needed. Although Happy prefers a 100 foot articulated ladder truck (with a driver in the rear to provide maximum maneuverability) ladders can also have buckets on the end, making them a different tool entirely.

Truck members will focus on ventilating the building of heat and poisonous gasses by opening windows and cutting holes in the roof they gained access to using their wide variety of ladders. These folks do not concern themselves with fighting the fire, that is not their job. If I am on an engine, shooting water on the fire, they are working above me cutting the roof, or behind me using thier hooks to pull the ceiling down to check for fire spread. Without them the fire could work it’s way back over our heads and emerge behind us, cutting off our escape.

Very rarely does a ladder truck carry water, and even then it is a small amount compared to the engine companies. The mission of these firefighters is not to fight fire directly, but to aid in the containment and ability of firefighters to attack the fire effectively.

At non fire scenes truck companies often provide forcible entry, advanced extrication, rope rescues and similar tasks, not to mention they are my heroes when a fire sprinkler needs to be shut down and replaced.


“God Save the Truck”


The Medic Van

The Paramedic units can, of course, treat and transport the sick and injured, but in a fire or rescue scenario are trained and equipped to fit into most roles on the fire ground from the hose line from the engine, or the saw on the truck, or harnessed up to go over the edge with the rescue squad to execute a rescue. This is the most versatile crew in the service today, and my favorite spot I might add. You can go from transporting a skinned knee and hate your job one minute, to carrying a person down a flight of stairs at a fire the next. Ok not that fast, but you get the idea.
And intubating with an airpack on…not as hard as it looks, but no reason not to gear down first.

“God help the medics”

The Squad

A squad in the US can mean a number of things. It can range from a Paramedic pickup truck as in the Emergency! TV series. It has been known to identify any team of firefighters not assigned to a pumper engine or ladder truck. A squad in the FDNY is a specialized team that can perform duties above a regular engine company. But for the purposes of Happy Medic Headquarters, a squad refers to the big boys, the HEAVY RESCUE SQUAD, the heroes, the Gods of the Fire Service. No really, just ask them.

Although the training, equipment and abilities of each rescue squad is unique, they are most certainly armed to the teeth for their standard responses and whatever else might get thrown their way. This is who responds for building collapses, swift water rescue, dive emergencies, you name it, chances are they drilled on it this week. Some units carry ice rescue gear, while the heavy rescue squads in San Diego, California likely fill that spot with something surf related. They carry heavy lifting bags, SCUBA gear, confined space and haz-mat suits, high and low angle rope kits, etc, etc, etc. A giant rolling tool box. These are the men who will go where I will not and hand me a (most often) viable patient. Or completely disregard my presence.

“God is the Squad”

The Quint


This hybrid combination (bastard) of the service is a politician’s dream and a firefighter’s nightmare. On paper it combines a 4 man truck company and a 3 man engine company into a 4 man quint company. But now that we know the engine and truck have COMPLETELY different tasks on the fire ground, this is just silly. Besides, you had to shorten the ladder to fit it on my engine frame and all the ladder hardware, the jacks, hydrolics, extra beefy frame, leave less room for an adequate water tank to fight the fire.
I used to serve on one of these and my verdict is: You’re fooling yourself. A 60 foot elevated master stream with a framed box ladder does not a truck company make you. Ahem…


The Ambulance

Not to be left out in describing the American Fire Service is the role of private ambulance companies. While not technically part of the service, they work hand in hand with responders to provide treatment and transport either as the sole carrier or to augment an existing, but not quite adequate municipal system. They are a needed piece of the puzzle in the American model. Some places they thrive, others they struggle, but where I am they do a great job picking up the slack from a devastated budget that cut EMS first.

So there you have it my UK friends, a brief introduction to that which is the American Fire Service. Perhaps when MedicBlog999 gets back from his engine ride along he can explain it in more detail. Graphs and charts perhaps.

Posted by happymedic on August 17, 2009 • Filed under: EMS Health & Safety, EMS Topics, Fire Prevention & Education, Funding & Staffing, Special Call, Technology & Communications, Training & Development

Sunday Fun – Bugles

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One of the lasting symbols of the modern American fire service is the use of bugles to signify one’s rank as an officer. But where did it start and why? I always wondered this and luckily my current department has a rich history to draw from.

Bugles, or speaking trumpets, were used on early fire grounds by the foreman of the hand pump teams to keep the large numbers of men working together to keep the pump working.
The foreman would often have to shout louder than other companies arriving, the fire and the crowds.

As hand pumps were replaced by steamers, the foreman became the leader of the fire fight and no longer dragged the bugle with him. The volunteer companies of the late 19th century and early 20th century used the bugles as a sign of their long history of service.

The bugle then became a kind of ornament at the fire halls, to be polished by prospective members and displayed proudly on parade day and in photographs. Similar to the ornate belts and helmet shields worn by the more experienced members.

But that explains why the bugle is used as a sign of rank, but why do we wear them on our collar instead of on our epaulets or our sleeves, as does the military?

The answer is in our professionalism. Note this photo from Hose Company No 1 in Nebraska. Each member is wearing their dress uniform, which was common at the time. Each coat has one row of buttons. The officer, in the center seat, holds the bugle, signifying him as the leader.

Without the bugle, he is difficult to identify as the Officer of the company, yes?

As departments became consolidated and fell under the supervision of the local governments, there became a need to have additional ranks between the bugle of the Officer and the white helmet of the Chief Engineer or Volunteer President. Enter the double breasted coat. This coat had two rows of buttons, making the new Officers easy to spot and gave them more formality than the original company Officers. In most departments a single bugle signifies a lieutenant, or Company Officer. Two bugles signifies a Captain, or multi company Officer. The two bugles noted that he controlled more than one company, usually a hose and ladder team in the same house or hall.

Often, the collar of the coat would button down to the coat. This became the symbol of the lead Officer. Try as I might, I can’t find a reference to who was the first to inscribe or order buttons with bugles for their coats, but the insignia appears in many photographs beginning in the late 1910s.


This photo from the LA Fire Department shows the two Captains on the right, double breasted coats, two rows of buttons and additional insignia on their collar.

As departments became more relaxed and dress coats were no longer worn, the insignia stayed on the uniform shirt. Right in the same place the original officers found proper to place it 100 years ago.

Now it sometimes appears on the collars of polo shirts. Sometimes I wish we would get back to the formality that existed in those days, but the last vomiting patient I had would have ruined my dress uniform. We change with the times I guess.

a note. This history is gathered from my experiences and photographs from my and other departments. Your department may have it’s own traditions and history, but this is the story I keep hearing.

Posted by happymedic on June 28, 2009 • Filed under: Fire Prevention & Education, Sunday Fun • Tagged: ,

Sunday Fun – The Maltese Cross

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Last week we had a bit about Saint Florian, Catholic Saint of Fire Fighters. This week a look into the history of another overused and often misunderstood symbol, the Maltese Cross.

Most firefighters, if they even know what the cross might symbolize, tell a tale of crusading knights in ancient times putting down their weapons to fight fires. Oddly, only firefighters seem to tell this tale, while the historical community tells a different, much wider story about the symbol and those who wore it on their tunics, shields and later stamped it on their coins.

First a bit about the cross itself. The cross is eight-pointed and has the form of four “V”-shaped arms joined together at their tips, so that each arm has two points.This was originally the cross of Amalfi, a province in Italy, but was adopted by the Island of Malta’s future rulers in the 11th Century. It is said that the points of the star represent:

  • Loyalty
  • Bravery
  • Generosity
  • Piety
  • Contempt of death
  • Glory and honor
  • Helpfulness towards the poor and the sick
  • Respect for the church

This original cross was worn by a group of crusading knights called the Knights Hospitaller and was so named from a hospital built in Jerusalem around 1080 to care for those traveling to the Holy Land. This hospital was built on the site of the monastery of Saint John the Baptist which is why the Knights Hospitaller were also known as the Knights of Saint John.

In 1129 they were charged to not only care for the wounded but to also provide armed escort to crusaders and pilgrims. To bolster their numbers they were paired with the newly endorsed Knights Templar, some of the best fighters the western world had seen.

As these groups attacked the Saracens, or followers of the Muslim faith, they encountered many new weapons, most notably a pitch oil later called naphtha. This was catapulted into the ranks or stronghold, then lit from afar by arrow or flaming bale of straw. The fire would be fast and intense. The Knights of Saint John, charged by the Pope to protect and care for pilgrims, treated the victims of these attacks as well as other injuries at their field hospitals.

It was written later, by other orders, that while the Knights Templar were fearless in the face of attack, the Knights of Saint John were fearless in the face of the flames.

This may be where modern firefighters saw a history to build on. A group of dedicated men who helped others and were fearless in the face of fire. Sounds perfect to me.

The modern cross, most often a four sided cross with rounded sides, resembles a Teutonic Cross rather than a Maltese Cross.

Perhaps geography is to blame.

The Knights Hospitaller did not come from Malta, they were given the island by Charles the 5th of Spain, also the King of Sicily, after seven years of moving around Europe. It was here they transformed what they originally called a bare rock of sand into a thriving Mediterranean port which would repel a Turkish attack in the 1500s.

And of course some of the first structures built were hospitals.

So where did the 8 point cross of Saint John become the modern Maltese cross available for free embroidery on suitcases? Probably the same way Santa Claus became part of Christmas.(No I’m not saying Coca Cola made the cross) We could figure it out but would that ruin it? Perhaps.

But looking back at what those eight points of the cross stood for, I think it is still there in our modern cross, just a little softer and more subtle.

But I imagine if a Knight Templar and a Knight of Saint John were transported into modern day America, they would see a Maltese Cross on a firehouse and know they would be welcomed, cared for and amongst family.

Posted by happymedic on May 10, 2009 • Filed under: Fire Prevention & Education, Fire Rescue Topics, Firefighter Safety & Health, Sunday Fun • Tagged:

…to investigate the smoke alarm…

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blogengineThe following tale is told not because we are reminded to always leave the engine with a tool; Not because we were the only ones to bring water to the fire; Not because you need to be careful when extinguishing burning wax, but because of how determined the owner was to “let us in.”

THE EMERGENCY
A caller states, “Smoke alarm downstairs is beeping and the unit feels like smoke.” Not smells, but “feels.”

THE ACTION

We are second due in the first alarm compliment. It is early evening on a calm winter night, no wind. First engine reports smoke showing from a garage, no fire noted. We kick it up a gear. Our assignment as second in is to supply the first in engine so we pull past them and to the hydrant, it’s a short pull.
The first in engine is at the garage door, peering in, we see no smoke. I grab my airpack, buckle the hip belt (like so many forget) and BAM! axe holster. Noting a heavy fuel load and no pre-connected line stretched yet, I reach for the pump can and away we go. Since our job is to back up the first line, and there is no first line, we’re searching for the seat of the fire.
In this shotgun style house, the garage and attached area reaches back maybe 60 feet, on average, and can be dotted with small closets and in most cases small illegal apartments. As we pass the halfway point the smoke has forced us to our knees and we have yet to find the fire. Smoke is mostly light, grey, but no heat.

We have good communications, no one is panicing, a plan has been made and is clear. As I’m reaching past some debris to see how deep the closet is I feel a touch on my shoulder from behind.

It’s a civilian. “I need to get to my unit and let you in” he mumbles as he begins to push past me into the closet. This guy is clearly altered and where on earth did he come from? He’s got keys in his leading hand and before I can react he suddenly disappears into the closet, gone. My officer and I decide to give chase in the most unusual search and rescue I’ve been involved in in some time. Turns out what we thought was a closet was simply a jog in the hallway with heavy painter’s canvas leaning in all directions. As I pass through, axe and pump can in tow, I see the occupant near another door near what must now be the back of the garage. Smoke is thicker and warmer here.
The man is trying to unlock the door when the officer reaches him first and pushes him forcefully out the back door, immediately ventilating the small, cramped hallway.
It also introduced fresh air to the fire area because the heat intensified behind the slightly open basement apartment door.

We found the fire.

The team now behind me started calling back for a line to be charged.
“We got it! Hand in a nozzle! We need a line in here.”
My officer sticks his head in from outside and screams, “Did no one think to bring water to the fire?”
“I got this Cap’n” already footing the door open and peaking in I see what used to be a candle on what is still mostly a dresser, all standing beneath what might have been a curtain.
Not 30 seconds of quick bursts and the fire was out. Well before the line made it in.
When I hit the dresser the first time, I knew the wax would scatter, but I had no idea how neat it would look. It was similar to throwing water on a grease fire, only the wax cooled as it flew.

I tried to help overhaul but the man in the back yard needed my particular attentions at that time.
Turns out he ws fine, mentally sound, simply wanted to make sure we opened the door instead of breaking down the door. Not sure why, exactly, since the landlord now will have to explain why this guy was paying rent on a tiny little illegal bedroom in the back of a garage.
At the end of it all I didn’t have a single drop of candle wax or water on my gear. The folks cleaning up were covered in it as it was still dripping from everywhere I had spread it.

Before you all start commenting about “You weren’t on air?” and “No charged line?” We were on our knees to maintain clear visibility due to all the junk in this garage. On a similar note, dragging a charged attack line around a crowded area can prove dangerous. There should have been someone assigned to bring it in, and there may have been, but I never heard if there was.

I mention this incident here because it was hilarious to hear the Captain the next night tell the story of a man just wandering into a closet and disappearing, “And me and my medic say, let’s see where it goes! Sure as hell it goes to the fire!”

Posted by happymedic on February 13, 2009 • Filed under: Fire, Fire Prevention & Education, Fire Rescue Topics, Firefighter Safety & Health, Firefighting Operations • Tagged: