Our pal Ambulance Driver has done a superb job spreading the “linky love” as he says, with the 11th installation of the pre-hospital ER/A&E blog carnival the Handover.

This month’s theme was centered around the call that made the shift and there are some new contributors you need to read.

Have a look and Merry Christmas to all.

In my confused and sleep deprived state I neglected to include an article in this month’s Handover from one of our favorites, Lt Morse from Rescuing Providence. An oversight I have come off of my break to rectify.

“It’s a three mile trip from the Rhode Island Hospital Emergency Room to the Allen’s Avenue Fire Station. ETA six minutes. I could probably make it. Everything was going great, light traffic, perfect weather conditions, no road construction in sight. I could see the promised land in the distance, a little more than a minute away. I started to relax.”

Only the hardcore providers among us have been in this situation and survived. I once ducked into a patient’s bathroom to puke, but I had been feeling bad all day and the timing was right. But never have I been a block from release only to be…well…read for yourself.

And then read all about the Lt’s movie situation, and follow along to see if I play the love interest, the cranky Captain or cross the street in the background.

This was almost a letter in my file.  Phew.

This month’s handover draws from our friends across the interwebs stories of close calls. Times when they or their patients, colleagues or family almost didn’t make it. I was inspired to make this the theme not just because of the holiday weekend here in America, but to remind us all that we are fragile and put ourselves out there sometimes. Hopefully one of these links rings back when you’re in an unsafe or curious situation.

Found with the Where did the angry guy go files-

“What do we do?” asked Eric, his eyes wide.

“I don’t know about you two,” I said, “but I’m about to jump through that window over there.  I don’t know if that guy’s getting a gun or what.”

by Buckman who runs Gomerville

From the I don’t think you should be driving file-

“I was overwhelmed by the dreadful realization that I had just accepted a ride from a highly intoxicated snowmobile rider and we were hurtling through the dark northwoods at 70+ miles per hour.”

from Greg Friese of, among many, Every Day EMS Tips.

From the Thank God you’re driving category-

“This was a serious incident. This was no routine, boy, we almost had an accident. This was my death.

I don’t know if my partner would have stopped on his own if I hadn’t shouted. Maybe. Maybe he had it all under control and was already getting ready to hit the brakes.”

from Peter Canning, a new contributor to the FireEMSBlogs family, at StreetWatch:Notes of a Paramedic

In a section titled simply Gulp

“Jill and I found him lying on the floor, fully clothed and in a coat, eyes shut, but eyelids flickering. An almost certain sign of pseudo-unconsciousness. A fake. I took a step back and called out to him. Jill was still standing by the front door, uncertain how to proceed. Something still felt wrong, so I asked her to go and call for police back up. With hindsight, I should have gone with.”

writes Ben Yatzbaz, resident Insomniac Medic

Found in the Basement selection

“This moment, this intense moment, was where I made a decision the likes of which I hope I never have to make again. I knew that if I stayed more than a few moments longer, I would suffocate and burn to death right there on that floor.”

from our pal Chris Kaiser at Life Under the Lights

From the lost in the snow pile-

“Dear God, they’re working a search pattern. Please, not tonight. It’s not mutual aid to another fire department; they’re working a grid search with the police. I grab my boots, then pad to the garage to check the fluids in the IV warmer. Anyone caught in this weather without shelter will be near death, if not there already.”

by Mack505 at Notes from Mosquito Hill

From the trust your guts file-

“I give my partner the “time to leave pronto” hand gesture. “Code 3, hurry up”. I give a little oxygen and attempt the IV enroute with no success. I realize that something is not going well for this patient and I don’t have the means to diagnose or fix the problem.”

by Rescue Monkey of Paramedic:Life on the Streets

From the Old School section-

“The smoke level now was to the floor as I grasped the hose line to find my way out. The urge to rip off my mask was strong but my training had taught me this would be fatal for sure.”

by HMHQ Contributor the Angry Captain

and finally, from the Hmmm…that looks wrong category

“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.”

from yours truly and the event that launched me into the blogosphere.

Next month’s handover will be hosted by Ambulance Driver, theme TBD, watch his space for details as they develop and, above all else, be safe.

HM Clear.

Have to get in a bit about the Handover before I pop along to England next week.

This month’s blog carnival the Handover will be hosted here at Happy Medic Head Quarters.  For those of you not sure exactly what in the world we’re handing over, one of our good blog buddies, 999medic.com, founded a blog roundup of sorts called the Handover.  It started as a collection of favorite posts collected by a volunteer host and is now the largest and widest read blog carnival for and by pre-hostipal EMS and ER staff.

Past hosts include

For November’s theme I have chosen “Close Calls.”  The theme is inspired with my own close call, which I have mentioned as the driving force behind starting this therapy experiment we now call the Happy Medic.  I want you to send me a blog post you authored or have read that made you say, “Wow, that was close.”  Perhaps a time you caught a patient right before something happened, maybe a time when you almost got hurt or, perhaps when you did get hurt but it could have been worse.  And as Mark introduced a bit back, feel free to send in anything EMS or ER/A&E related you wrote or enjoyed.  Share.

A little different than other months, I’ll be busy with Mark for a few more days then off to the UK for my turn in the passenger seat, so get your submissions in early.  The deadline for submissions will be Novmeber 25th, and i will save all submissions to my handy new laptop before boarding the plane home to the USA.  I will arrive home on Thanksgiving, hopefully with a good group of posts to share and be thankful for.  it will be published on the 27th of November.

This month’s EMS Blog Carnival, the Handover, will be hosted here and the theme is “Close Calls.”  With November in the US including Thanksgiving, I thought what better time to share an experience when we had that thought go through our mind “I/they might not make it.”

Send in your submissions about a time when you, a patient, or someone you know had a close call and I’ll put them together to share.  If just one person can use that information to make their job safer, then we’ll have succeeded.

So with that theme in mind, here is the Angry Captain’s Close Call.

8:30 pm February 1982

The call:  Structure fire, “house across the street has black smoke coming from it.”

It is a cold winter night with temperatures well below freezing; we are in a relief unit that had no inboard seats so I was belted in on the tailboard. On arrival, we found a residence with black smoke pouring from the rear.  Reportedly, no one was home.

The home is typical for the area in that the base of the home started as a house trailer with several additions around it. As the first engine to arrive, we pulled a 200’ preconnect and forced entry on a side door that appeared to be the entry. The captain and I crawled in below the smoke and worked our way through a maze of doorways to what appeared to be a fully involved kitchen area. The ceiling was flashing over as I trained the nozzle at the base of the fire. Suddenly, my air pack warning bell went off.

We could not have been on air much longer than 5-10 minutes. I patted the captain on the back to notify him that we needed to back out. He gestured for me to head out and took the nozzle from me. My training from my previous department was never to leave anyone alone in a fire. As I turned, my air pack quit entirely; no air at all.  The smoke level now was to the floor as I grasped the hose line to find my way out. The urge to rip off my mask was strong but my training had taught me this would be fatal for sure. Holding my breath was all I could do as I struggled to focus on following the line out amid my disorientation from lack of oxygen. As I moved along, I remember hearing a loud mechanical sound further confusing my strange journey through this black maze. The sound grew louder as I slowly followed the hose line hand over hand in the seemingly longest moments of my life.

Suddenly light appeared as the noise grew to a roar, but I crawled out, finally ripping off my face mask, gasping for air, and collapsing in a snow bank. My next memory was lying on the gurney in the back of the ambulance.  At the hospital, they ran blood gas tests and flooded me with plenty of O2. As my color returned to normal (apparently I was quite gray), I was told that they found me outside our entry point where the truck had hung a mechanical fan at the top of the doorway for ventilation. (The loud disorientating mechanical sound.) I am not sure how long it was that I lay there in the snow bank before I was noticed.  But Mrs. AC got the frightening call about 11 pm to pick me up at the hospital….no one likes that call.

Lessons learned:

1.       The air pack I was wearing was found to be working properly back in a warm station house and in fact still had about ½ its air. The speculation at the time was that the moisture in the diaphragm froze causing it to stop the air flow.  Had it been checked at the scene, it could have provided the exact problem.

2.       Never allow a member to leave alone or leave a member alone in a fire. This was long before 2 in 2 out.

3.       Always follow your training; i.e. following the hose line out and keeping your mask on in heavy smoke.

4.       Do not block the egress of the hose line with ventilation. Had I been on all fours coming out feeling ahead with my hands, my fingers may have been lost to the whirling fan.

This was a true wake up call for me and cemented in my mind how important my training had been and how things can go wrong in a matter of seconds.

The Handover is alive! And for the next 12 hours my link bar will likely have all links to this edition, hosted over at Life Under the Lights.

CK has put together the funniest. calls. ever. and did a fantastic job. Anything with a one armed fisherman joke, sign offering a free cat and stories about human urination can’t go wrong. Right?

CK at Life Under the Lights has sent out the last call for submissions to the Handover. This month’s theme is “Funniest. Call. Ever.” Grab a link to your funniest call and send it to him for inclusion, but hurry, today is the deadline.

The Handover Blog Carnival is home this month, where MedicBlog999 asked for submissions describing your first emergency.

I have the honor of being included in the list of blogs I enjoy reading, which is pretty neat in my book.

So go have a look into what the authors of your favorite blogs submitted as their first ever emergency.

Next month CKEMTP over at Life Under the Lights will be hosting the Handover with the theme “Funniset.Call.Ever.” Now I have 400 posts to go through. Thanks.

BasicsDoc has published the latest version of The Handover Blog Carnival for Pre-Hospital and Emergency Hospital providers. This month’s theme was “Communication” and I am honored to be included.