The concept of triage

Didnt even get through drug checks before getting a call for a difficulty breathing. Enroute was upgraded to airway obstruction, then to CPR in progress. Arrive to find a naked guy blue, and I mean dark blue, nipple line up. There was no CPR in progress and the people staying in the house couldn't even give us his name. Started working him on a filthy floor with no room to work. But that's not unusual. Worked the code.. cops found drugs in the living room... was preparing to call him and Bam! What do ya know... V-Fib. Had a rhythm for about 2 minutes. Lost it, got v-fib again and got a good perfusing rhythm back. Neurologically its a good bet to say that he wont be joining us for dinner anytime soon... but .. you just never know. I've seen worse patients make liars out of all of us. He maintained a good pressure all the way in.

Partner and I swapped throughout the tour. We ran a 9yr old with a deformed arm after crashing at the roller rink. He took the needle like a champ and the morphine knocked him out.

Did a call for a chest pain but turned into bladder pain when we got there. No basic squads were available so we took him in. He wanted to go to one of the furthest hospitals away, but, its his choice. He says his belly hurts, has been able to urinate fine and is just an all around cranky elderly man. "Just take me in or leave me alone, stop asking me all these questions!" Its my turn to drive and I'm laughing listening to this guy giving my partner all kinds of grief. We get to the ER and they send him to triage. He will have none of this. Demands that we take him somewhere else or take him home, neither of which we're doing. So my partner doesn't stroke out, I play buffer and lay it out for the guy. Choice 1: you can sit here in triage like everyone else who also has an emergency that is not life threatening or Choice 2: you can walk out of this hospital and walk to a pay phone and call 911 again. He was furious over the audacity of an ER to implement triage when he called 911 and since when did they start this triage stuff! We let him be and he eventually walked out on his own into the night. It the abuse of the EMS system and mentalities like that that burnout so many great medics.

Speaking of burnout... we had finally gotten back to the station around 3a and got called out @ 0400 for ab pain. When we get there.. the guy is rambling about losing $20 in the couch, would we help him find it and no... his belly didn't really hurt.

Normally it wouldn't have annoyed me as much, it just that at 0700 when I was getting off, I was hitting the road to drive to FL for 7 hours. Yeah I know, my choice, but still.... ugh. Handed over the drugs and radios to the crew, showered and hit the road. Florida for a week to visit my parents and relax. I am a happy camper.

Rollover

Started off the morning with a 6-month pregnant homeless woman who hadn't had anything to eat in 24 hours. She called 911 from a payphone in a Pizza Hut parking lot. She says that she sleeps in a vacant house across the street. Complaining of ab pain but not having contractions. She looked just so exhausted. I don't know if she was truly having ab pain for not, but it appeared that just being able to lay down in a clean environment and close her eyes was a great relief. I spoke with the nurse in L&D about trying to discharge her to a women's shelter. The nurse who took report was pissed that we brought her in. They would have been pissed had we brought ANYONE in... we interrupted their Sunday morning coffee and sitting on their butts. After I got her signature, I apologized for ruining her day and told her to perk up... she could be homeless and jobless too. If anything has been a shock to get used to its the attitudes of the ER to EMS.

Thunderstorms moved into the area and the next 5 hours were rollover after rollover after rollover. We had 8 or 9 but I could hear all the other stations too having them all day. None of ours were terribly serious. All self-extricated. First one, both folks restrained with no airbag deployment. Pax had no complaints, just shook up. Assessed her and BP was 168/100. She was refusing transport, and after she signed off and was heading out the back of the squad said her chest wasn't feeling right. Put her on the monitor and at first looked ok.. a little tachy with crazy tall R waves. Nothing terribly alarming. No past hx of cardiac. Another minute or so and she starts throwing trigeminal PVC's. She says her chest hurt and it was going straight into her back. She was pointing more to the Angle of Louis... I was thinking possible aortic bruise or tear.
So the refusal was out the window and we took her in. Kept watching the monitor as it would oscillate between trigeminal and bigeminal PVC's. 12-lead looked perfect. Am glad she didn't leave on the refusal.

Didnt see much of the station throughout the day. Got a little sleep and was called for a chest pain around 2:30am. It was really a post-delivery epidural wear off. She looked miserable... but the baby was adorable.
But it was that call that I almost blew the house up. We're pulling back into the station around 3am and there is a very strong smell of natural gas in the bays. I hop out of the drivers seat and notice part of the plug from the shore line is still in the ambulance port. My old dept had auto-ejectors for the shore lines. We do not. I say a little oops and we start opening the bay doors and investigating where its coming from. Walking around the bays I walk over to the shoreline cord and am looking it over.. three exposed wires.. wow.. I did a doozy on that one... I drop it and sparks fly everywhere! I'm realizing that I sure am glad there isnt a huge concentration of gas in the bays or that I started playing with the wires! I follow the cord up the wall to the ceiling, along the ceiling, along the top of the bay doors and back down to the wall plug and unplug it. It's about now that I'm looking again and the shoreline cord had been wrapped around the gas line on the ceiling that goes to the bay heaters. Yep, I broke the gas line when I pulled out on the earlier call.
"in the news today.. a firehouse was blown to smithereens in the middle of the night..."
We woke Cap up and he had to call the Bat.Chief to make a report. Good one rook... good one.
In the grand scheme of things not a big deal.. everyone forgets to pull the shorelines. I've seen engines flying down the road with 25' of cable following them. Bad part is.. "B" shift now cant cook or have hot water til the line is fixed. Oops.

Went back to bed after we aired out the place and woke up to the bell.... thank goodness for crews that come in a little early and take that call. God luv ya. I'm going back to bed.

Meds.... what meds....

With the horrendous heat here for the last few days, lots of heat-related calls, seizures and respiratory calls. Did a call for a 400+lb guy with difficulty breathing. My partner had him a few shifts ago for the same thing. 30yrs old, on O2 at home... and hasnt gotten any of his prescriptions filled from the last hospital visit. SpO2 said his pulse was 78 but thats not what I felt. Put him on the monitor and he was taching away at 162 with occasional PAC's and PJC's. 12-lead showed some ischemia and a possible infarct. He denied any pain... just couldnt catch his breath. His lungs were so full of junk. BP wasnt to high. Gave him a couple of breathing treatments and some solu-medrol while we waited for the bariatric squad. Signed him over and left thinking that he ever arrests, that'll be a MASH call.

The majority of our calls today were BLS which we sign over to AMR if they have a unit available. Several folks with just flu like symptoms who were perfectly able to walk out to their squad... right past their vehicle sitting in the driveway. It doesnt make me mad... just baffles me. Now I'm not really from po-dunkville, I've lived in several decent sized cities, but compared to where I have lived and worked... I feel like a small town girl from Iowa coming to the big city for the first time. Nationwide I know there is a horrible abuse of the EMS system on many different levels... we had our frequent fliers from where I came from. But I'm multiplying that by thousands here.

Did a call for a 90yr old woman in the middle of the night who woke up with respiratory distress. Again.. had been at the hospital about 2 months ago.. was prescribed Albuterol, Atrovent, and a bunch of others but has never gotten them filled. Hx of asthma and emphysema. Engine crew on scene had a pressure of 142/92. Partner got a pressure of 160/110. Gave her a couple of breathing treatments enroute and started to feel better. Temporary fix for a sweet woman living with minimal care... I know there is no easy fix, but the need for social services for the elderly living alone is overwhelming.

On my way out, the guy from above was in the room next to her getting ready to be discharged. Sounded like a brand new man who could actually complete a sentence.

Did a call for a seizure in the Wal-Mart parking lot... postictal all the way in. A chest pain with a known 90% blockage. A diabetic/syncopal episode.

We use the computer tablets here and thats usually what takes most new folks the most time to get used to. It would be so much faster if I could just write out the reports... the constant poking around with the pointer.. ugh! I do admit it makes you be as thorough as can be. It wont let you finish until you have everything accounted for. It has its pro's/con's. It can help you work the call while you sort out the complaints vs the pertinent negatives.. but its so time consuming it can be distracting. Another day... another dollar. I'm going to deposit my paycheck.

"Are you lost?"

Arrived at my new house with a "Are you lost?" LOL... Have heard all sorts of stories about just how busy the station is and figured we'd be hitting the ground going. Nope. My wheel chock cloud followed me through most of the morning. Everyone is great and I'm sure I'll create some nicknames suitable for the characters on my shift. It's gonna be fun.
Started off the day just before lunch with a chest pain at a dialysis center. He had enough Heparin in him to bypass the ASA, but a couple shots of NTG and into triage and he was a happy camper.
Ran an MVA, a structure fire, and a few others before dinner.
The night time.. well now that is another story. We ran and ran.. I think I got maybe 45 min of sleep. A shooting, in the leg, through and through... an infant with a high fever with unexplainable seizures. Apparently he has had them everyday since he was born, diagnosed not as epilepsy, but something else. He seized while we transported and it only lasted maybe 20 seconds with zero postictal time. Less than a year old, but mom says that he can be playing and just pass out. I am intrigued. He is as cute as a button and regardless of being sick, feverish and 0130 he is surprisingly alert and happy.
Ended the shift with a guy @ 0430 feeling weak and disoriented and some chest pain. Hx of HTN but his pressure on scene never got higher than 96/58 with a pulse never higher than 58. I felt bad asking to guy to crawl to the door since he said he couldnt walk, but he was a pretty big fellow and any help he could give us would surely help. Main hospital of choice was on full diversion enroute so we switched over to another one. Poor guy's wife never knew we switched and when I called the 1st hospital to adv that she was coming and to redirect her to the new one... they acted like they were being asked to raise the titanic.
Anyways... got back to the house and had a half hour before shift change. I still crashed for a while. I needed a little sleep for the hour and half drive home.

So... day one is down. Even though it is not the house I had really hoped for, I am really happy where I am at. The cross-section of people stretches across all socio-economic ranges and the territory covers a good range of different kinds of buildings. I am estatic to finally see the last two years come full circle. I drive down the highway with this big cheesy grin on my face.

No sir........ I am not lost.

Bill Craddock

Bill Craddock died from doing what he loved most: fighting a fire.

Mr. Craddock, a rescue specialist with the DeKalb County Fire and Rescue Department, had a heart attack May 4 while fighting a house fire in south DeKalb County. Two strokes followed, and he died Tuesday at Emory University Hospital.

Bill Craddock loved fighting fires and teaching other firefighters how to stay safe.

"Bill was what every fireman aspires to be what we call a jake, a fireman's fireman," said Christopher W. Holcombe of Buford, a firefighter who worked with him at DeKalb County Fire Station 24.

"Every time the fire department asked for volunteers, Bill was out in front. He not only was a dedicated fireman but an instructor on the local, state and national level known throughout the country for his teaching of technical rescue and firefighter survival. When they teach us to be firemen, they teach us to put fires out. But things can go bad in a fire. Bill taught the best way to save ourselves in emergencies and get other firefighters out."

As a rescue specialist, Mr. Craddock could do it all, said Mr. Holcombe. He was adept at high angle rope rescue from tall buildings, confined space rescue from places like sewer pipes, trench rescue from construction sites, scuba diving rescue, swift water rescue and extrication from vehicles. "Firefighting was Bill's passion," said his wife, Shainti Craddock of Jasper. "He called it his first love."

The funeral for William Leroy Craddock II, 37, of Jasper, is 2 p.m. Saturday at First Redeemer Church in Cumming. McDonald & Son Funeral Home is in charge of arrangements.

The Florida native served five years in the U.S. Marine Corps as a helicopter mechanic, Mr. Holcombe said. After moving to metro Atlanta in 1996, he worked as a car mechanic and began volunteering with the Hickory Flat Volunteer Fire Department in Cherokee County.

In 1997 Mr. Craddock joined the DeKalb fire department and soon was going through the arduous training to become a rescue specialist. Besides his extensive teaching, Mr. Craddock worked part-time for the Forsyth County Fire Department and was an assistant chief with the Bethany-Salem Volunteer Fire Department Station 8 in Jasper.

To help unite Georgia firefighters, Mr. Craddock joined with several other firefighters in 2001 to establish the fraternity Georgia FOOLS, a branch of FOOLS International. FOOLS stands for Fraternal Order of Leatherheads Society.

"It is an organization that promotes brotherhood and the traditions and lifestyle of firefighters," Mr. Holcombe said. A major part of the Georgia FOOLS agenda is teaching firemen across the state how to save people and get out safely, Mr. Holcombe added. The program has grown to numerous chapters, said co-founder Brian Gary of Forsyth County, a lieutenant with the Forsyth County Fire Department.

For fun, Mr. Craddock rode bulls in rodeos, went horseback riding with his wife and played hide-and-seek with his 4-year-old son Colby Craddock, who loved to come to his father's fire stations.

A fund for Mr. Craddock's widow and son has been set up by the DeKalb County Fire and Rescue Department. Donations to the William L. Craddock Fund can be made at any Bank of America branch. Other survivors include his mother, Gail Schueren and his stepfather, Bob Schueren, both of Epworth.

-Courtesy of AJC.com

It is finished

In more ways than one....
First off.. I said goodbye to a good friend yesterday. A brother in the fire service, Bill Craddock, an incredibly smart and funny man went home to be with all the other firefighters that have gone before him. 40 days ago, May 4th, 2006, Bill was fighting a house fire and went down from a massive heart attack. Since that day he has fought the battle in ICU. It was a roller-coaster of good news/bad news.
Compared to 99% of everyone else who knew him, I only knew him for a short time. But in the short time he taught me lessons that I will take with me for the rest of my career. Craddock was a gruff, no holds barred kind of guy who through tough words but a gentle spirit only wanted everyone to be able to go home the same way they got on the truck on the way to the call. He was... he is.. the poster child of firefighter training and safety. Full of mischief and piss & vinegar he stood out as a guy who loved this job so passionately and only wanted to share the knowledge he had with all his brothers and sisters.
Craddock is known throughout the nation as a hardcore firefighter who loved to train. Both himself and others to, quite simply, always be the best. There was no excuse for not giving 110%.
And just as much as he amazed me, his wife has amazed me. Throughout this whole ordeal she has been so kind, so thoughtful... in a time of utter heartache, she has so often thought of others before herself. I hope she always remembers that we will always be here for her and her family. We are all a family.

It so sucks that it is times like these that it is when we get to see long lost friends. But it will be a time to celebrate Craddock's life. To celebrate and acknowledge all his accomplishments and the advancements he has made. I came to this dept after riding with Craddock at his station. I was so looking forward to working jobs with him. To training with him. I can only work towards being the best.. to hopefully making him proud. Everybody wanted to live up to his expectations. I will miss him so much.

And... on a lighter note. Today was the last official day at the fire academy. I did it. Cav and I have to go back and complete a class tomorrow since we were at the hospital all day yesterday, but that is fine. The thee of us have our station assignments and all our stuff to hit the field. Finally! My excitement is anti-climatic... I still cant believe that I am here. .doing this... and they're paying me. The last two years have finally paid off!

I have been assigned to one of the busiest boxes in the county. It's a single company house so the amount of time I am going to get on the engine will remain to be seen. I will put my time in on the box, but I will definitely be looking to get as many fire rotations as I can. The call volume for my station is huge. In the first 5 months of this year one engine and one box have about 3700 responses. LOL... woo-hoo.. am I in for a treat. I think I might have said that I came to this dept was because I wanted to busy... maybe a little too much.
So.. needless to say.. this blog will have lots of interesting stories. Stay tuned....

2 down...

Today was a good day... PT aside, it was a good hard physical day. Hooked up with another class doing interior search and rescue and today was like being back home doing drills with Darin.
Our instructor switched it up this morning.. so the fact that I had my brain straight for what to expect flew out the window. But I had a brief moment of personal pride. As with most women in the fire service, we tend to lack on the upper body strength. I've never made excuses for that, and dont tolerate other women who do. If you want the job, then get into the gym and pump iron til you can. For all the CPAT's I've taken.. it is usually the hose hoist that eats my time. When I took the test for Dekalb it was like the others in that it really ate into my time.
In the middle of running the tower with the hose roll, Instructor S. had us stop off at the 5th floor and pull the hose. I pulled it without pausing and without that much difficulty. It was just a brief moment of "yea!" for me.
Did 3 evolutions with the group... the maze, disoriented ff, and a team search. I truly miss being all hot and sweaty in my gear, pushing myself...
I had a brain fart during one of the evolutions... LOL.. my old LT would have bopped my on the head. In the middle of the maze I was being hollered at to disconnect my regulator. I pulled off my one glove since my hood was over the regulator. Yeah.. I know. Just a brain fart. Had to re-do the maze.
Took a couple layers of skin off my knees but it's all good. I'm not sure what we're doing tomorrow... something in the burn building.
I am so looking forward to being back out in the field. 10 more days.

back into the groove....

Well if anyone actually reads this... I'm back. The past few months have been spent packing up, and realizing one of my life's goals. I have taken a job with Dekalb County Fire Rescue in Atlanta. After a year of traveling around testing for departments, I've picked them. My uncle lives in north Atlanta and he is so incredibly generous to let me shack up for a while. The things I wanted in my career dept was big, busy and progressive. Dekalb fits all of those. 268 square miles, 700K people, and about 105,000 calls a year. So anyway, I've been down here for about 7 weeks. The past 6 weeks have been all county and medic orientation. A long.. 6 weeks. We are the anomily at the academy.
Normally classes range 25-35 people. We have 3. Yep... 3 people. A guy from Dallas, TX a reinstate who used to work for the dept a couple of years ago and me. Its been a good time but we're all itching to get back out into the field. Even if they put me on the box for a long time.. I dont care... I'm tired of being in a classroom.
So.... we finished all that up last Friday. Today started accelerated fire training. All of us (all whopping 3 of us) are already FF II certified in some aspect, just not GA. So basically they're running us through all the skills and getting us ready physically for the academy's exit combat challenge.
Yeah... today was hard. But it was a good hard. Morning callestetics followed by running of the tower a couple of times with a roll of 3", followed by an uphill march (with the hose) for a couple of miles.
I'm hitting the sack early. We were advised before we left that it gets much worse.... right after we got done reloading 1500 ft of 5" supply line. But like I said.. I'm not complaining... it was a good hard physical day. But a 60 min body massage also sounds utterly divine.

Ok... enough writing for now... the light from the screen is killing my head.. I know... gripe, gripe, gripe... hell, its my blog I can do whatever I want.

Nite....