A simple plea for help

I'm sure I don't have many readers, but those that do see this, I need a lil help.

I need to find some examples of TEMS or swatmedic protocols. My FD has swatmedics, but no specific protocols for tactical medicine. I'm on with "Little City PD's" swat and they have no protocols or medical director (yet).

I've been a google whore for hours and can't seem to find any examples of TEMS-specific protocols out there.

Would you kind folks mind by helping spread the question? I'd really appreciate it.

Funny stuff on radio

Was listening to the car radio on the way to work a couple days ago. I have my favorite morning show that I always listen to. Lately, they've been giving each other lots of crap after their Christmas party. One of the guys was convinced to ride a horse, which he apparently has never done. Listening to them describe it had me nearly in tears.

Then they came up with a new description for morning rush hour, "beep n creep." They really hit the nail on the head.

Once at work, the funnies continued on our "real" radios. One unit had an open mic and you could hear them trying to sing with the radio. This was 2 guys mind you. Let's just say they certainly won't make american idol.

Later in the afternoon, a specialty unit was required to a scene but the crew assigned to that station was out on another call. There was a ladder already on the way to that station to cover the territory. Chief was obviously frustrated and finally told radio "there's a big red truck in that station and when XXX gets there, someone better bring me that big red truck."

We were all laughing....hard.

SWAT news

I met with the Captain over Uniform Division for "Little City PD" this morning. I was in the interview with him for almost 2 hours. We spoke about everything from my experience as an EMT, to what was expected of their swatmedics.

Things went beyond well!

He is going to work on getting me very basic gear, mainly a flightsuit (their swat uniform). I have been invited to any, every, and all swat training, as well as riding along with the officers on patrol. They are still new to the idea of having medics, so they will get any piece of equipment I feel is necessary to do my job. They don't appear to have a trauma medical control, so I may need to find a doctor willing to help with this.

As I attend more training and get more comfortable with both the team members and my duties, I will eventually go up for a vote. All team members are unanimously voted onto the team, and majority rules to kick you off (unless you are taken off the team as punishment). The Captain seemed to think I will fit in very well since I'm used to being around a bunch of guys in the firehouse. I'll be their first female swat member.

Once on the team, since I'm also interested in the tactical aspect of things, I'll be sent to the police academy. After completing the academy and being released from FTO, I will be elligible to attend the full swat school. After another vote, I can become a full swat operator (as well as medic).

Dear God, help me, I'm sooooo excited!

Imma jump in front da train!

Granted, it gets kinda cold here, but the day I'm talking about wasn't that cold. Maybe in the low-mid 40's.

As we're leaving the call of a 100 year old feeling sick (I would too at that age), we get sent to the transit station for a male down, chest pain.

We found him, along with 3 transit cops, in the bus loop. He initially admits he's been in the cold all day and just wants to get on the train or somewhere to warm up. We start talking with him more, trying to get the information needed for our paperwork. Meanwhile, the ambulance arrives and attempts to get a set of vitals.

When the medic goes to put the B/P cuff on the guy's arm, he made some smartassed comment about sitting in the truck where it's warm. The medic simply responded: "You've been out here for hours, what's 30 more seconds?"

I had to turn around, the 3 cops just started cracking up, and the pt tried to act like he was getting weak-kneed. It didn't work, and when he realized his act failed, he upped the anty.

"Put me on da train! Put me on da mutha-f***in train. Imma jump in front da train. Imma jump on da track in front da god-da*n mutha-f***in train!"

The cops, bless their hearts, started towards him to let him through the gates so he could access the train. I was just hoping he'd catch the 3rd rail so he'd actually have something to bitch about.

No, we didn't let him jump. *sighs*

We tried to help him onto the ambulance, and when he started being an even bigger pain, the other medic turned on her charm. They argued for a moment before we bailed.

The rest of the shift was uneventful, we even slept all night if I remember correctly.

October 5, 2008 House Fire

We'd just gotten back from a medical call and completed our paperwork. I was still sitting in the office with the OIC (officer in charge) and we heard the rip-n-run kick over. All calls we are dispatched to are printed on the rip-n-run. Me and the OIC walk out there and I grab the paper...

"OOh, fire........................Oh shit it's across the street!"

We took off for the truck, I had it cranked up before dispatch toned out any stations yet (whoohoo). We pulled out of the station and as we crossed the intersection, we were able to see the smoke and glow from the fire.

As we pulled up to the house, it was burning the fuck up...there's no other way to explain it really. So, I'll let this blurry picture do the talking for me. The houses on either side were major exposure issues as well, the one to the left was already catching fire.

I shifted the truck to pump mode, turned on the generator, and hopped out. I pulled about half of the 200' crosslay (preconnected attack line) onto my shoulder and took it as far into the yard as I could. I ran back to the truck and finished pulling the rest off and then ran to the pump panel and charged the crosslay. I pulled the other crosslay and set it near the house to the left, thinking it would be perfect for the exposure once we got more units onscene. I didn't charge that crosslay yet though.

Back at the truck, and as more units are arriving, I pulled and passed off one of the 2 1/2" attack lines, and hooked the end to a discharge (those lines aren't preconnected). I knew I'd have to wait until I had water from the hydrant (positive water supply) to charge that line. About this time, I also ran out of tank water. We carry 500 gallons and the person riding tailboard had been dumping the water on the fire (pointless) instead of protecting the exposures (what we're supposed to do).

I notified command (guy in charge) that I was out of water as I was throttling down the pump (I had throttled it up to put more pressure on the crosslay). Another driver was working on my water supply and I made sure my truck was ready for water. I *think* this was about the time I took the picture above. I also set up my command light, it's a huge bank of lights on top of the truck.

There was a major misunderstanding, aka, rookie that didn't know what to do, when it was time to charge the supply line...so getting the supply charged took a few minutes. I also didn't help that command was running his mouth on radio and wouldn't shut up so we could call the rookie at the hydrant and tell him to charge it.

FINALLY got water into my truck and charged the 2 1/2" line. Someone pulled the other 2 1/2" and I tried to charge it, but quickly realized there wasn't enough water from the hydrant, so I had to shut that line back down. The captain who wanted the other line yelled for me to charge it again, I told him I couldn't and why, then keyed up my radio and advised all units onscene that there was extremely low pressure off the hydrant. It's the nice and formal way to say "don't ask me for any more water, this is all I've got!" Of course, I immediately had 4 guys at my pump panel trying to troubleshoot what I was doing wrong. I was doing everything right, there just wasn't any pressure to be had. They left me alone and a crew was detailed to walk the supply line and make sure it wasn't kinked (kinks can drastically reduce the pressure). It didn't make any difference. I continued doing what I'd been doing, giving them as much as I could without cavitating my truck (cavitation is trying to put out more water than you're taking in).

Now, it's been 21 minutes since we were dispatched. It seems like a very short amount of time when you're there, but looking back as I'm writing this, it seems not a lot got done.

Really, about this time is when I ran out of things to do. I've been told that the first 20 minutes are crazy for the driver, and it was right-on. Nobody was allowed to go inside the structure until most of the fire had been knocked down, so there weren't any SCBA bottles to swap out. The driver that had helped with water supply had been getting water bottles or gatorade for the crews working as soon as the air truck got there. There wasn't really anything for me to do, so I just continued monitoring my pump panel and watching the scene.

Side Note** I just realized I never posted this, I initiallywrote about it in a different journal, but completely forgot to copy it over to this one.

Dispatchers

I've been up all night thanks to not feeling all that great. I've been entertaining myself by playing on a few websites I haunt and reading random blogs. It got me thinking (the blogs that is).


We all have them, sometimes we love them, sometimes we hate them. I'm sure the feelings are mutual.

I happen to be close to 2 dispatchers, one is like a father to me, the other, a best friend and nearly sister.

My other dad is a great dispatcher, loved by all. He is one of the senior guys at 911 and can handle anything thrown at him. He is also a FTO and is trying to make supervisor. I can recognize him on the air both by his voice, and his little quirks. I've been to his house, hung out with his family, and been mugged by his dogs (I have pictures to prove it). His daughter called me "sis" the first time we met (she's around my age). I've exchanged god knows how many messages on the computer when we both had time to be bored, even if only for a moment.

My best friend is also a FTO and from everything I can tell, a great dispatcher. You see, we don't work for the same department. I've spoken with people that do work with her and they love the job she does. She is my partner in crime, especially when shopping for birthday gifts. We've been the shoulder to cry on about calls or whatever, and the ear that listens when you need to vent about work.

Both of these people I love to death and am proud to say I'd work with them in my ear any day.

BUT...There are so many more out there!

A couple years ago, the partner and I checked out on a 911 hangup call. Long story short, I'm sure I gave the dispatcher a heartattack when I had to yell (yes, yell) for help. We were in a fight and there was also a pit bull attacking us.

"Rescue X, radio...We're in a fight, there's a dog, I need PD 10-18!"

She paused, but was calm, cool, and collected in her response. I could hear the urgency escaping her when my chief and a few other nearby units called her requesting our last known location. I hope she gave the city that was handling the PD response a good ass-chewing later. They were supposedly dispatched when we were, and we had to drive past their precinct to get to the call.


A couple months ago when I totalled my car, I'm sure I gave another a little heart-attack.

"ABC 911, what's the exact location of your emergency?"

"Radio, I'm an offduty ABC firefighter, been involved in a 41I (accident w/injuries) at "Maindrag" and "Cross-street". I'm in a (car description here) and was hit by a (other car description here). I had Engine X on -21 (phone) with me when it happened and they're already enroute, I need PD."

....(long pause).........

"What's your name and #?"

I'm glad I had a good idea what info she would need, and I still believe I gave it to her in a decent manner. You bet your ass I was excited, but I wasn't too fast because I didn't have to repeat anything or answer any further questions. Maybe it's from dealing with crazy stuff onduty I was able to control myself enough to do what needed to be done.

I had a double-whammy on that one though. My other dad was on fire/ems dispatch and he had to dispatch the call. My phone went nuts. As soon as I was done with the police officer and everything on the scene, I was loaded into the ambulance. I called dad at his console (he'd texted me the # already) and told him what happened and that I'd be ok. I also asked him to thank whoever took the call and tell them I'd be ok, just sore.


While I don't know what it's like to field calls or be a dispatcher, I do have a great appreciation for the job and how it works. My department doesn't require or even recommend that we sit in at radio. I chose to. At least 5 times now.

I understand what it's like to never know what happens next. On our old CAD system, I would sometimes look up what calltaker handled the call and send them a message with what I could relay. I always got a thanks in return. I can't do this as easily with the new system, it loses many messages, or won't stay connected. At least I try to bring some type of closure to the person who had first contact.


I know we all get grumpy with radio, and sometimes radio gets grumpy with us...Many times, it's neither one's fault (crappy area for the portables or similar). I just felt like saying thanks for what you do.


You may know where you are...God may know where you are...But if your dispatcher doesn't know where you are when you scream for help...You and God had better be on good terms. 10-0

Work lately hasn't been overly interesting. I'm in a new area and it's taking some time to get used to. New territory, new trucks, new crew, it's a different world. I was in my old station over 3 years and it was my home. I miss (some of) my crew the most. More than anything, I regret the timing of me being transfered. My crew was my family and I wanted to spend the holidays with them (considering I work thanksgiving and christmas eve this year).

So far, things are going good. Like I said, it's just taking a little getting use to.I *may* have found a swat team to get on with. They currently have 2 medics, but both are only trained cops, whereas I'm an EMT. I met their chief years ago and he's a great guy, takes care of his men and stands up for them. I need to call a Sgt sometime this week and see about meeting whoever I need to meet. Even if I don't get to work with these guys, maybe I can get my foot in the door enough to play bad guy whenever they need to train.

Last week was absolutely crazy, but I had a blast. I attended Tactical Medic training.

It took 61 hours and many scenarios, but I am now officially a tactical medic, or SWAT-Medic.

I had the opportunity to learn skills in the class that not even paramedics are allowed to perform out here on the streets. Things like needle-crics and suturing, even digital intubations.


Now, to find a team to work on....

House Fire with Entrapment

Sent to the above type call at 0805. We got onscene fast and scrambled getting our gear on (on the ambulance again). We were just about to walk in the front door when command assigned us RIT team. It's a very important job if you're ever needed, but usually, you sit outside on a spare hoseline and wait.

Just moments later, actually it was 0821, the lady was brought outside to us. I took off running to the truck to get jump bags and the stretcher, another firefighter in no gear beat me by a mile. We got back to the lady just as the other ambulance arrived (they were sent since we were assigned to "firefighting operations"). She was being bagged (we were helping her breathe), and someone was doing CPR. As soon as we had a backboard, we secured her to it and placed her on the stretcher. We snatched the other ambulance's stretcher out and put our's into their truck to save time.

After taking a few minutes to suction and secure her airway, as well as start an IV and push cardiac drugs, they were off to the ER. She did not make it. While she wasn't burnt, her body was covered in soot and she had already fallen victim to smoke inhalation.

The fire started in the kitchen and was somewhat contained to that area.
*****************************************
Ran this call about a month ago. I just never made the time to write anything about it.

Neglectful

I've been neglecting this blog lately, and for no particular reason. A lot has happened, and yet nothing has changed.

I started a part-time job near the end of June. The work is incredibly easy, and most of the people I work with are fun to be around. We see a lot of people on a daily basis, but it's all minor things. It's very rare that we have to call a unit in to transport anyone to the hospital. Ironically, many of our patients, are employees.

I've been sent off to fill in at other stations more times in the last month than I'd care to admit. I've also been putting up with a fair amount of BS lately. The most recent, a pratical slap in the face.

Our crew has been in some degree of turmoil since the beginning. We've had multiple captains and rookies, multiple people fired, and we are used as both a "last chance destination" and the guinea-pigs. I'm getting tired of it.

My personal turmoil is watching not only my old academy classmates, but people hired after me, being given opportunities that I'm constantly denied.

Most recently, my car was totalled and I was stuck in the hospital for over 5 hours. I'm planning to take the other driver to court over my hospital bills and such, so only time will tell how that goes.

Pumping my 1st house fire

Now, Fridays are truck days, so we spend a good part of the morning really going over all the trucks. I did the normal truck checkoffs and then we caught a call. When we got back, we washed the engine and took apart 2 compartments to scrub them out and clean the mats. The chainsaw leaks bar oil and the compartment it's in gets nasty. Instead of being boring with more details, let's just say we went over almost every square inch of the fire truck.

I had to take the truck to motor maintenance because we were extremely low on power steering fluid, that took over an hour (because they're slow). As I was leaving the station, our squad was being put in service for the shift (takes 2 to run it and 1 of our guys was at another station for a couple hours).

We didn't really run much that afternoon thanks to the squad jumping our calls. Right around dinnertime the whole department got extremely busy, we had calls pending and radio was freaking out. Thankfully that didn't last very long at all. Engine and squad made it back to the station and finished cooking and eating dinner.

And then it happened, the last thing I expected, the one thing everyone else wanted but I sorta feared... A house fire in our territory!!!!!

We all ran to the trucks. As my Captain was getting his gear on, our Chief called and wanted directions, the nextel was thrown to me. So here I am, driving the firetruck emergency down the street, talking to Chief on the nextel, and he's giving me a hard time about the directions. Got off the phone just in time to cross a major intersection and spotted the smoke column.

It's workin'!!!!!!!!!

The house was a single-story, 1 family, brick house, and it had heavy (lots of) smoke coming out both ends.

**keep in mind the other stations are extremely closeby, so plenty of help arrives fast**
I pulled up just past the house (have to see 3 sides if possible) and put my truck into pump mode. As I hopped out and started pulling my first crosslay to the front door, the next engine arrived and their driver (a classmate from my academy class) told me he'd get me water supply. I ran back to my truck to charge the 1st hoseline and throttle up the pump to give the correct pressure on the line. The 3rd engine arrived and I passed part of my 2nd crosslay their driver and made sure it came off the truck. Moments later I was charging that line as I opened my intake, water supply was completed.

Now that I had hydrant water, I throttled down my pump and used as much of the hydrant pressure as I could, why overwork the pump if I don't have to? I pulled a 3rd line from my skidload but didn't charge it with water, we always have to have a spare line on the ground in case something happens. I also went ahead and pulled my cooler and cups out and set them on the tailboard. It was over 90 degrees outside and Air & Light wasn't there yet.

Air & Light refills our airpacks and also carries rehab equipment like cold water and usually some type of crackers.

Most of my work was done for now so I stood beside my truck and watched the action. The corner of the roof had been breached by fire as I was charging the 2nd line, but was now out. Crews inside had gotten the upper hand on the fire. I met a crew halfway across the yard with my attic ladder (heard them ask for it). They used the ladder (attic ladders are skinny) to be able to get to and knock out the siding and plywood in the corner of the roof and make sure the fire was out.

Later on, we reloaded the spare line and I was able to shut down one of the crosslays. It was also reloaded onto the truck. Once that was done, the crews inside wanted a fan set up in the door to clear out smoke. The ladder's driver beat me to it with his fan, but it wouldn't stay cranked so I put out my electric fan...BTW, I have a generator on my truck and can power quite a lot of stuff with it.

Once it started getting dark out, I set up my light tower, so did my old classmate with his engine. Water supply was no longer needed and was disconnected. Everything inside was soaked one last time using tank water (we carry 500 gallons) and the line was shut down and put away. We allowed a couple of the residents to go inside, with our escort, and get their belongings. We were the last to leave the scene.

Fire was determined to have been started by food on the stove. All residents made it out ok and nobody suffered any injuries.

My captain was a driver/engineer before the department took away the position. He pulled me aside and told me that *now* I was released as a driver. He had no complaints about how I did pumping the fire either. That alone is the BEST compliment from him. He did finally say I needed to anticipate what the crews inside would need, but that that will come with experience.

Went back to the station and I refilled my tank from the hydrant out front while my captain took a quick shower and my other guy put on a clean/dry shirt. We went searching for fuel, went 4 places that were out before finding any. 27 gallons of diesel later we were on our way back home.

We did run 2 other calls overnight. At 619am we picked up another house fire nearly across the street from our station. Some arsonist tried to burn a vacant house down...he failed big time. The oncoming shift waited for the arson investigator and we went offduty.

Dull

Not much to talk about lately. Work has been somewhat dull as far as interesting calls.

Not long ago we went into a house that appeared to have a marijuana growing operation. I'm currently working with local PD's narcotics unit by making them aware of the house, and giving them as much info as I can since I was able to go inside. I'm really looking forward to helping out and getting to learn even a little something about their investigation process.

That's really all I have for now.

4 calls to blog about

We went to a house fire that was room & contents. My energy was gone in about 2 minutes. Holy crap I didn't realize I was weakened that much from being sick (got sent home sick the shift before). I did my best to pull some sheetrock, then just stood around with everyone once we finished tearing stuff up. The fire was pretty much out as we arrived, so it was time to put away hoses about 30 minutes after we got there.

Then, we responded to a 13yo that was wrestling around with his mother. She simply stated "he has mood problems, shut the door, he'll run." Apparently, the kid is known to local PD, the officer was familiar with the kid's story. Kid's dad is in jail and mom says he wants nothing more than to be with him. Kinda feel sorry for him, until he swiped my partner's phone. When we first got there, mom was sitting on him on the steps just inside the house. My partner grabbed the kid's wrists and made him sit near the sofa. We ended up wrestling a tiny bit with the kid, and eventually left the scene to PD.

We ran a few other not so interesting calls throughout the day. Overnight, we ran 2 that were just, wow.

The first was in a house that I swear had a drug-growing operation. The smell of marijuana almost slapped you hard enough to leave a mark when they opened the door. I could see a pile of it as big as both of my hands in another room. There was 1 room that was blocked off, and from outside, the windows had a blueish glow....blacklight. I've already notified the local PD's narcotics division and plan to work with them in any way possible.

The other call, I felt for the person. Local streetwalker (aka hooker) was raped, beaten, and left naked and semi-conscious in 40-something degree weather. She looked to be about 40, had a nasty black eye, and was really skinny. I'm thinking she may not be able to afford food on a regular basis. The one thing that may make her case, is that the f*cktard who did this to her, left the used condom at the scene.

All in all, it was a long shift and we didn't get much sleep. In fact, the truck I was on usually takes the medical calls for the engine. In the wee hours of the morning, they took one of our calls, to give us a break. I never loved those guys so much as in that moment. I still came home and napped for 5 hours. It may not have hit me so hard if I wasn't sick, but I have been, and have 5 1/2 days left of medicine to take.

A long shift

We were up all shift with maybe a 30 minute nap around 330am. The only call of interest was a cardiac arrest, but I'm not sure if there will be a case in this one so I'm going to keep it to myself for now.

.

The picture was taken shortly after arriving onscene under part of an automatic mutual aid agreement. We were dispatched around 0520. I had reported to command to let him know we were there if needed, and was walking back to my truck to get my jacket when I took this. The first engine onscene found it with the back porch fully involved and flames coming out of the corner of the roof. By the time they were ready to make entry, the whole roof lit off and command declared it a defensive operation (ie...nobody goes in).

.

About 0550, the tiller was put into a better position so massive amounts of water could be dumped on the fire from above. When we were released a half hour later, the ladder was still flowing, but the fire was nearly out.

.

I came home and played online for a few minutes before crashing into bed. I woke up when my phone rang at 430pm. Nice lil nap if I say so myself.

.

.

PS...I like my paragraphs spaced out, blogger isn't cooperating so you get extra marks to make it cooperate.

Tree on 2 houses and a car

Our first call of the day, shortly after lunch. The house on the left is currently empty. The car suffered some damage from the tree, but the carport took the brunt of the damage. The house on the right only had 1 person home when the tree fell. You can't see it in the picture, but they had a metal roof over the front porch area. We ended up taking the chainsaw and K-12 to the tree and roof, respectively. The front door was the only means of entrance/egress so we had to do something.

Oh yeah...and I was driving the engine...whoohooo!!!!!!!!

I finally made it down to see this handsome guy today. He's doing so good right now. The ferrier wasn't trimming his feet correctly so there's a new(to us) ferrier. He trimmed the toe down a lot and put eggbar shoes on Leo to support and encourage his heels to grow. The other guy had let the toe get long to the point where the heel had slowed growing and since the toe was so long, it forced everything into weird angles. Thankfully, Leo turns 5 this month, since he's young there shouldn't be any permanent damage...I hope.

And in other news, that pit bull that attacked my dog went after a human yesterday while I was at work. The guy's hand was pretty ugly from what I was told. The dog is at the pound right now, and our court date is in 3 weeks.

Currently, the bills from my dog's injuries are totalled over $4,000. I'm not sure how much the ACL surgery will cost. Not that we expect the pit's owner to pay a single penny, it's just the principal of the whole thing right now. He's never once apologized, not for either attack on my 2 dogs, or yesterday. All 3 times his dog was off-leash, and off his property. The 2 most recent times, they didn't know the dog had even escaped.

Dog attacks

One of my dogs was attacked by a pit bull a couple weeks ago. She developed a bad infection (even with antibiotics) and had to have a couple drains placed and become a cone head for a week. Her drains are now out and she's healing great. Next week, we take her back to see if she's good to go to have her torn right ACL repaired. It was also torn during the attack.

Eventually, we plan to take the pit bull's owner to court for vet bills...Well, let me rephrase, if he doesn't skip town we're going to try.


More about this later, I'm at work and duty calls.

Tornado hits Atlanta

Last night downtown Atlanta was hit by a tornado. So far, there are 30 injuries, 0 fatalities. I can only imagine how much worse it would've been if the SEC game had let out. Thank God for small miracles.

Many buildings have major damage, everything from blown windows to flooding to the roof being ripped off or collapsing.

GSAR was mobilized last night, not long after the storm hit. I believe GEMA and FEMA are also in Atlanta assessing the damage and helping to clean up.

Grady Memorial Hospital, Metro Atlanta's only level 1 trauma center, sustained damage also. Ambulances were diverted thanks to the damage both to the building and the surrounding area. Power poles, trees, and debris prevented units from reaching the hospital. I haven't heard what time they cleared enough damage to reopen for ambulances, but I would think it was a priority and should be open by now.

All traumas were sent to Atlanta Medical Center, just a few blocks away. AMC is a level 2 facility and the only other trauma facility inside the perimeter. There was massive damage all around AMC, but I haven't heard of any damage to the hospital itself.

It was a night from hell, the storms were wild. I was a little worried, but I'm also slightly freaked out by lightening if I'm not inside a building.

**Edited to add the picture**

Oops

Missed the driveway, no injuries and with the help of a van and a chain, the Jeep was towed back onto the road.

Sorry for the lack of posting, I've been sick for a couple weeks. Currently, I'm coughing so hard/much that I can hardly breathe afterwards. Working tomorrow is really going to suck.

Multiple GSW's

Last night we were called out to a GSW victim. We found the patient sitting in the backseat of a patrol car (not in custody, just sitting there waiting on us). The senior medic (a Captain) wanted the guy moved to the stretcher before starting an assessment, being on the transporting unit, I turned into the stretcher-fetcher.

Keep in mind our patient is approx. 6' and 300lbs. In the rig, we find 2 entrance wounds on his upper right thigh, 1 inside, 1 outside. Also 1 entrance wound on the outside of his left upper thigh. He's a big guy and we can't really get to the backs of his legs to do a better assessment (thanks Cap.)

Vitals 160/80, pusle 88, sats 99% room air, respirations 20.....We called in a report to our trauma center at this point.

I started an 18ga IV in his left AC, and attempted to give a bolus of Lactated Ringers. **I think the IV was positional and the patient kept calling everyone on his phone. **

I kicked everyone out of the truck so I could have room to move and also so we could get on the road. I finished cutting off the guy's pants and found a 2nd entrance wound near the first on the left thigh. He was also complaining of pain when he moved his right leg, and his "nuts are numb".

I called in an update, 4 entrance wounds, vitals 152/80, pulse 86, sats 99% on room air, respirations 20 nonlabored, IV established giving bolus, ETA 10

The patient's blood pressure continued to fall enroute and he became diaphoretic (sweaty).

Blood pressure was 114/52 on arrival to the ER, pulse 92, resp. rate and sats unchanged. Once the patient was moved to the ER's stretcher, we discovered a single exit wound on the back of his right thigh.

I left to type up my report and when I went back inside to drop off the copy, they were taking him to CT to rule out a pelvic fracture. You could clearly see 1 intact and fragments of a 2nd bullet in his left leg, they thought the round that didn't exit his right leg may have bounced upward and hit his hip.

I'm going to try to get an update on him next shift.

Nothing too interesting to report from work lately. We've had a few calls that I guess I could write about, but they're not too interesting(at least I don't think so). The only call I want to write about I'm going to hold off writing about until I can load a picture of the EKG strip. I'll give a little info as a teaser, severe hypothermia.

You win some, you lose some

While some calls are inherently worse than others, there's always those calls that we get more involved with emotionally. For some, it's traumas that get the blood flowing, for others the critical elderly patient does the trick. No matter how new or experienced, parent or not, everyone goes on high alert when the call is about a small child, especially cardiac arrests.

Fortunately, most calls that are dispatched as pedi arrests, really aren't arrests. Unfortunately, most that actually are arrests, are extremely hard on all involved. I've been fairly lucky in my career and haven't been on very many of these calls.

I remember my first one very well. We were dispatched for a 3 month old in respiratory distress. On the way, we were updated with CPR in progress. My partner told me to stand by the truck and if the child actually was in arrest, he'd bring her to the truck and we'd work on her there.

Onscene, it seemed like the moment he walked through the door, he was on the way back out with the baby in his arms. She was blue from the nipple-line up.

In the rig, we started CPR while my partner prepared and tried to intubate. As soon as the the tube was in place, a nice little geyser of milk came up through the tube. It was obvious at that point that when the home care nurse was feeding the child, she aspirated the milk.

I still don't know how he did it, but my partner also managed to find a vein and start an IV. I was ready to use the IO needle if needed.

A few months later, I attended a regional Star of Life awards ceremony where I was presented a Star of Life award. These awards are only given if a patient, confirmed to be in cardiac arrest, is able to leave the hospital expected to make a full recovery.
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More recently, we were sent to a 1 month old in arrest. There was already 2 units onscene when we arrived. I jumped into the ambulance along with my partner to see what I could do to help. When my partner unlocked the drug box to grab the Epi, I pulled the IO needle out of the bottom of the box and asked if he wanted me to go on and get access. He gave me the green light so I wiped the area of the leg with alcohol and mentally prepared myself for what I was about to do. I also tried to think back to the academy, which was the last time I used an IO needle, and that was on a mannequin. I double-checked my placement and went for it, digging the large needle through skin, tissue, and bone. It went in with a creepy "pop" I could feel. The line was hooked up and flowing extremely slow, which is the best you could ever hope for from an IO.

We worked our hardest all the way to the hospital, and the hospital staff did their best as well, but it just wasn't enough.

In the last couple weeks there have been a large number of SIDS cases. My guess is that this may have been one of them and the parents just happened to be awake and found it early.

If you have kids, give them a hug and tell them you love them.