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On a recent family trip we drove past a sub-urban/rural firehouse quite a few times. Each time we passed by, all three rigs were in quarters, sometimes bay doors open, sometimes closed, but I made an important observation I’d like you to confirm for me:

How busy your rig is is inversely noted by how many rig doors are open and how many boots sit outside said doors.

Each time we drove by all 4 doors of the ladder truck were open with boots on the ground and on some passes, even a coat could be seen hanging from the door. This tells me you aren’t running many calls.

When running a large number of calls it is important to keep all your gear safely inside the rig so as not to forget it or have it placed aside when the driver does something without you.

My system has 2 of the Nation’s busiest engine companies and one of the busiest truck companies and they don’t sit with their doors open, gear on the floor because they have become efficient in donning due to their call volume.

I thought back to my early rural days and we almost always put our gear out with the doors open in hopes of a call. Even the other night at the five-one I spotted a door open and we had had a slow day to that point.

Close your doors and put your gear back in the rig. All that “preparation” only telegraphs that you don’t get dressed all that often. Unless of course that’s the only time you get to touch your fire gear aside from the locker.

Happy Medic and Motorcop dive into the controversy surrounding the Alameda man who drowned while rescuers untrained in water rescue stood on dry land. Then, as usual, they find a tangent and discuss the costs, effort and resources involved in arresting and jailing someone compared to transport and hospitalization and why many times neither fits.

EPISODE 14

Our engine boss is cramming for the Captain’s exam when the bells ring for a call at the golf course.  A HazMat at the golf course.  This could be interesting…

THE EMERGENCY

Multiple calls for multiple sick persons, unknown cause.

THE ACTION

There are a few things we look for on the way to these types of calls, right?  There was no smoke, or cloud, and we approach from upwind, despite the requests from local law enforcement to pull up to the main entrance with him.  However, his skin remained intact and he was conscious, so our trusty litmus officer was helping in an odd way.

There were, however, 2 things that had me curious on our approach.  First, the ambulance had arrived before us and was staged across the street.  Second, there was a line of cars exiting the parking lot in a hurry.

Something was up.

We parked upwind at a hydrant so we could hook in and mass decon if needed.  Airpacks went on and the triage kit came out of the side compartment.  I was having trouble resetting my mind from being the EMS supervisor the day before, to being part of the engine company today.  Part of me wanted to establish the warm zone and set up the decon corridor while also designing ambulance ingress and egress.

Instead I had to find out what on earth spooked an entire golf course to run like hell on a beautiful California afternoon.

The remaining people near the clubhouse are pointing and giggling at the firemen approaching taking full precautions as we’re shouting for them to remain still and tell us wha on earth is going on.

As with most emergencies of this nature, their first action was to come towards us.  Great.

“In the kitchen,” a man with a name tag tells us, “Pepper spray.”

Huh?

Around the side of the building is a person with a wet towel on their face and a group of white shirt, checkered pants clad folks, clearly the kitchen staff.

Someone thought it would be funny to release some pepper spray into the kitchen during the lunch rush.

When the entire staff ran out of the kitchen screaming and rubbing heir eyes, the patrons thought the worst and did the exact wrong thing.

They dispersed themselves across the City and the region before we had identified what had happened.  Perhaps they understood it was pepper spray, but none of the non-kitchen staffers were able to tell us what had happened, so I doubt that.

Now imagine it was somehow something more sinister and all 300 people escaped without being decontaminated.  There you are in your district running a general sick call.  She mentions being in San Francisco a few hours ago on a golf weekend that went sour.  Then the husband vomits and passes out.

Worst case scenario sure, but we deal in those sometimes.

Any ideas on how to stop those evacuating?  And don’t say PD, because remember, he’s already in the hot zone.

From our friends at Gasda Software, creators of the BlackBerry Shift Calendar, a link to what real firefighter olympics look like.  Last ones I went to had darts and bowling.  Thanks D!

Happy and Motor are at it again, finally, and this time calling out some stupid things done by stupid people while representing EMS, fire and police. From the ambulance company who lost $1 million to the 27 year old DUI while driving a fire truck and a special comment from Motorcop about a narcotics officer in Happy’s area caught stealing and selling narcotics. Quit being stupid!

EPISODE 10

Sure, we taped the show two weeks ago. It took MC two weeks to limp his way through editing. But Huzzah! He finally got the job done. In this episode, HM and I talk about freeway lane closures, who’s in charge, and what happens when PD and Fire disagree.

We also take a couple more listener questions…remember, you can call with your question(s) at 313-451-HMMC. Want to know who figured out what 451 means? Listen to the show!

EPISODE 9

One of our Division Chiefs has seen more fire than a line cook at Outback Steakhouse and loves to ask odd questions in the heat of a situation.  Some think he’s just picking on people while others see it as a way to really think about the situation we’re in.

On other occasions this Chief likes to play with the RIC or Rapid Intervention Company.  This is the 4th due engine at a working fire and is tasked with standing by to rescue firefighters should the need arise.  Many Departments staff this position differently, but most will tell you they don’t like standing in the street while everyone else gets to work.

The RIC is responsible to size up the building, soften the exterior by removing hazards before they are an issue and knowing what operations are going on in and around the fire building.

It seems like a no brainer, but as the RIC team gets itchy to freelance, the Chief will turn to them and make them turn around to face him in the street at the command post.

From here he asks a very simple question:

“Describe the fire building.”

Each of the 4 members often have a slightly different interpretation of the building, from number of floors, to color, to where ladders are placed.

Ever since I saw him do it, I’ve always paid closer attention to the building as the RIC team.  And that was his intention.

This scenario was patched together from a few here at home and from around the community.  My service recently ran a call for nausea that included multiple persons in stacked rooms and handled it well.  But identifying the cause or possible causes of the illness can be difficult when multiple possibilities present themselves.

ICS focuses on being the first in and building from the cold zone forward.  This call would be so much easier if we were donning our Medical Group Supervisor vest and carrying the command kit into the lobby control.

Ah, if only life worked that way.  Most MCIs and Haz Mats evolve quickly and rarely come in reported as what we find.

I added the element of the unknown upstairs to make us think about what ELSE could be happening besides the seemingly straight forward CO poisoning call which, had this been contained to two adjacent rooms, is easy to include in our plan.

Medic 88 responded above us, called for a haz mat response and went off the air.  We got neither a status update on their condition or why they called for the haz mat activation so we must assume the worst: They are compromised.

On the 4th floor we have 3 or 4 patients directly needing our assistance with an unknown number possibly dead, dying or completely oblivious to the situation.  The first instinct is to evacuate the building, but scattering our unknown illness may prove more costly than not, so we need to evacuate to a place of safe refuge.

The enclosed nature of hotel rooms gives us the unique option of being able to stage our evacuation from the rooms to the hallway, establishing a warm zone.  Of course identifying those experiencing symptoms will be difficult so we need a way to identify them easily.  The MCI and triage kits are downstairs in the rig, so we’ll need to improvise.  Advise the persons you have already contacted to put on the hotel white robe (if they’re there) or drape a large white towel over their heads.  Asking them to also bring a clean washcloth to cover their coughs will help contain any airborne illness should it be present.  The 2 masks we carry are on us and we are considered contaminated until proven otherwise.

Now we have our original patients easily identifiable and a method to separate them based on signs and symptoms of illness.

This information now needs to be relayed to the other responding units.  Using clear text is key in this situation.  Identify your unit, establish command, list threats and give your status.  If Medic 88 is unreachable upstairs we must include them as victims until we hear otherwise.

For the time being we should stay on the 4th floor, triaging all the rooms who will answer the door.  Symptoms get a white towel/robe and washcloth, non symptomatic get moved the the other end of the hallway from our rooms.

This is no place to establish a command post or begin to orchestrate the response of additional units.  In most communities the first units on scene will be engine companies with basic gear and SCBA, and until we know what is going on upstairs, they should not enter the 4th or 5th floor.

Haz Mat Specialists can speak in more detail as to how they may approach this situation, but leaving what Medic 88 found unknown, I think makes us think in different ways, determining a solution for each possible situation.

Think about the following changes to the scenario:

Medic 88 reports a faulty pilot light on the water heater common to 403, 405, 503 and 505 and that symptoms clear in the hallway.

Medic 88 reports fumes of unknown origin seen coming from room 505, two patients are down inside that room.

Medic 88 calls a mayday and reports they are trapped on the 5th floor in heavy smoke, no SCBA.

Medic 88 stumbles from the stairway with blisters on their faces and arms, excessive snot from their noses and mouths, begging for help.

A hotel employee approaches you stating the hotel has received a bomb threat.

These are all exotic situations we may never see in out careers, but could actually happen when we are already set up for a different event.  Responding to any of these situations allows us to think ahead, set perimeters and stay back from the nasty stuff, but with dispatch systems keen on getting us out the door ASAP, most times without finishing the coding of the call, a simple code 2 sick call can become a dangerous unknown situation.

Think on your feet, use what is around you to your advantage and don’t forget that in this situation, YOU’RE a victim too.  At least until the heroes in the yellow suits say otherwise.

If you said “Slow down and think this through” you made the right call.

Dispatch has rung you out for a reported sick/altered mental status at a local hotel.  No, not the one all the addicts live in when they cash their checks, the one where all the conferences are held.  Confidence is high that this might actually be a call for a sick person.

Halfway to the scene you hear another rig toned out for the same complaint at the same hotel, different room.  Double checking your screen you are going to a Mr Brown in Room 403, Medic 88 is responding for a Mrs Gutierrez in room 503.

Arriving at the scene you are met by the manager who asks you to park around back so as not to frighten the patrons.  Ignoring him you take the elevator up to 403 and find Mr Brown doubled over the toilet, vomiting.  It is then the door to room 405, the room next door, opens and a young woman asks you to take a look at her mother, who is dizzy and vomiting.

Something is bothering you about this, but you agree to stop in after checking on Mr Brown.  Mr Brown’s wife is also feeling dizzy and complaining of nausea.

From upstairs Medic 88 is asking radio for a full hazmat response and to shelter the hotel immediately, then goes off air.

What is your reaction?

You make the call.

MAN DOWN! MAN DOWN!