Category Archives: Rescue

Rescuers stand by while man drowns?

No. Local agencies responded to an event they were untrained for.

I’m sure most of my readers have been in a pool before.  I’d go a touch farther and say that more have been in a lake or river.  A good bit even took a few swims in the ocean.

Does that make you a rescue swimmer?

I went skiing when I was a kid and in college.  Got pretty good at it too.  I can now serve as Ski Patrol.

As a Scout I learned how to tie knots and repel.  I am now a high angle rescuer.

Let’s change the headline:

“Ambulance crew stand nearby while man dies in fire.”  They don’t have the equipment or training to deal with the situation, let’s blame THEM.

Or how about:

“TSA agents do nothing as armed gang robs bank near airport.”  Again, no training, no equipment.

So why are so many so fast to jump in and say they would have gotten in the water and made the rescue in Alameda?  Likely because most of them have never been in the waters this event occured in.  This kind of event happens more often than you think.

What was the tide? Ebb?  Slack? Flood?  Why does it matter?  What has the weather been like the last few days? Why does that matter?

A bay rescue is not a simple jump in the water or into a swift water arena where your victim is always travelling in the same direction.  Depending on the distance from shore, the tides could create eddys which move water at high speed in different directions, meaning you could enter the water and be 20 yards south of your victim before you came up for air the first time.  Oh, and NEVER take your eyes off the victim, even when swimming.  Ever tried that?

Now, flotation.  Does your rig carry a Peterson Flotation device?  Something you can float to the victim, staying clear of their fight to stay afloat?  No? OK then.

Now, cold.  Your victim is experiencing hypothermia, how long until you feel the effects and become a victim as well?  Wetsuit, boots? No, OK then.

“But Justin, a bystander just swam out and got him just fine.”  Shall I link to countless stories of people going back into burning buildings to get something against the advice of firefighters on the scene?

Or should I begin linking to all the stories of would be rescuers drowning because they were unfamiliar with the waters they found themselves in and had no idea what a water based rescue requires or entails?

My point is this:

Had I been dispatched to this call without my swim gear, I would NOT have entered the water.  Period.

Keep in mind folks that there are no swimmers on the Coast Guard boats, only hooks and nets.  Only the helicopter can deploy a swimmer.  Them or the SFFD.  And now it looks like Alameda as well.  How many more people will die before public safety budget cuts are exposed as actually killing people?

Real Firefighter Olympics

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!

 

Sunday Fun – New Triage Tag

We have all come to be familiar with the black, red, yellow and green triage tags and train repeatedly on thier application.  Whether it's a neumonic a 5th grader can follow or based on common sense assessment, we know the green are slightly injured and the black tagged folks are dead.  The red and yellow cover everything else from a respiratory rate of 31 to myself, with a natural cap refill of 3-5 seconds.

We are trained to assess, tag and go to the next person.

The system works great on table top scenarios, in drills and even in the field at mass casualty incidents, but I was inspired recently to introduce a new color/tag/classification to the triage kit.

I know, exactly what we need, right? Another confusing category.

 

Well, this one makes it even easier, believe it or not.

White.

White Flag by erix!I am officially adding WHITE to the triage category here at HMHQ.

When triaging you will no doubt come across persons with no injury, illness or complaint, but see the opportunity to become part of what they believe will be a chance to make a few bucks.  This is not uncommon in my area during bus incidents.  A bus will have a minor collision or hard stop and call for help.  Before help arrives, people will climb on the bus and create injuries inconsistent with the collision or direction of hard stop.

These people will fall into the NEW classification of WHITE or "I surrender."

When in a triage situation, if I encounter someone who is uninjured and ambulatory, they are not "walking wounded" but simply "walking."  Last I checked we can do very little for the "walking" other than sitting them down, tagging them green and wasting what few resources we have on them.

Same goes for persons displaced after a fire in their building or adjoining buildings.  They should be triaged WHITE and told to wait nearby for information from the Red Cross or other agency who can help them.  If there is no injury, a green tag seems wasteful, does it not?

Have you ever encountered an MCI with a crowd?  How do you know who is hurt and who is not?  By asking?  Great assessment skills there, Sparky.  Don't let your mind get lost in the sea of "Oh my God there's 10 of them!" and remember that you are doing triage based on your agency's instructions.  Chances are you're using the START Triage system, which assumes by the time you arrive and assess that life threats will be already changing mentation, respirations and perfusion.  Keep in mind that an ambulatory person missing an arm, breathing 22 times a minute with good cap refill on the remaining arm is a green under this system.

But let's get back to the lady wandering the triage area asking who to talk to about suing the building owner/bus company, or who states they were hit by debris but show no signs?  Are they GREEN or are they something less?

Currently the system does not let you make that determination.  After all, what do you know anyway.  Just tag them and deal with it later.  And by later, I mean let treatment sort it out, right?  While it does take a short amount of time to properly tag a person with name, age, allergies, medications, pulse, respiration and mentation status, we could be helping the next person who actually needs us.

Getting to them later is not a liability, spending time confirming they are uninjured is the liability.

So why does the system not account for the liability of the "walking?"

 

Because until now there was no WHITE category.

To be tagged WHITE in an MCI a person (they are not injured so are not a patient) must:

1) Be ambulatory

2) Have no sign or symptom of illness or injury

 

There, wasn't that easy?  I just saved you 8 backboards and 3 ambulances at your MCI.

the Crossover – Episode 11 – Captain Daddy

In this episode, we introduce a special guest that had a major influence in MC's life…CaptainDaddy! Happy picks his brain about getting out of the job "whole". We also chat about retirement systems, budgets and whether drivers of emergency vehicles should be referred to as such.

Episode 11

The evolving call

Often our patients and clients tell 3 stories.  The one to get dispatch to send us as fast as possible, the version on scene is never as exotic, then they pepper in a completely new history and chief complaint at triage.

When very lucky, we get a call that evolves in front of our eyes from the mundane to the exotic.  In this case it was because of a bystander.

THE EMERGENCY

The caller states her husband has twisted his ankle and is unable to stand.

THE ACTION

Lights and sirens through the pouring rain and we discover the neighborhood parking attendant jumping up and down in the middle of the street waving his arms as if we were the first airplane to fly near his island in years.  Conveniently enough he’s in front of the reported address so we pull over and go to work.

The injury is straight forward enough and I begin my secondary assessment.  He’s sitting at the base of a couple of old steep steps and I almost made a big mistake by assuming the steps were the culprit.

“How did this happen?” I ask as the EMT begins to splint the ankle.

“Oh, I lost my balance.” He responds, clearly distracted by the discomfort of the splinting efforts.

“Were you dizzy, did the world start to spin?” Now there is a whole new window of concern opening, and quickly.

“Not until after the fall was I dizzy.” Or patient answers, occasionally wincing with pain.

“He felt better after he threw up.” Says a woman holding an umbrella just out of our little treatment circle.

When I asked about the vomiting he confirmed that soon before the fall down the steps he did indeed vomit, felt dizzy and had to catch his breath.

Needless to say my spider sense was tingling.  I was missing something and it was bothering me.

On further questioning we were finally able to patch together what had happened.  Are you sitting down?

In the backyard, under a tarp was a table saw.  Trying to finish a project before the worst of the storm passes through, our patient failed to use proper precautions against wood resting between the fence and the blade.  As the blade spins against the wood, there is a tendency for the wood to stick or kick back.  When a small piece of wood became stuck between the fence and the spinning blade he reached for it using a push stick, a god idea, but approached it head on.

The 2″ x 4″ by about 3″ piece of wood struck him square in the chest traveling at least 50mph, knocking the wind out of him.  Disoriented and in pain, he stumbled around the front of the house and vomited on the sidewalk, seen by our umbrella lady.  Then he tried to get in the side door to call for help, but lost his balance and twisted his ankle.

Then we were called.

He never showed signs of a traumatic injure to his chest, but there it was.  And we almost missed it.  Imagine THAT triage story coming out at the local ER instead of the regional trauma center.

Police car driver recovering after accident

An accident between an ambulance and a police car left the police car driver in the hospital and the ambulance crew recovering from minor injuries.

The initial investigation shows they were responding to separate incidents and that the ambulance had the green light.  All those things aside, I’m glad everyone is OK, considering the police car driver had to be extricated.

Police car drivers are given training to respond with lights and sirens, as are EMS personnel, and if the investigation holds, I wonder if the police car driver will be cited with failure to yield to an emergency vehicle, as EMTs and Paramedics are from time to time when they are the ones at fault.

Likely not, but I hope all police car drivers take this story and also a deep breath when responding, as we all should, and come to a complete stop to break an intersection with red light and siren.

What?

Wat’s that you say?

He’s not a police car driver?  How’s it feel to be referred to by only a portion of what you do? MC, I smell a crossover!

We have a tall hill to climb and perhaps we should start with some PSAs for the press.

“The ambulance drivers also were being treated at the hospital, Ramos said.”

Oh, and this lovely nugget:
“Sorrick said the ambulance company is prevented by privacy regulations from providing the names of the injured medical personnel.”

So here’s a HIPAA quiz (Adding information, creating a new scenario) – Does HIPAA prevent the ambulance company from releasing the names of the injured employees if they were not patients?
-Justin Schorr
Fire engine driver / Ambulance driver

Epiosde 10 of the Crossover – Quit being stupid!

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

Baltimore Begins

Tonight it’s the JEMS EMS10 Awards dinner, look for me tweeting about it using hash tag #EMSToday and #EMS10, then off to the Zoll Pre-Conference Blogger Bash at the Pratt St Ale House at 8 pm.

We also had an opportunity to track down Charlotte Norton from Zoll to say thanks for all their continued support of Chronicles of EMS and First Responder’s Network.tv.

Mentioned on the cover too

There’s a new article in your March EMS World Magazine.  Something about starting IVs or some such nonsense.

And special props to anyone who can identify where I am in the accompanying photo.

A Beautiful Morning

When the tops of the towers of the Golden Gate Bridge are a brilliant bright orange, it signals another day is about to begin.  The sun slowly rises over the City and that bright orange color slowly drips down to the rest of the bridge.  If you ever visit San Francisco the best place to see a sun rise is just at the base of the bridge at Fort Point.

Many mornings the bridge is fogged in, a pea soup so thick you can’t tell you’re on a bridge.  From below, at the fort, you can only tell where the bridge is by the fog horn.

On this particular morning it was crisp and clear. The temperature is in the low 40s and the sky is bright blue while the orange begins to drip down, coating the towers.  The water is eerily calm, only the beginning of the flood tide, but the surface is almost glass.  The only interruptions are the occasional dolphin, random bird or rescue jet ski.

Both skis are making their way towards the flare that was dropped in the water at the location the jumper was last seen.  The flare sparkles a bright red and the smoke it gives off is almost motionless as the source slowly drifts with the tide.

The coast guard ship makes the jet skis seem like ants at our range, and the rescue and fire boats are now approaching to aid in the search.

As the remaining units arrive at our location under the bridge the sun crests over the City and bathes us in warmth, the whole bridge now bright International Orange.

We stood there for nearly an hour.  Taking deep breaths of the crisp clean air, watching the City awake and listening to the traffic pick up on the bridge above.

It was a beautiful morning.