Category Archives: Special Operations

Celebrating the Voices

I hear voices.

At least I used to hear voices, before I took this desk job at Headquarters, but before that, in the field, I heard voices.

The voices woke me from my sleep and interrupted meals more often than not and always seemed to know someone was ill or injured.  Most of the time anyway.

For all my griping about MPDS, dispatchers and call takers, they still show up everyday to do a job I would fake a seizure to not have to do.

They take the confused, rambling mumblings of someone, code it, send it and away I go to deal with the problem.  So what if it’s not always what they say it is, all they’re doing is telling us what someone told them.

And many times, after listening to some of these calls for QA purposes, “told” isn’t exactly the right word.

A man is shouting to please hurry! please hurry! but won’t say why or what is wrong.  He simply says please hurry.

The woman holding the lifeless baby can’t get a word through her screaming but the voice still tries to talk her through CPR.

The whispers of the young boy hiding in the closet while someone assaults his older brother in another room are barely discernible because the call taker next to them is dealing with the screaming mother from before.

The voices belong to a group of folks who aim to bring a few moments of sanity to an insane world, and all over the phone and the radio.

Call them dispatchers, broadcasters, call takers, whatever, they still always answer the phone and will always answer the radio when you need them to.

So call up your local dispatch center and see if they have an event planned.  If not, step up and put something together.

A quiet weekend in the City

Some boats in the bay…

America’s World Cup

More boats…
Fleet Week

Air traffic ticks up a smidge…

Blue Angels

Music…

Hardly Strictly Bluegrass

A bit of sport…
Cincinatti Reds at SF Giants MLB Playoff Game

Buffalo Bills at SF 49ers NFL Game

 

Should only triple to population for a few days, all 33,000+ hotel rooms are booked, and I wish my weekend cars luck.

“Daddy, did you win this hat?” A Daughter Learns of 9/11

My 6 year old is a quick learner.

She was dusting the shelves in our living room as a chore when she moved a few books as she always does.  But this time she noticed something on one of them.

“Your buddy looks sad.  Daddy, did you win this hat?”

She was pointing to the cover of one of the two September 11th books I keep on that shelf.  On the cover is a firefighter holding an American flag with a leather helmet on it, not unlike the one they see I wear (wore) at work.  The shield says 343.
We stopped the chore and sat down to look through the books.  She had heard the term “twin towers” and had seen the “343” before, but I began telling her about the bad men in the airplanes and how daddy’s buddies (their term for firefighters and paramedics) went to put the fires out.

The images of the towers collapsing had an impact on both of us and she asked how many buddies got hurt.

“Alot.”

I was starting to get emotional.

“Tell me about them?” she asked.

I flipped to the page with an ambulance in the rubble and shared the story of Paramedic Carlos Lillo on Medic 49 Victor.  Then I turned to Chaplain Mychal Judge and showed her the picture burned into my soul.  We looked through another book with photographs of all the firehouses who lost members soon after and saw Ten House.  I told her I had been there and seen Carlos and Mychal’s names on a beautiful sculpture.

The impact of that day was not completely understood, I imagine much the same way Pearl Harbor is lost on recent generations. But her questions and my being able to relate on a personal level to the photos from that day will help her understand the human toll when it finally clicks exactly what happened that morning.

And because we take the time to learn their stories and share their stories they will not be forgotten.  Their names shall be spoken long after they, and we, pass from this earth.

Forget the bumper stickers and memorial T-shirts and learn a story, any story, there are hundreds to choose from.  Learn it, learn from it and share it.

Only then have you never forgotten.

CalFire Air Ops up close – VIDEO

Our good pal Dylan, noted BlogStalker, childhood Explorer Scout friend and Chief Programmer at GasdaSoftware got a surprise while out back the other day:

 

CalFire was responding to a slow moving fire that proved difficult to access on Sept 3rd.  It was on site of the Concord Naval Weapons Station, a deactivated WWII munitions depot primed for development if anyone can figure out how to remove all the ordinance. While we could smell the smoke at HMHQ Dylan, from Gasda Software, had a far better vantage point.  I’d be curious to hear the pilot’s thoughts about all the kids at the edge of the pond.

 

And yes, that’s a separate helicopter.

 

Thanks for the video Dylan!

Special Call Mobile Surgery 1, Mobile Surgery 2, EMS Surgeon 1…

A nice resource to have if your system is innundated by, oh I don’t know, the shaking of the earth until everything falls down.  Especially in a City with water on 3 sides and only 4 trauma bays…total.

 

[yframe url='http://www.youtube.com/watch?v=lc707gqtzcM&feature=fvwrel']

 

[yframe url='http://www.youtube.com/watch?v=J67e2qclHe0&feature=related']

Interventions Issue 4 – Supervisors

Please enjoy!

10 House “Still Standing”

Each year I choose 1 story to share in an effort to keep alive the memory of those who died. Buying a sticker or a T-shirt that says “Never Forget” isn’t enough, heck it’s nothing. Learning about the lives of those who went into that morning not knowing if they would be coming out and sharing their stories with others is the only way to remember and keep them alive in our hearts.
I used to think the ancient Egyptians were foolish for claiming they were going to live forever, yet we still speak their names and honor their traditions in our museums and textbooks. They truly did accomplish living forever and if we want these men to be remembered in the same way we must continue to share their stories and speak their names aloud.
In my search for a story to share about those who died on September 11th, I kept coming back to a number: 10.  10 years, 10 Engine, Ladder 10…10 House…

A firehouse is much like a family and when a member of a family dies it can have an impact on the survivors. But what if more than 1 dies? Or 2. What about 6?

This year I share the memories of 10 House and the day she lost 6 of her children.

 

10 House is the quarters of Engine 10 and Ladder 10 who, in 1984, adopted the logo of a firefighter straddling the tops of the twin towers on fire reading “First due at the big one.” And they were.  Reports from survivors say that even as they rolled out the door there were already bodies in the street.
The firehouse is on Liberty Street directly across the street from the World Trade Center. The house survived the collapse and was re-opened after getting fixed up, but her family is still healing.
Both companies were established in 1865, later moving to the same house.  It is one of the few houses where the engine and ladder companies happen to have the same numbers. For almost 150 years she saw only 3 deaths in the line of duty, on that September morning the number would triple.

Lt. Gregg Arthur Atlas – Aged 44 years, Lieutenant Engine 10

Firefighter Paul Pansini – Father of 3 children, Firefighter Engine 10

Lt. Stephen Gary Harrell – Age 44, Member of 10 House assigned to Battalion 7

Sean Patrick Tallon – 26, Marine Reservist and only weeks away from completing Probationary status on Ladder 10.

Jeffrey James Olsen – Age 31, Firefighter Ladder 10

James J. Corrigan – Retired Captain from 10 House, oversaw Fire and Safety Operation for the WTC complex

 

The house was a gathering point for those wishing to visit the FDNY to offer their condolences.  Like many houses it was covered with patches and shirts from visiting firefighters, letting the members know they were in others’ thoughts.  A beautiful memorial was erected inside dedicated to the 6 members who died and included was a newer plaque honoring the 3 that had fallen between 1867 and 2000.

10 House became the site of a 56 foot bronze relief sculpture donated by Holland & Knight , a Law Office, who lost  employee Glenn J. Winuk, also a volunteer firefighter, when 10 House lost her children.  The relief was dedicated in 2006 and is the only 9/11 related site on my list of things to see when I visit New York later in the month.

I don’t want to see where 10 House lost, I want to see where she lives on.

You can learn more about 10 House on their excellent website.

2009’s memory

2010’s memory

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 Podcast Episode 8

Another installment of the blabbling on that is the World’s only crosspolinated podcast is back from the holiday break (we decide when those are, Sparky) and discuss scene safety versus a scene being secure and use the shooting in Tucson as a backdrop.

We also answer a listener question that was phoned in at 313-451-HMMC, which was our all requests oldies hot line, but is now just a drunk dial number for public safety folks to vent (when off duty of course).

So have a listen and let us know what you think about Medics carrying handcuff keys.

Episode 8 – It took you long enough

You Make the Call – Hotel Rooms – What Happened

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.