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

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.

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.

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

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.

As you know, we invest in preparation.  Training, equipment checks, drills, studying, all leading to when the bells ring and we are expected to spring forth with knowledge and actions that seem natural to the casual observer.

However, most of us leave all that preparation at work and come home to a completely unprepared family in case of disaster.  This is the reason I developed my own Family Disaster and Evacuation Plan.

Included in the plan are a number of instructions for my family, and me, on where to shut off utilities, how to shelter in place, who to call for help and what to take and where to go if ordered to evacuate.

As part of the plan, my family keeps on hand a 3 day supply of food and water.  You may remember a brief overview of the contents from the 60 Second lifesaving tip before Episode 6 of Seat at the Table.

Well, it’s that time of year to go through the kit and donate all the foods that will be expiring in the coming year and replacing them with new foods, updating your family’s tastes and needs.

If you would like to know more about how you can make your own custom disaster kit, click HERE to go to our Disaster Plan Page and learn more.

A full structure fire alarm has been struck for a dense residential area in the neighboring district. You catch the alarm while on the way to shopping and as you accelerate you see the first in engine sitting in the parking lot of the grocery store a block ahead.

You’re first due now.

On arrival you have light smoke from the garage of a 3 story type 5 house, approx 30 feet wide and 100 feet deep with the neighboring homes of similar type and so close it prohibits a 360 size up.

Your firefighter has made contact with the owner who states heavy smoke in the rear of the garage but no fire. Inside visibility is clear and his definition of “heavy” is clearly based on never seeing a fully smoke charged room.
In the back of the garage is an over heated electrical panel leading to the elevator control room, the door to which is blocked by storage bins and piles of laundry. Cutting the power immediately makes the electrical box stop buzzing.
As you exit the garage and send your firefighter to search the upstairs for signs of fire, the Battalion Chief calls on the tactical channel and asks for a report and if the entire alarm assignment needs to continue, they have another fire call nearby and could use the units. The engine you passed at the store is now arriving on scene and the officer is listening to the radio dispatch for the other fire.

What is your report and decision about additional resources? You make the call.

Our discussion with Dan Gerrard, Bobby Halton and Jow Telles continues in our special look at building relationships in Emergency Response.

Whether a Chief Officer or Probationary Member, all can learn from this discussion, have a look.

We had a great day of filming yesterday in San Jose with disaster experts gathered to attend the Tak-Response conference which ends today.

Even though we have not yet found a sponsor to cover the expenses, this opportunity was too important to let pass.

The conference has been a lot of fun, with Thaddeus, Natalie, Jeremiah and Sam Bradley begin_of_the_skype_highlighting     end_of_the_skype_highlighting, the extended Chronicles family, all except Mark.
For a new conference in a new place with a new concept I think it did very well.

I think Kelly Greyson would have enjoyed the shooting simulator side by side with some of the SWAT folks on hand at the show.
And the law enforcement members we did meet were interested not only in what we were doing, but marveling at the wide array of equipment EMS carries, not just a bag and a cot.

Just the show floor was working to break down barriers and let disciplines mingle, imagine what the speakers are inspiring.

The audio difficulties in the filming of the Seat at the Table are well known, but finding a solution we can afford on a negative budget is difficult. We’re trying, I promise.

Today it’s back to the conference with the meetup tonight at Gordon Beirsch Brewery. See you there?

FDNY*EMS Ambulance 485 was the first EMS unit assigned to what Battalion 1 reported as “An aircraft into the Twin Towers.”

This unit, on air as Medic 49 Victor,  was staffed by Battalion 49 Paramedics Carlos Lillo and Roberto Abril.

Roberto chronicled the events of that day in a notebook in his own hand.  The notes can be seen at the website of his partner, who died in the collapse, Carlos Lillo.com

He is one of the EMS Division casualties included in the “343 Firefighters” killed that morning.

From the website:

On September 11, 2001 we lost our beloved FDNY Paramedic Carlos Lillo from Battalion 49, doing what he did best, Saving Lives. Carlos was one of the most admired paramedics in New York City. Carlos showed his courage, dedication, and unwavering commitment to the people of our city, state, and nation with the ultimate sacrifice.

Carlos began his career as a volunteer at Astoria Volunteer Ambulance Corp. in the early eighties, where he went to EMT school. He worked for Associated Ambulance while awaiting his dream and passion to work for NYC EMS. This dream came true in 1984 and it took very little time before Carlos flourished as an EMT, working on a tactical unit in some of the toughest neighborhoods in the Bronx in some of the busiest times the EMS system has ever seen. He then realized another dream: becoming a paramedic. He spoke so passionately about not just being a medic but being the best paramedic, that one couldn’t help but be inspired by his attitude even the old time medics.  Carlos worked for many services within the 911 system where he was loved and respected by all for his professionalism and passion for what he did.

There is a grief that can’t be spoken when you lose someone like Carlos. It is our duty to carry on the tradition of excellence that Carlos lived and to keep his memory alive. Carlos leaves behind the love of his life wife Cecilia, mother Ilia, sisters Iliana and Olga , his brother Cesar and half-brother Alex.

It is in honor of this great paramedic and person that we formed “The Carlos Lillo Memorial Scholarship Fund” to benefit underprivileged students.  Every year we come together to celebrate Carlos during The Carlos Lillo Memorial Golf Outing which was formed to support the scholarship fund with the purpose to help those that want to be and do what he did for us.

Carlos was laid to rest September 14th, 2002.

Hidden in all the “Never Forget” and “343″ stickers and T-shirts are thousands of tales of heroism and bravery, brotherhood and citizenship. Learn one. Pass it along to others.

Please visit the site and learn more about Carlos and how you can help keep his dreams alive.

2009′s story to remember