It's been a long time since I've had my voice out on the internet with respect to firefighting. During that time period when I was brand new to the game, I was having new experiences every week, always something different to write about. Once the novelty wore off, though, what did I have to say? Ran another fire? Saw another corpse? No sense in publishing material just for the sake of producing a wall of text.
Things are different now. Several years under my belt, hundreds of calls, many educational experiences both as a student and as an instructor. I'm no expert yet, not by a long shot, but I know enough now to have opinions that I think are worth spreading, and there should be a form somewhere for my brothers to pile on if they agree or fire back if they don't. It's time for round 2.
Thursday, June 30, 2011
Thursday, November 18, 2010
Never too smart to learn
I've said before that pride is the one thing that gets in the way of learning, and I was forced to remember it again tonight.
Arriving at a routine medical call for a laceration on the back of a hand, I was first in the door and took patient contact. Checked the wound (top of the left hand), not too deep, roughly an inch long, I'd definitely seen worse. Smiling reassuringly I asked the patient to move her fingers for me, which she did without issue, and then I made sure that she had feeling throughout her hand and a strong distal pulse. Good on all counts, I asked if she wanted to go to the hospital, and she gave me an adamant "no", which I understood because I would have done the same if I were her.
Glancing back at one of the more experienced firefighters there on scene, I called out "she's refusing transport, we can return the ambulance". He looked uncertain, and after glancing at her hand, asked me "has she had a tetanus shot?". Realizing the thought hadn't even crossed my mind, I looked back at the woman and she said no. Furthermore he pointed out that she might need stitches anyway and that the best chance of not getting an infection was to have it cleaned well by a professional.
Keep in mind, on the whole I'm a very confidant person. I don't doubt myself easily, and that has it's advantages, but it also means that when someone else demonstrates better knowledge or skills than me I have to force myself to contain my pride well enough to learn from them. My instinct in this kind of situation, as it is for many people, is to think "oh, come on man, it's a little cut, she's going to be fine, would you just return the ambulance?".
Why is that? Is it because I'm sure that's the right thing to do, or is it because that's what I'd already decided we should do and I don't like being overruled?
I think the answer is obvious. We aren't in this job to play the numbers, however favorable they may be. Our job in patient care, past immediate stabilization, is to provide the patient with ALL the information necessary to make an educated decision about their treatment, and to always encourage treatment (liability is a mother, ain't it?).
The older firefighter was giving her the facts: you have a cut from a metal object, that means you can get tetanus, or another infection, and there could even be damage that we can't see just from looking at the surface. You're probably ok statistically speaking, but we recommend you get it looked at by a doctor. And next time, that's the information I'll give too. It's a little thing, but a habit of improving in all areas, every chance you get, has a cumulative effect over time in making you into a better and better firefighter, and once it's a habit you hardly even have to work at it anymore.
The best lesson to take from this, in my opinion, is that you're never so good that you can't get better.
Arriving at a routine medical call for a laceration on the back of a hand, I was first in the door and took patient contact. Checked the wound (top of the left hand), not too deep, roughly an inch long, I'd definitely seen worse. Smiling reassuringly I asked the patient to move her fingers for me, which she did without issue, and then I made sure that she had feeling throughout her hand and a strong distal pulse. Good on all counts, I asked if she wanted to go to the hospital, and she gave me an adamant "no", which I understood because I would have done the same if I were her.
Glancing back at one of the more experienced firefighters there on scene, I called out "she's refusing transport, we can return the ambulance". He looked uncertain, and after glancing at her hand, asked me "has she had a tetanus shot?". Realizing the thought hadn't even crossed my mind, I looked back at the woman and she said no. Furthermore he pointed out that she might need stitches anyway and that the best chance of not getting an infection was to have it cleaned well by a professional.
Keep in mind, on the whole I'm a very confidant person. I don't doubt myself easily, and that has it's advantages, but it also means that when someone else demonstrates better knowledge or skills than me I have to force myself to contain my pride well enough to learn from them. My instinct in this kind of situation, as it is for many people, is to think "oh, come on man, it's a little cut, she's going to be fine, would you just return the ambulance?".
Why is that? Is it because I'm sure that's the right thing to do, or is it because that's what I'd already decided we should do and I don't like being overruled?
I think the answer is obvious. We aren't in this job to play the numbers, however favorable they may be. Our job in patient care, past immediate stabilization, is to provide the patient with ALL the information necessary to make an educated decision about their treatment, and to always encourage treatment (liability is a mother, ain't it?).
The older firefighter was giving her the facts: you have a cut from a metal object, that means you can get tetanus, or another infection, and there could even be damage that we can't see just from looking at the surface. You're probably ok statistically speaking, but we recommend you get it looked at by a doctor. And next time, that's the information I'll give too. It's a little thing, but a habit of improving in all areas, every chance you get, has a cumulative effect over time in making you into a better and better firefighter, and once it's a habit you hardly even have to work at it anymore.
The best lesson to take from this, in my opinion, is that you're never so good that you can't get better.
Sunday, October 10, 2010
The infamous hose stretcher
Firefighting isn't all drama and speed. Although as an industry it's got it's own share of darkness (or maybe because of it), there is a lighter side that's worth examining.
Just yesterday, one of the rookies in my department's current recruit class asked me if I could help him find the hose stretcher, because he'd been sent to my station the night before and wasn't able to locate it. The guys who were home at the time told him that another station must have borrowed it for their own hose testing, since we'd already done ours a month ago.
I contained my hysterical laughter (barely) and composed myself before saying that I just wasn't sure myself, but the next station over had done their hose testing just last week and probably had it.
You see, with all the tools we have on our engines, it's not hard to understand why rookies make this mistake. They hear about a tool name like "hose stretcher" and they think of something like this:
That's right, rookie. You ARE the hose stretcher.
Just yesterday, one of the rookies in my department's current recruit class asked me if I could help him find the hose stretcher, because he'd been sent to my station the night before and wasn't able to locate it. The guys who were home at the time told him that another station must have borrowed it for their own hose testing, since we'd already done ours a month ago.
I contained my hysterical laughter (barely) and composed myself before saying that I just wasn't sure myself, but the next station over had done their hose testing just last week and probably had it.
You see, with all the tools we have on our engines, it's not hard to understand why rookies make this mistake. They hear about a tool name like "hose stretcher" and they think of something like this:
Or this:
But when you think about a real fire incident, you realize what a hose stretcher actually looks like:
-----
-----
-----
That's right, rookie. You ARE the hose stretcher.
Monday, May 10, 2010
The things that get to you.
You know how you sometimes see people walking down a street, and you think "man, that guy is just ASKING to get hit by a car"? That's what happened recently.
Delta response, auto pedestrian accident. The further is "a distraught complainant just keeps saying 'I hit her'".
First on scene, setup command. I really should have given a better sizeup. I should have said something useful like "one car, on it's wheels, moderate damage, patient is lying in the southbound lane apparently uncouncious with a serious amount of blood, make this a trauma alert". Instead I just got out something like "on the scene with *street* command, patient contact" before grabbing C-spine (I could hear her breathing, and my hands on her head could feel her pulse pounding in her temples, so there wasn't much to do but wait for backup).
She was hurt. About as bad as I've ever seen someone who wasn't already coding. One big laceration over the eye, another one down her back exposing some of that yellowish fatty tissue, blood and urine trickling out in a slow river downhill. She was twisted up like a rag doll, head facing one way, shoulders turned 90 degrees, hips another 30 degrees after that. No compound fractures that I could see, but with my hands tied up holding her head in place I couldn't do much but try to talk to her. It wasn't useful. All she could get out was "Hnnngh....Hnnngh....Hnnngh", every exhale another moan. I glanced over at the car that hit her, and the windshield was busted in like a bowling ball the size of a tractor wheel had been dropped on it. Hood was dented up, bumper flexed in, and the only thing it had hit was her body. The driver was a mess; physically fine, but crying and moaning.
The ambulance had been nearby and arrived quickly, and I was happy to see a paramedic. As she did an assessment, the clothes just came off in her hands, hardly had to cut a damn thing. a few other firefighters arrived too, and we managed to get her boarded and loaded pretty quick. In about 3 minutes, she was on her way to the hospital.
Finally I got to hear the story. This poor driver had been driving down the road late (no streetlights, no shoulders on the road, 45mph). He crests a hill, and there's a guy in front of him, wearing black, in the middle of the lane. With good reaction time, he swerves left....right into where the walker's friend (the patient) is walking in the other lane. Took her out hard, and it was probably her forehead and shoulder that busted in the windshield. Couldn't believe it, being in the middle of the road on a blind hill like that.
Yeah, the girl was hurt, but I don't mind so much looking at injuries anymore, after the first couple times, you're able to swallow most of the "horror" reaction. The driver is what really hit me. This was not his fault, not by any stretch of the imagination, and he was mentally broken up worse than anything I've seen before. Crying, gibbering, saying things like "I killed her...she's just a child...she's 17...I killed a CHILD". I know, sometimes people fake emotional responses to avoid lawsuits, but they usually say things like, "Oh god, I'm so sorry, there was no way I could have known!", not "I killed her" or other things that indicate it was his fault. I'd be willing to bet it's a few weeks before he sees anything else besides that girl coming through his windshield when he closes his eyes.
I didn't sleep really well that night, or the next. Luckily I have a new baby girl, so when most people ask why I look tired I can truthfully say the new baby keeps us up sometimes. In reality, I had a couple nightmares where I was that driver, unsuspecting, coming around a blind curve or over a hill and hearing the crunch as my bumper strikes an unsuspecting pedestrian.
I've heard it said before that everybody gets affected by different things. I've seen a man killed and baked by flames, a motorcyclist with organs protruding from the side of his body, a woman in labor drunk out of her mind, and I've felt pain for all of them. But the first thing that's really gotten into my mind since I've been a firefighter was this driver. His sobs echoed in my head the rest of the night, and I can still hear them sometimes. I guess what's most scary about it is that could so easily be me. You can't control what other people do, where they walk, what they think is a good idea. When you follow the rules of society you expect that everyone else will do the same, and suddenly when they don't you find that, though no fault of your own, you've potentially destroyed someone for the rest of their life.
There, but for the grace of God, go I.
Delta response, auto pedestrian accident. The further is "a distraught complainant just keeps saying 'I hit her'".
First on scene, setup command. I really should have given a better sizeup. I should have said something useful like "one car, on it's wheels, moderate damage, patient is lying in the southbound lane apparently uncouncious with a serious amount of blood, make this a trauma alert". Instead I just got out something like "on the scene with *street* command, patient contact" before grabbing C-spine (I could hear her breathing, and my hands on her head could feel her pulse pounding in her temples, so there wasn't much to do but wait for backup).
She was hurt. About as bad as I've ever seen someone who wasn't already coding. One big laceration over the eye, another one down her back exposing some of that yellowish fatty tissue, blood and urine trickling out in a slow river downhill. She was twisted up like a rag doll, head facing one way, shoulders turned 90 degrees, hips another 30 degrees after that. No compound fractures that I could see, but with my hands tied up holding her head in place I couldn't do much but try to talk to her. It wasn't useful. All she could get out was "Hnnngh....Hnnngh....Hnnngh", every exhale another moan. I glanced over at the car that hit her, and the windshield was busted in like a bowling ball the size of a tractor wheel had been dropped on it. Hood was dented up, bumper flexed in, and the only thing it had hit was her body. The driver was a mess; physically fine, but crying and moaning.
The ambulance had been nearby and arrived quickly, and I was happy to see a paramedic. As she did an assessment, the clothes just came off in her hands, hardly had to cut a damn thing. a few other firefighters arrived too, and we managed to get her boarded and loaded pretty quick. In about 3 minutes, she was on her way to the hospital.
Finally I got to hear the story. This poor driver had been driving down the road late (no streetlights, no shoulders on the road, 45mph). He crests a hill, and there's a guy in front of him, wearing black, in the middle of the lane. With good reaction time, he swerves left....right into where the walker's friend (the patient) is walking in the other lane. Took her out hard, and it was probably her forehead and shoulder that busted in the windshield. Couldn't believe it, being in the middle of the road on a blind hill like that.
Yeah, the girl was hurt, but I don't mind so much looking at injuries anymore, after the first couple times, you're able to swallow most of the "horror" reaction. The driver is what really hit me. This was not his fault, not by any stretch of the imagination, and he was mentally broken up worse than anything I've seen before. Crying, gibbering, saying things like "I killed her...she's just a child...she's 17...I killed a CHILD". I know, sometimes people fake emotional responses to avoid lawsuits, but they usually say things like, "Oh god, I'm so sorry, there was no way I could have known!", not "I killed her" or other things that indicate it was his fault. I'd be willing to bet it's a few weeks before he sees anything else besides that girl coming through his windshield when he closes his eyes.
I didn't sleep really well that night, or the next. Luckily I have a new baby girl, so when most people ask why I look tired I can truthfully say the new baby keeps us up sometimes. In reality, I had a couple nightmares where I was that driver, unsuspecting, coming around a blind curve or over a hill and hearing the crunch as my bumper strikes an unsuspecting pedestrian.
I've heard it said before that everybody gets affected by different things. I've seen a man killed and baked by flames, a motorcyclist with organs protruding from the side of his body, a woman in labor drunk out of her mind, and I've felt pain for all of them. But the first thing that's really gotten into my mind since I've been a firefighter was this driver. His sobs echoed in my head the rest of the night, and I can still hear them sometimes. I guess what's most scary about it is that could so easily be me. You can't control what other people do, where they walk, what they think is a good idea. When you follow the rules of society you expect that everyone else will do the same, and suddenly when they don't you find that, though no fault of your own, you've potentially destroyed someone for the rest of their life.
There, but for the grace of God, go I.
Tuesday, March 9, 2010
New post on FireLink, how to deal with mistakes
If you're interested in some of my more professional writing work, you can find my latest post on firelink.com here:
How to Shake Off the Mistakes
How to Shake Off the Mistakes
Saturday, February 27, 2010
Special Forces in the Fire Service
I just attended my first fire-service relate course this weekend that has to do with technical rescue. This is all the cool stuff that firefighters might have to do at incidents not necessarily related to a fire. Not gonna lie, this stuff looks fun, especially the rope rescue training. Not everybody is excited at the thought of dangling from a rope supported by an improvised anchor, but as a hobbyist rock-climber, I already enjoy heights.
Rock climbing is a long shot from rope-rescue, though. I've clipped into my share of carabiners, but that's about it. This is a little more advanced. Think more along the lines of rigging up a system capable of supporting 2 rescuers plus a victim, lowering all the equipment necessary to package the injured party into a stokes basket dangling from the same set of equipment, and safely transitioning this whole party of people and hardware back to solid ground.
It's not an easy proposition, but it's certainly challenging and exciting. So far all we've really done its work on knots and anchors, but we'll be doing our share of rappelling practice and such before the class is done. I have no doubt that this will be one of my favorite experiences so far in the fire service.
What occurs to me is what I've experienced to a lesser degree on previous "rare" calls. You see, we don't exactly go flying off cliffs for rescues every other week. This is a really uncommon occurrence, and that makes training for it tougher. How much time should we be spending preparing for calls that almost never happen?
That's a tough question to answer because it's true that we spend most of our time on home medical calls. Our most widely applicable training, the most "bang for our buck", is what time we put in making our basic patient care better.
But we can't just ignore our uncommon scenarios. Vehicle extrications, for example, are uncommon; but they're horrendously dangerous if done wrong. Without proper knowledge, it would't be hard to end up with a car on top of you. We almost have to train harder for these things because we run into them so infrequently that we don't get that much practice.
How much more does that ring true for something like rope-rescues where we may not run into a serious one for a year or more at a time? A poorly constructed anchor or an improper knot could tip the balance of the incident away from heroic rescue and towards horrendous tragedy. Yet that's what could happen all too simply with a skill that we almost never have to use.
Think of something you maybe haven't done much of for a while. How about calculus? If you were woken up tonight at three in the morning and asked to find the derivative of a large polynomial, with someone's life riding on the line, how would you feel about your odds?
That's why I'm happy to do this kind of training as often as we can: because I don't want to doubt myself in the slightest when the time comes to use it.
It's also a great excuse to spend a weekend playing around with some pretty cool toys. :)
Rock climbing is a long shot from rope-rescue, though. I've clipped into my share of carabiners, but that's about it. This is a little more advanced. Think more along the lines of rigging up a system capable of supporting 2 rescuers plus a victim, lowering all the equipment necessary to package the injured party into a stokes basket dangling from the same set of equipment, and safely transitioning this whole party of people and hardware back to solid ground.
It's not an easy proposition, but it's certainly challenging and exciting. So far all we've really done its work on knots and anchors, but we'll be doing our share of rappelling practice and such before the class is done. I have no doubt that this will be one of my favorite experiences so far in the fire service.
What occurs to me is what I've experienced to a lesser degree on previous "rare" calls. You see, we don't exactly go flying off cliffs for rescues every other week. This is a really uncommon occurrence, and that makes training for it tougher. How much time should we be spending preparing for calls that almost never happen?
That's a tough question to answer because it's true that we spend most of our time on home medical calls. Our most widely applicable training, the most "bang for our buck", is what time we put in making our basic patient care better.
But we can't just ignore our uncommon scenarios. Vehicle extrications, for example, are uncommon; but they're horrendously dangerous if done wrong. Without proper knowledge, it would't be hard to end up with a car on top of you. We almost have to train harder for these things because we run into them so infrequently that we don't get that much practice.
How much more does that ring true for something like rope-rescues where we may not run into a serious one for a year or more at a time? A poorly constructed anchor or an improper knot could tip the balance of the incident away from heroic rescue and towards horrendous tragedy. Yet that's what could happen all too simply with a skill that we almost never have to use.
Think of something you maybe haven't done much of for a while. How about calculus? If you were woken up tonight at three in the morning and asked to find the derivative of a large polynomial, with someone's life riding on the line, how would you feel about your odds?
That's why I'm happy to do this kind of training as often as we can: because I don't want to doubt myself in the slightest when the time comes to use it.
It's also a great excuse to spend a weekend playing around with some pretty cool toys. :)
Thursday, February 25, 2010
Don't take yourself too seriously
We interrupt this normally deep and serious string of blog posts for an amusing anecdote:
I've been starting to help with the recruit class for the latest group of rookies. I got my instructor I certification recently, and I've been wanting to put it to use, so what better way than to volunteer to assist with recruit class in my free-time, right?
Well, the officer in charge paired me with my old instructor from back when I was in the rookie program to act as his assistant instructor for the day when we were teaching SCBA donning and emergency techniques. After watching the old man work with the first couple crews that came through the class, I got a chance to take over and show what I could do with my own group of recruits.
Trying to be as serious and authoritative as possible, I carefully went through the parts-and-components lecture, and orchestrated some practice donning the SCBAs. Great so far.
Preparing to go outside and start our confidence maze, I addressed the crew:
"Are you getting this? Everything making sense?"
Nods all around the room.
"Ok, gear up! We're going outside to do this for weal."
Blank stares, then smiles. Damn it. You can't sound tough when you replace an "R" with a "W".
There was my old instructor at the back of the room, doubled up and shoulders shaking in silent laughter.
"That was my encouraging voice, you won't hear it again", I said, trying to shake it off and recover gracefully.
Oh well, no sense in taking yourself TOO seriously.
I've been starting to help with the recruit class for the latest group of rookies. I got my instructor I certification recently, and I've been wanting to put it to use, so what better way than to volunteer to assist with recruit class in my free-time, right?
Well, the officer in charge paired me with my old instructor from back when I was in the rookie program to act as his assistant instructor for the day when we were teaching SCBA donning and emergency techniques. After watching the old man work with the first couple crews that came through the class, I got a chance to take over and show what I could do with my own group of recruits.
Trying to be as serious and authoritative as possible, I carefully went through the parts-and-components lecture, and orchestrated some practice donning the SCBAs. Great so far.
Preparing to go outside and start our confidence maze, I addressed the crew:
"Are you getting this? Everything making sense?"
Nods all around the room.
"Ok, gear up! We're going outside to do this for weal."
Blank stares, then smiles. Damn it. You can't sound tough when you replace an "R" with a "W".
There was my old instructor at the back of the room, doubled up and shoulders shaking in silent laughter.
"That was my encouraging voice, you won't hear it again", I said, trying to shake it off and recover gracefully.
Oh well, no sense in taking yourself TOO seriously.
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