Saturday, September 29, 2012

The Demise of "Hearse" Ambulances and Other Good Things

Anyone who ever watched Emergency when originally on network television or later in syndication understands how far EMS, among other things, has come in the fire service.  With few exceptions, medical responses have long ago taken the lead over fire calls.  Some contend the name fire department is no longer accurate.  While I understand these arguments, I’m not prepared to go that far—yet. However, if you’re a firefighter today, particularly a young one, you better learn to “like” EMS, or consider another profession, because it isn’t going away. 

The development of ALS while the most prominent and recognized improvement is far from the only change.  Ambulance services run by funeral directors with a red light tossed onto the roof of a hearse have, thankfully, gone the way of the horses.    Overall availability has improved as well. 
How much?  A lot.  When I was six or seven years old, some buddies and I were playing in the woods, jumping in piles of leaves and generally doing the things young boys did back then when no one had to be worried about us being kidnapped if we went ten minutes from the house.  One boy jumped into a pile over a bank and hit something hidden beneath the leaves, breaking his femur.  His screams of pain frightened the living hell out of the rest of us.  There was no thought of moving him, not because we knew not to, but because of fear.  Practically as one, we all started running for our respective homes for one thing; to get our mothers—it was the 60s, they were home. 
The group of mothers followed us back, and mine, being a nurse, promptly recognized the fracture for what it was.  An ambulance was called, but it wasn’t quite as simple as today.  The first due fire department where Dad was a member had no ambulance or any medical capabilities at all.  No help there.  The neighboring department had an ambulance, but they only responded outside of their first due area on nights and weekends.  Monday through Friday, eight to four, they didn’t leave the district.  In the next village over, the police department ran the ambulance.  They didn’t leave their town at all, regardless of time or day.  The only unit available was operated by the county Sheriff’s department.  The road patrol deputy had to respond to get the ambulance from wherever he happened to be, and then across half the county to where we were waiting.    This wasn’t a rural area either; the suburban town had a population in the tens of thousands. 
Almost an hour later, it arrived to transport the boy.  Luckily the break hadn’t hit the artery or he’d have been dead long before the unit arrived.  After an extended convalescence; most of a school year, he recovered. 
Good?  No, but normal back then, so yes, things other than just ALS have changed a lot.  As much as almost no one wants to be on the ambulance every shift,  I think everyone would agree things are better now.   

Wednesday, September 19, 2012

A Challenging Mantra

Former quarterback Jon Kitna isn’t living the life of leisure in his retirement.  He’s teaching high school algebra and coaching football, and most importantly teaching life lessons.  The acronym he uses for the values he tries to impart is REAL.  

·         Reject passivity

·         Empathize with others

·         Accept responsibility

·         Lead courageously

The parallels are clear.  If underprivileged high school students can absorb this cultural challenge and change, hopefully so can our young firefighters—if we teach it. 

Sunday, September 16, 2012

Pizza Pie and Electrocution: The Srange Things That Bring Back Memories

Leaving a great pizza place in Endicott (Consols—originally Duffs—the same recipe for well over fifty years, but that’s another story) where Mike and I had stuffed ourselves with Dad, we drove by the old IBM plant and I pointed out a utility substation where I had one of my first serious calls as a youngster.

It was a summer day shift, and we got hit for an injured male.  This wasn’t our usual first due area but the ALS rig that normally covered it was on another call.  That the dispatcher or caller left out a little bit of information became rather evident when we pulled up on scene. 
There was a black male standing by the open gate of the substation with his arms extended out from his side.  Getting out of the front seat of the ambulance, I noted my observation had been wrong.  He wasn’t black—he was burned.  We got him onto a sheet on the stretcher and began carefully removing clothing where we could, and pouring sterile water onto his burns, trying to keep him talking to us. 
“They told us it was okay to dig there,” he kept repeating.  He and his partner had struck a high voltage underground line and it had blown them from the hole they’d been working in.  His buddy appeared to be less seriously injured than him but it’s sometimes hard to tell with electrical shock.  I called for another rig, and the cop that arrived along with some first responders from the plant helped with the second victim until a couple of our other members arrived on scene.  With victim two stable, and the second rig on the way, I decided to load and go with our patient.  I was worried about his airway, cardiac status; pretty much everything.  The ALS rig wasn’t available, and by the time we could get a medic to the scene POV, if one was even around, we could be at the emergency room. 
It was a wild and wooly ride as the far expanses of Chevrolet horsepower were explored by the driver.  We kept the victim talking all the way, the best tool we had available to keep him out of deepening shock, using every drop of distilled water in the cabinets on him as well.  I was ready to see it pour out the rear door when we backed into the ER ramp. 
Both made a full recovery and then, a few months afterward, filed a lawsuit against the utility that had let them dig there.  Yours truly received his first, but certainly not last, subpoena for deposition.  I was seventeen years old……

Sunday, September 9, 2012

Some Stories From the "Old Man"

With the approaching of Dad’s 77th birthday, some of the amusing stories about him from Fire Men come to mind.

His first actual fire call changed him for life, but not in the dramatic way some might think.  In the middle of the night, he woke up to the siren wailing in the distance, down over the hill.  He quickly got out of bed and dressed, racing to the car.  He sped toward the station, less than a mile from the house, impressed with his reaction time and rapid response to the emergency call. 

When he got to the station, he found he was a bit behind the curve.  Numerous cars were already there, and all of the fire apparatus—two pumpers and a squad truck—were already gone.  Luckily, the call was only right down the street; he could see the flashing lights at the nearby bank.  Driving the short distance, he saw the apparatus positioned around the building and ground ladders raised to the roof.  The fire was minor in nature, but he quickly figured out he needed to pick up the pace if he ever hoped to make it onto one of the fire trucks. 

After that, Dad became an efficiency expert’s dream.  Clothes were carefully laid out on the bureau each night before bedtime.  Keys, glasses, and cigarettes were strategically positioned.  The most radical idea was yet to come: an automatic garage door opener.  Those were unheard of in our neighborhood, but Dad took it to the next level.  Most garage door openers, even today, have the button that activates them in the garage next to the car.  That wasn’t enough for Dad.   He put an additional button in the closet in the bedroom which allowed him to hit the button while getting dressed.  The garage door would already be open when he reached the garage, saving a good five seconds.  A NASCAR pit crew would be impressed with his speed out of the house. When I was about 11 years old, we moved to a new house in a nearby neighborhood.  One of the first things wired in was the activation button for the garage door opener in the closet of the master bedroom. 

In the mid-1960s, a massive technological advancement happened—Plectrons became available.  Plectrons were tone-activated radio receivers manufactured by the Plectron Corporation.  As far as firemen were concerned, they were the greatest thing since sliced bread.  Now they knew exactly where and what type of fire they were going to.  The name Plectron for a tone-alerted receiver became the fire service equivalent of Xerox for copiers. 

The original models weren’t even solid state, instead they used tubes.  The warmth from the tubes made them attractive to animals.  My cat loved to sleep on top of the Plectron because of the heat it emitted. The cat loved it until the high pitched squealing tone alert went off at full volume.  Then he would jump simultaneously up from the radio and off of the top of the refrigerator upon which it sat.  It was a sight to behold. 

 Because of all this, as a young boy, the importance of speed out the door was ingrained in me.  When relatives visited, I knew to advise them of safety measures I had developed out of necessity.  If the tones went off, I would yell “quick, Grandma, get in a chair!  He’ll trample you.”  This came from the experience of being treated as a track hurdle while playing with toys on the floor when a fire call happened to come in. 

To say that Dad could be a little bit anal about equipment organization would be putting it mildly.  I think it was the ex-Marine in him coming out. 

Our engines varied in vintage from 1957 to 1975 back when he was a chief in the 1970s and 80s.  What didn’t vary is where things were located.  You could open any compartment on any of the four engines (three first line and one reserve) and each piece of hardware, nozzle, appliance, wye, gate valve, etc., would be found in exactly the same spot on every piece. 

Hose was a pet peeve of his.  We had a spare load of hose for each engine stored in doughnut rolls on hose racks in the rear of the building.  I would catch him regularly rearranging the hose on the racks so the end butt of each roll was in perfect alignment. 

If he saw you put a roll of hose on the racks and not line up the butt with the adjacent ones, you would hear about it instantly.  This was not one of his saner practices.  

 Dad was terrible with names.  Guys in the department upwards of five years were “hey you.”  If he did know your name in less time, it was not necessarily a good thing as there was likely a bad reason why he remembered it.  At least when I joined, he had no excuse not to know my name. 


Monday, September 3, 2012

“Quarterback” Size-up

The start of football season brings out the talking heads and sports commentators who spend an inordinate amount of time talking about the mental skillset necessary to play the position of quarterback at a high level; making it sound like the most difficult job on earth.  While admittedly I have no desire to stand in front of a snarling 350 pound lineman trying to make my body intimate friends with the grass, I do think that the situational awareness necessary for rapid decision making under center presents some interesting parallels to fire scene size-up.  With a pass play called, quarterbacks go to the line of scrimmage and see a defensive formation that may give an accurate representation of the opposition’s intentions or may be deceptive.  At the snap, he has a few short seconds to read the scene and hopefully be able to locate and connect with his primary receiver.  If covered, he then has to check down and look for his secondary or tertiary outlet.  He has to avoid getting tunnel vision as the defense converges and move, bob, and weave while continuing to look down field; big picture and small, refining his tactics based on what he sees. 
The first arriving fire officer on a residential structure fire faces similar challenges.  What “formation” is the fire showing and is it deceptive or obvious.  In just a few seconds, the officer needs to evaluate the construction, occupancy, exposures; read the smoke and extent of the fire conditions present on all those.  He can then audible his strategy and the associated tactics.  The firefighters under him have a similar complex job to do looking at primary and secondary escape routes and continually evaluating the effect that the fire is having on the structural integrity of the building so they too can check down and adjust their attack and team actions if necessary. 
The similarities are obvious although the salary levels are not.  The stakes on the correct decision making on the fire side are a little higher than a sack, incomplete pass or interception.