I joined the local fire department the other day. That makes me a ‘Firefighter/EMT’. Spiffy, eh?

I’ve gone from being one of three EMTs on the adjacent town ambulance to being the only EMT on the local FD. Now I have three squads; the SAR group, the ambulance, and the FD. I’ll be useful for the FD in that our town has no ambulance; a paid squad responds across the river from the next state to our town. Our FD seems happy to have a pet EMT even though I have no fire experience.

I haven’t actually joined yet; I went to a meeting on Tuesday and met some firefighters (FFs) and was shown around the fire house and the equipment. I still have to turn in an application, have it signed by three trustees, and be voted in next month. It seems like a done deal, though, and they have invited me to go on calls.

A big plus is that I can actually hear the local callouts on the radio.

This afternoon I was reconciling myself to actually doing some work when dispatch called the FD out for a head-on collision. I was torn; I had a conference call scheduled in thirty minutes.

The work/callout decision process is going to be problematic. Dull telephone calls, or helping people that are hurt? Stay tuned. My boss is supportive of my SAR work and my employer has paid for all of my emergency medicine training, but they may not like me not showing up for scheduled meetings for emergency calls. I haven’t told my boss that I’ve joined the ambulance squad or the FD.

My employer has a one-week-a-year technical training policy, but the things I do at work don’t have training available for them yet; it’s been six years since I’ve attended actual computer technical training (on XML). So they pay for medical training under the wink-wink policy that it’ll be really useful to have a trained EMT at work on the rare occasions that I’m there. The emergency response team on campus is trained with layperson CPR and very basic first aid, so I suppose they are right. The boss I had who approved my initial first responder course said “If I have a heart attack and you are here and have had this training, that will be a good thing”. So, I guess I should be pretty grateful… They’ve ponied up for wilderness first responder and wilderness EMT classes and given me the six weeks for training over the last four years.

I decided to go. I went over to the FD and followed the first truck to the scene. I would have gone direct except that I didn’t recognize the street name. It was exciting screaming down the street with the lights going and the truck clearing traffic.

I was the first EMT on scene, and the only EMT there for about five minutes. The injuries were relatively minor. The FD chief was at the vehicles when I came up. He asked me if I would like to take over medical care. I told him I would if he wanted me to, and he said that was what he wanted.

It was my second real scene and they put me in charge of initial care for multiple patients. It seems heady now, but at the time I just got to business.

The unbelted driver of one vehicle had hit the windshield and had facial lacerations, a possible broken jaw, and a possible broken thumb. She was still in the car, very unhappy, and in a lot of pain. By the time I got there the responding firefighters had started manual stabilization and put a blanket on her.

That is a really nice thing, actually; while I am getting my feet on the ground there are a lot of supportive experienced people who want me to succeed.

I was surprisingly okay with the driver’s visible injuries. They looked like they hurt like hell; several big gashes on her cheeks and chin from hitting the dash and windshield. My emotions were detached in a businesslike way, though. I took a close look and decided they did not need immediate intervention though they would need stitching or sealing at the hospital. If those cuts had been on me I would have fainted.

I went and found the other driver. He had been wearing his seatbelt. His airbag had deployed, and he said it hadn’t touched him. He said he was fine. He refused treatment and said he would sign the form when the ambulance showed up.

One thing I need to get a handle on; as the first EMT, I need to identify and assess all of the patients before fixating on one. After taking a look at the injured driver and deciding she didn’t need any critical interventions, I spoke to the other driver, then went back to the injured driver without realizing that there was a third patient.

The FF in the back seat had the driver’s head stabilized and she wasn’t bleeding a great deal; she was waiting for the ambulance to arrive before being removed from the vehicle and, frankly, there wasn’t a whole lot for me to do for her. I did give her a gauze roll to spit blood into, but that was all I could do before backboards and cervical collars showed up. The FF kindly alerted me to the presence of a third patient; the passenger of the vehicle with the injured driver.

The passenger in the first vehicle had been seat belted and had got out of the wreck before I got there. They had not started stabilization on him.

About this time, I heard the responding ambulance service call over the radio and give an ETA. The chief responded, “We have an EMT on scene.” I realized that he was talking about me.

The passenger was sitting against the back of the vehicle he had been riding in. He was complaining of some leg pain and some chest pain. I asked a nearby FF to provide stabilization and he did so. I did a rapid trauma assessment and found no other injuries. I had to look at his complaints and did so, finding a small laceration on his knee (probably from the dashboard) and no visible bruising yet on his sternum (probably from the seatbelt). I palpated his spine and found no issues, yay. Still, he claimed not to remember the accident, had a headache, and was in the same passenger compartment with more serious injuries so the threat of spinal injury was still present. My head-to-toe exam yielded no other injuries.

About the time I finished the initial assessment the ambulance arrived. One of the EMTs started working on removing the driver from the car while the second one came back and reassessed my patient. I helped her collar the patient, then we did a standing takedown with the help of two FFs. We strapped him to the backboard, placed him on a gurney, I wheeled him to the rig with the help of a FF, then we put him inside. The driver had been removed from the vehicle already, boarded, and placed on the bench in the rig.

Then I was done.

I probably could have chosen to ride to the hospital (I was the initial and primary caregiver under state law), but I chose not to.

I found the chief and asked him if it was okay if I left since I had to get back to work. He said yes, and thanked me for coming.

As I was driving out, there were two FFs directing traffic at the intersection of the accident road and the bigger street. I recognized one of them as the FD medical officer (non-EMT) who I had met on Tuesday. It was an interesting feeling to realize that she and the chief already trusted me enough to let me run the medical care while she directed traffic. I stopped, got out, and gave her a report of the injuries. She and the other FF both thanked me for coming and I went on my way.

I was ten minutes late for my meeting. I apologized for being late but did not elaborate.

I was pretty happy with the way the call went.

I made some mistakes. I made a big faux pas with patient care (I asked my patient if the driver was his mom, but it was his girlfirend). I fixated on the obviously injured patient to the exclusion of an additional patient. I got chastized by the local police chief for not pulling over and letting him drive between me and the fire truck.

Still, it went well, and I seemed to do okay as far as the other volunteers were concerned.

Maybe I’ll be able to handle this EMS stuff after all. I still haven’t seen anything truly nasty, but I’m beginning to think that when I do, I’ll get through it somehow.

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