I had my first ‘chest pain/difficulty breathing’ call this morning.

I hadn’t been on a call since the two brush fire calls last Monday… I haven’t writtten about them but they were quite exciting, especially the first one. I was on the first truck to the big Perkinsville brush fire and ended up actually in the brush with the fire, trying to dig firelines, spraying water, cutting burning things up with chainsaws. It was so smoky that you couldn’t see much and it was difficult to do much while trying to hold your breath and dealing with smoke stinging your eyes. It so was windy that every time you turned around, the fire had jumped over yonder into that pile of leaves.

I was at the scene for five hours. Fifty five firefighters from seven departments worked on that fire.

It was caused by an ‘illegal burn’ that jumped onto a wooded hillside. It threatened a saw mill that had been freshly rebuilt after burning to the ground last year. We did stop it before it got to the mill.

I provided some minor care for a FF who hurt his finger driving one of the engines. I improvised a finger splint by cutting up a SAM splint and following the BUFF principle… Big, Ugly, Fat, and Fluffy. Apparently the emergency room was really impressed by my handiwork… Made up for the crappy job I did on the kid’s elbow at the accident at the beginning of the month. I’m batting .500 as far as splinting goes.

Regarding the accident, I went to a debriefing at the state police barracks the other day. Apparently everyone is doing okay. Both the head-injury female and the toddler had pulmonary contusions in addition to the problems I found. They should have both gone by helicopter; next time I’ll know.

I’ve heard the dispatch radio tapes for both the EMS dispatch frequencies and the law enforcement side. They are very interesting.

Anyway, it had been a week since I’ve been on any kind of call. We were getting ready for an appraiser to come by and look at the house. My pager went off. remarked that of course, this would be the time for a medical call (i.e., one that I absolutely have to go on immediately). The dispatcher came on (usually there’s a few-second delay between the tone and the dispatch information) and announced a medical call; sixty-eight year old male, chest pain, difficulty breathing. Out I went.

I stopped at the station and grabbed the defib. A firefighter was on the scene by the time I got back in the car. I drove on over to the house, missing the driveway the first time but being quickly corrected by radio by the FF on the scene who saw me pass by.

The patient was lying down. He was text-book diaphoretic. He looked like a stone statue of himself, except that he was moving. He was clearly in a lot of pain. I tried to find a radial pulse and was unsuccessful; weak.

I started oxygen and tried to take a blood pressure. I was unable to find a blood pressure. On the second attempt, I found a 90 heart rate.

I spoke with the patient and tried to calm him. His wife was trying to help in any way she could. She and I both got a little excited when he told us that he was ‘fixing to die’. I was glad we had the defib handy; supposedly the patient will often make some remark like that before coding. He held on, though, and I was glad to see the ambulance come up the driveway.

The ambulance crew came in. They had difficulty getting vitals and finally the blood saturation monitor was able to get a pulse; it was bouncing between 25 and 150.

We could not get the cot into the room where the patient was, so we used a stair chair to get him down the hallway, around the corner, and down to where the cot was. The two firefighters on scene disassembled part of the porch to get the patient through.

We placed the patient into the ambulance. My oxygen cylinder had gone dry while working my patient (my first used cylinder) and I took it to the rig to trade it and get another rebreather mask to replace the one I had used. I watched the ambulance crew start an EKG , install an IV, and attempt to draw fluids. When they were ready to transport, I got out.

I put my gear away in my car, helped the FFs put the porch back together, then went back to the station. I replaced the AED, called the dispatch center for times and address information and filled out the paperwork.

I got home to find that I had completely missed the appraiser.

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