Emergency Services


On the way out of the office to the structure fire last night, I knocked over a plastic shelf that someone’s lead technician (you know who you are) had left propped against the door to the kitchen.

On my return, I stopped at the house to grab a beer (okay, two) and returned to the office. Striding confidently through the dark kitchen at the office, I stepped on the shelf which shot out from under me.

Kicking both feet high in the air and throwing my keys across the room, I ended up flat on my back on the floor. Happily I did not split my head open nor drop either beer.

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Last night I taught a three hour class on ambulance operations and mass casualty incidents to an EMT-Basic class.

I was pretty well prepared, all in all. My final preparation was interrupted by an actual EMS call but luckily I had been looking at the material all week so I was pretty well set.

I brought candy and passed it around halfway through the first section (before the break) and again halfway through the second part of the class. The regular instructor seemed somewhat annoyed; I’ve raised the bar.

At the end of the class, the students applauded. I was told subsequently that I was one of only two instructors who had been applauded… Out of 28 class periods.

I had some other excellent feedback. One student told me that I should teach regularly, not just a class here and there. Several people told me that I was very thorough and that they appreciated the other practical advice that I incorporated into the material.

The mask rattles against my face. The PASS device screams in my ear. Still; I feel calm, detached.

My pack air was low before I became trapped. I had been working interior as part of a two-person hose team for some time at the incident. My partner and I had been called out of the two-story residence as part of a general withdrawal in response to horns blowing on the fire apparatus outside; the situation had been deemed too dangerous for interior crews. After exiting, I had been given another quick assignment back into a part of the building still deemed safe.

Without bothering my relaxing partner, I quickly ducked back into the building. I did not replace my air bottle. I knew, or thought I knew, that I had enough air remaining in the bottle to complete my task.

I entered the space beneath a stairway. The next thing I knew I was on my back, staring at the blackness where the ceiling would be. A bit of comforting weight, the halligan bar I had been carrying, lay across my chest.

I lay there for an unknown time. At some point I realized that my mask was vibrating, telling me that my air was low; the bell on the regulator clanged twice a second to emphasize the vibration. My PASS alarm, a motion-sensitive device meant to alert rescuers to the location of unmoving firefighters, was emitting an earsplitting shriek near my right shoulder. Neither sound upset me though some part of my mind recognized them as signs of danger.

My radio crackles from the speaker/microphone attached to the collar of my turnout coat.

“C5 from C1. C5 from C1.”

I know the chief is talking to me. I don’t bother to reply. Responding would mean raising my hand to the microphone, keying the button, yelling though the mask to be heard. I can’t confront the effort. Maybe I just don’t care at that point.

“C5 from C1. Status check, please. C5, are you okay?”

I lie on the floor and consider the sounds. I can’t see anything although my eyes seem to be open.

“C5?”

“Interior team one from C1, interior team three from C1. Please enter the building to search for C5. C5 last seen entering the building from the ‘A’ side about five minutes ago, no contact since then. Believe C5’s air to be low; take a spare bottle. “

“Team one acknowledges.”

“Team three acknowledges.”

My training has kicked in and I am using circular breathing; breathing shallowly to maximize my remaining air. I lie on the floor of the dark room and explore the universe.

Clanking and pounding sounds get louder and softer through the building. From time to time, my radio makes noise as one team or the other updates the incident commander with their progress. At one point I hear a pounding sound on the other side of the stairwell wall; I think about knocking on the wall but ultimately can’t summon the effort.

After some time something hits me on the side; once, twice. After a few seconds, gloved hands touch my helmet, my mask, my pack.

“Shit! He’s in here!” A rookie screams to his team leader.

My radio crackles to life again as the interior team leader yells though his mask into his radio microphone.

“Team three to team one. We’ve found C5. We’re on the first level in a closet off of a room on the ‘B’ side. Please assist.”

“Team one. We’re on our way.”

I am being pawed at. Someone removes the halligan from across my chest. Someone puts their head to mine and yells, mask to mask.

“James, we’ve found you. We’re going to get you out of here.”

I hear the two team members discussing how to get me out of the closet. Without ceremony, I’m rolled onto my left side, entanglements removed from my legs, and pulled on my side through the doorway into the room beyond.

I become aware that the second team has arrived; I can hear more yelling voices, muffled through my mask and theirs.

Someone leans down and yells into my mask.

“James, we’re going to change your tank.”

I’m rolled farther onto my side, almost face down. I can feel activity at my back. I hear one of the leaders yelling instructions.

“Unstrap the bottle first. That’s right. Okay, turn it off before unscrewing it.”

The firefighters at my back turn off my air bottle. With my next breath, my mask presses to my face; no more air to be had. The firefighters quickly start to affix the new bottle to my pack while one of them yells to me.

“James, we’re changing your bottle. Fresh air coming right up!”

The new bottle is screwed in and opened; I take my first breath after twenty or so seconds. The air is cool; delicious.

I’m left face-down for a few seconds; the rescuers are having a quick conference.

“C3 to C1. C3 to C1. We are going to pass C5 though a window on the ‘B’ side.”

“C1 acknowledges. Will be ready to receive C5 on the ‘B’ side.”

The rescuers flip me over onto my back and drag me through the room. They are crawling on their hands and knees; they curse and grunt as they drag my 16 stone across the floor.

I hear the window being broken. The combined interior teams try to lift me from their crawling positions; I am heavy. On the third attempt they get me up and my back onto the window sill, head dangling out of the window. Rescuers on the outside grab my pack straps and heave me out as the interior teams lift and push my legs to assist.

The chief and another firefighter half-carry, half drag me to a position on the lawn about fifty feet from the building. The chief leans down to talk to me as I sit up and take off my mask.

“Well? How do you think they did?”

The local chapter of Students Against Drunk Driving arranged the mock car accident. They were a little over the top; when we arrived on scene, there were twelve people involved in the accident; five in one car, four in the other, and three on the ground. Although we were only expecting four patients, it was excellent practice for a mass casualty incident.

My ambulance was the last on scene by about a minute. I went around and counted patients; the incident commander then asked me to concentrate on the victims outside of the cars.

Two of the three were deceased and the other had a significant head injury. I performed a rapid trauma assessment and got that patient collared and on mock oxygen. I grabbed a passing firefighter who helped me roll the patient onto a backboard. I attached the patient to the board and grabbed the next passing firefighter to help me get the patient and board onto the cot. My patient was the most critically injured living patient so she was selected to go by air.

The helicopter arrived as I was setting up mock IV access; with the help of another firefighter, I wheeled the patient down to the field where the helicopter was. I gave a report to the helicopter crew while we were transferring the patient to the air crew’s cot.

Once I had turned over the patient, I took some pictures as I was momentarily at loose ends.

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I returned to the scene as the last patient was being extricated from one of the cars. While he was being packaged, the hearse arrived to remove the fatalities. In actuality, this would not happen until all of the living had been transported but it did add to the drama of the scene.

This patient had glass embedded in his face and cheek but was conscious. We got him into my ambulance, loaded up with three other ‘walking wounded’ patients, and got underway to the hospital.

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It was interesting and a lot of fun. Although I was too busy to really pay attention to the audience, the students seemed fascinated and I never heard a peep out of the crowd of several hundred.

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The complete set of pictures is here.

The patient had tried to commit suicide; at least tried to appear to have tried. She claimed to have taken a handful of several different types of drugs including some powerful opiates some time before we had been called. Her story didn’t add up, though; she was not as out of it as she would have been if her story was accurate.

Still, she claimed to be suicidal; the police reported that her husband had wrestled a pistol away from her earlier in the evening after she threatened to use it on herself.

We delivered her to the hospital. The nurse asked a few questions.

“You have some family here… Is there anyone that you don’t want to see?”

“My children… I don’t want them to see me like this.”

I was instantly irate. She tried to try to commit suicide but, now that she failed, doesn’t want her kids to see her in the hospital?

On the way out, I saw her family; two tearful teenagers and a tearful husband. I felt really sad for them.

I just don’t understand people.

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Responding to a brush fire
Cornish, New Hampshire
April 28, 2009

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I outran the taser.

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