Training: Preparing For the Worst

Posted in Uncategorized with tags , , , on June 7, 2012 by 3dot0

Did a little ladder bail training last shift. We are fortunate enough to have a very good instructor at our station & another that came out to allow personnel from two stations to practice our ladder bails. For many it was the first time performing the skill, for the rest of us, it was a valuable refresher in self-rescue skills. Unfortunately, in our over-litigious society, the state training agency demonstrates ladder bails in its safety course, but does not allow students to attempt the skill. Saving ourselves & each other is a critical skill that is grossly overlooked in many training courses. Fortunately there are programs available to us to allow us to add tools to the toolbox in order to better accomplish our tasks on the fireground.


Light At the End of the Tunnel

Posted in Uncategorized with tags , , , on March 3, 2012 by 3dot0

Lets just hope that the light isn’t an oncoming train.  Today was the first day I get to work with a newly transferred lieutenant at my station.  While I’m not unfamiliar with him, as he was assigned to the training academy while I was going through, it is the first time I’ve gotten a chance to work with him in the field.  I must say that some new blood is a breath of fresh air.  In very short order he had myself & other members of the crew today wracking our brains about things aren’t taught in basic firefighting & rescue courses.  Not only that, but he had us out and training most of the day since we haven’t been busy.  In one afternoon, I’ve done more in house training with this lieutenant than any of the rest in recent memory.  Sure, its nice to be able to perform all of the various tricks I may have learned from some of the other officers, but the basics were not on the menu.  Not only that, but the logic behind why things are done the way they are done was explained.  I’m very pleased to have an officer who takes pride in training, who doesn’t just throw a task at me & walk away, & who will constantly challenge me to become a better fireman, and hopefully a better person.  Not to knock the other officers that have been through here, but this new Lt. stands head and shoulders above the rest on first day impressions.  If this can keep up, I’m sure that some of the trends that I’ve been seeing will reverse themselves.  Its almost bedtime on day 1, but I’ve gotta say so far, so good.  This guy is combat ready, and I hope the attitude is contagious.


An Open Letter to the Fire/Rescue/EMS World

Posted in Uncategorized on February 12, 2012 by 3dot0

This is an open letter to everyone in the Fire/Rescue & EMS community.  I won’t name names, but there is a growing list of you who are pissing me off.  First and foremost, I will say that I am guilty from time to time of any of these things & I work every day to correct myself & better myself.  However, those of you who are the way you are & refuse to change for anyone or anything, you are whats wrong with public safety today.  I am sick and tired of people being lazy.  We did not start this job to become couch potatoes & reactive.  This letter will focus mainly on the fire side of things, but the principles can be applied universally.  We have fallen from grace.  Why in the 10+ years since 9/11 are we seeing the public trust & public opinion of us falling (not at first, but noticeably of late)?  The answer is that we suck.  Not all of us, but even one bad apple gives the rest of us a bad name.  I for one am not a fan of a lot of things, not the least of which is not being “Combat Ready.”  Yes, I’ve copied that term from others, but it holds true.  What is “Combat Ready?” Combat Ready is being ready, being proactive, and taking the fight to the fire (even if it turns out there isn’t a fire).  Being Combat Ready is NOT:

– Being lazy (in any form)

– Not laying out supply line

– Not stretching handlines (or doing so sloppily)

– Not re-packing lines properly

– Having equipment that is not easily accessible so that it can immediately be placed in service on an incident.

– Not throwing ladders

– Not training when not on calls (as well as not using calls as OJT)

– Not being proactive (that 3am medical local is a good time to learn the layout of a building or to check smoke alarms in a house)

– Sitting on the couch all day eating junk food as opposed to training & PTing

I run many alarm calls & other adaptives (odor of smoke, alarm bells, electrical short, odor of natural gas, appliance fires, etc) where the first due engine drives right past the hydrant & up in front of the address & blocks out the truck.  Not to be outdone, the truck gets off not in full PPE, goes right inside & never even looks at a ladder, let alone throws one.  Countless times, my engine has pulled up, hand jacked a supply line to the first-due wagon, then reverse laid to the hydrant.  It’s a bad day when I show up on an engine company, layout, stretch lines, & throw ladders all because people couldn’t be bothered to take an extra 5 minutes to put their toys away.  Then, when the big one does happen, everyone is quick to point out how long it took to get water from the hydrant, put ladders up, stretch a line to the seat of the fire, etc.  It can’t be both ways.  If I have to take the extra 5 minutes to pack a crosslay & a couple hundred feet of 4″ line, so be it.  If I miss a box, oh well, there will eventually be another one (perhaps one that involves more that a pot on the stove).

Then there’s our truckies.  It’s been said that 99% of the fires we go to, the truck work could be absolute crap & it wouldn’t make a difference.  Pretty much true in my experience too, mainly because our truck work around here is pretty lackadaisical.  When I pull up on a rapid intervention assignment, the first thing I do after dropping my ensemble of tools in the front yard is to do a circle check of the structure, then go to the nearest truck & start throwing all the ladders they didn’t throw, then go to the 1st couple of engines & throw their ladders, and so on until every window has a ladder in it.  Those ladders do the guys inside no good if they aren’t put up, and put up properly (after all, I’m gonna be mighty pissed off if I’ve gotta dive out a window to save my ass from a flashover & there isn’t a ladder there.  I’m not a stickler for tying the ladders back, but at least tie off the halyard & assure a decent climbing angle.

And for all of you fire gods, when you have to run an EMS call with me at lunch time, or during the big game, or at 0-dark-thirty I don’t give a rat’s ass what you think of the call, don’t try to weasel out of the call until I tell you I’m good with just myself & my driver.  And when I do let you head out, please carry my equipment that I’m not using back to my unit, it makes me more likely to let you break away for that box that we all know is a culinary disaster & not the big one.

To my fellow gutter-surgeons, please stop being lazy.  To the paramagicians, stop turfing everything BLS without so much as a second thought about what the patient really needs.  Sure, more patients survive due to high-quality BLS, but absent ALS is an ambulance-chasers dream…it also earns us a bad name from the BLS guys, the ER, & the bucketheads.  To my BLS compadres, please think before calling for a medic.  Think about what I can really do for the patient.  Think about how much time its going to take me to respond, assess the patient, argue with you about what a “Priority One” patient is (away from the patient & family members), and then transport.  DO NOT call me to rendezvous in sight of the ER, I’ll be there, but I’m just going to hop in and have you drive to the ER.  And whatever you do, don’t call me and have me show up without having a story, vitals, or a good reason you don’t have the first two.

Now I will step off of my soapbox.  Sorry to rant after months of not writing anything, but recent events have prompted me to be more irritated than my normal level of discontent for the things that I seemingly cannot change.  Until the next time, stay safe (and warm).

Creatures of Habit

Posted in Uncategorized on July 26, 2011 by 3dot0

Admit it, if you’re like me, and I’m sure most of us in public safety are.  You’re a creature of habit.  Every morning you walk into work, grab a cup (or several) of coffee, read the paper, watch the news, check out your unit, etc.  You do things the same way every time.  Why?  Because since day 1, you’ve been taught to do things the same way so it becomes automatic.  The upside is that some things remain relatively constant.  I know that starting an IV won’t change drastically unless they totally revamp our catheters or I mangle my right hand.  Either way, I’m confident that I can adjust.  However, the bad side to our consistent, unchanging nature is that needed changes are not made.

My father has a saying that he uses quite frequently, and I feel that it applies to many things that we do in fire/rescue & EMS, “A hundred years of tradition unchanged by progress.” Why is it that we are so resistant to changes?  I’m very hesitant to go to new restaurants, let alone try new things on the menu at my favorites.  Now imagine that attitude towards our way of fighting fires, extricating patients from traffic collisions, or practicing field emergency medicine.  You probably don’t have to imagine, many of us serve in systems that embrace the past & fear future change.  I come from a place that implements some changes, ignores others, & completely misses the mark on the rest.  We have some of the world’s leaders in medical & scientific research in our backyard, but we don’t implement everything they recommend.  I’ve been criticized for my direction of resuscitation efforts on a code…because I used the new 2010 AHA ACLS guidelines & emphasized high quality CPR, reducing hands off time (minimizing interruptions in compressions including continuing CPR during charging of the defibrilator).  Why is it that because I’m equipped with some of the latest knowledge, which is based off of research results & not anecdotal medicine, I’m considered to be wrong?  Just because its different doesn’t make it wrong.  As the medical field moves forward in the hospital, we must do our best out of the hospital to keep up, move forward, & push the envelope. 
I recently read about a study of mode of transport (lights & sirens vs. policy-driven mode).  While the results were questionable, it rang true to me as I work in private ambulance where I’ve gotta ask mother may I to go hot.  But I also volunteer where I have a great deal of discretion as to my mode of transport.  While I understand the reasoning behind restricting transporting patients hot, I don’t believe that the means to that end are the right choice.  The only collision I’ve been involved in while transporting a patient was a backing accident on a routine transport.  We literally got 10 feet from where we loaded the patient.  That being said, I’ve have plenty of close calls in the emergency mode, & a number of them in the routine mode.  I believe that slowing us down is as much to protect us from ourselves & the public from us as it is to protect us from the public.  The drivers in the Baltimore-Washington region are some of the worst in the world.  Some days I’m convinced that they are trying to hit us.  Naturally, the solution to the problem is to handcuff the drivers with more skill, ability, & training (generally speaking) to a policy that greatly limits them.  Yes, we do have our screwups that drive like maniacs & crash.  However, a good deal of the poor driving I see is attributable to John Q. Public.  So, do we raise the bar on him, make him pay attention, pull over, stop for the ambulances, not race and/or follow us, etc?  Nope.  Just another change that needs to be made that we won’t see.
I’ll leave it at this for now.Insanity: doing the same thing over and over again and expecting different results.” – Albert Einstein.  The problem I see is what’s changing, what’s not, & what needs to change. It seems that our priorities are out of whack as a system some days. I’ll touch on other things that I think are insane (outdated protocols) later on.  Until then, I’ll see you on the big one.


Posted in General Posts on July 11, 2011 by 3dot0

My first confession, I’m a night owl.  Regardless of when I wake up, when I have to wake up, etc. I stay up very late.  And that’s why I’m writing a post at midnight.  My second confession is that many people come to me with their problems & their confessions… And I enjoy listening & helping when I can

In my last post I talked about how I enjoy interactions with other people.  I wrote that while  sitting in my truck at work, while my partner went into Wal-Mart to shop (we should all be so lucky to be that “busy”).  No sooner did that hit the internet than my partner gets in the truck, makes a comment about being frustrated.  I’ve known her for a couple years, we’ve pulled our share of shenanigans on each other, so I joked with her.  This sent her into how she was having relationship problems as of late.  So for the next 2 hours until end of shift, I let her vent, asked questions, and shared my opinions/advice.  Sometimes the questions, opinions, & advice are not a part of my repertoire; but for someone who seemed lost & looking for a push in the right direction, I felt it wasn’t inappropriate.  As it were, she managed to work things out within 24 hours (using some of my advice, I hope).

This is not an isolated incident.  It seems like a regular occurrence for friends, co-workers, and total strangers to confide in me.  I’ve gotten a murder confession on the scene of a call, I’ve gotten people to tell me about the worst time in their lives, I’ve gotten all sorts of stories that I’ve been sworn to secrecy about.  It’s not just on duty, its everywhere.  I don’t know why people trust me enough to tell me.  I’m relatively good about keeping secrets, but not perfect, but I enjoy the opportunity to be someone’s outlet.  Someone like the gentleman last week so displeased by his girlfriend’s driving prowess, that he leapt from a moving vehicle.  Fortunately for him, he only suffered a single fracture & was able to vent his frustration to me as he was a stable patient (besides the decision to leap from a moving vehicle).  Many people voluntarily blurt their secrets & their problems out without the slightest bit of coaxing from me, others I manage to coax the info out of them, and some (mom) I pry the info out of.  Okay, the last one was a once in a lifetime chance to turn the tables on my mother who told me a story, but left out a key name of someone we both knew.  Needless to say, I managed to get the name after badgering her & using Jedi mind tricks to get her to tell me.  While I don’t use that tactic very often, every now & then, I can use it to get people to open up.  I can see it on people’s faces when they’ve started letting something slip out that they were trying to hold in, & I try to allow them to tell someone, to get it off their chest knowing I’m not going to hold it against them, or spread it around.  I enjoy the power to listen to people.  I also enjoy talking…  But you guys already knew that.  But I take pride & feel a sense of purpose any time someone has the confidence in me to tell me their secrets or problems.  I walk around holding hundreds, if not thousands of secrets right now.  I hope that people will continue to trust me, its one of the things I value most in my life.

I’m sure the uniform helps at work, but there has to be something people see in me to continue telling me these things.

Until next time, stay safe out there & I’ll see you on THE BIG ONE!


What Makes You Tick?

Posted in General Posts on July 9, 2011 by 3dot0

We all came along to the fire department and/or EMS for our own reasons.  Some came for money, others to get medical experience to move on to nursing or med school, etc.

Personally, I ended up in EMS on the public-sector side because my county requires firefighters to become EMTs, so I reluctantly got my EMT-B.  Growing up, my parents would watch “Trauma: Life in the ER.”. My siblings and I couldn’t understand how they could deal with watching some of the stuff on TV, let alone handle it in person.  Years later, my friends who are not from the EMS realm question me as I once questioned my parents.  Once I realized that EMS wasn’t that bad (I actually enjoyed it), I got hired at a private ambulance company in an effort to earn some money while looking for a job I actually wanted (still here).  Eventually it occurred to me: “what am I doing for my patients as a BLS provider besides transporting?”  I decided I was tired of hauling people to the ER, & not having much to do for them.  I turned my application in for paramedic class 4 hours before the deadline, aced the entrance exam, and was accepted into the program.  At the time I was not 100% sure that ALS was for me.  Within a couple of weeks of starting class, I was sure that I had found something I truly enjoyed.

I’m still a new paramedic, I’m still relatively new in the fire/EMS service, & I’m still very energetic & gung ho to do this job.  I hope that never changes & I feel that so long as I can continue to enjoy positive patient-provider interactions once in a while, I’ll continue to hold onto my generally upbeat attitude.  After all, why are we out here?

I’m heavily involved in EMS because I care about my patients and I enjoy interacting with them.  I don’t mind running tons of calls that aren’t really emergencies.  They can be quite enjoyable if I have a pleasant patient or even one who is not so pleasant but is entertaining or has an interesting story.  I enjoy calls where I can personally make a difference.  Generally speaking, these are calls such as anxiety attacks, or people who are having emotional breakdowns who I can affect using absolutely no medical skills.  I enjoy that I have a wide range of skills I can perform, but the skills I enjoy using most, and the skills I must work the hardest to master are my people skills.  I love interacting with all sorts of people and EMS is one of my outlets to do just that.

So there it is, that’s why I do what I do.  What makes you tick?  Why do you do this?  What is one thing you want that would make EMS more perfect?


Posted in General Posts on July 5, 2011 by 3dot0

Hello to those of you out there reading.  Before I get into talking about my experiences, I thought I’d tell you a little about myself.  I am a third-generation firefighter & have grown up in the fire & rescue service just outside of Washington, DC.  I started as a junior member of a local volunteer fire department 9 years ago, continue to volunteer as a firefighter, & am in the midst of completing my paramedic internship as well.  I have just been given the lead position for my duty crew.  I love the crew I’m in charge of; all of us are young, & my crew is as eager to learn as I am to train them.  I also am a paramedic for a private ambulance company in the area and run all sorts of calls from simple BLS transfers, to balloon pumps, to ventilator calls & everything in between.  I love what I do.  There are downsides, as there is with anything, but overall everything is good.  Hopefully in the near future, I can add Maryland State Police Trooper/Flight Paramedic to my resume.  Until then, I’ll be almost constantly somewhere on a fire truck or EMS unit.  I’ll be sure to post some of the craziness I encounter, as well as some other posts about my interests, & some of my feelings about the current state of Fire/EMS.  Until next time, stay safe.

– RC

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