Tuesday, March 11, 2014
Sirens
Wednesday, January 15, 2014
Plain Speech
Friday, March 22, 2013
Crossing the Floor
Monday, March 18, 2013
The Secret List / Highway Safety
Anyway... the last lecture I attented at EMS Today was on Saturday, and I heard Gordon Graham talk about non-punitive critical event reporting. He's part of the group behind FirefighterCloseCalls.com and Chief Goldfelder's "The Secret List". If you aren't already getting TSL emails, you're missing out. They are a combination of alerts of LODD's (Line of Duty Deaths), alerts and follow up of serious incidents, and some advice and remembrance of major incidents.
Just last week, Chief Goldfelder sent out an email that hits very close to home: "Lionville, GA LODD Details, "Wrong Way" Crash Lawsuit (The Secret List)"
An excerpt:
WHAT HAPPENED IN LIONVILLE:I'm from Chester County, PA. This incident happened a year and a half before I joined the local FD's Explorer Post. Growing up in the firehouse, I had many mentors that were on that scene. It changed how we responded to highway incidents, especially the PA Turnpike. I remember stories of our Chief going toe-to-toe with State Troopers demanding that our blocking apparatus be moved from a travel lane. There were threats of arrest. Thankfully, it never came to that - but my Chief at the time made it clear that our safety was paramount, and that if we had to, we closed whatever lane(s) the IC felt was needed... up to and including the highway.
At approximately 1418 hours on 3/9/1998, Lionville Fire Company (Chester County, PA) and Uwchlan Ambulance were dispatched to a single vehicle automobile crash at milepost 310.9, just west of the Downingtown Interchange on the Pennsylvania Turnpike. A Heavy Rescue Truck, Engine Company, Assistant Chief and Ambulance responded. Upon arrival on the scene, the Ambulance, Rescue Truck, and Assistant Chief's vehicle parked on the shoulder of the road off the travel lanes of the highway.
At the same time, two additional crashes were reported on the Turnpike. The second accident was reported at milepost 307 westbound (west of the first incident). The Engine responding to the first accident was directed to continue past the primary scene to respond to the second crash. A third accident was reported of a vehicle overturned at milepost 314 on the eastbound side of the highway (east of the original incident). Then Lionville Fire Chief William Minahan responded to that call with mutual aid units to investigate.
At 1438 hours, as personnel were loading the accident victim into the Uwchlan Ambulance, a tractor trailer traveling westbound lost control and crashed into the Assistance Chief's vehicle, overturned, and slid into the back of the ambulance and the other responders in that area. The Assistant Chief and a Firefighter with him in his truck were trapped in the severely damaged vehicle and had to be extricated by mutual aid rescue personnel using the Jaws of Life. Firefighter Dave Good of the Lionville Fire Company was killed in the line of duty. Nine other emergency responders were injured, three seriously. The injured included Assistant Chief Steve Senn, Firefighters Chris Good, Mike Cox, Eric John, Pete Harmansky, James Rattrie, and Robert Doan, all firefighters with the Lionville Fire Company, and EMT Brent Kaplan and EMT John Wanczyk of Uwchlan Ambulance.
Firefighter David Good was 38 years old and had 5 years of service as a Firefighter with Lionville Fire Company. He was survived by his wife Maryanne and two sons, Johnathan and Jason Good. RIP.
That incident 15 years ago eventually led to the production of a video called the “10 Cones of Highway Safety” and a training program about Highway Safety both by VFIS. It also was one of two Firefighter struck-by-vehicle line of duty deaths in 1998 that led to the formation of the Emergency Responder Safety Institute (ERSI) (www.respondersafety.com ) a committee of the Cumberland Valley Volunteer Fireman’s Assoc.
Since that time ERSI personnel have worked constantly to build awareness of the dangers responders face while working at roadway incidents, to develop training aids that are available for free from the website*, and to collaborate with government and fire service officials to develop standards, regulations and guidelines to protect emergency responders at roadway incidents. ERSI personnel continue to work on more new training programs and educational material related to this subject and to pass along this information at fire service trade shows and conferences. Their motivation started with the death of FF Good-and hasn't ended....
FIRE/EMS HIGHWAY SURVIVAL TRAINING MATERIALS:
LIONVILLE FIRE CO PROGRAM: http://www.lionvillefire.org/hwy_safety/
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| Every so often someone will comment that Uwchlan EMS doesn't have an "Ambulance 87-2"
This is why. At the time, they were station 47A... but this is the last Uwchlan ambulance to carry the "-2" number http://www.lionvillefire.org/hwy_safety/sld013.htm |
I no longer run as a firefighter in Pennsylvania. In addition to my work as a Paramedic in PA, I'm volunteering in Prince George's County, MD. Last summer, they had two incidents in less than a month where engines were struck while providing barrier protection on the Capitol Beltway (I-495). Two stories about those incidents: http://pgfdpio.blogspot.com/2012/09/beltway-near-miss-again-avoided-by.html and http://pgfdpio.blogspot.com/2012/08/barrier-protection-difference-between.html. Those incidents happened in an area of the Beltway I've responded to before.
Both of these happened in the late night / early morning hours of a weekend. The incident involving Greenbelt's (35's) engine actually involved 2 separate collisions... one into the engine, and one into the striking vehicle some time later.
| The September incident http://pgfdpio.blogspot.com/2012/09/beltway-near-miss-again-avoided-by.html |
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| The August incident http://pgfdpio.blogspot.com/2012/08/barrier-protection-difference-between.html |
Where am I going with this rather long blog? Well, we need to learn from incidents that have killed or seriously injured *us" in the past. We also need to study and learn from near-miss incidents that COULD have killed us... but didn't. Often, luck plays as much a role as anything in the difference between a near-miss and a LODD. FirefighterCloseCalls.com is a good source for that information.
Lastly - be careful in traffic. Treat every driver as if they are blind, intoxicated, and texting. Use blocking apparatus whenever possible.
Thursday, December 27, 2012
Sandy Hook / "Gun Control"
There is lots of talk about gun control on a daily basis. I try to tune much of it out, because my father once taught me something about wrestling with a pig. Sometimes, I attempt to have reasonable discourse – often it ends with folks who like to profess tolerance and acceptance telling me they are sick of arguing with me, and that they shouldn’t have to “tolerate” my kind. I always find that bit ironic.
Some of the discussion lately has gone so far as to suggest drastic restrictions on gun ownership – like the bans in the UK and Australia. News flash: The Supreme Court has repeatedly upheld that the Second Amendment does, in fact, grant residents of this great country the right to keep and bear arms. If you truly want to discard the Second Amendment, I urge you to reconsider. The framers gave us 12 amendments as a proposed Bill of Rights to cover issues not addressed entirely in the Constitution (11 of those were passed as amendments, and the 12th would drastically increase the number of members of the House of Representatives, so it’s probably just as well it hasn’t passed).
Any argument that could be used to justify the repeal of the 2nd amendment could be used to justify the repeal of any of the amendments. I would fear for our country if it comes to this. What would life be like without freedom of the press, or freedom of religion? What about the protections against unreasonable searches and seizures? If we see the Second Amendment gutted, how long until we have “papers, please” checkpoints and searches throughout the country?
There’s a parable that is attributed to Martin Niemöller, a Lutheran minister and outspoken opponent of the Nazis:
First they came for the socialists, and I didn't speak out because I wasn't a socialist.
Then they came for the trade unionists, and I didn't speak out because I wasn't a trade unionist.
Then they came for the Jews, and I didn't speak out because I wasn't a Jew.
Then they came for me, and there was no one left to speak for me.
This particular parable speaks volumes to me because I AM a Jew. Yeah, I’m even a member of JPFO, Jews for the Preservation of Firearms Ownership (http://jpfo.org/).
For my Law Enforcement and .mil friends – if you haven’t heard of the Oath Keepers (http://oathkeepers.org/oath/) , I’d strongly encourage you to look into the group. Many elected and appointed public servants SWEAR to “support and defend the Constitution of the United States against all enemies, foreign and domestic.” Oath Keepers profess “Not on our watch!” They say they will refuse unconstitutional orders, such as firearm confiscation, or the unlawful detention of Americans.
And what of lesser measures? We had an “Assault Weapons” ban for 10 years. There is no real evidence it made a difference in firearms crimes. All it did was raise market prices for things like “pre ban” magazines and firearms. Registration? Well, why does the Government need to know what guns I have… unless it is a prelude to confiscation? On top of that, once they have the information, no good can come of it. The number of times that law enforcement has successfully used registration data to trace firearms in crimes is statistically insignificant.Now What?
I’m all in favor of discussing mental health, and “keeping the crazies from getting guns”, to quote something I heard on Facebook. I’m not convinced that more gun laws are going to make a difference in preventing another mass shooting event.
One thing that many of these shootings have in common is that they occur in areas where firearms have been prohibited. Add to the fact that several recent events have been stopped, at least partially, by folks lawfully carrying concealed, and I am having a hard time understanding arguments in favor of restricting concealed carry.
As for incidents, look no further than the Clackamas Town Center shooting last week. 2 Dead, 1 injured. An individual carrying a concealed firearm says he drew down on the shooter, but held his fire because he didn’t have a clear shot. The shooter than retreated and took his own life. In the Tuscon shootings, one of the civilians that ran TOWARDS the shooting to help was carrying a concealed firearm. Since that psycho was already restrained, he didn’t need to use it.
Oh, and I’m assuming most of my readers have already seen the “RUN. HIDE. FIGHT. Surviving an Active Shooter Event” video. It’s linked here anyway (http://www.youtube.com/watch?v=5VcSwejU2D0). Look at 0:58 in the video. The Section 30.06 Trespass warning is clearly visible. (http://law.onecle.com/texas/penal/30.06.00.html). The video illustrates the point that shooters often choose Gun Free Zones. On top of that, we are told that, as a last option, we should fight with improvised weapons – like chairs and fire extinguishers. Why must they be improvised? Oh, that’s right – we’re in a GUN FREE ZONE. So why does the shooter have a gun, again? Oh – he’s not really concerned with violating one MORE law, given that he’s planning on KILLING a whole bunch of folks. From what it sounds like, that’s exactly what at least some of the Sandy Hook staff did. And they paid for it with their lives.
Saturday, January 21, 2012
Snow
I love the feel of an all-wheel-drive vehicle hugging the road, even through a thick white blanket. One can even practice things like resolving skids and handbrake turns without putting undue stress on vehicle parts.
Snowmen. Snowball fights. Even just walking in snow can be fun, if you're in the right mood.
I hate snow, though. It piles on you and weighs you down. It makes even the most routine responses anything but routine. It hides the street signs, and it can give you the same powerless, out-of-control feel of sledding - in an ambulance.
After its done, though, all there is to do is hate it. It goes from pretty to dirty, soot stained and yellowed in a day or two. Then, depending on how much there is, it can linger. It makes simple tasks like parking on the street, and walking down the sidewalk, a treacherous challenge. It also makes good people have accidents. They slip and they fall, and as they shovel out, they overexert and injure themselves, in some cases, they even have MI's
Tonight I get to enjoy it, though. It is only a dusting - an inch, maybe two. Someone else did the driving, and I'm off duty for my last weekend off before my (hopefully) last undergraduate semester starts next week.
Jon
Wednesday, March 23, 2011
Pins and Needles
I'm in a dark room, with a one-armed man. I'm trying to find an IV so I can give Nitro and Morphine for his chest pain... I search and search for a vein. I've got one, but it's resting on fatty tissue, with nothing to put tension against to hold it in place. I swing... and a miss. Clean the site and try the other side of the AC. Swing and a miss. Again... back at the first site. I get flash, but can't advance the catheter. I try to float it in. It blows. I swear in my head.
We load the patient up, and once in the truck, I find one more vein on the arm that I think I can get. I pray. I miss. I look at my partner and say “Just go”. I talk to the patient on the way to the hospital. Trying to keep his mind off things. It doesn't really work.
At the ER, we place the patient in bed. I explain that I can't get a line. The nurse looks at me and incredulously says “Are you a paramedic?” I doubt myself. I think I stole the patch and don't deserve to wear it. I say Yes, but inside I wonder.
After registering the patient, I peek in on my way out the door. The nurses are on try 4 or 5 themselves, with no more luck than I had. I walk out with my head just a little bit higher, recognizing that it wasn't JUST me.
~~~~~~~~~~~~~~~
I hate IV's in my own arms... it hurts. I cringe when I stick my patients. I don't dig for the vein, because that trick never works. I hate turning my patients into pincushions, but sometimes they have NOTHING for veins, and I'm desperate to get a line so I can push drugs to make them feel better.
Thursday, May 14, 2009
Scrubs
Anyway - I've seen most of the medical TV shows that have played. Emergency! was the best, of course. They really, really worked to make it realistic.
ER, Third Watch, etc - they've all been wayyy too much drama and not enough medicine. And they got stale and corny.
Scrubs never got stale... yeah, it was a sitcom, but it was also funny, and had serious times, too. Also, as much as it was humorous, it was realistic in some aspects. Poking fun at new doctors... and in some ways, bringing House of God to life.
But now thats gone. I'm just a little saddened.
Thursday, April 16, 2009
The begining of the end
ACLS is this week - PALS is next week... and then we are done. I realized last night, looking at the course syllabus, that we are DONE with the classes out of the Paramedic textbook. Part of me is relieved, and part of me is frightened. I've been here before - and I wasn't ready. Now I feel almost ready for my final field internship.
I was asked a question today by a paramedic who is my age, and I consider a friend. He aksed me if I feel ready to run a code (cardiac arrest) by myself. I had to think a moment before answering, My answer was two-fold. “Yes – I know the protocols, and codes are pretty simple. But No… because I’m not done school and through field intership yet – and I am not a paramedic yet, I’m not even sure I’ll be ready for my first code when I’m out on my own… but I’ll just have to get through it.”
I look around my class, and I still see a classroom full of people. We’ve only lost 2 people from the class. This is a very small number, compared to previous classes. I think this is a good sign, but I also know that statistically, there are a few folks who aren’t going to make it though the final testing, and will never become medics. That sucks… but it is life.
All that said – It was a shocking realization that we are DONE with the easy classroom portion and are moving onto the full-out balls to the wall practical phase, where everything will become my show. This scares me more than anything, because this is where I fouled up before. Anyone can sit though classes – but being able to come up with an adequate treatment plan at 3am in the cold and the rain, on a patient that just doesn’t quite fit the protocol? That is a different challenge, and requires a knowledge of the body, the protocols, and the patients disease/injuy processes. That is what being a paramedic is all about – and some medics are AWESOME at that, and some aren’t as much. I want to be AWESOME… but first I’ve got to be there, and do that.
Well – Tomorrow night is the megacodes – wish me luck.
Monday, March 02, 2009
Stars
Still, there is one night that stands out as being different… I was about 13 or 14, and still involved with my local scout troop.
It was a clear, warm fall evening, and as the campfire burned down and the troop members headed off to bed, everyone went towards the tents they used the previous night.
Then one of the scouts my age, actually a year older than me, points out that he was using a jury-rigged tarp as a shelter. The tarp is very large, and an idea is planted… there will be no rain. It is a clear night, and lots of stars are in the sky. We discuss, and several of us agree that we should try to sleep “cowboy style” under the stars… no tents, just using the large tarp as a ground cloth to put our sleeping bags on. If things go wrong, our tents are still set up – and empty.
Thinking back, I remember two things about that camping trip – one was the idiot scout that used gasoline to get the fire going, and the other was falling asleep under the stars… no tent, going back to a more primitive time.
Since then, I’ve only had the opportunity to repeat that once… about 8 years later, on my OA Ordeal, where I was “required to sleep alone, apart from other campers” and using the same minimalist supplies of a ground cloth and blanket/bedroll. That was a much colder fall night. And it was wet… and we were under trees. It wasn’t nearly as pleasant, but it was a formative experience.
That said… one of my goals for this year is to find a perfect time to yet again sleep out under the stars… not in a tent.
Wednesday, February 25, 2009
Why I avoid Bars
I'm looking around the bar, at all these OBLITERATED people at midnight on a Tuesday, and I really wanted to know why none of them seemed to have jobs to worry about being at the next morning. And then I realized why I felt uncomfortable... I was barely intoxicated... and had no intention of getting more so, because I've got stuff to do in the morning. In fact, I wonder why I was even out at all.
Still - if those people don't need to be ready to work in the AM - how can they afford to go drinking?
And so long as I continue to act like a responsible adult... I will continue to be reminded of why I DON'T drink in bars.... although I have been known to occasionally work the door.
Wednesday, November 12, 2008
And Miles to go before I sleep.
As I was typing last night, I thought back to a poem I once read... Robert Frost's "Stopping by the Woods on a Snowy Evening". I can appreacate some poetry, and I remember this one from middle school englis
The line that kept running through my head was "And miles to go before I sleep." Given my current schedule, sleep has become the "optional" part of my scheducle. So When I got to work this monring, I took several shorter naps, and probably slept for close to an hour.
Anyway.... I need more sleep.
Whose woods these are I think I know,
His house is in the village though.
He will not see me stopping here,
To watch his woods fill up with snow.
My little horse must think it queer,
To stop without a farmhouse near,
Between the woods and frozen lake,
The darkest evening of the year.
He gives his harness bells a shake,
To ask if there is some mistake.
The only other sound's the sweep,
Of easy wind and downy flake.
The woods are lovely, dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
~Robert Frost
Monday, November 10, 2008
Monday again
Last night I had to fuel my car, and it was refreshing that a full tank of gas was less than $50! I remember cringing when I was payin $80+ for a full tank, so it is nice that the price is a little better.
I was just watching on TV that it's the Marine Corps birthday today, and Veteran's Day tomorrow. THANK YOU to everyone who is serving, or has served our great country!
Check this video out on YouTube:
Wednesday, November 05, 2008
I woke up this morning, hoping that last night was a bad dream. Nope. Obama won, it seems.
Anyway - yesterday was busy at work... Cardiac Arrest at the local "Skilled" Nursing facility... came in as "Unresponsive Person".... and we walk in and the CNA is doing compressions. It don't get any more unresponsive than that!
The arrest was wittnessed. We worked it into the ED and got ROSC on the way in... guy coded twice more in the ED before it was finially called an hour or two later.
We then got our butts kicked with 5 calls between 2 BLS trucks and the medic... and we had another BLS cover us for a 3rd call.
Monday, November 03, 2008
Daylight Savings Time
But why do we do it? I don't care if the sun comes out at 7:30 or 8:30... I've got to start work at 0600... so it is going to be dark when I get to work - all the time.
Then there is the inconvience of having to change all your clocks. And we have clocks on everything - Phones, radios, microwaves, DVD/VCR's, computers.
Then the government goes and changes the program... and screws up the time on any electrical device that is programmed to automatically change the time.



