Code 4

A few months ago, I blogged about “plain speak” and how terminology changes from place to place. Now that I'm working in the Western US, I've learned a NEW term for an ambulance – out here, it's called a “Rescue”. They have “Heavy Rescue” or “Technical Rescue” units – those are the “rescue” trucks I'm used to talking about.

Anyway – the agency I work for still uses some 10-codes. Things like “give me a 21”, short for 10-21, meaning: call dispatch via phone. Some folks use 10-7/10-8 for out of service/in service, and there's a smattering of other ones, too. There's a new one for me, “Code 4”. It's actually the same as a 10-code I'm used to from the police back home, “10-92”. Code 4, 10-92, or even “92” mean the same thing, ostensibly, “status OK”. That said, the code means so much more than that. The use is very context-dependent. Most often, it's how I answer status checks by dispatch when my unit hasn't been on the air recently.

We also use it for other things. Talking about a disabled motorist: “He's code 4, waiting for AAA.” Or, after a property damage collision, “occupants are all Code 4, just want to file a report.”

An example, from an EMS perspective, is a call I had at the University EMS service, while I was a supervisory lieutenant. I was onscene for a psychiatric emergency, and the other lieutenant arrived, and asked me on our ops channel if I needed anything. My response was “Nope, we're 92 in here, just let me know when the BLS arrives.” Suddenly, by using that 10-code, he knew that a University police officer and myself weren't doing anything useful inside, and were simply waiting for the ambulance to arrive, so the person could go to the hospital for care, after their cry for help.

Another great use from the EMS side is when we are requesting a LE unit to assist us for something minor – forcing access into a house, dealing with securing property, that sort of thing. Over the years, when I've request a LE unit for something minor, it's not uncommon to get more than one, because they all come, just in case I'm in trouble. It's great to know the cavalry will come when I call, but it's also a waste of resources. Being able to use a code that the dispatcher and LE know, that says “I'm OK” can help ensure that my LE friends don't get hurt racing to “assist EMS” for something dumb.

“Code 4” isn't some huge secret. It's online, and can be heard on most scanner apps for western LE agencies. Its use is varied, and very flexible. It, and 10-92, the 10-code from back home, are one of the more useful LE “codes” that I've used.

Jon

Fellowship

I’ve had the opportunity this spring to be involved in something really cool. I’ve been involved with a new group, called the American College of Paramedics. Here’s the idea – Paramedics in the United States becoming a self-regulating body, like is seen in many Commonwealth countries.

From the website:

The title of “Fellow of American College of Paramedicine” represents an EMS practitioner’s commitments to clinical excellence in the prehospital environment, the promotion of evidence-based EMS practice, and development of the EMS profession into that of true allied health professionals. Candidates for FACPM will have demonstrated the following during a 5-year candidacy period

http://acparamedic.org/fellowship/

I’m proud to say I’m part of the fellowship committee, and the Board members seem to be working diligently to make this happen. I think this is a great next step for American EMS. What do you think?

Check out the website:

http://acparamedic.org/

And the Facebook page:

https://www.facebook.com/Paramedichope

Jon

Philly Fire at Level Zero

Philadelphia Daily News has an inflammatory headline today: In case of emergency, say a prayer? Sad part - It's spot on. Getting EMS care in Philadelphia is as much luck as it is anything else. It's a finite resource that has long been neglected.

 

Tuesday brought seasonally expected high temperatures, and with that, predictable high EMS call volumes. That’s NOT a surprise to anyone who follows the saga of PFD*EMS. Add in a small-scale disaster, such as the food truck explosion that happened Tuesday afternoon, and the system went back to Level Zero. And was there a couple other times during the day.

Level Zero is a term in the EMS industry. It means the City has ZERO available transport EMS resources – everything is committed (on calls, at hospitals, cleaning up, completing post-run paperwork, restocking, or out of service for training).

Here’s the thing. Even when Philly DOES have EMS units available… they may not be in every neighborhood. On busy days, it’s routine to see ambulances leapfrog across the city, getting sent on 20 or 30 minute responses as soon as they clear a hospital. Is there really a difference if it takes 10 minutes to dispatch an ambulance that’s coming from 20 minutes away, or if an ambulance from 30 minutes away is dispatched without a delay? Other than the statement of “no medic available” on the radio? The scene gets the closest available suppression apparatus, and they wait for an ambulance.

It’s common in major cities to supplement municipal EMS resources with mutual aid providers. In some towns, that consists of agreements with adjoining towns to help provide coverage for normal flows of service. In other towns, that involves a public-private partnership where ambulances that are primarily used for non-emergent transport are used to supplement the 911 system. Some areas do this more frequently than others, but it’s a common solution.

Philadelphia doesn’t seem to know how to call for help. They have a procedure where quite a few agencies have radios mounted in ALS ambulances that can communicate with PFD’s dispatch so that these units can be used in a disaster. These radios are used in the annual airport drill, and regularly tested, and that’s the end of it.

Philadelphia invested money in the system, and unveiled it 4years ago. Yet, to my knowledge, it has never been used for an actual event. Especially these occasional surge events that happen EVERY SINGLE SUMMER. These surges happen in extremely hot weather, and also on warm summer evenings when the city's "knife and gun club" starts up, and fills the hospital trauma bays with battered and bleeding individuals.

Philly is planning to “fix” their EMS system by hiring a whole bunch of EMS-only EMT’s to ride ambulances, paired with Paramedics, allowing them to return to a all-ALS deployment with more units. That’s the stated goal, anyway. That isn’t going to happen overnight, though. The City should use the resources it has available to cover it’s requirement to provide EMS until PFD*EMS is on a better footing.

Stars

 Over the years, I've spent many nights sleeping outdoors, and many more nights outside with friends. One thing I've never gotten tired of is starting at a sky full of stars. 

Where I live, there's just a little too much light pollution to be able to look up at the sky and truly enjoy the view. Some of my favorite memories of the outdoors are of my time under the stars. Like the night, as a scout, I joined in with a dozen others and slept out on a tarp brought by a friend. Going to sleep under a blanket of stars is magical. Or the year I was Camp Health Officer - after our senior staff celebrated our final night with a BBQ and campfire, I wandered out into the deserted field in the middle of the camp and ended up laying back, contemplating the heavens.

Some other great times have been with friends at caving events in West Virginia. When you're 20 miles from the nearest strip mall, the view gets so much better.

Even now, in my temporary home 25 miles from the midnight sun of the Las Vegas Strip, I get to see the night sky. My little neighborhood only has moderate light pollution, so the view is pretty good. Of course, I'm living under a major approach route to McCarran International Airport, so my stargazing is punctuated by an ever-changing constellation of planes stacked up, traveling west across the lake into Vegas.

Anyway... The night sky never gets old. I love the mysticism behind the constellations, and technology now makes it easier than ever to identify stars and constellations. I use Sky Guide, but there are other apps out there too.

Big Change - For real this time

So, it's been over a month since I posted. Sorry... I've been a little busy.

I decided to take my blog title seriously, and I accepted a seasonal position as a Paramedic for the National Park Service at Lake Mead. That means that the last week of April, I moved cross-country for the summer.

-My new ambulance. Credit to my friend Matt Goldberg for this

It's been a very interesting transition. After a month, I'm getting used to the desert. It's been very ironic that the East Coast has been hit with some very nasty rainstorms and flooding, while out here, weq've had rain sprinkles one night, and the local weather folks got all excited over a few drops of rain.

I've also had to get used to the altitude, and that's been a gradual thing as well.

The land is beautiful, even if it is in a drought.

Anyway.... Sorry for the absence. It's been a busy couple of months with getting prepared, tentatively accepting the position, buying a new car, actually getting the official job offer, then packing up and moving, and then getting settled out here. I've got some posts pending about some of my adventures on my road trip, as well as my adventures on my days off. Oh, I'll talk a bit about some of the differences in my role out here, but the usual privacy stuff applies, so I've got to be careful.