Live IV's and a kinked catheter

Years ago when I started this blog, I started it with the idea that I would write mostly about my services as a Firefighter EMT and my adventures through paramedic school.. Certain privacy laws and the wishes of my Chief have kept me from blogging about many of my most interesting calls, As I sat reading a few blogs today I realized however that I haven't really written much about my experience of going through Paramedic school- So from time to time I'll write about a story from my time at Medic school. First: Let me clear something up, IV Medicine uses a plastic catheter that stays in the vein, There is a needle involved but ONLY to pierce the skin and vein, once this is done the needle is removed and there is only plastic left... I have found through setting up and starting many IV's that this is a common misconception about getting an IV. This story comes from about the mid-point of my didactic (classroom) instruction.. It was time for IV's. Up until this point we'd been discussing IV related drugs and the uses for intravenous medicine. We were supposed to practice on an IV mannequin (An arm designed to look and feel much like a regular arm) Our instructor for the day decided it was best to learn the real way right off the bat.. I really didn't have much of an issue with IV's- I had received several in my lifetime and knew basically how it worked, Still I was nervous as hell... The person I'd been paired up with was an Army Medic who I'm grateful to have had in my study group because he knew his stuff and he provided a huge sense of humor to ease the tension. Ron wanted to me to start an IV on him and walked me through it (I was the first of the class to attempt it) It took me a while but I eventually got the "stick"- my first one and I got it right the first time but it didn't always stay that way (more on that later) Our instructor used the way the catheter "flowed freely" as an example..

 I began to offer up my arms to people with a little less confidence in the procedure that I had displayed because I have HUGE veins that I call my "pipes".. That didn't stop my buddy from screwing up his first live IV on me though, Again I was used as an example for the class. When the IV was started on me, The catheter was not advanced completely into the vein before pushing the plastic catheter inside the vein, (To be clear, The needle had poked the vein but the plastic part around the needle which is the catheter was not yet inside of the vein) as he pushed the catheter forward I felt it pop into the vein and then it proceded to fold over on itself inside my vein..

Our instructor saw this as a teaching opportunity, He pulled the class over and told them all about how this was going to create a large hematoma (bruise) on my arm, As he was speaking I could feel my arm beginning to swell up so before too long he had him pull the tourniquet and catheter out revealing the bend inside.. I bruised pretty badly and I'm glad I did because it made me even more self conscious when giving an IV to a patient to try and avoid leaving them with a hematoma- however in the ER environment that became inevitable.. (more to come on that later).....

This is the life!

It's morning: I'm sleeping after working all night long, I'm not sure how long I've been out, I just got the news a few hours earlier about the possibility that I may be laid off from my job, I don't know what the outcome will be yet but I'm clinging to a glimmer of hope, Still I laid awake wondering how I would support my family should the worst come..

10:15 AM I'm finally fast asleep, The tones go off on my pager which I left on full volume since I'm on call to respond for the next 12 hours. My wife and daughter were playing in the next room, BEEP BEEP BEEP.... "Engine, Batallion, Respond on a 'Fire Other' at ____ Machinery" followed by a bit of information and an address. I peeled myself off of the ceiling, rolled out of bed and threw on my FD coveralls, I sprinted down the street to the fire station, threw my turnouts on over my coveralls and jumped into the engine.. Our chief had already turned the engine on and opened the bay (Its much faster for us to run in through an open bay door and get into our gear than it is to run through the living quarters and into the bay) "Morning Chief! What have we got?" He laughed and said, An oil and water evaporator fire, Workers called the station and asked us to respond non-emergency. (A laugh was shared because our protocols don't allow us to respond to any fire in a non-emergency manner) Workers haven't been able to put it out using several extinguishers and 9-11 was notified. We waited another minute for a few other volunteers to show up and staff our engine and we rolled out lights and sirens blaring. -"This is the life" I found myself thinking while I was buckling into my SCBA and prepping to go play. While en-route we discussed our options as a crew and decided to pull a trash line and bring our supply of engine fire extinguishers.
(A trash line is a 100 foot section quick roll used for quick fire attack on simple fires like dumpsters, vehicles and situations that do not require longer lines for fire attack)

Upon arrival we could see a thick black plume of smoke coming out the side of a machine as well as out of a chimney chute at the top of the machine, The fire itself is contained inside the machine and hasn't extended to either of the buildings. We mask up and go on air, about this time our Battallion shows up and takes over command,  We have our trash line pulled and hooked up but not charged, It appears at this point as though we can tackle it with our extinguishers, My partner and I each grab a 20 lb Class B powder extinguisher and prepare to spray as our 3rd firefighter opens the hatch exposing the burning oil inside the machine, As soon as we start to spray, fire shoots out of the chimney and balls up into a 30 foot tall ball of flame, surprised, both of  us quit spraying for a minute and the flames die down, we go at it again this time knowing what to expect, Our 3rd firefighter repositions himself and opens the hatch but that didn't stop his turnouts from getting a 'badge of honor' as we call it- That is the fire was so hot that it melted the reflector stripes on his arm- The turnouts did their job and kept us all safe from the heat, 30 seconds later my extinguisher is empty. We are called off to re evaluate how to better tackle this fire, The machine is then moved further away from the buildings and the trash line is charged, We decided to cool the machine for a few minutes by spraying a general fog pattern around the outside of the machine with the hatch closed and oil still burning inside.. Once the machine had been cooled, We stepped toward the machine and I took over the job of holding open the machines hatch while our other firefighters sprayed extinguishing powder inside the hatch (and subsequently all over me for that matter). A few minutes later our fire was finally out, We stayed and watched the machine for the next 15 minutes or so to make sure it wouldn't reignite.. Overall this fire emptied 2 of our 20 lb extinguishers and 2 additional 5 lb traditional powder extinguishers. This fire was a different experience than most in that it was mostly contained, However this was the first time in a live emergency that I've seen multiple balls of fire rising into the air some 30+ feet. As we cleaned up and headed back to the station we shared our experiences from this call, The general train of thought: "This is the life!" I had completely forgotten about my job worries and I had a huge smile on my face.. I LOVE what I do!

An image similar to what it looked like when we started spraying our extinguishers on the fire. 

Black Friday a HUGE disappointment

I went out early with my wife to hit up a few Black Friday sales. We headed out as an entire family excited for what we were going to be able to grab together and hoping to have a bonding experience. The race started out at Wal Mart where we stood in line hoping to grab a few big title DVD's for 2 bucks, No real issues here, That is UNTIL I see a woman over in the gaming section who had been pushed down, She is laying on the ground across a cardboard pile of Xbox games, the contents of her purse, meds, phone, etc scattered across the floor.. I could not believe what I was watching as people attempted to roll her over to get to the games underneath her and nobody stepped up to offer their assistance to this woman who was very obviously in need of someones helping hand.. I could barely  make my way over through the crowd of people throwing elbows and walking over anyone who didn't have the strength to push through the crowd. I didn't make it and luckily a few good people stepped up and helped the woman to her feet. I doubt that she got the items she was after. My only thought at this moment: "When did the need to save a few bucks on a game overcome our natural human ability to show compassion to someone in need".. I was literally blown away..  The next terrible experience came as my wife and I left electronics and headed over to TOYS to find an item that my daughter had fallen in love with and sat down in the isle to play with for 10 minutes a few days prior, It took us standing for 30 minutes before we were able to move at all towards the toys section because people with carts were blocking the isles and would not move their carts stating that they "Don't want to lose their place in line" This is where my wife stepped up, and I love it! "MOVE" she yelled, a variety of negative comments came her way about how shouting wasn't going to do any good, They didn't want to lose their place in line for items that wouldn't be going on sale for another 2 hours... An older woman in front of us in line had been asking very politely to have a few inches to squeeze through for several minutes and nobody gave her any attention, It wasn't until my wife shouted that people began to recognize another simple need.. It didn't take much to move the carts and let those of us who just wanted to get through room to squeeze by. I stepped in when people started yelling at my wife saying that "Shouting wasn't needed" by saying something along the lines of "Well, Asking politely wasn't working very well for any of us, Was it?"
 Wal Mart on Black Friday: I won't EVER be returning.. That is unless I return as an EMT on a Truck or Ambulance..

Next we went and joined my brother in line at Shopko, We had fun standing in the freezing weather for the next hour and a half waiting for the doors to open, It wasn't until about 10 minutes until the doors opened that I again saw a general lack of respect or decency by people attempting to save a buck or two.. The lines wrapped around the building in both directions. We were near the front, At 10 minutes to, families and people started gathering in the parking lot in front of the doors giving no respect to anyone who had been standing in the freezing cold waiting in line.. People were getting roudy and a chant was started by everyone in line. "Get In Line! Get In Line"... The people in line behind us grew more roudy and I saw several people come up and start calling people out: The doors opened and the rush came in, My pregnant sister stepped up, stood there and started calling people out directly.. I wanted to stay there and make sure that she was going to be OK but I was being pushed through the door: My wife stopped in front of me, planted her feet, and put both hands up on the standing theft detector systems she was standing between. In front of her 3 young girls had been pushed over and she was trying to protect them.. In the meantime and in an attempt to join my wife in slowing the crowd, my hand was smashed between the doors and is still swollen. Once inside the madness seemed much more organized than Wal Mart, Still I was disappointed at the reaction of people in general..
 We finished our shopping experience at Kohls with the family, standing in line and laughing at jokes we were telling and this was the best experience we had all night long- Perhaps due in part to the fact that door-busters were already inside.. We were at Kohls for what seemed like endless hours but made friends with the people in line around us, Overall: Kohls wasn't bad, Just terribly boring..

To top it all off: I was on-call through out the remainder of the day- Every ambulance in the valley was out simultaneously due to a huge demand for EMS services, I ran several calls related to Black Friday, and a few other general medicals.. I'll sign up to cover EMS for Black Friday any day, But count me out in the future when it comes to any shopping!

I want...

Right now, I want more than anything in the world to be able to provide a good life for my family.. I've got a decent job, but with this job, I don't get to see my wife too often.. I work graves, she works swings and I find myself sitting here at work everyday reading stories from my favorite blog. "Firefighter/Paramedic Stories" http://firefighterparamedicstories.blogspot.com/ Stories of an experienced firefighter paramedic working in the California bay area near where I went through paramedic school. I'd LOVE to meet the author of this blog and hear some stories face to face, This guy is living my dream, Every bit of it...

 Currently I love what I'm doing.. Moving to Utah gave me the opportunity to practice my skills with what I consider to be the best volunteer department in the state.. I love being a part of a great volunteer fire-department and having weekly contact with the local group of professional firefighters at both fire and emergency medical scenes. NLFD has provided me with opportunities to get hands on experience as well as to take additional classes like ADO (Apparatus Driver and Operator) Pumper and ADO Aerial allowing me to be certified in the pump and engineer operations of our Engine and Truck.. With all that though, I'm still in a bit of a stand-still and it's getting... OLD! I have completed all of the requirements needed for National certification as paramedic, The only thing standing in my way right now: The money and vacation time I need both to be able to take the NREMT Test.. I came home to Utah to finish my field internship with Utah's busiest paramedic rescue company after going through a year of classwork and Emergency Room clinicals in the bay area. The things I saw and experienced only added fuel to the fire and got me even more excited about the career I have chosen. I found out just a couple of days ago that I'll need to travel back to California and test where I took the course, This requires money and vacation time.. See where I'm going with that? There is not a doubt in my mind that I'm going to do what it takes to achieve my dreams of working with a busy fire-department as a firefighter paramedic, Busy being the key word (Eventually).. Nobody other than myself could stop me from making it happen...  

What I want more than anything and only second to my families happiness is to be a successful firefighter paramedic working for not just any, but a busy fire department, I want to clip in at the raised tip of a 75-105' aerial ladder and watch as water flows over a giant defensive fire operation, I want to be able to place someone who is in a dangerous position into a position of comfort and safety when they need it most, I want to be a part of helping out my community in a time when they need help the most, I want to reach the point where all I have to do: is do what good medics do without over thinking many of my EMS calls. What I want .... What I NEED.. is to be able to take and pass the National Registry of EMT-Paramedics exam, Get a job, (Anywhere) and start working with patients on a transporting EMS agency.

 While I look to the future to fulfill these things, Its the present that is keeping me grounded... My family is the most important thing to me in the world, I'll do anything to be able to provide for them and watch them smile. My favorite parts of the day include coming home from work in the early morning hours and snuggling up to my sleeping wife and when my daughter comes in to wake me up with a gentle kiss on the cheek saying "Daddy's Awake!"  The fact of that matter is: I'm completely imperfect, and I make mistakes all the time, I probably make more than my fair share of mistakes this day in age but I learn from them and I believe that is what makes me better, it makes me want to push myself that much harder to become better and the motivating factor of it all to me is my family... That is why I am doubtless that I'll succeed when I'm given the chance at working as a professional firefighter paramedic, and I can't wait for that opportunity to come around!

Would be burglers deturred:

The following is a true-story: This is a story that I have NOT shared with my mother yet because she frantically locks up her home every night just to avoid such situations: If you know her, I ask you to please NOT share this story- And.. Hopefully she doesn't read my blog:

I work a graveyard shift at a local Juvenile Justice center for troubled youth. This is a job that I am certainly excited about because it is above any pay grade that I've been able to get locally in a downed economy plus it comes with excellent benefits for my family: The downside is just that: Its a graveyard shift.. I get to sleep with my wife 2 sometimes 3 nights a week and at this point we've both grown somewhat accustomed to sleeping alone and hogging the bed. At any rate, as a result of working the graveyard shift, I sleep throughout the day and I often get much less sleep than desired: Sleep that I happily sacrifice to see my daughters smile, I also still carry a personal fire-department issued pager with me throughout the day and I respond accordingly to emergencies during the daytime. I am "On-call" to respond to fire and medical emergencies several days a week, Something that I LOVE doing and would sacrifice sleep for any time - any day...
 I live in an apartment complex directly across the street from my fire department and as a result I often make it there quickly, however this complex has its downsides: One being that kids run around and play in the park next door, We have single-paned windows and our room is right next to the parking lot and local storage sheds.. (Don't get me wrong, I love living there and most days I can sleep through the noise) However on one particular day this last week, I was absolutely exhausted and I chose to leave my pager at home and go to sleep in my parents dark basement where no light or street noise for that matter can get in for a few hours of sleep before I had to return to work..
There I was; Sleeping like a baby in the spare basement bedroom: I hadn't let anyone know where I was because I didn't wish to be disturbed... I was woken up to a doorbell ringing, which I ignored twice until it rang a third time. Reluctantly, I threw the covers off the bed and went to the front door of my parents house thinking that something must be important, "Maybe Amy needs in" I thought to myself, I opened the door and stood behind it for a second, expecting Amy to just walk in, It was then that I noticed a gray bag of tools sitting on the doorstep and a skinny unshaven man standing on my parents doorstep, It appeared as though he and I were both perplexed at the situation, I observed him reach down and sluggishly attempt to cover his bag of tools and then I managed to mumble through my bagged eyes and half awake mentality the words "Can I help you?" Still perplexed the man looked at me and introduced himself as "Stan." Stan was soliciting services for a local lawn chemical company, He quickly handed me a card with his name and company info, gave a brief although not very thorough statement of his services and then he turned around to leave without offering anything to sign up for; having worked sales before I began to grow suspicious,  Nobody comes door to door selling subscriptions to a service and leaves before even asking me if I'm interested in that service... I watched him grab his bag and walk back to a truck parked on the corner across the street- He didn't knock on any more doors, and he jumped into the passenger side of a trashy white truck with what I assumed for a brief moment was another salesman.. I didn't really think much about it until I tried to lay back down to sleep.. I got to thinking about his tool-bag, I used to work maintenance and I like to think that I'm familiar with tools- I haven't seen these types of tools before and I began to recall the entire situation... "What does a lawncare service salesman need with a bag of tools?" "Why didn't he try to actually SELL me anything?" "Where was his company shirt" I asked myself these types of questions for a few more minutes. It all seemed quite fishy to me now. I began to recall a situation a few years ago when my parents had a vehicle parked out front of their home and somehow over the course of an evening, thieves had managed to steal all 4 tires and rims off of that vehicle and had the car propped up on rocks! I decided I'd figure it all out in the morning...
 I looked over the sales card that he gave me and decided to call the number the next morning. "______ Lawncare" a woman answered.. "Hi, I received a card yesterday from a salesman for your company, I just had a few questions regarding your service"... (Long pause).. "Yesterday" came the reply" "Yes, Yesterday, A gentleman named Stan came to my parents door selling lawncare services and I just had a couple of questions about the services".. (2nd LONG Pause) We don't have any salesmen in the field anymore, and Stan no longer works for the company, Are you sure it was _____ Lawncare" "Yes, This is the card I recieved, It was pulled out of a stack of cards for your company" Again came the reply "Well we no longer have any salesmen out in the field but I'd be happy to answer any questions you may have".. "Strange, but I got the info I was looking for, thanks for your help" and with that our conversation came to an end... I have since come to the realization that somebody was about to attempt robbing my parents home, and I would assume judging by the size of that stack of cards handed out that their home wasn't his only attempt." I have no way of knowing for sure... Perhaps Stan was out there and bitter towards his ex company... Who knows... Luckily I have yet to hear any stories of anyone in the immediate neighborhood getting robbed, and perhaps my conclusion is off: But.. My advice: Lock your windows and doors when you're not at home because I live in a small community where crime is few and far-between and I think that the lawncare was just a cover...

The Pipe

Its been a while since I've taken the time to sit and blog about anything- Its not that life hasn't been treating me particualrly well, Mostly its that I've been preoccupied with other things that I've felt were more important and writing has taken a distant second to anything else:
 I finally received a letter allowing me to test for National Paramedic Licensure and I couldn't be more stoked about the opportunity, However, I couldn't be more nervous either.. I'm sitting here at work, Its nearly 2 AM and I've got 6 more hours in my shift, I just started a new job that I plan on keeping until the opportunity to become a professional Firefighter Paramedic comes along for me. Currently I'm working for the State with troubled youth, and the bonus to working the Graveyard shift is that I have PLENTY of time to study and prepare for the NREMT skills and written exam...
 I've also had the opportunity to be a part of a paid-call fire department where I have kept up my skills and hopefully learned a thing or two about life and emergency scene management. So: What's new? Why did I decide to sit down and write an entry that doesn't have much of a point into a blog that virtually nobody reads... Honestly, Its because I got an email asking me to post a few guest articles from a Paramedic recruitment site online based out of the UK and it reminded me that I've even got a blog. Now; I'm not much of a writer but I figure its time I get my thoughts back down on paper...

Here goes nothin...(You really haven't missed out on much) Sitting and reflectin on what to write is a bit beyond me, Its been 10 MONTHS since I last posted and for the most part those months have been great, Brooklynn (my daughter) turned 2 and we celebrated her birthday, She wakes me up with a kiss on the cheek every morning and its my favorite part of the day.. My two best friends moved on to bigger and better things, Both of them now carry the name of "DR" with them everywhere they go and landed jobs that are seemingly perfect, My congrats go out to them! I hope to join you guys sometime soon, Not that I'll ever bear the name of "Dr" but simply that I hope to be living my dreams and working as a full time Paramedic, Firefighter.. The new job is great, and I've got to get back to studying for that NREMT exam, I might as well use the time I've got... I'll attempt to write more quality posts and share stories soon.

I Wish You Could See: The Life of a Firefighter / Paramedic

I have often searched my soul to find the words to express to my family and friends how I feel about what I've dedicated my life to: As a Firefighter, Paramedic the things I experience and see in life shape who I am and how I react in certain life situations. I don't know who the writer of this poem is, But I give them my respect for finding a way to begin describing what makes us who we are and why we love what we do:

I WISH YOU COULD

I wish you could see the sadness of a businessman as his livelihood goes up in flames or that family returning home only to find their house and belongings damaged or lost for good.

I wish you could know what it is like to search a burning bedroom for trapped children, flames rolling above your head, your palms and knees burning as you crawl, the floor sagging under your weight as the kitchen below you burns.

I wish you could comprehend a wife's horror at 3 a.m. as I check her husband of 40 years for a pulse and find none. I start CPR anyway, hoping to bring him back, knowing intuitively it is to late. But wanting his wife and family to know everything possible was done to try to save his life. I wish you knew the unique smell of burning insulation, the taste of soot-filled mucus, the feeling of intense heat through your turnout gear, the sound of flames crackling, the eeriness of being able to see absolutely nothing in dense smoke -- sensations that I've come too familiar with.

I wish you could read my mind as I respond to a building fire, is this a false alarm or a working fire? How is the building constructed? What hazards await me? Is anyone trapped? Or to an EMS call, "What is wrong with the patient? Is it minor or life-threatening? Is the caller really in distress or is he waiting for us with a 2x4 or a gun?"

I wish you could be in the emergency room as a doctor pronounces dead the beautiful 5 year old girl that I have been trying to save during the past 25 minutes. Who will never go on her first date or say the words, "I love you mommy" again.

I wish you could know the frustration I feel in the cab of the engine or my personal vehicle, the driver with his foot pressing down hard on the pedal, my arm tugging again and again at the air horn chain, you failing to yield the right-of-way at an intersection or in traffic. When you need us, however, your first comment upon our arrival will be, "It took you forever to get here!"

I wish you could know my thoughts as I help extricate a girl of teenage years from the remains of her automobile. "What if this was my sister, my girlfriend or a friend? What is her parents' reaction going to be when they opened the door to find a police officer with hat in hand?"

I wish you could know how it feels to walk in the back door and greet my parents and family, not having the heart to tell them that I nearly did not come back from the last call.

I wish you could feel the hurt as people verbally, and sometimes physically, abuse us or belittle what I do, or as they express their attitudes of "It will never happen to me."

I wish you could realize the physical, emotional, and mental drain or missed meals, lost sleep and foregone social activities, in addition to all the tragedy my eyes have seen.

I wish you could know the brotherhood and self satisfaction of helping save a life or preserving some one's property, or being able to be there in time of crisis, or creating order from total chaos.

I wish you could understand what it feels like to have a little boy tugging at your arm and asking, "Is mommy OK?" Not even being able to look in his eyes without tears from your own and not knowing what to say. Or to have to hold back a long time friend who watches his buddy having rescue breathing done on him as they take him away in the ambulance. You know all along he did not have his seat belt on. A sensation that I have become all too familiar with.

Unless you have lived with this kind of life, you will never truly understand or appreciate who I am, we are, or what our job really means to us....
I wish you could.

--Author Unknown