The last blog post - Week 3 reflection

When I look back on senior project, the first thing I think of is the list I made on my computer of all the calls I went on. My end count was a little over 40, between Andover, Franklin, Sanbornton, and Penacook. I'm proud of this number. Now when I listen to my pager on open and hear Franklin's tones I pay attention for a second and think about the type of call until I remember that I'm not riding with them on senior project anymore. I listen to their ambulance respond and wish I was there.  It's kind of upsetting and when that happened to me this weekend it really struck me, finally, that senior project was over and I was graduating. The week perfectly culminated everything I have learned over senior project. The last shift at Franklin was insane. Everything I had known about doing maintenance work around the station was thrown away because we were running calls back to back, a total of 12 in the shift. In a span of 24 hours I reasoned with unstable women, ran vitals on a postictal patient, backboarded a drunk driver, ran two calls back to back, and was trusted enough by my sponsor to talk on the radio with Lakes Region. My second goal was to gain exposure to Advanced Life Support pre hospital care. As much as I hoped this would happen, uncertainty is the name of the game in the fire service. I was lucky enough to work with an aggressive and talented paramedic who I saw push narcotics multiple times. In addition to that I developed a ton of confidence in taking vitals on my own and applying 4 lead EKGs, basic skills I was unsure of earlier. I left my comfort zone and went to a different, professional, department which required me to be in uniform and follow orders. In the end I left with complete understanding of their equipment and procedures, and most valuable, trust from the firefighters and captain on my shift. I've never worked with a better group of guys and I feel so fortunate to have been let into their tight  bond. I witnessed first hand how successful teamwork can be, and above everything, that is the biggest "take away" I have from my senior project. I want to extend thanks to Phil, Jason, Jon, Captain Goldthwaite, Greg, Joni, Captain Hicks, Deputy LaChapelle, Chief Smith, Deputy Taylor. Deputy Brechtel, Supervisor Gibbons, Officer Callahan, Wanda Bowers, Lieutenant Parker, Paul Steele, Bruce, Karen, Jim, Sue, Mike, and the Andover Fire + Rescue crew who have supported me since day 1.

No sleep, 12 calls on my last shift at Franklin Fire Dept

I knew I had to end my senior project with a bang. Like every day I come into Franklin I have no idea what the day will bring. Friday was warm and sunny making for a busy day in the city of Franklin. The first call came in for a lift assist, so we went across town to help a man with legs amputated at the knees into his wheelchair. He denied transport to the hospital. After that we conducted a fire drill at Franklin High School. Back at the station we installed the air conditioners and closed all the windows, slowly turning the living quarters into a refrigerator. I felt bad for my roommates sweating on the third floor of Carr House. Around lunch we had a call for wires down by the hospital which the chief handled until the power company responded. Shortly after that we got a call for a fire alarm activation at a credit union in a strip mall across town. I got to ride in the front seat of Engine 4. As soon as we pulled out of the station we had a red light and heavy traffic on central street. We laid on the air horn and Q siren and it was a thrill riding in the front. The fire alarm activation was because of a malfunctioning air conditioning system. It was sweltering being in turnout full turnout gear but it is standard for firefighters to wear full gear to fire calls even in intense heat. Back at the station we cooled off in the air conditioning, hydrated, and ate lunch. Captain Goldthwaite was at the captains desk working on alot of paperwork so this left the rest of us to take it easy around the station. We got a call for a paramedic intercept to highlands mountain bike park in Tilton. EMTs in Titlton wanted Captain Goldthwaite to give pain medications to a biker with a broken arm. Back at the station we finished installing the AC units and Jason and I went out on a service call to an apartment where a woman was complaining there was no oxygen and her heat was on. The woman had a psychological problem and even though we used a gas meter show her that the air in her apartment was 20.8 % oxygen she wanted to go to the hospital. It was a bummer to have to take our ambulance out of service to transport a woman who didnt need to go to the hospital. As we brought her out to ambulance 2 we got pre alerted to another call. The hospital was up the street and we headed that way quickly. I did a BP fast and gave it to Jason. He radioded the hospital as usual but basically said we were handing the patient off quickly because we had another call. Then we got toned to a car accident on central street. From the hospital we headed to the scene and met other call members there who had taken the extra ambulance and rescue. Jason, Jon, and I backboarded the driver of a pick up truck. We got back from that call and ate american chop suey for dinner cooked by Jon. It hit the spot after a long day. We did chores after dinner and I was relaxing in a recliner when we got pre alerted for a man having seizures at a restraunt in town. On arrival I got the monitor as usual and we were introduced to a man sitting at the front step with his wife. I noticed the wet sidewalk and thought it was vomit from the man seizing, which was right. He was fairly young with a clean health history so we did a 12 lead EKG to see his heart rhythm. In the end it seemed to maybe be food poisoning. Back at the station I couldn't find anything good on TV and Jon and I went outside to set up the ladder truck. I decided bed sounded good and fell asleep within minutes in the frigid bunk room. That didn't last long. The night was a long blur of calls. In order from 11 PM to 7 AM we had a fire alarm activation, three med calls, and a car accident. Throughout the night I was so delirious getting dressed for calls I couldn't remember what the previous call had been. Jason kept asking me, "have you had enough yet?" I had to say no because I was really loving how busy we were. It can be annoying at first but once we start investigating the patient's chief complaint, I get into it and I like working the monitor, taking BPs on my own, or doing paperwork. At the hospital I try to do just as good of a job dressing the cot and deconing equipment at 4 in the morning as I would in the middle of the day. I think my attitude reflected well on the shift. After that night my internal clock is pretty messed up. It feels like a Sunday afternoon. The busy shift was an awesome way to cap off senior project. Thanks to everyone for reading and especially to my sponsor, his shift, and Franklin Fire Dept for making it all happen.

Last Day - Franklin Fire B Shift

I'm exhausted and if this pattern continues, I will have more to write about tomorrow. So far we've had 7 calls and its been a long day. I'm going to postpone my last shift's blog until tomorrow morning. Make sure to check back.

Power Napping at Penacook Rescue

Today I woke up at 0545 and took a long cold shower to cool down. I wasn't looking forward to spending the day in duty boots and EMS pants in the heat. I got to Penacook Rescue and had no idea what to expect because the day crew were people I would be meeting for the first time. Mike and Patrick, both paramedics, were working the day shift. They both had gotten off from shifts at different departments, Mike at Laconia, Patrick at Portsmouth so they were tired. Mike was a nice guy though and he knew Brad from Proctor. I went down into the ambulance bays periodically throughout the morning to look around Ambulance 1. I wanted to practice loading and unloaded the cot but the station is too small. Instead I went through the compartments on the monitor case and the first in bag. After lunch I was watching TV and Mike and Patrick were asleep when we got toned to a migraine and jaw pain charlie level. On the drive over I wondered what jaw pain coupled with a migraine could be a sign of. On arrival we had an alert and oriented male who could walk to the ambulance. I helped Mike set up the monitor and we did a 12 lead EKG as to get a better idea of what the patients heart rythm was like. I was interested in learning about the rythms and what to look at but Mike was busy during the transport giving narcotics and I was busy filling out the run sheet so I didn't get the chance to ask. The narc that the patient was getting caused the patients blood pressure to drop with each dosage. I was repeating the mechanical BPs and it was fascinating to see the trend coorelate with the doses. Mike taught me a simple way to raise a BP, just by reducing the angle of the semi fowlers position. Again I watched the trend and the BP rose after that. We got to the hospital and I dressed the cot. I've been to the hospital so much lately between Andover and Franklin. I'm proud of how easily I can navigate the ER and get linens, faxes, and help with resupply. The rest of the shift we watched movies in the station and I listened to a bunch of good calls in the Capital Area, like water rescues in the Merrimack river and people pinned by Bobcat loaders. I left Penacook Rescue at 1800 and headed to my sponsors house in Franklin, grabbing dinner on the way, to get his signature for my weekly time sheet. I hung out there for a little while talking with Jason and his family and playing with their new dog Goofy in the backyard. Tomorrow is my last day at Franklin Fire with B shift and the last day of my senior project. I'm really hoping we get some good calls during my last 24.

Warm weather brings a busy day for Andover Fire + Rescue

Today started with Greg coming into the bunk room at Franklin and turning on the lights. I sat up in bed and looked out the window and saw sun and blue skies for the first time in a while. I had a cup of coffee around the table during shift change then headed to Proctor to get breakfast. I spent the morning finishing my hall table in the woodshop. After that it was lunch time, then I went swimming in the Blackwater river with a bunch of people. I went back to the room to change and my pager triple toned (tones for east andover, andover, & andover rescue) followed by the fire noise. Fire in a building on racoon hill road. I bolted down the stairs, hopped in my truck and headed to the station. Zach met me there followed by Jake and we rolled Engine 3 and Engine 4 before the first re tone (6 minute mark). For a volunteer department during the day this is fast. Upon arrival we found a 2 1/2 story wood frame with two occupants outside, a clear driveway, but the nearest water source (a dry hydrant) far away on a cross road. (COAL acronym from my previous post). Fortunately the small oven fire had been extinguished and I started to evaluate a patient with burns to her hand with Heather, Jenn, and Mac. She denied hospital transport. Later that day after dinner my pager went off again for headaches charlie level. I got to the scene a little late as it was across town, but I got there and Officer Shaw from Andover PD was there and gave me an update. Heather, John, Andrew, Jeff, and Zach were there and the ambulance was parked in the driveway. The patient had an unknown sickness complicated with nausea, vomiting, and general discomfort. We were only an EMT Basic level crew (unlike Franklin who is usually at the paramedic level) so we did every assessment possible but were concerned when the patients orientation decreased a little bit. Luckily by then we were pulling into the hospital and we transferred the patient to them. The hospital was busy as it was, and another fire department was on the way with a working code (cardiac arrest). I quickly dressed the cot so I could watch them transfer the patient. I scanned the door open for them and saw the patient and paramedics giving care as they rolled by to the trauma room. Tomorrow I'm on at Penacook Rescue for the day. Back to their different ambulance and equipment but I'm ready.

COAL WAS WEALTH - Franklin B Shift

Today I came into Franklin psyched for the shift. I'm loving this routine. I pulled into the parking lot and was bringing in my gear, when I punched in the code for the back door I was surprised to see that no one was at the table drinking coffee before the shift change. I found out that Captain Goldthwaite was out with an injury and wouldn't be in today, and Jason would be late.  Jon and I started truck checks as normal. Captain Goodearl would be covering Captain Goldthwaite until Jason came in. Jon and I checked E 4 and the rescue. We took the rescue's laptop out of its mount in the cab and brought it to the table where we all played with different programs on it for mapping, HAZMAT, and other things. Then someone called the station reporting an injury from a fall at the Franklin Falls Dam. The dam is huge and because of construction on the high walls there we rolled the Rescue with the ambulance. Deputy Chief LaChapelle left his office to respond with us. I hopped in the rescue with him. We got to the dam and found a simple rolled ankle. Jason had me splint the leg and take vitals, as usual. The injury reminded me of injuries on ski patrol at Blackwater. We got back from that med call and went to the station to finish the rescue's truck check. It has a huge light mast that I got to run with the remote control. Jason also showed me the struts and confined space rescue equipment. I ran out to get some lunch and was finishing eating when we got a med call. This med call didn't involve a critically ill patient and we just provided transport. The call reaffirmed my biggest weakness in EMS is cigarette smoke. This house was drenched in it and it made me feel nauseous. After that we saddled up in Ambulance 2 again and headed to the dam (same one) for a tour of the construction work being done on the high walls by the foreman and Deputy. As were pulling in to the parking lot we got another call for seizure like activity at a nearby address. This was not an ordinary call. One of the most reliable signs of a stroke is facial droop with partial paralysis and we found this immediately upon arrival. From there, it was obvious that this patient needed immediate transport. While the Deputy, Jon, and Jason, were each devoted to different Advanced Life Support care I went outside to the ambulance and brought the cot in. I tried to be as helpful as possible doing extra things because this was an "all hands on deck" situation. As the initial assessment is completed, everyone knows what their job is and like a good hockey play, there's "chemistry" and its very efficient. Loading from the house to the ambulance, and ambulance to the ER, I had to walk alongside the cot to support the patients side that had paralysis. Later I did a documentation narrative (imitating the ones legally required) on the call and had Jason proof it, he said it was pretty good. We went back to the dam after that call, took a tour of the construction, then went downtown to do size up training. I asked Jason and Jon for this in the morning. A size up is your initial impression of the building(s) which is what you base your operations off of. Franklin's downtown neighborhood has a ton of good examples. This was when I learned the long pneumonic, COAL WAS WEALTH. It's pretty long so I won't write the whole thing but COAL stands for Construction, Occupancy, Apparatus, and Life Hazard. Jon and Jason ran through each one for different buildings and I came away with a much better understanding of scene size up. We finished that then headed to Hannafords to get dinner, until we got a med call. It was a lift assist and then we went to Hannafords. After that we went back to the station and Jason cooked pizza on the grill for dinner which was amazing. In the process he was showing off his dough throwing skills and dropped it on the floor, so we had to throw it out. Soon we will do chores and then relax a little before heading to bed. The air conditioning has been cranked in the bunk room all day so it should be a good nights sleep until we get a call.

C Shift Sunday @ Franklin Fire Department

I waited until today to write this (one day late) because other than nap today and train on the forestry truck, I didn't do much today. I got to Franklin Fire Sunday morning then turned around and made a run to Hannafords to get some food for breakfast. On weekends and holidays the shift cooks a big breakfast and everyone chips in to get a ton of food. Call company Lieutenant Junior Davis came and made some breakfast potatoes with alot of garlic. I mentioned to Captain Hicks the garlic gave me a stomach ache. He insisted garlic was very good for you (I didn't protest) and said he would eat a whole spoonful. I laughed and he went to the fridge and ate a whole spoonful. This inspired Greg to eat some whipped cream. We got the dishes done and finished truck checks. Then Greg and I went out in the utility (pick up truck) to test fire alarm boxes in circuit one. Each box is numbered and I called Joni at the station on a portable radio to tell her the number. She would then verify that the box had rung in at the station, I would reset the box then we would go to the next one. While Greg and I were out testing he told me a bunch of funny stories of going to Proctor and being on Andover Rescue. So it was a good time. Then Joni called us on the radio saying they had gotten a phone call to the station reporting a dumpster fire in an apartment complex. I reset the box and Greg and I hopped into our gear we had brought with us in the bed of  the pick up. The tone came and we headed across town to the call. Smoke was visible as we descended from the veterans project area to the center of the city then to the apartment complex. We caught up with the engine 4 and engine 3 and pulled into the complex where a dumpster was involved with fire. On the way over we discussed over the radio, if there could be an exposure (life or property threatened because of close proximity to fire) and how we would handle that. Luckily there wasn't and we used the trash line (line folded in the front bumper) to extinguish it. We cleaned up then finished testing boxes. Joni made American Chop Suey for dinner and we watched Captain Hick's favorite show - Band of Brothers. After dinner it was chore time as usual. I vacuumed then started to mop. I'm not a beginner mopper, in fact I would say from my various work experience I am a intermediate. However I learned I have been doing it the wrong way! Captain Hicks was nice enough to correct me and thus came the climax of my senior project. (Just Kidding!) After chores we got back in the recliners and put on Band of Brothers. Jason, Karen, and Alexa stopped by. Then we got a call for a signal 21 (suicide). These are more common and less traumatic than you would think. It was more of a pyschiatric problem and we transported the patient to the hospital. I was dressing the cot outside of the nurses station and Franklin's tones came over the scanner. I quickly finished and loaded the cot. We met the police for a medical alarm activation. A very old woman thought her garage was invaded. She didn't need medical attention but we had to wait for a family member to come. I got back to the station and collapsed into bed. Three hours later we got toned for a victim of an assualt meet the police. It was at another apartment complex. I was in such a deep sleep that I woke up for second repetition of the address and was close to missing the ambulance. It was frustrating because when we got there we immedieately got released by the police. A couple hours of sleep later and we got a tone for difficulty breathing echo level, I woke up for the whole tone this time. It was a good thing because we are out the door very quickly for echo level calls. This wasn't quite an echo level call but the patient needed transport and I filled out the run sheet while Captain Hick's did patient care, assisting with the EKG too. He showed how the sinus rhythm coorelated to the patients condition. We got back and it was 6, only an hour until shift change so I we sat in the recliners and had coffee and watched the news until we were relieved by D shift. It was a long shift, hence the reason why I took a long nap during the rain today. Back on with B shift tomorrow. Go to www.proctoracademy.org and watch the video on the homepage, Sam Johnson filmed it and I am in it!