New Station

I first heard rumors of a new station back in 2005.  Originally built as a firehouse back in World War II, the station I work out of started life as a single purpose fire house.  It became an EMS house around the time I was born, and it was pretty decrepit back then.  In early 2005, the brass finally decided our home was no longer suitable for occupation.

After endless debate by the Board of Aldermen, Environmental Impact Reports, a drawn out RFP/bidding process, union foot dragging, construction delays, supplier shortfalls, bad weather and a number of zombie attacks, our new station is projected to open on Wednesday.

I'm on my days off, and come back in on Thursday morning.  I'm so thankful to miss all the hoopla, pomp and circumstance that'll come along with opening day.

The new station looks something like this:

You'll have to excuse the architectural liberty here; apparently the architect thought he was building a station in Pleasantville or something. 

The neighborhood gentrification projects have made the area nice, but it's not as nice as this rendering would have you believe.  Regardless, though, I'm not gonna lie -- it looks pretty nice.  We'll run two squads and have an EMS captain in the house.  It'll be interesting having the boss around all day, but (at least on my tour) he's a good guy.

Hospitals

My last post about Homeboy Ambulance reminded me that I still haven't talked about the major hospitals in Fairview.

There are more hospitals in the downtown area than I've got listed on the map, and there are quite a few in the outlying areas that may come up later.  For now, though, I'll talk about the Big Four:  FMH, SMH, UMC and RVH.

Fairview Memorial Hospital, map page A-3
FMH is in the heart of Metro Center.  During the day Metro Center is pretty well filled with high powered corporate firms, but at night you get a crazy mix of street dwellers and tourists.  Accordingly, in FMH's waiting room it's not uncommon to see bums and executives argue about triage priority.  It's a zoo on an average day, but on the weekends?  Fuhgeddaboudit.  Picture the ER in, well, ER.  While it hasn't been a trauma center since the 80s, they constantly act like they should handle any trauma west of the river.  Their cath lab is down a lot, and once Heartland Medical Center opens up I think all the cardiac patients in the area will go there.

Saint Mary's Hospital, map page E-3
Originally started by an order of nuns as a Women and Children's Hospital, Saint Mary's has grown considerably and treats just about everything except major trauma.  While it's a great pediatric facility, the really sick kids typically go to U-Med.  Despite its... um... historic looking exterior, the facility is well equipped and employs some of the best practitioners I've ever dealt with.

University Medical Center, map page D-3
At the cutting edge of technology and a damn good teaching hospital, U-Med (or UMC) is where I'd want to go if I end up in a bad way.  They do it all here.  They're a bitchin' trauma center and offer some of the best burn treatment in the country.  It's also Fairview's de facto Children's Hospital.

Riverview Hospital, map page C-1
Great for everything except cardiac and neuro issues.  There's been talk about them trying to get some specialized neuro services going, but so far it's just been talk.  They're well known for their oncology services, and most of our cancer patients end up going to Riverview.

Note: Heartland Medical Center is supposed to open in mid-2011.  It will primarily cater to cardiac patients, though it will offer basic emergency services.

Homeboy Ambulance

Another beautiful fall day in Fairview:  I've just finished up a run, the gurney is back together, the run report is done, and I'm just waiting for an ambulance that'd blocked mine in to move out of the way.

While I stand there playing with my phone, a Homeboy Ambulance rig flies into the ambulance bay at Fairview Memorial Hospital.

Homeboy Ambulance, you may wonder.  What on Earth is that?

Here's the definition according to Urban Dictionary:

Homeboy Ambulance

noun; 

1.  A car which is used to drop off victims at a hospital or police station. The vehicle usually drives into the ambulance bay, or to the front of the hospital, where the patient is pushed out, and the homeboy ambulance leaves quickly, without making any contact with hospital staff. Most patients dropped off by these homeboy ambulances are gang members or hookers. Usually seen in urban areas and county hospitals.

This is a fairly typical example of a higher end unit:

So, anyway, the driver gets out and yells, "You've gotta help me, man!  My buddy's been shot!"

I look around, and there's nobody else in the ambulance bay to help.  Wonderful. 

I walk to the passenger side of the 'ambulance', in this case a purple metallic-flake El Camino, and observe a conscious, alert and very lethargic 25 year old Latino male sprawled across the bench seat.  He says his name is Junior, and he says he's really scared.  He states that he was minding his own business in an area notorious for drug and gang activity when a 'whip' pulled up, 'a bunch' of guys got out and 'someone' shot him.

As I extricate him into a wheelchair, I take a quick look at the entry wound in his stomach: small caliber, minimal exterior blood loss, no stippling.  I check his back, but there's no apparent exit wound.  Not much for me to do here except wheel him inside.

FMH isn't a trauma center, so I figure they'll be excited to have a shooting victim.

Boy, was I right.  And then some.

They freaked out.  Now, sure this kid is in rough shape, but panic seldom does anybody any good.  They cleared out the closest bed -- in the cardiac room -- and all the nurses went off to find a doctor.  Or maybe they all took a smoke break.

Either way, they were gone for two or three minutes, and I was alone with the patient.  I got him into the bed and got his shirt off without cutting it off, which I suppose is really helpful from an evidence preservation perspective.  We can't get away with that out in the field too much, but here there was no reason to destroy the evidence.

I again asked him about the circumstances of the shooting, and he was again very evasive.  He knew the assailants were male, and that was it.  No sex, age, height, weight or even ethnicity.  This kid clearly had some idea who they were, but he wanted to keep it to himself so his crew could score some revenge.  Amazing.

The ER staff suddenly reappears with a doctor in tow, so I tell the guy good luck and get out of the way.  He seemed to have a change of heart, though, and gave me a decent description of the shooter.  He lost consciousness shortly thereafter, and they scrambled to get him into emergency surgery.

FPD showed up, and I gave a statement to the officer.  Given the kid's shaky hold on life at that point, I went into the interview with the assumption that the guy's gonna die sooner rather than later.  If he ended up giving me his dying declaration, I'm glad he gave up who was behind the shooting.  If he ends up making it, hopefully he gives up bangin' and makes some positive changes.

Life's short enough as it is, y'know?

Back Up Units

I will never, ever be able to look at a back up rig the same way ever again.  I'm lucky enough to work out of the same squad most of the time, and when it goes in for service we usually get it back a few hours later.  Sometimes another ambulance covers our district, sometimes they just have us at the shop ready to respond in an extra car if everyone in the city suddenly calls 911.

When something more than routine maintenance comes up, we always get a back up bus.  It looks great and runs okay, but it's gettin' a little ragged around the edges.  It's definitely not my favorite squad to run in.  It kinda smells like a cross between grandma's house and a locker room.

Check out these ambulances, though:

 

I guess I could do way worse back up wise than a 6 year old car with 150,000 miles on it.  I know folks at other departments and agencies that are in 10 year old rigs that have more than 300,000 miles on them, but even they are riding in luxury compared to this.

I guess the moral is be thankful for what you have...

Downtown Fairview

I realized that it's a little hard to visualize Fairview when I'm writing about it, so I've put together a basic map of the city.  I'll try and refer back to the map grid when the location of something I mention is relevant.  The only difference between the two maps is that the first one has map grids for quick reference, while the second one doesn't.  Unfortunately some of the streets hide behind the grids...

Questions and comments are welcome!

New Year's Day

As promised, here's the second story of off-duty shenanigans.

It's New Year's Day, and I'm with 3 friends a million miles from Fairview.  We're a motley bunch, for sure.  My best friend is an Intelligence Specialist for the Army, and he's riding shotgun.  In the backseat, his ex-girlfriend (but now close friend) -- a Math Major -- and her best friend -- a 2nd year nursing student -- are excitedly talking about the wedding we're on our way to.  The girls both know the bride and groom, but me and my buddy... well, not so much.

So we approach a 3 way intersection very similar to the one below.  Assume that north is at the top of the picture. 

© 2010 www.portlandmaps.com

We're heading eastbound in the fast lane, and my light goes yellow.  I slow down and come to a stop.  I'm the only traffic heading east bound, and the traffic at the dead-end gets the green light.  A motorcycle that had been stopped at the light proceeds through the intersection, turning left in front of my vehicle.

As the motorcycle enters the westbound lane, the rider gooses the throttle.  It being New Years Day at 8 in the morning -- and a cold morning -- the predictable happens.

The rider gets tossed.

The women instantly freak out and tell me I've got to go help.  Now, the rider is in full racing gear, including an armored jacket.  He high-sided at 15 miles per hour.  As soon as he hit the ground he popped up and ran for the shoulder so nobody ran him over.  How can I possibly help?

So I pull the car out of the traffic lane and park in the (relative) safety of the buffer zone between the east and westbound lanes, just west of the intersection.  I get out of the car as another rider stops his bike.  We pick up the wrecked bike and wheel it to the shoulder of the westbound lanes and drop the kickstand.  There's minor damage to the bike -- mostly broken plastic -- and the wrecked rider (WR) seems to be okay.  He denies any injury, and he doesn't want to report the wreck.  I'm totally fine with this, and asks if he can borrow my phone to call a buddy with a truck to come pick up the bike.

While the Good Samaritan rider and I continue to talk to the WR, a huge Suburban screeches to a stop near the wrecked bike.

As the Hallelujah Chorus pours from the heavens, God's gift to EMS exits the vehicle and strides confidently toward us.

Wait.  Let's fix that...

As the Hallelujah Chorus pours from the heavens, God's Gift to EMS exits the vehicle and strides confidently toward us.  Okay, one more try.

The huge Suburban pumps exhaust in our face, and my worst nightmare jumps down from the truck.

"I'm first aid and CPR certified," he bellows, "and I'm assuming control of this scene!"

Really?!?  Did this goober really just say that?  Whatever.

"Thanks for stopping, sir" I reply, "but we've got this under control."

Ricky Rescue?  More like Risky Rescue... but how about this: God's Gift (GG) pulls a cell phone from his hip holster (lame) and calls 911 to report the wreck.  When SHP answers the 911 call, the first words out of GG's mouth are, "We're gonna need some help here!"  I die a little inside, and once again try to get him to leave.  After giving the location of the wreck, he hangs up.

He immediately grabs the wrecked rider's head.  Oh, so now he's gonna hold C-Spine?  Nope, he's gonna try to tug the still-strapped helmet off the rider!

WR yells, the Samaritan yells, I yell: "Hey!"  GG is not to be deterred.  I grab him and say, "Sir!  I need you to step back!  You're gonna kill somebody with a stunt that!"  He slunk away in shame, never to be seen again.  Or so I thought.

With GG out of the picture, the WR asks the Samaritan and I to help him remove his helmet.  Since I witnessed the wreck and was familiar with lack of mechanism, it wasn't too hard to remove the helmet.  For liability's sake, though, I went through the Ambulatory Post-Crash Spinal Clearance Protocol.  Everything checked out, and we pulled the helmet off. 

We stand around for a minute, and, with nothing better to do, we start talking bikes.  WR says that his big, a brand new R-1, has just over 600 miles on it.  He feels like a total chump, even though it could've happened to anyone.  He's an experienced rider, and his ego is pretty bruised.

I look at the Samaritan rider, and realize he looks familiar.  Being nearly 250 miles from Fairview, I take a wild shot in the dark.

"Hey, do you ride at Fairview Raceway?"

"Yeah..."

"Did you go down in turn three a few months ago?"

"Yeah!  How did you know that?  Are you a corner worker or something?"

"No, man, I was the one that took you back to your pit in the ambulance!"

Recognition fills his eyes and we laugh about the coincidental circumstances.  I didn't even transport the guy to the hospital, and was only with him for a few minutes, but happened to both come across him AND recognize him, 250 miles and 3 months later.  Crazy

We're now a few minutes into this ordeal, and the adrenaline starts to drain from WR's system.  He says that his left arm is starting to hurt, and he asks for help pulling his jacket off.  I ask him if there's a position of comfort (POC), and if so to try and maintain it while we pull the coat off.  He lets his arm dangles much lower than the right when he finds his POC.  Wait a tic...

The Samaritan helps WR pull his right arm out of the jacket, and the movement jars a big fat drop of blood out of the left sleeve.

"Hey, buddy," I casually ask, "where're you bleedin' from?"

"I'm bleeding?"

"Yep, some blood just dripped out of your sleeve."

"Well my arm is really starting to hurt."

I tell WR that we'll slowly and carefully work the jacket off, but he tells the Samaritan to quickly pull it off.  As the jacket comes off, I see where the blood is coming from.  Apparently WR hit the bad luck lottery.  He apparently landed just wrong, resulting in a compound humerus fracture AND a compound radius/ulna fracture.  Bad times.

We sit WR down on the small embankment on the northern edge of the roadway, and I explain the need for immediate medical and surgical intervention.  He tells me his arm really throbbing now, and I explain that, while pain management is at the discretion of the responding medic, he is a suitable candidate for some morphine or Fentanyl.

GG, to everyone's distinct misfortune, hasn't gone away yet.  He sees us sit WR down, and comes back over to be nosy.  He sees the fractures, and his eyes go wide.  He grabs the cell phone again and calls 911 again.  The very first thing he says is "We've got a compound fracture here, tell the ambulance to step it up!"  Unreal.  No location information or anything, just pure wigging out.  What a yahoo.

The dispatcher, God bless her, patiently talked some sense into him and calmed him down.

GG hung up and told WR that the ambulance was about 8 minutes out.   He then tried to move WR's hand (WR was holding the left arm in a POC with the right hand) to look at the injury.

That's it.  I'm done.  No more Mr. Nice Guy.

"Sir!"  To my surprise I was interrupted by the Samaritan.

"Hey, asshole, this guy's a paramedic, so why don't you just go away?"  Not diplomatic, but sometimes diplomacy's overrated.  I wouldn't have put it in those words, exactly, but the Samaritan made sure that GG got the message.

With GG gone again, there wasn't much to do except shoot the breeze until the cavalry showed up.  Despite that compound fractures, there was very minimal blood loss.  WR was uncomfortable, but he maintained his arm in a POC and didn't complain much.

Two SHP units arrived on scene about 45 seconds ahead of the ambulance, and sure enough, GG couldn't wait to give a statement.  His first words to the trooper?

"I saw everything, and I think he's drunk!"  Wrong on both counts.  He saw nothing, and WR was stone cold sober.  But whatever, stupid is as stupid does. 

The other trooper approached me and asked for my statement.  I kept it short and sweet:  Solo vehicle/rider, cold tires, goosed throttle, high side, no booze.  My statement was done by the time the rig pulled up on scene.

I approached the medic at the ambulance and gave him the quick rundown:  Low speed, isolated fractures, no loss of consciousness, fully alert, significant pain.  He thanks me, and I go back to the car.  Despite everything, I'm sure the poor guy ended up on a backboard.  Hopefully they took him to a trauma center or receiving hospital with some good orthopedic surgeons.

As I drove away, GG was still blabbering to the cops.  Big surprise.

My friends acted like I saved the world for a few minutes, but it was a really easy call to run.  I guess it was a good thing I listened to the women and stopped -- GG probably would've killed the patient, or at least driven him crazy, if left to his own devices.

Oh, and we made it to the wedding with about 10 minutes to spare.