OIS - Officer-involved shooting

So we're driving down the road enjoying some Cold Stone when the radio crackles and the dispatcher sends us to a reported officer involved shooting.

It never fails.

We sigh, flip on the lights and sirens, and start heading towards a nicer hotel way out in the 'burbs. The pucker factor shoots sky high for about 2 seconds until we hear scanner traffic that the cops are okay and the suspect is down. While enroute to the call we get an additional update that law enforcement has cleared us into the scene, and they really want to know our ETA. That's a pretty decent indication that somebody's probably pretty banged up. Thankfully, the suspect was still down and the cops were still okay.

We pull up to the hotel and park, but there's something wrong.

I've responded to a number of shootings over the years, and with one big exception there've always been a number of police cars on scene. But an officer-involved shooting? Fuhgeddaboutit. Usually those calls bring out the cavalry... city cops, county mounties, troopers, Amtrak police, military police, game wardens, transit cops, park rangers, postal inspectors, the occasional federal agent and maybe even a bored Mexican Federale or Scotland Yard type. No joke, officer-involved shootings are a sure way to get a HUGE law enforcement response to your scene... and we had one measly sheriff's vehicle on scene. Granted, the cops were all okay, but still.

Uber weird.

We grab our equipment and gurney, and head inside the lobby. We catch the elevator upstairs, and attempt to get off on what we hope is the right floor -- God bless our dispatchers, but we don't always get the best information in sketchy situations like an OIS.

The elevator doors open and reveal a sea of uniforms, easily a dozen cops. They're standing outside a room right in front of the elevator.

What the what? Did they roll in Shriners-style, a 15 cops in one car? Are they teleporting to scenes now? Are we getting Punk'd?

Taken aback by the unexpected sight of Johnny Law's whole extended family, we hesitate for a second.

I clear my throat and yell out, "Anybody order a pizza?" Okay, maybe I didn't, but it would've made a great opening line. I tap the closest cop on the shoulder and he turns to see what's going on. He sees us and his eyes light up.

"Hey guys," he yells, "the ambulance drivers are here!" Without missing a beat, I say, "Can the police car drivers please make a path?"

That didn't happen either, but someday I'm gonna use that one, too.

Anyway, the cops happily move away from the elevator, and we approach the patient's room. A trooper sergeant is standing guard at the door, and he nods in greeting as he recognizes me.

"Hey, FM, welcome to the party. You've got two shell casings on the floor right at the threshold. Try not to kick 'em around too much, would ya?" He then happily scurried out of our way and starts doing... sergeanty things. We carefully step over the evidence and enter the room. As I approach the patient, I do a quick survey of the room.

That survey reveals a 35ish male supine on the ground with two county deputies rendering first aid, a sizable quantity of narcotics, narcotic distribution and packaging paraphernalia, and a butt load of cash in small bills. The patient is conscious and alert, and frantically saying he can't feel his legs.

Huh. That's funny. Deputies rendering first aid, and a trooper sergeant at the door. I look over my shoulder and see the cops all trying to be nosy and peer into the room, and realize that all of them are troopers. That's really not normal. 12 troopers in the same place at the same time usually only happens at really big wrecks on the expressway, inside a state police district office, or at Super Troopers-themed parties. I shrug it off and start my patient assessment.

Our patient appears to be in typical health for an unlicensed urban pharmacist, which is to say, not great. He's dressed in only ratty sweatpants, which should be no surprise if you've ever seen even a single episode of Cops. He appears to have been shot twice, once just below the bellybutton and once in the upper right chest. Both wounds have been covered with dressings by the deputies, and there is very little external blood loss. There's no other obvious trauma.

The rapid trauma assessment revealed absent sensation from the bellybutton down - a pretty good indication of spinal cord damage - and a priapism, which, when combined with the lack of sensation, sealed the deal. Priapism is a persistent erection, and is often found after transection of the spinal cord. I'm willing to bet my entire paycheck that this guy is paralyzed. Aside from the two gunshot wounds, though, the assessment is unremarkable. We package the patient for transport and head back down the elevator towards the rig. We load the patient, and the younger of the two deputies jumps into the patient compartment. We beat feet towards the trauma center.

During transport, the patient keeps muttering that he wishes they had just killed him, and the younger deputy tells him that he almost got his wish.

I learn that the the two deputies had been serving a warrant for the patient's arrest. They knocked on the door, and when the patient answered the door he yelled, "F$%@ you, I'm not going back to prison!" as he quickly reached behind his back. The other deputy fired two .40 rounds at the patient, who never actually had a weapon. The deputy riding into the hospital with us didn't have to fire a shot, and he made the 'shots fired' call on the radio. There happened to be a number of troopers next door to the hotel in a training exercise, and they quickly ran next door to provide assistance. Hence the mysterious presence of one lonely squad car.

We drop the patient off at the trauma center, and find a bloody ten dollar bill that had apparently fallen out of the patient's pocket on the floor of the ambulance. We put the money in a biohazard bag and headed back toward the scene to drop it off. By the time we got back, it looked like a typical OIS scene -- squad cars everywhere, and bored rookies manning blockades at the driveways. I explain the situation to one of the new guys, and the trooper sergeant sees us and walks over. I won't bore you with the details of chain of custody and evidence rules, but let's just say it would've been a lot easier to deal with if the money had just stayed in the patient's pocket in the first place.

Sheesh.

All in all, a pretty tragic situation. Bad guy will end up in a wheelchair, if he survives -- apparently there were complications in surgery -- and the deputy was pretty distraught that the bad guy attempted suicide by cop. The smallest disaster of the evening was having to drink melted Cold Stone out of the cup instead of eating it with a spoon. Eating it is better, but even melted Cold Stone is pretty awesome.

CSI: Fairview - Stabbings

The third crime scene I'd like to address is stabbings.  The "stabbing" call could actually be a cut, puncture, stab, slash, chop, clice, thrust or scrape, all of the above or none of the above. Like shootings, they are often very dynamic and charged scenes. While bullets differ mainly in size and velocity, edged weapons come in all shapes in sizes, and there is a huge variety of wounds that can be inflicted by them.

Many of the points from the CSI: Fairview - Shootings post apply to stabbings, but there are a few additional considerations.  Take a look to refresh your memory - I'll wait - and then we can explore the differences.

Again, hopefully you'll stage until law enforcement has arrived on scene and cleared the scene to the best of their ability.  You'll still want to enter carefully, scanning for evidence and not stepping in puddles of blood whenever possible.

It's nice to think you won't have to look as carefully for shell casings, but don't fall into that trap. It amazes me how many people think it's a good idea to bring a knife to a gun fight. It's also very important to note that shootings and stabbings are often confused for each other, either by the calling party, the call taking dispatcher, the radio dispatcher, or even the patient.

I think a lot of the problem lies with the person reporting the emergency. They may not hear shots and assume it's a stabbing, or they may have heard some loud noise and just assumed that stab wound is actually a bullet hole. The fight or flight response has a way of skewing people's perceptions and recall, so that's a factor, too. Further complicating matters is that the Emergency Medical Dispatch (EMD) code is the same - 27 - for both shootings and stabbings, as they're both penetrating trauma.

Don't assume that you don't have to pay attention to your surroundings just because the call came in as a _________ and not a shooting or other obvious crime scene.

So, being mindful of evidence as you approach, you size up your scene, evaluate your surroundings, and assess your patient.  If the butcher knife/ice pick/ninja sword is still penetrating the patient's body, secure it as you would any other impaled object.

I've heard of a paramedic intern (or rookie paramedic, or a stupid paramedic) who responded to a stabbing and found a large steak knife lodged in the unconscious patient's chest. Without thinking, he quickly pulled the knife out. When he realized that he'd breached protocol by removing the impaled object, he immediately replaced it in the original wound in the patient's chest. That's right - the paramedic stabbed his own patient. Since the patient would have died no matter what, the paramedic only got a slap on the wrist.  Now, this is almost certainly an urban legend - very non-specific details coupled with very specific details never strike me as believable - but it illustrates the point well. Don't remove any impaled objects that you don't need to. The chances that you'll need to are very rare indeed.

Anyhow, that little digression aside, let's continue.

If the weapon is no longer embedded in the patient but it is on scene, try to obtain a description of it. Again, the weapon is evidence, and you should not disturb it without the knowledge and consent of the law enforcement officers on scene. While a description is great, a picture can be very helpful too. A picture of a knife may or may not indicate scale, but a picture of a knife with a ruler or other common object next to it for scale - quarter, dollar bill, trauma shears, etc - paints a much more accurate picture for the hospital staff. If your agency prohibits taking pictures, don't do anything that risks you getting fired though.

If the assailant fled with the weapon, you may be able to ask the patient what the weapon was.  The wound itself may give you an idea of how big the weapon was, but not necessarily. It will likely be impossible to tell how deep the wound is.

Remember that the patient may be altered or otherwise combative, and remember that the patient might not be an innocent victim. Watch the hands, and check for weapons.

It's important to again point out that the patient may be suffering from more than one wound, so do a complete and thorough physical exam. Remove the clothing carefully, and don't cut through any puncture holes if at all possible. Keep the clothes together, and don't dispose of them at the hospital.

My earlier points about patient statements being important evidence are still applicable, so be sure to accurately document the patient's description of the weapon, assailant and circumstances. You'll probably remember the guy attacked by a ninja sword for the rest of your life, but the guy that was stabbed by a pocket knife may not be as memorable. Both runs could land you in court, though, so be sure to document thoroughly.

So to recap: treat your patient appropriately and professionally while maintaining vigilant situational awareness, preserving the evidence and thoroughly documenting the circumstances.  It may be easier said than done, but it gets a lot easier with practice.

Again, this isn't all-inclusive, and I welcome input from other responders. Whether you're a stockbroker whose only public safety experience is getting stopped for speeding and watching Third Watch reruns or fire chief/SWAT medic/Navy SEAL/dog catcher/paperboy, the odds are that you've got good ideas and a different perspective than me, so let me hear it.

Stay safe out there...

CSI: Fairview - Shootings

The second crime scene I'd like to address is shootings.  In a perfect world, you'll be dispatched to a shooting and then stage until law enforcement determines that it's "safe" to enter the scene. Motorcop and Happy Medic have talked about scene safety on The Crossover Show in the past, and scene safety means different things to different folks, but I digress.  Once cleared to enter the scene, you can go to work on the patient(s) and save the day.

We don't live in a perfect world, though. Shocker, I know.

I've run more than 50 shootings in my career, and they're typically pretty dynamic scenes.  I've had the unfortunate honor of being on a number of unsecure and unsafe shooting scenes, and made it out safely, but I don't recommend it to anyone sane.  Of course, most of us in Public Safety dance on the line between sanity and insanity, but I still can't really encourage you to be any part of an unsafe scene.

So, once the scene has been made (as) safe (as it'll get), you'll make your entry.  Maybe I'm just unlucky, but I can think of maybe a half dozen shootings that I've ever responded to that happened during the day.  Those of you with wicked maths skills have probably figured out that I'm in the dark most of the time - ha.  Flashlights come in really handy in those dark alleys and parks.

So, armed with your trusty flashlight, you (and probably some number of street cops with their own flashlights) walk into the scene.  You'll need to have your eyes constantly scanning for evidence.  It's not typically like a movie scene, and those nice big yellow evidence markers you're used to seeing on TV are probably gonna end up being folded 3x5 index cards or something similar.  In the initial flurry of activity, shell casings may not even be seen by the first officers on scene, let alone marked.  The last thing you want to do is kick a shell casing or step in some blood droplets.  That valuable forensic evidence you kicked away or turned into to a useless dirty smear probably won't make too many friends in the Detective Squad.

So as you scan for shell casings, blood droplets and pools, narcotics, firearms, and even assailants and suspects, make your way to the patient.  If at any point you have no choice but to destroy evidence, give the police officers the opportunity to see, and, if possible, document, the evidence before you alter the scene.

As you make patient contact, pay attention to their hands.  Even if the patient is a truly innocent victim of violence, their condition may make them prone to hurting responders inadvertently.  The patient may even be armed themselves, so keep that in mind.  A quick physical exam will help reveal both trauma and evidence, so it's a great idea to take a second and do a rapid full body exam.  This can (and probably should!) look like a pat down.  Pay attention to the waistband and pockets.  Should you find weapons, contraband or other potential evidence, make sure to notify the closest officer/deputy/trooper in order to secure the evidence and maintain the proper chain of custody. 

This whole pat down physical exam should only take 15 seconds or so.  As you go, note the normal medical findings, but also take special note of any bullet holes in the clothing and, in the case of close range shootings, the presence of gunshot residue (GSR) and powder marks.  Aside from the obvious clue to penetrating trauma in close proximity to that bullet hole, you'll want to take care to not cut through that hole or GSR when you remove the patient's clothing in the ol' strip 'n' flip.

Because gunshot wounds may or may not be obvious and the patient may not know how many times they've been shot, it's very important to remove all their outerwear.  All that clothing can be valuable evidence as well, so remove it with evidence preservation in mind.  Try to make as few cuts as possible, and if you can cut along the seams, even better.  If you can make a few straight cuts along seams, that shirt or pair of jeans will probably still look like a shirt or pair of jeans in 5 years when the evidence is presented at trial.  But a ragtag piece of fabric that doesn't look like clothing anymore just makes us all look sloppy.  It doesn't really take any longer to do it the right way, so you should really make the effort.

It can be very helpful to know the type of weapon that was used and the caliber of the bullet.  Those shell casings we talked about earlier can be a great indicator of that, but you won't make any friends by picking up the shell casing to look at it.  Under no circumstances should you take a casing to "show the hospital staff." Ask the cops -- this is their sandbox, and you're just visiting.  If shell casings aren't around, it might be pretty hard to tell what the patient was shot with by visual inspection alone.  This is common when the weapon is a revolver, in a drive-by shooting, and in some outdoor environments with lots of ground cover.  If the patient saw their assailant, they may know what they were shot with.  Even if you're unable to determine the size of the projectile, knowing if they were shot with a pistol, revolver, shotgun or rifle can be very important.

Another note about shell casings: especially if you don't know much about guns, a trip to a gun shop, shooting range or even the PD can teach you a lot about ballistic considerations.  It doesn't take much time to learn the difference between a 12 gauge shotgun shell and a .22 casing, and when you can actually see the difference in size between a .22 and a .223, you'll have a much greater appreciation for the difference that muzzle velocity makes in the impact on soft tissue.  Again, the size of the round can have a huge impact on the mechanism and severity of the patient's injury, but don't get caught up in trying to determine the information if it's not readily available.

Also, despite what you may have heard, it can sometimes be almost impossible to tell if a given wound is an entry wound or exit wound.  In truth, it doesn't even matter -- it won't make a bit of difference in how you manage the wound.

Once you've assessed the patient's injuries and initiated the appropriate treatment, you may believe that the time for evidence preservation has passed.  Many times, this is true.  There are some clear exceptions, though.  If for some reason you have the patient's clothes or other potential evidence with you, make sure that it's not disposed of. 

The patient's statements to you may be very valuable as well, especially if the patient is in extremis.  Shocking as it may seem, some shooting victims will refuse to identify their shooter to the police.  This can be out of fear of retaliation, or a desire to inflict their own retaliation, among other things.  If they give you a dying declaration that identifies their assailant, however, that could be the key piece of evidence that takes a violent criminal off the streets.  If the patient opens up to you, do your best to obtain the who, what, when, where, why and how.  The more you get from them, the better.  "Some middle aged white guy" is better than nothing, but "my ex's new boyfriend" is better.  A name, even a street name or nickname, can be better still.  If they don't know their attacker, a good physical description, along with a vehicle description and direction of travel can be very helpful.  You get the idea. 

Like I said last time, it's not EMS's responsibility to investigate the scene or catch the bad guys, but we can be valuable assets to our law enforcement brothers and sisters.  Situational awareness and proper documentation of the scene, circumstances and patient conditions can be very helpful to the investigating officer and agency.  Be aware of the presence and importance of evidence, and be careful what you do out there.  Vigilant situational awareness helps you minimize your impact on the crime scene, so work to maintain it. 

Again, this isn't meant to be all inclusive, and I welcome input from my EMS and LEO brethren.  Stay tuned for crime scene number 3...

CSI: Fairview - Traffic Collisions

The first crime scene I'd like to address, and one that frequently isn't thought of as a crime scene, is the traffic collision.  When people are yelling & screaming for help and there are mangled vehicles everywhere, many of us fall into the tunnel vision-auto pilot trap.  We fail to keep our eyes open and assess for threats due to traffic, downed lines, weather. HAZMAT / fire issues etc.  We also fail to recognize that these responses are very nearly always the result of someone breaking the law.

It's important to note that evidence preservation will be much more important for a wreck with major injuries or fatalities than a typical fender bender, and common sense must be employed.  If you are first on scene of a minor fender bender that's blocking the roadway, there won't be some crazy investigation.  The cars should be removed from the roadway as quickly as practical and evidence preservation will be of minimal importance.

We march in, pull out tools, kick debris out of the way, cut the cars apart and in general destroy evidence from the moment we arrive.  On your approach to a TC, you should be assessing for all these hazards anyway, but there are few other things that all too often fall through the cracks.

As you approach the scene and select a safe and appropriate place to park your apparatus, be sure to avoid driving or parking over evidence.  This includes skidmarks, glass, debris puddles of fluid, damaged sections of roadway and anything else that wasn't there before the collision occurred.  If law enforcement is already on scene, park as directed -- the officers on scene probably won't direct you to park in an area that  destroys evidence or will impede their investigation.  If everyone is on the same page regarding blocking lanes, it'll be that much better.

As you approach the vehicle(s), in addition to continually assessing for hazards and scene safety issues, displace as little evidence as you can.  Don't kick debris out of your way, and if you do move evidence, be sure that law enforcement knows how you've altered the scene.  If it's feasible, allow law enforcement a moment to see the vehicle(s) in it's final rest position before beginning extrication.  More and more agencies are implementing policies forbidding the taking of pictures on scene, and if you don't have a policy forbidding it and you do decide to take pictures, be aware that your pictures could end up being subpoenaed by law enforcement.  If there is any doubt about when a collision occurred, touch the hood of the car and see if it's warm.  This can help you estimate when the TC happened, and that knowledge could come in handy later.  If the engine block is cold, it's probable that the wreck happened some time ago and has only recently been reported.  This is good to know, particularly in late night DUI collisions with minor injuries, as the drunk driver may have delayed reporting the accident in the hopes of sobering up before the cavalry arrives.

As you evaluate the vehicle and patient, assess for injuries and evaluate the mechanism of injury, bear in mind that the indicators we use for these purposes frequently help law enforcement investigate the scene.  That beer can jumps out as evidence, but what about the prescription bottle?

As you begin the process of extricating the patient, the scene can change quickly and dramatically, especially in a complex rescue situation.  Evidence can be altered and destroyed, and care should be taken, when practical, to minimize this.

Once the patient is extricated, law enforcement will frequently try to obtain a statement from them.  If the patient's condition allows for it, it's helpful to allow the officer to obtain the statement while still at the scene.  Bear in mind that the patient's injuries themselves may be evidence (ie, forehead trauma consistent with striking the windshield, seatbelt abrasions, etc) that will contradict a patient's statement.  This frequently happens with DUI/DWI collisions or when a driver is unlicensed.  They lie about where they were in the vehicle at the time of the collision.  If your physical findings contradict the patient's statements, it's a good idea to OBJECTIVELY document that.  Slurred speech, odor of alcoholic beverages (not the odor of alcohol itself -- it's odorless), horizontal gaze nystagmus (HGN) and other physical signs of intoxication are important for both you and law enforcement.  A blood sugar will  be important to obtain as well, as drunks can play the diabetic card and diabetics can appear to be drunk.  Pupillary response can be an indicator of both head trauma and narcotic use, so be sure to document those findings as well.

If your jurisdiction and agency protocols and procedures allow for an evidence blood draw, follow those guidelines.  If not, or the officer doesn't have the blood kit, then don't do it.  There's not a lot that's more frustrating than watching a drunk go free because of improperly obtained evidence, and you don't want your blood draw to be the weak leak in the chain of evidence.  Using improper technique or standard blood tubes is a great way for a savvy defense attorney to get a drunk off the hook.  The rules of evidence require that the chain of custody not be broken, and standard blood tubes don't typically meet the criteria for a legal blood draw.  

Also be aware that doing a favor for a cop buddy can turn around and bite you down the road if your agency or protocols forbid the blood draw.  If the case goes to trial and you get subpoenaed to testify in the case, you will probably find yourself in hot water for violating the rules.  Getting drunks off the road is great, but not at the risk of a medic losing their job.

Another issue to consider is vehicle vs pedestrian incidents.  When this happens, someone screwed up, and the potential for serious injury is very high.  Be especially alert to anything that immediately suggests fault, especially if the evidence contradicts the statements by the involved parties.  If your pedestrian patient is clutching a paper bag with booze in it or has a death grip on their cell phone, that suggests that inattention to their surroundings could have contributed to the incident.  If the pedestrian was in a crosswalk in good lighting conditions, that suggests that the driver may have been the inattentive one.  If the ped was wearing dark clothing and crossing the street at midnight in the middle of the block, they'd be hard to see.  If the EMS crew removes the patient's clothing and disposes of the clothes upon arrival at the hospital, they've destroyed evidence that could be pivotal in determining fault.

While it's not EMS's responsibility to investigate the scene or determine cause from a legal perspective, situational awareness and proper documentation of the scene, circumstances and patient conditions can be very helpful to the investigating officer and agency.  Evidence can be smaller than paint chips & glass fragments and larger than a Mack truck, so it's important to be aware of its presence and importance.  Evidence can be cars, people, clothes, vehicle contents, personal effects and just about anything else, so be careful what you do out there.  Pay attention to your surroundings, and minimize your negative impact on the crime scene.

Again, this is not meant to be all inclusive, but it's a good start.  Stay tuned for the next crime scene...

CSI: Fairview - Intro

Nope, it's not CBS's latest wannabe prime time hit -- it's how I'll (not-so) lovingly refer to many of my coworkers here in the land of dreams and schemes.

Crime Scene Ineptitude (Idiocy? Ignorance? Incompetence? Imbicility?) seemingly runs rampant among my fellow medics and firefighters.  I'd love to be able to say it doesn't, but we all could learn a lot from the cops when it comes to responding to crime scenes.  This topic can easily (and, dare I say SHOULD be...) be addressed in an 8 hour class, so while the scope easily exceeds what I can write about here, I hope to at least increase awareness...

While it's impossible to address all of the possible crimes fire & EMS would respond on, there are a few biggies that are worth addressing briefly.

As a quick overview of my own experience, I started out on this crazy planet as the son of 2 MPs.  I became a law enforcement explorer in high school, and did my EMT training on the grounds of a highly respected police academy.  Our training consisted of significantly more hours of classroom time than the EMT curriculum requires -- roughly 350 hours of didactic time -- and a large part of that training was on thinking tactically.  We did a lot of crime scene awareness exercises, and I feel I know more than the average bear about responding to crime scenes.  My paramedic program didn't acknowledge crime scene operations beyond admonishing the age-old "scene safety" advice, but a decade of practicing what I learned in EMT school has paid off handsomely.

Despite my 10 years of experience and training, though, I AM NOT a cop, and have never worked in law enforcement.  Most of this stuff makes sense if you think about it, and, if put into practice, will greatly improve the working relationship you share with allied agencies.

In the following days (weeks?) I hope to address some of these common incident types and the mistakes we make.

Stay tuned!

Urban Legends

Hang out around the public safety field long enough, and you're bound to hear endless stories that may, over time, seem to be all the same.  Whether you're telling 'em, your partner is telling 'em, the new guy is telling 'em or the charge nurse is telling 'em, storytelling is a great way to bond and build camaraderie and friendships.

But...

You'll also find out that a lot of us are full of it, and urban legends are prevalent.

Here are a few of the most common I've run across:

1. Sem-antics
      Somebody claims that, while in an A&P (anatomy and physiology) or Bio lecture, a fellow classmate embarrasses herself.  While discussing the composition of semen, the instructor talks about the sugar content of the fluid, leading a (usually reported to be both very attractive and pretty dumb) student to inquire why it "tastes so salty"  See also http://www.snopes.com/college/risque/salty.asp


2. Your name is what?
     While obtaining patient information for a run report or medical chart, the provider asks for the patient's name.  The patient says what sounds like "Limmonjuloh," so the medic asks for the spelling.  The patient says, "L-E-M.  O-N.  J-E. L-L-O."  The medic says, "Lemon Jello?!?" and the patient indignantly replies that, "It's pronounced Limmonjuloh!"

The same story goes around about Orangejello and "Sha-theed," which is always spelled Shithead.

3. Hyphen hijinks
     In the same vein, there's the medic that asks for the patient's ID, and sees the name "Le-a."  The medic calls the woman "Leah" and gets chewed out by the patient, who says that "No, no, no! It's LaDasha!  The dash ain't silent!"

4. Language barriers
     Then there's the guy that swears he transported a young Latina woman in labor.  On the way to the hospital, she gives birth to a bouncing (the rig is always doing warp speed, and the pun NEVER gets old. Sigh.) baby girl.  Not knowing any Spanish, he cleans the baby up, wraps her in a blanket and tells mom, "Fuhmolly" - his assumed Spanish pronunciation of Female.  The mom, being young, naive and unfamiliar with American law, assumes that in the US the practitioner that delivers the baby names the baby, and ends up naming the little girl "Female."  Other terrible and unfortunate names that your partner SWEARS he's seen can be found here: http://www.snopes.com/racial/language/names.asp

5. The big uh-O
     Many a medic also claims to have responded to a residence for a woman in her late teens or early twenties complaining of shortness of breath and flushed skin.  The patient is found in a bedroom with her boyfriend or husband holding her hand and trying to calm her down.  After describing her symptoms, the medic asks what she was doing when this started.  After a few moments of embarrassed evasion, she relays that she had been intimate with her boyfriend or husband when her body started to tingle and she got flush and short of breath.  The medic then laughingly congratulates the young lovers and informs the woman that she's just had her first orgasm.

6. The Star-Spangled Bummer
     Let's not forget the yahoo that responds to the call of a man bleeding and arrives to find a couple cops and/or firefighters caring for a Hispanic man named Jose that was brutally assaulted.  His face is a mess, with multiple lacerations and contusions, a misshapen nose and two swollen-shut eyes.  The medic pulls out a pen light to assess the patient's pupils and unthinkingly asks, "Jose, can you see?" and is promptly humiliated by the other responders humming and singing (usually off key, sometimes even into a radio) the rest of the first verse of the Star-Spangled Banner.

7. Why'd you call 911?
     This one is semi-unique in that I've heard it from both responders and dispatchers.  Either at call time with a dispatcher or upon scene arrival of the crew, a frantic family member hysterically relates, "Chicken breath!  Chicken breath!  Hurry, hurry, chicken breath!"  The perplexed crew makes patient contact and discovers a woman in extreme respiratory distress, and quickly figures out that "Chicken breath!" is what "She can't breathe!" sounds like in the family member's heavily accented English.

These are just a couple of the most common I've run across.  I've heard them time and time again, and while I can believe that SOMEBODY out there has had one of these happen to them during their career, I find it really hard to buy that the 21 year old probie has run across all of them.

I may have been born at night, ladies and gentlemen, but it wasn't LAST night.

Good grief.

Try Before You Pry

It's 5am, and I'm getting ready to clear Fairview Memorial.  I put the final touches on my run report when I hear the call go out:

"Engine 2, pin-in response for a vehicle rollover.  Northbound lanes of Interstate 1 at Highway 34.  Following units to respond..."

Well, that puts the call in map grid A3.  Which, if you're paying attention, is pretty close to FMH.  Sigh.

I advise that we can handle the call, which lets a crew stay in their station, and we take off toward the freeway.  As we approach the scene, I'm amazed at how much damage there is to the car.  Picture this exit without the safety barrels:

 

Now picture a car sliding sideways into the point where the two guardrails meet.  The car is center punched at the passenger door by the point, which flips the car and sends it roof first into a bridge abutment.  

Based solely upon the wicked passenger space intrusion, I figure this'll be a bad one.  Fire and SHP are nowhere in sight, and we're completely alone on scene.

My partner doesn't initially see the wreckage of the car, and nearly drives by the scene.  We stop, he says a choice 4 letter word, and we get out of the rig.  I approach the car and assess the damage.  The roof has been smashed to the point that it's level with the doors, and the car is upside down.  I bust some leftover shards of glass out of the rear window frame, get down on my belly, and look into the car. 

To my surprise, a well dressed young woman waves and says she needs some help getting out of the car.  She doesn't have a scratch on her.

Huh.

So I crawl through the broken glass and make patient contact.  She states that she lost control and wrecked over an hour ago, but SHP had been unable to find her.  She had an older non-GPS enabled cell phone, so it took some time to find her.  She knew where she was within about a 5 mile stretch of road, but since she said she wasn't hurt and was out of the roadway SHP handled higher priority calls first. After waiting, trapped in the cold, dark car for almost 45 minutes, she finally called 911 again.  They were finally able to get an approximate location based on how loud the sirens were, and that's when we were dispatched.

Aside from being a little bit cold, she has no complaints.  Her short height (5 foot nothin'), her seatbelt use and the solid construction of her little Honda combined to keep her safe.  The only reason she was still in the car was all the broken glass -- she didn't want to cut herself up.  SHP shows up, and the Trooper grabs a blanket while my partner gets a board.

So my partner slides the backboard into the car, and I have her lay on the board and cover her up with the blanket.  We slide her out of the car, I clear C-Spine (again, completely unhurt) and we have her sit in the back of the squad with the heater going to warm her up.  The Trooper and I climb into the back of the squad and ask her a million questions about what happened.

This whole process took less than 5 minutes, so we're sitting back there when fire shows up. 

The fire crew looks at the car and begins to unload all the extrication equipment.  As one of the firefighters pulls the begins to set up his stuff (the Jaws), my partner approaches him.  He waves my partner away impatiently.  So my partner walks up to the lieutenant, who turns and looks at the ambulance.  He shakes his head and laughs, and goes to tell his probie that we've got the patient extricated already.

We ended up transporting the young lady for an evaluation.  While she had no injuries, she was very cold and had no quick way to get off the side of the road.  The ER staff got the glass out of her hair, gave her some warm food and coffee, and called her dad came to pick her up.  She was in and out of the ER in less than an hour.

All in all a very simple run, but it reinforces the old saying... "Try before you pry" -- the rookie firefighter never even assessed the situation before assuming that he'd need to use rescue tools.  There are many times where doors are fully operational, and forcing entry or using rescue tools is completely unnecessary.  This was one of them.  The door edges were buried in the dirt, but accessing the patient was very easy with bunker gear on.  He also completely blew off a seasoned coworker who tried to advise him that the patient was out of the car.

He's a good kid, though... He bought us Cold Stone on the next shift.

Allied Agencies

Just a quick note about the agencies that frequently respond on our runs. I'll probably use the acronyms more often than typing the whole thing out, so to alleviate some confusion (especially for those outside the US or civilians that might not get it...) here is a list:

FEMS - Fairview Emergency Medical Services - my agency
FFD - Fairview (City) Fire Department
FCFD - Fairview County Fire Department
FPD - Fairview Police Department
FCSO - Fairview County Sheriff's Office
SHP - State Highway Patrol

We also have other adjacent municipalities that respond with us on occasion, and I'll do my best to follow the same format:

FD - Fire Department (Typically a city)
CFD - County Fire Department
PD - Police Department
SO - Sheriff's Office
SD - Sheriff's Department

That being said, I am fortunate to respond with a great group.  Our firemen come with us on almost every call, and our cops are typically very good about doing everything they can to help us when we need it.