Category Archives: Uncategorized

When have you seen too much???

The hot topic on numerous forums these days are about EMS, PD, and Fire workers and the PTSD that is built up along your career.   There are support groups out there such as: The Code Green Campaign, who offer skills and help with PTSD.

I am the leader who wants to deal with it and shield the younger members or even the older members form seeing things that they really do not have to.    Something as simple as going in to confirm an unattended.  I remember a 66 year old, with a self inflicted GSW, and how a younger member (who already had psychiatric issues) was mad that I didn’t let him approach the body.  The gun Was moist from the humidity that day which had also coagulated the blood to a mold behind the patients head.   While questioning the patients wife, she stated “I went to work at 09:30 and found him at 17:30 when I came home”.   The wife also noted,  ” I did not even go down there, I knew if he was going to do it he was going to do it right”.

This was also the year of the heroin outbreak,where once a week I was telling a mother, girlfriend, and or wife that their loved one was deceased.   That their lives had not even started but were cut short by a “quick fix”.  A  27 year old who came home to score by heroin, score by having sex with his girlfriend only to have her wake up after to find him dead.

I try to shield other members so that I absorb the gory, nasty, traumatic  scenes to try and keep their minds fresh.

I can remember one summer a couple of years ago now where my “body count” was through the roof.   From 66 and 77 year old males, both suicide by handguns,  to a double fatal motorcycle where I had to call the male, and work on his female girlfriend.   One that I will no doubt take to my grave, is a MVA on the TSP late one weeknight.   A famous anthropologist adopted a family from Papua New Guinea and was traveling from New York City to her Vermont summer house when she lost control and struck a rock wall.   The female driver was killed instantly.   By the grace of god, there was a NYS Trooper who I had worked with, and after this incident became quite close with,was within moments of the poll.   The Trooper removed everyone from the car as it started to catch fire.   Just doing what he does.

Upon my arrival there were 5 patients 4 of whom were laying on the side of the road in the grass, a scene from MASH.   All I could here was moaning and crying. My eye caught site of a fireman doing CPR on a very small child.   Instantly it clicked like second nature, “that’s where I need to be”.   I remember how small this adopted immigrant from a third world country was, I had to resort to compressions consisting of 2 fingers.   Soon after, an ambulance pulled up from the jurisdictional agency with a medic who I have known for years.   We both loaded the male child onto the stretcher and into the ambulance while we continued to breath for him and pump his heart by compressions.   About 3 minutes in route to the hospital the patient regained a pulse.  Arriving at the trauma center with the “team” waiting for us and the other patients to arrive, we handed off the patient.   In 23 years I have done CPR a million times and unfortunately, only two patients have walked out of the hospital to a “normal life”.   Thinking with the extent of the blunt trauma and potential head injury not to mention the lack of oxygen that this child will either not make it or be vent dependent for the rest of his life.   I followed up as just regaining a pulse was enough to jump start my heart……

This young man walked out of the hospital, a true miracle.   While I have received pictures  of him I never did get the chance to see him after his discharge from the hospital.  I can see him every night or time when I recall the accident.  I can see face, his jaw is clenched as I am trying so heard to get a airway adjunct or ET tube into him.

That summer I started to drink, more then normal.   As my psychiatrist said it was a coping skill, “not a good one” but it was a coping skill.  I remember being very short fused at home with my family who has stood by me 100% in y career from day one.   I have since grown older and have rekindled my role as a husband and father to a level that I have never been to.   I have always thought: When is enough enough?  Will I snap one of these days?

Or most recently while attending a baby shower at the firehouse we were dispatched to a MVA with a possible car fire.  I hopped in the ambulance as the driver as there was a somewhat new EMT who had her card for a little while but was not cleared to drive.   In 23 years I have never had 911 tell me upon response that I had “a report of fatalities on the scene”.   I remember looking over at her and saying “the game just changed” and that “Someone will drive and I will be in the back with you”, again my instinct.   In route to the scene approximately 3 miles away the column of black smoke was more then I have seen at some structure fires.   Arriving on the scene to a fully involved car rolled over on its roof, you could feel the heat as we drove past. We parked where we would have the safest, and quickest access to a male patient lying on the shoulder of the road.   The patient’s wife laid 6 feet away already pronounced deceased prior to our arrival.  The car was 25 feet away, the heat from the sun and the fire were both blistering.  Somehow, once again, the good humanity showed as both were pulled from the car by bystanders.  This was NO easy task as this gentleman was fairly large…..   I turned to my now EMT partner and said “I need suction and a BVM yesterday”.   We all worked as a team to treat this patient and remove him to definitive care.   Returning to the baby shower to see my family I realized that my pants had 3 decent size blotches of blood from my patient on them.   I wondered if they would understand why I left? where I was? what I saw?  What I did?  Who’s blood was on my pants?

I can tell you, when the shit hits the fan, I want to be the one.  The one in the “danger zone” or horrific scene.  Why is that?  One reason is, I have been there and done that, I have absorbed it and been back for more.   I do not want anyone to see anything that I can shield them from to protect them.  I guess how a senior member should be?






 What if we were in it together?  As a team!

I have been thinking a lot lately, I know you can smell the burning…  What if we were in it together, as one, as a actual TEAM?   Instead of living the firehouse drama.  What if we actually were “brothers” like we constantly claim to be?   Or is that only on a fireground?

  • Elections are fast approaching which means in normal fashion we will be cutting each other’s throats to earn a spot on the “rank list”.   I encourage all running for positions to dust off their stabb proof vest.   This leads me to who are we voting for?  Is it the most qualified candidate?  Maybe the click ring leader?  The loudest mouth in the house/district?   

The main question to the above  is:  Are we moving forward in a safe manner?, Are we recruiting and retaining members?   Are we pushing away members?  If so we may want to re-think our positioning and remember why we are actually here.   When I joined may years ago the sign up sheet for elections was full of eager, aggressive, passionate leaders who wanted to be the best, but the best as a whole.   Now it seams like you can calculate the sheet prior to being hung.  Just fit the click to the sheet like a puzzle.    

On that note I am going to take my morning nap while visions of pride or lack there of dance in my head….

Do we really need the “buff or wacker belts”. 

Lately it seems like part of the EMT dress code is to outfit yourself with a “buff belt” which I refer to as a wacker belt.  

I understand being “prepared” but these belts are carrying everything from a set of keys to rappelling gloves and socket sets. Like the gear we carry is not heavy enough.  The only thing that I carry is a raptor (Gerber multi tool) and a spare key with a 02 wrench.  

I saw a younger EMT come into a ER last night with the following on his “buff belt”:  Multi tool, UHF/VHF portable, Chinese brand portable,  bristojet, handcuff case (unknown contents) glove pouch, cell phone case, tourniquet, OC spray?  Really  

Where have the competent Emergency Medical Technicians gone!?!?

What are we teaching in the Basic Life Support classes?   Diesel and lights? Remain on the scene until the medic arrives?   Incompetence?

I see more and more EMT’s awaiting a advanced life support intercert on the scene rather then using the skills you should have been taught and transporting.   Especially with all of the BLS interventions available today.   Narcan, Aspiren, Epi, C-Pap..

We as providers must remember DO NOT DELAY PATIENT CARE, especially definitive care.   Remember your A, B, C,’s and transport.   If you do not make a intercept/meet “oh well, you attempted”,and that is what local and state offices request.  
A cardiac arrest is actually a BLS skill.   Now don’t get me wrong ALS interventions can of course increase the chance of survival but……..  waiting at a residence, roadway, or driveway is doing nothing but decreasing the chance for a successful outcome for your patient not to mention that 3 letter word (SUE) that everyone throws out when something does not go there way or they need a quick dollar.  

EMT is not just a title!  It is a higher power, a trained professional who can react in a split second.  Someone who views horrible images first hand but treats them without being prompted.
Remember take a deep breathe and use your skills.