Hub911 - Emergency Services Information for all First Responders; Fire, EMS, LEO
LIKE us ->
  • Home
    • Free Medical Information Card
    • Contact Us
  • EMS
    • EMS Dept. Links
    • EMS Sponsors
    • EMS Classified Ads
    • EMS Events
    • EMS Forum
  • Fire & Rescue
    • Fire & Rescue Dept. Links
    • Fire & Rescue Sponsors
    • Fire & Rescue Classified Ads
    • Fire & Rescue Events
    • Fire & Rescue Forum
    • SOS Supply
  • Law Enforcement
    • Law Enforcement Dept. Links
    • Law Enforcement Sponsors
    • Law Enforcement Classified Ads
    • Law Enforcement Events
    • Law Enforcement Forums
  • Towing & Utilities
    • Tow Equip
    • Towing Company Links
    • Towing Company Sponsors
    • Towing Classified Ads
    • Towing Events
    • Towing & Utilities Forums
  • More
    • Dispatch
    • Explosives
    • HazMat
    • Lifeboat
    • Search & Rescue
    • U.S. Military >
      • Army
      • Navy
      • Air Force
      • Marines
      • Coast Guard
      • National Guard
      • Air National Guard
  • Forums
    • EMS Forums
    • Fire & Rescue Forums
    • Law Enforcement Forums
    • Towing & Utilities Forums
  • Info
    • Contact Us
    • Advertising >
      • Rate Page
      • Classified Ads
      • Links
      • Sponsorship
    • Resources
    • Disclaimer
    • State Listings
    • Site Map
  • Design
    • Website Design
    • SEO
    • Social Media Marketing
    • Hosting
    • Branding
    • Graphic Design
    • Printing
    • Signs and Banners
  • Blogs
    • Health Blog >
      • Mold Test Sale
    • Hub911 Blog
    • EMS Blog on Hub911
    • Fire Blog on Hub911
    • LEO Blog on Hub911
    • Towing Blog on Hub911 >
      • Positive Spin on Covid-19
      • COVID-19 and Isolationalism
    • PSA Blog
    • Hub911 Products Blog
    • Contests
    • Hub911 Recipies
  • Store
    • Service Animal Memorials
    • Contests
  • Print ID card
  • Parts Department Managment
  • New Page
  • New Page

The Toughest Decision

11/3/2012

3 Comments

 
Picture
The ear piercing screech of the firefighter locator beacon coupled with the screaming engine trying to pump the water & hysterical yells of the family & neighbors was a bit overwhelming at the moment. How I wish I could shut off this cacophony... my head was starting to hurt. My right side began to feel very wet... I look over and the snake coils of the water hoses were leaking badly, spraying cold water onto my side. The fountain of water coming out was almost refreshing on this hot, humid, muggy night. Just seconds earlier two firefighters tumbled down a flight a stairs trying to carry a 250+lb man.
 
"You alright man?!" I scream at him, trying to battle through the chaos of the noise. "Yea!! Just check him out, damn it!" He yells back at me. As he tears his mask off, he looks visibly shaken... I would be too if I just somersaulted down a Victorian flight of stairs carrying guy on top of me. I turn my attention down at my knees where the patient that was tossed at me lay. The porch where we were was way too small for everything that it contained. Me, my partner, two firefighters, hoses, bags, a variety of fire equipment I can't even begin to name... and now a body... alive or not was for me to decide.

Moments earlier, I was peacefully munching on my mini-chocolate donuts downing it with a quart of milk... a gas station dinner of champions baby! at 1am on this busy night.... when our peaceful "dinner" gets interrupted by dispatch to a possible house fire "smoke coming from the 3rd story window." The area we were going to is well known for some impressive house fires... the houses are old... all made of wood... and they love to burn. Summer, Fall, Winter, Spring... egh whatever... season non-specific, they burned nonetheless. Knowing all of this, there were normally two outcomes... this was either nothing & we were going to be back in service in 10min or we were going to be there for rest of the night. "I hope it's burning man." My partner exclaims. "We EOT in 4 hours, and this would last us through the night!"

EMS is a weird kind of profession... in it other people's misery can occasionally make our life easier... sucks, but that is the way it is. My partner was right. The house was going to burn regardless of whether I wanted for it to burn or not. That decision was already made for us. People are going to get shot... whether I want them to or not. They are going to die... despite even some of my best efforts... that's just the way it is. For us to say, "I hope it's burning man" doesn't mean that we HOPE for houses to catch on fire... it just means that WHEN they catch on fire, that WE be the ones there for it. This is an interesting concept that no one outside of EMS rarely gets.

We get on scene just behind the fire department. Amazing. 1am. When it is a house fire, they beat us there in droves... when it is a "chest pain" call, I'll have the patient half way packaged before they show up. As we stage a block away from the scene, the fire command advises us that this is a working incident with one upstairs bedroom on fire. "Egh I don't see flames... they gonna have that thing out before we even get out of the truck. I'm not getting out." My partner exclaims. I went in the back to set the stretcher up just in case. I throw in: immobilization, monitor, jump bag, suction... drugs? Nah... I'll come back for them if need be. What else do I need? Blankets... nah... it's too hot out. I jump back in the front, and as soon as I do so, fire command advises that they have possibly two to three casualties in the upstairs bedroom and outside behind the house. "Well @#$@#$!" My partner exclaims again. I call for a 2nd truck as we now have a possible "confirmed" patient/s... the city is holding calls so my call is 3rd in line. Typical night indeed.

We get out & drag our heavily packed stretcher across the cobblestones to the front of the house... spectators have gathered far & wide... some look at us with awe... some with disdain for having awoken them at this time of night... others with pure boredom, I guess expecting to see flames or other sorts of excitement. Just as we get up to the porch, two firefighters tumble out of the front door having lost their footing on the stairs...

And now in front of me was a man... a body of a man... lying prone across the coils of the fire hoses... in front of the entire neighborhood. It was so loud... I could barely hear myself think. I begin to turn the patient over with my partner's assistance when the man's pant legs
slide off under my hands... and with his pants came his skin... all of his thigh & leg skin. He was a bigger man... and the fat underneath clearly reached the boiling point... I have never known fat could & would boil out of a human being... but it did... I hope never again to see it... my instinct already told me the verdict... but my brain has not quite caught up. I immediately open his airway & see a charred tongue & throat... pulseless... apneic... the decision became split second... and final. "He is a DOA!" I yell to the firefighter that brought him out... he is standing right next to me, but yelling was all that I could do to get him to hear me. "Are you @#$%ing serious!!!" He yells back. I wave my arms side to side indicating DOA. "NO!!! WTF man... you @#$@#ing work him man!!! WTFFF... NO!" He and the other firefighter angrily shove past me down the stairs off the outside porch ... in front of the entire neighborhood.

It was done. There was nothing more I could have done. I was the only paramedic on scene. I had the possibility of 2 more patients, and
no additional assist units within the foreseeable future. The man was dead. He boiled inside out. I made my decision. A split second decision. The toughest decision... a decision to officially call it what it was and to do it without hesitation, in front of the firefighters that "saved" this man from the burning building... in front of his family... in front of the neighborhood... all in the midst of a chaotic scene. Right decision? Wrong decision? Who cares... the end result is the same. I had two more patients to worry about, and this one became an afterthought... at that moment.

We in EMS are occasionally faced with split second decisions... and we make some of them without hesitation... because when we hesitate at the WRONG moment, people die... when we hesitate at the RIGHT moment, people live. But when is the RIGHT vs the WRONG moment? Who the hell knows... Like a police officer that has someone at gun point, and makes a split second decision to either pull or not to pull the trigger... I held in my hand the power of working the patient or not... work it, and my other more viable patients may die... not work it, and the patient... may have had a chance.... I guess in the end it really is all about chances... about statistics. At this point, all I really needed now were just two blankets... one to cover the body... the other to cover myself, as I was getting cold from getting soaked by the fire hose... but I didn't bring the blankets, I didn't think I would need them... plus I have other patients to worry about... I'll see them wet, and cold... it's not a problem... done it before... will do it again.............

3 Comments
Dan Heidt link
11/3/2012 02:12:12 am

I am VERY familiar with the split second life mattering decision...
I've had to make it myself more then once and some cases/jobs You save a life and still get in trouble because your decision saved a life but was NOT Protocol.. In the end protocol is a highly recommended procedure to follow But should NOT supersede COMMON SENSE..As seen in this blog a decision was made Maybe not understood by non-professionals I probably would have made that same decision under the same circumstances

Reply
shelle
11/3/2012 06:43:55 am

Thanks for what you all do. Like it or not, it is life. Decisions made... people that can be saved and can not be saved. Find peace my friend.

Reply
Rick Ornberg link
11/10/2012 07:12:49 am

I was already composing an in-depth reply supporting your decision when I read right at the end:

"....plus I have other patients to worry about.."

'nuff said!

Reply



Leave a Reply.

    Hub911.com

    EMS blog for hub911.com - Let us know if you would like to be interviewed, or of someone who should be interviewed.

    Archives

    December 2013
    March 2013
    December 2012
    November 2012
    October 2012
    September 2012
    August 2012
    July 2012

    Categories

    All
    911
    9/11
    Ambulance
    Angel Of Afghanistan
    Apartheid
    Bio
    Boiling Fat
    Book
    Colorado
    Columbine
    Cub Scout Leader
    Dan Heidt
    Don't Be Afraid
    Educate Kids
    Emergency
    Emergency Responders
    Emergency Service Info
    Emergency Services Information
    Ems
    Emt
    Er Ny
    Fire
    Harlem
    Hub911
    Hub 911
    Hub911.com
    Joe Galizio
    Katie
    Kids
    Large Scale Threat
    Manjula Naidoo
    Medic
    Medics
    Mitchell Stern
    Newtown
    New York
    Nyc
    Nyc Ems Emt
    Paramedic
    Rona Ortiz
    Rush In
    September 11
    Sherry Wood
    Shooting Mass
    The Godfather
    The Toughest Decision
    Tom Giorgi
    Tommy Giorgi
    Wtc

    RSS Feed

Powered by Create your own unique website with customizable templates.