Author Question: The Pesky Reporter and the Wildfire
Posted by dtbAdmin on Jun 27, 2012 in Blog, Medical/EMS | 0 comments
Charise’s question is very pertinent particularly with so many wildfires burning in my home state of Colorado right now. How does EMS handle it all? Charise asks: I’ve got a forest fire happening and a news photographer out trying to get the best shots. She’s walking around recently scorched areas. Her car is parked on black top. It’s still pretty hot and smoky but she is there without an air tank so it can’t be too crazy. I need her car to be inoperable but nothing too crazy like exploding. Is it possible that parked on asphalt, the tires would blister or begin to melt (but a person could still be okay walking around on the dirt)? It seems the way heat is conducted in the earth vs. pavement makes this plausible? Also, I know animals flee a fire but do they get caught sometimes? Is it possible she’d come across a dead deer? After she leaves the area, it’s normal she’d have some smoke inhalation problems? Coughing, hacking, etc? Does that require medical treatment or would she be left alone since she’s lucid and otherwise healthy? Dianna says: My first thought is that rescue personnel (fire, EMS, law enforcement, haz-mat, etc.) form a perimeter (boundary circle) of three areas: the hot zone, the warm zone and the cold zone. Hot zone is where the actual emergency event is occurring (in your story case, the forest fire). Warm zone is the surrounding area next to the hot zone; it’s for rescue personnel to enter and exit the hot zone and for decontamination. Cold zone is the area beyond the warm zone and is the only area okay for civilians, including the media. That said, your character wouldn’t be allowed in an area that her car would experience the damage you stated. Now, of course, sometimes the media and other civilians enter a restricted area like the warm zone (they wouldn’t enter the hot zone unless they’re willing to die). So, you could certainly add that into your story, but she would have charges brought on her, so your story needs to reflect that. It sounds like you have your reporter character staying with rescue crews, and that’s not accurate. We ”deal with” the media this way — we tell...
Read MoreDecompresion Illness
Posted by dtbAdmin on Apr 27, 2012 in Blog, Medical/EMS | 0 comments
If you ever write a scuba diver character, a deep sea diver, a search/rescue/recovery diver, a Navy submariner, etc., you’ll need to understand Decompression Illness (DCI), a serious illness caused by trapped nitrogen. There are two mechanisms of DCI: 1) Decompression Sickness 2) Arterial Gas Embolism SCUBA (Self-Contained-Underwater-Breathing-Apparatus) divers breathe a purified air mixture of 79% nitrogen and 21% oxygen. The longer a diver is breathing this mixture and the deeper he/she descends, the more nitrogen will be absorbed by the body. A slow ascent and a safety stop at about thirty feet for three minutes, allows the diver to efficiently exhale the nitrogen. Dive tables set limits for dive times and depths. Decompression Illness is caused by tiny nitrogen bubbles forming (instead of being exhaled) and becoming trapped in the blood and tissues. There are two types of Decompression Illness: 1) Type I 2) Type II Type I: 1) Skin capillaries fill with the nitrogen bubbles, resulting in a red rash. 2) Musculosketal: Joint and limb pain Type II: 1) Neurological decompression sickness: Tingling, numbness, respiratory problems and unconsciousness. 2) Pulmonary: Bubbles interrupt blood flow to the lungs, causing respiratory distress or arrest. 3) Cerebral: Bubbles travel to arterial blood stream and enter the brain, causing arterial gas embolism and symptoms of blurred vision, headache, confusion, unconsciousness. General Decompression sickness symptoms: Extreme fatigue, joint and limb pain, tingling, numbness, red rash, respiratory and cardiac issues, dizziness, blurred vision, headache, pain with swallowing, confusion, loss of consciousness, ringing in ears, vertigo, nausea, AMS (altered mental status), pain squeeze, SOB (shortness of breath), chest pain, hoarseness, neck fullness, cough. Factors that increase the risk of getting decompression illness: Dehydration prior to dive, stressful dive or rapid movements during dive, alcohol intake prior to diving, flying too soon prior or post diving, not following dive tables. As every patient is different, every diver will have their unique combination of symptoms and reaction to both the illness itself and the treatment. Decompression illness is treated by hyperbaric recompression chamber therapy. Only certain hospitals in the word have a hyperbaric chamber. The severity of the patient’s condition and his/her symptoms will decide the...
Read MoreUnbelievable Real Life, Believable Fiction
Posted by dtbAdmin on Mar 12, 2012 in Blog, Medical/EMS | 0 comments
When I hear a reader say: “That’s not realistic; all of that couldn’t happen to one character.” I think, “That reader has skirted through life with little trial.”Spring 2009, a cop barreled into our car, injuring my oldest daughter, my son and myself. My husband and our youngest daughter escaped uninjured. The two kids healed; I suffered a shoulder and cervical injury. Actually, those injuries initially occurred when I was in a bicycle accident (a driver ran a stop sign); the car accident worsened those injuries. A few months following the car accident, my husband’s biopsy on an enlarged lymph node was negative, but a few months later he was diagnosed with head and neck cancer (the biopsy results were wrong). In 2009 and 2010 he endured two surgeries and cancer treatments. During this same time, our son battled a mysterious illness I suspected was Lyme disease since he had fourteen Lyme’s symptoms, but Curtis didn’t test positive so no physician would listen—see Brandilyn Collins’ posts May 2011 titled: The Lyme Wars. Most Lyme’s patients don’t test positive. For the love of hockey, Curtis fought the pain and continued to play; unfortunately, he suffered a shoulder separation during a game. In a sling for that injury, he had a MRI on a large cyst behind his knee; it tested benign. Hoping I was wrong about Lyme, I agreed to allergy injections to treat Curtis’ allergy-like symptoms. Days after the injections started, he developed a systemic rash. The allergist responded, “There’s an underlining cause.” So, I told an infectious disease MD, “Don’t think of me as a mom; as an EMT I’m telling you this patient has Lyme disease. Please help him.” After several months of Lyme’s antibiotics, Curtis improved but still battled bilateral knee and ankle arthritis. My orthopedic surgeon (explanation later in this paragraph) diagnosed Curtis with Lyme arthritis saying, “Bring on the CDC; this kid has Lyme disease and I’m treating him as so.” During the several months of Curtis enduring tons of doctor appointments (pediatrician, allergist, dermatologist, infectious disease, rheumatologist and orthopedist) plus countless tests, my shoulder worsened to the point I needed surgery to repair a labral tear. To date, Curtis...
Read MoreDiabetic Emergency
Posted by dtbAdmin on Nov 21, 2011 in Blog, Medical/EMS | 0 comments
EMS 4 diabetic emergency at 123 Fox Street, at 123 Fox Street on TACH Channel 12 I stuff the rest of my sandwich into my mouth and gulp down some water as I rush out of the fast food joint to hop into my ambulance. As my partner signals RESCOM (dispatch) we’re en route to the above (sample) call, I speed our ambulance down the road, lights and sirens. I won’t discuss the full assessment and treatment we’d perform on a diabetic patient, but if you want clarification or further explanation for your fictional writing needs, please ask me. On scene we find first responders assisting an unconscious male sitting slumped over in a Target bathroom. “His blood sugar is 12,” one of the firefighters tells me. “He works here and his co-workers say he takes insulin daily.” “Sir?” I say to the patient. “Can you hear me?” No response. His eyes are half open. His pupils are dilated and sluggish. My partner and I insert a line (IV), and push one 25g AMP (ampule) of D50 (dextrose 50% in water). I attach him to our cardiac monitor via a 12-lead (ECG patches), and assess his heart rhythm and all his vital signs. He’s in normal sinus rhythm and all his vits are within normal range; however he’s slightly tachycardic (heart rate too high), but an elevated HR is the body’s defense to survive a hypoglycemic episode (low blood sugar). “Sir?” I place my hand on his shoulder. “Hey, buddy, talk to us.” The patient remains unresponsive, so my partner and I push another 25g AMP of D50. Via a glucometer, we test his BGL (blood glucose level). It’s now 43. We’re headed in the right direction, but the patient is still unresponsive. We administer 1mg of glucagon IM (intramuscular injection). “Sir?” I squeeze his hand. “I need you to talk to me. Okay?” He stirs, his eyes attempt to focus. We load him onto our stretcher and wheel him inside our ambulance. Within a few minutes, he stares at me. “Where am I?” “You’re in an ambulance, sir. I’m EMT Benson.” I finish retaking his BGL again. It’s now 98 (within normal limits). “Do you...
Read MoreEMS Call: Respiratory Arrest
Posted by dtbAdmin on Oct 28, 2011 in Blog, Medical/EMS | 0 comments
Dianna is back for her monthly EMS post. I’d like to pass along my congratulations to her for winning in the ACFW Genesis contest this year! This is a much sought after award and will turn the heads of editors her way. I know we will be seeing her books published in the coming years. Today, she focuses on the aspects of a respiratory call. This will help add those factual details for your scenes. EMS 18, respiratory distress at 1234 Greene Road, at 1234 Greene Road on TACH channel 7. joeyvest As we climb into our ambulance posting (parked) at our station, my partner and I radio in we’re en route to the above scene. Lights and sirens, we rush out of the garage. En route, we’re notified via our computer that the patient is a 24-year-old female and is conscious and breathing. Once on scene, we find the scene is safe and no dispatched law enforcement. Typically a fire crew arrives on scene first (prior to us) since there are about three times more firehouses thanEMS stations globally, thus they’re closer than we are. However, fire is not always dispatched along with EMS, so for this sample EMS call we’ll say fire wasn’t dispatched. Upon our arrival at the patient’s side, my general impression of her is she’s SOB (short of breath) and in respiratory distress (dyspnea). She’s sitting in the tripod position (leaning far forward with her palms on her kneecaps) and she’s breathing shallow and fast (tachypnea). She’s not cyanotic (blue lips or fingernail beds), so she’s perfusing fine at the moment and not hypoxic (lack of efficient oxygen), but that can quickly change. I won’t discuss everything we’d do on a respiratory call like this, but if you need clarification or further explanation for your fictional writing needs, please do not hesitate to ask me. julezcourt As my partner whips out a non-rebreather mask and connects it to the oxygen tank at 15 lpm (liters per minute) then slips it over her mouth and nose, I assess her breathing rate and quality and find it definitely out of range, certainly labored and not efficient to sustain life, so I assemble a BVM (Bag Valve...
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