Fire Fire Fire!!!

Time is flying bye! Only a few more weeks and some patient responsibility will hopefully be able to fall into my hands. Supposedly of course (if all my credentialing goes through on time). Feel like I am losing my IV skills, med skills ect quickly. I am still unsure of the exact reasoning for all of this shadowing and pre-hospital experience. I think they are wanting us to create great relationships with pre-hosptial folks, earn some trust, and of course help create the big picture. I have learned lots over the last two weeks and had a kick a** time with EMS. And for all those old people you know you pile up junk in the halls and stairs...encourage them to clean it out!! So hard to carry a patient through halls, over piles, and down steep stairs. Now I understand why all the fireman show up...to move all this stuff. Okay let me began my EMS/Cardiology stories. I hopefully can explain it like you were there.


On Monday morning I arrive at the fire station about 0.4 miles from our loft. I was following Capt. Thompson. His job is to jump in his pickup truck when there is a code or a large fire. Basically anything fun and exciting he goes. But he told me anytime bells and whistles went off I could jump in which ever truck was going. The station has a engine truck, ladder truck and ambulance. They all trade off between the trucks and ambulance meaning they are all EMS and fire trained. There was really nothing going on until about noon and they were all loving that I was there as I was supposedly the "white cloud." At noon the engine check light went off with the loud horn and whistle. The firemen truly keep their boots inside their pants outside the truck and have to be ready in the truck in 90 seconds. This means I had 90 seconds to get to the truck, open the door, jump in and buckle up. The door to the truck is so high, I actually have to jump to reach the handle. Thank goodness when I opened the door the stairs rolled out. And thank goodness I didn't have a miniskirt on as I would never have gotten in (don't worry I would have never worn a mini skirt to the fire station, just saying so high I did the splits getting in)!! I quickly strapped in and put my headset on. Off we go lights, sirens, and lots of honking! My heart was racing as we were flying through downtown weaving in and out of cars! I quickly identified stupid drivers, drivers who have their music too loud, and drivers who just don't pay any attention at all. My heart was racing!!! I was going to my first fire!!!  I was worried about my role... do I get to hold the hose? Will I have to try to rescue people? Do I have to stay in the truck? We arrived in front of the library downtown. Everyone jumped out of the truck and so did I. My instict was to start sniffing...but I couldn't smell any smoke...where was the fire? We looked all around and found some construction workers putting water on some dirt, but they were only keeping the dust down. Finally, to my right was a small plant in the flowerpot smoking. Looked as if a cigarette was "still burning." They took this tiny water can and put it out. Basically peeing on it! All this hipe, fast firetruck, lights and siren, heart pounding and all we got to do was put out a ciagarette. I could not believe it. A man comes running out of the SS office to say he would have put the fire out but he can't leave his station or he will get fired. The fireman asked, "sir you just left your station." The man ran back. I knew that people call EMS for dumb stuff and they transport them. People come into the ED for dumb stuff...but a smoking plant? Really? No worries, another plant saved, it remains green today.

We all piled back into the truck and started heading away from saving the day and rescuing the plant!! But right before our eyes down the road was a large area of smoke coming from what looked like to be the freeway area. And this time I smelt smoke!!! Is this the real thing? The captain (the man who sits shotgun) called into dispatch and asked if it was a fire along the freeway. Dispatch  responded back and said that there was a large three mile fire on the west side of the freeway. The captain shouted," we are on our way."!! And in a split second we were hauling ass down Jefferson Street lights and sirens quickly getting on the on-ramp for the freeway. I think I yelled out a little WOOT WOOT! Now flying in a helicopter does get my heart pounding and gives me a great adrenaline high. But I think going 60 mph in a firetruck might beat that!!! We arrived on first area where there was fire. The right side of the freeway was engulfed in smoke. Cars were flying by on the left hand side so we jumped out the right-side door. "Stay close to the truck Nurse Woman," they yelled!  The four fireman grabbed the hose, shovel, and watering cans and quickly start putting out the fire. They were all working so hard. I stood by the truck planning my escape route if the fire got too close! So much smoke! And man did it stink!!! A fireman yells over to me "Alissa how you doing?" Waving my hand back and forth in front of my face I said, "Can you hurry and put this fire out all this smoke stinks!!!" They all started laughing... We (meaning they) spent about 20 minutes out there fighting fire and then moved on about a mile down the road and did the same thing. After about an hour the entire  freeway was completely out. We definitely saved the day!! Sounds as if someone was dragging a chain along the freeway and sparks caught the freeway on fire. The best part was when the man in his tie-dyed pajamas jumped the fence and started to help fight the fire! I could see his amazing pajama pants through all the smoke! We left the scene and began driving back to the station but soon got a loud horrible noise over the headphones (its this loud large honk that will send anyone off their seat). This means we get another call!!! WOOT WOOT. I am no longer the white cloud. Dispatch reports that there is a large fire in the Wells Fargo building in downtown Roanoke. I was completely nervous as this building is right next to my loft and it is the largest building in Roanoke. I was already thinking bad thoughts of a mass causality disaster from the fire.  I quickly texted Mat and told him that the Wells Fargo was on fire!! He ran to the nearby bridge to watch. We were the first engine to arrive and on scene and again jumped out and went sprinting into the parking garage. The security guard motioned "over here over here." Of course I was expecting a large fire and flames pouring out the building! But in fact it was a rubber piece the size of an eraser smoking!! That's it!! I couldn't believe it!! Once again they spritzed it with the watering can and told the other 12 firetrucks that showed up everything is okay and the smoke is put out!! We leave the scene and start heading back to the station when Capt. Thompson and his little pick up truck stopped in the middle of the intersection and motions me into his truck. In the middle of the intersection I jump out of the large fire truck and go sprinting through traffic and jump into his truck. I was eating up all this excitement and didn't even shut the fire truck door! We take off going mach 20 through town again to a carbon monoxide leak in the lady's house. Turns out there was no rotten egg smell and everything was going to be okay!!! I think you have to have a good nose to be a firefighter. After a very quiet morning and incredibly amazing firefighting afternoon I got to go home! Can't believe I get paid to ride fast in the fire truck!!

Tuesday I was at a different station across town. It was the "white trash," part of town. Nothing exciting all day. Rode the ambulance to a lady who said she got bit by a dog but had no puncture or sign of a bite. Weird!! Another couple other calls that were about as exciting as the dog-bite.


Wednesday I went back to the fire station near our loft. It became feeling like home as I got to know everyone! Turns out Mat works with one and his boss is the cousin of another. They took extra good care of me!! I got to go grocery shopping in the ladder truck with the fireman (check and check off my bucket list) and then played on the firetruck the rest of the day. They took me to an empty parking lot to see how far the ladder can extend. There is no way I could climb strait into the air for 100feet. NO WAY. They wanted me to climb to the top and take a picture looking strait down. I got sweaty palms just thinking about it!! No way!!  The ladder truck is soooo cool! The truck is 1.2 million dollars. Amazing!! Got to see the jaws of life and play with them (they are the only truck to carry them). They are 55 pounds. I couldn't hold it up too long! Got to see all the crazy tools to stabalize the car before they retrieve patients. All this stuff I had no idea went on in the field. I got to learn how to fill the firetruck up at the fire hydrant, and lots of other cool stuff that had nothing to do with ED, but was so cool! No crazy calls that day...but I had the opportunity to learn lots about the fire truck and what goes on in saving patients from fire, or car accidents. We got to go to false alarm fire in the ladder truck lights and sirens through town and once again this was amazing. The ladder truck  actually moves through town better then the engine truck as they have one person who drives the back. This allows the truck to turn much sharper corners. For teaching me everything and putting up with me for so many hours I baked them a cake when we got back to fire station with homade frosting.

Friday was code after code after code day! This is whereI learned how hard it is to carry old people out of a very full house and still do CPR. They have a special device that does the CPR compressions for them. This devise works much better than the one we used to have at Deaconess and it was much smaller. I loved it. I supposedly saved an old man's life with Narcan (as the daughter and paramedic were screaming "you saved him you saved him")! And I got to go have lunch with the head Chief Fireman of Roanoke at Red Robin. His daughter is in nursing school so we had lots to talk about!!

 This week I have been in the cardiac unit at Roanoke Memorial. It is just not the adrenaline rush of Lifeguard Helicopter or Firetruck and EMS. This has been a great learning opportunity to just concentrate on cardiac and EKGs (12 hours of EKG reading) but I was finding a lot of it way over my head. I think I feel like I learned a lot about EKG and feel I may be able to explain how to read them now.  Not enough to compete with Danny though!! Once I understand what each lead is looking at on the heart it all started to make sense. I got to spend some time in the Cath Lab as well as watch a TEE. Don't think I could do this job everyday and their 13.5 hours shifts are way too long. But it was fun to concentrate on cardiac only for a week. Next week I get to go to ophthalmology and also on Thursday I get to pretend I am a patient at the PA school and have ulcerative collitis. I am going to be a drauma queen for sure!!!

I hope everyone is having a wonderful week!! I am continuing to learn lots not only about medicine but about healthcare in general. Mat is doing well with his job...spending some time at Regis Hair Salon, Motherhood Maternity, and Advanced Auto. His stories continue to crack me up. Mat and I are heading to Virginia Beach for the weekend! Hoping for warm weather so we can stick our feet in the sand! We miss you all! GO GONZAGA!!

Kansas City Missouri to Cincinnati Ohio

 We awoke to a beautiful Kansas City Missouri super sunny and bitterly cold. It was zero out. We stopped at latte land for a nice cold latte. Rule number one always ask for extra hot when you hear others asked for extra hot.  We have been using our phones the entire way for the fastest and best route for each stop. I am always the navigator and today was no different. We headed on the on-ramp to approach the freeway when Siri asked us to cross 5 lanes of rush hour traffic "now" and take the exit 100 feet ahead! I laughed pretty hard as Mat was trying to make this impossible endeavor. Cars were storming us left and right. We only made it two lanes and gave up. We exited in a not so nice part of Kansas City. Probably should have stayed low in the car but after 30 min we made it out safe and alive. Thought this place had tornados... Why are these shacks still standing? We proceded on hwy 70 between Kansas City and St. Louis. Mat was so amazed of all the cops. Not 30 seconds later lights and sirens and we pulled over. The first time Mat has gotten pulled over and was actually going the speed limit. Tabs are updated, seat belts on, no phones in use. WTH? Why us? Well I rolled down my window in the 0 degree weather, barely. The tall officer said Mat gets too close to a semi before passing it. "3 second rule." Ya okay officer...(5 lanes of 9 am traffic, bumper to bumper and he was waiting too long to pass). "Sir I need you to go sit in my car, it's how we do things around here." So now Mat was sitting in a cop car ( he did inform me this was a first). The cop said where are you from... Wow you have made quite the drive...duh cop!! So I tried to get a picture of Mat in the car as that would look good for the family and good on a resume. But there was too much crap in the car that was in the way. Mat was back there for about 7 minutes while I was just blown away about what was going on. Does he get to come back! Is not passing a semi soon enough equal to jail time? Soon enough Mat returns shaking in his boots! I just started laughing!! He informed me we both don't have warrants from Washington, and that there are 1 million cameras in cop cars, and the guy had a dog too (good thing he wasn't wearing the same clothes he was wearing in Denver Colorado). So basically this guy saw WA plates and wanted to see what we were running from!! We continued on the highway for many hours. Today was a 9.4 5 Hour Dr. and it seemed even longer. The only thing that kept us awake where the funny signs once again. I saw a fireworks stand that was an outlet mall. Not sure I'd ever want to buy fireworks at any sort of outlet. We saw the world's biggest boot collection in about four different towns not sure they'll communicate that they have the world's biggest boot collection. We also saw the biggest Winchime  and the biggest golf tee which mad mats day.  Today was definitely the day of "the biggest." Mat finally let me drive. But he felt carsick and became very bored very quickly. But I did finish out quite a bit of a drive today. We saw the arches in St. Louis as well as as the NASCAR speedway, some cool horserace track it must be famous somehow, and bypassed Indianapolis!  at 7 PM finally arrived at IKEA. We begin some shopping for a bed and a dresser. Because we have lots of room in this car, not! Our car is completely completely completely full! I think that Mat the semi driver has to stick his head out the window to pass now! Good thing Miley can curl up into a small snake. Went to bed after watching the State of the Union address now living on the east coast so we should be more politically involved! Off to bed! We just can't believe we only have one more day. Kind of sad. Pretty fun to see the country on the places we definitely want to go back to and the places we know we don't need to see again  like the state of Kansas. It's hard to believe we've already crossed the state of Washington Idaho Montana Wyoming Colorado Kansas Missouri Illinois Indiana and Ohio. And seen lots of rest areas! Until tomorrow!!

Lifeguard days!!

Well this week was an absolutely amazing experience. I hope I can display in words how amazing it was. I'll do my best...here we go.

A little background. Lifeguard is Carilion Clinic's helicopter company. They have three stations in the area and take both pediatrics and adults. I am told that the other large hospitals on the east coast only have 2 helicopters including Duke, Wake Forest, UNC, and UVA so Carilion always has to "one up" them. The station I was at was at Smith Mountain Lake, about 45 minutes outside of Roanoke on a super windy back road that will make anyone car-sick. Lifeguard flies with one Nurse, a Paramedic, and a pilot. What a dream job. Okay scene is set. Back to the story.

I drove up early while watching the sun rise, only to find out it was too cloudy and 1 inch of snow was on its way. So they sent me home. Tuesday was a little more clear so I headed back up again. My first hour consisted of getting my helmet, my survival kit to placed in my jump suit, and learning how to survive a helicopter crash. I learned how to shut down the 10 switches in case of a crash and how to break out windows. I was just hoping I wound remember to breathe in case of a crash...there was know way I was going to find all the switches. We sat around for about 4 hours awaiting a call. Finally, at about noon we got a call. Now you don't get to know what call you are going for until you are in the helicopter and in the air. This way weather does not tempt you do make a bad call and go on a call that weather would make too dangerous. Pretty good plan. During the Virginia Tech Shooting they ran out to the helicopter but said they couldn't go as it was too windy. A few hours later they found out it was for the shooting and felt horrible but knowing that they would have flew in extremely bad weather. Anyways we took off, I was five-harnested in, helmet plugged in so I could hear the dispatch. "This is lifeguard we have 4 people aboard, no warnings no restrictions we are ready for the call." We were headed to a rurual hospital for a STEMI (acute heart attack) and taking them to RMH (Roanoke Memorial Hospital). Super easy, stable transfer. On the way back to the station the piloit did some tricks for me as he used to be an air-show pilot for the army. He made me scream in my microphone as we tipped strait up in the air and then strait down with all the bells and whistles going off. "Danger, Danger." I about had to change my pants. Super fun though. No calls for the rest of the day. I intubated every manican they had and learned some great techniques.

Day 3. We did not get a call till later in the day. I tried every thing to get a call. Ate lunch, started homework, people ran to the grocery store, ya da ya da. Finally the bells and whistles went off and we ran to helicopter, pushed it out of the garage, did the walk around, jumped in, helmets on, plugged in, strapped in. In about 5 minutes we were in the air. "Yes lifeguard you are going to an on scene trauma for a logging accident." WOOOOOOTTTTTTT WOOOOOTTTTT. I knew this was gonna be good. It was about a 30 minute helicopter ride and I was enjoying it once again as it was a beautiful sunny day. We could see for miles. On arrival we were to land in a cemetery. Now this was pretty funny as I have never seen so many flowers as the wind from the helicopter blew them all over the place. Wonder if they found which flowers went where. We could not land at the site as it was too swampy. So the ambulance was to bring him up from the site to us. We waited for a few minutes and they came. We were in po-dunk county where there are only volunteers. This was Lincoln 555 minus 10. But they were great. I opened the ambulance doors to find a man with his leg positioned near his ear and it wasn't moving. My exact words were "holy shit." Pulses of the foot were thankfully intact! Airway....clear and screaming. Sounded as if the butt end of the tree kicked out and hit him in the hip. That leg was not wear it belonged....and that was obvious. The nurse tried doing conscious sedation so we could try to reduce it but he started screaming immediately. We were afraid he would not fit in the helicopter. I thought my 500 square foot loft was small.....there is about 30 square feet in the helicopter. Well as reducing him was not going to happen we splinted his leg to his shoulders and took about 5 of us to get him in the helicopter. We gave him pain meds the entire way and I may or may not have started my first IV at 3,200 feet. Buuu YAAA. Now that was a great ride. I was super pumped and so was my adrenaline. Nothing like throwing you into a trauma and then add a little helicopter on top of it. Great time with lifeguard!!! And got some amazing pictures to go with!! Glad I got to have this experience. Might have to go spend more time with them. Found out this man's head of his femur was down by his sacrum and he fractured his acetabulum.

Thursday and Friday I took ATLS. A little background for that is that they only started letting NPs and PAs take the class 2 years ago. Trauma surgeons teach it and really are particular about the class. For every PA or NP in the class there must be 4 doctors. We learned chest tubes, surgical cricothyroidotomys, and central lines. I was a challenging class. The final consisted of "victims" who were moulaged.

Mat and I spent the weekend at Smith lake hiking around and letting Miley swim, and on Sunday went for a mountain bike ride up at Carven's Cove. Carven's Cove was truly amazing. Although you can't even stick a toe in, or let your dog in as it is against the rule. I have never heard of a lake where it is illegal to swim. Not because of the snakes and it is very clean water. Just because...hmmmm.

This week I am riding with the firetrucks....should be great stories to come.