On the Way to Paramedic in Northern VA
It is the waning days of Spring, when a young EMT's fancy turns to passing the NREMT test. DTs simply must study, folks. In preparation for the tests next week, both written and practical, a two day "refresher" course is offered by NOVA - an offer which I cannot refuse. Since I run tonight, and spend Friday and Saturday at the All Day Refresher Retreat and Jamboree, it is my earnest hope to have a new post up by Saturday evening, at the latest.
NOVA is, by the way, a most useless agglomeration of wordage while on-scene. Case in point.
Delivering a patient from a hospital to a rehab facility, DTs was pressing the "raise bed" control in his cupped and hidden left hand while "levitating" the bed with his right hand, eyes half-closed and humming the bit from Star Wars where Luke was lifting his ship from the muck on Yoda's planet.
DTs partner de jeure, sensing the need for input, darthed, "The Emergency Medical Technology Department of Northern Virginia Community College has taught you well, young DTs."
Well, okay. It was funny at the time simply because of the drawn out nature of the remark.
Something good (one would hope) by Saturday, then.
Last post I mentioned triage at mass casualty incidents, and how the victims were "tagged", or color-coded by the first-in unit. With an MCI, green means the patient is "walking wounded", yellow means "soon!", and red means "Now!". Our instructor in MCI advised us that, did we find ourselves victims in a train wreck, the best thing to do was to yell out "I'm a Red! I'm a Red!" over and over. He was kidding, of course - reds don't generally speak. Neither do black tag folks - they be dead.
But a good system is a good system. Color-codes are therefore not unique to field providers.
Hospitals utilize color codes as well. In TV-Land nurses are always sticking their heads out of the patient's rooms and shouting "Code Blue!" Funny, that's all they ever yell. Code Blue. One gets the impression that Blue is the only code - and that's just wrong. There are lots of other hospital codes out there.
But "Code Chartruese" just sounds silly over the intercom. Therefore, many hospitals use the same basic colors but each assigns its own meanings. At one of my facilities, "Code Black" means there's a bomb threat. At your facility, "Code Black" might mean "Fresh Coffee is Ready". Therefore, if you hear a code over the intercom, don't presume to know what it means. You'd look pretty silly fleeing the premises because fresh coffee is ready.
So: Code Green (at this facility) indicates a terrorist or terrorist situation. Or a hostage situation. Something to do with someone being a big jerk. One might therefore hear "Code Green, in parking lot A." over the intercom. No biggy. Step against the wall to let the SWAT guys run by.
Code Black indicates a bomb threat. Again, no big deal. "Code Black, in parking lot A" simply means you no longer have to get your parking validated.
(Warning for the sarcasm-impaired: The rest of this article is baloney.)
Codes can occur simultaneously, in which case just mix the colors! Mixing our examples above, we get a Code Dark Green, "Terrorist with a bomb."
If our morally corrupt social engineer claims his bomb is "dirty" with biological, chemical, or radiological material, we must slide a Code Silver, "decontamination needed", in there somewhere. On the intercom, then, we hear "Code Dark Green with a Silver Lining".
"Doctor Red" or "Code Red" usually indicates a fire someplace. And it is often the case that a secondary fire might pop up from an explosion, so we now have a "Doctor Red possibly reporting later to a Code Dark, Dark Green with a Silver Lining."
Anyone hearing that over the intercom will probably Code Brown themselves, which means just what you think it does. Which is a shame, since at their facility "Dark, Dark Green with a Silver Lining" means "The lunch special today is a romaine salad with a light vinaigrette."
A lot of EMS is about what some folk might consider "snap judgments", but that term usually has bad connotations. Call it "quick thinking" instead.
What really needs to happen, often, is a lot of data needs to be sucked in and processed in a very short amount of time so we can stop staring and begin treating. For instance, at the scene of an auto accident, certainly everyone in the car is going to be treated to the best of our abilities. But some need help NOW while others can wait thirty seconds. This is the whole triage thing - worst goes first, and figure it out in 20 seconds or less.
The same twenty-second rule applies to mass casualty incidents (I've never had one). Victims are literally tagged, and the color of the tags indicates the severity of their injuries: Red is priority, yellow "soonest", green "walking wounded", and black means dead. The first EMS unit on the scene, not otherwise engaged, goes through tagging the victims instead of treating them - treatment comes from the units which follow.
What all this boils down to is that the"quick thinking" ability is Good, and so is naturally carried over into other aspects of the job. Sometimes, however, a hideous transformation turns "quick thinking on the scene" into "snap judgment at the station".
This is well illustrated by some folk who insist on pigeonholing others, a sort of "First Impressions Gone Wild" effect which causes otherwise sane individuals to draw erroneous conclusions. For instance:
Beer Mary defines a "Randy Rescue" as the "New Guy with more shit on his belt than Batman."
It is true that DTs has distended his shapely 34-inch waist by the inclusion of a few useful items which depend from his belt. And although he's never been called "Randy Rescue", it is also true that a firefighter has been known, occasionally, to ask, "Got enough shit on your belt, there, DTs?" This is the sort of comment which might call one's clarity to question.
For it is to laugh - one such firefighter was later desperately seeking a seatbelt cutter when DTs passed over his leatherman tool, you're very welcome.
Many a PD officer has been glad of DTs Enviable Selection of GloveWear when the vomitous drunk was headed to adult detention, rather than the hospital. Both latex and nitrile flavors, since some folk have latex allergies.
And while it is true that no fewer than five light sources may be found in various pouches, it is a canard that DTs carries enough candlepower to replace a tanning bed.
Anyone who derides the cell phone obviously has not tried to radio the hospital from our fair city's "dead spots". The digital camera in the same pouch is for you, fire guys, when the bambulance is staging on your scenes - we're much too busy to take pictures of ourselves when it's a medical call.
The rest of the stuff, trauma shears, penlights, pager - all standard issue, everybody has that stuff. And of course a good pen or two.
Damn! I am a Randy Rescue. If only my BDU trousers had any spare pockets, but alas, they're stuffed with...