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Red Lights to the Left of them, Blue to the right! – Coloring Emergency Lighting

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So you’re driving down the road in an unfamiliar state, let’s say that it’s Iowa or Wisconsin, when in your rear-view mirror you see flashing red lights on a big utility truck coming your way. You can’t really make out what kind of truck it is, but you see red lights flashing so you pull over to let it go by. When it does, you realize that you’ve just pulled over for a tow-truck.

Or how’s this? The same thing happens, but it’s a flashing blue light in Colorado. When you pull over, you realize that you just got pulled over by a snow-plow.

I live in Illinois and work between IL and Wisconsin and there’s quite a bit of a difference between the different lighting colors and upon who can use what color light for what purpose. As a volunteer paramedic/Firefighter in Illinois I run a blue light with no siren in my personal vehicle. Even though I rarely turn it on, I have it in case I get stuck behind a 20mph Grandma on my way to the Big One. Interestingly, the blue light gives me no legal authority or any legal leeway on traffic laws and I must obey all traffic laws even while running the light. I Wisconsin, however, volunteer firefighters and EMS people may use red lights and sirens in their personal vehicles. They have the same legal status as governmental emergency vehicles when they’re driving with their lights activated.

In Iowa, volunteer firefighters may run blue lights in their personal vehicles with no legal authority granted them, and EMS volunteers may run clear (white) lights in their personal vehicles. Volunteers for fire and EMS combination agencies may run a mixture of both, however if a person volunteers for both a separate Fire department and a separate EMS agency, they must be careful to run the clear light for EMS responses and the Blue light for fire responses.

Of course, that’s just for personal vehicles right? Allowing emergency lights in the personal vehicles of emergency volunteers is a debatable issue in some circles. I argue for responsible control of their use and think that they are needed in some communities and not needed in others. Out of the 400-500 volunteer runs I respond to annually, I probably turn on my blue light for less than ten percent of the runs. I use it judiciously, but I know others that I can say did not.

However, this isn’t a post about volunteer emergency lighting and the pros and cons of it. It’s about the messed up spectrum of colors that we use on emergency vehicles in this country. Sure, we have the same stock colors pretty much everywhere. Red, blue, amber (yellow), green, clear (white), and in some states purple (Yes! Purple!). In the southern states, blue lights are for law-enforcement only and red is for fire only. In Wisconsin, law enforcement runs red and blue lights and fire and EMS is red only. In Iowa, up until a few years ago everyone ran red lights except for volunteer firefighters. They changed the law and now allow blue on the Passenger side only. In the City of Chicago, the Chicago Police Department runs blue only and the Fire department runs Red and Green. Downstate Illinois (Read: Outside of the City of Chicago City Limts) runs red and blue for all “Authorized Emergency Vehicles” and blue lights for the volunteers. Green lights are only permitted on stationary vehicles for command lights but can also be used for private security officers. As I mentioned before, in Iowa and Wisconsin, tow trucks run red lights. In Colorado, snow plows run blue. In some states, funeral processions run purple.

Confused?  I sure as heck am.

Consider this: Different lighting colors exist because different members of the driving public see different wavelengths of light in the spectrum (i.e. “Colors”) better or worse in differing ambient light conditions. Also, different colors penetrate different atmospheric and/or ambient light conditions better than others. You can see blue forever at night or in the fog, but not so much in the bright light. Red washes out to amber in the day light but is still fairly visible. Clear lights penetrate for a very long way but can be confused with light reflecting off of a surface almost the same as amber lights. We need a diverse spectrum of colors emanating from our response vehicles in order to ensure that the highest amount of drivers out there are able to see the lights. If someone’s color blind to the particular light color that we choose, they’re not going to see us all that well, are they?

The arguments that I hear for the use of lighting colors don’t hold much weight with me. Who cares if the public is able to see that an approaching emergency vehicle is Fire, EMS, Law Enforcement, ASPCA, Haz-Mat, Tech-Rescue, Volunteer, or miscellaneous. They just need to pull over and get out of the way. One color lighting schemes may give the agency a sense of personality or whatnot, but they’re certainly not the safest way to be seen. An emergency vehicle needs to throw out a lot of light across the spectrum of visible colors in order to help ensure the safest response possible.

So why are we having this hodgepodge of warning light colors? Why do people think they’re a good idea? I can think of a few advantages of having “law enforcement only” colors, as in reducing false traffic stops from people impersonating police officers, but having one color and one color only simply makes it easier for a criminal to get a hold of that one color of light. Why fire would only need red lights is a question that I can’t come up with a good reason for.

So good luck driving out there! If you see me, I’ll be on the side of the road letting a tow-truck go by. Then I’ll run my blue light in Wisconsin because we got a house fire in my district that touches the WI state line and I’ll get arrested for impersonating a police officer. Then I’ll be at work getting into a crash because someone driving out there was color blind to the color red.

Anyone want to add to the confusion? What colors do your state or country use? Is anybody else in favor of a national standard?

Posted by Ckemtp on April 7, 2010 • Filed under: 911 fail, Administration & Leadership, Ambulance, Ambulance Driver, Ambulance maintenance, Command & Leadership, EMS, EMS Health & Safety, EMS Management, EMS Topics, EMS rant, EMS safety, Emergency Medical Services, Fire Rescue Topics, In the Line of Duty, Iowa, Iowa EMS, Line of Duty, Management, Technology & Communications, Vehicle Operation & Ambulances, Vehicle Operations & Apparatus, accident, ckemtp rants, code-3, drive fast, lights and sirens, politics, technology-communications-ems-topics, volunteer fire department, volunteer firefighter

Be the Glow Worm – HazMat for EMS.

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I am not a glow worm.

Full disclosure – This is a repost from 09/2009 – It deserved a bump-up and to fix the video. Make sure to watch the vid!

Hazardous Materials, or “HazMat” as it is commonly known, is scary stuff. At least for me that is. In public safety circles, they’re mainly the concern of firefighters and I’ve never received training on them outside of the realm of the fire department. My EMS only agencies have always told me that we remain in the “cold zone” and wait for patients to be brought to us after decontamination.

And that’s just fine with me. Ckemtp is NOT a glow worm… did I mention that?

But, since I’m also a firefighter I finally broke down one weekend and gave in to the pressure I was under to get my HazMat Operations certification. 40 hours of class, lots of homework, and some very dry PowerPoint slide shows. After the first weekend of the class there’s some things that I’ve learned and figured out.

1. HazMat’s still scary.

2. Ck’s still not a glow worm.

3. EMS agencies really need to train more on HazMat.

“We know hazmat” you say. And I know that you’re saying it because that’s what I would have said before those last 20 boring hours spent learning that I knew nothing about hazmat. HazMat is something that we take for granted in that we think that it won’t happen in our jurisdiction, or that it won’t affect us on our day to day. I happen to hope that it won’t hit during my duty days.

This video is from Seward, IL. A small town in the middle of a lot of corn that found itself one day having a big problem. The video is from a surveillance camera on the side of a grade school in the middle of town. The vid starts slow, but has a definite “HOLY CRAP!” moment about halfway through. You’ll see what I mean, all hell breaks loose.


 
See? Holy hell on crutches! That’s anhydrous ammonia, a common chemical used in farming (and in methamphetamine production). A tanker truck full of the stuff sprung a leak and flooded the town with a toxic cloud. Thankfully, nobody was killed. There were a few firefighters sent to the hospital, and some very scary moments, but it all turned out to be ok. This one’s from the same school. It’s just as scary.

Remember this, a HazMat incident doesn’t have to be the once in a while overturned tanker truck full of MethylEthylBadJuJu. Any every day response can turn quickly into a hazardous materials incident.

Not too long ago, an EMS only agency that I may or may not work for received a call for an “eye injury” in one of our really rural response areas. This call generated a single ALS ambulance only response out to the farm where the injury happened.

The medic and the EMT responded out to the scene, which was about a 15minute emergent response. Arriving at the farm, they were directed to the dairy barn to find their patient.

Their patient was in a lot of pain.

Apparently, he worked for a dairy services company and was delivering product to the farm when he was injured. If you don’t know much about dairies, milk processing leaves a byproduct called “Milk Stone” which is the dissolved minerals in milk solidifying on dairy equipment. Think of hard-water stains. Dairies use products containing phosphoric acid to clean it out. It’s like Lime Away on steroids. This stuff is pretty nasty. Dairies use it in a diluted form, but the supply companies carry the concentrated stuff. This patient was filling a container with the high-powered stuff to dilute it into the customer’s container when the concentrate fell. He reflexively looked right down at the falling container and got a face full of the stuff when it splashed back up at him.

Do you remember that chemical burn stuff you were trained on? He had them. Do you remember the decontamination training you had? What about proper personal protective equipment, do you have it? Do you know when to put it on? Do you know how? What do you know about the chemical?

While treating the patient, one of the paramedics noticed that his EMS gloves was turning white. It was the acid eating through it. A lot of water was used to irrigate the patient, and the providers, before transporting the patient to the hospital.

This was an everyday incident that actually happened. Think about how you’d handle it, because tomorrow it could happen to you.

And once again, Ck is not a glow worm.

Posted by Ckemtp on January 20, 2010 • Filed under: EMS Topics, EMS safety, EMS training, Fire Rescue Topics, Firefighter Safety & Health, HazMat, Major Incidents, Special Operations, Uncategorized, Videos, accident, disaster, training-fire-rescue-topics, volunteer fire department, volunteer firefighter

Sunday Randomness – Some EMS Pet Peeves

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< Rant>

Call me old and cantankerous. Call me obsessive too, probably. After being in EMS for a while now, like over a decade or so, I’ve become somewhat set in my ways.

No, not to the point where I’m not keeping up with cutting edge medic stuff or to the point where I won’t try out new fast food joints… and heck, just today I even tried out a new way to clean the station bathroom using the hose and the truck brush.

You know that the “Wash and Wax” stuff we use to shine up the trucks works AWESOME on the porcelain goddess! I can see my reflection!

But I have definitely developed some Old Guy in EMS Pet-Peeves (or as you UK folks call them, “Frumpydumples” or something weird like that) and I just remembered that I have a blog that people come to read. Because of that, I think that I’m perfectly entitled to rant a bit on what my EMS pet-peeves are. It’s a beautiful thing, for me.

So, without further ado, in no particular order, here are some of Ckemtp’s all time EMS pet peeves.

#14245 Swearing in front of a (member of the public)

Look, there are days where I can spew forth a string of sassy talk that would make Popeye blush. I get it from my mother (She’s a saint). I also grew up in the country around farmers and got my start in a rural firehouse. I know how to swear with the best of em’ (“#$Q#$” See? There ya go). However….

IF YOU ARE AN ON-DUTY PUBLIC SAFETY PERSON DO FREAKING NOT SWEAR IN FRONT OF A PATIENT, THEIR FAMILY, OR ANYONE ELSE FOR THAT MATTER!!!

It’s not cool. It’s not “Just how I talk” and I don’t have to get used to it. People don’t have to adjust to you. You’re a professional, you have to adjust to them. When you do this, it not only makes you look like an ignorant ass (ahem) but it also makes ME look like one by shaping public perception of our profession.

Call me what you want to. I don’t really care. It doesn’t matter matter if we’re with a patient, at a facility in front of staff, or out in public having lunch. You are representing everyone, every EMS and public safety person. Act like it.

Do this in front of me and expect correction, immediately, in front of the patient. (Yes, it’s that important). Swear in front of children and I might just have to hit you.

#3523 Encouraging the Refusal of Medical Assistance (RMA) before assessing and treating the patient

Hey, guess what… I understand that you’re tired. I understand that you’ve got better things to do today. I completely understand that you’re tired of running what you consider to be “BS” calls all day.

But you’re an EMS professional, right? You’re SUPPOSED to be sent to people who call 911. Yea, there… I said it. It’s your FREAKING JOB to assess everyone who calls you to the BEST OF YOUR ABILITY before you give them a professional recommendation about what they should do. If you ask a person “So do you want to go to the hospital or what!?” angrily before you even, like, feel for a radial pulse or get a pertinent history and physical exam you’re NOT DOING YOUR JOB. Most patients WANT you to give them a recommendation on what you think they should do. You’re an EMS professional, do just that.

If we told more people “Well, Ma’am/Sir I believe that what’s going on doesn’t really warrant an ambulance trip to the emergency room. I’ll be happy to take you if that’s what you want me to do, but perhaps you could get better care by taking a trip over to the (Insert Local Urgent Care Clinic Here) or by calling your personal physician and telling the receptionist that a paramedic/EMT told you that you should be seen today, or (Insert locally specific alternative treatment path here)” we could defer a lot of what you consider to be “BS” calls. Not everything is an emergency, but every patient deserves our professionalism, if not our respect. It’s our job and our duty to everyone. Yes, it really is. No, your argument doesn’t hold water with me. You don’t deserve to be so cynical.

Appropriately assess, treat, and make your decisions on behalf of every patient. Don’t put your personal feelings in there. It’s not ethical. No, it’s not. You want to be an EMS professional? Act like one and Earn It.

#7628 Not being EXTREMELY CAREFUL when handling the cot

Ok, this is a patient safety gripe. Have you ever dropped a patient while they’re on your cot? I have. I don’t consider it to be my fault other than the fact that I was responsible by being one of the two people holding the cot at the time. I’ve never forgotten the look of horror on each and every one of their 4 faces. I. Felt. Terrible. It haunted me for weeks. It still does. We’re supposed to protect our patients. To ‘First Do No Harm’ is somewhere in our extended code of ethics. If you’re dropping people on your cot, you’re doing harm.

If I see you absentmindedly wheeling the cot, I will stop the cot, watch you continue walking until you wrench your arm out of it’s socket, and then laugh under my breath. I will compel you to pay friggin’ attention to the cot and the patient before I move again. If you resume being absentminded, I will repeat.

If you don’t know basic physics, which will tell you that the center of gravity for flipping a cot is much smaller when the cot is travelling on from side to side rather than from front to back, then you shouldn’t handle a cot. Yes, the cot wheels rotate 360degrees but that does not mean that you can move the cot sideways. Move it in a straight line. When you need to turn you stop, rotate the cot on its axis, then move in a straight line again.  

Yes, I ended that paragraph with a period. There wasn’t any more to say about that. Know what else there isn’t much to say about? The fact that you WILL have BOTH hands on the cot when moving on anything less stable than a level hospital hallway. That’s the only time you can use that little handle on the front of the cot. If you’re on ANY other surface, it’s both hands on the cot.

Yes, that was another period. Trust me. I’m saving you years of torment and some lawsuits.

Alright. Today’s rant has gone on long enough. Thanks for reading! < /rant>

And yes, there will be more coming. I rant a lot. It’s one of the reasons I started blogging. Thank you for reading it.

Posted by Ckemtp on October 25, 2009 • Filed under: Ambulance, EMS, EMS Health & Safety, EMS Topics, EMS rant, EMS safety, Emergency Medical Services, Public relations, Vehicle Operation & Ambulances, ckemtp, ckemtp rants, pride, profession, professionalism, rant

The Drunk Responder

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Greg Friese, over at Everday EMS Tips, has written a post in observance of Drug Free Work Week – Oct 19-25th, 2009 entitled “When a Coworker is Intoxicated” In it, he asks what we would do as EMS professionals and Firefighters in cases where we suspect that a coworker is under the influence. This originally started as a comment to his post, but it went long enough that I thought I could get a post out of it. Here it is:

Ewww, I hate these situations. I’ve worked full-time EMS for a long time, but I’ve volunteered for longer than that. One would think that this is a problem that I’ve encountered more often in the volunteer services, however I’d have to say that the few times I’ve actually noticed it are about equally distributed.

Thankfully, these situations have been few and far between. However, EMS and Fire people like to drink sometimes (ahem) and the potential exists for this to happen more often than you’d think.

In a volunteer service, the classic example is someone showing up for an emergency call after consuming alcohol. Often, these people sincerely did not want to “show up drunk” but thought that the need was great enough for them to show up after having “Just one or two”.

For the paid services, aside from the absolute taboo of consuming alcohol while on duty, the classic example would be spending a late night out at the bar and then showing up for work in too short of a time for the alcohol to be removed from the person’s system. If you’ve ever had a coworker show up complaining of a hangover, this may indeed be the case.

Both are unacceptable. Personally, I know that my career depends on never doing this. I also know that my patients deserve a caregiver who is on top of his (or her) game. I subscribe to the FAA’s rule governing pilots, or the “8 hour from Bottle to Throttle” rule. I take myself out of the response roster for at least 8 hours if I have had one sip of ETOH and I stop drinking a minimum of 8 hours before having to go on duty.

There’s no excuse for a provider having any amount of alcohol on board while performing any aspect of EMS. If the patient smells even a whiff of ETOH on their provider, that provider is drunk until proven otherwise. Even if the provider is under the legal limit the patient loses confidence. Our patients deserve better. If you had EMS come for a family member and smelled alcohol on the responding ambulance crew, you’d think the same thing and would probably become very angry or fearful for the actions of the responding crew.

Remember, each “drink” defined as one ounce of alcohol, raises your BAC (Blood Alcohol Content) by roughly 0.02%. That amount of alcohol takes approximately one hour to be removed from your system by your liver. Each person is different, and other factors come into play… however if you’ve been drinking you need to leave hours between your personal fun and your professional care.

The problem here, of course, is the percieved effect on the person who reports a coworker for possibly being under the influence. In some agencies there may be fear on the part of the coworker who notices the smell of ETOH or other intoxicant that they will be ostracized by the group for blowing the whistle and turning the offender in. In reality, it is your duty to your future patients and the reputation of your agency to turn someone in no matter the percieved ill effects. However, to make this easier I have some tips:

  1. Act immediately – If this person gets activated for a call or otherwise interacts with a patient, they could cause that patient harm. This is unacceptable.
  2. Enlist the aid of a coworker if you’re uncomfortable immediately going to a supervisor – Get someone else to nonchalantly speak to the person or linger in their vicinity to see if they notice what you do. Go together to report the suspicions even if the other person doesn’t notice what you do. It’s that important.
  3. Remember that someone’s life may very well depend on your actions – Friendship among coworkers is one thing, but a drunk firefighter or EMS provider may very well kill someone. You or another coworker may be injured or killed by their actions on the fireground or emergency scene. Your patients may suffer at their hands because their decision making ability and reaction times are impaired. Can you stand that on your hands for not reporting it?
  4. You may be helping the person through a real problem – Is the coworker an alcoholic? Could they be? Being at work drunk, especially in such an important job as EMS and firefighting is indicative of a real problem with alcohol. Turning them in may be the first, and biggest influence in getting that person help or in allowing them to help themselves.

This is a tough situation, but is an easy call. Keep alcohol and other drugs out of the emergency services. Keep yourself sober and sharp while on-duty or responding. It’s just not worth losing everything over a couple of beers. Have your fun and enjoy yourself while off duty but remember, alcohol can be a wonderful servant but is a terrible master. Do yourself, your career, and your patients a favor and leave ETOH in your personal life, far away from your station.

Posted by Ckemtp on October 22, 2009 • Filed under: Administration & Leadership, Command & Leadership, EMS, EMS Health & Safety, EMS Topics, EMS ethics, EMS safety, Emergency Medical Services, Ethics, Fire Rescue Topics, Firefighter Safety & Health, edemse, everyday ems ethics, medical ethics, professionalism, safety

Soapy Demons – Ckemtp is a geek

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Washing Machine Sta 1Ok, so this post really proves just how much of a geek I really am. Just bear with me for a bit.

This subject causes me a lot of personal grief. I know that it probably shouldn’t and that I am indeed a geek for worrying about this issue because seemingly no one else does, however this issue has plagued me for years and I need to get it off of my chest.

This is about the washing machine at the main fire station where I work. I’m at this station a lot, whether I’m working one of my three weekly scheduled paid shifts, hanging around with my wife who works there three scheduled paid shifts as well, or volunteering my time for call response, training, or work projects. So I have the opportunity to use this particular large, commercial, washing machine quite a bit.

It’s a nice machine. It handles the huge loads that we generate on a daily and nightly basis. It cleans the stuff pretty well and runs pretty quickly and quietly.

The problem is, the soap. It does not rinse the soap out of the clothes, bed sheets, blankets, turnout gear, or anything else that we put in there. The “rinse” water is always white with suds and everything comes out soapier than when we put it in there.

I am well aware that this is not a sexy problem. It’s not a big issue and castles will not fall because of it. It just drives me nuts.

When it comes to be my time to use the machine, I run two full cycles at a minimum to rinse out the machine. The third cycle usually has at least some soap in the water but I use it anyway because all of the residual soap that is left in the stuff that we constantly wash in there. The stuff is full of soap! Our sheets, our towels, our turnout gear… everything. After you run a load in there, even after a second full cycle, the water is white with suds on the final rinse phase.

For a few years, I begged, pleaded, cajoled, and bargained to get people to use less soap in the machine. I tried to get the purchasing division to get us a different type of soap that might rinse cleaner. I even went so far as to post up a few memos in the washing room and write a couple of written requests to the purchasing division and the officer above them.

Predictably, nobody cared those times and still nobody cares about the issue now. Everybody still dumps the same big glob of soap into the machine when they start it and then promptly forgets about it. Whomever comes in and removes the stuff from the washer just puts the stuff right in the dryer, still soapy as all get out, and throws another load in the washer. Then, they dump a big glob of soap in the machine and the cycle perpetuates. Honestly, it’s a losing battle for me and I know that I’m the only geek who cares out of the 100 other people on the department. Nowadays I’ve resorted to trying not to care about it so much and also by surreptitiously watering down the soap that we use. I’ve been doing that for years and nobody seems to ever have noticed (until they read this). It helps a bit, but still our stuff is soapy as heck.

Am I crazy? Probably, but consider this: This small issue is hurting my department and the way we function. Really. We spend hours per week cleaning and polishing our apparatus. To do that, we need towels. Lots of them. Now that they’re all full of soap, they don’t soak up water anymore and we have to constantly replace them with new towels that promptly get full of soap and don’t absorb water and leave our trucks streaked with laundry soap and water spots. Then, we replace the towels again and the cycle perpetuates. How much money do we spend on new towels?

Consider this also: Our guys sleep on linens that get washed every day after they’re used. These linens are full of soap and are against our guys’ skin every night. What happens when one of them develops an allergy? Occasionally, some of this linen goes for use on an ambulance… when will we get a patient with an allergy to our soap?

Consider this as well: How much does it degrade our turnout gear to be full of regular laundry soap? Sure, we bought the expensive specialized turnout gear cleaner, but it doesn’t matter because the water we’re using to wash the gear is full of the soap from everything else? Does that degrade our protection? How much are we harming our very expensive protective clothing by filling it with soap? When will the gear fail and someone get burned because of this? Will it happen? When someone gets burned will it be my fault because I didn’t try hard enough to fix an issue that I saw?

Yes, I’m a geek for caring about this issue so much. I feel like an OCD Chicken Little. However, this small, nothing issue is costing the department money overall and could get someone hurt out there on the fireground. After that, I’m sure people will wonder how this could have been prevented. I’m sure also that they’re looking for ways to cut costs now that the economy tanked and tax revenues are down.

And there sits the washing machine, quietly driving me crazy.

How many issues out there do people know about like this? Issues that are small enough so that nobody else cares but that snowball into big problems for the organizations. How many of these issues affect EMS and the fire service industry-wide. How many of them affect everything?

One day I’ll conquer my soapy demon. For now, I have to keep watering down the soap in secret… but as crazy as it seems, I feel that I’m making some small difference. You can too. Be it the way your equipment is checked in the morning, the way you package your lifesaving gear, the way you make sure that the gas tank is full, or the way you do whatever it is you do to make your service the best it can be.

Now get out there and water down your soap. You might just save a life.

Posted by Ckemtp on October 10, 2009 • Filed under: EMS, EMS ethics, EMS safety, EMT, Emergency Medical Services, Ethics, Fire department, Firefighter, Paramedic, edemse, ems 2.0, everyday ems ethics, fire, new perspective, pride, professionalism, soap

Holy Crap! UK medics…

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Y’all need a taser.

http://www.telegraph.co.uk/news/uknews/5364780/Knifeman-copied-scene-from-The-Shining-as-he-attacked-paramedics.html

Glad that this kind of stuff doesn’t happen where I am much. Medics get attacked all the time, and I am no different… but I’ve never gone through this. I think that here in the states there wouldn’t have been a court case for the perpetrator on this one. I don’t think that the local cops would have used pepper spray here. Probably they would have pulled out their trusty 9mm or the like.

Wow.

Posted by Ckemtp on May 25, 2009 • Filed under: EMS, EMS safety, EMT, Paramedic, UK medic attacked, attack, safety, united kingdom