You don't get to destroy three cars before breakfast most places ...

... but here at the firehouse, we call it "Saturday".

The crews are in the midst of spending the entire weekend out-of-service to conduct a series of rescue squad 'extraction' drills to keep their techniques as sharp as their jaws-of-life.

Most people have heard of the 'jaws' and the actual jaws themselves are everything you would expect them to be - strong, impressive and able to cut through just about everything within reason.

They, along with the other gear we have, make for a relatively straight forward extraction most of the time - getting things done quickly enough to be of help is the real trick. That it is simply a matter of practice, I suspect, is why we have these 'squad days' every few months.

One of our set-ups had us deal with a flipped car; rather than an attempt to free a passenger from the wreck as quickly as possible, this was more a chance to try our hand at each of the tools in the company arsenal - the air shears, the rams, and the circle and panel cutters.

The ultimate goal here was to cut the floor right out of the car - I couldn't help but remember my own four-door Impala as the one before us was ripped to the four winds.

The five junkers - an old brown thing, a nineties model Corolla and a few others - looked bad enough before we got to them - and Good Lord, you should see them now.

There are signs on darn near ever corner 'round these parts offering 'free removal or unwanted cars' ... even 'fifty dollars guaranteed for any auto' in some cases - I have to admit I was sorely tempted by the potential score of 250 smackers for the shredded pile of iron and steel now waiting to be carted away in our parking lot.

The Corolla saw a pretty harsh end too - I had always known that a sawzall was a pretty hearty and versatile tool; that said, I had never seen it taken quite to the level I saw today ... Not that I would ever think to use one to say - cut the trunk off of a compact car, but trust me - it is more than adequate for the task.

The scenario in this case was a passenger stuck in a car - crushed and buried - with only the trunk accessible. After removing the trunk cover and taking the sides off the vehicle, the rear and then eventually driver's seat were torn out so a backboard could be put in and the dummy stand-in extracted. It was all pretty interesting.

The next entry should be post-physical ... I am practicing for my hearing test. Wish me luck.

Enough of that few-and-far-between stuff.

Yes. Guilty as charged. I haven't updated the ol' blog in a while now. But there is a good reason - two good ones actually.

I've been busy, and I saw no good reason to bore you with the quiet evenings I've been frittering away at the firehouse.

That said, there have been a few interesting developments which I will now attempt to recount for you in my usually rambling if not entertaining fashion.

First, I have passed my background check. Take that, National Sec - err ... other people who've done checks on me !

Thanks, really - don't clap. I really can't chalk it up to anything but honest, good, clean living.

Second, I have succeeded in scheduling my physical with the Department of Transportation. The bad news on that front is that the first day they have open is two weeks from now.

(Yikes. Good things I'm not in a hurry - oh ... wait a minute --)

I had been told to expect as much, and am sad to report that my charm didn't really get me any further up on the list.

That little jaunt will involve three stops for me when it finally comes - between treadmills, the specimen bottles and those E-LPOZ eye charts, it should prove a pretty full day.

The last little piece of new information is that I now have a start date for my EMT class - shortly after the new year, I will get things moving in the classroom again.

So, after a lull that was a bit longer that anyone would have liked - and one that quite frankly still isn't technically over yet - things seem to be getting a little more exciting again.

I will fill you in on the details as they happen.

Call sheets, a late dinner and one of those I'm-glad-it's-you calls

I've never been that big on food - anyone who knows me knows this - but for some reason, more than a few very distinct memories from my early childhood deal with it in one respect or another.

Strangely enough, in nearly all of them, the color green is somehow involved - the lime green snow cone at Cedar Point with my brother, portions of Del Monte canned green beans at least once a week, and, a set of white china dishes with a green floral pattern around the edge, about a quarter of an inch in from the rim.

The only reason I bring it up here is that there just happens to be one of the same make and model plates in the cupboard at the firehouse. It makes me smile every time I see it, even in spite of the fact that I am usually cleaning it at the time.

It also makes me think back to the time when I used to go everywhere with a red fireman's helmet on and my toy med kit in hand. The helmet eventually cracked, only to be mended by my grandfather with, of all things, green duct tape.

(On a side note, I want to take this chance to thank my big brother Dave for showing me there was actually stuff INSIDE that case ... I had lugged it around for weeks just because, completely oblivious to the stethoscope and other assorted things therein.)

These events fondly remembered, I started off the evening by practicing taking blood pressures. I still need some work of hearing just when the diastolic pressure announces itself - I'll keep working on that one.

I think I've mentioned our printer before - the one that gives us a hard copy of the details from dispatch ? Well ... whenever the bells go off to herald an in-coming call, the pertinent info displays on our light boards about thirty seconds later.

The print out always rolls off just before the boards light up though, so anyone standing near the printer can read about the call before anyone else knows whats happening.

If I happen to be nearby, I usually take a chance to review my protocols and think about what sorts of things I would prepare to see and do : for an overdose or a birth; for trouble breathing, or a motor vehicle accident.

I happened to catch a glance of a sheet from a few days ago. One of the guys filled me in on the case - I imagine it would have shaken me up a bit being there, so I asked whether or not the members of the team ever debrief after a tough call.

The response was a shoulder shrug and a 'not really', but they were just as quick to say that everyone in the house is there to help everyone else, and that support would be there if needed.

I made sure to check in with the aide who rode the call later on - he really seemed to be doing fine ... I guess that's just something that comes with the territory. I still told him I'd be available if he needed to talk.

Two of the guys were trying to lure a rat out of the outer wall of the station with a peanut butter sandwich while we're grilling kabobs for dinner - we were trying to finish in time for the night's training activity and they were trying to rid the neighborhood of a rat. Neither team succeeded.

The captain walked by while we were sitting there, so I mentioned that I had applied to become a notary. I figured since it was a bit of a hassle for me and my fellow applicants to get our papers notarized, it would be of help to have one on sight. Assuming my state senator signs off on the paperwork, I should be all set in about six weeks.

As I was heading out a quarter after ten, a call for help came in ... every so often there are those calls you'd just assume pass off on - especially having come right from the dinner table - well, this was one of those.

The aide put on a brave face as he headed out the door, and I'm sure he did just fine. I can chuckle now, but am sure my time will come some day.

Location, location, location.

And, before you ask - no. That doesn't mean the firehouse is for sale.

It's just a fairly good way of summing up what tonight's principle activity was - an 'area' drill: the way they test a fireman's knowledge of the vicinity.

I, for one, had been under the impression that I had a fairly good grasp on the local streets ... an impression that vanished - like a wisp of smoke, if you'll excuse the simile - within the first three minutes of the evening's little quiz.

Sitting around in a circle, each of the guys was given an address that he had to give road-by-road instructions on how to get to. I seemed particularly ignorant of the whereabouts of particular blocks; the 6800 block of this, the 2200 block of that.

Watching them rattle off the litanies of streets, avenues, places and courts was darn impressive. There were of course, a few trick questions - two streets with the same name that were a city apart, a long street that was broken up by dead end segments - only a few of the guys fell for them.

Every now and again, the officer in charge would chime in with a follow up question - this was what separated the men from the boys, so to speak :

Q. Why is 42nd a bad choice ?
A. Because of the speed bumps.

Q. Where's the nearest hydrant to this location ?
A. Four hundred feet or so down the street.

Q. When you're headed south, which come first the avenues or the places ?
A. Avenues, then places.

Q. What's at this address ?
A. A six-story apartment building.

Q. What's unusual about the building at that location ?
A. It's on a steep hill, so it's two stories tall in the front and four in the back.

They took a few minutes to disparage one particular apartment complex as being a complete death trap - turns out I used to live there.

Interestingly enough, we were kicked out ... I guess the property owner's desire to see after his land only went so far.

Some of the guys are in the process of competing for professional slots in a nearby city ... they regaled us all with stories of their recent agility tests while we made dinner. Had I known we were making burgers, I would have laid off having them at lunch.

We practiced splints again to finish up the evening ... I thought I played a fairly convincing "victim with a broken elbow", but somehow I doubt I'll be getting a call from Juliard anytime soon.

Not a whole lot to report from this end.

It does seem like things are taking one or two steps forward though.

Thursday night, my two cohorts and I (the two guys who have been with me consistently pretty much since my odyssey began) will get to start covering some of our VRS material.

"VRS" or "volunteer recruit school" addresses some entry level topics that you have to complete before you begin your EMT classes. A good bit of it, from what I hear, is much more oriented to people doing fire and EMS.

Another part of it is the infectious control class that I've already audited twice. I imagine it also includes CPR and the AED, which I have also already had. So, I feel like I am in pretty good shape going in.

Most of the topics can be covered in-house by our fellow crew mates as time and circumstance allow; and as for the infectious control class ... we'll just have to wait for the next time it rolls around. Assuming we have our numbers before that happens, we'll actually get credit for being there this time.

That same night, we'll also get a little stick in the arm to test for TB and start any multi-shot immunization cycles that we haven't had. I'm already free and clear of HEP-A and B ... hopefully I'll be able to upgrade by tetanus then too.

I spend the first part of the evening reading through my electronic copy of the 2007 Maryland Treatment Protocols.

I was a bit confused by the stuff I read about using the ERMC - that's the system used to connect the aides in the back of the ambulance with a doctor at the hospital the patient is being shuttled to. So, I pitched getting a refresher on using it as a topic for the evening's training.

What we learned this time was at least a little more in depth that what I got weeks ago ... turns out you're supposed to hail a doctor anytime your patient is rated a priority two or higher. I didn't know that one. Once you do, the doctor waiting for you might give you some direction, though he might just as easily recommend nothing more than what is in our standing orders.

These little lessons always allow for the tossing in of those theoretical questions that only come up in context ... the guys are blessedly good about trying to answer them.

A few calls went in and out - including a harry one that, for a number of reasons, I won't go into - its high initial priority spoke to its seriousness, and the fact that it got canceled with the guys still in route spoke to its sad ending.

There's a special acronym for trips that get called off for our reports -- PISPTA : placed in service prior to arrival.

Yes, they love those acronyms in the EMS world. Somebody should set them all to music sometime. Maybe I'll borrow my brother's long-neglected, morally ambiguous banjo and give it a whirl myself.

First-due Chinese, plans for a new firehouse and stories of broken femurs.

The guys were in and out all night tonight. It made it really hard to find someone for a training exercise. The engine had been transfered to another station nearby earlier - it's sort of like being put on temporary loan.

We also had some guys headed out for EVOC training - that's the Emergency Vehicle Operators Course ... part one of becoming an ambulance driver. Having so many members of occupied with other things left the ambulance OOS - that's Out of Service. Not too many more of those terms ... I promise !

Those left behind had to be on their best behavior ... a bit of a stretch for some. There were five members of the city council at the house to show the station leadership the architectural drawings for a new station house they hope to build for us. From what I saw, it looks pretty darn nice.

It was nice to see that there are some members of the city council that are responsive ... the folks in my ward just don't seem to respond to emails anymore. Then again, perhaps it's just my email they ignore ! I tend to harp a bit too much on those red light traffic cameras, and they probably hear the majority of my rants.

We did finally get around to eating dinner ... in several different groups, mind you -- I headed to the nearby Chinese carry-out for some sweet and sour chicken with another of the regular trainees.

They guys affectionately refer to this particular restaurant as "First-due Chinese" since it's the place closest by. (The term "first due" refers to an area covered by a certain fire company that's the first line of defense in event of an emergency.)

Once the meeting with the council had broken and most of the guys were back, I got a chance to learn about splints ... both the regular and traction models.

Getting people with broken limbs to the hospital is actually a pretty straight-forward process - the gear just looks kind of gnarly ... the traction splint especially. It's really just a way of securing a broken leg in a way that allows it to set. Not a big deal for the aide, but most certainly a painful experience for the patient.

That's all the news from Lake Wobegon, anyway ... more fun to come next Tuesday.

A run-through of a working code.

I got a great lesson tonight in what to do on a call for a true cardiac arrest - and trust me when I say there's one heck of a lot to remember.

Knowing how to perform adequate CPR and use an AED is one thing, but it gets a lot more complicated when you arrive on an ambulance. There are airways to establish and maintain, backboards to put in place, compressions to deliver and electrodes to attach, suction to have at the ready and O2 masks to prep and apply.

I've known for quite a while now that ALS teams are rolled at the same time our ambulance is, but it did surprise me to learn that the rescue squad is usually sent a minute before the ambulance is when a call for a cardiac arrest comes in.

One reason for this is so the bigger, louder truck can clear a path. It's also so an EMT from the rescue squad can get to work on the patient while the ambulance aid takes an extra minute to ensure that everything typically needed for such cases actually gets in the door the first time through.

The first priority of the ambulance crew is getting the AED on the patient. According to the Red Cross, for every minute a defibrillator isn't put to use, the chances of the subject's survival drop by forty percent. When you consider the starting point - that is, just how many cardiac cases end up being brought back anyway - the importance of the AED as a life saving tool becomes even more clear.

When you factor in the amount of time takes for 911 to dispatch an ambulance, for the ambulance and rescue squad to load up and roll out, and for the teams to get there, find the specific location and get everyone and everything inside to begin their diagnosis - even though we are talking about minutes here altogether - the roll of educated civilians cannot be understated. If you have the time, please learn about CPR and AED use.

But I'm getting ahead of myself - all of this started as a talk about suction in the back truck number 19. The discussion about cardiac arrest detailed above came up when our teacher for the night asked us what kind of situations might necessitate the use of a suction unit.

Suction's main role is to clear the airway of a patient to ensure that air can get through. If he has aspirated or vomited, the material needs to be cleared, and that is done with suction. The patient might then be fitted with an oral-pharyngeal airway.

There are actually three different suction units on the ambulance - two portable and one fixed. The fixed unit is on the left side of the truck and is controlled via the same panel that runs the environmental and oxygen units. The second unit is battery powered and functions much like the fixed unit. The third unit - a unit of last resort - looks to date to about 1970 and is powered by hand. It is kept in the O2 bag, All three units are also designed in such a way that any material collected can either be safely provided to doctors or disposed of at the hospital.

After the lesson, I was left with the very distinct impression that the procedures inherent to these cases are something that should not only be drilled in at training, but also practiced and reviewed with teams of two, three and more on a regular basis.

It also made me even more confident in my previous conclusion that one needs to have a complete and immediately accessible recall of exactly what goes into each of the bags we carry; not being to find the trauma shears to get a shirt off a patient would add to an already sky-high tension on scene.

This led me to a new appreciation for the slow-and-steady approach I mentioned in an early entry when seeing a case of overdose. Thoughtful methodical action made it a lot easier for us to get all our gear up to the fourth floor that time, and I imagine that will be the case in the future too.

From my estimation, thoughtful and methodical only comes from comfort, and that comes from practice; even if it doesn't happen at the station, I imagine I'll do mental run-throughs every so often to stay sharp.

The night's dinner of polska kielbasa and pirogies went over pretty well; I had the pleasure of dicing up seven or so onions for the pots; every time the guys got started doing it themselves, the bells went off. Thanks to the gang at l'Academie de Cuisine for teaching me how to make that process as painless as possible.