Blood Flow Through the Heart

I like to get into discussions with my partners about EMS topics and find out which topics we can increase our knowledge.  It helps us improve in explaining ourselves and also keeps us abreast on topics.  I personally notice that many EMTs can’t explain the basic functionality of the heart and it’s circulation of blood flow.  So I drew a little diagram and wrote a little explanation about it.

Basically the heart pumps approximately 7,000 liters of blood through the body each day.  The process starts with the right side of the heart or the pulmonary side. Blood that is low in oxygen and high in carbon dioxide comes into the right atrium through the superior and inferior vena cava from the body.  As the right atrial wall contracts, this blood passes through the tricuspid valve and into the right ventricle.  Once into the right ventricle, the ventricular wall contracts and the tricuspid valve closes pushing the blood into the pulmonary artery, where it is oxygenated in the lungs.

Now we move onto the left side of the heart or the systemic side.  Now this blood that was oxygenated in the lungs, and is now high in oxygen and low in carbon dioxide, comes back to the heart through the pulmonary veins and into the left atrium.  As the left atrial wall contracts, blood moves through the bicuspid valve (or mitral valve) and into the left ventricle, which is the strongest part of the heart.  When the left ventricular wall contracts, the blood moves through the aorta and feeds the rest of the body. 

An instructor once taught me this diagram and I drew it out for you to use.  It’s a simple diagram of the heart instead of the 3D image where you can’t really tell which side of the heart is the left and which side of the heart is the right.  I hope you enjoyed this post about blood flow through the heart.  Let me know if you like it and I will start doing more of these.

Customer Service in the Fire Service

The Fire Service has to change now if it wants to be the knight in shining armor that it has always been.  The Fire Service is built upon a lot of great ideals and some of them have been lost as time has gone on.  The one ideal customer service is one that departments are starting to work on again.  It is one thing to talk about customer service but it’s another one to make strides and to start delivering customer service.

Every morning in the Fire House crews get together and talk about the day’s daily activities, daily drills, and usually go over some continuing education topic.  I have yet to hear someone bring up a continuing education topic such as customer service.  Yet, the Firefighters will go over an LODD, ventilation topic, SOP, or something else.  Why don’t they throw in a topic such as, "What can we do to provide great customer service?" every once in awhile.  Some people are naturals in customer service and others need to be retaught.

Some simple ways to start working on your department's customer service:

• When the crew goes out for groceries, help someone put groceries into the car.  
• Opening a door for someone.
• Help make a bed in the ER, when the ER staff is overwhelmed.
• Patience, I know it's hard at 0330 waking up for the fourth time that night.
• Get out of the Fire House and go walk a block to see if people would like their smoke detector battery checked.
• Answer your phone with Good Morning, Afternoon, Evening instead of just Fire Station 47.

These are just a small start.  Brain storm about customer service and see what you can do to provide great customer service in your district.


Why don't you bring customer service up at your next morning line up? 
 

Listening to Directions Part II

Continued from the post on Thursday last week..

So we took off lights and sirens to our call. We had mapped it out and knew where we were going. Unfortunately, this was a frequent flyer con home with ONE drive way. The engine and ambulance always park in the same spot and have a certain way of doing things at this con home.

The engine was behind us and I noticed in my side mirror they had pulled over already. I was at the location but missed the driveway. I had to go down the street and make a u-turn. As I turned, I see the engineer standing on the sidewalk with his arms above his head with a disgusted look on his face. I turned beat red, we messed up. We ran the call and my partner made a few mistakes on an acute call.

At the end of the call and back at the station. We were told we were only going to be gurney men for the rest of the shift. They understood it was my partners first EMT position and that I had experience. The rest of the shift the Captain assigned me to work on my partners skills. My Captain also reminded me about following the rig out of the house for awhile until we knew the area. I responded with "Yes, sir." and did not give any kind of excuse.

I learned a lot and the crew understood it was our first shift and that we were excited. I have a great bond with my crew now and they always joke when tones go off and that address is said. They always ask me if I want directions on how to get there.  It was a great learning experience that I will never forget to listen to directions.  

Listening to Directions

Listening to directions is huge in the Fire Service.

I had just been hired and finished my mini academy with the department to work as an EMT. I finished my ride outs and did very well. I made an appointment to come meet with my captain at the station I had been assigned to.

I brought treats, a pen and notepad, and a great attitude. I met everyone and sat down with the captain. We talked about when to wear bullet proof vests on calls, station duties, expectations, AND that we should follow the rig out of the house for awhile until we know the area.

My first shift at my new station, I was paired with someone who was on overtime who had never been an EMT before.  This was his first shift off of ride outs, he did not know the area, and was in my academy. He is a great guy, a hard worker, and I enjoy working with him.

We called each other the night before and made sure we got to the station at the same time and went into the station and greeted everyone. We went out to the rig and spent a ton of time out there to learn where all our equipment was located.

We got a call, OUR FIRST CALL EVER with our engine. My partner ran over to the bay door panel and waited for them to come out so he could open the bay door for them. The engineer came out and said to my partner "What are you doing, we have a call, GO!" I was driving, my partner came over to the rig and said the engineer told us to go. Unfortunately, that meant go to our rig not leave.....


Continued on Monday...

Picture found here.

FDEMT IS MOVING

Please excuse the lack of posts.  My wife and I have been moving into a new place and we are still waiting on internet to get hooked up.  Also, there are a lot of things that need to get done around the new house.  I am setting up a nice new study/office room that we have never had, a garage that we never had, hanging up picture frames, moving furniture, and doing whatever other kind of honey-dos the wife needs.

I have a few posts on my plate that I have been thinking about and I will post those soon.  Be careful out there!

If you have time check out unofficial FDNY page and the Sergio Villanueva Soccer Foundation.  I am a big soccer fan and believe this foundation is doing some great things.

Your Name is Everything

Recently, I picked up an overtime shift with a crew that I had never worked with. For those of you who have not worked for a Fire Department, this situation is always a little awkward at first, you never know how it's going to go. Here's a little run down of how my day went.

0630, an hour early to normal changeover, I show up for shift and immediately introduce myself to everyone going off shift and I go into the station locate the Captain and Crew I am working with that day and introduce myself. I get a "Hello, I'm Rank So and So." no emotion that's it. I also drop off the goodies I bring in for the day.

0635, throw a second pot of coffee on and head out to the rig. Coffee(1st pot), newspaper, and Flags are always done by the off going ambulance crew.

The rig checkout is a little more crucial here. It's not my normal rig so I have to make sure I know where everything is because I don't work on this rig and the Firefighters love to test you. So a great way to learn where everything is, is to pull everything out and clean. One, this makes you look good because you're in your rig learning where things are and two, you are cleaning.

0730, *BEEEEEEEEEEP* LINE UP, LINE UP
0731, I make my way into the kitchen and shake the other Firefighter's hands whom I had not met yet.
0732, Captain starts talking about what's going on for the day and they are joking around and I see one of them staring at the wedding ring on my hand and all of a sudden I see him look up and say:

FF: "HEY BIGS. HOW FUCKIN' LONG YOU BEEN MARRIED!?"
ME: "Two years sir."
FF: "You got any kids?"
Me: "No sir, just a dog"
FF: "Good, you don't need any kids yet."
FF: "Where you from?"
Me: "XYZ, sir"
FF: "Holy Shit, that's near me, a good spot."

CAPT: "Bigs, what you guys want to do today?"
ME: "Sir, I am going to wash the rig, clean, perform a full arrest drill, do paperwork, do some area familiarization, and work on a class that I need perform for my next shift."
CAPT: "Good, you guys are dismissed."

I now have a nickname "Bigs" I am 6'-2" and about 240, I'm a big strong guy, I actually feel pretty good I got a nickname right away.

I go out with my partner and wash the rig, clean the office, clean the heads, dorms, office, and sweep the apparatus bay for about two hours. I am noticed.

*RED LIGHTS TURN ON IN STATION, BOOOBEEBOOO BLS97 UNK. MEDICAL AT 123 Maple*

Run a call with a different engine in a different part of town because their BLS unit had gone out on a call. I come back to the station and the engine was gone. I go into the kitchen and wipe down their table, rearrange the newspaper, clean all the dishes, and clean the microwave out.

They arrive back at the station and I hook back up the Plymovent and plug in the engine before they can and I don't say a word just keep going about my business.

Then the Engineer walks over to me while I am doing a little project I came up with in the back of the station with about 20 different hose fittings in his hands.

ENG: "Hey Bigs, you know what these are?"
ME: "Yes sir, these are hose fittings."
ENG: "Ok, pull them all apart and tell me what each one is."
ME: *looks at first one* "2 1/2" Double Male."
ENG: "Bigs, give me a little more confidence when you tell me what they are."
ME: *smiles* "Yes, sir"

We proceeded to go over about 20 more fittings.

ENG: "Bigs, you're going to do great around here if you keep up what you're doing."
ME: "Thank you sir, I will."

At the end of the shift, they thanked me for all my hard work, and that it was nice working with me. They said I was welcome back anytime. I felt really good leaving.

If you work hard and don't expect anything in return, good things will happen in the end.

Exercising for the EMT or Firefighter

What is the number one thing you do as an Firefighter or EMT? Lift patients. I see a lot of posts on different blogs and websites about what exercises to do but a lot of them have nothing to do with your legs. Work out your legs and your back. Your biceps are good looking but that's not what is supposed to be doing all the lifting. Check out this article.

...carrying patients is the task most likely to require time off from work, the study says.

Here are a few SIMPLE exercises you can do at work while you are waiting for your next call. All the links are to videos of the exercises.

1. Air Squats

2. Lunges

3. Side Lunges

4. Calf Raises - You can use 2x4s to do this.

5. Jumping Rope - Jump rope needed.

6. Push-ups

7. Sit-ups - Good with a partner.

8. General Core Exercises

Supermans

Side Plank

Bird Dog

These are just a few simple exercises to get you started. It's something you can do throughout your work day and it doesn't take that much time.