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Monday, January 17, 2011

The Grumpy Dispatcher on the Road

Time for some regularly scheduled continuing education training hours to maintain my industry-required NERC power system dispatcher certification.

Numerous dispatchers from various companies will be traveling across state lines to meet in a highly secret undisclosed location to be educated. Or rather, reminded of what we're supposed to know and have partially forgotten. And I was kidding about the highly secret location thing, but you'll understand if I don't share where we actually are. It would cause an undesired stir if a horde of autograph seekers stormed our classroom sessions. Plus, the other dispatchers would be jealous and start their own blogs.

Man, I am so full of it.

Back to reality. For myself, I'm taking my family with me and making a two-week vacation out of it. As such, you won't hear from me until some time next month.

Take care, be safe.



Friday, January 14, 2011

Conflagration

Long post warning.

My father-in-law, a former Coast Guard officer, often regales us with tales of his days in uniform. He's an excellent storyteller, and I always like listening.

A few years ago he was telling the tale of a "conflagration" training drill, where multiple major contingencies happen all at once. The example he gave was a botched helicopter landing on deck resulting in a crash/fire/rescue incident, almost immediately followed by a torpedo hit, which indirectly caused a shipboard fire elsewhere on the vessel. That defines "oh crap", but was an excellent training tool in prioritization and improvisation, as all of those emergencies are critical, but none of them will get their nominal full standard response.

I designed and implemented a drill with that concept. It went well. I tell the tale here so you can perhaps lift the ideas and mold them into something you can use at your agency.

The setup: A traffic accident (into a power pole with wires down on the car, of course), with one patient, requiring extrication. After a fixed number of minutes into the incident, a fire in the spilled fuel would be simulated. A randomly-chosen response unit would be prevented from joining the response, and its crew withheld from the action other than to observe for the later review. After another fixed time interval, a serious-sounding but unrelated EMS call would be paged at a nearby address. Finally, at a randomly-chosen time (but after the command structure was set up), a random rescuer on scene would be "re-cast" as the victim of an accidental pedestrian hit-and-run by a driver passing the scene a bit too closely.

This was at a previous, all-volunteer agency, where the same people tended to get the station early on and drive certain rigs. The first order of business was to mix up the "normal" crews. Every member in attendance wrote their name on a paper keytag, and the tags were placed in a bowl. Drawn one at a time, a list was created from which the unit assignments and POV arrivals would be filled in the list order.

Prior to the drill, the units were also written on keytags, and one was drawn to be the withheld unit. Sweet. The first-due engine. That will mix them up. I rolled dice to set the number of minutes, after a formal incident commander was identified, that the car/ped event would take place.

The local auto recycler provided a car for us to tear up. It was placed adjacent to a wooden streetlight pole (not a power pole), and authentic distribution wire (courtesy of my power company employer) was draped over the car.

The members were informed which units they were assigned to, or if they were designated as POV arrivals, and the order of all arrivals. The members were NOT informed prior to the simulated page out exactly what it was we were doing tonight, other than that it would be a simulation of an incident. Then I "paged" the call over the training channel as a one-car vs. pole accident with wires down, no additional info.

And so it began.

Two POV arrivals were first on scene. The very first person approached the vehicle, stepped over the ditch, and steadied himself with a hand on the roof of the car as he removed his helmet (!!?) and placed it on the roof. I tapped on his shoulder and said "lie down, you're dead from electrocution". He whined about the mud. Too bad. Muddy is better than dead.

I told the second person that there was a flash and bang from where the first person had been, but it took them a moment to realize that the other person was in fact down. Two patients. This got fun real early. The remaining responder caught on and requested the power company. (C'mon you guys, you HAD to expect this angle from me of all people.)

The first due engine was told to go en route. Upon their arrival I directed them to park well out of the way, informed them that the simulation involved their unit being involved in a minor non-injury fender bender that disabled their apparatus, and they they should watch carefully and take notes on their observations.  The lone POV guy on scene so far was informed by radio that his first engine was not coming to play.

Two more POV responders arrived. They dragged the downed firefighter away and began treatment. I told them he was coded, and that tied all three of the initial responders up for the rest of the drill. Personnel resource management sucks in real life sometimes, and this drill was supposed to be worst-case real life, so be it.

The rescue arrived next. They had been en route before the engine was taken away, or else they would have brought the second engine. They had tools, and quickly set up for an extrication. I informed them that the power had been shut off by the power company, and they went right to work stabilizing the guy in the car (himself a randomly-chosen member) and started to work on his extraction.

Three more POV responders were trickled into the scene to see if they would freelance or integrate into the command structure, which still didn't actually exist yet. One of those three picked up on this, assumed command, and designated a safety officer. The keystone kops activity promptly began to subside. Good job.

The second engine arrived just as the fire timer came up. I informed everyone by radio that the underside of the vehicle was now on fire. The EMS crew with the downed firefighter scrambled to hurry up and move farther from the car, as they were downhill from it. The line was quickly stretched, its crew forgoing SCBAs, which I gave them a pass on considering the circumstances. Getting the line charged was delayed, because the randomly-chosen apparatus operator was not well-practiced on that engine, and it took an extra minute or two for the line to be charged. Unfortunately, the attack crew did not see the downed firefighter and three personnel working him behind the car, and pushed the "spilled fuel and fire" right at them. That was exciting.

More POV people were dribbled in, the Utility rig arrived with four personnel, and then the last couple of POV guys were allowed to join.

Fire more or less controlled, I then keyed up on the training channel and simulated a chest pain/difficulty breathing call about four blocks away. The IC was having none of it, replied requesting mutual aid from the next closest facility, and then ignored the new call entirely. This was the appropriate response considering our staffing and typical usage of mutual aid there. Good job.

Things were going sort of swimmingly, and the predetermined time arrived to throw the next curve ball. Who is going to be hit by a passing car? I grabbed the bowl of names and pulled one out.

You've got to be kidding, right? It was the incident commander's name. For realio.

So, I went over to him, tapped him on the shoulder, and told him to walk about 30' from the scene and lie down without saying anything. He actually laughed as he walked away.

It took maybe three or four minutes for anyone to notice the IC wasn't answering the radio, and a few minutes more before someone (the safety officer) became concerned enough to try to find out why. And then another minute or so to find him (it was dark). I'd say there was nearly a ten-minute delay between him being "struck", and him finally getting aid. That was not good.

Once it was announced on the air that the IC was down, disarray ensued. The safety officer became the defacto IC in the eyes of the crews, but the safety officer did not take that mantle. Eventually someone said something to prod him into the discussion, and a new IC was soon designated. Still, it was surprising how disorganized some things got in the fifteen or twenty minutes that there was no leader.

Once they had the (former) IC packaged up, the crews having started with one patient and ending with two patients and a dead firefighter, I stopped the drill.

What did we learn? What did we reinforce?

  • Everyone needs to be familiar with all of the equipment. You never know when you're going to get assigned to a job you don't usually do, and you better know how to do it.
  • Situational awareness 1. Frankly it blew my mind that the first guy got himself whacked (let alone took off his helmet, WTF?). He was snippy at me for a long time after this, because it made him look bad. This was not my fault, and the lesson was learned by all, so whatever pal.
  • Situational awareness 2. The attack crew did not evaluate the scene adequately to determine what was behind the fire, and the patient care crew working on the downed firefighter did not realize that the burning car was between them and the engine. The safety officer also failed to pick up on this problem. Thankfully, the patient was on a board and they moved fast enough that I didn't ding them with burns and respiratory injuries (which would have generated three more patients), though it crossed my mind.
  • Command. Establish it early! Form a somewhat self-healing command tree.
  • Law enforcement. The brothers in blue are your friends. We could have simulated using them for traffic control and to assist with nearly every task that was short-staffed, but not even one person on the scene though about calling them in to help.
     
  • Resource management when things are dire requires quick and decisive decision making, mad triage skills, and the willingness to cut your losses.
     
  • Doing an unannounced drill does a much better job of exposing your weaknesses by simulating real life, where personnel do not have a time period to think about what they're going to be doing before being neck deep in it.
It was one of the most productive training drills I ever organized, and a lot of really excellent points were made in the debrief round table.

Try this idea out at your place, and let me know how it goes. If you send me your review, and with your permission, I'll post it here on the blog. grumpydispatcher [at] gmail



Sunday, January 9, 2011

Refreshing Communication Skills

I went up the road and grabbed the engine from the station, with a bit of purpose in my movement. Traumatic injury to a 9-month-old, the dispatcher had said. I asked for more, and all they had was a hysterical woman sobbing about that her baby had fallen. It was way out down here, and I was closest.

This has all the makings of an oh crap call. Well, not any more than so many other calls, but the kids...... those of you with kids get it, those who don't cannot quite relate.

I arrived first to what I am guessing was one of Mom's younger sisters, who led me up to Mom and the patient.

Mom is standing there, a bit tear-faced (not "hysterical"), and a clearly irritated sniffly baby girl is lying on the bed, clutching a pacifier, and wanting to be picked up.

What happened?

Nothing that hasn't happened to lots of us parents. Mom put baby girl on the bed for a second, just as she had so very many times before, turned her back for a moment while getting dressed, and baby girl took a header about three feet to the floor. It happens. We're not talking about a completely helpless infant left to roll off here. 9-month-olds are mobile and wiggly, they're learning to climb and walk. They fall and get banged up. They're fairly durable most of the time, and they learn.

Anyway, I try to assess baby girl, and she is not thrilled about it. She starts to verbalize that she is not happy with this new weird guy in the blue coat being here. His exam-gloved hands are cold. And he looks funny, too. What the heck, Mom?

No deformities of the neck or upper spine, no visible head trauma or swelling. Eyes normal, breathing normal. Movement normal, no guarding, no resistance to any particular motions.

I have several children, I know how to read their crying. This is the slightly-frightened cry, the kind that usually goes away with a sippy-cup and being held in a blanket. It would already have been gone, but Mom was so worried about an injury that after reflexively picking up baby girl, she put her on the bed and tried to not move her until we arrived. She watches TV, she's heard of C-spine. Baby girl just wants Mom to pick her up again and she'd be cool.

It struck me, then, how amazing it is that these tiny humans, with no language speaking skills to speak of yet, are amazingly uncomplicated in their communication.

If I had a fallen adult, I might very likely be trying to psychologically navigate other issues. Are they taking something they shouldn't be? Are they embarrassed I am in their cluttered house? Are they denying an injury somewhere else? Are they faking it to get some attention?

Refreshingly there was no ambiguity about this little girl. She is not screaming in pain. She is moving all of her limbs and tolerating touch with nothing more than a "who are you, go away" cry. She is not lethargic. She is aware of her surroundings. She calms down when not prodded.

I pretty much know all I need to know. We're here more for this first-time Mom than anything. The career engine from 54 subsequently arrived and came to the same conclusion. We turned the ambulance back.

I wish all our patients communicated as well as this.


Wednesday, January 5, 2011

THWS: Appliance Repair

The latest Totally Handy Web Site (THWS) is likely to save you some money, and helps raise your stock in the household hero department, too.


The Appliance Clinic gives you loads of detailed help so that you can troubleshoot and repair virtually any major home appliance, or least determine whether you need to call for backup or not.

Many (most?) of us learned from our dad how to fix stuff. Often, what we learned was that you just had to take the danged thing apart and figure out what was what, and then attempt a fix.

I'm not knocking the practice of doing exploratory surgery on appliances, but you can greatly reduce the risk of accidentally breaking something in the process if you have an idea of what you're getting into before you start.

From the home page, click the "Repair" link, and you will see a fairly comprehensive list of makes and types of major appliances. Under these you will find a breakdown list of the common problems encountered and the steps to investigate, verify and repair as needed.

I first found this site back in 1996, so it is relatively ancient as far as web sites go, but its information is still updated from time to time despite its spartan web design appearance. The Restoration section, for example, just showed up within the past couple of years.

If you have a broken thing at home, go here and see if you can fix it yourself. Yes, you can be the hero at home too.