Housekeeping · Pre Planning Your Scene

BATTERY MONTH

It has been said that amateurs study tactics, professionals study logistics. I have attempted to put things aside for rainy days, and, with Mr. Biden at the helm, and Mr. Buttigieg as Secretary of Transportation, well, my achy knees tell me that rainy days are a’coming.

This being November, it is Battery! Month! Semi annually, I inspect my batteries, and assess their charge. I inspect for signs of leakage, I test the strength (using a voltage meter: Radio Shack used to sell them for $10-$20, once upon a time), and contemplate whether I have enough of each size. Unlike ammunition, “MOAR!” is not always the correct answer, for, ammunition keeps nearly forever if kept cool, dry and in the dark. Batteries have a self discharge phenomenon, and both rechargeable as well as alkaline (and carbon-zinc), or “primary”, batteries, will lose their charge over time. (“Primary batteries” are single use, and their charge derives from the chemicals with which they are made. “secondary”, or rechargeable, batteries can be brought backup to charge, after discharge, although after a sufficient number of charge/discharge cycles, they gradually lose their ability to accept and hold a charge.) Therefore, in an ideal bunker, I would have just enough that I would have fully charged batteries in service, and enough fully charged replacements to cycle back and forth, so that no battery would die a lonely, unused, death, way back in the back of my battery shelf.

I am still striving for that level of efficiency.

When I checked this month, to my disappointment, I found that most of my rechargeable batteries had discharged. Once I see if they will accept and hold a charge, I will know if they are in need of replacement, or simply every 3 month assessment.

I have some primary cells, for items that are frequently used. I have an LED penlight fueled by AAA batteries, and another identical penlight, except that this LED emits in near UV. That is handy for illuminating rashes, sometimes revealing luminescence typical of certain strains of dermatophytes. You might recognize the rashes caused, such as “ringworm”, or dandruff, or athlete’s foot, among others. Not all the dermatophytes glow under UV, but when it does, it is an “AHA!” moment.

My SureFire and ITP flashlights ride in holsters on my belt. They are bright, “Light-up-the-yard” lights. There are two, because should one fail, it is likely that the other will function. There are two, because should one fail, it is likely that the other will function. I have spare batteries in my “Bag Of Tricks” (h/t to Felix The Cat)

Our vehicles each have a “torch”, to differentiate the hand held lights, from the headlamp, the light-up-the-interior-of-the-vehicle lanterns, or the LED warning flashers. One is powered by CR-123 batteries, two are powered by C primary cells (the torch, and one handheld flashlight)

The LED flashers are powered by AAA batteries, and are intended to allow oncoming traffic to see that there is something (Me!) in the roadway, in the event of a breakdown, collision, or other night time deviation from normal. It turns out, when you buy “budget” rechargeable batteries, they have fewer charge/discharge cycles in their make up, than quality cells. Guess which will replace the unsatisfactory batteries? Yep: buy once, cry once. Or cheap out, and cry. In the dark.

Each month has it’s own focus, such that I do not spend every single day off in any one month in my subterranean lair, checking off stores against a checklist. If all goes smoothly, I might get my inventory done in an afternoon. As a starting point for those who might be interested, I have included a representative sample of my battery-and-lights checklist.

BATTERIES

EDC: UV Penlight AA x 2

Penlight AA x 2

Surefire CR-123 x 2

ITP CR 123 x 2

Proton Light

Keyring LR 41 x 4

Badge LR 41 x 4

Bedside

Surefire G-2 CR 123 x 2

Ultrafire 18650 x 1

Camper: Lantern Box

Coleman Quad Lantern #1 D x8

Coleman Quad Lantern #2 D x 8

Siege Light #1 D x 3

Siege Light #2 D x 3

Siege Light AA AA x 3

CAR LIGHTS

TDW Car

Torch C x 2

Headlamp AA x 2

LED Beacons AAA x 3 each (6 beacons)

My Vehicle

Torch C x 2

Headlamp AA x 2

LED Beacons AAA x 3 each (12 beacons)

Small Handheld light CR 123 x 2

Large Handheld Light C x 4

Medic Bag Surefire CR 123 x 2

Field Phones

Set #1 (2 phones x 2 D cells each) D x 4

Set #2 (2 phones x 2 D cells each) D x 4

Night Vision

AA x 4

Red Flashlight Toolbox

Mini Mag Lights x 2 (2 AA ea) AA x 4

Ray o Vac x 1 (2 AA) AA x 2

Mini Mag 3 cell AA x 3

Sure Fire Hurricane Light (weak CR 123, holds 12)

CUMULATIVE TOTALS, FOR EACH TYPE OF BATTERY

AA x 24 in service at any one time

AAA x 64

CR 123 x 8

18650 x 1

LR 41 x 8

C x 8

D x 30

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Duty · Pre Planning Your Scene · Protect and Serve

Another post, from another website

Bad Dancer (commenting at Gun Free Zone blog) says:

October 21, 2022 at 9:50 am

Thank you for the article and links Reltney McFee I’ve read it several times and will go through it again to make notes soon. I appreciate you sharing your experience and advice.

I’m building a few kits as Christmas presents this year. Are there any supplies you recommend added for a family that has a 1-2 year old?

Thank you for reading. Outstanding question! With regard to families that have toddlers (or infants), my first pass suggestions would sound very much like, “What did you want on your last camping trip, that you did not have?” along with, “what sort of comfort item does your child love?”

If I were to add to that, I would look to my own “Grand Kids Are Here: What Might I Need RFN?” (GKAHWMINRFN) supplies. Now, remember, I’ve been a paramedic, paramedic instructor, ED Registered Nurse, and mid level provider since Jimmeh Cahteh was the HMFIC (OK: President).

On the top of my “GKAHWMINRFN” bag is a pediatric BVM (Bag-Valve-Mask: commonly referred to as if they were all branded as Ambu Bags). You might be happy with a pediatric sized rescue breathing mask of some sort, or, easier to pack, mastery of mouth-to-mouth resuscitation.

Near the top would be comfort items, so as to both distract the child, as well as help the child “buy in” to the procedures to be performed. Blankets, pacifiers, stuffed animals: whatever floats the child’s boat.

Remember that children, particularly infants and toddlers, are NOT simply pint sized adults. Due to differences in body surface area, kidney function, maturity of their livers and other factors, they may metabolize medications quite differently from adults. So, just slapping some QuikClot on Little Johnnie’s wound may be a problem. OTOH, here is what I did find in a reference that I use, myself, clinically every day:

“Compared with standard sponges, the use of the kaolin-impregnated sponges in 31 infants undergoing the Norwood procedure had a significantly lower intraoperative use of blood products and lower incidence of perioperative bleeding requiring return to operating room for hemostasis (0 versus 41 percent) [44].” (source: https://www.uptodate.com/contents/overview-of-topical-hemostatic-agents-and-tissue-adhesives?search=quick%20clot&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2249912903

That means, better bleeding control. THAT suggests that a kaolin-impregnated sponge (QuikClot), at least, is not inappropriate for use on bleeding in children that is not otherwise controllable by dressing, direct pressure, and (in extremis) tourniquet-ting. So, small (2×2, 3×3) dressings impregnated with QuikClot appear to be reasonable.

Splinting materials for fingers, limbs, or whatever, are going to be a challenge, both because children do not, as a rule, comprehend the entire “lay still while I splint you” thing, nor the bit about “do not wiggle about, you will work you way out of this splint, and your injured (whatever) will hurt, and be injured further.” So, however much tape or gauze you THINK that you will need, you are wrong, and will require considerably more than you guessed. Unless, of course, you have made it a habit to secure IV armboards to infants and toddlers, several times a day, for the past several years. If you have done so, and done so successfully, please tell me when/where your classes will be, and save me a seat.

Another tangent from adult IFAK/Jump Bag/Holy Fertilizer kits, and child directed emergency care, is that children will both dehydrate, as well as become hypothermic way, way more rapidly than adults, and, once they have burned through their reserves, will crash and burn, often irretrievably. The axiom is that children generally do OK with their injuries, until they don’t. And, when they don’t, they crash biggly. Adults generally slowly decline, until they die. Therefore, measures to protect a child from heat loss are important. That means blankets and knit caps in appropriate sizes. The foil “emergency blankets” are a mixed bag: they are not going to get saturated in whatever bodily fluid is present (good thing), but they are not going to trap heat in a maze of air pockets formed by a Mark 1, Mod Ø fuzzy/fleece/wool blanket. (and you will notice the difference). Select thoughtfully.

Another feature of kid injuries, particularly infants and toddlers, is that they are top heavy. Their heads are a greater proportion of their body weight than adults, and that means that their initial point of impact may be more likely to be their heads, than their hands/wrists/forearms. Therefore, when you are in the hot seat, you need to be suspicious of the possibility of a head injury, when children fall. You have learned to spine board/cervical collar/secure for transport, head (and that is often spelled N-E-C-K) injured patients, right?

Right?

Another needful skill, that you pray is never needed.

That is it for my off the cuff, just got home from work and warmed up my laptop, answer to your question.

Thank you for the stimulating inquiry. Gonna be food for more rumination!

Reltney McFee

Fun And Games Off Duty · Life in Da City! · Pre Planning Your Scene

Lessons Learned From Other’s Experiences

Another blogger posted a recounting of his experience, recently, at a public range (I believe he is in Canada). He cited Elisjsha Dicken, the armed civilian who stopped the Greenwood Indiana mall shooter, hereafter referred to as Some Asshole In Greenwood, within 2 minutes of the crime beginning, and, according to Dicken’s attorney, from a distance of 40 yards.

Speaking only for myself, and throwing no shade one way or the other, I attempted to recreate Mr. Dicken’s accomplishment, with my EDC sidearm, and no time/life threat pressure. I failed, miserably. My personal take home, is “Moar! Range! Time!” If you get advice to practice, practice, and practice some more, that is sound advice, and we all should do so.

Other reports that I recall seeing, assert that Dicken’s girlfriend, a student nurse, responded to care for casualties, once the shooting had stopped.

THAT reminds me of everyday carry. As is often asserted on the blog, Gun Free Zone, if you carry a sidearm in order to put holes in bad people, should the need to stop such arise, then you ought to anticipate that these selfsame bad people may put holes in you, yours, or other innocents. Therefore you (and I) ought to be ready to address that problem.

There are many ways to address that need. I carry a CAT tourniquet in an ankle holster, as well as a SWAT-T elastic tourniquet in my pocket, all the time. There are two exceptions: when I carry TWO CAT tourniquets, or when I am swimming.

While it is worthwhile to carry a medic bag, suitable to your own training, getting that training is JOB NUMBER ONE! I betcha that I can finagle trauma dressings from at hand materials, faster than I can learn, in the first place, what sort of thing is immediately needful to care for a trauma patient.

Of course, I have something approaching 50 years (not a typo) of experience in this business, so, there is that going for me, I suppose.

If you wonder what you ought to pack for bad times, look over my blog post, here. Or, you could see what Aesop has to say. He is controversial, but, regarding medical matters that I have the experience to have an opinion about, he is spot on. No crap, straight up. He recently posted a set of links to his “greatest hits”. I direct you to peruse same: there’s GOLD in them thar hills!

So, I will attempt to let my preachin’ end, here, for a while. Thank you for riding along.

Duty · Fun With Suits! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

FPC: Phenomenal Phone Company

A long, long time ago, in a state capitol city not so very far from here, I was seated in the basement of The Enormous Hospital System Mothership, where She Who Would Become TDW-Mark II was undergoing surgery of some sort. I was seated next to, well, let’s simply call him my father in law.

At this point in the celebrations, the divorce from The Plaintiff had concluded, and she and I had a week-on-and-week-off child custody arrangement. My adolescent children had cell phones, and had both me and their mother on speed dial.

So, Number Three Son had occasion to call me, but I could not make out what he had to say, and my attempts to re connect with him were for naught.

I did not know if this was generic adolescent ‘gotta call dad’, or something emergent. That latter was very unlikely, but, after all, I have kinda spent my life in the “this is sort of an emergency” business, and therefore considering that possibility is an occupational hazard. Therefore, since I was NOT at home, and, should my children need me, their ability to communicate that to me in a timely manner was mission critical, well, The Phone Company, and their inability to connect a freaking call something like 12 blocks from the freaking state freaking capitol, well, to understate the thing, I found it unsatisfactory.

Father In Law offered the use of his phone, on Another Carrier. I entered the number of my son, hit “connect”, and, par miracle’!, just like that, I was speaking to my son!

We concluded our conversation, since it was a generic “ought to call dad” call, and I asked Father In Law if I could make one more call. He assented.

I then called “customer service” (spit!) of The Phone Company. I explained my problem, and how this was not acceptable. Phone Company Minion asked my location, and I described myself as being one floor down from street level, in waiting lounge of Enormous Hospital System Mothership. Minion then regaled me with a bit of RF theory, to wit: “You cannot reasonably expect a cell phone to have a reliable signal when you are underground!”

I asked Minion, do you have caller id?

Affirmative.

Could you tell me the originating telephone number for this call we are having, right now?

He read back Father In Law’s phone number.

Is that a Phone Company number? If not, what carrier services that number.

Why do you ask?, responded the Minion.

“Because, that is the carrier who is henceforth going to be receiving checks from me approximating $200/month, because my phone, my childrens’ phones, and the phone of every mo$%#r f@!%&er who will stand still long enough to hear this story, will be giving their business to this carrier, whose phone I presently hold in my hand, in this basement, as you and I converse!”

Having said that, I realized that there is no satisfying way to slam down a cell phone. I miss plain old wired phones.

cats · Fun And Games Off Duty · Having A Good Partner Is Very Important! · Housekeeping · Pre Planning Your Scene

TASK STACKING

Eaton Rapids Joe, proprietor of the eponymous blog, must have been an engineer in a previous life. (and, I must have been dyslexic in my previous life, as the previous 5 words, pre-auto correct, read “enbgineer in a previous lidfe.”. Sheesh! I scare me!)

In any event, I seem to recall he once explained the concept of “tolerance stacking”. As I recall, however imperfectly, the concept might translate into, say, a rifle trigger pack, wherein one would take Part One, at it’s maximal permissible dimension(s), and add it to Part Two, similarly pushing the boundaries of out-of-spec-large, and add that assembly to Part Three, (ditto), until, finally, you had, say, a trigger pack, each part in spec, yet the assembly would not function, or else would not fit into the firearm at all.

Not so very long ago, I was reminded of that when TDW-Mark II assigned me (or, maybe, I was voluntold….) the task of cleaning the piles from the dining room table. I confronted the concept of “task stacking”.

To be honest, I had several probably 12-18 inch tall piles (more about that, in a moment…) of papers, magazines (the literary kind), boxes, and assorted whatnot, that (a) I had NOT addressed appropriately, (b) in any sort of timely manner, and (c) that TDW had, at long last, grown weary of seeing.

Along the way, may I observe that I share my home with several cats? And that cats are Agents Of Entropy? My appraisal is that cats are genetically incapable of viewing an organized stack, of whatever sort of stuff, and of whatever degree of righteous organization, without feeling the overwhelming need to Tear! It! Down!.

Of course, having several days off in a row, I was, well, “willing” probably overstates my enthusiasm for this task. Still, it will do. So, I was “willing” to address this problem, but I needed to have a space to take the stack-du-jour, in order to unstack it, triage each component, and then address same.

That meant establishing subsidiary stacks, one of trash (simple: stack same in the…wait for it!…trash can!), one of things to be shredded, and one of other, kind of valuable, things. That last stack would then be the subject of a re-triage, and once suitably thinned, put away.

This process was to be repeated, until the dining room table had my computer, and one (SMALL) stack of whatever needed to be addressed in the next couple of days. And, nothing else of my bullshit.

Well, in order to accomplish THAT task, I had to clear the table in the kitchen, that had, itself, become home to (yes, he admitted, embarrassingly) several stacks of things awaiting disposition to the garage, the trash, or other longer term, somewhat organized, rest.

The trash component, here, was simpler, due to being closer to the trash can, after all. The put-this-crap-away-somewhere-not-the-kitchen-table task, elicited it’s own task-stack, as my imaginings of organized stowage in the basement, required that there be horizontal surfaces, in that basement, that were unoccupied.

Do you, as well, see a pattern here?

So, I thinned the herd of bullshit in the basement, and changed the trash can. I imposed some modest organization in that basement, and then found homes, however transiently, for the keep-this-crap-just-not-on-the-kitchen-table items.

I shredded much of the shred-able stuff, and changed the trash can. Again.

I eventually had emptied the kitchen table, which I then re-filled with dining room table stuff.

Rinse and repeat.

So, it turns out that I am not the only pile challenged soul. I get several days off in a row, that follows a stretch of many 12 and 10 and 8 hour shifts. When I am in the midst of my duty week, well, my ambitions do not particularly exceed “get up and get around”, “get to work”, and do the above in accordance with my employer’s expectations (that is, on time). So, being a geezer, after a 12 hour shift, I get home, graze a bit, and turn in.

I had requested TDW to thin the herd of home chores, so that I might kill of the remainder on my first day off, then to laze away the rest of my stretch of off days.

Hard fail. She injured her foot (neither of us has any clue how. It hurts, that limits her mobility, and that mobility is kind of mission critical to things like putting away the dishes, moving the laundry along, and so forth. In addition to nurse-maiding an ailing dog and ailing cat)(can’t say we don’t know how to have good times!)

Being the loving husband that I am, I offered to heat and deliver some supper to her.

Task stack. Be nice if I washed my hands.

Which would be helped by access to the sink.

Which would be facilitated by loading the dirty dishes into the dishwasher, thereby emptying the sink.

Which would be easier, from a no-two-objects-may-occupy-the-same-space perspective, it the dishwasher were to be emptied, and the clean dishes put away.

Which, aesthetically, ought to be performed by clean hands.

Which required soap and water, currently unavailable due to the mosh pit of our sink.

Which inspired my present blog post.

After the dish part of the foregoing had been accomplished.

Finishing the dining room table is Tomorrow’s Task.

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SNIPPETS V

STORY THE FIRST

So, TINS, TIWFDASL, just a couple of weeks ago, and, as I entered the room, I was greeted by the younger of the two women seated in the exam room. “There he is! You saved my mother’s life!”

While that certainly was a welcome greeting, I admitted that I was confused. The younger woman, evidently the daughter, filled in the missing pieces. Several weeks previously, she (the narrator) had accompanied her mother (the other soul in the room while we conversed) to a visit to our clinic. She (the mother) had been having a cough of some sort, and I had felt that something in the experience did not sound right. After some assessment in clinic, I had sent the mother to ED, and those worthies had identified a 100% occlusion of one of mom’s coronary arteries (the arteries feeding the heart). Mother had received a stent, and been sent home, and was still among us. Indeed, she was here, today, due to another cough.

Thankfully, today’s cough appeared uncomplicated, and I recommended my usual measures to ameliorate the post nasal drip that seemed to be the source of the cough.

Sometimes I get to think that I really do, from time to time, positively impact people’s lives. That’s nice to think.

STORY, THE SECOND.

Just the other day, I was shopping. Such is the life of a life saving, disease fighting, internet blogging champion (of sorts). As it develops, I am middling tall: 5-7 or so. It turns out that the pasta I was hunting for was on the top shelf, and several other people had purchased some, before me. THAT meant that I could just barely not reach the boxes. I had just realized that I, a tool using animal, could open my knife and extend my reach, tipping over the needed number of boxes, and add same to my cart. That is, I had just realized it, when a gentleman, taller than I, reached up, grabbed a box, and handed it to me, asking me if I needed more.

I requested two more, and thanked him, moving forward with my shopping.

A few aisles over I observed a woman attempting to retrieve an item from a shelf beyond her reach. Before I could respond, another (taller) gentleman stepped up, retrieved the sought item, and handed it to her.

Everyday, plain folks, acts of civility and kindness.

STORY, THE THIRD

We visited my wife’s sister, and her husband, recently. They live in rural Kentucky, and it is rather a change from their previous neighborhood in Metropolis. Indeed, it is a considerable change from my table-flat neighborhood of Un-Named Flyover State.

We arrived, following the directions provided, and noted that the terrain was, well, “hilly” does not really do it justice. As a consequence of that terrain, roadways tend to meander, circling around this hill, or weaving their way up to, over, and down that ridge.

We had spent something like 45 minutes meandering , as the road took us up in elevation, when I noted a sign ahead, announcing “Curves Ahead!”.

I turned to TDW-Mark II, and exclaimed, “Wait, what? THAT was the STRAIGHT part?”

STORY, THE FOURTH: OOPS!

So, TINS, TIWFDASL, and, well, things had come to a slow down. I was working with a physician, on this day at this clinic, and she had never handled an adrenalin autoinjector. We had one handy, and I handed it to her so she could examine it.

I was not quite quick enough, to admonish her to not remove the guard, nor to handle the trigger, on the one end of the device. Therefore, she did, successfully, remove the cap, and then trigger it, sending the needle into one of her fingers, along with some of the adrenalin therein.

The Good News was that, since she was youthful, she promptly withdrew her hand, and therefore only received a fractional dose. The bad news is that adrenalin is a very, very powerful vasoconstrictor, and therefore her affected finger became very, very white, and also burned. Oh, yes, it burned. I cast about, wondering if we had any phentolamine. (an alpha blocker: used to reverse the effects of, among others, adrenalin, when injected into an end capillary bed, Like you would find in your fingers.) Since ours was not an ICU, nor an ED, we did not have phentolamine, nor anything that would serve.

The good news, such as it was, is that due to her youthful age, good health habits (spelled n-o-t s-m-o-k-i-n-g) and the fractional dose of adrenalin she had received, well, after around 20 minutes, her finger regained it’s color, the burning pain faded, and she returned to normal, simply just a bit more shaky than previously.

Subsequently, I obtained, and CONSPICUOUSLY labeled a trainer, specifically intended to harmlessly teach folks how to handle and operate an adrenalin autoinjector. This one has no needle, and no drug.

STORY, THE FIFTH

So, TINS, TIWFDASL….well, okay. I was NOT FDASL, rather, I was off, and, having accomplished all my chores (or, such fraction of “all my chores” as I was going to accomplish that day), my step son (son of TDW-Mark II) called. I had spoken to him about a range day, and he was off work that day, I was off work that day, and it was off to the range we went.

I took my Garand, my .380 pistol, and my 9 mm pistol. Of course, I grabbed the ammo can labeled 30-06 (for the Garand), .380 (surprisingly enough, for the pistol in caliber .380), and the ammo can labeled “9 mm” for, no doubt surprising, the 9 mm pistol.

Now, recall that I have been an RN for, lo, these many yeas. That I have passed uncounted thousands upon thousands of doses of medications, and double checked myself each time, so as to accomplish the “5 rights” of med pass: right patient, right drug, right dose, right route, and at the proper time. This was effected by reading the order, the med container, comparing each with the other, and then, DOING SO AGAIN.

So, we arrived at the range, uncased the Garand, and set up targets. Several dozen rounds later, we placed the rifle in the case, put the ammunition away, and took out the .380 pistol. Fun times.

When it came time to take out, and shoot, the 9 mm pistol, well, I went to the “9 mm” ammo can, opened it, and beheld something like 200 rounds of RIFLE AMMUNITION.

For those in the studio audience who are unfamiliar with Things Firearm, well, 9 mm is a pistol round, and rifle rounds are (a) the wrong size overall, (b) with the wrong projectile (bullet), propelled by (c) an entirely wrong charge of powder, leading to (d) entirely way, way more pressure once the cartridge is set off, for any common pistol to contain, meaning (e) should, somehow, a rifle cartridge be forced into the pistol that I had before me, anyone firing it, should they survive the resulting explosion, would forever after be known as “Lefty”.

Not mentioning the emotional distress I would experience should this pistol, one of my favorites, be reduced to shrapnel.

Sigh. It appears that I had horribly failed the ammunition labeling process, leading to jovial kidding from my step son. Other than that, a good day at the range.

And, the ammunition got re-(and correctly)-labeled.

Duty · Fun And Games · Pre Planning Your Scene

REDUNDANCY.

The other day, I was reading about everyday carry, and one writer was talking about how “two is one, and one is none”.

I recalled one night, nursing midnights in ICU. Now, every single hospital that I have ever worked at, has an emergency generator. These are equipped (or, at least, SUPPOSED to be equipped) with an automatic apparatus, that is intended to identify an interruption in the supply of power from the local power company, and start up the on site emergency generator, and then, once said generator is up to speed and functioning, disconnect the hospital from the shore power, and energize all “emergency” circuits from the generator.

As it developed, on this night, the power went out, and everything went black. We eagerly awaited the onset of generator power, but, alas, such was not to be.

Now, y’all may not know this, but in an ICU, there is an abundance of very, very sick folks. Indeed, several of them are dependent on ventilators to, well, ventilate them, since their illness renders them incapable of breathing adequately on their own.

With that thought in mind, it may not be a surprise that these life saving ventilators require an uninterrupted supply of several things, not the least of which is electricity, in order to function. When the power fails, and the emergency generators do NOT promptly start up, well, things get interesting.

While the ventilators, themselves, do NOT have battery backup, the alarms signaling malfunction, do. In order to respond to these alarms, the nurses, such as myself, need to alight from our chairs, walk around the nurse’s station, enter the room, and identify and remedy the fault eliciting the alarm.

(a) That is considerably easier to accomplish when you can see where the frack you are going, and identify trip-and-fall hazards, prior to, uh, tripping over said hazard, and falling upon your face.

(b) Should you have TWO ventilated patients, you are tasked with reaching each patient, disconnecting that soul from the (nonfunctioning) ventilator, and manually ventilating them employing the manual bag-valve resuscitator kept at bedside for just this sort of problem.

Except, you are one, non elasto-nurse, person.

As it developed, our ward clerk was in nursing school, was intelligent, and had paid attention. She ventilated my second patient, and the on-unit respiratory therapist ventilated Mary Sue’s second ventilated patient.

It only took a couple of minutes (…that seemed like hours!) before we regained power. But, I thereafter took to carrying a flashlight on my person.

Problem solved, right?

Not so right. A couple of weeks later, the power failed, again. The generator failed to generate, again, and I thought, “Voila! I’ll whip out my handy-dandy flashlight, and illuminate the area!”

Problem with that, is that the flashlight had somehow turned itself on, while on my belt, and was deader than disco. So, same cluster…er, hug (yeah! HUG!), same musical ventilation, and same subjective eternity until power came back on.

New! Improved! Plan, was a couple of flashlights, with a regularly (every other month) assessment of function and battery charged-ness. As well as additional flashlights squirreled about my person. So, presently, I have two flashlights on my belt, two in my shirt pocket (one Streamlight Stylus Pro, another that has been customized with a near UV emitter, so that I can use it as a Wood’s Lamp), one on my badge (one of the coin cell lights thrown in with my order from the folks selling me my CR 123 batteries), and one on my keyring (a Streamlight Nanolight). (none of these are any sort of freebie: I bought the Nanolight, and the Stylus, and then bought several more, at retail, because they perform for me what I need doing. Like, illuminate my way when nocturnal dogwalking, allowing me to avoid a dirt faceplant.)

Fun And Games Off Duty · Life in Da City! · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

THE PLAINTIFF AND THE HOUSE.

Long ago, and far, far away, I was sitting in a conference room with my attorney, The Plaintiff, as well as her attorney. We were discussing asset distribution. Her attorney announced that THEIR plan was that we sell the house, split the proceeds, and ride off into the sunset, separately.

Okay, that deserves some context. We had purchased that house something like 8 months prior to this conversation, it was in 2008 (remember those days? Housing values were plummeting like a drunken frat boy off a second floor porch), and we had obtained a “zero down” mortgage. I had kept an eye on housing values, and had noted that this house was worth less than considerably less than owed on the mortgage. We also had, between us, a camper trailer that had been paid off. I suggested, instead, that she take the house (simply so our boys would have their home, in a stable manner), and I would take the camper. I added that she could then, when she deemed it proper, she could sell that house, and keep all the proceeds. Alternately, as I observed, she could consider the market, and realize that the house was worth considerably less that what was owed. In that event, I would accept no responsibility for that shortfall. And, I’d take the camper.

Her attorney was aghast. “You cannot tell me that the house is worth as much as the camper!”

I said, “No, I am not telling you that the camper is worth as much as the house. In my appraisal the camper is worth considerably more than the house, but, it is about what your client wants, after all, isn’t it?”

To make a long story short(er), I kept the house, she got the camper, and no money changed hands in this matter.

Fun And Games Off Duty · Pre Planning Your Scene

Sleigh Bells Jingling, etcetera

So, TINS, TIWFDASL something like 60 northern Un-Named Flyover State miles from home. This was several years ago, of course, when we still had snowfalls (…he said, snarkily!) One night, I got out of work after 12 hours in our windowless ED, to find it had SIFAO. (Snowed….). AND, for bonus points, was still SIFAO. My daily driver was a 2008 FWD Hyundai Sonata.

So, it turns out that, at 45 mph, my typical 1 hour drive approaches 2 hours. Particularly when, SIFAO as it was, I followed the exit ramp, thinking I was still on the expressway.

You start to wonder about that, once the stop sign appears.

I re entered the highway, and plowed my way home, white knuckling it the whole way. I got home safely, the car gave me STELLAR gas mileage that trip, TDW-Mark II worried, and I galumped my crabby ass, along with considerable snow, into the house, unbruised.

Thanks Be To Chthulu.

More thoughtful observers, than I apparently am, might wonder why I simply did not obtain a motel room, and sleep my happy ass away, in the town that I was already in, and thereby allow the unsung heroes of the road commission and the state highway department, to work their magic and clear the roads?

Well, to be honest, that would require more foresight than, evidently, I possessed at that time. One might wonder if I had contemplated the McFee Four Stages of Snow Emergency. I had not.

To review, here are The McFee “Four Stages of Snow Emergency” Scale.

Level 4: wear your damn boots
Level 3: bring a coat, bring a shovel and a scraper
Level 2: do the s#!t you have to do and go the hell home
Level 1: Ermagerd! French toast by candlelight!

Life in Da City! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

If Only I had Gone to School For This, Or Something!

There has been a spate of RSV going around, lately. RSV, or Respiratory Syncytial Virus, is contagious, via airborne droplets. In small children, it can lead to hospitalize-level-illness, whereas in adults it generally causes “a cold”. The reason younger children can get so ill, is that should the virus elicit swelling of the smaller airways, children, having narrower airways, cannot tolerate as much swelling as adults and older kids, before their ability to move air is compromised. We can test for RSV in the office.

So, from time to time parents bring in their kids, reporting cough, or lack of interest in feeding, or runny nose. Occasionally such a child will test positive for RSV. Occasionally such a child has alarming vital signs. One such child arrived, and the MA truncated her intake, once she noticed retractions and diminished oxygen level in this infant. She trotted out, figuratively grabbed me, and brought me in to see the child.

I saw, myself, the retractions. Retractions occur when the effort of breathing in, is increased to the point that the skin between the ribs, or below the ribs, draws in from that effort. NOT NORMAL!

We administered a nebulizer (“mist”) treatment of a bronchodilator. Subsequently, the retractions had not particularly improved, nor did the oxygenation of this child. I directed the mother that she needed to take her child to the emergency department. She responded that her ride was not present, and there would be a delay as the ride returned.

I recommended EMS at that point. The child appeared to be stable, presently, but I was uninterested in determining how long that would take to go downhill.

The mother responded, “No, I want to wait for my ride.”

It appeared that I had not successfully identified to her the ways that significant delay could make things go horribly wrong. And, waiting for her ride promised to present a significant delay.

Mother was not impressed. Her ride (eventually!) arrived, and everybody went to emergency. Finally.