July 20, 2008

On C shift
Engineer Paramedic Rick Harrington saves lives. He also cooks, writes reports,
takes classes, makes repairs...

By KATHY GRAY
of The Chronicle

    It’s shaping up to be a dull afternoon for C Shift.
    The men on duty at Mid-Columbia Fire & Rescue, gathered in the watch office room adjacent to the equipment bays, warn that the presence of a reporter in their midst is a virtual guarantee not much will happen. It’s the Murphy’s Law of ride-alongs.
    I’m prepared to spend the afternoon and evening at the station, learning about station life if need be. But of course I’d like to roll with the crew.
    Fortunately for my story, while this day will be nothing at all like the day I’m writing, when firefighters from all over the Mid-Columbia rallied to beat back the threat of the 450-acre west end fire that threatened The Dalles, I’ll find a few calls to tag along on.
    Engineer Paramedic Rick Harrington is my guide to the world of firefighting and emergency medical response. At 35 and three years with the district, Harrington is the “low man” on C Shift, which may have played into his babysitting assignment today.
    Harrington and his partner Rob Graves are “first out” today, meaning they’ll roll first on any calls that come in. They’re on the ambulance for any emergency calls.
    Del Starks and Cliff Smith staff the fire engine today, and serve as second out for medical calls. Capt. Paramedic Fred Coleman is on third-out status.
    “But if there’s a structure fire — a significant fire — or a second-alarm grass fire, we all go in fire apparatus,” Harrington said.
    Five is the minimum manning level for a shift, with six preferred. But vacations and sick leave mean five is the usual number.
    “Any time there’s a call, minimum manning is four,” Harrington explains, which is why scanner traffic frequently includes manning call-outs. “Whoever calls in first comes in and mans the station.”
    With about a half-hour before lunchtime, Harrington fills me in on the morning routine. It starts with supplying the emergency medical kits and rigs.
Harrington opens the medical supply room door.
    “Certain drugs are under lock and key,” Harrington notes. “We check in all the drugs, that’s one of the morning things we do. That way, if somethings not right, the other shift is still here.”
    He points out the gurney district crews use for bariatric patients.
    “Some patients are very large,” he notes, “and it’s on the rise.”
    The gurney has a lift system, which minimizes the amount of lifting required, but it still takes extra muscle for these larger patients.
    C Shift rolls with a lot of gear, equipment and supplies — even more during the summer when wildland firefighting gear is added to the structure fire gear.
    The station routine also includes caring for and equipping the vehicles. On a rotating weekly schedule, the men tackle one bay of rigs each day, replenishing supplies, replacing lightbulbs and taking care of a variety small maintenance duties. Capt. Coleman oversees maintenance for the station, so C Shift does a fair amount of that work, Harrington notes.
    Harrington describes the ambulance as a “mini-ER on wheels.” In addition to the medical box — which includes a variety of medications, IV supplies and other items — the rigs are equipped with an airway kit, defibrilators and a pediatric response kit, which codes care information by size of the patient.
    “We don’t go on kids very often and when we do there are a lot of drug dosages and things that aren’t common,” he says.
    The pediatric kit allows paramedics to match dosages according to size.
A little later, at lunchtime, I learn that this was one of those rare mornings. C Shift had responded to the report of a child not breathing. Later police reports indicated that they had not been able to revive the 7-month-old child. (Patient confidentiality laws prevent the firefighters from divulging much information.)
    For these largely family men, a call on a child draws special concern. By the time C Shift had returned to the station, Chief Bob Palmer had already initiated a debriefing process. Shift personnel conferred and decided they didn’t need the debriefing, which is designed to address the stress of difficult calls.
    “Usually, it’s a really good job,” says Coleman, relaxing in the TV room after lunch, “but calls like this morning suck. Twenty years ago they weren’t any easier than they are today.”
    The debriefings are usually a benefit to other responders, Coleman notes. For paramedics, training takes over in high-stress situations, he says, to which Harrington concurs.
    As they relax, talk turns to their own families. Both Harrington and Coleman have teen-aged children who are good friends and active in sports.
    Harrington may be the newest guy on C Shift, but he’s been around Wasco County for a long time. He grew up in Dufur and worked on his family’s ranch and pheasant hunting preserve, as well as working for the aluminum plant before it closed.
    “I always liked firefighting on the ranch with wildland fires, but I hadn’t made the decision to do it for a living,” he says. “I like the thought of helping people. I like the hours. I like the job. It’s one of those jobs that you’re lucky to find and like doing.”
    The firefighters of C Shift work what they call a “set” schedule, working 24 hours on, 24 hours off, 24 hours on, 24 hours off, and 24 hours on, then getting four days off.
    “It’s based on a 56-hour week,” Harrington explains, or about 10 shifts per months.
    But there’s also overtime when all personnel respond to a fire, or when the station needs manning due to other calls.
    The speakers remain silent through lunch, which the men fix on their own from their shift’s food supply. Those who eat at the station chip in money each month for communal meals at dinner.
    When they’re not responding to an emergency scene, firefighters have more mundane duties. Harrington, for example, is responsible for the district’s fitness budget. He equips the weight room and budgets for all physicals each year for volunteers and paid staff.
    There’s also the unavoidable paperwork. Incident reports, quality assurance reviews — where the work from the previous shift is reviewed.
    Firefighters also work on monthly prefire plans for businesses that are large, or present special challenges. This month, C Shift is working at the local movie theater, where large crowds are the biggest issue.
    It looks as if the reporter’s curse may hold true today.
    After lunch, the crew gathers in the training room for a instruction on fighting ethanol fires. The plant-based biofuel, which is an increasing presence in Oregon gas stations, presents special challenges in fire situations. Physical training in the station yard outside was postponed due to the morning’s call, and ultimately cancelled because of the afternoon heat.
    After the training, a little after 2 p.m., Harrington and Graves start to exit the room, talking about their next project for the day.
    “Do you want to move those —” Graves starts.
    Report of a pedestrian-vehicle accident on Pomona Street comes across the speaker.
    “— I guess not,” he concludes, pivoting with the rest of C shift on a bee-line to the equipment bays.
    Within a minute, Harrington and Graves are en route, with me riding in the back. Starks and Smith follow in the engine.
    Coleman and Division Chief Jay Wood also respond, standard procedure with a motor vehicle accident.
    The victim is sitting up against a chainlink fence when the ambulance arrives, with residents of the home providing support.
    Harrington immediately fits him with a C-collar around his neck to guard against spinal injury. The whole crew participates as the victim is transferred to a back board. All the while, Harrington is talking to the victim, asking him questions about how he was hit. The victim is clutching his arm and complains of shoulder pain, so Harrington immobilizes the arm, as well.
    Within moments of arrival, a second ambulance call comes across the radios: A subject is passed out on East Second Street. Coleman pulls away, headed for the second response. Calls for manning go out over the radio.
    On the ride to the hospital, Harrington is quiet, businesslike and reassuring to his patient, taking his blood pressure and performing an IV stick as the ambulance moves calmly through traffic.
    “We rarely go Code 3 [lights and sirens] to the hospital,” Harrington tells me. “It saves a small amount of time, but not enough to ward off the possible crash. And a lot of times it stresses the patient even more.”
    Runs like this one are the meat and potatoes of Mid-Columbia Fire & Rescue’s business.
    “We average almost eight calls a day,” Harrington says. “We don’t average very much sleep anymore; we’re too busy.”
    While Harrington and Graves hand over responsibility for their patient to Mid-Columbia Medical Center’s Emergency Department, the second ambulance arrives with the Second Street patient.
    Back at the station, Harrington begins the part of an ambulance run the public doesn’t see: the report-writing.
    “There’s a lot of codes we have to fill out,” he says, getting to his task. At 3:50 p.m., Harrington and Graves are called out again, this time for a possible stroke at a local assisted living facility. The pair take turns as lead for patient care, so it’s Graves’ turn this time as Harrington drives.
    When local paramedics roll on calls they are following established protocols under the supervision of physician Erin Burnham.
    “There are a couple of things we have to call in, but not many,” Harrington says. When that happens, they work with the Emergency Department doctors by radio in the moment to respond.
    As the paramedics work to prepare the patient for transport, Graves questions the patient and the nurse at the care facility about various stroke-related aspects of her condition: mobility, speech, where and when she was discovered, etc.
    At the hospital, Graves oversees patient transfer, then writes a brief report to the hospital while Harrington cleans the back of the ambulance, paying close attention to the few drops of blood that resulted from the IV stick. Back at the station, he will replenish supplies used during the run.
    Then, as Graves takes his turn at the computer for report-writing, Harrington heads upstairs for dinner with Coleman and Smith. The three share dinner at the station — tonight extending their hospitality to me — while Starks and Graves are on their own. On the menu: a hearty steak, stuffing, salad and tasty olive bread.
    After dinner, some of the men retire to the sleeping quarters. Sleep is a precious commodity when night calls are the rule. Meanwhile, Harrington steps away for a bit to work on quality assurance duties.
    Coleman and Smith settle in TV-room recliners for a movie and a couple of episodes of CSI. I watch with them — my ride-along lasts until 8 p.m. — keeping an impatient ear out for the next call, which never comes.
    My stay with C Shift may be over, but their day continues for another 12 hours. They’ll have another tough run later that evening — a drug overdose.