Come and Knock on Our Door

Opening the firehouse’s front door to a mother throwing her child into your arms screaming, “You have to help him,” is surely an adrenaline rush for any firefighter. With a child crying and no major signs of an injury, we were able to put him on a desk to begin patient assessment. The mother was screaming, and we were trying to calm her down and get the child’s name. 

As we laid him down, we noticed he had a towel over his groin area. Removing it, we quickly found out why they both were screaming. As we tried to stop him from squirming around so we could size up the situation, the mother blurted out, “I accidentally zipped him up!” 

Looking at the pant zipper, we could tell that the foreskin (he was not circumcised) was trapped between the zipper’s teeth and completely through the slider. As the trauma bag arrived, one member quickly grabbed an instant ice pack so we could try and take some of the pain away, while others were discussing our best removal options. We quickly decided that all we could do was unbutton the pants and cut the crotch out using a pair of shears and try to gently separate the zipper to try to ease some of the pain. When the medics arrived, they saw our handiwork, agreed that we should hold off on any other extrication efforts, and whisked him away.

Thunderous Knocks

Hearing the thunderous knocks on the firehouse’s front door just after midnight also gets the blood flowing. Opening the door and seeing a car parked haphazardly on the front apron with screams of, “They’re shot; hurry and help them,” had us running back into quarters to hit the bells and announce it over the intercom for help in front. We also notified the dispatcher to put us on a “verbal” and of the need for an ambulance and police assistance. The crew assembled with the trauma bags, oxygen, and defibrillator; one of us surveyed the scene looking out for our safety. We wanted to make sure there was no gun on the victim or in the car and that the shooter wasn’t in the area planning a secondary assault on the victims or us.

Working in any area of this country nowadays with the rampant drug use and gang activity should have us all on our toes when we operate at scenes like this. Many departments are now issuing bulletproof vests for units to wear when responding to calls for a shooting. Luckily, the wounds weren’t life threatening and the victims were stabilized and transported to the hospital.

Repeat Incidents

Over the course of a career, you’re going to get those repetitive knocks for assistance: the person with a ring stuck on a finger or a child’s finger stuck in a lock washer, flat washer, or threaded nut. Hopefully, you have a manually powered ring cutter on your apparatus. We used ours one day to cut the soft brass of a mortise and rim lock bracket that a child had his finger stuck in. The ring cutter is great but, like many tools, it has its limitations; it might not cut a thick stainless-steel ring and you’ll have to revert to other tools.

The string removal method is one way to try and remove a ring off a person’s finger without using any tools. Some firefighters might use thread or dental floss, but sometimes that is too flimsy to slide under a wide ring and pull out the other side, especially if you don’t have a pair of tweezers to grab it with. Remember, the person’s finger is going to be swollen or discolored or even have large blisters on it, so you need something with some strength to get between the ring and the skin. 

We’ve had great luck in using the nonrebreather face piece’s elastic strap. The ends are like shoelace tips and, with lubrication, will slide through the area; the ends can also be cut shorter. Plus, when you go to wrap the finger, you can pull the elastic strap tight and squeeze the finger to compress the swelling so you can slide the ring off the finger.

Recently, we had to remove four stainless-steel rings; we slid each band off the victim’s finger using string. The extrication took some time because we paused in between bands to soak the finger in ice and the victim requested a few minutes in between removals to regain her composure. 

The string trick is very successful, but it also has drawbacks. In one incident, the ring wearer’s finger was extremely swollen because she jammed her finger. The ring design was her name written in script, and when the string began to unwind, it would get caught between the letters and snag, stopping the removal process. That plan of action quickly failed, and we had to revert to cutting the ring off with a smaller cutting tool.

Remember that these operations may necessitate a gentle approach with slower than normal operations. If you revert to power tools, let the person listen to the noise of the tool prior to using it to avoid any surprise when the victim hears the rapid revving begin. Always lubricate the material you are cutting, and put safety material in between the ring and the person’s finger so the cutting blade doesn’t cut the victim. You can modify spoons, utensils and their handles, and even sections of a tape measure. If any of these extrications become extremely involved or painful to the victim, remember that paramedics may be able to administer a digital nerve block to the patient.

There are plenty of knocks on the doors with all kinds of surprises, so be prepared. Remember, we’re open 24/7.

MICHAEL N. CIAMPO is a 33-year veteran of the fire service and a lieutenant in the Fire Department of New York. Previously, he served with the District of Columbia Fire Department. He has a bachelor’s degree in fire science from John Jay College of Criminal Justice in New York City. He is the lead instructor for the FDIC International Truck Essentials H.O.T. program. He wrote the Ladders and Ventilation chapters for Fire Engineering’s Handbook for Firefighter I and II (Fire Engineering, 2009) and the Bread and Butter Portable Ladders DVD and is featured in “Training Minutes” truck company videos on www.FireEngineering.com.