mvfire8989

Just to be clear this article is talking about blood plasma, it does not have a major role in transporting oxygen to tissues. This is a product with plasma proteins and coagulation factors only. It does not contain red cells, white cells or platelets.

Scenario: 45 year old female found on the street, called in by passer-bys. It's Friday evening, patient is responsive to pain with a GCS of 11 (2/4/5). Patient wakes up to sternal rub and quickly nods off. She is unable to provide any information as to her present condition or history.
Resp: 12.
HR: 66, Regular.
BP: 94/50.
SPO2: 97% room air.
BGL: 118 mg/dl.
Skin: Cool, pink, dry.
Eyes: Pinpoint, reactive.
Patient has x3 empty methadone bottles in her pocket.
Narcan or not? Keep in mind that ED's are using 1/10th of what we are in the field as the first line dosage now-a-days (that's 0.04 mg for those keeping score) and I've seen my share of crews bringing in patients who are either actively seizing due to narcan mediated withdrawal or some other acute stress response that ensures the patient's stay in the ICU...
No medication administration is without it's potential adverse reaction and unless you're equipped/trained to deal with it, you have no business administering the drug to begin with. *Especially* if the condition can be mitigated with a BVM and some O2...

Obviously this is hard to say for certain without being able to actually eyeball the patient and without a complete history and physical, but when I read the case description, my first impression was "dying as a result of the natural course of their disease." In a case like this you MUST be proactive and gain a solid understanding of what the goals of care are for the patient -- talk to the family, figure out how aggressively the patient wants to be treated if he can't tell you himself. I agree totally with the assessment strategies mentioned (ekg, capno, etc.) and if the patient wants to be aggressively resuscitated, everything said here regarding treatment is right on the money.
However, there's a good chance a patient like this will have some sort of advance directive (DNR/DNI, etc.) If they do, this DOES NOT mean do not treat. A doc I worked with used to say that palliative care is intensive care. You still need to do everything in your power to make the patient comfortable...in this particular case, you need to treat the patient's "air hunger." That may be as simple as supplemental O2, a warm blanket, and an easy ride, or it may mean nebs, lasix, or CPAP if they'll allow it. If you're going to be with the patient for a while (long txp), small doses of morphine or are useful (but good luck getting that order from medical control.) The patient may (probably) still be dying, but if you can make the process more comfortable and less stressful, you've done right by him.

I think a lot of people are missing the whole point of why people who have contact with patients should be vaccinated. We are talking about a disease that has a significant mortality risk for the elderly and otherwise immunocompromised, that we can transmit to our patients when we have NO or very minimal symptoms. It's not going to hurt us that bad, but it could kill them. This disease has a high incidence and prevalence, and it is highly infectious with respiratory droplet transmission. Most other vaccinations that you receive, such as hepatitis B are things that you could potentially get from your patient but not something you would transmit to patients using standard precautions. Hepatitis B is blood borne. I understand the desire to control your own body. The risks from this vaccine are extremely low, it DOES NOT and CANNOT give you the flu. The efficacy is somewhere around 60%. No vaccine reaches 100% efficacy but we administer them because the risk reduction is well researched and statistically significant.

The other issue is there is always an issue of flu shot shortages. There may be an extra burden on the flu resources during the season when the strain mutates and if they make HCP first up that may be an issue. I also just feel that the flu shot isn't a vaccine because there's no guarantee it will prevent you from getting the flu or carrying a strain of the flu. It just lessens your chances. I wonder how my employer will deal with this as I am not getting the shot. Also I want to see what the checks are to make sure those who don't have shots wear mask and the repercussions if you don't wear mask. What if I don't wear a mask will I lose my EMT cert or what? This is just a really interesting mandate because there's options and due to HIPAA isn't there some privacy amongst what vaccinations I have etc.

Since you have access to a computer, you are the best person to evaluate the effectiveness of any supplement that you are considering taking. From a quick search on the lipozene that you mentioned, I'm fairly certain that you would have a better result saving that money to spend on healthier food choices, the gym or investing in some exercise equipment for your home. The only effective way for anyone to lose weight is by consuming less calories than you need in a day. One thing that a lot of people struggle to do is understand exactly what they eat in a day. By using one of many websites or apps available, you can track the number of calories you are consuming and also track things like fat and salt.
There are some medications available that can increase your metabolic rate slightly, these are prescription only and generally only used in people with a BMI of 30 and above. The only verified pharmacologic way to help you lose weight available OTC is Orlistat/Alli which can decrease fat absorption, but commonly causes diarrhea, fatty stools and flatulence as a result.
You also mentioned that you don't consume much in the way of fluids. In general, if you are considering a supplement of some kind this is not a good idea. The lipozene is a fiber, acting as a bulking agent to hypothetically feel more full after consuming less food. If you were taking it in a dosage to be effective it is going to absorb fluid in your colon and potentially cause constipation. All of the recommendations for fiber intake presume you are consuming an adequate amount of fluids.
In summary:
1. Consume less calories than you burn
2. Track the food you consume and adjust accordingly
3. Try to exercise 30min a day most days of the week. Aerobic exercise such as running or biking is best for weight loss. Aim for a HR of 50 - 85% of your predicted max sustainable HR = 220 - Age
4. Shoot for a weight loss of 1-2lbs/wk if you want to maintain the results.

The problems keep surfacing!! This shouldnt have been so rushed! Cuomo was trying to make a name for himself and pushed through rushed legislation. This should be repealed and done the right way.

Personally, I think this just seems like a frivolous waste of money, It's just another form of duplication and excess, which if I'm correct is what most departments are trying to get away from. How do you justify such an expenditure when multiple systems are already in place for each aspect that it will be used for? Checking department e-mail? I'm sure each station has a computer, not to mention almost everyone has a smartphone or home computer (the few old school people I know who don't have either wouldn't care to check their department e-mail anyhow). Time card? I am fairly sure most employers prefer to have a supervisor handle timekeeping as opposed to the employees themselves, or in the case where no supervisor is present at a station they prefer a timekeeping system that can only be accessed at the workplace, not anywhere you take the iPad. As far as training goes, there is really no accountability for on-line training, there's no way to verify that the person doing it is actually the person it's intended for nor that they aren't just killing time in front of the computer while they have an answer sheet from someone else ready to copy from and fill out sections at appropriate times, I've seen it happen many a time. As far as dissemination of training information, what's going to make the employee read a training bulletin on an iPad if they are already the type who don't care to read it on paper? As far as patient care and written reports, I don't think each person needs one, maybe one per ambulance for PCR's, and one per station for community use in filing of reports, although it seems like the desktops or laptops that most fire stations already have could support this function, not to mention the fact that the majority of the time it is only one supervisor or member filling out the report, not each individual.
Many departments already have in place electronic systems to perform all of these functions, most can be easily accessed from a computer available to the employees at work or by logging on remotely from a personal device. Handing everyone an iPad and saying, "now this is only for work use", that's almost a challenge to some people, and expecting everyone to be on board, that's pretty naive, I have a teenage neighbor that if I wanted could have the thing unlocked in twenty minutes so I could use it how I pleased. You would probably be better off giving members unlocked iPads honestly. If it's locked down and can only be used for a few limited work functions its not really able to be customized to the employee and many members will simply throw it in a drawer as another extraneous piece of junk the job has handed them. If they can use it how they please they will be more likely to use it for personal and work use. As far as taking care of department business while off-duty, off-duty is off-duty, one of the great thing about most emergency services jobs is that you don't take your work home with you. If you want to read, train, and enrich yourself out of work that is one thing that I personally promote, but work, stays at work.
I also don't see any real efficiency savings, as you aren't really saving any money by spending more money. What can be eliminated now that everyone has an iPad? Saving paper maybe, but I doubt those savings will really make up the cost of your investment especially after maintenance and upkeep costs.
As far as the comparison to the expense of each member having a portable radio, how many lives do you think personal iPads will save? Will it give a Mayday for you? Are you going to carry it into the building with you? Is it your lifeline to other members when you are trapped or lost? Personal portable radios have been proven and documented to save lives, and not to sound hackneyed, but that is PRICELESS. Unless you can place efficiency on an equal footing with the life safety of members, then the cost of personal iPads cannot be compared to the cost of personal radios, period.
In my opinion, in this day and age of cost cutting, tightening budgets, and increased scrutiny by taxpayers as to where their money goes, this is a waste of money and will be conceived by the taxpayers as such. Many taxpayers and politicians have already begun to perceive the emergency services as a whole to be an expensive, extravagant, luxury item that can be slashed and cut down to the bone, lets not give them more fodder for their arguments. Spend money on the things we REALLY NEED and that are easily defensible to the public and politicians alike.

Do they advocate violence? No. Has the church or any prominent member of the church been accused of violence? No.
Do they speak unfathomable hate? Yes. Do I fundamentally disagree with their speech? Yes. Do they have a right to their speech? Yes.
What will labeling this group as a legally recognized do? Absolutely nothing, they will still be able to protest funerals and spew their hate speech. Do I agree with it? No, but god damn it they have a right to speak it and you better believe that they can and will defend their right. We can condemn their speech in the strongest terms but we can not limit their speech no matter how extreme it is. So long as their speech does not violate any law, there is absolutely no choice but to accept the fact that they are entitled to their speech.
What you see as "push the 1st amendment to the extreme" I, as well as the Supreme Court of the United States, see as simply exercising their right to 1st amendment speech protection. If you don't like what they say, don't listen but they have not broken any laws and thus you have no right to limit their speech.

maybe they should donate to a NY fire department that lost everything

Not sure that one will buff out.

Not sure that one will buff out.

I would just like to reach out and thank our brothers and sisters involved in bringing and letting us have their 1977 Oren. The Mahopac fire department generously donated the rig to our department, Sharon Fire Department. We have been struggling to keep our apparatus running and operating, it is a huge relief that we now know we have neighbors(could be far) that would do such a thing. I am sure, from what i heard, it will serve us great. I was sent a photo via email early this morning of it about to leave it's quarters for the last time. Now, ofcourse it made us happy, but we feel for their department for a loss, a loss because that engine served them well, we all know how they will miss it.
Again a very big thank you to everyone involved in making this occur, as it is greatly appreciated by us. They even lettered it for us too. We should be expecting the rig within a day or so. Then go from there.
A photo before being shipped..

Have a great day all any questions just ask

Why does it matter aside from maybe helping figure out what is wrong with the patient? Forget about how its just wrong to treat someone differently based upon a medical condition, what if they don't know they're carrying some disease. Everyone gets treated the same unless I suspect an infection requiring droplet precautions.
Moderator note: This was the very last post made by Lenny, before he left us for keeps. RIP.

The problem with parroting propaganda is that propaganda is often short on facts and long on passion. This combination hinders your ability to participate in intellectual discourse as it takes away from any salient points you might actually make. That being said...
If midterm elections are such an accurate assessment of the public's opinion what does that say about Bush's second term. It was the first time Democrats took the house and senate since 1994. More importantly 1994 was the first time in over 60 years that the Republicans held the House with one exception in 1947. In retrospect Republicans and Democrats generally agree that Clinton was a good president nd our nation prospered under him. So even though Clinton was doing a good job the Republicans were able to maintain control of the House and Senate. With a Democratic Congress, maybe things would have been better or maybe they would have been worse; there's no way to tell. What I can tell you is that since the Depression Democrats have been in charge of both the House and Senate more often than not.
Obama care is largely the healthcare reform proposed by Gingrich and his fellow "Contract with America" conservatives in response to Clinton's attempt at universal healthcare. Funny, in 1994 heath insurance mandates were the sensible choice yet 18 years later they're socialism. Before you get all up in arms about market socialism, the healthcare mandate is absolutely not socialism. Nothing is being taken from anyone and redistributed. People are being forced to purchase a product. The providers of said product are not government entities and free to offer whatever services set at whatever prices the market will bear as long as they fall within certain guidelines. If you live in NY and drive a car you will be familiar with a nearly identical system call auto insurance. You are required to have it, there are mandatory minimums, and there are certain rules regarding the provision of this insurance that the industry must follow. I disagree with the health insurance mandate in that no one is forced to buy auto insurance. If however you wish to drive a car, you then must buy in. Practically speaking however we as a society will never accept casting people into the street to suffer alone because they chose to opt out of purchasing healthcare. Sadly, I don't disagree that the Supreme Court will likely rule against the mandate. They did a poor job arguing their case. Luckily the past has clearly shown that just because you lost in the supreme court it does not mean you were wrong. Many decisions made by the court then would be inconceivable now. Google Dred Scott for a look at one of our not so great supreme court decisions.
The full effects of auto bail out are still yet to be realized. Educated and informed individuals can go back and forth about what might have happened to GM in bankruptcy court. Both sides have salient points and real world examples to demonstrate their arguments. What you are ignoring is Bush started the auto bailouts with his initial injection of cash to stabilize the companies while what eventually became the bailout was crafted. The very same bailout that Bush has since stated he doesn't regret and would in fact repeat if he were to do it all over again today. GM and Chrysler are both doing far better today than they were just before their collapse. Lehman Brothers is the closest in size to GM that has ever gone into Chapter 11 and today is a shell of its former self. Considering that Lehamn benefited from Barclays quickly jumping in and picking off they healthier divisions while no one was interested or able to buy anything that GM had I tend to agree that GM would be in far worse shape.
Obama's win was almost as much the result of everything you mentioned as it was the inability of the Republican's to run an effective campaign. The democratic primary was so bruising that election was the Republican's to lose. Absolutely, the wars and financial disaster were bad but they paled in comparison to the damage done by Palin. Obama's election wasn't so different from Bush's. A little known candidate with no real national experience that escaped a bruising primary on hype and squeaked out general election win more because of the failings of their opponent than the strength of their campaign. P.S. the same could be said for Clinton except that was more Perot's success than Bush's failure that opened the door for Bubba.
Show me where cutting taxes has been a time tested and proven solution for fiscal crisis?? Bush Sr and Reagan both raised taxes overall and Reagan expanded government in response to fiscal crisis. Cuts for the sake of cutting don't work. When corporations find their bottom line failing they spend money.You stem losses by cutting spending in some areas, but those funds are redirected towards investments designed to stimulate new business. You may disagree with where Obama is spending the money and how he is raising it, but outside of ranting tea party candidates republican and democrat economists agree that more money needs to find its way into the economy. Whether it is better to leave it to the "job creators" to spend our way out of this recession or better for the government to stimulate the economy is up for debate.
I can't even go near the Walker stuff. Except for the fact that Walker won, that whole bit is entirely based in fantasy.
Ironically our terrible economy has gone a long way towards improving our position in energy production. The dip in the dollar has hurt our buying power and made importing oil relatively more expensive. The flagging economy also resulted in a dip worldwide in energy demands increasing the price gap between fossil fuels and alternative energy. Coal is still taking a beating, and will be for a while. Even under Bush the EPA was harder on coal than they would have liked.
Feel free to google any of my reply here. All original, largely opinion, and all developed from careful consideration of the world around me. I wouldn't expect you to suddenly change your mind just because you read a few differing opinions, but it would be really nice to hear an intelligent and coherent reply from you just once.
Sorry, one thing I wanted to add...
Why do you and the rest of the incensed right insist on using Obama's full name? Clinton was never William Jefferson Clinton and even with two living presidents named George Bush the middle initial sufficed. Are you that bothered by the name Hussein or what it represents?

Don't try too hard to follow his logic. First off, it's difficult for anyone who appreciates the rules of grammar and literacy, and second off, it's all plagiarized. So basically, all of his "thoughts" are stolen. That makes him a thief. There no lower creature in academia than he who passes off others work as his own. I just picked three random sentences in that post, and they are all, verbatim, off the internet.
http://www.ehow.com/list_6683091_negative-effects-labor-unions.html
http://answers.yahoo.com/question/index?qid=20100921054610AAA0to0
http://answers.yahoo.com/question/index?qid=20091019184208AA8AYGx
If anyone wants to have an honest discussion about the pros and cons of organized labor, please step up, but if all you can do is steal others thoughts and pass them off as your own, your making yourself look like a fool.
(Besides, doesn't plagiarism violate forum rules? If not, it should.)

You're education on this topic is so one sided its almost comical. Unions absolutely have flaws. No one that has ever taken on the pro labor argument on this board has ever trued to say that unions are a perfect solution. The contention is organized labor provides a better environment for the working class.
The Walker recall did fail. But as others pointed out he spent a massive amount of money and barely won. Its no secret that money equals influence in an election. Obama is hammering California and NYC fundraisers just for that reason. He spent nearly 10x as much (yes that doesn't include all of the campaigners pumped into the state by the unions) and won by a much smaller margin than his original election against a much stronger candidate. This recall sent a powerful message heeded by tea party governors in other states like Indiana.
Yes, higher wages and better compensation has to come from somewhere. Paying workers more drives prices up. I have NEVER heard management suggest a reduction in their compensation or a reduction in dividends for the shareholders to prevent reductions in pay or layoffs. I do however constantly hear about reductions and layoffs to preserve corporate profits.
It has been shown time and time again that increased compensation leads to increased spending which spurrs economic growth. Economies do not grow when people save money. Henry Ford ensured a market for his car by paying his employees enough to buy them. WWII dragged our economy out of the depression because we were forced to dump massive amounts of money into farming and manufacturing. To pay for it the government drove the effective taxrates to levels not seen before or since and the economy chugged along just fine with largest expansion of the middle class and smallest wealth disparity in our nations history.
You say unions are preventing American corporations from being competitive yet Germany has managed to maintain a dominant manufacturing sector and one of the strongest economies in the world despite being saddled with healthcare obligations and national labor organization.
There is no doubt our economy is broken. However any ashole that insists all of the blame rests with any one side is just that, an ashole and should be discounted as such.

The key is, as others and BNECHIS has noted above, having a trained EMS provider to clear the patient before anything is done. This is why I believe that only those with an EMS responsibility should be the primary responders on these calls. The FD is absolutely the right place to call if they have trained personnel with the ability to properly (legally) evaluate and determine the patients' medical/injury status. In some places this might be the PD as they may have an EMS responsibility.

I just ask for facts. You clearly don't have them in this specific instance. Maybe no one has made the effort to track accidents per mile for firefighters career or volunteer. Maybe you have the connections to get the NFPA to look into this. I don't know how to make this any clearer. I don't give a rats arse who is more dangerous behind the wheel, I only want to see the statistics proving it. Lets look at NYC. I can't find a single instance where a volunteer fire company was involved in a fatal collision. I know of three involving FDNY. Now maybe the volunteers don't even have enough road miles to make a statistically significant comparison to FDNY, but on the surface it sure seems like the volunteers are safer. No one in their right mind would consider that a fair comparison. Similarly the MTA is the deadliest city agency. They've killed far and away more civilians than anyone else and are always governed by VTL. Their drivers receive more training and have more time behind the wheel than FDNY. But their road miles are so high it would be impossible for me to just guess at which agency is statistically more dangerous.
Do career fire departments actually put more road miles on than volunteer FDs? They absolutely have more calls, there are stats documenting that. But do they have more miles? I'm still can't find anything addressing that. What I can find shows that far more land area is covered by volunteers.
Absolutely every paid firefighter must first get to work, but unless I am mistaken, those accidents are not included in these numbers. Volunteers responding to their station for a run are included. Similarly volunteers headed to the station for a parade, meeting, drill, etc are not counted.
Again, you are correct that volunteers do not meet the same standards for selection, training, and accountability. However there is NOTHING demonstrating that volunteers are crashing more frequently than career firefighters and even less proof that the training gap has anything to do with it.
So you're just going to pout and go home? There are a lot of flaws in the volunteer fire service. First and foremost that it is an inferior level of service than you would receive from a paid department. The deciding factor between the two is cost. If you could get a functional paid department or reasonably close to what you're paying for a volunteer dept you'd stick with the volunteers?? You'd be a fool. That being said there is still a very large need for professional volunteer fire service in this country. The key is professional and that starts with addressing flaws and inadequacies within your own service.

I'm inclined to agree with ny10570. Let's say for argument sake, you have a career department with 12 guys on duty at any one time. The department has 2 trucks, and the manpower is split, 6 on one truck, and 6 on the other. An alarm comes in that is 5 miles from the station. Each truck will drive 10 miles round trip, for a total of 20 miles driven for just one alarm.
Now let's say that you have a volunteer department with the same amount of personnel and the same amount of apparatus. However, the station is not staffed at the time that the alarm comes in, as it is a nice sunny Saturday afternoon. Each member lives 2 miles away from the station. An alarm comes in for a location that is the same distance away from the station, 5 miles. Each member will drive 4 miles round trip to and from the station, which when extrapolated over the amount of personnel, is 48 miles. Then, the trucks will drive 20 miles to and from the alarm, taking the grand total to 68 miles driven for just one alarm.
At least in this particular example, volunteers would drive approximately 70% more miles for the same alarm. Therefore, with the increased mileage driven, and the laws of statistical probability being what they are, there would definitely be a correlation between the number of volunteers and vehiclular accidents.
The only controlling factor in the equation is due regard. Everyone is taught to drive with due regard and applicable courtesy, regardless of whether they are a career guy or a volunteer. The adjective describing what kind of firefighter the person is, is simply irrelavant.

Here it is: http://www.health.ny.gov/nysdoh/ems/policy/05-05.htm

Absolutely, the stats were in no way misleading. Your conclusion from those stats however was completely biased and unsupported.
You claim reckless driving is an "obvious problem" in the volunteer service. I'm not saying that it is not a problem. I just don't see any evidence of the problem. With every member driving and on average a younger and less experienced membership; there are piles of research demonstrating that if the fire service posts numbers correlating to those found in the general population the volunteer fire service should have a substantially worse driving record. I have not seen this in my extremely limited and cursory searches. This may be because the most common factors in young driver deaths; drugs, alcohol, reckless activities, and inattentiveness are rarely factors when volunteers are responding to alarms. Maybe its just poor judgement and it affects both sides equally.
I cannot speak for the posters stooping to snide remarks and cartoons, but I only look for accuracy in any side of a debate. Losing credibility in one facet casts a poor shadow on any other points. I am not attacking any departments, referencing isolated incidents, or defending anyone. I'm just trying to take an unbiased look at the facts. Want to say that the average Westchester VFD on the average day is providing an understaffed, undertrained, and slow response to calls for help? I completely agree. But to say that volunteers are obviously driving recklessly just doesn't stand up to scrutiny as far as I can tell. If you have the research, I'd actually like to dig through it. Post a link, send a message, anything.

Chief, i could be wrong, but i havent read any posts that were "anti-career." Maybe i am missing something? I also dont think anyone has bashed you personally. Many have responded to your posts, but i didnt see any as an attack?
Ive always enjoyed reading your posts, even when i may not agree with them 100%. Hell, i even enjoy your witty sarcasim. Its been said on here before that you're anti-volunteer. Guess what, maybe im alone, but i could care less if you are or not.
I must say though that i agree with your post that i have quoted here. Whether you're anti-volunteer or not, you bring up an excellent point. The issue of reckless driving (on either "side") is a big problem.
In the article, it is hard to tell what kind of vehicle the Chief passed. It says that he passed another member who was en-route to the call. Was this another Chief or a member in a POV?
Either way, its safe to say that this Chiefs actions were reckless and downright stupid. I am not too familar with Harrison, much less the intersection where the accident took place. The article states that the Chief was traveling around 60mph. This was not a highway, so the speed limit was certainly not 55mph. So, he may have been in a 45mph zone at best, no? To drive 60mph through a congested Town, then blow a red light at those speeds is crazy. Any apparatus operator (or civilian driver for that matter) knows that you dont just blow an intersection, controlled or not.
Another member had posted that statistics show that theres not much difference in response times when going the speed limit versus going over it by a small ammount. This is pretty much common knowledge stuff that seems to go out the window. Even if this Chief didnt crash, he would have only shaved off seconds of his response time.
Because of his actions, somebody was seriously injured, while he apparently walked away unscathed. Because of his actions, emergency personnel had to worry and respond to this 2nd accident which he caused.
Maybe i didnt read it correctly. But the article states that the monetary damages are to be paid by the Town AND this former Chief. Safe to say that it was determined that the Chief was at fault, no? But nowhere in the article (unless i missed it) does it say anything about him being charged or ticketed for anything. Also, was he suspended from the HFD and/or "de-moted?"
Guys and girls, this should be a wake-up call to all of us, career, volly, PD or EMS.
Stay safe

I have to disagree with you Capt. You can't throw around numbers backing your hypothesis if they don't actually do that. They may, after analysis, but not in the manner they were presented. It's no secret I think JF knows what he is talking about, but his ability to relate it often gets lost in his delivery to some.
As I don't have anything with the fire service, career or volunteer, I certainly don't take it personal.

As I think ny10570 was trying to say, the fact that the number of volunteers involved in accidents is higher is not surprising, but this number alone is meaningless without further data to make an objective comparison. You are comparing the numerators of two fractions while ignoring the denominator. Since there are vastly more volunteer than career firefighters, the comparison is not valid until you can compare it by the vehicle mile or something to that effect.
100 is larger than 10, but 100/10000 (0.01) is less than 10/100 (0.1)