dmc2007

Copy and paste strikes again... "We are seeking Paramedics interested in using advance technology, evidence-based medical protocols, and their own critical thinking skills to work for us in Indianapolis, Indiana. " Curious if this is them exploiting an opening with transcare being gone. They have all but packed up and gone home in Mass.

Not to beat a dead horse here, but this is where regionalization would help. The residents in this facility weren't beamed down from Mars, and while some may be from out of area, I'd wager (based on my experience talking to patients in these facilities) that most of them came from nearby communities. And, despite the jokes we've all made about gravity being stronger at these places, many of these residents used 911 services previously, so the net change in call volume to the system (on the regional or county level) on the whole probably isn't that great. If you have a regional system, you can easily shift resources to cover the relocation of these residents and their demand for services. Let us not forget that these are services that they have paid for, both in their lifetime as taxpayers and through the rent they pay to the facility, which in turn pays real estate and payroll taxes. As for the notion that these calls aren't serious, let us also not forget that falls are one of the leading causes of death and debilitation in the elderly, and can be a secondary symptom of a bigger problem. So while, yes, many of these patients require nothing more than help off the ground, they all need an assessment. Most of the time, these facilities don't have much medical staffing and, if they do, they aren't clinicians capable of making decisions without consulting a physician. Enter EMS. I'm not saying I enjoy going to these facilities at 3 AM after running all day, but the need for the service is there. As for the issue of the medic having to respond to every call, that seems like a failure of resource utilization that is indicative of a bigger problem. If the resource is limited, than an appropriate emd program should triage calls appropriately (as best you can given the often lackluster communication and clinical skills of the caller from these facilities).

On the topic of offering to create a joint system with Pelham-that seems like a pretty clear indication that the contract is empress' to lose, no? Either way that sounds like a great way to improve service to Pelham at the same time by consolidating systems-something Westchester (and mass too, among others) could use more of. The equipment section of the contract had a few interesting points. Granted, it's been a while since my NY card lapsed, and even longer since I actually spent any significant time volunteering there (and only at the Bls level), but the inclusion of video scopes and BiPAP capable vents was a surprise. Are a lot of services in Westchester moving to video scopes? As for the vents, are medics in ny allowed to initiate them (either for incubated patients or as NIV)? Or is that provision there for stat transfers out of SSMC/monte north?

If EMT/Paramedic->Firefighter isn't supposed to be seen as a promotion, then why isn't there a Firefighter->EMT/Paramedic Promotional exam? Don't get me wrong, the implications of appointing an unqualified firefighter are terrifying, and I fear for those that have to work with this recruit.

Am I the only one who finds the fact that the article (and FDNY on the whole) refers to the transition from EMT or Paramedic to firefighter as a "Promotion" equally bothersome, if not more so, than the main subject of the article?

Impala and Caprice are two separate vehicles, with the biggest difference being drivetrain (Impala is FWD, Caprice is RWD). The Caprice was reintroduced last year as a police-spec only vehicle, and is still in production. The Impala was redesigned for the 2013 model year (I'm guessing you drove the redesigned model), but the old model (which has been offered in a police package for some time) has stayed in production for fleet and government purchasers. There is no police package of the new model yet (nor will there likely ever be.

I'm in.

Pelham Manor is covered by Empress Ambulance (with an ALS fly car and transporting ambulances sent in as needed). New Rochelle is covered by Transcare with 2.5 ALS Trucks (2 24 hour and 1 12 hour). The Village of Larchmont and the Town of Mamaroneck are covered by Larchmont VAC, while the Village of Mamaroneck is covered by Mamaroneck EMS. The last two have 24/7 ALS staffing through the Town of Mamaroneck Ambulance District. An ALS intercept system would be a downgrade from the current system, as all of the areas you mentioned except Pelham presently have dedicated ALS transporting ambulances. You're talking about transport times here of 10-15 minutes max, often less.

Volunteer or paid shouldn't make a difference. Guess what-the citizens in your district probably don't know and definitely don't care whether the crew responding to THEIR emergency is paid or volunteer-they expect and deserve the same level of service no matter where they are. Do all assists need to end with transport by ambulance to the hospital? Probably not, but until any medical concerns are ruled out, the call should be handled by a crew that's trained to identify possible the red flags that indicate something bigger is going on or that an injury has ocurred, as well as to stabilize and properly move an injured person. If an EMS system doesn't feel like dealing with falls, which are the number one cause of injury death and trauma-related hospital admissions in the elderly (source: http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html), then its time to revamp said system. That being said, if a particular individual, or the family of an individual, keep calling for preventable falls that end up being non-medical, there is a bigger issue of finding a more suitable living environment for that individual that needs to be dealt with.

Sounds interesting. What's the date for the session?

<br /><br /><br />As far as I know, the only other company in the Boston area with Sprinters is Armstrong. Brewster had one unmarked in its garage (a demo maybe?) when I interviewed there back in October, but I've yet to see it on the road.

From the EMS point of view... I've freelanced a grand total of one time...I was en route to a large scale incident, in uniform and as requested by our command staff, when I came across a MVA that would have represented a small-scale MCI had all but one patient not refused. After talking to the command staff, I secured my POV away from the scene and offered assistance. Given that our area was already strapped from the prior incident, the extra help was needed and appreciated. That being said, freelancing without permission tends to be a major problem in major incidents. While we roster in house crews and don't have to deal with the issue of toning and hoping for a crew to assemble, we do have people responding to calls without permission, particularly those big calls that wouldn't have an issue garnering a response in other areas. Having responded to calls on the duty crew where this has happened, I'd say it's problematic. It creates needless chaos on scene and increases the workload for the IC, whoever that may be. If I was part of the command staff, I'd add consequences for it. I don't think I'd last very long in the command staff of a volunteer agency in this areas...

Some more info here: http://woburn.patch.com/articles/woman-killed-in-mishawum-car-crash-early-friday This happened only a few miles from where I live.

I'm pretty sure you can file for reciprocity with any state, with many requiring a re-test or at the very least a fee. I'm pretty sure CT and NJ have automatic reciprocity without re-testing.

IIRC those are actually used for traffic stops-side stops are still utilized there.