ny10570

The Fed and various highway safety groups love to tout the decreases in driver fatalities with the federally mandated reduction of speed limits but does little to address changes in vehicle and highway safety that were also occurring. Last year, late summer or early fall, the Journal of Trauma published a paper showing an actual decrease in the mortality rate after NYS increased the speed limit to 65mph. They also found a decrease in the percent of drivers speeding. Germany's and the rest of Europe's highways are safer because of strict enforcement of safe driving practices and a much more difficult licensing procedure. The roads are safe to be driven at up to 85mph. However the drivers are too often not capable at safely operating on roads with an 85mph speed limit.

Bad news killer, thats all elections. From POTUS all the way down to student council. I know I haven't seen the best candidate elected president in my lifetime. Its always the best salesman.

Not all criminal convictions are automatic disqualifiers from Fire, Police, and Military positions. It varies from agency to agency and has a lot to do with the individual.

EGR is viable and used to meet similar standards in Europe by some companies. However it is less fuel efficient and navistar was planning to use emissions credits they've already earned to offset higher than permitted emissions while they perfect their engines. Its more than just the EGR for navistar to meet the standards. This is a whole new engine using a variety of engineering and fuel injection technologies to try and meet these standards.

We manage to do just fine filling up the fuel tanks, I think we can manage DEF. It all depends on the size of your DEF tank and the percent of DEF used vs gallons of fuel but all of the tanks go much longer than your fuel tank. Most car and truck manufacturers are advertising 5 to 15 thousand miles on a tank and while Detroit and Cummins both offer customers a choice the smallest tanks are good for thousands of miles. The real problem I see is the shelf life. Only 2 years in the best conditions and as little as 6 months to a year. I see some rigs out there that only do a couple thousand miles a year. If these tanks are constantly topped off you will soon have some very old Urea in your tanks.

Wow, thats a pretty broad brush you're painting with. I know many EMT's who have worked no where but their volley corps who are excellent providers. I work with many knuckleheads and idiots in NYC who have received much more training than the vast majority of the volleys out there. Dumb is dumb is dumb. EMS, ALS or BLS is all about being smart. Using intuition, past experience, and training to figure out what is going on. 90% of my calls are just what Ckroll did for her patient and the other 10% the simple stuff is what made all the difference. There are plenty of problems with the volley world however going paid is not the solution to your problem. Where do you think all those new employees are coming from??

I witnessed a large horse trailer flip on 87 outside of Albany a few years back. It really wasn't a difficult scene. The animals that could flee did. Rescuers did their best to stay away from injured animals, and the fire chief had his communications center digging through the yellow pages for farm vets. About an hour later they had a couple on scene with drugs and harnesses and could begin lifting injured horses under the direction of the vets. NJMedic said it best. Use your head and hope the best. You'll never pre plan for every incident. Anyone here have cruise missile training? A dummy missile identical to the real thing fell on to 95 in the Bronx and the responders adapted to it.

When done properly these homemade hydrogen sulfide suicide kits works very well. Ideally the victim chooses a secure enclosed space, clearly identifies the hazardous area, initiates the reaction, and calls 911. The fastest response isn't going to save this person. The catch is what happens when you catch them before they're ready for you. For instance the victim happened to choose your favorite mid afternoon nap spot for their suicide and you stumble upon it just as its getting going. H2S is extremely flammable and heavier than air. If you do decide to break the window and rescue them, that car will still be filled with H2S. At concentrations these homemade devices are fully capable of producing, a single breath is enough to be fatal. Keep in mind waiting for hazmat assures the patient will die. On the other hand if they're already not breathing they're too far gone for you to help. Treatments in the field are going to be limited to symptom management, to combat he bronchospasm, pulmonary edema, respiratory failure and cardiovascular collapse. The only antidotes I'm aware of aren't carried around here, amyl nitrite ('poppers' for all the party people on here) or sodium sulfite.

I never said pronounce and walk away. I'm talking risk vs reward of entering this environment without the appropriate resources present. If it is done right then it will kill the patient. You really can't do this one half way short skimping on components in which case a few minutes more will get the job done. If they used the wrong chemicals then they won't be producing H2S but some other chemical that I have no idea how to protect myself against. If they never mixed the chemicals and just ODed then I go back to, signs of life I force entry. They're still going to get worked and brought to the ER. However, the risk of exposing yourself to a lung full of H2S or by some horribly unlucky chain of events ignighting said car full of H2S is not in my opinion worth forcing entry into a possible hazmat incident to save someone who possibly intentionally placed themselves in this situation. Once they are safely removed and deconed they would receive my full efforts at resuscitation.

subi, you do realize GE's tax advantages have come through both Republican and Democratic generosity. Republican's for their business first philosophy and Democrats for their me first philosophy. Kerik is doing time because he lied and lied and lied some more. Scum like Rangal know to pay up while proclaiming your innocence as soon as you are busted.

I would ask for clarification from your agency however if the vic is not moving they're already dead. This is an extremely effective method. FDNY EMS offers us the out of waiting for HazMat before even attempting to open the vehicle essentially assuring the patient is good and dead. If it were me and I saw motion from the victim I would don my APR or in your case SCBA, break the glass, and extricate the victim being careful not to spill the chemicals. The line would come in handy for immediate decon, but I wouldn't wait for it. H2S vapor is only a skin irritant.

What narcan does is keep the junkies alive. Hopefully long enough to eventually hit bottom and seek recovery. If you can figure out how to stop people from using you can push $15 Billion a year back into the government's coffers and thats just on the federal level. What is certain is punishing users does nothing to curtail use and adds expenses.

Do you really think the problem is on PD?? Cracking down on the users doesn't have any affect on this crap. All it does is tie up cops, courts and jails while someone else is out there getting high. Look at how completely ineffective the Rockefellar era drug laws were at detering drug use.

The insurance company did pay. The lien is against any settlement won in the case to prevent her from stiffing the hospital.

While narcan does have a short half life it remains therapeutic long enough to get the patient past the respiratory depression. Prehosp Emerg Care. 1999 Jul-Sep;3(3):183-6 is the San Diego study where 317 patients RMAed after receiving narcan and none were found to have died of overdose over the next 12 hours. A greater risk to diabetics is long lasting Insulins like Lantus with its 18 hour effective coverage. They still however do not require ER transport just because they're taking Lantus. Now if its an accidental overdose then they would need the increased monitoring available in hospital. Otherwise if its the usual they skipped dinner before bed or just haven't been eating as much as normal you treat them the same. Suggest they be evaluated at the ER, eat a complete meal, and contact medical control if that's your protocol before accepting the RMA.

The gas is created using easy to find household cleaners. If the victim follows the guidelines of these online posts efforts are made to isolate the scene and warn responders. It was a big deal in Japan and there have been dozens of cases in the US. Its already out there.

Its nonfeasance if you stop for the flagged incident and do nothing to ensure another unit is enroute to the first call. Once you initiate assessment that is your patient. Getting flagged for an abdominal pain on your way to a cardiac arrest, the abdominal pain is now your patient once you start assessing them. How do you know its not a real medical emergency unless you've properly assessed them?

I love all this hate on the idiots who's own actions bring us to their door. People who drive to fast, don't buckle up, or drive under the influence all get our care. People getting lost on mountains, getting into fights, and all sorts of other stupid actions get an eager response from us. Heart disease is the biggest preventable killer in emergency services. Look around and see all the members who are a bit more than an ideal weight. Should they all go piss off because of their affinity for fried food and cold beer? Yeah, the regular abuse of the system caused by heroin addicts, alcoholics, meth addicts, etc is frustrating. However WE CAUSE THE ABUSE. The intox sleeping on the corner usually doesn't want to go to the ER. The junkie who has nodded out didn't intend to end up in the ER and unless they're not breathing do not need the ER. Data analyses from two different systems shows that after administering narcan these patients just go back to doing what they were doing. Taking them to the ER ends up with the same result. There's not an addict alive that doesn't know where they can get help. Dragging them to the ER isn't going to change their behavior and if they're alert and oriented taking them to the ER can be construed as kidnapping.

http://www.nytimes.com/2011/03/25/business/economy/25tax.html?_r=1&ref=us Last year GE payed 7.4% of its US income in taxes. The poorest American pays 10% and I'm getting violated to the tune of 25%. Republicans tout the 35% tax burden as preventing American competition, and they're right. No one is going to pay 35% of their income to the US when they can just move overseas. Too bad no major corporation pays anywhere near that. No worries, the democrats are just a foul in this. Good ole' Charlie Rangel traded 4 billion in tax breaks to GE for 11 million to schools in his district. This crap is just depressingly frustrating. Can anyone explain to me how this should be allowed to continue? I get why it happens, I just want a reason to delude myself into believing its not so bad.

While the up billing is wrong, its standard practice in the industry. Get treatment at an ER without proof of insurance and compare that bill to the what they accept from your insurance company. The hospital is trying to get paid for the uninsured patents they care for. So the inflated rates aside, the ability to place a lien on a potential settlement is a good thing. No, bvfdjc they cannot come after your wages or other income. In most states, and it seems like Texas is one of them, they can only collect money related to this incident. If she wins the lotto the next day, the hospital is still SOL. You are only responsible up to the amount you received in settlement and in some states punitive damages are not subject to these liens. The alternative is a state like Massachusetts where the victim after his settlement is advised by the lawyer(who already got his cut) to spend all of the settlement money so there's nothing for the hospital to take. Instead he gets a Mercedes, sport bike, and an apartment Boston. My cousin got top notch medical care that literally saved his life at two different hospitals, a flight from Hyannis to Boston and a month of inpatient rehab all on the tax payers back. To anyone against socialized healthcare... its already here.

First and foremost, it is not a bad batch of heroin going around, but an extremely good batch cooked with synthetic opioids, most commonly phentanyl. Narcan is absolutely dangerous in the wrong hands. The jackass medic that uses it just to ruin the high or deliver a vomiting patient to the ER is even more dangerous than the EMT who dumps 2mg into the junkie who's just nodding out. Narcan is not there to assist in obtaining a patient history, it is used to restore respiratory effort. So now this BLS crew is doing a phenomenal job of ventilations. One member has the seal and the other is providing ventilations. After administering 2mg of Narcan IN the patient, before becoming fully awake begins vomiting. These two EMTs, used to this pt not being exactly compliant with ventilations since he's not dead, just doped up to the gills; continue ventilations until they've filled his lungs with stomach contents. Eliminate the narcan and this is a scene I've witnessed a couple of times. These patients need quality ventilations by competent rescuers. More often than not good CPR alone is enough to get back opioid arrest because that main affect is respiratory. Correcting the hypoxia and hypercarbia is what revives your asystolic opioid arrest. IN, IV, and IM narcan are the same drug. IN and IV systemic distribution rates are similar in the lab. However apnea, nasal congestion, and structural damage to the turbinates all result in decreased absorption during nasal administration. Nasal administration works great with someone with clear sinuses that can inhale for you. Apneic junkie who's probably snorted more things than you care to think about therefore isn't going to absorb so much. My preference is IV, IM, then IN. A more pressing topic in my world is the need to transport opioid over doses. There was a study out of San Diego in the 90's and another from the midwest more recently where zero patients treated by EMS with narcan for opioid overdose were found to have died in the ensuing 12 hours. While the emergence of synthetic opioids may impact this, as of now no one can demonstrate harm in offering overdose patients an option to RMA.

Thats horse poop. ZERO fortune 500 companies pay the full 35% tax. Absolutely the tax code needs a massive overhaul and 35% is far too high a tax rate, however the biggest corporation pay next to nothing while the companies that really contribute to American Jobs and the middle class pay the highest taxes. Kind of the same story with personal taxes. The wealthiest and poorest pay nothing while the middle class takes the beating.

REscue 1 has deployed their zodiac on several occasions. I'm guessing they have a way of getting it done that works for them. Whether it be a friction break and just lowering it off the back, a pulley system or just brute force, they've got something going.

Drinking out of a fake eye has quite an impact as well.

My 25% is just like GEs 35%. The federal assessment before deductions. Sadly as a single apt renter I have few deductions. The personal flat tax has a disparate impact on the poor. Expenses like food and shelter take a larger portion of your income the poorer you get. A simple slidding scale would work fine, however the loopholes and breaks need to be killed.