ny10570

EMS should have been spun off into a 3rd agency bit there was no leadership in place to push that. There were also other political motivations that pushed the FD to seek EMS. One of the better things about the job post merger is the FDs leadership. Staffing, training, equipment, and facilities have seen substantial improvements. A lot of people pine for good ol days but the majority of complaints stem from abuse by our bosses. Truck and engine companies each have their solo runs. Its not like the Engines are running all tour while the truck sits there. Why shouldn't the members be compensated for additional training and responsibilities? The CFR program saves a ton of money since to match their response time to EMS runs you would need to shave over a minute from our average. That minute equals dozens of additional units.

Where would there be massive holes? You mean like in the uninsured area covered by North General that no one from St Lukes/Roosevelt or Continuum tried to pick up? FDNY stepped in after Vinnys, North General, Mary Immaculate, St Johns, Cabrini, Vinnys Midtown, and OLM closed. Its just the insured communities around lower manhattan, queens, and downtown Brooklyn that the voluntaries fight for. Voluntaries didn't get their units by filling the gaps. They were given to them by a mayor and fire commissioner that had no interest in providing municipal EMS.

The only time I've seen the fire and EMS union get together was the joint statement they had categorically opposing the strategic plan to start ALS engines. The mention of a plan to consider looking at the feasibility of ALS engines got everyone in a tiff. Its going to take some serious pressure to get that moving. CFR Truck companies isn't going to happen because fire go snowed with the CFR compensation the first time around. Only one member per tour gets the money yet they all get in on the extra work. If 3 cardiac arrests drop in one area during 12 hours (I've seen it happen) one engine company is going to be doing a lot of CPR and carrying. The EMS units get run around so much I rarely see the same CFR more than once a tour unless its the intox hustle in Manhattan on a warm weekend night. There's also the that CFRs are usually available when a CFR run comes in. The coverage gap isn't large enough to justify doubling the number of CFR units. To help cover the gap there is or maybe at this point there was a plan in the works to send the closest BLS or CFR including calls where ALS is more than 10 minutes away.

I just wanted to emphasize this. No matter what type you are, all donations of any blood type made in Aksel's name will help. B-Negative is an added bonus for the system because its a rare blood type, but any and all blood types will help Aksel out. The blood supply always dips during the holidays because we're all so busy. Please take the time to do it, even if its only once.

I seriously doubt the list would be exhausted by February as that would only allow one more class and I know people on the list who haven't even been called for their agility yet. It also takes close to a year from test announcement to list certification and considering the new emphasis on only hiring civil service appointees I would think a new test would be out be before the list is exhausted. However, the city is still pushing to reclassify titles as non-civil service. There was a court case up in Greene county we were waiting to hear on, but I don't know the outcome. On the upside while things are in limbo the city is supposed to continue holding exams and the union has been staying on top of them about it. In short there have been no announcements about a new filing period yet so I'm guessing nothing before the spring.

Population doesn't dictate fire load. In fact a growing population tends to reduce fire load. NYCs war years Detroit right now, fire duty exploded as people fled the city. Its because the two stats have no causal relationship. They are symptoms of bigger things. What does affect fires is infrastructure and NYCs is only improving. As the population swells and middle class is replaced by the working poor FDNY will be much busier on the EMS side. CFR, entry, removal, extrication etc. Only two things have been consistently proven to save cardiac arrests, early defibrilation and quality CPR. FDNY excells at this when you have companies that embrace EMS. Seth FDNY is extremely responsible with their budget. It is NYC that spends like a drunk in Vegas. During good years opperstional expansion asside their budget remains very stable. They decreased their facilities expenses with the upgrade of several older houses and consolidation of many single houses. Most of the Marine division expansion is funded with grant money. Nearly all their research projects and pilot programs are funded by grants and no free rides were handed out at the bargaining table. Every deal came with concessions. You can't supplement Fire with EMS in NYC. Asside from all the union, contract, and legislative hurdles EMS has a much more severe staffing problem than fire.

Thats a pretty bold statement. I dare say that anyone that doesn't flow foam more than a couple of times a year is doing their community a disservice if they waste the money on an injection system and foam cell. They need to be used or else the maintenance becomes a serious problem. A 5 gallon pail, eductor, and a half dozen foam cans is just as effective and more versatile. Chicago is a big adaptor of CAFS and last I saw they were till using lots of water for their high rise operations.

Make sure your family is aware AND agrees with your decision. No matter how you indicate it, and how many ways you make it plainly obvious you want to donate, your family has the ultimate say. All that the donor card does is indicate to the hospital staff that this is a conversation worth starting.

Usually it is one of that area's authorized towing service.

I hate dragging. Up. Old posts, but m'ave had a better handle on EMS than most my co-workers. We don't even come close to covering our payroll expenses let alone our operation and capital budget. Several years ago the union looked at the numbers and found they could turn an opkerational profit if they ran all the ALS tours city wide. Since then the system has expanded significantly without a similar rise in collections, so it looks like the days of running a surplus are gone until they start telling patients no.

not exactly, bvfdjc. While rust is a result of simple oxidation there's a monumental difference between the end result of Aluminum oxidizing and steel rusting. Steel as a rule does not hold up well to oxidation, hence the development of processes like Galvanization and the multitude of stainless steels and other alloys.

thank you for understanding the importance of the first large independent study being so negative

The steel studs used in commercial and occasionally residential applications are made from galvanized steel. Anywhere its been cut or drilled there is eventually going to be some corrosion, but not enough to significantly weaken the structure. Any contractor can use the wrong product and screw the homeowner, however if they use the right stuff you're fine.

This is the largest independent study of RAD57 results. Everything else was either a very small sample set or performed by Mossimo as a part of the FDA approval process.

Yet NYC is still one of the safest cities in the country. Gun control neither decreases nor increases crime. NO ONE has been able to prove either side of this debate.

JBE, you're slipping, there's a Hillside Av in Manhattan too. RocklandFires, nailed the benefit to cell phone ANI/ALI. That cell tower location is a huge plus. Especially with car accidents. Just because you're at the sign for the NYC exit doesn't mean you're anywhere near NYC. Also lets not forget that a dispatcher is only only as good as the info they are provided. In this case the caller had the right info, but often people simply do not know where they are or even where they live.

LP15 does come with a pulse ox/CO monitoring option. And the Rad 57 technology is not that accurate. You cannot rely on the Rad57 to rule out CO exposure patients, only to confirm your suspicion of CO poisoning. As usual, treat the patient and not the device. If they've been inside a CO filled room for a while, they go to the ER. If they've taken enough smoke to cause them distress, they go to the ER. If they have any symptoms, no matter what the Rad57 reading, they go to the ER. Here's the full article

It happens all over. Pleasantville has two intersections of Manville and Bedford Rd and NYC has hundreds of duplicate addresses and intersections. This is why things like Automatic Number Identification and Automatic Location Identification are so important and just another reason for consolidated dispatch centers equipped with such technology.

Your problem is the details of your question. The clock doesn't stop when the patient hits the helicopter. It doesn't matter how long the patient sits at the LZ if the bird gets you to the ER faster. If the flight will take longer than the drive because of the wait at the LZ then you are potentially doing harm to your patient.

bvfd, either you need better lawyers or there was something lost in the discussion. Ignorance and good intentions are not valid legal defense. They'll save you from the dreaded and expensive gross negligence, but if you're wrong and the court believes that most providers of similar training and similar experience would have gone a different route then you are at fault. Number 3 is shaky too, because what service are waiting for from the helicopter? Waiting on scene at a trauma for a dermatologist would absolutely get you in hot water and waiting on scene for a trauma surgeon should get you in trouble. If the airway is managed and the bird is not substantially faster than driving, why are you waiting for it?

MoFire, don't get defensive. The good Captain is spot on. Even if you don't know the actual chemicals the business stores at the very least you need to familiarize yourself with what they claim to store and what are the common chemicals used in that industry. People lie when they have a reason to. They're usually very open when an agency just wants a list of what hey have on premiss unless they're doing something illicit.

Waiting 15 minutes for one form of transport while another form of transport could have done the job within those 15 minutes is pretty close to neglect.

Be careful with the Rad57. In the largest independent study yet comparing the Rad57 readings to the lab measured values, the Rad57 was so inaccurate as to make it unreliable for treatment decisions or triage. In my personal experience, ensuring the light blocking cover is used and the finger is clean helped get more consistent readings, but I have no idea if they're accurate. Study Link

But as multi gas detector, its a bit overkill. A simple single gas CO detector is cheap and so easy to use. Rugged ones on the market today for around $200 are water resistant, impact resistant, have at least a 5 year life cycle and need calibration every 6 months or as long as 2 years. Attach it to your bag turn it on, and forget about it till it makes a noise, because they tell you when they need to be calibrated, have the battery changed, or what CO levels your getting. Hell, even FDNY took their sweet time rolling them out, but after this no agency in the area should be without them. There is zero excuse with all the powered stretchers and short ambulance life span in Westchester.

Here's your Harley: http://www.motorcycle-usa.com/photogallerys/miami_motorcycle_medic.jpg