ny10570

I've seen plenty of research showing etomidate to be better than ketamine, versed, valium, etc and RSI is better than etomidate. They suggest more training and better QA/QI for paralytics because of associated risks with paralyzing someone. Etomidate is a sedative hypnotic, not an analgesic and its benefits are because it does not suppress respiratory or cardiac function. While there may be a brief period of apnea, there is no lasting respiratory depression. This applies only to when Etomidate is the lone induction agent. Once intubation is successful a benzo can be used to maintain sedation. When Etomidate is used in conjunction with a benzo the respiratory and cardiovascular depressant affects can be potentiated. The incidence of trismus or myoclonis is between 1 and 4% depending upon the study you read. If the clenched jaw is a result of a medical or structural issue (ie nerve damage, head trauma) then Etomidate will likely have no affect on that issue. If its a result of an anxious pt trying to maintain their airway or prevent you sticking that laryngoscope blade in their gullet then Etomidate could be just the thing you need.

Maybe its my ignorance since my only experience with RSI is my OR rotations as a medic student and my surgery last year, but what about a combative pt with an unstable airway specifically requires RSI? I agree its a great tool to have, but 20mg of Etomidate with a Versed back does a great job of taking the fight out of a patient and keeping them out of the fight. I am not trying to, nor have I ever been about dumping on a crew's decisions. I'm just curious to know the reasoning. Sometimes after a call we look back and realize that was excessive or maybe we should have done x,y,z. Either way we need to be critical of all of our decisions. It is only through discussion and frankly argument that we progress.

Macys announces the location in the spring. More than likely it will return to its previous location next year as this was specifically for the 400th anniversary of Hudson's trip up the Hudson.

I'm surprised they're going to an outside vendor. The lower manhattan house that was scorched about two years ago(I think) was repaired quickly and apparently quite beautifully by the FDNY buildings guys.

How severe were the actual injuries? If some or all are going to a trauma center for mechanism rather than actual injuries 4 patients isn't such a drain on resources. Keeping 4 family members together then caries more weight.

All barges will be in the Hudson this year between 23rd and 50th streets. The West Side Highway will be open to pedestrians and a couple of piers will be open to the public, but if you want a spot you'll want to get there early for the 9pm start time. If you can find a restaurant or bar with a view of the Jersey or NYC skyline or a westside roof top bar you'll have a phenomenal view. They're trying to elevate the show, with many shells reaching 1,000' to give a larger swath of the city a good view.

How about, just sad.

I got a chance to witness this one first hand. From engine on scene to water on the fire was maybe 6 minutes. Real issue was the delay in notification. 95/36 is only 4 blocks south and the store was front to back by the time they got there. Always make sure you put a ladder under the gate prevent the remaining slats or entire roll down from coming down on you. Take the extra minute to get a good opening you can work with. Once you get the heated gate wet its going to warp and you will not be removing anything without cutting it out. Here's the full series... 1 2 3 4 5

Would you guys get off your cross. This isn't about killing the volunteer fire service. This is about getting the most bang for your buck. If you are providing the better service for less money then through this legislation worst case your response area only grows. If your dept is not doing the job for less then things will change and should have changed a long time ago.

FDNY runs 9 hour days and 15 hour nights. Work 2 day tours off 2 days, then 2 nights and off 3 days.

stipulation of the agreement is that it is to stay where it is. They're pretty trying to sell naming rights. For $425,000 you can buy a bronze plaque that says "Donated by..."

NREMT is indifferent to protocols. Its based solely on the text book. Its called adaptive testing and has a certain number of questions everyone gets asked. Any area you get wrong the test delves deeper into. Long test vs short test has no bearing on final score and if you run out of time, no matter how well you're doing you're done.

I'm sure a rape conviction would not require piss testing. The particular stipulations that result in regular piss testing are a result of drug or alcohol offense ie: paraphernalia, possession, DUI, DWAI, DWI, etc. Non-distribution and non-violent offenses are often able to be worked around.

619 if you can truly provide a better service for the same or less than a paid dept than this legislation wouldn't affect you. Put the numbers before the people and they will vote with their wallets. While your dept may not be engaging in such extravagance plenty are. I've seen the the way some depts purchase rigs. Not sacrificing for members safety is great, but buying EVERYTHING the dealer has to offer is a different story. When you guys put on a fundraiser to pay for these trips do you advertise where the money is going or just put it under "support your local volleys" blanket. FYI, I'm a volley but some of the crap depts pull makes me sick.

2007 analysis of the energy cost per mile of cars available in the American market place. It includes estimates on everything from manufacturing to maintenance to disposal. Its brutally long, but pg 288 starts the breakdown of each vehicle. The most interesting thing is how little the cost of fuel affects the the end cost of the vehicle. For example an ecconoline van uses less energy to build, operate and dispose of than any hybrid on the road. http://www.cnwmr.com/nss-folder/automotive...F%20VERSION.pdf

I'd say bomb 'em back into the stone age, but that's be kind of redundant.

seems to hold true for just about every manufacturer depending on who you ask. Are fire apparatus heading down the same road as the car industry. Every company has a multitude of models often with few if any significant differences and manufacturers are more concerned with production volume than quality.

I think roof was trying to say that cops and firefighters are required to put themselves directly into harms way to help others. In EMS, unless we screw up we're not suppose to be in danger. We do not enter unsafe or unsecured locations. Yes there is still danger and yes even when things go right we can still get killed but the risks faced by EMS are also faced by other professions without federal LODI benefits.

Should the city also provide LODI and health plan benefits to private contractors? Commercial firefighters don't get the same benefits if the refinery they're working at blows up so what is different about EMS? This isn't about the value of the life lost. Its about who you work for. Where do you draw the line. What if they do transports and get flagged for a 911 job, do they get the death benefit if they were to die? How about the mutual aid units the city has been using these past few weeks? Should they also be eligible for any benefits FDNY employees are receiving. If you chose to work for a private company there are advantages and disadvantages. I'm worth more dead than alive, thats one of my perks.

Lets not forget hockey in Denver and Montreal. Boston didn't exactly go home peaceably after they beat the Yankees in the NLCS in '04.

Thats a valid point. This is for non-governmental emergency responders. Doesn't that mean private companies? How are they any different than say the utility company? They should be providing LODD benefits to their employees just as the government does so for its civil service employees.

Every contract since I got on has been going to someone other than Ford, yet every year its more Ford. The FDNY ambulance spec is annoying with a lot of little things no one else does. Horton has developed a model thats for all intents and purposes the FDNY spec so its easy for them to get the bid. As far as I know they don't have a preference for any chassis so it can really go to anyone, but I'd be surprised to see something other than a Horton on the back.

Last job tonight was a nice little "gas leak" on 163rd courtesy of the UCT's. Fire is getting good; identified, located and mitigated in under 5 minutes!! Way to go UCT's! No worries, EMS will keep those saved companies and everyone else busy as they're still cutting 30 EMS tours on top of not running our usually summer "enhancement" units. That means longer waits for a bus, more carry downs, more time staring at that drunk on the corner or COPDer with a chest cold for the engine co's, and more forcible entry calls for the trucks to find all those patients who left because they got tired of waiting. I know I can't wait.

NYC has always run an open spec bid. The catch is over time FDNY has developed certain demands that unless you're all ready building them its harder and more expensive to start adding. Thats how Ferrara got the Satellite pumpers and HM1 and Pierce got the Rescues. FDNY doesn't include propriety technology in their bids, but there are certain things some companies can't do, like the aerielscope ladders. I don't know the actual FDNY spec for their TL's, but I don't see it going anywhere else any time soon.

Officer was absolutely an a** from get go, but it still doesn't excuse the medic. Its the classic two wrongs don't make a right. After he informed the officer that there was a patient that they were transporting he should have been back with his patient and on the radio calling for another bus to take the patient. Let the officer dig his own hole since there is nothing you're going to say or do that will get a pissed off jackass to change their mind.