ny10570

There isn't a whole lot of patient going on during transport. If there has to be, a BLS is called to assist on scene and drive the vehicles. The big difference is patient care on scene. When the poo is circling the drain, a set of trained hands makes it all immensely easier and improves the quality of care given. Yeah, there's nothing that a single medic can't handle without a properly trained EMT, but the quality and speed improves when you run two medics. In a system as busy as NYC a lone medic is going to burn out handling all the patient care 8 or 12 hours a day.

Government agencies absolutely can bill for emergency service. Since medicaid only pays the transporting agency and most insurance companies follow the same guidelines it seems like a waste of time unless they're billing the transporting agency.

Paul didn't just abandon the kid on the door to the hospital. He was inside the Pediatrics ER awaiting triage for a period of time. At some point for some reason he left, leaving the patient inside the Pediatrics ER. Occasionally pissing matches develop between EMS and Nurses with people trying to exert their influence but if a nurse is refusing to sign, there is a course of action that we are suppose to take. That doesn't include forging a signature.

The one thing that is clear, if anyone is faced with a major collapse they are going to to be on their own for a while. Albany 3 hrs, FDNY 3+, WSOTF 2(?). So what is your dept going to do in the interim? Mine, very little. Evacuate surrounding structures, water supply and hose lines in place, and assist all non-entrapped victims to safety. Other than that it'll be a whole lot of hurry up and wait.

The larger chassis actually has a pretty good turning radius. I've only driven one a few times, but it seems pretty close the regular buses on the 350 chassis. Being blocked from your partner is a valid point. To address it there is speaker/mic in the back that is always on and even with the volume all the way down still clearly audible in front. From the back if you have to talk, its actually easier than through the opening of the standard type 1. From the front there's a push button to talk to the back. Downside is, no more badmouthing your partner when you're in back. They will hear you. As far as wether this set-up was the best idea is a different issue.

BLS and PD. If unable to gain access, FD or ESU responds to force the door.

Thanks for clearing that up.

That absolutely should have been part of the information provided by the EMS crew. Was the EMS crew aware the Taser had been used? While the Taser is relatively safe there are documented cases of a Taser exacerbating an underlying medical condition. A quick EKG should be performed to ensure there is no arrhythmia. Aside from any cardiac issues, the fact that a Taser had to be used speaks to the mental state of the patient and helps to understand the severity of her crisis.

Sadly, 200k really isn't that much for a custom bus. FDNY pays about 140k and it is a no frills rig ordered in bulk.

I'm sure you have been down to Lincoln once or twice. Get stuck on a late call and add on 40+ minutes of Lincoln Peds triage can entice someone to do something stupid. Its like that Chris Rock bit. I don't condone it, but I understand. I don't get why they went for the felony endangerment charge. He didn't leave the kid on a street corner. The child was in the appropriate part of the right facility. He just didn't do the formal transfer of care

I read a report on these I think out of Dallas. They were getting officers on scene by the time calls were coming into the system. They also found the system was more accurate than callers with fewer false alarms and better locations. Triangulated location of the shot rather than the various caller locations.

Influenza kills more people every week yet mandatory vaccination programs are deemed to not be cost effective. Hell even vending machines have killed more people in the last 7 years.

The banks failures in the clinton years was a drop in the bucket compared to now. Even economists that support letting banks or industry fail are not entirely confident it will work and that it won't cause more harm than good. No one knows. Everything right now is theory. Companies like GM, Citi Group, AIG, etc have their hands in so many industries that failure has potentially massive and widespread affects that no one can accurately predict. I'm not saying th ebail outs are the way to go. I'm just saying that because anything worked in the past has no bearing on what is going to work today.

Adding a collapse/hazmat medic to the team makes just as much sense as the team itself does.

While there is more and more evidence debunking the "golden hour", there is much more evidence showing that the right facility is much better than the closest facility. Its getting to the point where anything above BS is going to have a specialty facility. Right now NYS recognizes Burn, Adult Trauma, Pediatric Trauma, Psychological, Stroke, Envenomation, and Re-implantation as specialty referrals. NYC has added post arrest, Cath Labs, sexual assault, and soon to come child abuse. (I think I got all of them)

Their efforts should absolutely be applauded, however no volunteer is free. Training and equipment all cost money that at times could be better spent in other ways.

I think its great to have so many people put forth the effort and time to get the training and get this team established. I just wish their time and effort was not such a waste. The county guys have all the training and assuming they will always have the staffing, they will never have the response time of Yonkers or White Plains even to the furthest corner of the county. You could probably drag a collapse unit out of NYC faster than the county team will be able to respond. If it was not for the recent emergence of the Yonkers, White Plains, and Greenburgh teams I don't think the county team would be getting any of this flack, but it is impossible for them to provide the same level of service as what is all ready out there in spite of their best intentions and superb effort. What good is a swift water rescue team that takes 20 or more minutes to get there? The HazMat team is an excellent asset in that it is unique in the county, therefore the delay in assembling volunteers is acceptable.

Industry wide the vast majority is the van front. Most transport and nearly all BLS transport run type 2's and type 3's nearly as common as type 1's. While we may care about performance, as long as its "good enough" the people with purse strings only care about which is going to cheaper to run and thats going to be diesel. Ford is going to take a huge hit in this market but they should maintain their share of the type 1 market. As far as I know they have no issues with the f series engines.

In a recent thread about a Dutchess shooting a question was raised concerning the appropriateness of discussing the details of that type of incident. I agree that the pressing need for info and details about any of these incidents is a bit strange whether it be a fire, mva, or crime; but it goes hand in hand with increasingly voyeuristic nature of society. I was at a serious MVA last night and pulling up noticed the usual gawkers with cell phones in hand. What surprised the hell out of me was returning to the scene only to find what was 3 or 4 people had become well over a dozen in area with zero foot traffic at that time of night. At a fire it use to be the usual buff taking some shots. Now its many guys with some impressive equipment all clamoring for their shot. At a recent fire, between the command post and ladders it was damn near impossible for the poor guys to get a good shot and these guys were getting a bit annoying. Within hours these photos and videos are up on the internet and now even news networks are on the bandwagon soliciting peoples photos and videos for immediate national broadcast.

Understanding the extent of the injuries is everything from an EMS perspective. Looking at wrecked car, collapsed house, fire, etc does nothing unless you know what injuries that resulted in. When trying to discuss a job, the damage caused to a house in a fire is as important as the injuries suffered by a person in an incident.

A significant portion, I'd go as far as to say the vast majority of the incidents on this site offer absolutely no educational value. Either there isn't enough information or people don't want to open themselves or their dept to any potential criticism. Occasionally there is a unique incident where a brief review of what was done offers a chance for learning and once in a while an incident will spark a conversation questioning how or why we do things. Sadly, this is far from the norm. Taking the Westchester IA for example. The last 10 incidents generated zero discussion that anyone could have learned from. The 11th incident was the croton car vs backhoe and all that did was trot out the old air vs ground transport debate. Before that is the Bronxville Trench collapse from 2/12 in which only 2 out of 20 posts mention what was done to extricate the victim. The vast majority of this site is used to oohh and aahh over what others are doing and buying. Attempts to critique are slammed as monday morning quarterbacking and people are generally afraid to admit flaws in their response and operations. The whole point of this rant, since we're clearly dedicating more of our time to hear about and look at these incidents rather than discuss and analyze them; what makes a fire or mva acceptable and a medical emergency or police related activity unacceptable?

The new Ford cabs are significantly smaller than the last generation. FDNY may go with an extended cab on their next order (I hope and pray).

or they were 89 and buffed it.

What about an EMS call is any different from a fire or mva that people take an interest in?

I never liked putting stat flight on standby based on other peoples radio transmissions or calls into 911. Things often look much worse than they really are and when you're stuck on scene with an injured person and can't do anything for them it ups the urgency in your own mind. A perfect example was a trauma on the Bruckner tonight. First calls had it coming in as a rollover involving up to 8 cars. Then, car torn in half many cars involved. PD got on scene and was asking for "multiple EMS for a whole lot of serious injuries". Turns out we had minivan vs sedan w/ 3 critical and 1 doa. Not 8 cars, never even declared an MCI since multiple units had been assigned due to the variety of locations coming in from callers. While the issue here isn't so much about putting stat flight on stand-by t does put other things in motion that weren't necessary and made things more complicated rather than simplifying the situation.