ny10570

You are spot on stat. FDNY's CPR study is a little over half way over and they are all ready starting to implement changes. The AHA procedures have resulted in an increase in return of spontaneous circulation but the discharge numbers aren't going to be known until after the study is complete. One find was that we are hyperventilating our patients. Even the most focused EMT or Medic gets distracted some point and ventilation rates go through the roof. To address this the dept is now issuing LED idiot lights that fit onto the BVM, patients forehead, where ever that blink at 6 second intervals. Doing ventilations at that rate seems excruciatingly slow.

Thats one of the things about the Lakota...as of the demo I flew in, it was suppose to be flown buttoned up. Wide open with the crew hanging out the doors I can't see it carrying more than 6 evacuees. I can't see the reason for this becoming the premier homeland rescue bird. I'm not a pilot, but it looks like one Blackhawk could beat two Lakotas. I'm all for using commercially avalable equipment to save money, but this just doesn't do the job.

Its a great idea, but the bird cannot do the job that it was intended for. I was in one a year ago and there is no way it has the capacity to replace something the size of a blackhawk. As long as the patient is fine from the neck down two patients can easily be treated. Way to waste some more money. Thanks unky sam.

Top one comes with an indoor rock wall/escape simulator

As for the topic at hand, forget playing devils advocate, if you let your employer take advantage of you like several of you have then its your fault. Its their job to get the most out of you and its your job to get the most out of them. If they aren't going to treat you right then bail and move on to the next company. There was an article I believe in JEMS a while ago about the problems with attrition in EMS. They used a Jersey Hospital as a case study that for many years had always had the lowest attrition rates while paying similar pay and benefits as surrounding hospitals. One competitor when faced with now critical staffing problems got new management in house that increased pay and incentives to troubled positions. After their success a the other hospitals followed suit. Before long a hospital that never had a problem with staffing saw it attrition rates go through the roof. To fix it they set their benefits to match the others and the problem disappeared. Not a real complex story but it goes to show that we are the problem. Inter facility transports are only increasing. Sub-acute care is one of the fastest growing segments of the health care industry and the populace is only getting older, in fact for the next 10 to 15 (depending on who you ask) years the average age is going to be rapidly increasing. That means these transport companies are becoming busier and as much as medicaid and medicare hamstring them their profits are higher than they ever were. If the job you're working doesn't allow you to make ends meet then its time to do something about it. I have many friends who've had to make hard choices and move out to the sticks or leave the area all together. For my own happiness and future security I took a pay cut made some adjustments and set out towards a career that I can support myself with. Any EMT with half a brain should not be working transports for very long. There is no money in it. Work a 40 hour week at Starbucks and you will make more than most of your co-workers with better benefits than many. Anyone with an associates or better and some work experience can go get a job managing at Home Depot, Lowes, Walmart, etc.

I did my stint for Transports and still have to work an insane schedule to make ends meet. Too often I wake up with my heart in my throat after narrowly missing the concrete divider on whatever highway I'm on. It scares the crap out of me. I hate to play devils advocate, but at what point does the employer become responsible for an employee's schedule outside of work. Yes the pay forces you to have to work more hours and often multiple jobs, but we chose these careers and these jobs. STAT made an interesting point about over the road truckers but the traditional 8 hour day and I believe 12 hour days would be acceptable even under those standards.

You give the public entirely too much credit. Why aren't people surprised when the FD shows up at a car accident, drowning, or other non-fire related emergency? Its because they have been educated to expect the fire dept to show up. Unless you are going to list all of the capabilities of the agency in its name people are not going to know or care what services are provided until you educate them. Most ER doctors still don't understand the differences between EMT's and AEMT's or even all of the capabilities of EMS in general. How do you expect the average citizen to get it. All they know is that when they're sick or hurt they want an ambulance to show up. Just like they want a fire truck(not an engine, a truck, a rescue, etc) when their house is on fire and a cop(not and officer, sgt, detective, ESU, etc) when they're being robbed. Any knowledge people have of any emergency service is thanks to TV or personal experiance. Sadly a 1970's TV show, "Emergency" is probably the single greatest education tool EMS ever had. Fire prevention is help every October and FD's all over the country go to schools to spread the word. Police officers go to schools with safety messages every year. What is the extent of community outreach offered by local agencies. A few open houses is all I know of. We need to bring the message to the people. Lets get a professional image and presentation together and take it to the schools. The officers that came to my school in Elementary school where in uniform and gave a professional presentation. Fire prevention has members in dress uniform speaking and members in dept shirts and full turnouts familiarizing the kids with our equipment and taking hte fear out of the Darth Vader like image. How about the VAC's or EMS agencies get a few members together dressed professionally (not in t-shirts and wind pants that don't fit) and do some injury prevention. Maybe get involved in the bicycle helmet and car seat safety initiatives handled by PD.

Good luck with the unit. Hopefully this unit will be put to good use and actually used for ff rehab. Others out there apparently don't take this issue so seriously and instead prefer to sit on their rear while the ff's rehab themselves after exiting the structure. Medical monitoring, filled water jugs, etc are all necessary for effective rehab and I'm sure you guys are very capable of handling it. Thanks for looking out for the firefighters.

I don't get what you mean by the bare minimum of CME training. All of the rescue training and refreshing is in addition to all of the required ALS training. As for CME training the dept sponsored CME for the 5 year program is still being developed but in its current form exceeds the requirement to re-certify. The lack of calls requiring this level of training is the reason the program has yet to be expanded. I don't know the exact numbers, but since the program began I know of 3 trench collapses, 2 confined space rescues, and 2 building collapses. By those numbers alone thats seems like a significant need. The interaction between the Rescue Companies and the Rescue Medics is an good example of coordination between EMS and Fire. The medic is not there to effect the rescue. They are just there to evaluate the patient and perform any necessary interventions. Those who know best how to rescue people are still in charge. There is a problem with the Rescue and HazTac units being unavailable due to traditional EMS runs. The argument is that the daily EMS duties keep their skills up. In light of the risk involved with them being unavailable the number of HazTac units are suppose to be expanded as more members are trained and more Rescue Medics might be added. Money for these units is part of the bargaining for this contract. Personally I'm against it for several reasons. The big two being the majority of the Hazmat jobs and WMD jobs are going to be discovered by your average front line units and as a service in the event of a massive chemical or biological incident we are all trained to the operations level and will be operating in the warm zone where we will be considered contaminated.

He appears to be pro labor, but other than that there isn't a lot on his record. On the upside he was the candidate backed by MVFD. On the other hand the Vulcans were also behind him.

This guy has been in charge during an amazing decrease in mortality rates. We need more forward thinkers like him in hospitals everywhere. Recently FDNY EMS had a change in the medical directors that is leading to a year of extensive change in dept and REMAC protocols that are slowly guiding us towards a higher standard of care. Change is good.

I saw that story a few days ago. Didn't the statistic they used say there were 400 something meter fires nationwide. What ever the number was, the statistic didn't differentiate between mechanical or digital meters. It seems there isn't a very big story here outside of one family who is being shafted by con ed

Looks like its a cop saving fluffy. Didn't Greenburgh get animal BVM attachments a while ago? If you're willing to make out with someone's dying pet then its a great PR move.

Thats one of the big reasons why the state was so hesitant towards starting the program. The dept taking control and tracking everyone's hours was the solution.

Instead you would say..."Your honor, upon arrival I noticed immediately the signs of hypoglycemia and proceeded to treat the pt according to NYS BLS Altered Mental Status protocols." Not too long ago I went to court concerning a fatal MVA where my patient, the driver, was claiming his hypoglycemia was the cause of the accident. The ADA wanted to know first what we would do for hypoglycemia, then what we did for the patient, and finally how we knew he wasn't hypoglycemic. Apparently there was a problem where the hospital's blood glucose measurement were being contested. My partner and I explained hypoglycemia, the protocols, and our observations. Our observations and treatments were all well documented and in the end he was convicted. You don't need glucometers you just need to do your job.

Thats a whole different issue. At some point less is more. Take any manufacturer then shrink the tank, pump, and cab and you will suddenly have plenty of space to drop your hose beds and increase your compartment space. My thing is this is at least the third time I've seen PUC lauded on this site but I don't get why. It seems like a gimmick rather than real innovtion.

alsfirefighter is correct. I did my stint in Westchester as an EMT and the ability to operate effectively without ALS is the exception rather than the rule. Hatchet, whats the harm in administering D50 to anyone? Everything I've read covers in great detail the damage associated with pre event hyperglycemia, but nothing mentions and negative effects of glucose administration during an event. There is some inconclusive data about the results of post event hyperglycemia. As far as measuring blood glucose. In a South Carolina study every patient found to be hypoglycemic when presenting with symptoms of CVA had known histories of Diabetes. Of the cases of suspected CVA glucose resolved the symptoms in 4% of the cases. This study concluded that the time wasted on scene treated the hypoglycemia is better spent transporting and treating en route to a stroke center.

For CME the medics are scheduled to come to the academy once every 6 months for an additional 8 hours on top of the time required for the 5 year.

I've wondered about this too. You still don't have enough space to do it all bvfdjc. Average cross lay is about as wide as the pump space. Drop that and there goes your space savings. To get everything they offer you have to go with a 500 gallong tank 6 man cab. The PUC isn't everything they make it out to be. If EWFAC is still on this site maybe he can chime in with something.

BY JONATHAN LEMIRE DAILY NEWS STAFF WRITER Sunday, October 28th 2007, 4:00 AM Capt. Peter Bosco The lawyer - and brother - of the FDNY captain stripped of his command after the deadly Deutsche Bank blaze produced documents Saturday that he says clear the embattled officer. Capt. Peter Bosco of Engine 10, the fire company charged with doing mandatory twice-monthly inspections of the doomed tower just steps away, was reassigned along with his two immediate supervisors in the initial stage of the FDNY's investigation into the Aug. 18 blaze that killed two Bravest. But his attorney, John Bosco, Saturday unveiled memos from the Fire Department and the Lower Manhattan Development Corp. - which owns the bank building - that he believes indicate that the FDNY never was responsible for inspecting the toxic tower. "The buildings at Ground Zero were owned by the state and Port Authority and therefore were never under FDNY jurisdiction," John Bosco said. The city's administrative code clearly spells out that the FDNY is supposed to conduct inspections once every 15 days of buildings being demolished. But John Bosco pointed to the FDNY Fire Prevention Manual, which says that any checks on state or federally owned buildings would be only "courtesy inspections." In addition, he produced the minutes of a May 18, 2007, FDNY meeting that had been called to address safety hazards at the bank site after a pipe from the tower fell through the roof of the Engine 10 firehouse. John Bosco said he believed the memo - which reads, "The demolition of 140 Liberty Street ... would be under the jurisdiction of the DOB [Department of Buildings]" - clears his brother. "How come you're sidelining three fire officers for 'not doing their job' when it never should have been their job?" John Bosco asked. Peter Bosco has steadfastly insisted that FDNY inspections of the toxic tower had stopped long before he took over the Engine 10 command in December 2006. Peter Bosco, Deputy Chief Richard Fuerch of Division 1 and Battalion 1 Chief John McDonald have been reassigned to FDNY Headquarters for the length of the investigation. The FDNY did not immediately respond to requests for comment Saturday. jlemire@nydailynews.com

The polymer that is used in diapers is some amazing stuff. It can hold 100x its weight in water and once its bound with water its non-toxic, non-irritating, and biodegradable. You can pick up the stuff at garden supply centers where its used to retain water in arid conditions. When its dry the irritation is caused because the stuff is so hydrophilic. Its also very useful for practical jokes.

Glucose monitoring is nice little tool, but far from necessary. Even 500 of D50 isn't going to have a significant negative impact on a hyperglycemic patient in the time to definitive treatment. If its a stroke the D50 will depending on who you talk to have either a positive or no effect. I believe it was on this site that someone mentioned some research promoting administering glucose to stoke patients. If the drunk is a frequent flyer then you should know their medical history better than they do. If they're not acting like their normal self them throw 'em some glucose. Besides, the best test for how AMS someone really is, nothing beats glucose paste. If they don't gag on it then they really need it. Like others who are ar more knowledgeable than me have said, treat the patient and not the tool.

people really need to learn how to read maps. GPS isn't the be all end all. I am so sick of working with people who have absolutely no clue how to read a map. One new guy I worked with at least had the maturity to come out and say I have no idea how to read a map. Turns he just lacked confidence in his skills. Since, the last three rookies I've worked with have had zero ability to read a map. I have to ask them if its to the right or left of major landmarks or roads and figure it out from there since god forbid I can't drive and read a map at the same damn time. Gave one partner a 5 minute heads up that I was going to need to know which turn off of E. Tremont I was going to have to make. She was still trying to find the damn turn. The point of this babbling is before anyone goes out there and dumps $300 on a GPS get Hagstrom and learn how to use it. GPS gets stolen, lost and broken. Outside of a few services GPS doesn't take into account traffic problems nor does it know which roads are are faster at noon or 5pm. When you use a map you get a picture of the entire route an dnot just your next turn.

http://www.latimes.com/news/nationworld/na...=la-home-center By Erika Hayasaki, Los Angeles Times Staff Writer 8:46 PM PDT, October 21, 2007 PHILADELPHIA — A month after civic leaders and the police chief in this crime-plagued city called on 10,000 black men to patrol the streets, thousands arrived Sunday by foot, car, motorcycle, bus, in wheelchairs, with sons and nephews in tow. "Sign up here!" a volunteer shouted to the long line of men that circled Temple University's Liacouras Center. "Be a part of history!" In addition to the 6,000 already registered online, more than 7,000 men showed up wearing suits, fraternity letters, job uniforms and T-shirts emblazoned with the faces of the Rev. Martin Luther King Jr. and Malcolm X and the words: "Stop the Violence." Many waited more than an hour to register, though they did not know much about how they would be trained or deployed to curb violence. But all agreed they wanted to see an end to the killings and drug wars that have seized their neighborhoods. More than 300 people have been killed here this year. Last year, there were 406 homicides, and most involved black males. "It's the first step," said Ronald D. Morris Sr., 50, a middle school teacher who brought his 16-year-old son, who has lost two friends to violence. "I hope to try to awaken the spirit of these guys." Philadelphia Police Commissioner Sylvester Johnson has faced criticism in recent weeks for backing the plan to put unarmed men on the streets as "peacekeepers" who don't have the power to arrest. Some have questioned what kind of training volunteers will receive and whether the program will have longevity. On Sunday, Johnson, who is to retire Jan. 7, reaffirmed his support for the program, telling the men who crowded into the auditorium: "Traditional policing is not working." Organizers have asked the men to attend orientations in their neighborhoods, where they will receive training and instructions on how to patrol. The sessions begin Tuesday and will continue throughout the next few weeks. Volunteers are expected to be sent into the streets within 30 days. The call to participate was directed at black men, but organizers said all were welcome. The majority of those who attended Sunday were black. Tank Stewart, 59, a nurse, said he signed up because he was tired of seeing gunshot victims arrive at the hospital where he works. He said he was ready to protect his neighborhood, though he knows it will be dangerous. "Everybody should be afraid; we should have some fear," he said. "But I'll be willing to do it." But Lamar Reaves, 28, who brought his 5-year-old son, said he was worried that putting men on the streets could lead to more problems. "It will cause tension," he said. "It will make some who don't want to listen turn away." Many hoped the day would bring a spirit of change, whether volunteers decided to take to the streets or not. Throughout the arena, civic organizations handed out pamphlets about other volunteer programs. As people entered, a voice over the loudspeakers announced: "You're the person we've been waiting for. You're the solution, and you proved it by being here." The men hugged and held hands, raising them in the air and praying as one asked for Philadelphia to be brought back "to the City of Brotherly Love, and not 'Killadelphia.' " Mayor John F. Street greeted the crowd with the program's catch phrase: "It's a new day." He continued: "The naysayers are saying, 'Ah yeah, they went down there for one day, but they ain't gonna do nothing.' " The audience roared: "No!" erika.hayasaki@latimes.com This has a lot of potential to either make a difference or blow up in their face. It reminds me of the Guardian Angels and the always relevant Curtis Sliwa. Maybe this will even have some lasting social impact on the community and survive past the headlines. Some ownership and pride in the community goes an amazingly long way.

This says it all. A few have called this a call for alarm and in other threads people talk about more stingent background checks, tougher rules, etc. There's always a first time and you usually don't see it coming. Ever single time some nut freaks out and kills his family or commits some other heighnous crime the reports go straight to the neighbors and the always have the same lines about how they were such a normal family, he was such a quiet guy, they seemed so nice, etc. If it was only the creeps or the weird people doing this crap we'd catch them before they did it. I remember about 9 or 10 years ago there was a rash of big fires out west and it caught some major press when it was a fire fighter that was starting them. The big statistic then, more than half of all arsonists are firefighters. This will always be a problem because nearly everyone who gets into this job likes fighting fire. If there were a place in Westchester were you could burn a structure every day the line of people waiting to use it would be nuts. These people are us and we are them. The only difference is their line between whats right and wrong is at a different place than what is acceptable. THIS DOES NOT EXCUSE HIS BEHAVIOR. This is just why it has always happened and will continue to happen.