ny10570

I'm still waiting for the Doc to get me an article on this, but what I do remember from Biochemsitry back in the day is that free radicals are are Oxygen ions. Adding O2 to a free radical rich environment would serve to exponentially increase the number of free radicals. So I'm assuming this is the issue. If room air can pride adequate perfusion without the adverse long term affects then it looks like it will be onits way to the south soon and our area in 15 to 20 years. Here's some perspective; pre-hospital hypothermic care in NYC...not even on the horizon.

patient care restriction isn't that out of the ordinary. Close to 6 months ago two EMT's at my station were restricted for several months and after everything was said and done they learned that their restriction was an over reaction and it was a paper work failure that had kept them off the road for so long. I've personally been restricted for an incident that first wasn't a patient care issue and secondly wasn't my fault, but until the details get sorted out a knee jerk reaction from the wrong supervisor can have some serious looking affects.

Excellent point, but I don't believe so as long as you are doing like was originally posted and responding with traffic and not leaving your primary area of response. In freelancing is it is outside of what is expected of you to be doing. As long as you follow the protocols required to go out driver training, for street familiarization, etc then it would make no difference. To just show up on scene and begin operating would be equivalent to freelancing as you would now be doing something outside what is expected. Probably the best idea is to adivse dispatch of a report of a "______" at "______" and that you are responding to investigate or to see if you are needed. In EMS this is an ongoing issue where we have my favorite form of job notification..."flagged for the ______"

I haven't gotten a chance to properly look this up, it has been described as being a combination of several factors. The pH of the blood is more affected my people's tendency to hyperventilate patients. The issue is free radicals. There is apparently research indicating the saturation of these tissues in O2 is resulting in an explosion of free radicals which are accelerating cell death. Room air for an intubated patient should provide enough O2 for the body when properly ventilated.

ckroll hit it all ready. The pt died at least 14 hours after being assesed by the medic. In that time the patient was seen by the staff to two hospitals and the flight crew. I'm led to believe that the medics inaction did not cause his death. Until the actual cause of death is released no one can know if earlier treatment could have made a difference. Any interventions the medic could have performed could have been performed at any stop along the way. If the medic had missed anything in the EKG it should have been picked up in the first ER. SOP in every hospital I'm familiar with has someone with his complaints getting an EKG as soon as he hits the door. If there is nothing in the medics bag of tricks that can help the patient why waste the resource. If the medic sent the guy off to the ER lights and siren then there would be something to look at. He went cold. Having that medic ride along with him would not have changed the outcome.

are you sure its that cheap?? Thats amazing. I know NYC is by no means a deal, but BLS starts at $450 and $6 or $8 a mile. Stat flight I believe starts just short of 10k.

You can't compare commercial to working NYC 911. Either for FDNY or a Voluntary and its an entirely different job. Work an average bus and after a year you will have used most your protocols, seen just about everything you thought you could see, and still have more surprises coming. What about transport ruined EMS for you?

Never seen a ff able to pass on a BS job so he can finish his meal, but unless the dispatcher gives an exciting job type crews will usually refuse the job. Technically the 10-100 cannot be used for food, but as you know so long as you don't abuse it they let you slide with it. Back then it equaled less freedom and more supervision. Now that we're being watched 24/7 people want back out of the bus. Nothing would make me happier than being able to turn out of a firehouse. Run a block heater and box climate control off a plug so the bus can be left outside in houses without the space and you'd be good to go. Except that the nature of the job has you out of the house too often for guys to develop the feeling of ownership of their facility that ff's have. The best run EMS stations are that way thanks to the minority who care. That and you need your supervisor to be an EMS supervisor. Having them chase units at every FH in the battalion would be tough. What I would like to see is every battalion get a station. From there maybe something can be done with rotating units out of the station to cover areas as jobs come in. Then at least when its slow there is some down time.

Enough water and you can over whelm the burning magnesium and the heat out of the fire.

Getting over is a big issue these days. Almost a year ago the fire department changed their test format to address a pending legal action by the DOJ. Shortly after the test was taken there was a big to do about the radically new format. Since then there has been no info or progress about the test. Originally the dept said there were going to be promotionals every 12 or 18 months. Since the last one they scheduled a new test but recently canceled it. When U hear talks about attrition they usually throw around 15 to 20% looking to go to fire. How many actually get there I don't know. The dept loses about 400 EMT's a year.

Yeah, the FDNY hourly sucks at $14 for the first year; but the pension, LODI benefits, health insurance, and job security are a big bonus. I'll be honest I don't really know much about the compensation packages offered by the voluntaries, but I do know a few employee's of St. Vincents and Cabrini who are pissed and out of a job. If I get hurt at work I don't have to do deal with the comp board. I've been there and I am grateful I'll never have to go through it again. Something I forgot earlier is the possibility of 12 hour tours coming. That mens every other weekend off, built in over time, and 16(?) fewer appearances each year. From what I understand both sides want 12 hour tours, its just a matter of the details and convincing the Labor Relations Board that its a good idea. Why thats an issue is beyond me.

Let me start by saying I'm a post merger employee and everything I know from the days of green and white are anecdotal or published information, not experience. If you take a serious look at NYC EMS before the merger all of the great things about EMS are either nostalgic or not good for the general public. Freedom from supervision. The ability to bail on BS assignments to go get the shot or trauma. Nights spent down on the point getting high and getting blown. Talk to cops and firefighters who worked back then and they all have story after story of having to wait an insanely long time for a bus. By the mid 90s about half of the ambulance tours were covered by voluntary hospitals. HHC was not able to keep up with the growth of EMS in the city. Wether the city should have given HHC more money or HHC should have improved its billing was the main contention. The city settled that by handing EMS over to fire who intended to turn EMS into a money making venture. While EMS is still far from profitable, improvements in billing and record keeping have made allowed EMS to expand and continue to cost less. The biggest problem is the Comissioner and Mayor promised EMS the moon and delivered NOTHING. Over time things slowly changed and in the last few years the change has begun to take off. FDNY is now running about 2/3's of all ambulance tours with more to come. The thing holding back expansion is a lack of employees. Training and equipment are improving. The newest ambulance contract will deliver 170 buses including a new larger box for all of the rescue and haztac units. Treaded stair chairs are coming soon. New protocols and tools are being explored. New training is available. The ALS engines will never happen. The first and only time EMS and Suppression unions got together was to fight ALS engines. Changes to the dispatch system will eliminate CFR companies when a BLS is closer on ALS/CFR assignments. The city is finally building some of the EMS stations that were promissed in 96. The money still blows but with uniform status this time around we will at least get a contract that is proportional to Fire and PD. How long and what it will take to get the salary disparity corrected is just a guess. There is a lot more command and control some of which is hindering patient care. However it is not nearly as significant as the improvements made. City wide response times to life threatening emergencies is down to 6:30 and all arrests is at 5:13. All emergencies 8:17. CFR's are arriving in 4:14. In 1998 the earliest I have available the times were at 7:25, 5:39, and 8:36. By comparison suppression was at 4:16. They've been doing their job since the beginning. EMS is slowly catching up. FDNY*EMS provides a service to the residents, cops and fire fighters that is far superior to what NYC*EMS was able to provide. Is that at the expense of its employees? Yeah it was. Could NYC*EMS have reached this level, I doubt it. Now for the sales pitch. If you are an EMT and looking to make a career at EMS give FDNY a serious look. Right now they are hiring at a rate that is just barely above attrition and promotion. They are constantly looking for more people. As good as Marty and the rest of the guys at WCC did, my 3 months in the EMS academy taught much more than original cert, time as a volley, and doing transport. There is also no place that will show you more of everything than working in NYC. Yonkers and the Vern are close but they still can't compete (my last partner did her time with Empress before coming south). If you want to be medic, why get jerked around for 3 years by a program that you have to arrange your job and life around when you can get paid to bust your butt for 9 months after only a year with the dept. I'm in the beginning of the program now and while its effectively the end of my social life for 9 months its the best deal going.

yeah, we're a little less fanatical here. When was the last time a ref was killed for a blown call?? A comic once explained perfectly exactly why Soccer will never take off here, its because if you really are a talented athlete you head towards sports like baseball, football, or basketball. The more fringe sports that Americans dominate are individual sports, like golf, track and field, or tennis. When was the last time you heard about a kid in your neighborhood who was going to grow up to be a really good soccer player? Soccer is still often relegated to all the kids who couldn't compete in another sport. The same thing goes over seas. Cultural pressure drives talented kids to different sports.

FDNY is still trying to get the membership all squared away and lined up for the 5 year recert. TO make up for time lost for people who are one or two years into their card the dept is bringing everyone through "bridge" training to cover that gap. The current program involves 1 hour a month of peer training led by station supervisors, 1 hour of journal based drill a month, and 8 hours of state mandated training at the academy a year. The minimum requirement is 90 hours over 5 years for EMT's. The peer drills are going involve all of the hands on skills that would be covered during a refresher, the journals should cover the didactic, and the academy training will cover what ever key issues the state is currently harping on. The biggest selling point on the 5 year program was the amount of work the average FDNY EMT/Paramedic does. To qualify for the 5 year it looks as if you would have to in a very busy system. As for medics the in house training and journal components are beginning to address their training needs. The articles are written by Dept MD's so as to count for physician led instruction. The dept is also making efforts to make more lectures available. I'm not entirely sure of how the ALS portion works, but I'll check it out. The benefits of the program aren't expected for another two years once the program is in full swing and refreshers and bridge training is no longer needed. The dept is hoping this program will first save money in keeping people on the street and out of the academy and free up the academy to focus on other programs. The dept is adding new units monthly and is in the middle of several changes to the depts ALS and BLS protocols. This alone has the academy running full tilt. Right now there are 3 medic upgrade programs, a new EMT class, and a GED program running on top of the bridge programs. The place is bursting at the seams. I don't see NY getting away from the certification. Legally speaking being certified puts you in the same position as being licensed. If anything the certification ensures greater accountability through continued training. Look at CT, to maintain your medic license you send in your renewal app with your check and you are on your way.

One of the big issues with the program is tracking and keeping up with the training. The 5 year would probably be difficult outside of an agency. Its very similar to the current 3 year challenge recert that is available. If you have any specific questions ask away. Anything I don't know I can get the answer from one of the programs architects.

At the start of this thread an article was posted where Stefan Svensson PhD said "instead of teaching 'use a lot of water on the fire, the more the better,' firefighters should be trained to ask 'why is it burning and how do we put it out in a safe way?" Looks like not everyone is Sweden picked up on all this training. Assuming a reliable water supply around here by the time that TL was up there would have been at least a 2 1/2" or 2 on the ground and some real flow out of the bucket on a fire this size. I don't think there's a dept around here that would have gone in spraying a stream like that on this much fire. Then there's the bucket placement. Use all that damn ladder to get up and away from that roof. http://s123.photobucket.com/albums/o299/AR...sweden_fire.flv

Every time I've seen someone have trouble with foam its been human error. Mistakes at the pump or people who thought they knew a trick. JUst pump the right numbers and use the foam stick and you will get a blanket. As for the Foam Pro system we run, sadly I haven't been around nearly as much as I want or even should be and have only seen it used once.

You're right e92l44, I've certainly never heard it called Tiny Town. Edgewater has always been called much worse names.

I love dogs, had one for 16 years and miss her every day, but before we start writting e-mails and making phone calls have you written to your legislators about fund allocation for emergency services, medicaid reform, or any of the other dozens of issues I see bought up on this site. Who here has written a letter to one of our service men and women serving our country? If you've contacted all your representatives and written a soldier, why not spend some time back in the text books so you can rediscover some info you may have lost that might save your life or maybe learn something new. Its a dog. We brutally kill animals every day as a society but just because this one has such a fond connection to us we freak out every time one of them dies.

Until they start growing the stuff locally its not going to be a real problem here. The stuff loses its potency so quickly that unless you're flying it in its not practical to really get high off of.

As one of the lucky few to have gone through this training (a week later and I still have the bruise to prove it) I have to admit this device is a great idea and worth the expense. At first I thought it was overkill, but I've been won over. I've gotta thank Ex Chief Ferg for getting it going and Chief Lamonica for keeping it alive.

glad I could help

Maybe we can get an exhibitionist gay couple to go at it in full view of this group. Really put on a show for them.

Wishful thinking, but hopefully this is the opening for municipal EMS.

The info is all out there. You just have to ask the right people. Batt 3 was announced a while back when the dept finally purchased the land. Batt 27 plans were announced with some inaccuracies by "The Chief" a few weeks ago. A Manhattan Capt first told me about the new Manhattan Battalions 9 and 13 (the actual batt #'s are speculation). Call me paranoid but I don't like posting where I get info from because you never know who is reading what and what they'll do with it. I'll PM you Casson because I've seen around here a lot. To anyone else who reads this info, take it for what it is. Its information posted by a faceless screen name. I don't have any special connections. I just make an effort to ask the people in the know when I see them. They are all easily approachable.