NWFDMedic

Mark, Are you guys going to have any at the CME tomorrow night? I'm hoping that I can get into work and then get over to the CME, so long as the Town of Lloyd and lower Dutchess are compliant and let me stay in the Poughkeepsie area.

If you're in, I'm in ... so long as I can get my relief to come in a few minutes early. I get out at 7am from our C/Poughkeepsie office and I have yet to figure out how to teleport myself to Fairview.

I don't know how valuable the training exercise was from the fire end. I've heard from some first due agencies that all they were allowed to do was stand there for 4 hours and then went home. Having been to drills like this before the FedEx fire and after the FedEx fire from both the fire and volunteer EMS side, I don't really find them all that 'valuable' of an experience for the average firefighter/EMT. I think the most valuable experience I ever had on site at SWF was the FedEx fire itself. From looking at the picture, I can tell that they have made some adjustments at least in staging to make the operation a little better. The FedEx fire was a mess right from dispatch because all of the protocols at the time were written based on "souls on board" and didn't account for the potential of a large freight plane. That was dispatched as an alert 3 / level C which was a rescue-intensive response when they really needed more fire supression equipment. It just went downhill from there, but I got a nice day off of work.

Well, that wasn't quite the road I was headed down Chief, but I can see the point. Maybe there needs to be a list of essential job functions or some kind of provision that allows employers to only be responsible to let X-percent of their workers go.

While this might be a "feel good" piece of legislation, it also has quite a few shortfalls as noted in the posts above. I attended a CME last night on Pandemic Preparedness and while not exactly a classic disaster, a lot of the things discussed are still poignant to this topic. It's all well and good to say that volunteer firefighters and EMTs are protected from losing their jobs but who is going to do their jobs while they are gone? Also, what impact does their regular job have on disaster mitigation? For example, let's say a major flood hits New York City and the city was declared a presidential disaster. Volunteer firefighters and EMS workers from Orange County were "forced" down to the city to help with this disaster. Let's say, for argument's sake that 100 volunteers went down to the city to help. Well, now you have lost 100 workers in the local workforce right off the bat. You will lose probably double that number because of "effected families", people who are calling into work because they are doing what they can to shelter family members, attend funerals, etc. etc. To some extent, you are also going to lose local resources from commercial EMS/Fire agencies trying to do their part. You are talking about losing a significant portion of the workforce and that's going with the assumption that career firefighters, EMS, doctors, and nurses don't head that way. Here come the problems. Problem #1: Transportation to the city is going to be nonexistent, increasing the population and the subsequent need for services in Orange County. Problem #2: Survivors from the flood will be headed here, straining our resources. Problem #3: Disaster mitigation requires resources. If you take truck drivers off the road because they are volunteer FF/EMT's, how long is it before you don't have food, gas, and medical supplies in the effected areas? Even if you take away 20% of the cashiers at Wal-Mart, how are people going to get the resources they need in a timely fashion here in Orange County? While it's a nice thing for the bureaucrats in Washington to say that they will protect the jobs of volunteers in the case of an emergency, I sure hope there's some kind of verbage in this bill that protects employers and gives them first right of refusal to let their employees go. While the initial management of a disaster (24-48 hours) may be intensive for first responders, the continuing logistics of a major incident require the entire workforce to remain as intact as possible for successful mitigation.

This is a very good and expensive lesson. I can remember being on a scene several years ago where we had what appeared to be a well secured landing zone until a driver drove past a barrier manned with a fire policeman and went under the helicopter that was still hot. Apparently the occupant of the vehicle was in a hurry and couldn't take the short detour (and it was a very short detour). Unfortunately for the driver, they endangered a state police helicopter and its trooper pilot. For their efforts, they were rewarded with a nice pair of bracelets.

That's what I was kind of wondering about when I saw the new 63 considering how much "non traditional surface" work you guys must do up in the Lake and for that matter all the troubles they have out near 82 and the Taconic (yes I know that's St. 1 area but they no longer have a utility). Maybe they're planning on using the new 63 as a district vehicle; it would be an upgrade over the one at HQ. In that case, they can use it pretty much anywhere to drive through trees. I know they've got a plan, they always do. Nice looking utility, good luck with it (and bring plenty of manpower to help on EMS calls).

Hopefully doctors will take the time to educate patients (and family for our special needs population. While the EMD card might allow for it, I do think they need to develop a canned set of directions to instruct the caller to administer the epi pen. I know that there were a good number of unintentional epi pen injections last summer... so what appears to us as idiot proof is not really.

The cost of running these ads is far from nothing. I was treasurer of a VAC that produced and ran and ad with the help of Time-Warner Cable back earlier this decade. Radio would probably be more inviting for PSA's, but your cable company isn't going to be, except maybe on the local access channel. Honestly, the effectiveness of these commercials IMO is next to none but someone must think differently, because I know they can use SAFER funds to do them.

With all due respect to some of the very intelligent EMS authorities noted in this article, it stinks. This is the second thread I've read on EMTBravo in a week where the topic is basically "why don't they do something better for us?". This article takes it a step further, basically saying the EMS is doomed and there's nothing that can be done about it. I hate to say it folks, but changes in the EMS system aren't going to come from some national EMS czar or anything of that ilk. In fact, if you want something to get screwed up from the top, getting the Federal Government involved is a good way to start. Merging with fire may work in some locales but assuming that the person best suited to care for a sick or injured person is the same person that is going to run opposite the rats to go into a burning building is probably a less than valid assumption. The opposite probably also isn't true. I'm sure some departments do things well on a local level, but every time a large EMS system merges with fire, the medics are met with second class status, lower pay, and glass ceilings. If you want to enact change in your EMS system, you should be starting from the bottom. Start to change yourself, then work to enact change within your community (or the community/s that you serve for commercial) and agency. If you work in a busy system, maybe you should tell yourself the truth and realize that working a 24 is not the best thing for your patient or for you and your family. Sure it might make life more difficult but I'd rather be inconvenienced with a bit more cumbersome schedule than putting myself at risk. Also, if you're one of those medics who just gets the minimum done to stay on-line, maybe you should consider that you're not doing the best for your patients, your coworkers, or your profession. I'm probably preaching to the choir here, but I like preaching. Now, let's look at your agency. Does your agency actively participate in providing top notch patient care? Do they give you the proper tools to provide the same? Are they interested in being on the leading edge in care provided? Or, do they just do the minimum to stay on-line. If your agency is in the latter group, work to institute change from within. It's not always your boss who has to come up with the good idea. I know for a fact that our CPAP protocol was due in large part to a field staff medic with a mission and it's been shown to provide great results in the field. Finally, once you have yourself and your agency on the right track, it's time to educate the community. They need to understand that an ambulance isn't a widget; there are indeed good and bad ambulances. There is a standard of care that should be expected AND there is a standard of response time that should be expected. Establish realistic expectations for your community and then back them up on paper in the way of contracts. If your community doesn't know what to expect for EMS service, remember ignorance is bliss. Now, there are proactive medics, agencies, and communities out there, but they are the exception rather than the norm. As far as the agencies are concerned, I haven't once said anything about volunteer v. career or municipal v. commercial. These are the things the entire EMS system should be doing to influence change from the bottom up, instead of waiting for either (A) someone from above to do it for us or (B.) a total collapse of the system.

Well Seth, a month ago I could have said yes. Now I'm sitting at home with a torn MCL awaiting an MRI Saturday to figure out whether it will need to be treated surgically or rehabbed. The good news is my orthopedist thinks it will heal on it's own. It better, a week of wearing this bionic brace and I'm sick of it.

Great post Chris.

The real answer here has nothing to do with union v. non-union or municipal v. 3rd service, the answer lies in the cashflow into EMS. I'm sure most of you couldn't name another field where the government is allowed to set the price of your product or service. Could you imagine if Obama went to Ford and told them that an F-150 that they are selling for $30,000 is now going to be sold for $10,000? The good news is that the government will pay you that $10,000 but the bad news is that you cannot bill the buyer of the vehicle. Oh, by the way Ford, you don't have a choice... you have to give the F-150 to anyone who requests it; you cannot turn them down, even if they don't qualify for the $10,000 government payment. EMS is a tough business in which to remain profitable. One can make arguments for or against unions but I've seen good and bad results. One can also make an argument for municipal service but you really need a good tax base to make that worthwhile. A town in this area went for a "quasi" municipal service over a third service... the result was a 270% tax increase and less coverage than the town had to begin with with the third service. I think the best thing we can do to better the standard of living in EMS is to go out there and work. We should be constantly pushing to increase our scope of practice and increase the amount of education that is required for the job. Education is not the enemy here; it's the opportunity. The more we can do, the more valuable we become and eventually... the more we will get paid. Nurses weren't just given money without working for it; the scope of their profession has changed a lot in the last 30 years.

I found it kind of interesting that City 911 got the AFA for the address about 15 minutes into the fire.

Where's the money going to come from? You can't find a simple 300 level course anywhere around as is, now they're going to make the basic classes classroom instruction???

While this is tragic, it brings up a good point. We all have places like this in our districts where we may have to make the decision between evacuation and sheltering in place (prisons, hospitals, etc.). I know of a good number of these IRA homes as well that would at the very least be a difficult evacuation.

If you did effective BLS ventilation it would be fine.

I'd bet that the Fishkill PD may have been at your work location when the call went out. Either that or they had a spare unit around. Good for them for being willing to lend a hand. It is really unfortunate that the economy looks like it's going to continue to trend down which means crime is going to continue to trend up. Even when the economy begins to trend up and unemployment starts to go down, the jobs don't get to the inner-cities first.

Are they trying to bill the patients direct or the individual municipalities for the use of the service? Either one has bad news written all over it for the patients. Medicare and Medicaid are not going to pay for the flycar service. If the volly squads (or their townships) are getting charged for ALS intercepts, would they start making inappropriate decisions to try to get ALS as little as possible?

Not a dumb question Mike. They do have a CON for Orange which is probably why it's on their advertisement. (Oh, and they drop of patients at Cornwall too.)

You think it's confusing now Rob, you should have worked the OC back in the day. Almost every agency had their own dispatch... here's a little sampling of our old radio plan: Channel 3 - Base 3, used to contact Town of Newburgh PD (dispatches TONVAC) Channel 4 - Base 5, used to contact New Windsor PD (dispatches NWVAC) Channel 5 - Base 4, used to contact Cornwall PD (dispatches COVAC) Channel 6 - Highlands Base, used to contact Highlands PD (dispatches THAC) Channel 9 - 473, used to contact Walden PD (dispatches Montgomery VAC) Channel 12 - WAU718, used to contact Sheriffs Dept (dispatches Otisville and Florida ambulance.. sort of) - 510 delta, used to contact Cullins Communications (dispatches BGVAC, GOVAC, CVAC, TOWVAC, GVAC) - 460, used to contact someone somewhere who dispatches Lenape Ambulance - 200 charlie, used to contact Warwick PD (dispatches Warwick VAC) - 593, used to contact Greenwood Lake PD (dispatches GLVAC) Channel 13 - Finchville tower version of Channel 12 which was on Beacon Channel 14 - Pine Bush dispatch, forget what they called themselves to contact Crawford PD Channel 16 - 410, used to contact Monroe PD (dispatches MOVAC) Channel 17 - Woodbury Base, used to contact Woodbury PD (dispatches WVAC) We never had communication with Tuxedo because we didn't need it. Port Jervis was also on channel 12, but I don't remember who dispatched them. My favorite time was when we went into Walker Valley... you were expected to switch to 13 for 718, 14 for PB dispatch and 26 for Ulster Comm. manage all 4 and hear anyone calling you on any of the 4.

He may have been doing it for 26 years but it's only a miracle he hasn't gotten someone killed. Everyone is focusing in on the smoking, and while it's unprofessional and against most agency policies, that's more unprofessional than dangerous. He wasn't just rolling through stop signs and red lights, he was barely decelerating. Then he says that the engine "cleared the intersection". Now I know that most of the people on this board have taken an EVOC or CEVO class... the second vehicle in an emergency vehicle chain is actually the most likely not to be seen. People stop for the big truck with the loud Q-siren and then go on their business again, right into the side of the ambulance. Funny how the press blows over the big issue and is more worried about someone smoking in the bus.

That's only in ALS contract areas in Dutchess. I was pretty sure in volunteer areas, it was BLS only, and I heard a dispatch this morning to confirm the same. It actually kind of surprised me because I thought 4th party calls with no info always went P-1 in Dutchess. It would be interesting to see if there's a study out there regarding automatic medical alarms. I would imagine the percentage of actual patients (even with no contact) is probably fairly high compared with automatic fire alarms. Just from my experience I'd say probably 30% of my no contact AMA's are actual patients, and probably just more than half of that subset end up being ALS.

I don't have any more information than is in the articles but I heard the dispatch. I was on the phone with our dispatch for something unrelated and he told me we were sending a second unit to Warwick and it piqued my interest and the scanner. How often do we get reports of cars in lakes and find them to be parked next to puddles? From the sounds of the radio transmissions, it sounded to be a calm and coordinated effort. Kudos to the firefighters, LEO's, and EMS providers out in Warwick.

Great story Seth and it doesn't surprise me either. The only thing that seems to get to my mailbox on time anymore is bills. My property tax bill for this year has yet to show up; I had to get a copy from Town Hall. The only thing that surprises me... that the USPS delivered it at all as it had insufficient postage.