NWFDMedic

I drove a few gas ambulances back in the day (type 2) and they had plenty of power. The biggest problem was that the gas engines really didn't stand up to the daily wear and tear that's put on an ambulance. My dad has the ford V-10 in his Class-A motor home and it has plenty of power.

Great job Arlington. I actually relieved our crew that transported the patient to the LZ and they were very impressed with all of your firefighters.

Hey Seth. Do you know of any companies that have generator powered modules in type 2 ambulances?

From WHAM News: http://www.13wham.com/news/local/story/Bod...P_Tuhpb7aw.cspx A volunteer firefighter and EMT and sophomore at SUNY Geneseo, Arman Partamian was found dead Sunday morning at an unsanctioned party house near the college campus. Per the NYSP, alcohol is possibly a factor in his death. My condolonces to his friends, family, and brother and sister firefighters.

Best of luck. Stay safe brother.

You have a bat phone for county and still don't have a medical control line. Saints is pretty good about providing information about their availability if you ask them. I had 6 leaving from an MVA once to go to Poughkeepsie hospitals and much to my surprise, as I was trying to figure out which ones to split, Saints called back and said they can take all 6. They are also pretty good about having things ready if you call them with what is going to be a trauma code.

That's a funny story. I know I often find myself in the same situation as a medic if I'm responding to an area that I don't know. If I'm going to be treating a patient with medications, I'm definitely going to take my own set of vitals, but there are plenty of ways to explain why rather than saying you "can't trust" another provider. Sometimes something so simple as taking a B/P on the other arm can be a good way to explain to a patient why you are taking another B/P. Or explaining that we like to watch for trends in vitals if the first responder didn't just take vitals. Or maybe something so simple as saying we generally check vitals when patient care changes hands (note that we generally DO do that, as do hospitals, etc.) I actually did just this on a call in the City of Poughkeepsie a month or so ago. I didn't know the FD crew at all, they gave me correct vitals and a competent report (in fact, they were spot on) but not knowing them, I wanted a set for myself... especially for a patient who I thought might be having an MI. My course of action was to build in a few minutes by doing an EKG and a 12 lead, then rechecking B/P. When the patient asked why I was taking a B/P again, I told him we were looking for trends and it had been about 5 minutes since last vitals.

As a commercial ambulance paramedic, I always see myself as playing in somebody else's sandbox. If I beat the FD to the scene and find out that I have a situation where further personnel would not be beneficial in any regard, I will advise the dispatch agency that we are under control at the scene and FD can disregard at their discretion. This allows the FD officer to make the decision and I don't step on any toes because I can't possibly remember every department's SOGs on cancellation when I could be in any of 100+ jursidictions. In areas where we respond with volunteer FD's, I see it as my effort to help get the firefighters back to their jobs, families, or beds a bit quicker.

Just as a base for further questions, what is your level of certification and authority as an agency? Since you do standbys at events, I'm assuming you must have Mass. certification, which would likely include a medical director, completion of patient care reports, a QA/QI system, etc. Does the University pay for the service of the ambulance that is on standby for events such as football or hockey games (the two sports I know that the NCAA requires an ambulance on standby)? Do you guys work well with the local FD/EMS services when you are at the standby details? All in all, I would think that the best option would be to sit down with the local town department and discuss the options. They may be more than receptive to your assistance and may even be interested in adding your providers into their system. They might be willing to support your student service and maybe even enter into an agreement to allow your providers to tend to patients in their ambulances (which might better response times, get their ambulance out more, and get money for them in the process). It could be a win-win situation for their department, your agency, the patient, and the University as a whole. The other side of the coin would be if there's an adversarial reltionship... if so, good luck.

Most municipal agencies have "non-revenue" EZ-Pass tags for their apparatus if they have a primary response to a toll road. There was a time that these tags were provided free of charge, but I don't know what the current procedure is. For the commercial agencies, we pay just like anyone else does. From time to time we have had issues with the people at EZ-Pass for calls on the Thruway because sometimes we will enter and exit at the same interchange or if we utilize a crash gate, we may get a violation for exit without entry. They are generally resolved with a phone call. Back in the day, for an emergency response going to a Poughkeepsie hospital from Ulster, we would call the bridge authority and ask them to open a lane. They will still do this, but it's not the preferred procedure. For the 2 seconds it takes to slow down and let the EZ-Pass register, it's not worth the aggravation to make the phone call, not to mention the fact that it's far from safe to go speeding through a toll barrier.

You think he could have just asked you instead of posting a new thread. What are they feeding those kids out in the Lake?

Maybe you can inform Orange County how much better your numbering system works. We seem to still be stuck in the dark ages.

I think Chris192 hit the nail on the head with his post. This is typical New York Post and political sensationalism. I am 100% sure that there are abusers of the system out there; in such a large department you would be a fool to believe otherwise. However, I also believe that a good percentage of the disability retirements are just and the number is too high. The City should be working to cut these costs, no doubt. Cutting these costs, however, should not focus solely on finding the abusers, they need to spend money to find out how to best help firefighters meet the physical and emotional needs of the job. The City also needs to realize that the men and women of FDNY are doing one of the most important and difficult jobs in the biggest City in the country.

Well in real terms, a firefighter's job is to prevent the loss of life and property. I started in the volunteer fire service in 1990 and back then we had fires, and lots of them. I was inside my first fire on my second call and got a 30 second in-service on an SCBA on the way from the firehouse to the call. Today we have a lot more regulation and technology in the fire service. Our training is better but unfortunately there has been a tradeoff in experience because we have done our job too well in the prevention category. There is no substitue for experience and "knowing" a fire, which is why it's really great to have a combination of trained firefighters and experience firefighters (and hopefully ones with both) in the ranks. There have been a lot of improvements to make the preservation of life and property more effective. In fact, coming up in 2010, I believe, all residential new construction will be required to have sprinklers. That will be the next step in preserving life and property and probably an increase in our call volume of false alarms. In all, I wouldn't say the men and women in the fire service are any better or worse than 20-30 years ago, but instead uniquely different. What is for certain is that the job of preserving life and property is getting done better and for that we should all be grateful and proud.

They won't give you speeding tickets, but they will suspend your ez-pass if you go through toll barriers too fast.

We've had this discussion here before. When you buy a foreign car, the wealth associated with the sale goes overseas. Yeah it's nice that we get some jobs when the care is manufactured here, the profit is going overseas and making us a poorer nation.

I can't agree more with Ben Franklin's quote. If it only tracks tagged plates and the only ones that can be tagged are in the bad boy database, I have no problem with it. From the way it sounded originally, I thought they were making a huge database of people's travels.

Amen to that.

Doesn't that seem a bit like big brother? I have little problem with them scanning the plates, but holding a list of where you were and when... not only does it seem like big brother, it also sounds like a violation of my civil liberties.

Lisa, you are hitting the nail right on the head here. You are a responsible mother and have access to medical care and insurance. The population demographic in NYC is not likely to have the same resources. These are not situations where you can wait the extra 10 or 15 minutes to get the care. The only acceptable explanation from an FDNY standpoint would be that EMD is catching the greatest (95%+) of these calls and sending ALS trucks AND the fiscal repercussions of training every EMT are cost limiting to handle that other 5%. We all know what will happen here. Someone of political influence will die or someone that has family that will raise enough stink to get activists involved. Then and only then will you see action.

I have seen several. I can specifically remember a patient last year who was on that borderline of being intubated when the epi/benadryl finally started to turn him around. Certainly more of our calls are of the less than anaphylactic variety, but there are several factors: 1. In the Hudson Valley, our patients usually have better access to medical care. Move the focus to a place like NYC with several areas of patients that have less than optimal access to medical care, and you'll see more patients without proper remedies. 2. A good number of our summer calls are at facilities that have access to Epi-pens. 3. Most BLS services in the Hudson Valley carry Epi-pens and begin to turn the reaction before I get there.

Actually, the BLS protocol does not limit Epi-pen use to patients with a known allergy and a prescription. Direct from the NYS BLS Protocols: " A. If the patient is having severe respiratory distress or hypoperfusion and has been prescribed an epinephrine auto injector, assist the patient in administering the epinephrine. If the patient’s auto injector is not available or is expired, and the EMS agency carries an epinephrine auto injector, administer the epinephrine as authorized by the agency’s medical director. B. If the patient has not been prescribed an epinephrine auto injector, begin transport and contact Medical Control for authorization to administer epinephrine if available." I don't think the purchase of Epi-pens would be a huge burden on FDNY and the fiscal portion of actually maintaining the medications would be a drop in the bucket. The cost of training, continuing medical education, etc., could be a HUGE factor. Those who argue that there is a hospital on every street corner and 100+ ALS trucks in the city don't make a great argument, in my opinion. How many times will the BLS crew get to the scene, have to walk up 8 to 10 flights of stairs (if not more), and get to a patient who is having a severe reaction. Then a request for ALS, assuming a unit is close and you have good communications with dispatch, would be another 5-8 minutes, plus add in the walk up the stairs (maybe split the difference as the BLS crew should be moving), etc. In these cases where swift action is crucial, I would hope that my brothers and sisters in the FDNY have the proper tools available to them. Bagging a patient may help to bridge the gap, but it is not always effective.

Nice looking truck for out there in Union Vale. The color scheme is definitely better than some of the recent trucks. Good luck with it.

GPS my friend. GPS.

Indeed. The transporting unit would do a PCR as usual. Patients treated in triage and not transported should have some kind of informed refusal documentation, whether it's on a PCR or some other form developed by your agency. If you treated patients and turned them over to transporting agencies, I would think that you would have to do one PCR to account for your presence at the incident and include the appropriate documentation of your activities (triage tag portion not sent with transporting agency, some type of patient accountability listing).