NWFDMedic

I guess I sometimes forget what it's like to work in the city environment. I should say the reason is "very often" sheer laziness. I've definitely had the patient who meets you with his bags packed on the sidewalk who wants a ride to the ER. And yes, I agree with you about the Medical Center. I remember when we first got a trauma center up here and everyone was convinced that every fender bender MVA patient or every finger laceration had to go to the trauma center. I think that's changed now.

I don't know how it works down in Westchester, but I've never had a career/combo department up here that responds to EMS ever have a complaint about being there. Also, in the vast majority of cases, if they are there before us, they have an excellent assessment in progress. Maybe I should be giving more credit to the guys and gals in Kingston, Poughkeepsie, Arlington, and Beacon because they do an excellent job and are always willing to help. I'll grant you that they'd rather be on a nozzle or cutting a roof and I've had officers come up to me and ask "hey, we have a job, do you have this" and I'll say "absolutely". I know the feeling, because I've been in the same position when the EMS system is hitting the fan and I'm on standby at the remnants of a small fire. I have to kindly ask the OIC whether he can manage if we cleared and they usually understand as well. I'm sure that the vast majority of calls that they are sent on could be handled by the EMS crew alone, just as the vast majority of room and contents fires can be handled by a single engine company. The reason we send more help is because of that minority of calls that may require it and the fact that those minority of calls, whatever the percentage, put life in danger. And when life isn't in danger, I definitely appreciate the extra hands when the last 3 calls I did were 300 lb. 3rd floor carry-downs alone.

I was shown the blanket roll method in my 2004 PHTLS class, but not in my 2008 class. I really liked the idea. The issue with the new spinal immobilization protocol is this... which apparently some don't understand in this thread. Just because you don't have to immobilize someone if the appropriate criteria are met and you are comfortable not immobilizing the patient, doesn't mean you walk them to the ambulance. Apparently things may have been done correctly on this call, but that doesn't excuse some of the comments here. Do not immobilize doesn't mean "walk to the ambulance". Would any of you even think of doing that with a patient on icy roads who was just in an accident? If you think the legal risk from the 1 in 100,000 that may have an unstable c-spine fracture is bad, consider the chances of someone who is rattled after an auto accident being walked to an ambulance falling while he was in your "care". With VERY, VERY rare exception, everyone I pick up gets put onto the stretcher and not walked to the ambulance. Doing anything different is sheer laziness.

Very nice looking rig. It's not loaded with bells and whistles and has simple switches, something you will appreciate when things go bad or blow out. I've noticed the more sophisticated stuff you get, the more expensive it is to replace. As for the CPR seat, I've never found it helpful at all during CPR except that one person can be on the other side and out of the way. I'd love to see them move the seat toward the back just a tad more because it's really tough to start an IV on the right side while sitting in that seat... but every manufacturer puts them in the same spot.

Maybe I'm thinking too simple, but is it possible your speaker is starting to go?

Yeah, like I said, it doesn't seem to apply here but I was just throwing an idea out there. It looks like EF did a great job considering the initial reports (and yes Nate, every fire is fully involved to some police officers or laypeople). I was just kinda throwing it out there not as a criticism but a point of discussion. The other thing I noticed is that I don't see a secondary ladder to the structure, but I'm guessing it was probably set up on the 3 side, maybe near the 2/3 corner?

I think pretty much any of us that post on EMTBravo can be defined as some kind of buff. There is clearly a lot of experience and good conversation here that might help us be better LEO/FF/EMT types, but the majority is for the buff.

I could see it working out well for a career staff callback as well. As far as using it for a first response system, not so much.

I was reading the IA for this call and they clearly had a priority to leave the driveway for the truck. Being in a department that doesn't have the benefit of a truck, I guess I don't consider this too often. When I volunteered in a department with a truck, the first due engine company and the truck company generally responded simultaneously so there wasn't much of a delay. For the chiefs out there with more experience than me... would you complicate the initial attack of a fire like this in an uncomplicated residence to leave room for the truck coming several minutes later? Now it doesn't seem to be an issue here, as the road looks to be nearby and the front yard is pretty clear. I fought several fires in development houses like this, even in a department with a truck company, and we generally found that putting up 2 ground ladders was quicker and more effective than the tower. It also allows you to position the first due engine for the initial attack and may not waste valuable minutes while the fire doubles in size.

Sorry to break it to ya, but PV isn't even close to one of the largest districts in the state. There are some districts upstate that would make Putnam County look small. Anyhow, that wasn't the point of my post. Am I reading correctly that you guys still call into the 911 center to tell them that you are responding? If so, I stand corrected; I thought those systems went away with the 1980's. I would assume that most departments have some type of pager to alert you for calls. With the decreasing prices of some of the small radios out there, many departments are using them as pagers as well. Why not get radios at a similar price, get a frequency, and put up a cheap repeater in your town somewhere. Then you guys can talk to each other and figure out the response.

The more I think about this system, I suppose it would be great for specialized teams (Hazmat, Collapse, Trench, etc.) but for day-to-day operations, I think it's more of a senseless expense than anything else. If your area still works on a call-in system for EMS, which I'm pretty sure we're all out of the dark ages, I guess this could be an upgrade and could eliminate headaches in the dispatch center.

Do you send Ricky Bobby to those competitions to stand there, get in all the pictures, and do nothing more than hold the lieutenant's lid? Just kidding Ant.

I have seen it in action at a couple of departments and quite honestly I'm not a fan. First of all, you're expecting your members to make a phone call either (a) before they leave wherever they are or (b.) while driving. Neither responsibility is one I would put on my fire district, especially with younger members driving to calls and us older guys sometimes waking up from a dead sleep to go to a call. Some have said that it's only 2 or 3 keys that have to be pressed, but that's still 2 or 3 too many in my opinion. Think of this conversation... "So, let me get this straight Chief, your member was calling an automated response system that you required when he backed out of his driveway and hit little Johnny." The other thing that it doesn't give you is correct information. If there's a call at 8pm and one of my members were to put in that he's resonding, it gives an ETA, but the problem is that ETA is from their home. If he's at Wal-Mart, I might be waiting for him because I figure he's up the street and he's really not. I suppose for departments that allow members to go directly to the scene, it might help people at the firehouse figure out who is going to be there for the crew, but I honestly didn't think that many departments are still allowing members to go to the scene.

The sad part about these cases is that the consumer is often left holding the nut and the businessman knows it. I had a landlord refuse to return security to me once and I challenged him in small claims court. After taking the first day off to go to small claims court (in his town as required by law), he didn't even show and instead sent a letter to the court requesting a change in venue because of a personal conflict between him and the judge. The venue was changed to a town further away, I took a second day off, and finally got a judgment against him and I thought I had won. After several months of sending letters, phone calls, and letters from my lawyer (with their accompanied fees), I finally went to the PD, who had no interest in assisting to exercise a petty judgment. To make a short story long, I finally ended up being able to put a lien on one of his properties for $600 at my personal expense of two days of work and about $500 in lawyer fees. While he would have to satisfy that if he sold the property, I might be old and gray by the time I see my money.

We were listening to this at work and were pretty familiar with the block because we drive by it pretty much every time we go to or from Vassar Brothers. Those residences are indeed VERY tight and they did have to do some work on the B exposure (per radio traffic) but it sounds like they were on top of it quickly.

Mobile Life Support has 3 Special Operations Response Team vehicles that can be sent to any incident in their coverage area (or outside if requested by a mutual aid agency). Each vehicle has command information, rehab supplies (both water/gatorade and ALS supply), cots, misting fans, EZ-UP tents, lounge chairs, oxygen manifolds for multiple patients, etc. etc.

Yes, the NYSP helicopters do, but you're talking a long and drawn out process for 150 passengers. The LifeNet (StatFlight) helicopters do not. Also be aware that in many situations, the NYSP helicopter must be outfitted for either rescue or medevac, not both.

Helicopters are useless unless they are rescue helicopters. LifeNet and MedFlight might be options for getting patients that have reached shore to an appropriate facility, but they do not have rescue capability. Rescuing 150 passengers with Lifeguard is going to be an all day process at best. For a smaller scale incident, Lifeguard and maybe NorthStar and SouthStar (I don't know their exact capabilities, but I'm pretty sure they are rescue-capable) would be options. Neither is that far away as the crow flies and mitigating this incident would take plenty of time to get them here and they could be useful. Relying on helicopters as your escape plan is very risky though. All you need is a rainy day, and you better have a plan B.

What's next, give paramedics SCBA's too? In some places, it's entirely possible that the paramedic service would be the first on scene. A piece of equipment does not give you the training required to be a firefighter, experience and training does. We don't need to be creating more patients for FD to rescue. I will grant you that it's a helpless situation but I wouldn't expect the police to give me a body armor and then give me the ok to enter a situation with an armed assailant until they arrive. Personally, I think all emergency responders should receive some cross-training in the other disciplines, not to do their job, but to find out what they can do pending the arrival of the trained responder. Police officers and EMS workers should be trained not to park in front of a collapse zone or fire hydrant, when a safe inspection can be made, how to interview residents about other occupants and where they may be found, any potential for hazardous materials, location of utilities, etc. There is plenty of information you can gather for the incoming fire units without putting your life in danger. I also don't have a problem with training LEO's a bit about making a safe and limited entry (say within sight of the access/egress) teaching them what to look for that may present a hazard that may preclude them from doing so. Unless we make all responders universal emergency responders, there are always going to be situations where the first discipline that arrives is not the most appropriate for the job. Regardless of training, there are always going to be those rare but possible sentinel events where an emergency responder may have to make the conscious decision to take a risk to save a life. OSHA and PESH or local agencies can make all the regulations they want, but they can't change the programming of most emergency responders and how they will act in that moment.

Date: 01/12/09 Time: 1536 Location: Hudson View Drive, Town of Fishkill Frequency: 453.900, 453.925, 453.800 Units Operating: Chelsea FD, Beacon VAC, Alamo Description Of Incident: 2 school bus accident, one bus rolled over with approximately 12 patients. Writer: Me 1536 - Initial dispatch, reports as above. 1540 - Chelsea 35-52 responding, report of extrication in progress to driver of one vehicle. 1541 - Chelsea 35-12 responding 1543 - Chelsea 35-1 on scene (I'm guessing I missed BVAC and Alamo responding because they aren't getting 2nd dispatch) 1546 - DC911 advises Chelsea Command that full first level assignment is either responding or on scene at this time. 1547 - 35-12, 35-52 on scene. 1552 - BVAC 82-67, 82-4 on scene. 1603 - BVAC (unknown unit calling) requesting an additional BLS ambulance to the scene. 1603 - BVAC and Alamo EMS for a 2nd BLS ambulance. 1605 - DC911 requesting headcount of patient transports and destinations. 1607 - BVAC 82-71 responding, Alamo unit relocated by county as all 3 BVAC units are committed to calls. 1618 - Chelsea command reporting 3 adults, 3 children to SFH, 1 to SLH. (Believe I copied that, Chelsea command's radio isn't the greatest) 1621 - SFH advises they can handle the 6 patients 1624 - Chelsea command with an update on patients - 1 adult to VBMC, 4 (3 children, 1 adult) to SFH, and 8 RMA's 1627 - BVAC 82-72 enroute to SFH with 3 BLS 1628 - Alamo Medic 8 enroute to VBMC with 1 BLS 1646 - BVAC and Alamo dispatched to bus garage for a patient who originally RMA'd at the bus accident. 1647 - BVAC 82-73 and Alamo Flycar 73 handling.

Well everything went off topic when we started talking about the age of an officer who might be in command of an incident. In my experience, it all depends upon the person. I've been to a number of scenes where I've looked at the Trooper who is in charge and quite frankly wondered when they started putting Jr. High School kids through the Academy. In each, the fire or police representative may have more experience dealing with the incident. They need to talk, discuss their concerns and go from there. I love the idea of slowing traffic enough a long distance from the scene so that they will not be as much of a danger when they get to you. Last week I responded to a medical incident as the result of an MVA on the Parkway and EFFD responded with a Fire Police unit and the NYSDOT responded with a plow vehicle. Both positioned themselves within sight of the accident, but also in a position that they could be seen around the prior hill/turn so motorists had plenty of warning to slow down. As the first arriving "command" type unit, all I had to do was tell 39-98 to make the scene more evident and they knew what to do, great job. However, I have seen incidents go the other way, where a complete disregard to traffic flow is evident. I can remember my old FD used to allow us to respond direct to calls on the Interstate (15+ years ago) and I really can't think of a good reason for that. Traffic is bad enough then add personnel with blue or green lights trying to push their way through and then having to add unnecessary vehicles to the scene. I can also remember a department that would shut down the opposite lane of an interstate and work across the median rather than going up the road a half mile to a turnaround and coming back (and there was no issue getting to the scene in the opposite direction). That caused not only both lanes of the accident scene to be closed when they generally only needed one lane closed, but now also a lane in the opposite direction. Sure it's simple to just close down the road and ask questions later, but is it always appropriate? There is a huge impact when you shut down an interstate highway and while you should not risk personnel or patients becuase of that impact, you should also not disregard it completely. If you're on a NYSTA road and you can't come up with an amicable resolution with the Trooper, you can always request a Zone Sergeant to the scene. The NYSTA also has safety managers who will respond out to these scenes on request. Believe me on this one, the NYSTA safety managers have all the authority you will need to mitigate a problem between your FD/EMS agency and the NYSP.

My condolences to Rich's family. The one thing I will remember about Rich is that he always made people laugh. I can remember having a bad day evaluating a practical session up at the college (basically wondering how our students were disappointing that day). Within 30 seconds of talking to Rich, he had me laughing way too hard. He's honestly one guy in EMS I've never heard anyone say anything bad about. He will be missed greatly.

Others have said this, definitely don't be worried about the anxiety. Understand that it happened and try to control it in the controlled environments. Remember these methods because you might need to use the same ones when you get to that "uncontrolled" environment. The post by ALSfirefighter was a great one with some great training ideas. I don't care how much you train, there is still going to be that situation that makes you anxious; controlling it is the key. Honestly, I'm 34 years old and have been wearing SCBA since I was 16 and the blacked out mask still gets to me. Even in the worst fire conditions, there is some light or at least some indicators of your position and goals. Being in a training environment where you don't get to sense the movements of air, the density of the smoke, the presence or absence of objects, the heat of fire or lack of heat in escape areas, and the sound of the fire can be more difficult for some than actual fire situations.

It's definitely a difficult situation because if you actually read the proceedings of the trial, these two officers were definitely in the wrong and in violation of policy. A jury should not be asked to render their decision based on the length of the sentence, but merely upon the facts, which in this case were pretty clear that the two officers were in the wrong. I certainly agree with the sentiment of the jury that law enforcement officers should be held to a higher standard than your average Joe. Just because they shot scum doesn't mean the ends is justified by the means. These guys were made an example of and I'm sure the point was made crystal clear. Unfortunately, the sentencing requirements are more punitive than corrective.

I voted for Mahoney's, but I work Friday nights.