NWFDMedic

I have seen a ring around the moon before that's just outside its borders, but what I saw last night (12th) was pretty cool. It took up a full 1/4 of the sky and was a perfect circle.

Great looking vehicles. Good luck with them. I don't think it would be a good idea to use the escape in Medic 2's territory. I remember at Sloper where we had a weighted down S10-Blazer and it couldn't get around some of the tough terrain in Put Valley in the bad weather. I also wonder if a certian very tall medic is going over to Transcare to work in Putnam. I remember having to move medic trucks around so he could fit if the S10 was going to be where he worked. You would have to squeeze him into the Escape with a shoehorn. Again, good luck. Of all the agencies that I've seen come and go in Putnam County, Transcare has the best chance of going in and doing it right.

Back in service with a good intent call. The patient was obviously alive and kicking.

I don't believe they have any 911 contracts left in the Kingston area. I believe they are still the backup for Ellenville Rescue if they don't have a medic available to respond. They are also on county rotation with West Hurley, I believe... meaning they cover every other month's ALS requests for that FD. There might be a couple small places out there also on rotation, but most of the area is covered by Mobile Life for ALS. I guess HVP has also been doing quite a few standbys at HS football games with BLS units. The odd thing is that they are calling the primary EMS agency for the area should someone actually need an ambulance instead of transporting and backfilling. It seems to defeat the purpose of having the ambulance there.

Thanks for the info Doug. These ambulance acquisition things are always kind of strange and it seems like every one has different rules. Usually the contracts of the company (or division in this case) being acquired don't automatically carry over from company to company but maybe since they are keeping the Regional EMS name, there is some kind of difference. I wonder what happened to the personnel that was working both Orange and Rockland shifts on a regular basis.

From the sounds of things Empire is taking over Regional's Orange County operations. Basically, Regional has the two smallest hospitals in the county (Bon Secours in Port Jervis and St. Anthony's in Warwick). They also have a few nursing home contracts here and there on the west side of the county (St. Theresa's, Middletown Park Manor, and half of Valley View of the top of my head). As far as the east side of the county operation goes, once New Windsor goes ALS, they basically will have none. Regional is doing preferred provider transports out of St. Luke's and Cornwall by insurance company request, but they would have to be renegotiated and quite frankly, Empire could have worked out those deals before the acquisition. On the west side of the county, they actually have quite a few of the smaller townships, but none of those contracts/agreements would automatically go to Empire anyway. Mike has dealt with many of these agencies in the past, so I would guess that he's already made his pitch and feels that enough of the agencies will stay with Empire to make this acquisition. The Pike Co. operations are extremely limited and probably weren't a deal maker. I don't really see the sense in this acquisition, but I'm not an EMS manager. It will at least make things interesting for a few months; hopefully all of our brother and sister providers are able to keep their jobs and not get hurt in the deal.

Along with this, we as an EMS system need to do a better job of educating the public. Ten years ago here in the Hudson Valley a hospital was a hospital and you went there regardless, with the possible exception of a serious trauma or burn. Sometimes a patient's preferred hospital is not the best choice and you have to educate them and their families. Sometimes, even other medical professionals (ie. doctors) need to be educated. I've even had cases where I've gotten the ER doctor on the phone and had him tell the patient that their facility was not the most appropriate and could not provide them definitive care. The patient will not always agree with our definition of closest appropriate. The other issue I've had recently is with some of the facilities. Just because hospital A is a trauma center and hospital B is a cardiac center, it doesn't release their responsibility to be an emergency department. There is no reason why the cardiac center cannot handle a simple trauma that does not meet trauma criteria. Likewise, there is no reason why the trauma center cannot handle a non-acute cardiac patient. Even hospitals that do not handle certain types of patients (ie. pediatrics) still can treat basic ED cases. I try to make an appropriate decision and I will advocate my patient going to the closest appropriate facility. Sometimes, however, that may not be possible.

I was actually working in the SUNY-Orange Extension Center in Newburgh. On my way into work, WPDH cut into their morning show to a radio report about a small plane hitting the World Trade Center. I remember thinking that a small plane would likely bounce off and cause a bit of a mess, and how stupid could a pilot be to miss the 1300 foot building, and then I went into work. As the timing had it, class time was 9:00 at the college, so most of the students were in the building before any news of the second plane hit. The building has no cable service and you can't even get any radio stations on a little deskside radio, so basically we are cut off from the world, short of someone surfing over to a news website in their office. I went in, checked my work email, fixed a problem with a server, and then got a phone call from my captain (or assistant captain) at NWVAC. He asked me if I was available to help because the town might be in a state of emergency at some point. I asked why and he was amazed that I hadn't heard what happened. By the time the South Tower collapsed, I had left work, gone home, got a uniform, and headed up to the VAC building just to see the horror on TV. I spent the day doing whatever my captain asked me to do as lieutenant and trying to calm down the 18 year old kids with no experience that wanted to go down there to help, not realizing what they would see. (I was 26 at the time and had seen plenty and I would have had no problem doing whatever duty I was called to do, but I knew it wouldn't be the glory job that the kids were looking for.) That night, I went to work for Sloper-Willen, my normal night shift on 83-89 in East Fishkill. I spent most of the night with the guys at IBM Emergency Control, watching television and more than anything else just not wanting to be alone. We got hourly updates on one of our coworkers who was a full-time firefighter for FDNY. I can remember all of the conflicting reports and finally the realization setting in that he was gone, despite the fact that it was some time later that he was officially declared presumed dead.

ATCff's post is correct; one of the three is required for high school football: (1) MD, (2) EMS, (3) ATC. Interestingly enough, NCAA football requires a "certified" ambulance to be available to the players in addition to whatever resources are required for the event itself. My service does standby for the Army football games and we are there for on-field coverage while the West Point EMS system takes care of the crowd. I'm sure we would be utilized in an emergency (best for the patient), but our primary coverage is on-field. I can't speak for the other sports, but NCAA Division 1 hockey has the same requirement. At my college, the local EMS squad provided coverage for the games. If a fan got injured, they would be attended to by on-scene personnel and the "duty" ambulance would respond to the arena to transport unless the patient was critical, then the game was held up and they did a switch (or at least that was the plan... it never happened while I was there). As far as high school sports are concerned, I've never heard of standby ambulances being requested for hockey in this area, only football. It's kind of odd actually, as hockey is every bit as dangerous as football. I guess that football is more "visible" to the community and you have the additional issue of crowds.

Well, until we can see inside a patient, it is very hard to determine whether a patient needs a trauma center or a local hospital. Although the latest studies out there tells us that mechanism is a relatively poor indicator (in motor vehicle crashes), we still have a trauma protocol that's based largely on mechanism. It's easy to tell the patient who might need a trauma center; it's not so easy to tell the patient who might not. I wonder how many of those 50% of patients released in 24 hours were under the influence of drugs or alcohol. For my money, if I have a patient in a significant crash who is altered, they are going to a trauma center whether they smell like a brewery of they have a needle sticking out of their arm. I suppose a lot of the released patients also come from areas not accessible to a trauma center who may have a local hospital with limited ability. I am lucky enough to work my full-time shifts in an area where I'm always within 30 minutes of either a level 1 or level 2 trauma center. Assuming the patient is not an extensive extrication, I'm going by ground unless they are either a specialty case (burns, pediatric) that would require a specific facility or if I'm near the level 2 and not the level 1 if they are severe enough to need airway control. However, there are areas in my relatively suburban region that don't have access to trauma centers or even an aggressive local hospital.

There is a whole different world of paperwork once you become an employer. Not to mention having to actually do the scheduling, etc. I think that writing a check to an outside agency to provide the EMT's and forgetting about it is a lot less headache. If someone calls in sick at 4 in the morning, it's MLSS's problem to get someone to cover the town, not TONVAC's. As far as the other person who mentioned the "first response" vehicle being in Poughkeepsie, that is the Captain's vehicle, not a first response flycar. The fact that it's in Poughkeepsie is an individual operational choice of the agency to let her take it to work. I would rather have the car with a Captain that I know responds to calls and does her job as captain than to use it as a flycar and allow 4 kids to drive it around to calls with a driver and an EMT and leave the ambulance sitting in quarters. I've seen the flycar/clown car problem with other EMS agencies and I'm personally not in favor of having them.

Best of luck to our brothers and sisters going down there to help and best of luck to the people of the Gulf area. I know it's tough to talk about, but I remember after Katrina people said it was a once in a lifetime storm. Well this is twice in three years. I think they're going to seriously have to reconsider whether a city that is largely below sea level on a good day is a good place to inhabit. We all know that weather patterns change and the earth's dimensions change over time and there is a pretty good possibility that this oceanfront property is going to be ocean property.

Well, if it came down to the law, I'm pretty sure the EMS agency could park its flycar where it darn well pleases during the course of an emergency operation. While the priest could complain, he probably wouldn't have a leg to stand on legally. However, as an EMS agency representative, I would rather come to an amicable resolution to whatever issue the priest has rather than causing a fight in the newspaper.

I hope you get some more information Izzy. This seems to be a situation that could be handled by a phone call or two between the two parties rather than a letter to the editor. I can't see any house of worship having an issue with a meet taking place or a flycar being parked in the lot; maybe the placement within the lot, dangerous driving by apparatus operators, EMS responders smoking in the lot or leaving a mess, or EMS responders making unnecassary noise during late hours, etc. etc. Those are issues that should be able to be handled by the agencies involved rather than making the lot unavailable. If the priest is just being difficult, then maybe it would be better to find an EMS worker who was a paritioner and have him talk to the church fellows.

I've got to agree with you here 100%. I can understand if you're on duty (in whatever service) and need to run into a store quickly and the parking lot is not easily accessible should a call happen, but for 30 minutes??? Even if you do take a little "extra liberty" with your parking, you shouldn't be doing it in a manner that obstructs traffic.

I've got to agree with the last poster. There is obviously an issue, probably the same types of issues we all run into on a daily basis with traffic accidents. The FD, PD, and EMS all have different priorities and each has a substantial reason that their priority should be the top priority. There has to be something that caused the RCSD Sergeant to all of a sudden change his stance and start shouting out orders (from the first hand accounts). His delivery was obviously flawed, but I think all parties involved need to sit down and discuss water operations so this doesn't happen again. Problems don't get solved on internet chat boards.

Exactly. I got a T-shirt from East Fishkill FD's Chili Cookoff last year and the logo said something like "Humanitarian Committee". But I also have countless T-shirts from other agencies and most are sold and available to the public (wetdowns, parades, etc.). As far as resolving a problem with the local PD thinking that it was an FD or VAC member that was causing problems, that can be easily resolved. The general public, not so much. What bothers me more is former members (one in particular who is a troublemaker) walking around town in my FD t-shirts and most people still associate him to us, even though we kicked him out. Then again, this kid also has a very official looking FDNY job shirt with his name inscribed on it. We had a standing rule in my old VAC ... if you were not an EMT, you were not allowed to wear attire with the VAC insignia in public unless you were on duty with the duty crew. The premise behind this was if a non-EMT was walking around Price Chopper in his NWVAC shirt and someone needed assistance, they would be placed in a bad position.

Doug, I remember sitting in that meeting or a similar meeting and realizing that there was more information about radio communications in my EMT book 15 years ago than the guys from MACOM and NYS could provide. The system was failed from the beginning and we know all about failed radio communications in Orange County. My chiefs have to have 3 radios in their vehicles to talk to the mutual aid departments to which we are first due, not to mention the fact that in most cases we have no direct communication to EMS. Then there's the whole county v. local base mess (sorry Doug, but it's a pet peeve of mine...some of the Base 5 dispatchers are great). Oh well, another blunder by the state. Back to the drawing board.

I think this falls along the lines of right church, wrong pew. While a chaplain may be able to address the spiritual and emotional needs of responders and at times the public, they should not be on the ambulance. I think it could cause a large deal of discomfort, especially if you come from a religiously diverse community. If there is one of this incidents like they described in the article, there is no reason a fire department chaplain cannot be called to the scene for emotional support for both responders and families, if they choose to utilize the resource.

I was yapping with another medic who worked Putnam back in the day and we were talking about this point this morning. I hope that the County can keep those core medics they've had there for so long because Putnam is not the easiest to navigate if you don't know your way. Getting from east to west in the county can take forever and it takes a lot of familiarity to get around anywhere. I used to like working Medic 2 on Sunday mornings because the PVFD would always be willing to send a member with me to direct me to the call; it was like having a GPS in the passenger seat.

You couldn't have said this better ALS. I was working that night and unfortunately I was moved to Orange Co. earlier in the night and wasn't paying attention to the UHF radio that intently. The helicopter may have been called for by the FD before the ambulance got there because as I understand it, there was some delay with the ambulance getting there as they originally went to 9D and Alpine Drive instead of Route 9 and Alpine Commons. I have also been told that despite the call being a pedestrian struck, there was some "extrication" from the vehicle to be performed. If you can get the helicopter there or close while you're doing extrication and rapid trauma assessment at the scene and the patient needs a Level 1, then it's the right call. Without all of the information, nobody can Monday morning a medic deciding to send a patient to a Level 1 over a Level 2.

Well I get the feeling that Mike wasn't getting the support from the south end of Regional that he needed to grow the operation in Orange County. I'm not privy to any of the information about Luke's and Cornwall (and if I was, I obviously couldn't write it here), but as far as the ALS mutual aid contracts were concerned, they are selling their municipalities short and I don't think that was Mike's doing at all, but the unwillingness of the powers-that-be down south to give him the needed resources. As far as New Windsor and Cornwall are concerned, you are correct, NWVAC is soon going to be a full ALS provider. I don't know what's going to happen to Cornwall, because I would think that NWVAC couldn't legally provide ALS to them and I can't imagine Regional would keep a presence here for that small call volume, but who am I to guess. I live in New Windsor and personally I'm happy to know that I'll have a full-time provider for my town. I wish the employees at HVP the best, because although they are the competition, they all have mouths to feed and rent to pay and we are all brothers and sisters in different uniforms.

Regional comfy? Apparently you haven't been in Orange County lately.

I actually see their point here and I don't have a problem with it, at least for firefighting. Volunteering in another jurisdiction is effectively helping to keep union firefighters out of that jurisdiction. However, I don't see why it would matter for police officers. Most police officers are union and I don't see the conflict. EMS is a middle ground, because there are many IAFF shops that want to keep or bring the EMS work into their shop.

Trancare got the Putnam contract. I guess this will spell the end for Empire/HVP. They have nothing left in Dutchess and Ulster is hanging by a thread.