NWFDMedic

Simple question... do these firefighters working up as officers get out of title compensation for the day?

It's a simple concept. The fire company owns the building and the fire district pays rent for the portions of the building operated by the district. It works pretty well as long as both parties are responsible to the community but it COULD leave the door open for corruption. For a volunteer department, the disadvantage of having the district own the building is that you could have 5 non-members controlling what you can and cannot do in your firehouse (limiting access at night, banning alcohol on premises, etc.). The major advantage to the district owning the building is that the membership would not be stuck making major repairs. Up until this year in New Windsor we had owned our firehouse, but we voted to turn it over to the district for a number of reasons (basically to facilitate building our new station). We never charged a rate to the commissioners that was out of line; if you looked at our budgets the amount of money spent on the building was actually more than we received in rent (as it should be, because the commissioners only rent a certain percentage of the building). A few things have changed since the district has taken the building over, but both parties are being cooperative.

Exactly what a lawyer would tell you. Maybe I should move to Maine. Of course, the bottom line in all of these situations is that you need to work together to get the job done.

I know of quite a few places that have these firefighters in sheep's clothing. I am not a career firefighter, but I still think this is the wrong path for any volunteer department to tread down. Not only is it circumventing the real problem, it's actually creating more problems for the District, the Department, and actually the "janitor" as well. Being relatively familiar with Civil Service laws, if this "janitor" is a full-time employee, shouldn't they require a CS test as a janitor? Now, if the "firefighter" you want to hire doesn't end up in the top 3, you'll be in quite a pickle. If your department needs assistance of paid firefighters, then get paid firefighters. Shell out the extra money to get the proper training for them and don't sell short the "janitor", the department, the district, and worst of all the resident.

When he explained to me the system that you guys operate in where there's going to be a medic and/or a cop on the scene as well, that's a bit different. Honestly, I couldn't imagine the lawsuit if something happened if an EMT and Joe Driver took the ambulance with no other qualification if there was an accident or a patient got dropped. Given the system with other responders available to assist, utilizing any FD driver makes a bit more sense. It would be nice to cross-train the drivers though... my former volunteer ambulance service actually solicited one of the FD's in their coverage area for drivers willing to help. They did training at the fire house and set up procedures for utilizing the FD driver if they were available. And alsff, I don't take anything personally, unless you're after my parents or grandparents.

That form nobody carries is actually part of every patient information/billing packet at my agency but that's beside the point. Maybe you are correct in your opinion but I can tell you for a fact that my former fire department addressed this identical situation with their lawyer. The conclusion that they came to after reading state regulations was that our medics, even in a non-EMS providing agency, had a duty to make sure the patient was receiving appropriate care and it was not appropriate to turn an ALS level patient over to a BLS agency. Of course my department interpreted what the lawyer was saying as "We're not sending our guys on that ambulance unless the EMT's are completely clueless and will kill the patient." P.S. This very legal opinion led that FD to stop responding to all EMS assist calls because they didn't want to incur the liability.

Actually, we all understand the scope of practice is based upon the agency. You obviously can't perform renegade ALS skills in New York State. However, you still have a higher level of training in the eyes of the state. You don't magically forget everything you learned about patient care when you ride for a lower level agency. It is your responsibility to make sure that patient receives the proper management and even at the BLS level, your patient management skills trump the provider from the BLS agency.

Actually, an appropriately trained doctor has every right to direct patient care at the scene if the medical control doctor you consult approves his assuming patient care. That doctor is then REQUIRED to accompany the patient to the hospital. Usually when you tell a doctor about this little protocol, they walk away and say good luck. If you are a paramedic on scene and you turn a critical patient over to a BLS agency for transport, you better hope your insurance is up to date.

This is quite a shortsighted point of view. It's not as easy as just driving the damn ambulance. The driver of the ambulance with an EMT attendant must be able to operate a stretcher, stair chair, reeves, etc. and at least know where the equipment is in the ambulance. They should also have at least some sort of familiarity with the apparatus. I don't know the situation with the departments you are discussing, but with a 2 person crew, you just can't take any emergency driver and throw them on the bus.

That's a completely different situation. You didn't abandon the patient, you rode the patient to the hospital. If you are the highest trained responder on the scene, regardles of your affiliation you DO bear some responsibility for the patient, regardless of the equipment in your bag or the level of the agency you respond with.

If you have FF/Medics turning ALS patients over to BLS ambulances in your county, your system is severly flawed.

Situation #2 is interesting because you should not be turning over a patient requiring a higher level of care to someone of a lower level of care, even if you don't have the equipment. Even if you are operating as a CFR, you are a still a paramedic in New York State and I imagine some abandonment issues come into play here. If that BLS provider did something even at the BLS level that was harmful to the patient that an ALS provider would have known better to do, you would be liable for that harmful care (ie. giving a treatment to a CHF patient).

Hey Bart, now there's a name I haven't seen in a long time... but for some reason I still remember your medic number. I don't know the exact numbers, but Mobile Life did somewhere around 52,000 calls. I feel like I did that many last night alone.

The Putnam County system hasn't worked since I worked down there in 2001 and probably long before that. The same problems we're all used to hearing about in the volunteer service have made the problems even worse. The county itself is set up poorly for a countywide system and in a lot of places politics makes it worse because the county line might as well be the Great Wall of China. The addition of the daytime ambulance from the ALS provider I'm sure has helped, but it's kind of like putting lipstick on a pig ... you still have a pig. (Not bashing the provider with this comment, any provider in the PC system would be poised to fail). What PC needs is to have the important people realize that this is a problem. If you can't make the politicians on the county level realize the problem, get on your town officials and inform the residents. There are plenty of people who have ideas and maybe some brainstorming can result in a better system. However, as long as they try to hang onto this system, the problems will continue to grow.

Hi Mike. I think the answer to your first question is that the answer lies in knowing your response area. If you are in a city environment with short response times, I wouldn't even turn on the lights and siren. If you're responding from further away, I'd cut the response sometime around 5 minutes from the scene. You should consider traveling well-traveled and well-lit roads if possible. You should avoid areas likely to be involved (ie. a bar with a "reputation" that is 5-6 blocks from the scene). Along with this, you should consider the possible means of egress for a perpetrator. I went to a shooting yesterday morning and pretty much all of these things came to mind in my response. All of these things come down to being vigilent in learning your response areas. Apparatus and manpower placement is a whole different situation. No offense to any police officers on this forum, but a dispatch notification that the "scene is secure" only changes the situation from hot to warm in my book. As an EMS provider or firefighter, your job is to cover your rear end and your crew's, don't take anyone's word for it. I can remember a shooting several years ago where we responded with 2 ambulances and specifically placed one away from the hostile crowd and faced it out in case it became an evacuation situation. We left that ambulance in a close but safe area with a driver ready to go.