NWFDMedic

Mobile Life has had a bike unit for quite some time and we are starting to use it more. The units are an invaluable resource in large gatherings.

It is not out of the ordinary for commercial services to get called for organ transportation. I once had to transport a heart down to WCMC... kind of an eerie feeling if you ask me.

I often hear the argument made that "we keep our apparatus longer than someone else". Coming from a department that owns a 1989 engine that isn't going to (or need to) be replaced anytime soon, I can certainly understand the benefit of an apparatus that is durable enough to stand the test of time. However, what is the "real" cost? Assume that your requested $688,000 engine lasts 25 years and a $450,000 engine will last your department 15 years. That makes the average "yearly" cost of the more expensive engine approximately $27,500 and the less expensive engine approximately $30,000. When you take into further consideration the increased maintenance costs and OOS days for the engine when it is 15-25 years old versus, the more expensive engine in the long run may just be that, more expensive.

As an EMS supervisor, if an ER nurse got a substantiated complaint like this from a patient's family (especially a doctor), I'd expect them to be making a phone call to me. There's NO excuse for a medic to be trying to convince an elderly patient or their family that they don't need to go to the hospital. Furthermore, there's no excuse for that same patient, given the vital signs that you noted not to be an ALS patient. In the words of the State, it is the responsibility of all EMS providers to suggest that a patient goes to the hospital for evaluation. I know there are situations that clearly don't warrant it but I've never found occasion to tell a patient that they don't need to go to the hospital. The closest I came to it was probably a patient who called because their home BiPap machine was set incorrectly when delivered that day and she was having trouble breathing in bed because of it. We fixed the problem and she immediately felt better. My response to her was "would you like to go to the ER to be evaluated?" not "now you're fixed, you don't need to go". As expected, she said no, so I then informed her that a period of time without the proper oxygen may cause problems that should be evaluated. Again, as expected, she said she was fine and didn't want to go. She was then advised of things to watch for and to call back at any time if needed. I knew this patient needed a hospital no more than I did but it's my responsibility to do what's best for the patient, not to mention what the state REQUIRES. Stories like yours are precisely the reason why we don't have paramedic initiated RMA's in New York. It's a shame that we don't because sometimes I feel we are doing a disservice to the patient and the ER by transporting them for no reason but when you hear of medics who can't discern what a good reason is, I can see why the folks at SEMAC wouldn't want to even consider the paramedic initiated RMA.

The same people that question the manner in which security is provided at these events are the first in line to criticize the police when and incident happens. There have been 2 domestic terrorism incidents in the last week, one involving a sporting event. Personally, I say, if you want to act like a criminal, be prepared to get treated like one.

No gloves Dan, I think it's a great service to have. The timing is a bit odd though while everyone is being asked to tighten their belts.

With the resources available from the SP both from Newburgh and from LI and "mutual aid" from NYC, it seems like quite a duplication of services during these difficult economic times.

It's hard to believe this historic hospital is closing. I can remember back in the day when we would take a ton of patients down there from the Hudson Valley. Parking was horrible but the awesome food across the street made up for it. They used to be on par or better than Columbia Presbyterian and not too long ago either. The role St. Vinny's played on 9/11 is very well documented as well. Does anyone know what it will mean for the other St. Vinny's facilities? We bring a lot of behavioral admissions down to their facility in Harrison. Best of luck to those affected.

Actually 79 designates an ALS ambulance, not necessarily from a commercial agency. It just happens that all the 79's are via commercial agency contracts at this time. If BVAC, for example, wanted to staff a medic ambulance rather than a flycar and a BLS ambulance, it would be called 82-79.

Some people don't understand what upstate is. As a Clarkson graduate, I'm well aware of where upstate is. Have fun up there in the North Country.

Yes, MLSS still covers East Fishkill for ALS. We're going to maintain our current station on South Avenue and we'll have a bigger station more on the east side of the city.

The I-84 operations were basically on the Stormville Mountain. The rest of the highway that was "closed" was actually quite driveable. I would imagine Greenville Mountain was the same on their end.

While obstructing governmental authority is clearly an arrestable offense, wouldn't one think that this can be handled better? I think the officer would have been better served to contact his boss and let them work it out with the BC's boss. The only cost here is a bit of traffic flow. The Thruway troopers here in NY are also very concerned about closing the road during incidents and keeping traffic moving is a big part of their priority at an incident. It has often caused issues on the scenes of calls but very rarely gets resolved. Most agencies go back to their departments and then complain about the cop, fire chief, or EMS crews that did something stupid in their eyes. We spend a lot of time critiquing our own activities within service, but as far as critiquing incidents with multiple agencies involved, it too often doesn't happen and results in complaining around the crew room table.

There are some municipalities that have a policy in place that alcohol will not be paid for through public funds. If this was the case in Buffalo, then the Union should have known that the bill would not have been paid. I tend to think, however, that a city the size of Buffalo probably doesn't have such a clause because their officials like to have their expense accounts when they travel on "conferences". The fire district that I volunteer for has a strict "no alcohol with public funds" policy. I don't see that as a bad thing and the district has provided funding for our installation dinner (legally) but the company provides for the cost of the bar. I know a lot of smaller districts do this as well. If there was a policy in place, shame on the Union for expecting payment. If there was no such policy, shame on the City for choosing this event to make a political splash.

I'm not getting baited into the consolidation argument but I think the idea of looking into a used rig would be a great one if the taxpayers don't approve a new one. Replacing 2 engines in this small district in a short period of time could certainly be a stress to the taxpayers but a 20 year old rig may also not do the job. If they get a used rig and keep it for maybe 10 years, they could get on a replacement schedule of 1 rig every 10 years rather than 2 in a 2 year period.

When my department goes on a parade, we put a company, usually from out of county, on standby in our quarters and we usually return the favor when they parade. When we go to a parade and (neighboring) Vails Gate goes too, we often put a company on standby in each place and they both respond to alarms in both districts. We also can utilize the assistance of City of Newburgh FD although we try to limit that to confirmed incidents because we know they have a high volume and limited manpower. As far as the fiscal concerns, we've definitely cut the number of parades we attend, basically to the town Memorial Day, the County Assoc., and the HVVFA. If we take another parade, it will usually be a VERY local department's major anniversary parade. The cost of a parade is downright ridiculous these days.

What law actually changed here? I understand that WPH is going to be able to do angioplasties but the past procedure was that you had to do a certain number of diagnostic caths meeting certain benchmarks before you moved to the next level. Here in Orange County we've been watching St. Luke's-Newburgh and ORMC-Horton doing this for quite some time with a good degree of success. The concept behind the step-by-step approval was that you have to learn to walk before you learn to run.

I was in Bristol for the weekend and driving home when I heard/felt the explosion from the area of CT-8 and I-84. I had no idea what it was and didn't really pay it any mind. The one down side of satellite radio is you don't know what's going on around you. Good luck to all those operating up there.

I don't know the first thing about the PV fire station as I haven't been inside it in nearly 10 years but what has the world come to when politicians (or potential politicians) have to resort to personal attacks on blogs instead of discussing facts.

Congratulations to BVAC. I was transporting a patient to Vassar yesterday morning when I heard 82-89 call in service.

We got them at Mobile Life about 3 months ago and after the initial glitches (mostly connection and learning curve issues), the majority of staff seem to have adapted. Personally, I absolutely love them. My paperwork gets done quicker, I think it's more complete, and I don't end up with cramping hands after writing a couple of calls like I did when using paper and pen. The one down-side ... when the crew you relieve doesn't plug the Toughbook in all day and you do a call right out of the door. I had a critical patient where the staff wanted paperwork before she went to the cath lab and I had to keep running back and forth to the charger in the ambulance because the computer kept going into hibernate due to a low battery. Pens and paper don't require batteries.

The board that tells us where to go is great. They use it most of the time at night and it prevents crews from piling up in front of the core with patients (coincidentally the most "in the way" place you can be in the Vassar ED). As far as the computers that they use for triage, they take a bit of getting used to both on the part of the nurses and EMS but they will, if used correctly, lead to more precise patient care. It might take you another minute to give your report, but it's well worth it.

Maybe Cablevision is just trying to get better ratings for the Knicks games by eliminating other channels. It won't help; the Knicks stink.

We recently installed inmotion wireless into all 45 of our ambulances basically making each ambulance a WiFi hotspot on wheels. I have no idea how much the system costs but with additional software it will also allow you to maintain vehicle locators and also vehicle performance information when hooked to the vehicle's computer. When fully functional, the system is going to provide some great information to our communications center. There are a few things to be cognizant of, however. First and foremost is security versus access. Beyond that, read the fine print when you order a system and match it with your needs. Although the inmotion system advertises 100 MBps internet service, the truth is that 100MBps is only a reality while the vehicle is standing still. While moving, your internet service is 10MBps at best and sometimes less. If you are trying to download database information while the vehicle is moving, that may not be the most reliable access. You should also consider the terrain that may limit your access. We have a few emergency rooms where the entrance is up against a several story building or under a canopy and the service is limited in those areas. We can usually resolve that by moving out of the ER bay after discharging our patient but if you're regularly parking your rescue in a city environment, that may be an issue. Overall, once the bugs worked themselves out, the wireless access has been great via the inmotion system.

At the moment, you cannot do it. The theory behind passport is that you need to be authenticated to be on "the system". Therefore, a scanner that doesn't provide the proper handshake to the receiving tower wouldn't be allowed to authenticate. As sad as it may sound, it's really annoying not to be able to hear what's going on at work from home sometimes.