comical115

What's the rationale for unique ID numbers for each individual PO? Accountability? Any integration with EMS more then messaging between dispatchers?

Not to mention employees who negligent in providing proper patient care, and down right abusive to patients. The union serves its purpose, but it is far from perfect. It's just like physicians at private clinics that call for chest pains but miss the obvious lower respiratory infection or the DKA. For each case they "dump" on EMS, they evaluate and treat 20 other people that without the clinic, would have just called 911.

It hides the fact that you don't have proper staffing to get an engine out the door in the first place...

I can assure that on my rig, quality patient care is paramount. I offer the services of my hospital but always with the disclaimer that they are my employeer. I always try and do what is best for my patient. The attitude that voluntary units are only interested in insurance information and brining "home" paying patients is a slap in the face of hard working medics and EMT's who are doing their job. It has always driven a wedge between services in the NYC EMS community, and we wonder why they don't take us seriously.

A simple question to continue a conversation we keep having. Can volunteer based EMS provide the *required* level of service to a community? No, but if REMSCO feels an agency is not taking a mandate seriously through QA/QI then they can turn to NYS DOH. I believe it's Article 30 that requires every EMS agency to provide information QA/QI information to the regional organization (REMSCO). On a side note, I was browsing the Westchester County REMSCO website and I stumbled across a study from 2008 that evaluated the Westchester County EMS system. Quote: "The system is designed based on home rule where every community operates its own service in its own way. This is inefficient and results in available resources functioning independently and without the ability to benefit from surrounding resources. The system struggles to reliably reach the first call and additional simultaneous calls suffer from extended response delays." (Page 69, Finch & Associates LLC Study on Westchester County EMS system). Westchester County EMS Study from 2008

I don't think its a union issue. No one is concerned about losing their jobs to the volunteers. I know voluntary hospitals would love to staff more units (both BLS and ALS), the fire department won't allow it (...another discussion). I don't think ny10570 was talking about harassment from the bosses being an issue. The powers at be tend to rate a boss's productivity based on the 89 checks, vehicle inspections, if they can get the units in their area back in service from the ER in an "acceptable" amount of time, etc. By adding more units you are adding more overhead to a Lt's shift and potentially decreasing their availability for on scene functions (Cardiac arrests, RMA AMA, MCI's, etc.). It's a good point. So the question is, ny10570 when are you moving up?

It'd be nice to know which jobs were being handled already, avoid duplicates and increase efficiency within the system. It's always nice to dream, right?

Municipal Units = FDNY EMS. Voluntary Units = Hospital based units that are dispatched and treated like a municipal unit. The hospital based units now run an even amount of BLS and ALS units. On the ALS side of things the municipal units and the voluntary units carry slightly different medications (controlled substances, cyanide/smoke inhalation antidote kits) and other tools (CPAP). Being a paid provider in the NYC system, I have never had a bad experience with a volunteer unit. I have a lof of experience with Central Park Medical Unit, 90% of the time they are on the scene first and they always provide high quality patient care. Its too bad the powers at be don't see the resource that they have at their disposal.

It's my understanding that the individual VAC's and FD's determine what EMD Code results in an ALS response. So the idea that properly EMD'ing all EMS calls in the county will result in freeing up medics is slightly erroneous due to the fact that a 40 year old male with abdominal pain will still result in an ALS assignment.

Isn't that similar to what FDNY EMS is testing in Statten Island?

I can finish a paper ACR/PCR in the time it takes to watch the video, and if I lose the paperwork or my pen, I'm only out 75 cents... I'm narrative heavy on all my documentation so all of those neat little features about assessment and treatment do nothing but waste time. Its the wave of the future, resistance is futile.

About time... They are great boxes but I can't begin to describe how frustrating those generator systems can be...

Heaven forbid we learn from our mistakes...

If you are running BLS and you don't have pulse oximetry, how can you titrate to effect? If you deviate from your local protocols, *no matter how backwards and/or improper you feel they are*, make sure you have a reason and document properly.

Banksville FD gets dispatched by Greenwich via 60 Control. So yes. There is a link. I think there are some strong merits for a county run EMS system. For instance a county run EMS agency could interface and allow for volunteers to maintain their presence in their communities, but also allow their citizens a guaranteed response if they call for help. I know if the agency I'm involved with calls for mutual aid, we are relying on other volunteer services. You have better odds in Vegas some days...

Why not give PD another avenue for criticism from the non under-educated public? Let PD do their job so the scene is safe when the medics get there and let them deal with the medicine. As for BLS, I still don't know why NYS hasn't given the combitube / king to BLS minus the EtCO2 requirement. Its a great tool in the hands of a properly trained provider, and in my opinion more benefit then naloxone in this situation (but that's another discussion / thread...). Bump to BLS getting out the door in a timely fashion. Should It is a higher priority then IN naloxone.

Forget LENS, you just have to pick up the daily news. http://www.nydailynews.com/news/ny_crime/2009/03/13/2009-03-13_emt_charged_with_abandoning_child_at_bro.html

http://www.youtube.com/watch?v=zwwBeY-ABb4

This is a fairly specific situation, but every time I've been in a class A burn, the instructors have made a point to show us what a downed brother or sister looks like in the fire room on a thermal imaging camera. The SCBA bottle is what I've been taught to look for, it will stick out right away. I'm just curious as to how this new SCBA would look under similar situations. Because there are multiple smaller cylinders within a protective covering would it even show up?

I agree with you that a quint will not help staffing issues, but most communities in Northern Westchester apparatus placement is an issue. Some of these driveways are longer then the street I live on, when the first due is an engine and a tanker, there isn't much room for a stick or bucket to get to work. The OIC has to have a really good idea of what he or she has enroute and where they need to be in order for it to work... I can see why some departments feel the quint is a good option for them.

He could've thumped himself. I'm good friends with the owner of the laundromat where he was last seen and the surveillance video shows him hunched over as if he was in pain before he even made the 911 call. Who knows.