v85

What can the EMS M.D. do intervention wise? Pain Management, Field Amputation, Surgical Procedures (chest tube, cricothorotomy)?

I think my main point was that you get prepared for handling the "big stuff" by doing the "small stuff". I remember in the topic on the school shooting response someone said that "you will get a lot of help, if it is qualified help it's a different story". If your not prepared to handle small things, what makes you think you can handle big things.

This was just a question that I have been wondering about for some time now. It seems that after 9/11 everyone is focusing on preparing for "the big one", as well they should but it just seems backwards to me when: An ambulance corps has enough MCI equipment to treat 100+ patients, but can't get out the door for an elderly fall victim A fire department has all of the latest and greatest HAZMAT and WMD gear, but needs to call massive amounts of mutual aid for a room and contents fire A police department has plenty of tactical and active shooter training, but needs to call the state police or sheriff's office to handle a past burg or larceny

The people in the article, and one of the local civil rights lawyers who appears to have posted a comment say that the police need to be trained to de-escalate situations like this. Can anyone please tell me how to de-escalate a man wanted for homicide who is charging at you with a knife? There is a time for "verbal judo" and "crisis intervention" and there is a time to take action. This was definately a time for the latter.

I wonder how many injuries those airbags will actually prevent? Yes it will prevent the person from hitting the windshield, but they would still suffer the trauma of the initial impact with the car. 2,000 pounds of metal hitting your legs at 50 miles an hour is going to hurt.

I wish more agencies, especially PDs in Orange County would use MDT's connected to dispatch. This way the radio is saved for true emergencies, not "Call Mrs. Smith at 845-555-1212 in reference to where she can get the best seat at the fireworks show"

You forgot the family and friends hiring some "reverends" to act as their spokespeople and hold "peace marches"

I don't recall ever seeing a state policy on anything like that, other than the fact that you need a driver and EMT on every call, and that there is an obscure section in the Arts and Cultural Affairs law that allows anyone 15+ to "work" on a volunteer ambulance. Don't ask why it is in Arts and Cultural Affairs, probably says something about the level of competence in the statehouse. http://public.leginfo.state.ny.us/LAWSSEAF.cgi?QUERYTYPE=LAWS+&QUERYDATA=$$ACA35.07$$@TXACA035.07+&LIST=LAW+&BROWSER=EXPLORER+&TOKEN=23844272+&TARGET=VIEW I would imagine though that departments have there own policies

These are the new protocols for external bleeding. From what I am hearing, they are finding out from the military hospitals that use of a tourniquet does not equal automatic loss of that limb, hence the reason why it is back in the protocol. While the idea that I mentioned might be "extreme", something does need to be done, or else an EMS and LE agency may find themselves on the witness stand trying to explain to 12 citizens who know nothing about emergency services why "nothing was done" while children bled out. II. Control bleeding by: A. Immediately applying pressure directly on the wound with a sterile dressing. NOTE: If available and bleeding is severe, a hemostatic gauze dressing should be applied directly to the bleeding site simultaneously with direct pressure. B. If bleeding soaks through the dressing , apply additional dressings while continuing direct pressure. Do not remove dressings from the injured site! C. Cover the dressed site with a pressure bandage. III. If severe bleeding persists from a limb, apply a tourniquet just proximal to the bleeding site. If severe bleeding still persists, a second tourniquet may be applied proximal to the first tourniquet. Record time tourniquet was secured and document near the tourniquet site. IV. If severe bleeding persists from the trunk, neck, head or other location where a tourniquet cannot be used hemostatic gauze dressings should be used.

I know this would probably be impossible in NYS because of liability, but I know that tourniquets and quick-clot type bandages are in the BLS protocol, so even if police just carried them to throw to a downed student or staff member the encounter while clearing the building. It's not much, but at least it would be SOMETHING to buy time until the scene can be properly secured for EMS to come in.

Not to take this thread too far off topic, but what happened the idea of tactical medics? I remember reading a couple of years ago that more places were implementing them and they had a wide variety of "styles" from police officers were only there to treat other police officers to EMS personnel who were sworn in as special police officers and given firearms training who would attend every SWAT callout and treat everyone. Did this idea die out with the budget cuts of recently? Is it feasable to implement something like that here?

I would consider anyone catatonic or in a stupor to be exhibiting physical symptoms(ie... issues like hyperventilation) and would be treated and transported as such. I was referring to people who were not exhibiting any symptoms like that.

In the Ohio incident, one news agency reported that the lockdown was lifted within 35 minutes of the initial report(s). But yes, there does need to be something done about the wait time for PD to secure a scene, and not just at active shooter incidents either. But also, like ny10570 mentioned, a school shooting is generally not like HAZ-MAT/WMD incidents where you are going to have 100+ persons to be deconned, monitored and possibly transported. You generally are going to have a smaller number of victims with physical injuries, of course when you have agencies that can't even handle one call at a time, that doesn't mean anything. In Orange County at least, BOCES and the school districts have put together a CISD team made up of guidance counselors, social workers and psychologists, so I imagine they will be handiling those in emotional shock, unless they were also displaying issues like hyperventilation.

Yes, a sector car is a car that is out on patrol, and the unit type that "Central" assigns the vast majority of jobs (calls) to. If another unit, like a foot post, is closer they will come over the radio and say that they will be handling the job, but the initial dispatch 99% of the time goes to the sectors. Also, be aware that not every marked RMP (police car) that you see is a sector car, even if it is from the local precinct. Other specialized units and even some supervisors use marked cars. For example there are patrol sergeants, patrol lieutenants, domestic violence officers, auxiliary coordinators, community affairs officers, summons cars and probably a whole bunch more that use marked RMPs, but are not considered sectors.

And what appears to be quite an empty hosebed in the back. Hard to put out a fire with NO HOSE.

I'm not sure where the failure was, with the dispatcher or protocols, but obviously something went wrong. I can tell from the first line of the transcript. I have never heard of a 911 line being answered "Good Morning" anywhere.

As far as I know, the website is still www.hvmedics.com Haven't seen anything with the Care 1 name yet.

What website are you looking at, and what then is the Medstat/ Ahava connection

Well SeniorCare does have one or two 911 buses, I believe in Queens, but I thought they were doen under the SeniorCare name.

I couldn't find one. MedStat/RevivalCare/Ahava don't have a website, and SeinorCare's website doesn't mention anything about them. The only thing I can think is maybe RevivalCare is such a small agency they contract with SeniorCare to provide dispatching.

This is what I found on the NYC REMSCO website nycremsco.org: Copy of the Medstat Ambulance dba Revival Care ambulance certicate was received. ID # 0949, expires 11/30/2012, territory: Brooklyn & Manhattan South of 59th Street. Further searching show that Medstat is part of Ahava home care http://npidb.org/organizations/transportation_services/ambulance_341600000x/1023313186.aspx

Anyone who thinks that there is no problem with this department operating needs only to look at the photo page on here. Their "fire engine" is older than I am, and carries NO HOSE other than a booster reel. Would you want that showing up on your scene? I think NYPD Highway would have a field day with those rigs.

Date: 1/23/2012 Time: Appx. 1600 Location: 348 Old Dutch Hollow Road Frequency: 154.205; 46.16; Greenwood Lake FD Units Operating: Greenwood Lake FD (Full Department except Rescue), Warwick FD (1 Engine to GWL firehouse, FAST standby in Quarters), 36-16 Weather Conditions: Warmer, cloudy Description Of Incident: Reported oven fire. Reporters: INIT915 Writer: v85

Date: 1/24/2011 Time: 0749 Location: 934 Red Apple (Woodbury Commons) Nieman Marcus Store Frequency: 154.205, 46.16, Woodbury FD Units Operating: Woodbury FD Weather Conditions: Description Of Incident: Confirmed Structure Fire at Nieman Marcus store in Woodbury Commons Reporters: Writer: 0749 - Woodbury FD Dispatched for Structure Fire 0752 - Resound for all available manpower, confirmed structure fire

Cornwall EMS has been released and returning to quarters