EMT-7035

We just took delivery of 4 LifePak 15s for our fleet about 2 months ago which replaced our LifePak 12s. We didn't demo Phillips at all, but we had the Zoll X and the LifePak 15 for about a month, while taking a poll from the agency, the BLS providers were split between the Zoll and LifePak, but every single ALS provider we have voted for the LifePak. For BLS, the cuff does seem to have some nice features, and as several others have pointed out it's much, much lighter and more compact. It seemed to be more intuitive to use, but some felt it seemed like a toy. One of the biggest complaints from the medics were that the printer is in the back, and analyzing anything or even printing strips to show the ER became a challenge, especially if the monitor is on the back of the stretcher or on a self in the rig. We use ImageTrend for our PCR service, and both worked well with the system so that didn't really affect anything for us. We put the quotes against each other and got both vendors down considerably, and by the end, they were within a thousand dollars of each other (for the 4 monitor quote) so price wasn't a big factor for us in the decision. However, a potentially big contributing factor is that the majority of our medics are employed or volunteer elsewhere in the almost exclusively LifePak filled region. Most other agencies still have LifePak 12s, something I'm sure is soon to change, but people certainly are used to the Physio layout.

Going along with that, the #1 cause of line of duty deaths is not necessarily from traumas/burns, but due to the health issues (mostly cardiac related) that seem to statistically go along with the job, as has been beaten into our heads in any fire class. I'd be curious to see what the leading causes of deaths are in other "dangerous" occupations.

My assumption would be that this would have to be a statewide change since I believe the DOT needs to permit vehicles (or departments) to operate with red lights and sirens as emergency vehicles. But assuming that hurtle is overcome (or I'm wrong about the process) then how would this occur logistically? Would they be in the run cards for any wires down, gas leak... or just be available by request of command as they are now?

I'm currently butting heads with some people at my agency who believe that crew sizes don't matter, and if the crew chief (EMT in charge) is okay with running a 5 person BLS crew, then so be it. Aside from the public image, patient intimidation and the practical amount of size in the back of the ambulance, patient's house or hospital, are there any state regulations that dictate this? I remember reading somewhere that only 4 providers were allowed in the back of the ambulance, but I can't find it to source. Personally, I prefer a driver, a crew chief, and maybe an aide/attendant/third, when it comes to BLS crews, but my position is challenged by the idea that we need to train people and introduce new members to EMS. I've seen (BLS) crews show up with 5 people, then a medic and ALS trainee jumps on and no one gets off, because they're all "learning" from the call. Please note that I'm not trying to single out a specific agency, but wanted to get people's thoughts on this.

I do agree with some of what you said, and I don't think I worded my post appropriately. However, while I do agree that everyone that is an interior firefighter should be trained to a standard (I know to what standard is being discussed on another thread), we don't want to "scare away" those who cannot or do not want to be interior qualified firefighters. In my department, the interior qualified firefighters are given priority on the trucks, but if you have 2 interior guys and 2 exterior, is that not better than having just the two interior, one of whom has to be the driver? If there needs to be another name for such support personnel (scene support, exterior firefighter are the levels we have), that's fine, but I don't think we can expect every volunteer to be interior qualified. Also, like someone mentioned, what about those who are still learning? I'm still new myself, and watching scenes can teach me more about the job than sitting in a classroom. Would there be a requirement, like 1 year to become interior?

While I do agree that every interior firefighter should be trained at least in the basics of FAST/RIT, and that everyone received some of this training in FF1 when we did victim rescues, I do not think that everyone needs to be interior to be considered a firefighter. There is definitely a place for those who do not want to, or cannot be interior firefighters for whatever reason, whether it's driving, setting up lines or putting up escape ladders to help those inside.

What happens in my district is that if PD has an available car, they will go to almost any EMS call, as they carry life support supplies including AEDs and Oxygen. They will never clear the patient by themselves, but are there to help EMS with lifting and such when we arrive. And the medics (I live in Northern Westchester so our ALS is provided by WEMS) are not dispatched to things such as lift assists (assuming the nature of call can be established). Also, I have never been on a scene where fire was called for anything other than a fire or major MVA.

No, I had just heard that they were decently powerful and you can get them for real cheap. And what do you mean they're a pain to park?

When I was working at a school district a few summers back, we accidentally set off the security alarm and they charged us ~$500 just to send a cruiser over and make sure everything was okay. Their (reasonable) justification was that we wasted resources and took a car off the road and it wasn't the first time it had happened.

I am currently considering buying a new car (I currently have a '99 Accord) and someone had suggested buying retired cop/ems cruisers as they are generally really cheap considering their age and mileage. I had always assumed that fleet vehicles tended to be more abused than a personal daily driver because there tends to be less of a sense of ownership and responsibility for each individual vehicle. Note that this is a POV, not a department vehicle. I'm sure it varies department to department and even vehicle to vehicle, but on a whole, is it worth buying one? Or am I setting myself up for a future of repairs? Also, what is a good place to buy them assuming I do decide to go this route?

My moot point reference was in regard to the idea that while we are allowed to speed to whatever degree we feel is safe, it doesn't protect the incident in question as he was not proceeding with due regard and he clearly presented a danger. I agree, but again this comes to the point of cautious discretion, not the law. But on the topic of safe conditions, though I do not have the numbers to back this up, I have heard in many trainings that most accidents occur on bright sunny days and other days that are deemed "not particularly hazardous" because there is a false sense of security. We (most) know that in general we must be more careful in snow, sleet, fog, rain and whatnot, but, we need to proceed carefully. In agreement with you, you're right, it's not just about the numbers, but that does seem to be what the media is hooked on.

Unless I am reading this wrong, according to www.health.ny.gov/nysdoh/ems/pdf/srgvat.pdf section 1104.c.3 states that "the driver of an emergency vehicle may ... exceed the maximum speed limit so long as he does not endanger life or property. So reading this, I do not think there is a legal maximum speed limit though all of my departments have SOPs that limit speeding to 10mph over (and some do not allow any exceeding at all). But that point is moot as he did not meed the condition of endangering life and property. Sorry JJB531, I didn't realize you had already posted.

It can be a professional courtesy like is occasionally extended to us as mentioned, by businesses and well as fellow MOS. However, while everyone appreciates these gestures, they are exactly that, just courteous gestures and should never be expected or implied. I'm sure most if not all of us have had times where being an MOS has helped with taxes, discounts or others, and more often than not, it was a surprise. But it's not why we do the job, nor should it be.

The actual station is about 3 minutes away, so that's assuming a 2-minute response from page time, no one can complain about that.

Routine drill? Really? What agency has enough money to set fire to a BMW?

I also started riding at a VAC at 17 and thus I was able to begin training as an EMT and tested about 2 weeks after I turned 18. We have a similar policy in that any crew chief or line officer can sideline a junior member for whatever reason. I personally was sidelined on an extrication just before I turned 18. As also mentioned, I had a lot of time to ride when I was still in High School after I had been cleared as a crew chief and I was able to ride a lot and cover a lot of shifts, and I must say, it has been making me wonder if I want to pursue a EMS Career (I am currently Computer Science) and I would not have had these thoughts if I hadn't been able to get fully involved as early as I did.

I think the point is here that just throwing supplies to untrained bystanders is not likely to solve any issues that wouldn't have been taken care of anyway. What I mean by that is, as mentioned previously, anyone with the training to determine that a tourniquet is needed would likely have made a makeshift one, or would identify themselves as being "trained". And this relates to the idea of applying pressure, anyone who has the training for a tourniquet would (hopefully) already have attempted applying pressure and other attempts. And in terms of the use in the OR, again it comes down to training, we can (hopefully) assume that they are being applied as a last resort and that they are not going to be removed without necessary precautions. Who's to say that a bystander wouldn't take it off once they think the bleeding has stopped or be stupid enough to try to use in on their neck? And in terms of the CPR example, I would agree that while they are dead, and dead is dead, as you mentioned, it can reduce the low statistical chance, generally considered more harm than good.

Mount Kisco VAC traditionally rides with 1 (or none) juniors, but as for a limit, we've never come across the situation. Shifts were always scheduled in advance so there were no overlapping, I'm not sure if this was done out of protocol or just the desire to teach one member at a time.

Aside from the liability of it, as it is now, tourniquets are a last resort and great care must be taken when deciding to apply one. If you were to as you say, "throw them to a downed student", several problems may arise. Even assuming they are able to determine how it works, if it's their only option, they may apply a tourniquet to a limb that would've survived even if it had to wait an hour for EMS and assuming that same hour wait time, that limb has little (if any) chance of being recovered. It's like the same idea as poorly performed CPR, it can do more harm that good unless properly trained.

I would assume that the training accounts for this concern no? I mean even for EMT-B with basic drugs we went through the indications and contraindications for each, and briefly touched on the physiology why... Am I wrong in assuming that this is also the case with AEMT-CC?

At this point, I am not planning on staying upstate after college, but I am currently a freshman and am looking at taking it next year. @GBFD111, Broome Community College offers a medic program and allows AEMT-CCs to jump in halfway through to get the full cert. In terms of getting AEMT-I (85 or 99) BCC also has an AEMT-I program, which I considered, but it is my understanding that they no longer offer it. And as for the jump from AEMT-I to Medic, I haven't seen anything, but that doesn't seem to be the route I would take anyway. I do have a biology requirement for my major (Computer Science) so maybe I'll try to take an A&P class and kill two birds with one stone.

I am a member of a volunteer ALS agency in Broome County that utilizes and trains AEMT-CCs. Is it worth getting this certification? The local community college offers a Critical Care to Paramedic program that I could do later on if I decided to do the full certification. It would be great to get it now that I am sponsored by an agency, and can get ALS experience before deciding how far I want to take it, but the certification is only recognized in several counties in New York. Note that this is not my home county, I am a BLS provider in Westchester and am up at SUNY Binghamton.

Mount Kisco VAC: 1276