FireMedic049

I would think that he who takes the patients to the hospital would be the "primary" EMS agency. If your agency and personnel don't actually transport the patients they encounter, then I think it's hard to argue that you aren't a "supporting" agency when it comes to the delivery of EMS. As it should be everywhere.

I'm no doctor, but this sounds very, very suspicious to me for multiple reasons: 1) I find the notion that a physician would direct a paramedic to medicate a patient to the point were they stop breathing highly suspect; 2) If the physician wanted the paramedic to take over breathing for the patient, then this could be accomplished by sedating the patient with Versed rather than having to stop their breathing altogether using Morphine; 3) If the goal was to stop the patient's breathing in order to take it over manually, then why give the morphine in 5mg/5 minute intervals? Why not just give it faster?; 4) I can't quite fathom the conversation between a paramedic and a physician regarding a patient with the symptoms described above and how it would end up with the physician deciding that the best course of treatment for painful breathing would be to stop the patient from breathing. I would be curious to know more details. As for your question.......would I do it? Hell NO!

Better at what?

I don't know if it's the case or not, but you seem to come across as someone who is not having success testing for a firefighter position and therefore is arguing that the system is flawed rather than accept the possibility that maybe you aren't as qualified as you think you are or that other candidates are simply more qualified.

There's a certain level of irony in advocating for a "more relaxing and better test experience" when discussing a test used to get hired into a high stress/high pressure job like police officer or firefighter.

Exactly what do you mean by "well rounded" and what sort of "important modern skills" are you talking about?

If I'm not mistaken, the difference between Seagrave's bid and KME's bid was in the $200,000-$300,000 range with Ferrara roughly in the middle.

I don't know off hand. I haven't had the opportunity to read the full standard yet. Regardless of what it says on that, requiring the ability to do so pretty much flies in the face of the safety push we're talking about and it isn't necessarily in the best interests of good patient care. Without some sort of revolutionary change in ambulance design, there's pretty much no practical way to securely transport 2 litter bound patients while affording EMS personnel the ability to care for them while seated and using seatbelts or other such device. From a patient care perspective and 20 years of experience, if one of the patients requires ALS care whether due to specific injury/illness necessitating intervention or due to treatment protocol, you need at least 2 providers in the back otherwise patient care for one or both suffers. Accounting for a 2nd provider to be seated and restrained further complicates the situation. With the exception of some volunteer based ambulance services, having more than 2 providers on an ambulance is not a common practice. So where does that 2nd provider in the back during transport come from? Another ambulance, the FD? If you're pulling from another ambulance, then why not just put the 2nd patient in that unit? Is pulling from the FD even a viable option - do they have a trained provider to spare? IMO, I don't think we are in need of some sort of radical change in ambulance design. The current basic ambulance design is working pretty good and just needs to evolve some. The industry and designs are already evolving and moving towards the "work station" type set up for interior design. The biggest thing that really needs addressed is keeping the provider seated and restrained as much as possible. Developing a crashworthy seating & restraint system that is able to move side to side, forward and back, and pivots in order for the provider to adjust their position relative to the patient and care being provided without having to unbuckle would go a long, long way to accomplishing that.

The discussion really isn't off course. Part of the original post asked about a "replacement" for the KKK specs in addition to discussing "better ambulance design". I pointed out that the NFPA had already developed an ambulance standard that is just being rolled out. The validity of the NFPA creating that standard was then called into question by you and that was addressed. I guess you didn't like the answer since you are asking that we get back on course with the thread. So, if you wish to discuss better ambulance design, then stop bashing the NFPA and the fire service's involvement in EMS and start talking about ambulance design.

I would tend to agree, but the reality is that this pretty much already exists with medical command, treatment protocols and state oversight agencies. However, the fact remains that the fire service is a major player in the world of EMS care and transport and therefore should have a seat at the table for any discussion regarding ambulance standards. Right, because for the most part the PD doesn't staff and operate fire engines, but firefighters do staff and operate ambulances every day.

The reality is that it makes sense for the NFPA to expand their apparatus standards to include ambulances when you consider just how many fire departments provide EMS transport services. We could debate the validity of the NFPA standards and their process, but I really have no interest in doing so as there wouldn't be much point to it. Regardless, if you don't want the NFPA in your ambulance, then don't let them into your ambulance. Unless codified by the local AHJ, the NFPA standards are not law and it is possible to get non-compliant apparatus from the manufacturers. You may have to sign a waiver of some sorts in order to do so, but you should be able to find somebody to build what you want. FDNY has been purchasing apparatus that is not fully NFPA compliant. One obvious sign of this is the fact that their apparatus continues to be delivered without the rear reflective chevrons specified in NFPA 1901.

Your kind of late to the game with this post. It's been known for months now that the KKK spec is soon to be extinct. It should be noted though that the KKK spec was created as an ambulance purchasing specification for the federal government, not as a manufacturing standard for the ambulance industry. As I understand it, basically if a manufacturer wanted to build ambulances for Uncle Sam, their unit had to meet the KKK spec in order to get the work. Over the years it was pretty much the manufacturing standard by default since nothing else existed. Many EMS agencies have been moving away from the traditional open end bench seat configuration for several years now. The NFPA has been working on an ambulance standard for the past few years (NFPA 1917). It either just went into effect this year or will be shortly. I recall reading a couple months ago that there's work being done from the EMS side of things on some sort of standard since the NFPA standards are viewed as "Fire" standards and not necessarily applicable for non-fire-based EMS agencies.

They operate as regular engine companies.

The fact is all times should be measured as they all have statistical significance in evaluating performance of the various components of the system.

Right, because the Republican Presidential options have been so much better in recent years and their prospective candidates for 2016 at this point look to be so appealing. While I'm willing to admit that he hasn't fully lived up to my expectations on a number of issues, the far greater "mistake" was electing the ultra conservative tea party candidates to Congress. We already had a strong unwillingness from the Republicans to work with President Obama on any issue, something we've never experienced at the level it's been since he took office. If that wasn't bad enough, now we have a small faction of Republicans gleefully trying to inflict great harm on the nation based on ideology rather than sound policy and an unwillingness from the rest of the Republicans in Congress to stand up to them and stop the madness.

While you are correct that employees in all departments for an employer count towards that threshold, unless the fire department is an actual municipal entity (like career departments typically are), the volunteers would not count towards the municipality's employee count and vice versa. Most VFDs tend to be independent legal entities and the relationship between them and a municipality that they serve would be more accurately described as that of an independent contractor. So most VFDs likely have little to worry about since they don't have actual employees. I doubt that this is going to be much of an issue for the VFDs. My guess is that it's going to be more of a manufactured issue based on an overly broad interpretation of the language and the definition of "employee".

No doubt and as gamewell45 correctly pointed out, those personalities are on both sides. However, like many things in life, how you conduct yourself can often have a big influence on how others view and treat you. If you are squared away as a volunteer firefighter and/or fire department, then the vast majority of career firefighters will not have an issue. Now, if you act like a clown, don't know how to do the job or won't do the job, act more like a social club than a fire department, then they're will likely be some animosity - especially if you start playing the "we're all the same" card. I work in a small career department in a small urban city surrounded by a good dozen volunteer fire departments who's districts directly border the city and few more close by. We pretty much have no choice but to use the volunteers if we need assistance with a fire. One is pretty squared away and we tend to call them first. A few more are ok and we use them when needed. A few more are pretty much posers and we've had issues with them when we've worked with them. We maintain a pretty good relationship with most of the departments around us, but when you show up at our fire and your engine company gives us the "you want us to go.....in there and do....what?" look, we aren't going to view you favorably and you won't be invited back. We don't get invited to many out of town calls for whatever reason, but when the neighbors do extend the invitation, we expect to work along side of you and not in place of you. We also expect that your IC (the fire chief) will not be drunk and require our duty chief and another mutual aid chief to assume control of the incident before somebody gets needlessly hurt or killed! When this is the case, we aren't going to view you favorably. And for the record, I spent 9 years as a volunteer before getting hired 11 years ago.

Thanks, it's seems to be the one thing I got plenty of these days. Well, that and aggravation.

NYC laws wouldn't apply outside of NYC. The unit is probably "covered up" already because it would likely make more sense to do it at the factory or dealer (assuming it's outside NYC limits) than to try and do it road side right before crossing into the city.

That's not an F-350 chassis. It's probably an F-450 chassis. The easiest way to tell the difference visually if you can't read the actual F-tags is to look at the tire/rims. The F-350 has the same sized rim as the E-series chassis while the F-450/F-550 chassis has the larger rims shown in these pictures.

I saw it at the Fire Expo in Harrisburg back in May. I thought it was pretty nice for what it was. It would work great in my city, if we had the staffing for a "dry" truck. We've been running an E-One HP75 Quint for about 11.5 years now and it's been a very good fit for us. With the loss of staffing and stations a couple decades ago, we were no longer able to staff a dedicated truck (Aerialscope) and maintain a staffed suppression capable unit in both stations. We ran with engines in both stations until acquiring the Quint. We could use a longer aerial, but we have a lot of tight streets and most tandem ladders would be too big to get around effectively. From what I've seen of it's specs, this unit is pretty close to the same size as our quint (which also carries our extrication equipment). If we had the ability to maintain staffing for a third unit on-duty, this unit would be another great fit for us. Longer aerial, possibly shorter jack span, additional ground ladders, plenty of space for equipment (could make it our extrication unit and expand our rescue capability) and all for about the same overall size as our current aerial.

In all likelihood this really isn't a patient care issue. It's highly likely that this guy is not the only EMT on his crew and as mentioned above, the fact that he chooses to not participate in caring for an individual patient is probably having little to no impact on patient care prior to the arrival of the ambulance unless the rest of the crew are a bunch of "medical nitwits". Given the likelihood that patients are being cared for regardless of this firefighter's participation, his reported enthusiasm to care for patients of a specific race and his reportedly blatant avoidance of caring for patients not of that specific race makes this matter first and foremost a RACIAL issue, not a patient care issue. Additionally, if the OP's observations as posted here are correct, then the person responsible for making this "into a racial issue" is the firefighter refusing to care for patients not of a specific race.

Some of what you suggest might be more appropriate if all involved were part of the same agency. In that situation, I would agree that talking to the person directly might be the best way to start working to a resolution. However, in the situation described, the OP and the FF in question are employed by different agencies. Typically, inter-agency problems in para-military organizations are supposed to be handled via the "chain of command". This is exactly the type of issue that should be handled that way rather than as a one on one bonding session. As presented, this is not a situation were a provider is in need of assistance from a peer to improve their patient care. He appears to be providing NO patient care if the patient is not a specific race. That requires immediate action by his superiors, NOT peer counseling.