FireMedic049

We just had a hospital in my area obtain level 2 trauma designation. From what I have been told, the main difference between a level 1 and level 2 has little to do with the level of trauma care that can be provided at the facility. The main difference is that the level 1 is a teaching facility and may have more redundancy allowing for treatment of more trauma patients at the same time. For example, having a couple of trauma surgical teams on duty vs only one.I'm not sure if hospital trauma designations are consistent nationwide, but based on what I know for my state, it would probably be better to take the patient to the level 2 by ground than taking twice as long to go to the level 1 by air.

I've spent 20+ years in EMS working in areas remote from trauma facilities to just down the street from them. I've spent the last 15 or so in a metro county that is somewhat fly happy despite having 4 trauma centers within reasonable drive times for most of it. IMO, in the vast majority of cases, the use of medevacs in areas that are within this middle area, has more to do with ALS providers who are not confident providing advanced care to trauma patients for the duration of the ground transport time rather than with the patient actually needing care beyond the normal scope of practice for a street medic. Now there are certainly cases in which timely provision of critical care level care in the field is warranted, even if it delays arrival at the hospital by a few minutes. As for the "time saving" aspect of medevacs, in this middle zone, it's often a toss up as to whether or not it truly saves time. I know of numerous incidents in my area in which units have spent a majority (or more) of the time it would have taken them to get to the hospital by ground, sitting at an LZ waiting for the helicopter to arrive. I know of a number of incidents in which patients from the same incident have been transported to the same hospital by ground and by air and excluding extrication delays, the ground units almost always get their patients into a treatment room faster than the air units can when you factor in waiting for them to arrive on scene, the transfer of care and then time to move from the helipad to the ER.

Although the decline in volunteers is a real problem and needs addressed, I think the article was poorly researched and written. It was particularly weak in addressing the aspects of fundraising and its relation to the ability of VFDs to keep the doors open and responding to calls with qualified personnel. One part of the article was a gross misrepresentation of the situation it alluded to. The article makes mention of a recent ruling by Pennsylvania labor officials granting volunteers the right to organize and that this would increase to number of unionized firefighters in the state. The reality of the situation is that the firefighters specifically affected by this ruling were not actually volunteer firefighters, but rather part-time employees of the municipality. The information linked in the article is the ruling from the PLRB which describes the situation in detail. The quick version is that the fire department is operated and funded by the municipality. The department has full-time and part-time personnel. The municipality is directly involved in the process for hiring new members for the department. The firefighters are scheduled for shifts at the fire station. They are paid an hourly wage for these shifts by the municipality (~$10-15 range) including the deduction of all applicable payroll taxes. The municipality claimed that the firefighters were volunteers and not employees of the municipality, but the ruling states that the firefighters are clearly not volunteers, but rather employees of the municipality. As such, the non-managerial firefighters of the department were eligible to organize under PA's municipal police and firefighter collective bargaining law (Act 111). The labor union involved in this situation, the IAFF via the Pennsylvania Professional Fire Fighters Association (PPFFA), the state association for IAFF Locals in PA does not organize volunteer firefighters.

I don't think you are fully comprehending what the situation appears to be. I can't speak to the specific civil service laws involved in this situation, but yes, typically they allow for the selection of one of the top 3 candidates on the established civil service eligibility list. In smaller communities, that selection is typically made by the Mayor or City Manager type position depending on the political structure in place. I get the impression that their system is set up in a fashion that the board votes to confirm the Mayor's selection. In this situation, it appears that this person was #1 on the eligibility list and WAS selected from among those 3 top candidates. He was NOT simply passed over for selection in favor of one of the other two top candidates. Civil Service testing is typically conducted by a Civil Service Commission which typically does not include local government officials such as Mayors and City Council/Board members. As such, they would not know if he had a "bad interview" unless they somehow "score" the interviews, but if they score the interviews, then it really isn't an interview, it's an oral test. Since it appears that the board votes to approve the Mayor's selections from the Civil Service list, the board's involvement in the hiring process may actually take place beyond the confines of the Civil Service system. If that's the case, then this certainly wouldn't be a matter of being passed over in the pick one of the top 3 phase, but rather a deliberate decision to deny employment and he would have a pretty good case. The enactment of Civil Service laws were a direct result of this kind of government misconduct in the hiring process. The reason they didn't approve his selection is so blatantly obvious, that even a blind person could see it.

What makes him "so diff" as you put it is that this does not appear to be a case of just not doing good enough in the testing process as he apparently was #1 on the list, selected by the Mayor, was endorsed by the Police Chief, supported by the community, but has a sister who is a board member that is not a political ally of the remainder of the board. Take the family relation out of the equation and unless the board is being mum about some sort of serious skeleton in his closet that nobody else appears to know about, this guy would've been unanimously approved. This isn't the time to just "get over it", this is exactly the type of situation in which a lawsuit contesting the hiring process should be fired, unlike the numerous lawsuits filed on behalf of minorities that don't get hired claiming "racial discrimination" because they simply weren't prepared enough to score high enough on the tests to get hired.

I was just referring to this article I read in the past, that is all.......http://traditionstra...-means-nothing/ It probably would've been a good idea to have posted this link initially or at least cited who the quote belonged to. Regardless, the article is correct in that a scene can look benign upon arrival and quickly deteriorate. However, the scenerio presented only reinforces what I stated, the problem was how the personnel reacted to the initial report, not that the words "nothing showing" were used. If using the term "nothing showing" is truly the problem and reason for complacency among additional responders to the incident, wouldn't it follow that any report on conditions short of "fully involved" also risk additional responders underestimating the severity of the incident if we're supposed to treat every report of fire/smoke in a building as the fire of our career until proven otherwise?

Wrong! "Nothing showing" clearly means that there is no obviously visible signs of a fire from the street. I've been to a lot of fires in my 20+ years in the fire service and there have been very, very few instances in which there were absolutely no visible indicators of a fire of any significance upon the first unit's arrival. I would suspect that my experience is consistent with the vast majority of the fire service. I would submit that if 90+% of the time when you arrive, there is no visible indicators of a fire and subsequent investigation finds that there is in fact, no fire, then "nothing showing" clearly does mean something. The report of "nothing showing" would mean that there's a very high likelihood that there is not a fire of any significance in progress at that location. Yes, there could be a fire hiding somewhere waiting to break out, particularly in a commercial building vs a SFD, but to take the stance that the lack of exterior visual clues is irrelevant is simply irresponsible. The report of "nothing showing" or use of different terminology conveying a similar meaning is not where the problem lies. The problem lies with your personnel and leadership if they show up and are not ready for battle.

I definitely think they (the EMS personnel) could've handled the situation better, however the video appears to me to be ambiguous at best as to whether or not the pt had a pulse or was breathing. The only thing that was clear was that the guy needed medical attention in some fashion. If their assessment was that he was breathing and had a pulse, then the administration of CPR would in all likelihood not be appropriate. They certainly could've had a little more pep in their step, but the patient was on the stretcher and on the way to the ambulance within a few of minutes contact by EMS. Again, if their assessment was that he was breathing and had a pulse, going to the ambulance rather than initiating care right there was the appropriate call IMO. Now, if their assessment was that he wasn't breathing and/or didn't have a pulse, then initiating care on the spot would've been the right thing to do. I think the only thing clearly obvious to a lay person was that the guy appeared to be in need of medical care in some fashion since he was unconscious. The average lay person is often ignorant to exactly what care a patient needs on scene and what care EMS can actually provide at that point. I know I frequently encounter patients, family or bystanders who question why we aren't just putting the patient in the ambulance and driving to the hospital. The average lay person also often thinks that their medical needs or that of another person are more of an "emergency" than it actually is and this feeds the belief that EMS should be doing "more" to treat the patient, when in fact they may be doing everything they can within their scope of practice or the patient's condition only merits "minimal" care. I think the video is a little less murky to the trained eye in that the initial assessment could have definitely been performed better, but it still fails to definitively answer the questions "is he breathing" and "does he have a pulse". We can only assume the answer to both questions was "yes" since they didn't immediately start CPR. Without knowing all of the details, it's hard to say whether or not any or all of the suspensions for the 4 EMS providers were appropriate, but I think the speed in which they occurred were a PR move first (damage control) and a patient care issue second. The public often sees what they want to see in these situations, particularly when their is racial component (real or perceived) and want immediate action and far too often, management et al are too willing to bow down to that pressure and take punitive actions with incomplete information and in violation of the employees right to "due process".

When the Union President stated that it was okay to just tell the other paid firefighter that he was sick and left the job without telling anyone else, that hits me as extremely strange, especially since he was one of only two paid on duty. Shouldn't someone on the administrative end have been notified who could call in another one of the paid guys, like the part-time one they mentioned, to cover and finish his shift? Yes, going home sick without notification to management and possibly being relieved is certainly "extremely strange" to most of us, but as Bnechis pointed out, this isn't a unique situation. I can fully understand why he had at least a five-day suspension, cannot see why they are rescinding and back-paying him for that just to avoid the expenses of a full law suit trial. Based on the information presented in the article linked, I got the impression that the suspension was a secondary matter. The main matter being litigated was the unilateral changes to compensation and work schedule that the fire company imposed. These actions were clearly a violation of labor law and if the matter proceeded, the company would (in all likelihood) have lost the matter and spend substantial money on attorney/court costs and then additional back wages for what could easily be an additional 6-12 months while that process played out. He left them short-handed without telling anyone else but his co-worker, and unless they did not have any calls to cover in that time period and lucked out, cannot see any justification for his thinking that was okay because "that's how it was done in the past". Same lame excuse the Charleston commander gave without seeing anything wrong with not giving report to the arriving IC and ignoring ICS and NIMS, even though he lost 9 firefighters in the fire and collapse. Though admittedly very different scenarios, but same ignorant attitude. Again, if the fire company has no written policy regarding this type of situation, then you have to look at "informal policy", also known as "past practice" for guidance on what to do. Based on the "that's how it was done in the past" comment, it's highly likely that there isn't a written policy. So, if it has been common practice to not make notification to management when someone leaves work for whatever reason and management has failed to correct that practice from its onset or thru subsequent negotiations with the union, the fire company doesn't have a basis for imposing discipline in this case, barring other extenuating circumstances that substantially make this situation different from those in the past. Since the judge ruled to overturn the suspension, I would guess that the fire company failed to show an established policy or practice that was violated and probably failed to show past disciplinary measures for prior occurrences. If I tried that at work, I might be looking for another job relatively quickly. I probably would be too, but we have a clearly understood procedure for this type of situation. You have to notify the on-duty shift boss for the OK to leave.

That's great, but unfortunately there are a lot of places where this is simply not the case. In my state (PA), the only training requirement to be a firefighter is a basic hazmat certification. There is absolutely no state required firefighting training. Efforts to adopt something are strongly opposed by the volunteers of the state. Now, some departments have some pretty stringent requirements, but many others, not so much and it usually shows in their operations. In my experience, the career side is completely in favor of the volunteers getting as much training/certification as possible (ourselves too for that matter), but unfortunately there's a significant portion of the volunteer fire service who don't feel the same way.

Prior information released indicated that the 24 SAFER FFs all had to work at TOR for the duration of the grant period. If the plan is to relocate existing career staffed units into the TOR stations, how are they going to comply with that requirement? I'm not 100% positive about it, but I'm pretty sure that they will be reimbursed for the FFs that they do hire, even if they don't end up hiring all 24 for whatever reason. I'm not sure the financial shell game is as obvious to some as it may be to you. Could you enlighten the rest of us?

That's pretty much my point. Beyond that.......since the grant hires have to be assigned to TOR............are we going to see career staffed TOR units with 4 FFs and no officer while existing career unit staffing includes an officer?

I don't know. The article is ambiguous at best regarding that. The TOR person is pretty much saying the grant will cover all of them due to paying a lower level of total compensation (specifically benefits) than current city firefighters. The PSD for the city is saying the grant won't cover all of the costs and will make up the difference from "(department) savings from having hired the firefighters", but is that the city department or TOR? Additionally, it's not clear if the difference that will be made up is the amount needed to provide compensation equal to that of the existing career firefighters or the "reduced" compensation level that the TOR person alluded to. Considering that TOR put in for the grant independently and openly stated the intent to pay the grant hires a lower compensation package compared to the city firefighters, it's probably not a case of them asking for "not enough" money from SAFER.

No mix up. The grant was awarded to TOR to hire 24 FFs. As such, the new hires have to be assigned to work there. If I understood the article correctly, these new FFs will be on the city payroll, which will make them city employees. They will also be members of the existing firefighters' local. This will create a situation where you'll have two groups of employees in the same job classification, performing the same job, for the same employer, represented by the same union, but receiving different compensation packages. Maybe it's the Executive Union Officer in me talking, but this is going to be a mess!

Although, I can't officially comment on the OP's question , I'd imagine that it'd be ok to add a couple of "simple tricks". I guess it depends on how you look at the first one as to whether or not it's "simple", but for pre-connected lines, I've heard of departments flow testing their lines/nozzle combination(s) to find the psi for the intended GPM and then marking that psi on the discharge guage. Some have even marked more than one target point for a line. It takes some upfront work, but on the scene you just need to throttle up to the predetermined mark. The second is a "rule of thumb" type thing. For small handlines, nozzle pressure plus 15 psi per 50 foot section of hose. For large handlines, nozzle pressure plus 5 psi per 50 foot section of hose. It's not exact, but it'll put you in the ballpark and can adjust as necessary. Using this at my department puts our small handlines at roughly 185gpm and 95psi for 150 feet and 110psi for 200 feet using 50psi nozzles. I forget the gpm for the larger line offhand, but it's in the ballpark of what is commonly flowed from those lines.

My department doesn't have a plan for the Zombie Apocalypse, mainly because when we look around our city, it's possible that we're already a couple decades into it.

If you think that's no fun, try pulling in with only 4 firefighters.

Aren't all saves "great"?

The issue being discussed is not about junior firefighters, but rather members that are 18 or older and still in high school. Child labor laws already restrict the "work hours" of juniors by statute. The issue being discussed is the organizational authority and appropriateness of restricting the response of members no longer restricted by the child labor laws, but still attending high school.

I agree, however, if I'm not mistaken, child labor laws already prohibit them from being such.

You should go back to the start of the thread and reread everything (assuming you read any of it in the first place). First, the 18 and 19 year olds serving in the military already have their HS diploma or GED, these kids DO NOT! Second, the issue being raised isn't that these kids aren't willing to get their "asses out of bed" to help the community. The OP has a problem with a very reasonable and appropriate department policy that prevents them from responding to calls after 10pm on school nights.

Child labor laws restrict the hours in which a Junior FF may respond to calls. They are limited to the same hours that they'd be able to work at a regular job. If I recall correctly, they are not required to leave the scene if the incident extends beyond the daily cut off point, but they can't take in any additional calls.