JJB531

Any cop who gets sloppy or complains about having to hold a salute for half the time this kid did should be forced to watch this video.

The problems with employee retention go well beyond the issue of yearly salary, as a NYPD Police Officer at top pay who does a little bit of overtime is easily right at, if not over the $100,000 mark. Understandably in this day and age $100,000 is a middle class salary in the NY metro area, and often still requires a two-income household to raise a family, but the issues that plague employee retention is not so much the salary after the last few contracts, but a host of other issues.

Yes

Just a heads up cause I don't want to see anyone get burned, I would highly suggest not ordering any emergency services related equipment from Pacific Rescue, LLC (www.pacificrescue.com). I ordered various items from them back in May, and never received the items eventhough the money was debited from my account. After almost 30 phone calls and numerous emails from myself and the Better Business Bureau in an attempt to civilly rectify this issue, neither of us received any response from any representative of the company. My last option is small claims court which is not feasible, so basically they ripped me off.

Of course it would be a disaster, for all the reasons you mentioned a whole lot more. A large scale incident like this with 50+ victims would more then likely it would come down to depending on the commercial providers, especially TransCare and Empress, to send any available resources they had from both their 911 and transport divisions. As mentioned before, there is training available, none really locally but it's out there. The problem comes back to your second point. Fire and EMS can go for all the training in the world to prepare themselves for one of these incidents, but unless they have a good working relationship with their PD, and can train together to respond to one of these incidents, you'll end up with a disaster on your hands if the bell ever rings because it won't be a seamless, joint operation. Instead it will be the PD doing their thing, while FD and EMS will be trying to do their thing without really knowing where they fit into the equation. If FD and EMS start to go operational on the inner perimeter without the PD's knowledge because they were afforded some training by a third party training organization, especially if they are volunteers showing up in "plain-clothes", it could be a nightmare, and can hinder with the PD tactical operation. To really prepare for this type of scenario takes a lot of training, equipment, and most importantly pre-planning with all 3 agencies sitting down together and coming up with written SOP's so there are no questions about each agency's roles and responsibilities when it's time to go operational.

Most Tactical Medic courses are generally 5 days long, some are up to 10 days, which is not an easy venture for most providers who are working 2 or 3 jobs and can't get the training on job time. I've had the opportunity to take a few Tac Medic programs, and in terms of the medical aspect, if you're a competent Paramedic, you're not going to really learn anything new. Needle decompression is needle decompression, surgical airways are surgical airways, IV's are IV's, and intubation is intubation. There are some distinct differences in the priorities of care (C-A-B instead of A-B-C, importance of tourniquets which we're now seeing in conventional EMS, use of hemostatic agents, zones of care, less importance on spinal immobilization, Medicine Across the Barricade, remote patient assessments, among other things) and the environment you're expected to operate in is obviously quite different. A lot of it is tailoring your conventional EMS skills to the tactical theatre of operations. The other important aspect, and this depends on how you are integrated into the tactical operation, is the actual law enforcement tactics part of it. Weapons familiarization and safety, basic team movement, defensive tactics, understanding cover and concealment and how to properly utilize each, and so on are all aspects of training some medics may have to go through if they are going to be a fully integrated member of the "stack". If the role of the medic is a less aggressive one, as in they are staged in a warm zone and will only be called up to the target location once the scene is relatively secure, then they may be able to get away with a little less tactics training, but having a knowledge of the latter is still beneficial. The other important aspect is preserving the crime scene; what you should do and shouldn't do to help preserve evidence while still providing necessary patient care. Having the training is great, but as you pointed out, unless your local PD allows you to train with them, integrate your medical skills, and develop SOP's regarding the medic's role and operational guidelines in a tactical situation, all the training in the world won't lead to a "seamless" joint operation because the left hand won't know what the right hand is doing. Your local PD doesn't necessarily need a tactical team, because in the event of an active shooter incident it's going to be the first responding patrol officers who are going to deal with the situation. If your local PD does have a tactical team, then you have to come up with SOP's to integrate a civilian TEMS component to the team, including monthly training and operational standards/guidelines. I already discussed the LODI/LODD benefits before.

I give the benefit of the doubt to those providers who deserve it, and unfortunately the majority don't. Of course there's lazy cops and firemen... The same way there's lazy doctors, nurses, and workers at Walmart. I still work as a medic and I will come off a midnight tour with the PD, straight to my EMS gig and get my coworkers up off the couch to go out and train after working all night. How many other medics/EMT's do that where I work? Bottom line is that if I don't get the guys up to train, then they won't take the initiative themselves. It's nothing against any of them, it's just the way it is.

I wholeheartedly agree with you and your assessment of this topic and the importance of working together and being better prepared to respond to these types of unique and overwhelming incidents. I get it, I agree with it, and I support the notion. That being said, it's not a question of if we need it, it's how do we implement it? This is why I'm curious about the 3E program. The benefits issue aside, are we going to be able to "force" volunteers to take on this responsibility? For a career crew we can make this a part of the job responsibility, but what about Susie Homemaker who volunteers 6 hours a week to get out of the house? How do we prepare an EMS agency who has a crew with the average age of 65 to respond to this type of incident? How do we prepare certain EMS providers who may have a hard enough time managing a BLS patient in a nice controlled environment, and now expect them to operate in a more austere environment? We need to be brought into 2012 with the mere BASICS of EMS, such as disability benefits, comparable wages and financial benefits, professional standards, competent/well trained providers, better training and educational programs/opportunities, more advancement opportunities, changing the mindset of your typical EMS provider to go from being a stagnant, lazy, uninterested employee whose priorities are sleeping and what they're eating for lunch and instead fostering employees who are motivated; motivated to train, motivated to expand their scope of practice, expand their responsibilites and professional capabilities and so forth. With a lot of EMS providers, I just don't see it. In the Fire Service and Law Enforcement there is some level of motivation to excel or put in the extra effort because doing so leads to professional/career advancement, either through promotion or through reassignment to a desired specialized detail (SWAT, Rescue Company, etc.), which then leads to other perks (i.e. increased pay, future advancements, etc.) Before we can charge ahead and add this huge responsibility onto an already fractured and disorganized service, we first need to address the basic issues/problems that plague the EMS service.

T John, are there more resources out there to get more information about the 3 Echo program being rolled out in Minnesota? I don't think that anyone can argue that a coordinated PD/FD/EMS response to these incidents is necessary, and I agree with you wholeheartedly T John that we do need to take a better look at how we respond to a hostile event. But there are a few factors, like them or not, that are going to hinder the type of aggressive coordinated response to these incidents we would all like to see. No matter how necessary it is, no matter how much it will benefit the victims of a hostile incident, there is still one rather significant issue at hand that would need to be addressed before we can even consider placing non-sworn EMS providers in a hostile environment and task them with the extraction of wounded victims... LODI/LODD benefits for EMS responders. I understand this can vary from state to state, even agency to agency. I'm going based off my "local knowledge" of EMS systems in the Metro NY area. There is a plethora of training programs to prepare EMS providers to work in a hostile/tactical environment. There is a plethora of high speed tactical medical equipment designed for EMS responders to operate in a tactical environment. We can supply EMS providers with ballistic protection and other specialized PPE to operate in the midst of a tactical assignment. The training and the equipment is readily available, and incorporating EMS into these types of responses is not an unrealistic or impossible venture. Now try convincing a volunteer or even commercially paid EMS provider to don such equipment and go charging forward with PD into a potentially hostile environment. It is easy to have our judgment clouded by the thought of throwing on this high-speed equipment and go forth to render aid to our victims in the tactical theatre of operations. It sounds exciting, looks cool, has the CDI (chicks dig it) factor associated with it, and so on. But what if things go south, and now the EMS provider ends up a victim him/herself? I know as an LEO, if I am seriously injured in the line of duty, I will have the financial security through a generous line of duty salary to pay my mortgage, my bills, etc. If I am killed during the scope of my employment as an LEO, my beneficiary will be well taken care of financially by my employer, union, and numerous police foundations. Now if I switch patches on my shirt and act in Paramedic mode, serious injury leads to basic workers compensation, and if I'm a volunteer who now can not work and provide for my family and pay my mortagage and bills, I have to hope the generous public will donate money to alleviate any financial strain I have endured as a result of a serious injury. Killed in the line of duty... maybe some donations for my family, but nothing guaranteed. Like it or not, these are issues that need to be raised first before we can expect any EMS provider to take on such a task. Anyone who says it's a selfish way to look at things or just doesn't care and is going to go charging in there anyway cause "it's the right thing to do", then go for it. When I was younger I had that mindset that I didn't care. As I've become more informed and a little more experienced, my mindset has changed a bit. It's not about being a coward, it's realizing that if we're going to take on this great responsibility, then take it on with addressing ALL of the variables and issues, not just the obvious issues of training and equipment. We are all adults who hopefully understand the dangers and magnitude of certain incidents and are therefore capable of making our own decisions about our fate, whether it's running into a burning house without PPE to effect a rescue, or entering an unsecured location that may contain a potential armed threat to render aid to the injured. Most times these are split second decisions made within a moments notice as an incident is rapidly unfolding in front of us; but if we're talking about a coordinated, pre-planned response, we need to look beyond the obvious operational and logistical issues. And for those of you who are going to say, "well I can get injured or killed at the scene of an MVA as an EMT", you're right, you can get killed at an MVA, responding to a "fall down go boom", dealing with an intox in the back of the ambulance, and so on. That's why we take certain safeguards to make these scenes safe; road flares, blocking lanes of traffic, PD escorts, safe driving practices, etc. While we can't can't control every single variable at these "routine" incidents, we can control and mitigate the majority of them. Hostile scenes have so many variables that as Helicopper pointed out, it can take hours for a scene to be deemed safe. Is the shooter identified? Contained? In custody? Threat neutralized? Are there multiple shooters? Explosive/secondary devices? There are a lot of variables to process that typically require specialized PD resources (SWAT, bomb squads, aviation, etc.), and it may take time to mobilize such resources and then time for each resource to carry out its function. So I fully understand that anything can happen at any time, and that's why these issues of LODI/LODD benefits for EMS providers shouldn't just be limited to active shooter or hostile situations.

Truly a sad day for NY10570's friends, coworkers, family, and his extended family here on EMTBravo. It didn't take a very long to realize NY10570 was a consummate professional who loved being a Paramedic. The knowledge he shared with the EMTBravo community, and the manner in which he articulated his responses and views was a testament to the provider and the person he IS. It's a huge loss for the EMS and EMTBravo family... I'm not the sentimental type but the loss of NY10570 is a complete shock and is being felt by all the active members here... There will always be a void here on EMTBravo without him around. Godspeed Brother.

Hoping for a positive outcome...

http://www.nypost.com/p/news/local/fdny_sued_over_fatal_heart_case_ZGvPR5yeIgh8rsfr62dh0J

You're absolutely right BFD, the firearm itself is not the end-all, say-all; more significant is the hands that possess that firearm. A firearm in the hands of an individual who is proficient in its use can change the course of events with just one well placed round. When engaging an armed individual, the most effective way to end the fight is by placing accurate and effective gunfire on the perpetrator... the firearm itself might as well be a water gun if you can't utilze it to its maximum effectiveness through consistent and continual training. I sometimes shake my head at Police Officers who go to the range twice a year for on-the-job qualifications and don't bother training on their own the rest of the year. When the bell rings and you're engaging an armed perp in a gunfight, you just entered the big leagues. You think Major League baseball players go to the batting cage twice a year? PGA golfers go to the driving range twice a year? I never understood the rationale of going to the range just twice a year. If you're legally allowed to possess a firearm it's "better to have and not need, then to need and not have".

It's because of his initiative to reach out to the Journal News and issue a press release this "story" even made it to the paper and you guys have something to say about it? Maybe if someone from DES took the initiative our emergency service "brethren" wouldn't have to get all bent out of shape over absolutely nothing.

It would depend how many tac medics were on call/working or if they had to be recalled, and depends on their SOP's whether they can operate as a stand-alone tac medic provider or if they have to be attached to the tactical team, which is more then likely an on-call team which takes time to assemble.