JJB531

Stranded hiker(s), NYPD aviation and 2 ESU cops standing by (one rappel master, one tactical medic) to conduct a rescue if needed.

First off, I am not your bro.... Secondly, I said that I agree that he could have been taken into custody, I just didn't agree with swimming out there in a bathing suit. Thirdly, we all risk our lives to save others. The model of risk vs benefit that I use is one that allows me to conduct a rescue while taking the proper necessary precautions to ensure the highest possibility of success to effect the rescue without placing myself, my co-workers, and my victim in unnecessary harm. Unnecessarily risking your life is utterly ridiculous, a dead rescuer is no good to anyone, especially when the proper training and equipment is readily available. Cowardice? If you see my respect for the standards that have been established to ensure rescuer and victim safety as cowardice, then so be it, it's not worth arguing. But if you need to prove to yourself what a brave man you are by carrying out "thrown together" rescues for the people you "swore to protect", then I'm sorry but you are a dangerous individual and I just hope you don't get anyone else hurt.

Wow, where to begin. First off, these type of rescues are NOT performed by "college kids with a can buoy and a red bathing suit" every day in Cape Cod. Granted yes they do perform water rescues on a daily basis, but the are rescuing people who want to be rescued! Swimmers who have ended up in an "oh s**t" situation and want to live. They are not rescuing a potentially violent individual who as we stated may take any lifeguard, firemen, police officer, or Good Samaritan who tries to intervene with their intentions with them. There is a very big difference between rescuing a individual who ended up unintentionally in a precarious situation versus taking an EDP into custody. That's the basic difference here; yes we can say you are rescuing this individual, but you are really taking an EDP into custody. Taking a non-voluntary EDP into custody (which is what they were presented with in this situation because from what it sounds like if this guy was a voluntary EDP he could've just walked back to shore if he wanted to) always has a very high propensity for a very violent encounter, many times requiring the use of less lethal devices and restraint systems to successfully take these people into custody with any injuries to responders and the EDP. If you received an EMS job for a suicidal EDP in an apartment, would you enter the apartment prior to PD arrival? No, any smart first responder would wait for PD. Why? Because of the propensity for a violent encounter. This situation is no different, other then the water part. I agree that something should have been done to take this individual into custody, but I don't think swimming out there with a can buoy is the right answer. As far as the whole we do rescues but have no formal training and our personal equipment is fine... Well if it works for you then it works, but I think that you are opening yourself and your agency up to a tremendous amount of liability. All it takes is for someone to get injured, whether it be a responder or a victim, I don't think it's going to matter how good your intentions were, an investigative agency is going to want to see what level of training, who conducted the training, the type of equipment used, etc. Despite what your personal feelings are about the NFPA, they've still set the standards; standards that hold up in a court of law. To deviate from those standards and freelance, especially when talking about technical rescue, is a dangerous game.

What were they supposed to do, pack up and drive away?

I don't think anyone is playing God, I think they appropriately weighed the risk of fighting with a suicidal EDP in the water while lacking the appropriate training and equipment to safely effect the rescue. They didn't say "oh he's an EDP who wants to die so we're not going to rescue him", they said, "oh he's an EDP who has a propensity for violence and we don't have the proper equipment and training to effect this rescue safely, so is it worth risking the safety of the firefighters on the scene".

55 degree water definitely calls for donning a drysuit

Thanks for the reply, I kinda assumed it was for a second bus but the way it was worded in the IA was a little difficult to follow.

Actually I had two questions related to the incident alert posted. My first question is the incident alert stated that the IC determined this to be a level one trauma that required medevac response. Is this accurate or was the determination made by the highest medical authority on scene? My second question is a noted a significant amount of time had passed when it was posted in the IA that Croton was toning out for a driver for their ambulance. Was this for a second ambulance to respond or was this for the primary responding ambulance?

Excellent posts so far. Also from a law enforcement perspective, this is a suicidal EDP in the water. Little bit of a difference between a "victim" who unintentionally ended up in the water and an individual who purposely placed himself in that position to cause himself harm. Placing a would-be rescuer who may not have the proper training and/or equipment into the waterborne environment is dangerous enough, now put that rescuer up against an individual who may have no problem taking a rescuer and anyone else who tries to interfere with their plans to commit suicide with them. Edit: I just read the article that Seth posted a link to which discusses the same concerns I just brought up, I didn't read it before posting so I apologize.

So, you really think that in addition to all of the current financial responsibilities these agencies have (equipment, training, insurance, fuel, etc.) that there is enough money available to support salaries, health insurance, pensions, etc.? Contract out to the nearest paid department? Fire Departments across the country are laying guys off and closing firehouses and want firefighters to do more with less. Locally some paid departments have their own manpower issues... is "contracting out" and increasing the workload and geographic area of response really going to solve the problem?

I think you have a better chance of seeing FDNY allowing NYPD ESU to take on fire suppression activities before you see them call in a single volley department from Westchester or NJ. (obviously a sarcastic statement... In other words there's no way FDNY would turn to volleys unless completely, absolutely necessary)

To the best of my knowledge the PBA hasn't done too much in terms of making a big stink about the manpower shortage.

It's not even worth explaining crime cop. 18 years old, not involved in law enforcement in any way, and he's the expert. How about you go out there and show us how it's done kid?

No insult taken, but consolidating or shutting police precincts is impossible in NYC. In my old command we would turn out 4 or 5 sectors a night, each car handling on average between 20 and 25 jobs on a 4x12... This was an average night. In the summertime, the midnights would come in and we would be 20 to 30 jobs in backlog, meaning they were already coming into work 30 jobs behind the eight ball they had to handle first before they got to the jobs during their tour. It's not uncommon for complainants to have to wait hours for a patrol car to arrive to take a non-priority police report. Most precincts cover pretty big geographic areas as well, and the smaller commands tend to be very densely populated. In my old command, it could easily take well over 15 minutes to get from the north end of the command down to the southern border. With current staffing levels and the minimal amount of cars on patrol, patrol officers are already stretched way too thin with just the every day workload of handling jobs assigned by central, and now more is being expected of them in terms of proactively addressing conditions in their sector, increased summons and arrest activity to balance the jobs manpower shortage, and handling daily counterterrorism duties (CRV, Surge, etc.). So now the NYPD is thousands of officers below staffing, and the individual officers are expected to produce more with less. The majority of station houses can barely handle the number of personnel assigned to them, and holding cells on a busy night are literally "bursting at the bars" with perps. Once again, in my old command I had to share a locker with 2 other people my first year... I couldn't imagine shutting down a command and then being able to accommodate 300 cops and 2 times the number of prisoners without it being a complete nightmare. I can remember having to wait 2 hours just to be able to get on a working computer to start processing my collar. The job hasn't escaped from the economy crunch unscathed. Yes, precincts haven't been shut down, but cops have been reassigned, details have been cut, manpower has been reduced in specialized units, ESU went 4 years without an STS class, Highway District went years without picking up any new personnel, academy classes have been minimal, and so on. I know cops who were in specialized units for years, and were the suddenly sent back to patrol because of staffing issues.

My only complaint about the IA's is when someone reads a news article online and then generates an IA based on the article that just regurgitates the information contained in the article and doesn't offer any real "inside information" (times, units who responded, radio transmissions, etc.)

More then likely its all a part of the week long securing the cities training exercise going on in the tri-state area.

The EMS crews in New Rochelle are pretty familiar that the firefighters are at a minimum EMT's. The point of having them there is to initiate patient care, especially to recognize and address life-threatening conditions which is where they are going to have the greatest impact on patient outcomes, and in New Rochelle they do an excellent job. That being said, there's a stark difference being trusting the BP someone else took and just heading to the hospital compared to trusting the BP someone else took and then giving medications that can kill someone if the BP as reported was incorrect. The responsibility always comes down to the highest medical authority on scene. While it's a nice warm and fuzzy feeling to trust the people you work with, a responsible Paramedic will ensure that the patients vital signs meet the criteria to be eligible to receive certain medications. Maybe I'm the minority, but I'm not about to endanger my patients outcome as well as my certification because I was too lazy to do the responsible thing and ensure the patient's BP meets the criteria before I start administering medications. As I said, it's nothing personal, but strictly business. I do agree that knowing who you work with and building a rapport with other agencies is important, but when the responsibility for the patient is resting in the lap of one person (highest medical authority on scene), that person has a responsibility to the patient to ensure that they receive the appropriate medical care and do not receive any treatments that could be detrimental to their outcome.

I don't deny that the reverse occurs on occasion. My only issue with what occurred is the response by the EMT from the EMS crew, not the re-taking of the patients blood pressure. If the medic who responded to the job has some level of trust in his/her EMT's ability to take an accurate blood pressure, and is not familiar with the FD crew or their ability to take accurate vital signs (remember, there are great EMT's and medics and there are horrible EMT's/medics), then it may be SOP for that particular crew to retake vitals on every patient they encounter to ensure accuracy. You know the importance of accurate vitals (especially BP) when treating patients with exacerbation of CHF with vasodilators. Eventually the responsibility falls on the medic, not on the EMT or crew from the FD. Personally I recheck every BP myself before medicating patients unless I'm working with someone who I have absolute 100% trust in. It's nothing personal, it's just business. The EMT should have come up with a more diplomatic response instead of demeaning the FD members on scene. A simple, "we just need to make sure your BP is still stable before we medicate you" would have sufficed.

Just wanted to jump in on the discussion for a quick second. Forget about the title of EMT or Paramedic for a minute; speaking solely as a trained and certified practitioner of emergency medicine, nothing frustrates me more than walking into a room full of other trained and certified practitioners of prehospital emergency medicine, asking "What do ya got?" and being met with blank stares. Then asking "What vitals did you get?" and being met with blank stares. Then asking "Can anyone tell me anything about our patient?" only to be handed the clipboard with the patient's name and address written on the PCR, which does me absolutely no good at that given moment. My point is that an EMT is certified by the State of New York Department of Health to practice prehospital emergency medicine. As basic as some of the skills may be, they are the foundation for every single intervention and treatment the patient is going to receive, at both the BLS and ALS level. Every trained and certified EMT passed the Patient assessment station during their NYS EMT practical skills exam, so when another trained prehospital care provider arrives on the scene where another trained and certified care provider has already initiated patient contact, there is an expectation that certain basic things are completed, time permitting of course, upon the arrival of additional providers (I.e. paramedics). Personally, all I look for is that the chief complaint has been determined, the airway is controlled, oxygen is being administered, ventilations are bein assisted if necessary, serious bleedings being controlled, and a baseline set of vital signs are taken. That's it! It's that whole initial assessment/focused history/vital signs part of the NYS patient assessment station. This is all that most medics are looking for from BLS providers. If you happen to get more, bravo! but I won't be frustrated if you didn't uncover that the patient had foot surgery in 1978 or that you failed to recognize the patient had muffled heart sounds. Why the rant? Because one individual in a previous post brought up the "paragod" complex when referring to Paramedics. Are some medics guilty of this syndrome? Yeah, unfortunately some are. I can tell you with the majority of Paramedics out there, it's not a "paragod" complex, it's an overwhelming sense of frustration that builds up in trained and certified prehospital care providers over time when they witness on a near daily basis the incompetence of some (note I said some, not all) trained and certified BLS providers who can't even handle the simplest of calls. I keep using the phrase "trained and certified" because that's what we all are; trained and certified to practice prehospital emergency medicine. Since we are "trained and certified" we should be held to a standard, not only by the state and other regulatory groups, but by our peers also. As an "EMS peer", I am deeply troubled when I witness other "trained and certified" providers who basically know nothing about the basics of providing prehospital emergency medical care. I have some semblance of patience with new EMT's because we were all new at one point. No one started out as a seasoned veteran. But when a trained and certified has to hold the hand of another trained and certified provider on every single call over the span of months, even years, the frustration starts to set in. This frustration, while it usually ends up being directed at the incompetent provider because they're the easiest target to vent, the overall problem goes well beyond just the provider. Anyone who's been in the field long enough can tell you that BLS skills have diminished because: A) A "dumbed down" EMT curriculum that doesn't promote thinking and understanding, it merely promotes recognition. We expect non-trained persons to recognize there's a problem, we should expect "trained and certified" medical professionals to interpret the findings into some form of a presumptive diagnosis to effectively treat the patient. B. Minimal amount of BLS ambulance rotation hours. 8 or 12 hours of rotations are nowhere near adequate to prepare EMT's for the street. C) The EMT certification has become more of a joke than anything else. Individuals at job fairs are encouraged to take the EMT class because "after 6 months of training you can make $10 an hour". It's like a bad infomercial. This is not a knock to EMT's, but more so at the means of selecting and recruiting candidates who are being attracted to the field because it's marketed as a quick and easy way to get a certification and start making money; similar to these shady phlebotomy and medical assistant programs you see on TV at 3am. D) Medic dependency. With the overwhelming number of medics out there, and the fact that they often arrive at scenes first, EMT's are not getting the experience they need to be good providers. One of the problems Paramedics are faced with is walking that fine line of alienating BLS providers on jobs which leads to medic complaints, and then standing back and not getting intimately involved in calls that don't require ALS care, and getting medic complaints for not helping. I don't mind helping out on BLS calls or being a source of guidance, but I shouldn't have to run a BLS call. You're an EMT, you're "trained and certified", you should handle the call. E) Lack of appropriate field training for new providers and a lack of continuing education for all providers.

Same incident... The tiger, alligator, and human resident were all living harmoniously together in a Harlem apartment until the tiger took a chunk out of his owner.

I only live in Putnam, I don't work here, so I'm not intimately familiar with what's around up here. Muscoot in Somers, Green Chimneys in Brewster, Tilly Foster Farm in Brewster are a few that come immediately to mind. I know there are several more farms in Putnam/lower Dutchess County who could offer assistance.

I agree with you that responders should be aware of the dangers, and hopefully this is where common sense would kick in! The mention of a class was posted here by someone else, sorry to tie that into my response to your post.

Someone from one of the farms, your local animal control officer, some police departments carry tranquilizer guns to deal with aggressive dogs and/or wildlife. Those are some viable options, check with your local resources and see what's available. Several years ago when NYPD ESU was tasked with removing an alligator and a tiger from a Harlem apartment, they received assistance from the Bronx zoo who supplied them with the appropriate sized darts and correct dose of ketaset to knock down these animals. The point that NJMedic was trying to make is that no one on scene there was a "tiger technician", but the job was handled safely and effectively by using common sense and calling in the appropriate resources.

If you want to ensure the safety of the responders, don't enter the scene until these hazards are mitigated by someone who is accustomed to handling these animals, plain and simple. Thinking outside the box is one thing, but attending a "bovine technician" class is pretty ridiculous if you ask me when we have numerous agencies that can't handle routine everyday requests for service.

How about agencies first become above proficient when it comes to properly treating and handling humans before we start worrying about livestock? Just hook up with your local animal control officer if its that much of a concern? Or meet with one of the local farm owners for tips or just let them deal with their own livestock in the event of an incident.