Ga-Lin

You weren't a flycar, you were an ALS ambulance responding to a call that, when needed, was able to transport the patient weather ALS or BLS. You were in a vehicle that, because of adequate people, were able to transport. I'm maybe, because of where I have worked, have been a car by my lonesome. So when I think of "Flycar" I think that way. If there are two people in an ambulance, that's what you are, an ambulance, despite what you may call it. The original post was regarding using an ambulance as a single medic flycar.

At this point, does it matter?

While there is no restriction, that I am aware of, of using an ambulance as a fly car, it might cause some awkward conversation on the scene with some of the family members, who might not be up on emergency operations. Especially if there is a delay in getting another ambulance to the scene. you know, paging out several times for a crew even if after waiting( as I have) before telling disp. that I'll ride it in BLS, just get me an ambulance please. I can see it going something like this.... "What are we waiting for, my (pick your loved one, wife, husband, child etc) needs to get to the hospital" " I'm sorry we're waiting for an ambulance" "Isn't that an ambulance out front" "No, that's my fly car" "It says it's an ambulance" "Well its a little complicated, you see my (fill in organization) has some difficulty keeping appropriate vehicles on the road some times so we're filling in with what we have in order to to serve the community" Family member mumbles under breath "The only thing you're serving me is a load of B*##@%&+" "Does it have one of those, whatchamacallits, little beds inside" "Yes, but I don't have any one else to drive" "Can't one of the other (half dozen or so) responders (getting in their points) standing around drive for you" "Well, no they're from a different agency and our insurance won't cover them" "Well I haven't had an accident in over 20 years, not even a parking ticket, I'll be happy to drive. I'll sign any wavier of liability you want" "Thank you for the offer, but I can't allow that either" "Oh hell I'll drive them myself" (after hearing the third or forth page for this location) " I'm sorry you can't do that until you sign my RMA form" "RMA form? What's that" "Well, that says you're Refusing Medical Assistance" Family member now a little red in the face "I'm not refusing anything!! You can't get them to the hospital!!" "Sir, I'm going to have to ask you to control yourself or I'm going to be forced to ask you to leave" "LEAVE, LEAVE!! THIS IS MY F#*#*&g HOUSE!" "Sir, sir if you don't get yourself under control I'll be forced to ask the officer to remove you" It quickly spirals down (as if it could get any worse) from here While this might be a little over dramatized I would rather be spared this particular or similar conversation. While there might not be anything preventing such use I wouldn't want to be involved, thank you. Sending a patient transport vehicle to an emergency and then saying you couldn't transport would be like sending an engine to a confirmed structure fire, KNOWING, that you only have the driver going. (Yeah, I know, unlikely, but it's the only comparison I could think of) "Sorry, I brought the truck but we don't have anyone to man the pumps." Permissible, maybe, but a public relations disaster as the driver and home owner watch the house burn down. What do you guys out there think? Maybe I should think of starting a new career writing fiction, no? Either that or apply for a job at LoHud! I got it, I could run for President!

I found it interesting that there was never any mention of concern for the EMS providers that brought Pt. 1 (Mr. Duncan) ? to the hospital the 2nd time. The first time he walked in on his own and, as we found out later, was sent home.

Capt. Tony Grider, 41 has died of his injuries at noon today. All LOD is a tragady, but this one should not have happened. Just goes to show that whenever you gear up & go out, even for training or something like this, you are never 100% safe. RIP Cap

Link doesn't work

Same here. I had trouble with the video

Read this in the THR this morning. My question is why?

I understand that over the years that WEMS has been dispatching there have been a number of emergency "walk-ins" which were handled by the "live" dispatchers, who are (or were when I remembered them) EMT's, until a crew arrives. Don't misunderstand, I'm in favor of a central dispatch system, but in a day & age of automated everything it is a nice touch knowing that there is actually a trained someone around the town 24/7.

Who is this guy and more importantly who's advising him ! Don't they call this a nusiance lawsuit?

I must agree with both of you. There are two things that increase your chances of survival in these circumstances time and mobility. The more time it takes for an active shooter to either find you or get to you is to your advantage, so anything you can do to delay or otherwise fustrate the shooter works to your advantage. Most of these punks are not marksman plus they are, as said in another post, looking to do maximum damage in the shortest period of time. My wife, who is a teacher, use to worry about me, back in the day when I worked in NYC, now I'm the one who worry's about her. We've spoken about this many times. She's told me her administration favors sheltering in place. I've told her that's BS pure and simple. Her classroom is on on the ground floor with a door that can be kicked in by most middle schoolers (besides, have you seen the size of some of these "kids") her window exits to the employee parking lot with a parocial school across the street (not much traffic if any). Most of these manics are not going to take the time to aim and fire at two dozen kids running and ducking between cars, and they certainly aren't going to follow them outside. If caught inside they are just going to herd you into a corner and finish off as many as they can in the time they have. I also gave her a bottle of clear liquid (not colored) dish soap to spill on the floor inside her room in an effort to delay. I've also suggested she have a wide mouth bottle of acid to use as a last resort. She worried about securing it in her room and what might be said if she ever had to use it. I would have no such problem, as a matter of fact, law or not school rules or not if I was a teacher now adays I'd be packing. I'd rather be judged by 12 than carried by 6, if it ever came down to that. It's also interesting to note that after the shooting in Ct. that when the head of the NRA suggested armed LEO in the schools and was meet by a firestorm of critiziem. Interestingly enough, I'm reading how many schools are now requesting and in some cases the parents are demanding "service officers" from their local departments be stationed in the schools.

The point is the amount of effort that is sometimes needed to establish that control.

I also remember having Albumin on the bus, never used it. Most systems and studies stress a quick transport decision and rapid transport, preferablly to a trauma center, not field fluid resusitation. Trauma patients need only one thing, a surgeon & an operating room (OK two things), not a medic trying to get that 20ga line on a multisystem trauma. Years back, a study was done in NYC, to keep this short, ALS had higher mortality than the BLS crews. Why, because BLS were "scooping and shooten" to the hospitals. ALS units were doing to much "medic" stuff.

Doing CPR for 20-30 minutes waiting for an ambulance (paged out 3-4 times & goes Mutual aid anyway) is to much work. Much easier to squirt narcan up the nose.

I agree, sounds like it's outfitted for law enforcement more than anything else. May be of use in wildland firefighting advising which way it is going, but then can't do anything about it. This is going to turn out to be some sort of VIP transport vehicle.

Well that answers some of my questions and concerns, thanks

By your post you obviously haven't "been there" which is OK. I always welcome, and I am sure bnechis agrees with me, the opportunity to educate those not as knowledge or those who have had a more sheltered career. The concern that most of us, who have more experience, are just saying to use caution when administering this med. If awoken to quickly not only can they become violent(doesn't always happen) but can also cause severe and in some instances life threating problems(again, doesn't always happen). I for one, not being familiar with the IN form of narcan, am unsure of the uptake (this means how fast it takes effect) of this form or if it can be titrated (given in increments, which I doubt)until the desired effect (they begin breathing on their own again)is reached. Just for the record, I've never, and again I'm sure bnechis hasn't either, held back any care or treatment for fear of a negitive response from my patients, I've done my own share of wrestling with those I'm tring to save in the gutters because they don't appreciate my efforts. Bringing them back to the living as you say is debatable, that the lives they live is called living. My other concern is that this is being touted as the "wonder drug" to bring back the dead, figuratively speaking, and given out, like candy, to just about anyone who asks for it, regardless of training, indeed, often without any training. While, generally, I think it a good idea to have in trained hands, FD, PD, EMS, I have my reservation about it in the hands of the general public. My first concern is that other treatment, breathing for them, will be delayed for to long a time, waiting for the drug to do its thing which, by the way, can also happen in the trained hands mentioned above without proper training. This might not even happen (breathing) because it is caused by a different problem and therefor not affected by narcan. Second concern is that the calling of authorities (911) will either be delayed or deffered altogether. I mean, why call, we have the medication, all they (911) are going to do is force poor johnny the junkie to take an unnecessary trip to the hospital. (poor Johnny, all alone in that cold ER, because his other friends are to high to walk in and keep him company, surronded by uncaring people whose sole purpose is to ruin his good time high, for which he paid good, honestly stolen money!). I think we in the emergency services sector need to start speaking with elected officials to pull back on this issue and move a little more cautiously.

There are no ill effects, that I know of, if given to someone who is not experencing an opiate overdose. The only bad effects would be giving Narcan to an opiate OD (morphine, heroin, methadone, codine and the recently popular synthetics vicaden, hyrdocodone) to quickly, which may cause sudden and violent withdrawal, in addition, if you administer enough to actually wake them up you will also have to deal with an upset junkie for "ruining" their high. Sometimes this can get out of hand. The other problem with waking them up is they always want to RMA which means forcing them to go or leaving them. This usually means you WILL be back for them (if they are lucky OR they get to go to that big shooting gallery in the sky) ALS usually gives just enough to get people to start breathing again on their own. I'm not sure of the uptake or dosage of the IN narcan. Opiate OD's are actually pretty easy to care for, you just have to breath for them. The last few years I've been telling students that if they are working in an tiered system and they have a complicated route back to the ambulance (flights of stairs mostly) to call for als backup (if they aren't on their way already), and stay put, cause it's not possible to bag someone going down the stairs and you always think you can get a "little" farther between breaths.

You just need to be careful about MLSS. From what I understand, MLSS now forbids you from working for a competitor. That's just about anyone in Orange county, EMSTAR, and maybe anyone in the HVREMSCO region.

You can not, ever, count on OT. It ebbs an flows, comes and goes. Even at MlSS where 8 hrs of your regular work week is OT, I would count that as part of your regular pay check. Other "true" OT is just that, extra pay, put it in the bank, use it as "mad money" if you are young enough and don't have a family, morgage etc. Don't ever count on it. If you want a reliable source of extra income do what the rest of us have done over the years, get a second part-time or per-diem job with another company. Just beware of "THE TRAP" the more you have, the more you want, the more you work, the more you have........

We us to do this (collar only, on ambulance cot no board) when I worked the streets down in NYC back in the day, as they say, a long time ago. Just funny how the more things change the more they stay the same.

After looking at the news video, just another person (and his ambulance chasing lawyer) looking for a payday. A swiftwater rescue in the mud, give me a break. And if the road was so dangerous, as he contends, what was he doing out on it.

I think this guy should be given a fair trial, judged by a jury of his peers (us), followed by a first class hanging!

EMSStar has merged with a Philadelphia based company, Keystone Quality Transport co. According to an article in the Philadelphia Inquirer March 4, 2014 this was done in response to a crackdown by the Feds to corruption in the commericial side of EMS in the Philly area. They (the Feds) are no longer registering new EMS agencies in the Philly area. The merger was done to make the new agency stronger and more competative.

That's great. The next question whould have to be, do you have SCBA gear, and is everone trained in its use?