antiquefirelt

While my dept strives to balance risks by responding non-emergency whenever we can, there are numerous reasons that every type of call must be evaluated for it's potential. Like another thread here, discussing move-ups and station coverage, there can be mitigating circumstances that drive policy. One thing on this issue that's not been brought up yet: treating an activated alarm as if it was not an emergency says what about the alarm system? I'm not advocating responding emergency to all activated alarms, but if the reasons you're not is due to the high number of activation without cause or malfunctions, this should be addresses on a larger scale. We need for consumer alarm products to be reliable and for the consumer to be confident that an alarm means a potential emergency. In our case, I've yet to respond to a CO alarm that was part of an alarm system, while they exist, they are either rare or don't have the same issues the stand alones do. So when a CO detector arms, the occupant calls 911 and typically gives a fair assessment of whether or not the building is occupied. In our case if it's a single family and they report all out, no symptoms, we respond with an engine and ambulance non-emergency. If there is any question as to occupants we respond "emergency" status. We find that most of our SO alarms are actual elevated CO calls, rarely are they high concentration, but most of the time they indicate a properly working CO unit, thus we respond as if the unit is activated to the presence of CO. I'd also note that 10-15 years ago we went to a far greater number of activated smoke detectors/alarms that often were not armed due to smoke, yet we never modified our responses unless it was multiple time to the same address in the same shift. Today, it is rare for us to get an AFA that isn't properly functioning. Now the cause may not be an emergency, but the device is working as designed more often than ever.

As was said early on here, yelling "expedite the bus" into the radio smacks of amateurism. Sure anyone can be overwhelmed, but most of the time, some actual useful information would be of more benefit than just being told to speed up (regardless of how you're travelling). I'm in no way advocating dropping the word from our vocabulary, merely asking that it be qualified/quantified with some real information. While our cops are not trained medical providers, they are trained emergency responders who have been faced with numerous intense situations, they understand the need for better information and should be able to display some radio restraint and provide basic information (bleeding badly, not breathing well, color looks bad, seizing, unconscious, etc.) We had this exact scenario last night with the previous shift. They were on a AFA call and got called to a rollover MVA with ejection. First PD units arrive and request the ambulance "expedite", which they followed with "the victim is losing consciousness." The squad and bus were already enroute RLS and made no change to their response. No harm, no foul, just timely. On the other hand we get numerous calls via PD that we get little or no information on as they radio dispatch with "send me an ambulance", which the dispatcher does without any information of EMD code, thus we must make decisions on how to responed and with whom based on inadequate info. Like everything else, it's about educating people, sometimes each other.

As I've said previously, as a singular word, "Expedite" implies the requesting person person does not think the responding unit(s) are fully aware of the situation and are already travelling to the scene as quickly as safety allows. A better solution would be for the person requesting the "expedite" to give a brief condition report that gives real-world details. In your scenario you assume that if PD asks you to expedite the pt. is significantly ill or injured (we do the same). Was that not how you were dispatched in the first place? If not, then wouldn't knowing the difference in actual medical concerns be more relevant? If I'm coming to the scene I'l always appreciate as much real time information as I can get, vs. "just get here ASAP". Typically our units travel with the flow of traffic or as fast as the conditions allow using RLS. Just because someone at the scene wants us there faster doesn't change "due regard". It's really not about the word, but about actual communication.

If this were reality, ambulances wouldn't have lights and sirens. Responding to an EMS calls RLS puts your #4 up front and endangers the other three. Amazingly if you're there as a firefighter/EMT then suddenly your safety or your partners may not be #1, we often find ourselves accepting significant risks for the benefit of a patient/victim. I would re-align the prioritization to place by-standers first (once we arrive we need to stop further harm), and then depending on your oath determine who's risking what for whom, and I'd add that your partner should be on the same line as yourself if you're a team.

I think the real message here is everything said after the word "Expedite". Using it as the OP noted "Expedite the medic" or Expedite the truck" merely indicates someone feels you need to come as quick as possible, as if you weren't already. By adding in actual useful information after the word, you've turned it from sounding like a chaos to a controlled decision making process that allows incoming units to modify their decisions with updated information. To me it's nothing to do with the word and everything about how to provide useful information to ensure units respond as efficiently as possible (not always faster!)

I don't like calls to expedite. Typically they're yelled into the radio by an LEO or untrained firefighter/fire officer who is facing a situation outside their comfort zone. The problem is that it does in many cases lead to people mashing down on the throttle. Face it, not everyone has the wherewithal to process the request, realize they're already travelling at the fastest rate they felt safe at and continue without change. Most of the people making the request would totally understand the reasoning behind this on any other day, but seeing the situation at that moment they want professional assistance, now! Excited voices on the radio perpetuate excitement, we should be working to de-escalate excitement, not increase it. I'm sure the police officers in our area are not always monitoring our dispatch channel so they have no idea how our bus was dispatched and if they're travelling RLS or not, especially if the call they (the LEO's) responded to themselves caught them off guard. Much like an IC yelling into the radio at a fire, this gives the perception of a loss of control or a chaotic scene. Most of the time RLS is used, the unit is travelling as fast as the driver feels is safe. A better way of handling this would be for the person making the request to try and calmly call dispatch and tell them the current conditions and ask to advise the ambulance of them. This allows the dispatcher to pass on relevant information in a more beneficial manner. While the bus won't travel any faster the crew will be better prepared when they arrive. Win, win.

Not to worry I'm enjoying the fresh air in my station that you all helped pay for!

Who "really" picked up the tab for this equipment? I'd suspect that if it was anyone but NYC taxpayers there is some MOU ensuring it's availability outside NYC proper? In which case you'd either get and FDNY operator or the keys.

We have a similar system, our water districts fall under the Public Utilities Commission, but they never seem to deny a rate hike. On the other hand our water district is constantly working on the system and making improvements. Our previous chief had the city council convinced not to let them open a pubic street unless the main they were replacing was going to be upsized. For the most part that's how they still operate, thus our system is improving all the time.

Interestingly enough, I had a thought about this topic this morning after a parallel conversation (different topic). In our area, the water company bills the users for metered water use, but bills the municipalities for hydrants and system infrastructure that is passed on to the taxpayers, some who are also rate payers, some that are not (live outside the water system). In our case this spreads out these infrastructure (and hydrants) costs out to more households reducing the rate payers bills (though they're paying from their other "tax' pocket). The justification is basically that even if you live outside the water districts system, you reap the benefits whenever you enter a sprinklered building, or don't lose a neighborhood to fire because the system allowed FD operations. My question would be how will taking the municipality out of the equation effect future decisions of the districts? Without a singular voice (the municipal government) the districts can conduct expansions and improvements without anyone in their way to ask how much it costs. Will they be able to push project cost directly into rate payers bills and those payers will no longer have a united voice? The above bill seem to be very palatable in that the savings will be tied to a first year tax break, but after that it appears maybe the same taxpayers. minus those who do not pay for usage, will end up splitting the costs among a group of fewer users and with less ability to say "no" to future costs?

While in general it would be great to utilize a multi-million dollar CAD system to it's full ability, typically it's only as good as the information entered into it. It's hard to compare to a large city or county systems responses, as when you start talking about assistance from outside FD's you have varying levels of training, staffing and equipment, though all call an Engine Co. an Engine Co. In my area this is the most significant reason our CAD system is under utilized. Updates are too infrequent, many local VFD's, staffing is inconsistent and proper equipment "typing" or minimum equipment lists are non-existent; all hamper a system of standardized responses. One could build a decent system is the FD's involved agreed to give up some local control for the greater good, but sadly this is far from the reality of the situation. We all want to be part of a bigger better system as long is we don't have to be the one's to change! At least you have numerous people in the Westchester area that understand the issue and are trying despite numerous obstacles.

Interesting topic, with I'm sure many opinions. 1. Up this way, 99% of the FD's are volunteer and they tend to call M/A to the scene mostly, with a few calling for station coverage. Oddly, our career crews get requested to at least two FD's for station coverage, while these stations sit empty 90% of the time (all POC). It doesn't seem to be all that sensible to call in station coverage if the station is typically unmanned unless due to the incident the nearest units are significantly further away? If you need more units for staging, then ask for units to stage, but as covering assignments to FD's that are running less than 100 calls a year? On the other end of the spectrum, we request M/A for covering units whenever we have a third alarm or greater, and quite often the covering units are sent on other runs. 2. Units do not run lights and sirens to covering or staging assignments. 3. We have no apparatus so vital to us that we keep it at "home" but we do ensure we have primary EMS and fire apparatus to respond to other calls for service, so the station is typically covered (excluding ladder service due to the scarce aerial resources in our area 3 total!)

I'm not sure how it is in NY, but up this way many (most) apartment buildings make the tenant pay for their own heat whenever possible, which leads to those who can't afford it resorting to alternative measures: open ovens, kero-sun heaters in the living room, propane lollipops, you name it. In those buildings where heat is provided cold weather visits frequently reveal windows open and the heat cranked, why not, they're not paying for it. Typically these issues are circular in nature, the absentee landlord could care less about the actual renters and the renters could care less about maintaining the landlord's property or money. The two groups end up despising each other. When I meet landlords or building supervisors for the first time (usually outside their building for an inspection) I can tell you the conditions we'll find inside from just a few minutes taking to the landlord. Almost never fails the landlord makes excuses about the condition of the building due to his" dirt bag renters". When we talk to the renters privately they typically reveal complaints about leaky faucets/pipes, electrical issues, stoves that don't work, heat that's irregular and more, all of which go either unanswered or very slowly corrected. Conversely, the landlord/owners that are onsite or who are local tend to take care of their properties and their people and the renters pay it back by treating the property better. The answer is to find a way to hold both parties accountable for their responsibilities. I know that I as a taxpayer have a hard time paying for people rent in buildings that aren't up to code. On the other side I also hate that we pay people rent who haven't the decency to take care of what they're given (a place to live). This is part of our overall morale dilemma. Those who abuse the system make it difficult for those of us who support it (pay taxes) to feel good about it when our paychecks are shrinking. On the other hand we're way past ever turning people out into the cold with no social services (food, shelter, medical care). If the abuse could be curtailed we'd all pay less and feel better.

Sounds like a decent bill. I know we pay a significant number of dollar per hydrant due to the overall size of the local water delivery system. At budget time "Hydrant Rental" is another $350k+ item that makes the budget that much higher inviting the "it must have some fat" attitude.

Step Ladder? Is that what you guys call a 75' quint?

Perfect timing, our regional comm center is looking at a regional radio designation system right now. Anyone have a system they think works well? It appears that using a singular dispatch freq with lots of auto aid ends up with a lot of similar sounding apparatus moving thus they feel a numbering system is the answer. I understand it works well for our local LEO's, though I'm not sure the numbers or types of resources are nearly as complex.

I can't comment for all cases, but in our case we went from two apparatus to one. he first was a light rescue vehicle with a set of Jaws and a few hand tools and a standard class A engine. Our "Squad" now carries far more rescue tools and no less engine company tools, with the addition of more "ladder company tools (saws, rakes, hooks, etc) air monitoring equipment, RIT gear, some level C and B Haz-mat PPE and mitigation gear, and more. I think the larger issue with quints vs.standard apparatus is less the apparatus and more about the company. Though it is more difficult to put a full ladder company and a full class A engine on the same apparatus given the amount of space the hose bed, tank and aerial all take from the same functional area. This isn't to say there isn't a downside to the rescue engine. When you're assigned to one function, typically the other is unavailable. In our case our Squad is our lead engine with the career staff assigned to it each tour. Last week we provided "extra" confined space coverage to the largest industrial plant in town, and to ensure the crew (hired at OT for said duty) was properly equipped we had to strip the con-space gear from the Squad so the apparatus could still be used for other emergencies while maintaining a ready(and equipped) rescue team. I'm sure Bnechis can more accurately address the ISO point, but I do not believe you'd be penalized for a rescue engine unless you were not carrying the full engine company tool compliment. The reason quints are "penalized" is they're unable to perform the two functions completely separately where both functions are being rated. Rescue companies are not a requirement of ISO. For an apparatus to count as two it'd have to be able to be in two places at once and be staffed with two complete companies, both are nearly impossible in today's economy. As for which is it: a rescue pumper or pumper rescue? Who cares? We labelled ours a Squad as it was notably different from all other apparatus in the area. As the saying goes "you can put a cat in the oven, but that don't make it a biscuit!" Up this way there are very few true rescue companies, in fact most FD ambulances in Maine are called Rescues. To my knowledge Portland FD is the only one on Maine to have a rescue company (just came back on line after disbanding it a few years back). And theirs is minimally staffed (all inclusive 3 personnel).

Pretty much the same here, 2 of our 3 buses have no squad bench. I will say that some personnel report the single seat is not as easy to work from though as it's not always in the optimal place for all patients. This means the EMT might have to "unbelt" and move outside the captains chair "cubby" area more often depending on your seat layout and restraint system (and actual use).

Same thing happens in our area, it's become a large pet peeve of mine. I see it as a sign of the first due person/officer at the minimum, not understanding the value of the size-up report, something that should be understood before someone is given a radio, regardless of their rank.

The fact that you think it's free might be incomprehensible to many of us! Where do you think the government gets it's money?

I understand where your coming from and appreciate your sentiment. I agree with the concept but again, I'm not so trustful our government can do what's best for us at this time. I certainly agree that not all that are not working are taking advantage and understand that many working folk still cannot afford healthcare, but I see some inherent problems that continue to plague this program as it stumbles forward. Sadly, the fact is we put a dollar sign on human lives everyday. We've yet to mandate sprinklers, yet we know the enormous benefits to life, the only downside, literally is the cost. We know we need more ambulances on the street but we only staff what we want to afford. Most of us can't afford the safest cars on the road so we buy subpar ones and gamble... As a nation we choose the cheaper option rather than the safest one, thousands (maybe millions?) of times a day. We do have the need to fix our healthcare system, let's just hope it can serve the people and not continue to drive more people toward the poverty line while failing to address the real cost generators. When the 'experts' used to compare our system to others in the industrialized world, they'd note how much of every dollar went toward paperwork vs. actual care, it appears the Obamacare system is only contributing toward increasing paperwork and confusion not reducing it.

I agree with the access, now tell me how everyone pays? Do we all pay the same amount or do we pay more based on income, does this cap off at a certain level or does Bill Gates buy healthcare insurance for more than he could just pay for the services? Equal healthcare means that some people will end up with less benefits and choices while others will gain some? Is it fair to reduce the benefits of those who are willing to pay more for more options? Again, I want to be part of helping those who need help, but I don't want to feel like we continually area asked to give while other seem to continually get a break and still others continually take and take and take. Show me a system that is fair, I'll sign up in a heartbeat.

I'm conflicted on this, I do feel there is a huge need, and am certain we cannot/should not let people suffer, but I don't think you can call this "equal". much like every government program, there are people exempted from the provisions, and forcing those who work the hardest for their money (middleclass) to pay the most (percentagewise) for those who contribute less and use services more (those who don't work) seems to serve to drag more people down toward the poverty level. I know that in the past 4-6 years our meager salary increases have been outpaced by rising costs of requisite items and services (heating oil, gas, food, insurance). So while I'm not against the concept, I'm very skeptical especially when I hear that plans like the one my work offers will become even more expensive and likely we'll lose it to a lesser plan. And of course forcing us into anything that costs more or reduces benefits is not met with open arms.

Have you got a link to the 30 hrs? Our finance dept. sent "Obamacare" letters attached to all payroll stubs this week that state the benefit is only for those who work 37.5 hours or more? As we discussed today at work, the program would likely never kick in for our paid call employees who'd have to see a huge increase in calls and training to make that an average, but.... Those other departments in the area running per diem services without offering benefits will certainly need to scrutinize what this might mean.

This will definitely make things interesting. The employer is not the department you work for, but typically city hall (with municipal employment) thereby getting to 50 doesn't have to be within the FD or EMS agency, but under the same finance department or WC provider. Could get sticky, some places such as my own FD do not pay our call personnel by the hour, but by a credit system. We don't track the hours they work, but if they calculate their hours like the career personnel who are paid for the same drills and incidents they'd get the same minimum hours as the Union has negotiated for recalls and off duty training. That sudden increase in costs to the taxpayers will certainly be detrimental to our budget, but also increase the costs of "volunteers/ POC" staff nationwide, reducing the "savings" they provide a given community.