SRS131EMTFF

I am not looking for treatment protocols, I am simply looking for any documents that NYS DOH BEMS or WREMSCO has put out regarding its use on patients at the BLS level. I use it up here in VT, every patient of mine gets a pulse ox and SPO2, of course l assess for accuracy of the unit and the quality which a digital read out can not provide. Obviously if you are sating at 99% but blue or having difficulty breathing or the indication for O2 is present, of course I give it right away, but if I don't need to give you O2 why should I? Then again, if I knew you were sating at say 85% vs. 95% that would certainly change the amount of O2 I would be administering or even the administration method/route. I guess I am simply asking, is there a protocol for pulse ox/SPO2 at the BLS level in NYS and is it wise to allow BLS crews to use individual discretion in tandem with pulse ox/SPO2 in regards to treatment decisions and oxygen administration.

Are you trying to become an NREMT?

Can anyone direct me to information regarding any NYS BLS Protocols for use of pulse oximetry? Specifically to measure oxygen saturation? I have looked in both the NYS DOH BEMS site and the WREMSCO page and the relevant documents on each of these pages but I have not been able to find any mention of measuring oxygen saturation and pulse oximetry. I am sure it is out there in one regard or another but I just can't seem to find the document or the page. Thanks in advance.

#5 is a stretch but #2 and 3 are definitely true.

Looks like Rescue Me with Chase from House instead of Denis Leary. So long as they stick to the firehouse and don't bring in anyone the nonsense that Rescue Me did, I figure it will have moderate success, at least among our circles. But if I get even a whiff of any sort of Rescue Me type drama, I will certainly be finished with it. All of that being said, it looks amazingly poorly researched...I lost track of the number of things that they did wrong in that three minute clip. From the diving from the bridge to the car accident to the patient in the back of the ambulance to structure fire, it looks like they did more things wrong than right...

No one ever said they did it well. FDNY and LAFDCo are the model, everyone else is an imitator...

Why would/should they? This is nothing more than the annual scare tactic from bloomturd. Every year its close 20 houses and every year the money is found else where and no houses close. It been like that for at least 4 years now. Second, your saying that each truck company should be 33% less effective at their job, putting firefighter and civilian lives at risk? For what reason? To prevent the non-happening closure of 20 houses? One of the hallmarks of the FDNY and the reason why NYC has among the lowest fire deaths, property loss and fire department services tax per capita in its history is the fact the FDNY is so well staffed, trained and equipped. Imagine what would happen to your truck co, your department, your citizens and your municipality if you cut your truck company in 1/3 truck12345. I think you should get a better idea of how and why the FDNY staffs and functions as it does before you make wildly uninformed suggestions about how the FDNY should be run...your no better than those who seek to cut the 20 companies...

1. The charger gets better mpg than a crown victoria. 2. one can hardly call orange county or newburgh urban. 3. even if you want to call Newburgh urban, they are so outgunned and under staffed, their officers need to everywhere immediately. edit: *need to be everywhere immediately.* Crown Vic, average mpg 7, Charger average mpg 17. 50,000 miles/10 mpg=5,000 gallons of gas. At an above average civilian rate $4.00/gallon, which is not even close to the municipal tax and levy free rate, 5,000gallons of gas X $4.00/gallon, you are still looking at $20,000 saving by not using the crown vic. If they have 5 chargers, they have saved themselves 100,000 annually. However, that is not nearly enough to hire even one additional officer considering benefits, allowance, salary, OT, comp. and pension... You see it as losing money, when in reality it is saving money.

6. 1 officer, 5 firefighter on all FDNY truck companies.

No, its 4 firefighters and 1 officer on all 194 FDNY engine companies. In January, the 60 engine companies assigned an extra man (a fifth firefighter) had that firefighter removed due to the overtime it was costing the city. yes, minimum staffing is in their contact, a contact that expired mind you on the same day they pulled the 5th man...

I dont think the city asked when they took the 5th man from those engine companies...

Your average brick in a brick house will expose you to more radiation a year than several chest x-rays. Each brick is roughly 7mrem/yr while a chest x-ray is roughly 1mrem/scan. Had a load of bricks gone past the sensor, im sure that too would have set off the detector. Im sure the reason why they cant bring them into underground places or places with high stone/brick/masonry is all of the radioactive elements naturally in the ground or included in the stone building material. I dare anyone to take a scintillation detector and hold it up to any random brick, I am sure the radiation levels would be much higher than you expected. I work with a form of radiation in one way or another almost every day, I am not afraid if it, what does amaze me however is how misinformed we as first responders are.

*can't edit, but remove the couldn't disagree more part* I believe if you don't have adequate resources, then use the FD, otherwise, I am fine with just EMS...

I couldn't disagree more. The only reason to call the FD is if you don't have the manpower, which is a system issue on your end, not a guideline or protocol issue like you seen to want to make it by forcing the inclusion of FD. I run on a crew of 4 EMT-B's,I's and P's. Between the four of us, we can stabilize, lift and move almost any patient we come across. The only reason why we would consider calling the FD is if we need more hands or more tools, other than that, calling the FD will only bring more bodies to the scene, bodies I might add can cause further embarrassment and stress to an already distressed patient. People, especially if they are elderly or in a residential treatment facility, see ambulances on a daily basis, it is quite the commotion when our huge red truck comes screaming down the road to the facility. That commotion is stressful to the residents and the patients. Sometimes a lighter touch is what is required in these calls... If I need the FD, they are a radio call away...

And that is why all of the 60-Control dispatchers are EMD, so they don't send a medic on to pick up Mrs. Jones after she fell out of her wheelchair again this week.

FD and EMS. EMS to evaluate the clear/transport the patient. FD for the extra hands. PD too if they are having a slow day and they feel like it... These can be generally simple with an extreme potential to go south quicker than anyone would like.

Would you mind posting it. If it is the same one I am thinking of, I have been looking for it for a while and have not been able to find it.

2 points: 1. Nice job Medic Hart 2. Why is EKG transmission to the ED only new as of March. Where I am in the literal sticks of Vermont we have had this options on our monitors since we bought them way back in the day.

RIP. Thoughts with the first responders and the family.

There are complications beyond the 2 second recap I posted above. I did not want to include them because frankly I did not want to turn this into a call debrief. All I have to say is that there are reasons why these things happened beyond a guy with a medical emergency hit me in the face to have the local police considered filing charges. Although I did not get the full story, the attending ER DR did include something regarding complications from cocaine and other illicit substances in the patients system that contributed to his condition. I never expected or wanted charges to be filed. However once I filed the injury report and documentation with the town risk management people, the town rolled with it.

It did not occur in New York. I was informed by the investigating officer that although charges were possible, in all odds they would not be filed. That was the last I heard of it, and frankly I am glad I am done with it. The black eye healed and I went on with my life.

I was assaulted by a patient Memorial Day weekend. The patient was having a subarachnoid hemorrhage and had no real motor control. He could move limbs, breathe, blink etc but had no control of these processes. While we were in the process of attempting an IV I got slugged right in the eye. After detailing this in my PCR and writing up my injury report and having it forwarded to our PD, it was decided that although the "hit" constituted an assault during official duties, no charges were to be filed considering the nature of the circumstances. It didn't help that he was a vegetable either...

http://www.time.com/time/health/article/0,8599,2112732,00.html this article explains why

What happened?

I cant edit my post but here is some more info from statter911. Firehouse had a full article. http://statter911.com/2012/04/22/detroit-fire-commissioner-proposes-letting-vacant-buildings-50-involved-burn-to-the-ground-donald-austin-asked-to-make-cut-in-next-years-budget/