gmspro

For anyone to "comment" on what they would have done, unfortunatley exemplifies that persons lack of understanding of the environment true 911 professionals work in. We are not talking about baking a cake here. If you weren't there, if you weren't dealing with all the events at hand including the incident, responding personnel, appropriation of resources, assessment, escalation, mitigation and deescatlation of the incident; as well as coordinating appropriate care, notification and more; regardless of how many years you may have sailed, flown, swam or run; it is arrogant of you to sit here and thrown your two cents in where it is not needed or warranted. Who are you to even question or judge the brothers and sisters who we are all confident risked there own life and limb to save their fellow brother? Those at the scene did what they felt was right, given the parameters they were working with. Whether or not you intended too, look at your statement and the situation. Your comment completely second guessed a situation that had nothing to do with YOUR life experience. If you have any concept of what 911 is all about; then you should know full well that there is a lot of information that will not make it into the press. That information may very well be the reason that certain options were chosen; which may have been the deciding factor in why they did not run the operation the way you feel they should. Out of respect for all our brothers and sisters out here; think before you make disrespectful comments; especially about our own people. Normally I would not even comment, but the utter disregard for the professionals in your comment who raced to the scene goes too far.

First of all.. if you are a fellow brother and you have a "source" who was there... then you should know that the information regarding a fellow brother's medical condition is PRIVATE and it's NO ONE ELSE's BUSINESS, including yours. It is unfortuante that we live in a world where the press out's someone's information. Just because it happened, doesn't mean its fair game or fodder for all the loads of verbal vomit that has followed here. Worse are the individuals who come up on this site and begin to monday morning quarterback a horrible situation.. questioning the Department who put the pro in professionalism when it comes to fire suppression and rescue operations. Those at the FDNY are the best of the best and we all know it. A fellow brother is hurt and needs to heal. For those of you who don't know when to just shut up and let it be... take some somber refelection of this situation and think about if it was you, your family, your friend or child. Would you want their information out there, or people who, regardless of their experience; were not there and are now spouting all sorts of mouth diarrhea about their opinion of the validity of the incident or how it should have been handled? Just because you are able to give your opinion doesn't always mean you should. Let's all just keep our fraternal brother in our thoughts, lets keep respect for his privacy, respect that his fellow brothers and sister's did the right thing and the best they could in the situation; and hope the best for his recovery back to a normal life without pain or permanent disability.

Sir, You have raised a FANTASTIC question! As an active EMS person in the NY and Westchester County area for decades, it is a topic I have raised to many. There is a state of mind, especially in the Westchester/Rockland areas and areas north; that is "It could never happen here." So many EMS providers, even at this juncture in our post 9/11 world, think that because its not "da bronx" or "brooklyn"; that such a type of shooting will happen in Westchester or surrounding communities. That mindset is part of one of the issues that keeps Westchester from becoming an even more progressive and formidable, cohesive set of providers. Westchester, for example, actually presents a number of serious issues in large-scale EMS incidents. Westchester is extremely agency-disassociated; in that you have areas that are served generally by three types of services; paid EMS (most of the paid services are either by a "for profit" agency or known as an ambulance company that is contracted to provide BLS or ALS services to a community, a combination of paid staff and volunteers and some all volunteer. Because you have so many differently run agencies and there is still a lack of true incident orchestration for EMS incidents; it is usually done on the fly. The County has not made great effort to establish a solid EMS command structure that is understood by its providing agencies. They have left much of it up to the individual agencies and with forty-five EMS providing agencies, that leaves way to many cooks in the kitchen. The other issue is experience. You run the mill of different experience levels in the county. Some providers have extensive experience, some in urban environments where large-scale MCI's are normal. But often because of the difference in the area and suburban settings; many volunteers are not as practiced in the sheer amount of patients or the level of injuries that may be encountered. Additionally and not as a matter of fault, but because MCI's are not as frequent in the suburban areas, as opposed to urban environments where there are MCI's daily; the lack of experience in this area makes it even more essential for county providers to be prepared. The County does need a more intensive EMS program and exercises should be mandatory to meet the needs of the post 9/11 counter-terrorism world that we live in. More EMS providers need to be introduced to tactical EMS, working directly with the law enforcement providers around the area. This would mean S.W.A.T. teams from agencies in their local area, as well County, State and Federal units. It would be a great service and experience in the horrific event that what happened in Ohio, happens locally. There should be at least a bi-annual drill for as many agencies as possible including EMS, Law Enforcement and Fire. There should be County-wide protocol set up by municipality, taking into account the amount of resources the agency has and the expected response of the other public safety agencies. There should be specific plans laid out to act as a guide of things to remember; staging areas, landing zones, resources in the immediate vicinity that may be forgotten in a crisis situation. There should also be a pre-planned Critical Incident Stress Debriefing that is MANDATORY for all providers once the incident has completed its de-escalation phase. Westchester County and the surrounding counties all the way out to Long Island have outstanding volunteer EMS providers. Westchester County for example, in an effort to fully support their EMS providers and give even more support to a major incident; should have a greater number EMS Battalion Coordinators with a larger role in the EMS response of the County. There are ten Fire Battalions Coordinators and only three EMS Coordinators. WIth a major airport, miles and miles of roadway, industry, Indian Point and all of those who reside in the County; it is time to step up the adaptability and efficacy of Counties everywhere. There are grants through DHS and FEMA that can be utilized to augment current holes in EMS Incident Command. Sometimes, there are those who want things to be like they were many years ago, and we just don't live in that world anymore. There also needs to be better credentialed EMS leaders who have direct experience in Incident Command on a large scale, and not just someone who might have been appointed because of their popularity. It is not an insult; but some have no concept of when to admit that there are bigger problems in front of them, and teamwork is essential. It is important to put down the ego's and arrogance for the benefit of patients, and come together as a family of providers, evaluate each others strengths and weaknesses and build on them.

I need to add something to all of the comments I am finding here. There is a quagmyre being presented in all of this and that is that the Police Department, no matter where they are, are not medically-trained individuals. No offense to them at all, they have a very needed and well-performed function. But in the case of a patient that you have been dispatched to, even one who is a confirmed psych patient..... YOU HAVE TO ENSURE THAT THE PATIENT IS MEDICALLY CLEARED FIRST, BEFORE THEY ARE PLACED IN A NON-ED (PSYCH) SETTING. One thing I have noticed in my years in this profession, particularly with the advent of HMO management and mis-management on the part of clinical practitioners, is that not even we (the EMT's and Paramedics) in the field, are in a position to determine if someone is a complete EDP. In fact, they may be a complete EDP, but there may be a medical component in play that if you miss, you can harm your patient, the care you provide to that patient and eventually when it catches up to you, your certification. So many EMS professionals want to follow what they see from other seasoned staff, but the problem then is if the more experienced staff are lazy, or feel that they want to be apart of the old boys club and just follow what they police officers tell them to do; they are not living up to their training, certification or purpose. The Emergency Emotional Health Warrant or Directive that Police Departments operate by, though nice to have, is inherently flawed and also puts the law enforcement agency at risk for liability and litigation; but this is a liability that the law enforcement departments accpet and are willing to live with. They are not trained to the level of medical care that EMT's and Paramedics are, and often facilities will just turn you away if your patient has a medical component on board or even the question of such. Be very careful not to get caught in a trick bag and have your certification yanked by your local medical control if you act outside the scope of your findings. Unless you are performing the functions of a pre-arranged transport via a crisis team, generally all patients in the 911 system are to be transported to a 911 receiving Emergency Department. EDP's can and will lie, so just because they tell you that there is no involvement of substances does not mean it is true. YOU will be the one held ultimately responsible if anything happens to a patient that you transported to an incorrect facility. Be a leader, not a follower! Just a few thoughts.

There is a time when years of tradition needs to be tossed out the window. First of all, all this babble about why is it becoming an issue now needs to stop. This practice has always been unsafe; whether riding to alarms or in a parade. It is common knowledge in the public safety community that it is unacceptable and unsafe to be riding on any poriton of apparatus unsecured. To make it even worse, all of these parades also center around alcohol consumption, so that it is safe to assume that those riding the side or rear step, or those on the hose-bed may very well be unable to balance and hold themselves properly. How about we just play it safe and not allow this! I applaud all of those who have the guts to speak up about this, even if it appears to be a negative hit on the profession they love so much. Those that oppose are just trying to ensure that their friends and fraternal colleagues make it home safely..... WE ALL HAVE TO LOOK OUT FOR ONE ANOTHER... ON AND OFF THE FIREGROUND!