helicopper

Unless there's been a major shift in policy in the last two years, the minimum grade to pass a DOH EMS exam is 70 - at all levels (CFR through EMT-P).

EMAC (the Emergency Management Assistance Compact) is coordinating mutual aid requests from the states for the midwest. I know that the State's Incident Management Team was canvassed and they are working on whether or not they'll be deployed to Iowa to assist them. I'm not personally aware of any other specific requests from the states for any kind of first responder assistance.

ICS for Expanding Incidents (I-300 Course) at Camp Smith July 15-17, 2008 ICS300_7.15_7.17.08.pdf All registration info and other details on the course announcement!

And the hospital goes bankrupt because they're expending funds on non-reimbursable charges and tying up beds on nothing more than an intox. I don't think it's a "smart move" and I don't think dumping a social services problem in an ER is "CYA". This is a problem bigger than anyone one agency and all we do when we dump on the ER is transfer the problem to them. No medical condition = no need to tie up a bed in an ER.

Actually, the crime rate in Yonkers is rather low given their population and other demographics. This is a credit to their cops who are working long hours to make it safer for the citizens. I know Bloomberg is a billionaire, maybe he was a bad example. My point was there is no correlation between the salaries of cops and elected officials and the crime rate or anything else in a given municipality.

What exactly does that tell you? Everyone in NYC makes more than Bloomberg (his salary is 1 dollar), what does that mean? The Journal News has done this story on my job for years and all it proves is that we're understaffed and continue to do more with less. Yonkers is no different! Great points about the number of hours worked - these guys are missing their families and their lives working those long hours. Yonkers benefits from this overtime by not having to pay more full-time employees and all their benefits.

It's only going to be worth it if you will be able to practice your skills in an Intermediate or Advanced life support service. Otherwise, the knowledge is nice but the skills are perishable so you'll lose them if you don't use them.

And, with regard to incident alerts, jobs must be confirmed or actually verified before the IA gets posted. Please do not post based only on dispatch information! Unconfirmed or jobs that do not meet IA requirements will be deleted by the staff. Thanks!

Putnam had some heavy rains, wind, and good size hail (some an inch in diameter) but that's about it...

That's ridiculous! You don't discard your rules or training when a life is at stake. The rules and training should be consistent with the objective - otherwise why train and why have rules? Hopefully that's a retired old chief and he's not still promoting that kind of attitude. I'll concede that judgement calls need to be made in such situations but you can't promote the mindset that you'll just "do whatever" when a life is at stake. Rules and training exist to protect all of us! If a civilian can't be rescued, that's a tragedy! If firefighters die (as they have in so many instances) because obvious hazards and safety rules were ignored because a civilian was in peril that's just negligence. Didn't a certain department in a certain southeastern state just get beat up for ignoring rules and training and obvious hazards? Isn't there always a life at stake when you're battling a fire? YOURS!!!!!

mfkap, you really need to lighten up a bit. The point is we don't get paid to get hurt! We do get paid to carry heavy people and deal with all kinds of other nonsense but when someone gets combative the situation changes! Would you prefer that PD allowed a combative patient/suspect to beat the crap out of the EMS crew rather than run the risk of hurting him? That's what we're talking about - if a civilian gets hurt so we can protect ourselves and/or our brothers and sisters in the other services that's the stark reality of the job. Nobody wants to do it but that's the result.

Newsweek even picked up the story and did an article on it and the psychology of helping. Link: http://www.newsweek.com/id/141226?from=rss

I've seen six officers fight with a senior citizen - and two of them got hurt - just trying to get her handcuffed (that's right her). That scrawny 18 year old could be tripping on drugs, could be an EDP or could be a student of martial arts. Do you judge a book by it's cover? I hope not. Is that fire not going to kill you because it's in an apartment not a wood frame dwelling? Anyone can kill you - you don't take anything for granted! "Unless he was shooting at you"? With all due respect, if someone is shooting, nobody is using a Taser! Deadly physical force will be met with deadly physical force. You're drawing a lot of conclusions from an article that is awfully short on facts! We don't know how combative he was, we don't know whether or not EMS tried to let him work through a post-ictal state (if that's what it actually was), we don't know if any of the EMS providers requested the PD intervention. As for the officer "trying to hurt your patient", I hope that this question is just because you're experienced or naive. The police don't do "harm" to people - they protect people (sometimes from themselves, most times from others!). Once a patient becomes assaultive or combative he is a suspect - stay out of the PD's way and let them do their jobs. It might be your a** they're saving! As for this call from the article, you're assuming that he was still post-ictal, we have no way of knowing that for sure. Anytime I dealt with a post-ictal seizure patient their aggression was usually uncoordinated and not focused at me or anyone else. If this "patient" was attempting to strike the EMS crew or police and actively resisting, it may not have been his seizures! We simply don't know from the article. If it is the first example, you can tell the cops what's going on so they don't think you're being assaulted. I strongly recommend that you spend some time talking to veteran EMS providers and police officers to gain a better understanding of the relationships and duties/responsibilities. Statements like "the officer was trying to hurt my patient" are inflammatory and may not truly reflect the circumstances.

INIT is right, the article doesn't provide any details but at the point when he started fighting with the EMS crew and deputies he went from a patient to a suspect. What would you prefer; to let him assault the EMS crew? Don't act so surprised - people do wild and crazy things every day! As for "first-line" status, Tasers in the rest of the country are an everyday piece of equipment. Rather than put hands on and attempt to "fight" someone, you gain compliance with a Taser. It sure beats a nightstick and is far less deadly than a firearm. Since most cops are not martial-artists, the use of a Taser reduces the likelihood of injury the officer or suspect during a hands-on confrontation.

From a time management perspective it's probably more efficient and economical to fly.

It's not just lately. This has been happening ever since we created divided highways. Whether caused by impairment, stupidity, inattention, age, unfamiliarity with the area, or anything else, wrong way drivers are always going to pop up.

I was under the impression that the trauma protocol had been updated to make MOI a component in the process but not a sole criteria for designation as a "major trauma" - is 2004 really the latest update to that protocol? Using your rationale shouldn't you respond to EVERY auto accident to obtain a refusal then? If there's a six car rear end accident during rush hour because one car got slammed injuring the person in that car and the other four got "bumped" are you really going to get RMA's from everyone else involved? I gotta agree with ALS and there've been threads about this in the past - if I'm not injured I'm not refusing anything. 16 year olds are a different situation - let's stick to one problem at a time. If I complain of pain/injury then I do have to refuse. Back to the MCI question... don't confuse your one on one decision making with the triage and multiple patient decision making. As ALS and BNechis have said in the past, without training, policies, and practice, we're never going to resolve this! Prior threads on refusals: http://www.emtbravo.net/index.php?s=&s...st&p=103840 http://www.emtbravo.net/index.php?s=&s...st&p=103370

You can't work in this business (any emergency service) with the mindset that this will "leave me open to litigation" or "will I get sued if I do this - or don't do that?". If you do your job within your training and protocols without biases or discrimination you have nothing to worry about. If you or your ageny do get sued, so what? There's no basis for a judgement against you. As for your comments, 1. Assessing the mechanism of injury is a valid component of a patient assessment but it should not be used by itself! A rollover does not an ALS patient make. I've seen prolonged extrications for patients with ankle injuries so the extrication alone is not a determinant that ALS is required. Start with the PATIENT then factor in all the environmental considerations to confirm or support your findings. If you consider the environment first there's a good chance you'll miss stuff with the patient. 2. If PD or FD is on the scene, leave the RMA's with them and transport the criticals. If not, have them sign the refusal and go. Don't delay transport of critical patients to babysit refusals. In the event that a patient crashes after you leave any other RMA would you be screwed? Of course not! If you have an extra EMT and want to leave him with the RMA's until other EMS arrives, do that if it will make you feel better. 3. If you have six patients you don't necessarily need six ambulances. Double up the patients - with the monster rigs around now that's not an issue - and transport. Now you only need three. Given Life-Net/STAT-Flight's response time, treatment time, and transport time, it's going to be at least 30 minutes. Can you use them? Sure. Should you? That's a judgement call. Every situation is different and there may be compelling reasons not to use them today and equally compelling reasons to use them tomorrow. You can't lock yourself into a single decision now. EMS requires good judgement and decision making skills - that's why we have QI/QA programs, to understand what happened and why people did what they did. Good decisions get highlighted as what to do and bad decisions are learned from so we eventually stop making the same mistakes! Get involved in your agency's program and develop these skills and you'll ultimately be a better EMT.

Nope, parks units are just that: police officers assigned to parks patrols. The "Public Safety Emergency Force" (PSEF) is the group of volunteer peace officers that wear the green/tan uniforms and drive the sheriff cars. They're essentially an auxiliary arm of the Department of Public Safety.

The "sheriffs" you refer to don't do any type of enforcement - they're almost exclusively for traffic direction and control at special events. They can also be mobilized for disasters (I think they were during Tropical Storm Floyd) but they're not out with the traffic guys.

Sobriety tests are actually accurate enough to be admissible in court. These include standard motor function and divided attention tests and the use of horizontal gaze nystagmus testing. The "blow in the box" devices that so many people think make the decision for us are merely a guide to further bolster our determination from the above tests. Anyone using nothing more than a PBT (alco-sensor or similar) is out of their mind! They'll surely be chewed up and spit out by a competent attorney. So, the moral to the story is you can't have an elevated BAC and not be intoxicated but you can get just about any reading from a "blow in the box" device.

Ditto! I also recommend that you take some time and visit her site to read some of her other works. They are exceptional and provide tremendous insight into the world of law enforcement as seen through the eyes of a police officer! Jill, thanks for all that you have done and are doing! Keep up the great work!

I'm not sure what you mean by this... Perhaps you can elaborate?

Barbaric and immoral? Isn't that a bit extreme. I can't speak for the European incidents but in many US states you can be billed for search and rescue if you leave an authorized ski area and become lost or injured as a result of your own disregard for posted regulations. How is this any different than air ambulance agencies charging for their services? I've never heard of a first responder (or other player in SAR) in the US turning their back on anyone in a rescue situation. The whole billing thing is after the fact as a way of charging the recipient of the services and probably as a deterrent. The National Guard doesn't lower people from their helicopters with a credit card machine to charge you before plucking you off of the mountain.

Complete article available at: http://www.legalsurvival.com/dwilink/vol22.html