helicopper

True enough, but with enough support, things do eventually gain traction and momentum. (Not to say that this will of course) Had they truly made the effort to implement the proposals in the Westchester 2000 report that came out in the 80's, we might actually have SOME of this today. Of course, politics won out back then too. We shall see!

Roof, I completely understand the emotional nature of your posts as I have been to entirely too many funerals as well. However, it is highly unlikely that any lawyer is going to use this forum as a source of expert testimony - they all know where to get that already. Nothing being posted in this forum is confidential or directly from the investigation so it is not going to impact anything relating to the case or potential civil/criminal actions. It is a discussion among and between colleagues. Nothing more, nothing less. There is no "good" time to discuss the circumstances that caused the death of a brother but if we can learn from it, we certainly should so another death or injury can be averted. I know that I've sat in classes and watched the dash cam from police cars where the officer was killed. We've discussed his/her actions and tried to learn from them so we don't make the same mistake again. That's not disrepectful, that's what I would want if something happened to me and someone else could avoid the same situation. Do you write to FOX to complain about video of crashes/pursuits/etc. shown on TV as entertainment? We're not reviewing these situations as entertainment, we're trying to do our jobs more safely! Take a deep breath, nobody is trying to defame the memory of a fallen brother!

Aren't there already a couple of these types of trailers established in Westchester and staged at DES in Valhalla (and one at the airport)?

The training is a basic NYS Peace Officer course plus some first aid, department policies, and administrative stuff pertaining to the PD. New hires get about 80 hours of training (the 40 hour state course plus 40 hours department in-service). Retreads may get a little bit less because they can take a "refresher" for the peace officer course. As for qualifications, they should all be on the announcement. Some of the training is also offered in the evening to accommodate full-time day students. Hope that helps a little!

Just 36 years old and dead from a heart attack. That's TRAGIC! Along with the 44 year old SP Sgt who died while shoveling snow right here in our area, this emphasizes the need to stay healthy, exercise, and avoid shoveling snow!!!! Stay safe! RIP, fallen brother!

I'm pretty sure that you're correct. I think they started in White Plains and expanded to other cities in the County before the competitive bid process started and the providers changed frequently. AA may have been the next provider in the County and don't forget that the Yonkers PD ESU was originally a paramedic unit so they were among the first paramedics operating in the County.

Paramedic programs CAN weed out bad EMT's... if they choose to. JJB hit the nail on the head. They're receive funding based on graduates so they're inclined to maintain a lower standard than I think most of us would like so they can make the most $$$. If they raised the standard and remediated average EMT's to make them excellent EMT's before starting the medic program we'd all be better off. There should also be a stronger screening process so an EMT with no experience can't just jump into the medic program. When I took my medic class, I was interviewed and my experience was evaluated before I was allowed to enter. Do we do that anymore? Not exactly true... Rockland Paramedics! Every unit (except Tuxedo and that's only because of volume) is two medics. They have the ability to work together to expedite treatment or split to cover secondary calls in their area. I'd really like to see Putnam go to two medic units especially on the east side where they're always relocating to cover due to multiple calls. The expense is there but if they're in the same truck you're offsetting some of the cost. Seth, the EMT-I idea never took off for a couple of reasons - one someone already hit on and that's the EMT-I not being able to perform skills because the medic needs to keep his/her skills sharp. That's a problem in low volume systems. The other is that EMT's in volunteer systems already have a hard time with all the demands for their time and adding several hundred hours of training for "I" is a major commitment. Some will make it, many will not. In paid systems, there's very little return on the investment so why spend all that time/money to use EMT-I's when you can use EMT-B's.

Come on, lawyers may stretch it to try to make it look like abandonment but it's not abandonment if you're facilitating their treatment or transportation by making sure you can depart the scene safely (backing up) or getting equipment from the rig while performing an extrication or something like that. There has to be a termination of patient care, not a pause in care. It may be argued otherwise but the reality is that if you back over someone behind you or have an accident you're going to have a harder time! I agree with ALS, if you're ventilating the patient you can't stop to push the button so the driver can back-up. That's absurd. But to move to the back windows to clear the rig for backing with 95% of your patients you're not interrupting - or terminating - their care. Here's a good article on abandonment from JEMS magazine... JEMS article

Wasn't that Ron Hernandez?

Rob hits a lot of good points and he's definitely right about having to respect the other members regardless of their level of involvement or resistance to change. You may also want to develop a brochure about your agency that you can give out to prospective members or just the public educating them on who you are and what you do. That can be done in conjunction with the membership drive Rob described. Call volume is also an issue. If you have really low call volume it's hard to keep energetic members energetic and that provides the older members with the ability to maintain the status quo. You've got to remember that change comes very slowly and is often resisted. Instead of major, radical changes you should try smaller changes that will eventually get you where you want to be. Be patient and keep up the good work! We need advocates for change in this business!

In addition to WCC... Rockland Paramedics / Rockland Community College may run them. Phelps Hospital also ran them a while back but I don't know if they still are. Your best bet may be to find an agency providing EMT-I and find out where they do their training.

Also, in addition to the pathetic hourly wages, there are many agencies that provide minimal benefits and there is no pension, no right to work (unless a union shop or civil service and those are rare).

You gotta love that kind of notice!!! Do they have to have their uniforms on day one or do they at least get that as a gimme?

It is just a shell game. It's like municipal agencies "billing" each other for services. It's so they can keep their own budgets low and run up the budget of whoever uses their services. It is absurd and irresponsible that agencies have long-standing (with no end in sight) policies of using tax dollars to pay rent for a firehouse. Buy it, build your own, or work something else out. If tax dollars are being used to pay rent and then that money is going to the social fund of a "company" and are not being used for firematic activities I, as a taxpayer, have a real issue with that. Taxes are high enough without paying rent (at a commercial market rate, no less???) every month. At least a mortgage gets paid off over time.

What exactly is accomplished by putting the medic in the very uncomfortable position of knowing that more should be done and not being able to do anything about it? Conceptually, I appreciate that the "medic has more knowledge" but that doesn't translate into performing advanced skills in a BLS setting. All the medic is going to be is another set of BLS hands - maybe THAT is warranted but it could be any BLSFR it wouldn't have to be the medic. The patient you've got should always come before the call that might be coming but if you have to take first due apparatus out of service because personnel are being used to augment BLS transport units, there will eventually be a problem. In NYS, a medic in the BLS setting can only defibrillate when an EMT can and oxygen is going to be administered the same way whether you're a PD CFR/EMT/medic, FD CFR/EMT/medic or on the ambulance crew. I don't understand the benefit to the patient or the agency involved by using a medic in this capacity. I remember when Putnam County had NO ALS - at all - unless you want to count the occasional medevac (they were based in NYC at the time) or the intercept when going to a Dutchess County hospital. I was a medic in Westchester and a volly in Putnam. Are you saying that I should have ridden with every candidate for ALS instead of letting the other EMT's in my agency be EMT's? Frankly, I think EMT's were as intuitive as I would have been and recognized that a patient was circling the drain. They didn't need the extra "P" on my card to tell them that. It also would not have changed the patient outcome because they could do BLS skills as well as I could.

We are not the EMS police just because we're paramedics. There has to be an assumption that a certified ambulance arrives with certified personnel who are competent to perform skills required of their level of service. You have a higher level of training and knowledge/experience but that does not change the fact that in a BLS system you're a BLS provider. I would challenge your assertion that we trump the BLS agency having jurisdiction. To do what exactly? We're not an ALS provider in this scenario so what are we going to do?

Situation #1 - The medic can and should be in charge of patient care decisions. That may mean directing the CFR's to provide care appropriate to their level of training or actually doing it him/herself. The officer can and should be in charge of the scene - making sure transportation is coming, coordinating with other agencies, etc. Situation #2 - Given the original scenario, there is no ALS available. So the FF (who is working as a BLSFR) is perfectly within his/her scope to allow BLS to transport. If he/she has ALS equipment, they have to be within the ALS system for which they are given medical control. They can't just "have ALS equipment". The certification does not confer authority to them, operating within an ALS SYSTEM is what gives a medic their authority to perform ALS. Yes, the medic should absolutely make sure that candidates for ALS receive it within the constraints of the system they're working in. There absolutely is a distinction between being a medic and being a medic within their ALS system and I imagine that you'd be hard pressed to tell the XYZ fire department that one of their employees who is coincidentally a paramedic must accompany every candidate for ALS within their operating area. What about cops/medics? You going to tell PD Chief's the same thing - of course not. I wouldn't say that. I've had physicians and nurses assist me more times than I can count. I even remember an anesthesiologist riding with us to the hospital with a crappy arrest. He took care of the airway - soup to nuts. Couldn't have worked out better. So, I wouldn't make blanket statements yay or nay. Not to say I would have done the same thing with a podiatrist, it was a unique situation. He also never gave medical control - that was vested in the ER doc.

I think this is the fundamental point of the original post. Who determines what priority simultaneous (or near simultaneous) calls receive? This is why EMS needs to be a priority - regardless of the oversight/overall agency. Of course, the whole problem could be eliminated by dispatching all calls as personal injury accidents with entrapment - no agencies have a problem getting out for those.

Oh yeah, with regard to the "practical sheets" - they are the minimum standard that you're required to perform to and not the benchmark for the performance of any skills. DON'T rely on them as so many other people have already stated. Use them only when you're getting close to the test time and only then to back-up what you've learned from the book and other references provided.

Unfortunately, I've learned that there are surprisingly FEW SOP's that spell out what you're referring too. I would have hoped that the EMS call would take precedence over an alarm but there I go thinking again!!!!

Great points (as usual)! Under NIMS, the Coordinator will get whatever title is appropriate for the assignment that they are taking from the IC. There is a lot of flexibility here and unless someone specifically spells it out in their own agency's plans/procedures it is going to be incident dependent. Remember NIMS is a framework and not everything is going to be spelled out therein.

OK - that makes more sense. But keep in mind, the Logistics Section probably won't be established until sometime during the first operational period, long after many of the initial mutual aid requests have been made (and hopefully filled). And Logistics probably won't make a list of what's available to respond - they'll make a list of what's NEEDED and then work to fill that order. I think there's a lot of confusion associated with logistics vs. mutual aid/resource coordination. The Deputy Coordinator or person tasked with coordinating mutual aid may not be the Logistics Section Chief. It all depends on how the organization develops.

If an instructor makes an error like that, it is best to point it out on a break or after class and let him/her make the correction rather than starting an argument during class. Your dive accident example is a very unique example and while you may be an expert on that it is best to remember that you're not an expert on EMS - no matter how many calls you've been on or how much you think you know. Bottom line, the others are right - DO NOT ARGUE WITH THE INSTRUCTOR! In addition to all the other good advice, remember that your EMT course is only one stop on the EMS training evolution. Having that little card in your wallet is a great start but you'll still have LOTS to learn. Keep an open mind, keep asking questions, and keep reading! Medicine changes and it is a challenge to stay current and knowledgeable on everything in EMS. As I was told once, now you've got your license to learn! Most of all, enjoy the class!

Could you please direct me to where this is written? ICS is a management process and does not dictate how to request or direct resources specifically. As such, there is no mandate for the "closest available units to respond". Quite the contrary, ICS promotes requesting the RIGHT resources for the task to be performed even if they are not the closest. That's why resource typing is such an important part of NIMS compliance. If you need a Type 3 Search and Rescue team, you should order a Type 3 SAR. If you need a type 1 Haz-Mat Team, order the type 1 and so on...

That's the way the IRS looks at it. It's in your best interest to check with a really knowledgeable accountant because some of these "perks" can and will be considered income by the IRS and if you don't report it you can get slammed down the road.