WAS967

The driver should be charged regardless of city status. I hope the family has a good lawyer. They can press the issue with the DA and can hold them responsible as well if they don't act in kind.

Hello everyone. I need to drum up 2 MC CMEs by June and was wondering if Putnam Hospital center ever holds any CMEs at the hospital (or perhaps at Putnam County EMS?). One would think that being a MC receiving facility for the HV Region they would be obligated to run some at least from time to time but I can't find anything past or coming up on the HVREMSCO CME calendar. Anyone know anything? I know HVHC hold CMEs that are good for both Westchester and HV and they aren't on the list either so perhaps it's something that's just not listed. Any information is greatly appreciated.

I attended a CME last week at Vassar. The doctor there was friendly and didn't treat me as an outsider even tho she'd never seen me before. Plus (and maybe this was a post-EMS week special) they had a nice spread of food - too bad I ate before I got there.

Yeah, so far the Transcare experience has been pretty decent. A lot of parallels to the other company I work for (might have something to do with our DO being from Transcare). The vehicles are new and kept well, not ghetto patched with duct tape like they were at Abbey or the old Westchester. I would like to see TC get a few more things on the medical side - most notably some kind of alternative airway. Not having combitubes is a little unnerving. My tubing skills are decent, but would be nice to have a backup. One of the bigger transitions for the Alamo employees will be the paperwork. The ACRs are interesting. One day we'll all be using computerized versions tho. (One can dream)

http://www.wremsco.org/protocols-drafts.htm New Paramedic Protocols go into effect in less than ONE MONTH - On July 1st, 2009. All Paramedics credentialed by the Westchester REMAC have until JUNE 30th (That's 26 days from now) to be in-serviced on the new protocols or your credentials will be SUSPENDED until you are properly in-serviced. Everyone who dislikes the short notice given by the county should call them and voice their complaints (914-231-1616). Perhaps the date will be pushed back. While you're at it, be sure to ask why we have one month notice when the Protocols were approved by SEMAC SIX MONTHS AGO. Points of interest: -Etomidate now on standing order for MAI -Morphine on standing order for pain control -Elimination of Nitro Paste -Elimination of Thiamine -Addition of Dobutamine and Dexamethasone Points of distress: -Not enough stress RE: Not using Etomidate in instances involving trismus (clenching). -Still no standing order sedation for Pacing/Cardiioversion -Still no antiemetics -CPAP should be mandatory

I've had numerous discussions with a colleague about this and the paramedic protocols he helped develop specifically consider trismus an absolute contraindication to the use of Etomidate for MAI. I'm trying to get more information - stay tuned. Google hasn't turned up much information about it so I'm curious to learn more.

As far as being a separate entity from Brooklyn, they pretty much are. Yes there are always going to be links to the mothership in the BK (things like HR and higher end stuff) but for the most part, if you need something, you go to Wappinger. I can't see ANY reason why they would take people who have been working the areas that they have been working and put them anywhere else. It wouldn't serve any logical purpose. I'm sure there are people out there that are worried about being stuck at the bottom of the corporate ladder and being relegated to working transport trucks, but I just don't see that happening. TC will need people on the road in the 911 areas that they are familiar with to get to the calls in a timely manner and interact with the people they have been interacting with for a long time. Putnam is a good example. The medics that were there in the system are (for the most part) still working in the system. I don't forsee that being any different with the Alamo contracts post conversion. And August 1st? Wow. That's quick. Will everything be past the region and state approval process by then?

Someone pointed out to me earlier the lack of any sort of mention of ETT medication administration. Perhaps this can be used as fuel to light fires under people's butts to get real IO guns/drills on the units.

They ARE as of the new protocols. Problem is, it's still optional. IMHO it should be mandatory. Go big or go home.

I disagree. As you said, you foresaw issues and called in the resources you thought necessary at the time. No harm done. THIS

Personally, as a medic, I have no problem canceling a helicopter if I get on scene and determine that one is not needed. I really don't care if I hurt people's feelings but in the end it comes down to what is best for the patient. Yes there are some instances where maybe the helo has something I don't (RSI comes to mind). As STAT mentioned, the crew can hop in and we can paralyze and go. Just because the crew came on the chopper, doesn't mean they have to transport on the chopper. The pilot can meet them back at the hospital. Up north Albany's helicopter program specifically says they are available for ALS intercepts if needed. Yes, with the helicopter. They right out say they will land, board ambulance, and transport by ground if needed. (Ironically a local REMAC issues a policy statement saying that helicopters are not to be used for routine ALS intercepts - go figure). In this time and age it seems there aren't as many people that are dazzled by a Stat Flight landing as there were years ago. I remember people calling the bird at the drop of the hat, a lot of time because "it's cool". That trend SEEMS to have died off quite a bit in the last 10 years, but that's not to say that people don't still do it "just because they want to do a STAT Flight job". But anyways, back on point. It's hard to judge the call at hand without more information so I personally refuse to say whether the decision was the right one or the wrong one or somewhere in between.

It would be by the ALS agency. If warranted, I'd imagine the QA coordinator might reach out to the BLS agency for additional information if needed. I think the only time there is any regular interactivity between ALS and BLS is at call audits. Again I will stress that the QA process for Medivac jobs such as this is automatic and routine, as it is for several other types like cardiac arrests and acute strokes. I've no idea if the call for medivac in this case was warranted or appropriate. I will leave that up to people on a higher pay grade than I.

ALS: I know which one you mean. I wondered about it myself. Rest assured the lead agency involved automatically flags all Medivac jobs for QA/QI review.

Count me in. Love Mafia Wars. So much better than Mob Wars. And there is a new Beta coming out as well. Should be interesting to see what they add.

I don't think it's all about underbidding. I seem to recall Transcare actually came in ABOVE Alamo on one or more of the Pawling/Beekman/Unionvale contracts and the towns still decided to go with them.

I still remember all the rumors way back when about Sloper and Alamo merging. People swore that would never happen. Oh wait....

http://www.alarabiya.net/articles/2009/05/21/73440.html

I think the picture is a deception. There is no way to get a practical Helo pad on the roof of a bus like that. I suspect the actual ambulance to be much bigger. Plus i suspect this "ambulance" to be more of a "lets get to the MCI and treat patient on scene" kinda of setup rather than "filler up and get to the hospital" gig.

Good point on the going the cheap route with insurance. Didn't see the part about it being Arson. Either way I think we all agree that she doesn't really have a case against the FD who was just doing their job. If a jury DOES award her damages and tells the FD they need to pay up, then that Jury needs their heads examined.

Frankly, no she shouldn't. Her car was damaged due to no fault of her own. She was in a legal spot and paid the meter like a good law abiding citizen. Why should she have to pay to fix the damage to her car? I won't blame the firefighters either. They have far bigger fish to fry than worry about where a window lands that was blown/knocked out due to whatever (tho I should hope they made sure nobody was standing below). She has the right to seek compensation for the repairs to her car. I'll leave it up to the legal eagles to figure out who is responsible to pay.

I seem to recall a pissed off director but other than that there were quite a few laughs because it was the bloody TRUTH. (Or are you talking about the MC information given out by PN?)

Yup. I just re-obtained my HVMAC and was told I need 2 MC contact CMEs by June under the whole retro-activity schedule. The CME setup in the HV region is downright retarded. They make it so you can get 24 PC (Physician Contact) CMEs in 3 years but each year has to have 8 PC CMEs, so there really is no advantage to the new system. It's all smoke and mirrors really to make it seem like things are easier, when all it did was make things more confusing. In Westchester you have 3 years to get (I think it is) 72 hours of CME, 24 of which is CA and the rest CME. No time restraints or anything. You can do all 72 hours in the last 2 months if you wanted to blitz. But apparently not in the HV.

Thanks Fitz...I'll drop him an email.

Thanks for the info but I only am really interested in Putnam Hospital, not NYC. I need HV Regional MC credits.

There were rumors of a big event but doesn't look like anything big is going to happen. Frankly the last two (Saugerties and Rome respectively in 1994 and 1999 were small scale disasters). There reportedly IS a reunion concert to be held in August at Bethel Woods, but doubt it will be anywhere near as big as the original. In fact it will likely be limited to the number of people able to fit into the Bethel Woods Center. EMS for events at Bethel Woods are likely subcontracted out to a local vendor as any gathering over (I believe it is) 5000 people must have EMS coverage according to state law.