WAS967

Hey now. I graduated from Paul's Paramedic Ninja Dojo at WCC. The dead never see us coming!

Any EMT can pronounce given the obvious death conditions (decapitation, dependant lividty/livor mortis, rigor mortis, etc). Our protocols as medics are very specific about situations we can and cannot pronounce. If we pull up on a call and it's, lets say, a V-Fib arrest that becomes asystole, the patient has full ALS [(combi)tube, line, meds], is nontraumatic and not in a public place, the family doesn't object, etc....then we can pronounce if there is no sign or recovery. My last code we did in a church parking lot. Public place. Protocol says we HAVE to transport. PD not available becuase they are chasing criminals/too busy to babysit a body. Then you have to transport. Does it mean you have to work the code in transit? Absolutely not. I have no problem calling codes in the field. In fact I think a lot of family members feel more comfortable knowing that thier family member "died at home" rather than in an ER. The few people that still believe that not having thier loved one transported to the ER is not doing enough, can be talked down, as 95% of the time it involves hysteria becuase the death was unexpected.

Three words: Content Management System (CMS). Makes managing the page and navigation MUCH easier.

No one person "started" Cortlandt Paramedics. If you mean the director, then the first director of CRP when we started in 1992 was Chris Lieberman (sp?) who is currently a full time officer with Westchester County PD. (He also teaches ICS classes for the county and last I talked to him a while back he was an apprentice helo pilot for the aviation unit). While Chris was the inital "Director of Operations" a guy names John Filangeri from St Vincent's Downtown in NYC came on board to teach the first few waves of Paramedics that went through the "Butterfield Class" (which as mentioned, was an extension of the DCC program). The class's main purpose was to train the paramedics for the CRP program. It wasn't so much the funding that dried up as the pool of students was no longer there and DCC combined the classes into one held at the Dutchess campus. When Chris left CRP, John came on as the full time director and continued teaching for DCC for a time. Last I checked John is no longer a NYS Certified Instructor but actively teaches ACLS and CME classes at HVHC. Funny stories related to the Butterfield closing: I remember Alamo used to post an ambulance there for a short period becuase, despite the hospital shutting down inpatient services, it still ran an ER "clinic"of sorts, and any patients requiring admission would be transferred by ambulance to HVHC. The closure of the hospital left a large gap in the ER coverage of the area and local news outlets reported the possibility of opening a replacement ER at Craig House Hospital (anyone knowing craig house would find the idea laughable).

I used to advocate Spybot myself but as much as I'm not a huge fan of Microsoft programming, thier AntiSpyware (Windows Defender) is very robust and does it's job well. I also like AVG but tend to go with Avast for Antivirus. Both work very well.

I think EMS should be actively involved in any high risk operation where the potential for injury to either the SWAT team members, or even the perps, is high. I'm not a huge fan of the concept of medics tailing the team during the actual raid, but have them staged nearby (inside an RV or whatever) with an ambulance down the block, in case something does go wrong. Arming the medics, especially when they are civilians, is quite controversial. I don't believe either the RPS or MLSS teams are armed during operations.

Verizon has other plans for those fiber opical cables going to your house now (once they install it). I addition to the fact that it can carry a few DOZEN phone lines, they also plan to get into the television market. Deregulation at it's best.

I wish. I don't think we even have DSL availability in my neighborhood yet because of the distance limitations (you have to be roughly 3 miles or less from the phone company central office (CO) to get it. I can only hope that since Fios is last mile fiber optical, that distance won't be an issue. I guess it's just a matter of time before we get it. Ask me how it is - in 2010.

Phelps teaches EMT-I classes on a fairly irregular basis. You can call Christina at 366-ELSP and ask if there will be one in the fall, however I am not aware of one planned. They just finished one down county somewhere.

File not available.

It should be noted that (for those who itemize thier taxes), you are eligible for a tax deduction anyway when you respond to calls. I believe the deduction is somewhere around $0.30/mile and requires documentation of the milage and what it was for. IE: Keep a list in your car and document total milage for a call (to and from BTW) and the date and perhaps location. Something to back up your deduction if you get audited. I'd imagine the above would just be an added benefit to that which we are already entitled. EDIT: See here for more information: http://www.irs.gov/newsroom/article/0,,id=151226,00.html. Apparently the rate went up since I last checked (a few years back) BUT the rate I was thinking of was for business. For charity (ie....volunteer fire/EMS) it's fixed at $0.14. Which is kind of bogus if you ask me. Definatly a good reason for the added benefit.

Related: http://www.theinquirer.net/default.aspx?article=32550 Yay dell.

Common sense would dictate that we should be taking our active MI cases to a Heart Center where Angioplasty/Bypass can be performed. Yet our protocols do not support us transporting to anywhere but the closest facility. Why do you think that is? We have designated stroke centers, but not designated heart centers. Something needs to change.

You just missed the summer option that Phelps was holding at MKVAC. I'm afraid you will have to wait for fall and challenge out then.

I have to disagree with you here. In many cases it is actually MORE comforting for the family if the patient passes away at home. Most people associate hospitals with death and dying and suffering and what not as it is. As for time of death, name one reason why a medic shouldn't be able to post a time for the police report.

When you have an advanced airway in place (ie....patient is intubated) you don't have to worry about ratios. Like you said, you just push while someone else blows. BUT, regardless of that, it is important to make sure you "push hard, push fast" and are ventilating properly. Huge emphasis is being put on good BLS. So next time you go on a code, be sure you have good depth and rate to your compressions and that when you ventilate it is over a full second and only at a rate of about 10-12 ventilation per minute. Too many people hyperventilate (and many don't realize it) and this is actually a BAD thing from a perfusion standpoint. Also, minimize the length of time that compressions aren't being done (ideally under 10 seconds). People are gonna think we're nuts but when you put that AED on, work around the person doing compressions. When you analyze and when you shock are the only two times your hands should off that person's chest. Yes, that means when the defib is charging, someone should still be doing compressions. As a barrier to injury, I would suggest that the person doing the compressions be the same person that hits the button, that way there are no accidents. Sequence should be like this: Compressions->second person puts pads on->as the AED analyzs the compressor takes thier hands off just long enough for the AED to make a decision->compression while charging->AED is ready->compressor verifies everyone else is clear->compressor lifts hands, hits the shock button->right back to CPR (NO PULSE CHECK AFTER). Any questions, feel free to ask.

They said in the video that the X on the end of the MNCX designation was indicitive of military origins.

Wow. Thats one well used helmet Lieu!

http://www.wltx.com/news/story.aspx?storyid=40695

Wow. I don't think I've ever seen that building. I can see why they want a new one. Good luck with the build.

The study only seems to support what we are already doing. The first set of indicators seems to mirror the termination of efforts protocol that we already have in place. The second set of criteria seems to imply that if the other criteria are met, then even in a BLS setting, efforts are futile and should be terminated. The one thing the study doesn't seem to take into account is extreme cases (like cold water drownings). In the end it all comes down to good clinical judgement.

At least bust a bottle of champagne on the bumper.

Yeah. The problem probably went beyond his own company's DNS. The problem seemed to resolve later on that night. In related news: if someone is/was having Firefox problems, a newer version just dropped in the last 24 hours bring us to version 1.5.0.6. We're keeping our fingers crossed that that fixes some of the problems.

Wow. Is he 18 yet?