WAS967

This might be the perception from the outside, but in reality the most dangerous part of a flight is the landing. A LOT can go wrong from landing gear malfunctions, ice on the runway, wind shear/cross winds, etc etc. Look at recent incidents at Teterboro (tho I think one happened at takeoff). The FF team from HPN (the airport for those who don't know the code) DOES respond off site. They were at the cessna that crash landed in IBM's parking lot in 2002. Plane crash. Approximately 70 or so souls on board (I never did get exact numbers - reports varied), 53 survivors in various states of trauma. Fire visible to responding units. FDs: Airport Department, PortChester ("incident command"), RyeBrook, Armonk, Purchase....maybe Greenwich? Ambulances: Armonk FD, PCRVAC, GEMS, WEMS, ChapVAC, MKVAC, Transcare, HVAC. PDs: WCPD, none others noticed. A lot of setup was involved and I was impressed overall with the execution of the drill by the organizers.

Where is the drive-in in Lake George? I believe any schmoe can run a small radio station so long as the signal is below a certain power level. I dunno if they're relegated to specific frequencies but I'd imagine broadcasting on a freq used by a major out of the city will override your signal unless the reciever is REALLY close.

Bingo.

Anyone go to the airport drill today? Any thoughts?

No No No. 45 Air 1. Anyone who was at the drill today and was paying attention (and isn't deaf) saw a Freedom Fighter take off from the southern runway (the one right next to the drill) at the end. Apparently it is privately owned and kept in a hanger off Tower Drive along with a Mig (not sure what model). I was told by the airport personel that sometimes the guy takes off and goes right to vertical.

I don't understand why Amber Alerts don't go out over the EBS. Just think of all the people sitting at home watching Judge Judy that would now be aware of a missing child.

Okay, I know Class A, B, and C. But whats the specifics of Calss K?

http://nbs.gmnews.com/news/2006/0427/Front_Page/033.html

http://www.midhudsonnews.com/News/SC_EMS-18Apr06.htm

Response issues have been a problem at verious departments in Putnam for a while. Have they done anything about it? Have they supplemented thier crews with paid staff during hard to cover hours like other local corps (Peekskill, Phillipstown)? If the county doesn't do anything, who will? The corps themselves? History seems to reflect an answer of "NO".

I got cut off on the Sprain by a Lambo once. Instead of being pissed, I was honored.

One thing I liked about working in Ossining was that for a village of it's size, it had not only a very high call volume but a wide variety of calls, a lot of which were quite legitimate and more than just your typical taxi ride. I think I gave more Narcotics at OVAC than I have anywhere else.

First off...it doesn't cost New Castle $505k for the flycar so stop mincing words! They pay now...what $267k? I forget what the number was. Anyone can look it up. Do so if you care. The fact is this - it costs $505k per car. Plain and simple. No WEMS doesn't bill for the services in the system. And how many times has WEMS thrown a fourth or even fifth flycar into the mix? Did they get paid any extra for the extra medics? The books are open. They are reviewed regularly. WEMS has even given money BACK to the towns when there was surplus. How many other companies do that? Now don't get me wrong. I'm with 585. [OVAC may have a 5-6 minute response, FOR THE CALLS THEY COVER.] And there is no perfect system. There is no perfect company. I could bash Empress (who I bet ziggy works for also), Transcare, Empire et al until the sun sets but I have better things to do with my time. I'd love to see a flycar on every street corner. But who's going to pay for that? Improvments are inevitable. The addition of a fourth flycar has even been discussed. We'll see what develops.

I'm with ALSff on this one....there is no easy answer to this. Th ebest answer is use your best clinical judegment. That comes with experience. For traumas I'd get moving to the hospital. People with severe trauma need one thing - a surgeon. Most traumas come down to immobilization, hemmorage and airway control. Most can be done on the BLS level - intubating aside. I run into similar situtations where I work from time to time. We have outlying areas where a lot of times we used to have the BLS agency get on scene, they would scoop and run to the ER. Average response for me to the far reaches of that areas is about 12 minutes and I'd be coming from opposite the direction of the hospital. But the hospital is about 15 minutes down the road. Obviously if they are about to transport and I'm 2 minutes away, waiting can be justified. Maybe moreso for time if the patient is stable. But they also have the option of transporting and calling for an intercept from the recieving hospital so they kind of have the best of both worlds if push comes to shove. In the end, this is one case where we truly, as ALS providers, rely on good clinical judgement from our EMT partners in the field. If you take the best interest of the patient in mind, you really can't go wrong.

Part of the secret to building the house so quickly is 1) They used the existing foundation apparently 2) They prebuilt a lot of parts/sections at IBM and trucked them to the site like a half prefab - parts were apparently numbered and pieced together like legos 3) a huge amount of volunteer help. I can't wait to see this all on TV in May.

Didn't I hear recently that Ethanol actually produces more polutants than Gasoline? Tho I agree we definatly need to reduce our dependance on foreign fuels.

This video is old. I was posted once before I believe.

I'd have to guess an agency that was formed AFTER the alamo/sloper numbering took place. Not sure when they were formed but I'm gonna guess the County Fire Police Squad.

Phelps runs a class just about every trimester (spring, summer, fall). Best to call them at 366-ELSP and ask. Also if you are on the WCDES EMS list, a posting usually goes out there. The website is woefully out of date. If you are able, try and get affiliation with a NYS PCR Participating agency so that you don't have to pay for the class (it will be paid for with state funds).

I just heard about this from ScubaSam tonight and agree that this is awesome and such a wonderful for the Arenas. NYTruckie: By "demo" do you mean the unveiling that they film when everyone gets to see the house for the first time? I'd love to see that in person.

A recent hot topic of discussion has been that of Diversion to Stroke centers. Attached please find both the BLS protocol from NYS and a recent advisory posted from the Westchester REMAC. My question for all is this. If the patient meets the criteria, do you/will you divert to the nearest stroke center? In many cases (Northern Westchester, Putnam, Dutchess) this could mean a significantly longer transport than usual. Has anyone run into problems with a transporting agency refusing to take a patient to a stroke center because it was "too far away" or the like? Any cases of medical control or medical director saying to go to the closest facility even tho a stroke center might be more appropriate? Many hospitals (Northern Westchester, Hudson Valley, Phelps and Westchester Medical for example) are working toward being Stroke Centers and approval could be imminent. But in the mean time the closest for most parts of the county is White Plains with Rockland (Good Sam and Nyack) and the Bronx (West. Square and Barnabas) being appropriate for others. Keep in mind CT hospitals do not yet factor into the stroke protocol because NONE have been approved by NYS as stroke centers. Yet. I'm interested in hearing feedback. NYS_strokeprotocol_update_feb05.pdf REMAC_ADVISORY___stroke_centers_2sep05.pdf

The latest WREMSCO advisory regarding stroke centers is HERE. There are SIX hospitals in Westchester that are Stroke centers: Hudson Valley Mount Vernon White Plains Northern Westchester Westchester Medical Center Sound Shore There are several on our borders that people should be aware of in the event of diversions and the like: Good Samaritan, Suffern (Rockland) Nyack Hospital, Nyack (Rockalnd) Jacboi (Bronx) Montefiore (Bronx) Westchester Square (Bronx) St. Barnabas (Bronx) St. Francis, Poughkeepsie (Dutchess) St. Luke's Cornwall, Newburgh (Orange)

I'm with JBE. I would have made him a hood ornament. Pickup Truck vs Pedestrian with Gun? No need to guess who I'd bet on.

A lot of CICs use question pools from the books they use Mosby/Brady/etc and any GOOD CIC would make sure that questions correspond to NYS Protocols and the NYS Curriculum. There are several cases where the material in both the books and the test pools contradict the NYS Protocols/Curriculum and CICs are responsible to make sure that students learn the material according to the curriculum NOT the book. CPR does have a few questions on the EMT test but it's definatly NOT 80%. I'd say closer to 5% at most. Just remember that the NYS EMT test uses the 2000 guidelines so don't take a 2005 guideline class until AFTER you take the test to avoid confusion.

I believe it was one of those drugs that was hard to produce because of lack of raw materials. Most manufaturers stopped making it back in 1999. And with the 2001 ACLS guidelines no longer listing it as beneficial, it was pretty much the nail in the coffin. Interesting bit of trivia about Bretylium (tho obviously no longer useful) - it was the onle drug we carried that you couldn't administer Intraossioussly. Apparently it breaks down the bone marrow. Amazing what you learn at Pediatric Conferences. And god yes do I remember those old learning mnemonics. How about ONAVEL? Oxygen, Naloxone, Atropine, Valium, Epinephrine, Lidocaine? Guess we can change that to Oxygen, Atropine, Vasopressin, Epinephrine, Lidocaine huh? (For those who don't know - ONAVEL, LANE, etc, were acronyms we used to remember what meds can be given via ET tube. Vasopressin can be given ET as well. )