roeems87

As for the hospital thing, you're supposed to give them your unit number. The reasoning is that if you're coming into Lawrence for example... Eastchester could have multiple units coming, Empress certainly does, Scarsdale comes down, etc... so for places with multiple units from the same agency, they're supposed to know who has what patient... Thats how HEAR comms were explained to me... I wouldn't bet my life on it's truth though...

There is one capt. in our district (fire) that says, every time he calls DES, "Eastchester Car 2102 to 60-Control"... Some would think that excessive and "taking up too much air time" (as is often an argument on here), but I think that is the clearest way of identifying yourself and letting control know that you are infact calling them. The words "60-Contol" should come out of your mouth. Saying "Eastchester" automatically lets 60 know which frequency to click on the screen, 2102 may not click right away with them (even though it probably should, imagine how many sets of numbers... the difference between 2302 and 2102 is not very large). Saying it all out helps. Just like when you call the hospital you say your full ID, "Eastchester EMS 57-B1 to White Plains ER." Sometimes with EMS it's easier to immediately know what agency you are just by the leading two numbers (less to know off the top of your head than the FDs), but simply saying "Bravo1 to control" is not proper, not is it helpful to 60-Control. If everyone is clear with who they are and who they are calling, it's better and helpful for everyone. Even though everything is supposedly identified by your numbers, it's difficult to know them all easily... Some other places use various types of systems. Bergen County for example, "FLA1" is "Fort Lee Ambulance 1"... that way the leading letters tell you who's calling. Up in Tomkins county (school), NY, everything you call is "Cornell EMS 2481 on Med10 to Emergency Control" (that's what they call it up here, not Fire Control, even though I think that's what it officially is, maybe it's officially 'county control,' according to the state, i'm not sure). It helps to be clear with who you are and who you want to talk to.

Anyone doing an EMT-B refresher in the upcoming months? Hopefully December-January...?

Congrats, Glen! I promise Eastchester won't come up empty handed ever again!

I went to recent conference on this at White Plains hospital and I have heard opinions by many people on the idea. I am one who believes the protocol is a great idea. At the current time the protocol reads: "the hospital that will be most appropriate for treatment of the patient." That is what we are supposed to be doing anyway. "Stroke Centers" are a specialized form of treatment in the same way that "Trauma Centers" are. It means they have the staff, capabilities, and protocols to treat that specific medical problem (or symptoms of it) as quickly and most efficiently as possible for the patient... As an aside for the moment, rememeber that these protocols are written for all of New York State. The county where I go to school (Tomkins County) has one hospital: Cayuga Medical Center. There aren't any other hospitals in this county. Transport to a trauma center or elsewhere means transporting 45 minutes to an hour (sometimes even longer, ROUTINE, transports). We are extraordinarily lucky (not un-duely so) to have 15 some-odd hospitals in Westchester county. Especially in lower Westchester, we have 7 or 8 hospitals within 15-20 minutes. This is a luxury, and besides that, one that should be used to best treat the patient. If you have a patient presenting with obvious symptoms of a stroke, you are within the 2 hours (allowing a hour or so for transport and treatment initiation) of KNOWN ONSET OF SYMPTOMS, then I think it is certainly progress for field Emergency Medicine to transport to a stroke center. The person's chance of survival and full recovery is so much greater when taken to a designated center than it is just any community hospital. Remember the time frame necessary for the TPA stroke treatment. We don't just make these numbers up randomly, it has to be within 3 hours or it's not worth the risk. If we want to be considered an important link in the chain of Emergency Medicine, we have to do our part to make the most appropriate medical decisios for our patients--in the same way that any level of training would do that same. You wouldn't take a patient with 50% third degree burns to Lawrence Hospital (unless they're already in full arrest)... they would go to the medical center, without a second thought (level 1 TRAUMA CENTER, or BURN CENTER)... Would you bring a patient in need of a hyperbaric (hypo?) chamber to Dobbs Ferry Hospital? A stroke is the same type of assumption and treatment protocol. Making STROKE CENTERS furthers our ability as EMS providers to get our patients the best treatment possible. Part of the problem with Emergency medicine is that it is "treat 'em and street 'em" and we really have no lasting impression on continual care. Remember that the last stop for our patients isn't the ER many times. They have so many other doctors, nurses, and departments that they may be going to shortly thereafter. Getting them to the best hospital for the treatment they need is the first (and arguably the most important) step in ensuring adequate (and excellent) patient care... Just one more note. We're not in this business just to get the job done and go home (especially if you look from a VAC standpoint). As much as getting through the shift and getting through a call efficiently is important, the reason we are there (as a whole) is to help people in a time of need. To make an argument that choosing a treatment that may take longer could keep you from other things (even if it is better for your patient) is not a fair one to make. Remember what this is all about... the patient...

I was in my first class of the day, English with Mr. Flynn (I remember where I was sitting, who was around me, everything), at my school in Manhattan when we were told to return to advisement (homeroom). We weren't quite sure what was going on, but when I walked back into the room where we went first every morning, one teacher was leaving and said, "I'm going to watch CNN, you guys go in here..." and then the first thing we heard on the radio (blasting in the room) was "OH MY GOD, IS THAT THE SECOND TOWER? YES, YES IT IS. THE SECOND TOWER OF THE WORLD TRADE CENTER HAS JUST BEEN HIT BY ANOTHER PLANE. OH MY GOD... THIS APPEARS NOT TO BE AN ACCIDENT ANYMORE..." Manhattan went into lock down. Our school went into lockdown. Our auditorium quickly became a command center for our school and the schools around us. We were surprisingly incredibly well prepared for this type of thing. As most people know, subways, buses, traffic, everything but walking home was not allowed. There was no way our school (a commuting school) was going to work that way. Students were told if their parents could get here (whenever they could) they could leave WITH them and ONLY with them. I'll never forget how that day went, but it's too long a story to tell here. My father and uncle got to the school (via parking in the bronx, walking nearly 80 blocks, and finally finding a cab willing to drive south, then walking another 20 blocks from the farthest point the cab would drive) at around 4:30. Subways started running out of Manhattan (very limited) around 6:45. We were on the first 4 train out of Manhattan. But then we were stuck on Jerome Ave... long story short, a doctor who was driving home from Montefiore spotted us and was able to drive us home on the Deegan. It's really incredible how it all ended up working out... There are many details I could share, many too long for here...

I actually think they are an awesome idea to alert to emergencies. I'm also a big believer in those phone boxes that are set up along county highways (some of them). People have no idea where they are sometimes when they are calling for help (for themselves or someone else). Having a fixed location where they are calling from (even if they can say, I passed a car accident about a half mile south of this phone) will help rescuers immensely. Having emergencies phones in areas and pull boxes for FD or EMS emergencies is a very useful tool. Calling on cell phones can cause some delays as well. I know they are minimal, but the 3 minutes it takes for the whole call transfer (never mind how long it takes to get FDs rolling or truly ascertain the exact location of the emergency) could mean the different between life, death, and property destruction. It's certainly an asset... I wish there were more of them around...

To the best of my knowledge, all of the radio traffic monitored by 60-Control is recorded and saved for a while. I'm not sure how long. To get any sort of tape, I'm just about 99.99999% sure online would be impossible. To get it, I think you will have to submit a request to the director of emergency services, Michael Volk. (He's in charge of communications and EMS)... Hope that helps a little bit...

Big Breasted Bagels (cough) excuse me, Brook Street Bagels in Eastchester. Not only is the food very good...

Are you trying to start a school VAC? Sounded like perhaps you were trying to start one with another school (hoping NYU--I'm thinking the school, not the hospital) joins up. If it's a school thing, probably not a big deal, but to take a 911 portion, you may have to bid for the contract when it comes up...

Being an EMT at Playland, the death hits home (this second year in a row) moreso than I think it can with many other people. Granted, many (I would say, most if not all) of us have seen death before--children, adults, anything inbetween--but it certainly affects us all more when it's a child. I just have a thought to bring up and I'd like to see what you all think about it... 440,000 Americans die each year from diseases secondary to smoking... 200,000 children die each week in Africa from HIV/AIDS... One child is tragically killed at an amusement park and the news will harp on it for weeks... Think about it... You won't see the media praising the heroic efforts of our troops or emergency workers each day, but you will see over 20 news vans and 5 helicopters present at an amusement park where a tragic accident happened, ever-ready to place blame and mock the efforts upon the one that today, we couldn't save... It made me sick to go to work this week and see the news vans all over everyone. They're in every row of the parking lot at the park. Just yesterday, I had to call an ambulance for a patient (a minor medical, though ambulance worthy)--not to mention calling ambulances is definitely a regular pattern, at least a few a week--and as PCRRBVAC pulled up to the emergency gate behind our office, there was a news camera in our face. If I didn't have the park's reputation and my own in my hands, I may have just been brutally honest with this given news station, but I wasn't. What do you all think of the coverage of an event such as this? Or about any insignificant (in the broad scheme of things, as can be shown by the stats above) tragedy when looked at in the big picture? Has anyone else ever felt this way about something, where they work or live? Why is there no praise or are positive stories not shown more often on the news? The only heroism we get to see is in light of tragedy, and usually the latter is focussed on more. Finally, what the heck could possibly be done to change this pattern?

Believe it or not, NYS DOH does have a protocol type thing on how to write PCRs and goes through each section with what should be included and what things are important and what exactly the bubbles you are filling in mean. The summary written above is pretty good. This a point I have made time and time again. Documentation is a chapter in the EMT books, but all we really learn in class is "document everything on the PCR." No real teaching on how to do it is actually done, and in my opinion, that's a shame. PCRs are one of the things you are 100% going to use and have to fill out every time you get on that ambulance. That's more than you can say about just about everything else, and we practice other skills time and time again in class. Not for anything, but I think PCR writing should be part of the patient assessment practical test. After you are done with your assessment and have asked and obtained all the information you may need (via verbal and physical exam), then you should be asked to document your findings on a PCR. That PCR should be evaluated for accuracy and thoroughness. That would ensure all EMTs out of school learned how to write and properly document the call they have just completed. That is a NECESSARY and ESSENTIAL skill that is not emphasized nearly enough in class. CYA and "document everything" are not nearly adequate learning techniques...

Date: 8/8/05 Time:1548 Location: Intersection of Brook Street and Ewart Street in Eastchester Frequency: 453.675 (operations), 154.340 (dispatch) Units Operating: 2102, 2107, E27, E31, 5711, 5714, 57M1, 57B4 Description Of Incident: Dispatched as "MVA with injuries, possible extrication." Units first on scene confirming no extrication necessary, however two vehicles involved, in head-on collision, one of which is now located inside a building. 2102 requestion 2107 to the scene to determine building structure problems. Two patients transported (both drivers) by 57B4, one ALS, one BLS to Lawrence. Reported one driver passed through a red light. Current building situation unknown. Writer: roeems87

Generally I wouldn't write "NKDA" if you never asked because that implies that none are KNOWN, i.e. you know that there are none... at least that's my impression. If I haven't done something, for whatever reason I usually write UTO, which means Unable to Obtain. Sometimes if it's a transport where the patient won't allow that BP cuff around their arm if their life depends on it, then in the BP box (for example) I would write "UTO" and if applicable, I would put "+ Radials" showing that the blood pressure is at least70 (I think that's the number, maybe 80, 60, I don't remember, somewhere in that ball park)... Whenever something is a necessary step, and I can't do it, it gets the "UTO" and a quick explanation why not in the narrative...

As for the comment about being 19, I'm not sure what being 19 had anything to do with it. Younger EMTs (many of whom are very good at what they do) often take offense to comments like that... As for other agencies... to the best of my knowledge WEMS at the BLS level is only transports, though the 45-Medics are Westchester EMS trucks and staffed... Transcare covers two cities... White Plains and New Rochelle. I don't know much about the company, but from what I have heard, getting to do 911s in either of those places takes some work. You should know that Transcare does the GREAT MAJORITY (almost all) of their work from transports all over westchester (mostly southern and into the city). Granted, I have also heard that if you show some degree of competence, they beg you to do 911s in either place. Knowing what transcare techs are like sometimes, I find the latter more likely. it can be a political game... however that's the deal. Greenburgh is EMS provided by employees of the PD. It's not an easy job to get from what I understand, but you can look into that as well. You can also look into VACs that hire paid EMTs to cover certain shifts during the week. Many don't even require you to be on calls, but to be in the building in case there is no voly crew. Check out all the VACs in the area that would be likely to hire some (i.e. VACs that do more than one call a week): Eastchester, Larchmont, Mamaroneck, Scarsdale... With Yonkers and Mt. Vernon being the other two large cities, I can't think of anywhere else with fully paid agencies other than fire based in some smaller towns and villages up north. if anyone has others to add, by all means....

The exact details of what happened are still under investigation, and the basic ones that are pretty much known by the majority of the staff are not to be discussed until the conclusion of the investigation, however, a couple things to note... This ride is so slow and tame that there are no seat belts whatsoever to hold you into the ride. It travels a very short distance, but takes 6 minutes to do it. It does seem reasonable that Mom didn't notice for 20 minutes, sometimes that happens faster than it seems (and would it be reasonable to suggest perhaps it was closer to 15--then it seems only two rides have completed and another began)... For those of you who have been on the ride, you would know there is really only one way he could have gotten off that ride, and that was if he intended to get off the boat, at no point would the ride do that all by itself, unless something he was doing was totally awry. On another note, since our lovely boss at Playland (the big baba, not the EMT Captain) has failed to support his staff yet, I'd just like to add that the people who were there did an excellent job with what they faced that day, and unfortunately, despite their best efforts, fate wasn't on our side.

Date:8/6/05 Time: Time out> 15:05 Responding> 15:05 (Eastchester Units) On scene> 15:07 (First Eastchester Units) Transporting> 15:38 (First EVAC txp unit) Out at hospital> 15:38 (units to sound shore) In-service> 17:00 (all units cleared from all hospitals and scene) Location: Intersection of White Plains Rd and Prospect Ave. in Eastchester Frequencies: EVAC, EFD (Incident Command--Operations): 453.675 (fireground is talk-around) EVAC, EFD (Dispatch): 154.340 ScarVAC (Operations/Dispatch): 155.490 Transcare (White Plains Units Operations/Dispatch): 460.400 Units operating (according to the CAD): 2102 (EFD), 31A1 (Transcare White Plains), 31B1, 5711 (EVAC Chief), 57B1 (Eastchester VAC), 57B2, 57B4, 57M1, 79A1 (ScarVac), CONED-E, DPT3100(Trans-WP), DPT5700(EVAC), DPT7900(ScarVAC), E27(EFD), WCNOTIF(Squad 5, MCI Notification) Description Of Incident: Van carrying 9 people crashed into utitily pole. Driver and one passenger in rear of van transported ALS, one to Sound Shore, one to White Plains. All passengers were adults with mental disabilities making triage very difficult, most were walking wounded with abrasions and small lacerations. Four patients total transported to White Plains, Five patients to Sound Shore. 57 B2 used as support, did not transport and Squad 5 returning from drill used as triage area to get seperate Patients from bystanders. No Children in this Van. Writer: roeems87 and Pudge3311

I think the new iCom radios can do the tri band thing. They cost about $400 I believe. Just remember, when you're on one band, you can't scan the others. So when you are talking on VHF for example, UHF is unavailable, and vice versa...

I mean, I know people pay taxes higher than many places in the country here in Westchester, but what in God's name is everyone's problem with this? I just don't get it sometimes! Do these people not realize that this tower is to benefit emergency services that (god forbid) if they needed it would be better served if they had that radio tower? I don't understand what the big deal is. It's like the residents of Scarsdale who don't allow a cell phone tower anywhere within their borders, but they do nothing but endlessly complain (because they have money and they think that is their god given right to complain about anything and everything) about not having cell phone service. WHAT DO YOU THINK IS THE RESULT OF YOUR IGNORANCE IN THE FIRST PLACE?! I don't know, this type of stuff really gets me mad. People disagree on principle, not realizing this doesn't make a big difference (IF ANY AT ALL) for them and it will only be helping them in the long run... Nonetheless another set-back for Westchester Emergency Services and the future of it because of the ignorance of the public.

A perfect example of the duty to act, someone who should be an example to all of us. That's a great instinct that springs in your mind, a frightening and dangerous one, but one that I think all of us have felt on so many numerous occassions. Nice job, Sean...

Very cool. I guess the problem with this may be that (now I'm not a paramedic, this is just by word of mouth and observation by an EMT) many doctors and nurses don't pay any attention to the 12-lead the medic does in the bus and completely ignore their interpretation of what's going on. That means relying on telemetry in the time it takes you to begin a rapid transport to the nearest hospital, this will require a rapid sequence of events on a fairly regular basis, but it would be great if it could work. And I do believe it has the potential to in our area... This is another one of those specializations that hospitals are becoming more solidified in. The other classic example is hospitals becoming "designated stroke centers." White Plains I believe is the only one in the area at the moment currently applying for it. That protocol would be to show that you bypass all hospitals except the stroke center if you can place the known time of the onset of the stroke symptoms within 2-3 hours and you can transport within that time frame. I think it's all great. There is no reason why the only real designation we make for transports is trauma. Granted, when someone has special needs, you consider the most appropriate hospital, but having "centers" like we have leveled "trauma centers" for many other problems that can be "diagnosed" on scene is a giant step up in field patient care. In the same way we evaluate MOIs for trauma, perhaps NOIs can become the same type of standard.

Just to point out your misconception, the word casualty doesn't mean death, it also means injury. Casualties can also be injuries, not fatalities. In the military sense of the word it means "men down"... So, as everyone has already pointed out (contrary to your rant), an MCI is a situation where the injuries (or in fact, some--if not all--fatalities) exceed the resources of the response agency.

there's one in Yonkers too. On Central Avenue just south of Nathan's on the opposite side of the street.

Any of us who live in (me) and around Yonkers know that the way people drive on central avenue sometimes is nothing short of incredible. Besides, given the traffic situation on any given saturday or sunday, you would understand why Comm. Taggart would ask for State Police assistance. I would assume the main reason is traffic control (i.e. tickets and traffic), not crime. Yonkers cops have so much on their plate as it is, not for anything, but dealing with too many speeding people on CPA shouldn't be one of them. YPD is a great dept. though. Emergency services in yonkers, FD, PD, yeah and Empress makes you happy to live here.

On a different note, one other thing frustrates the hell out of me with taking up airtime for no reason whatsoever. There is a certain fire department, which might happen to the be the one I know best (though I'm EMS, may be the same district, but who knows :wink: ), they always get their times and run numbers over the air after every call. From what I understand, they are the only fire department left in Westchester that 60 allows to do this. EMS being on the same frequency, I cannot tell you how often frustrated we get when we can't get a word in edge-wise on the radio because the FD captain is getting his run number (another one tallied by EMS, without it they would have like 10--a little joke) and times and taking up all the time. There was one instance that came to mind when we were running 3 different EMS incidents and a 4th was pending (possible mutual aid or someone was going to do a turnaround), but we couldn't communicate between ambulances and the medic car (and our supervisors) because the FD captain was copying times and run numbers OVER THE AIR ON THE SAME FREQUENCY for FOUR different calls. Not for anything, but USE A LANDLINE when you are taking up that much air time, what's the big deal with using the phone? It's what we have to do. If we ever said, "57-B1 to 60, we're 10-8, ready to copy..." (which we've tried), we get "57-B1, 10-1 please." Just to settle the story I just told, we ended up using the police dept. radio (a VHF frequency other than our own UHF operations shared with FD) to talk to eachother while the FD was getting their times. Another side note...there is no need to give an EMS disposition as a fire captain. There is nothing more frustrating for us (or for the dispatcher I would imagine) as "2--2 (numbers out for the purpose of ambiguity, though it's not hard to figure out at this point who I am talking about) to 60, fire units are going 10-8, patient is packaged and in the care of EVAC, being transported by EVAC 57-B1 ALS to Lawrence Hospital. I'm ready to copy." You think I make that up... that's a real one from last week. One may think it would be helpful to have one transmission and then the bus doesn't have to say anything, but often times, we are still performing ALS in the bus and not leaving the scene yet, and even more often the fire captain is wrong in what they say to control. They assume sometimes and they never get the straight facts before they get radio-happy. Leave the EMS dispositions to EMS. We don't give instructions during fires, and we sure as hell don't cover your airspace when you are running fire calls. Rant over. Agree? Disagree? Anyone who monitors our frequencies hear this stuff besides the obvious frustrations of those on scene?