Goose

God this job sucks.

The below link was sent to me in an email. It's well written and thought out and while its soley about Sufflok County, it seems awfully similar to what goes on in Westchester. http://resqrev.blogspot.com/2013/06/volunteers-vs-patients.html

The FDNY exists in a vacuum. Regardless of what the very best cardiologist says, you are often at the behest of the department doctors. You would have to start the hiring process to find out anything for sure, but they would undoubtedly make you go to the department doctors for clearance (again, regardless of whatever your personal physicians say). My personal experience (via family) is that they are not in the business of taking chances with cardiac disease. As far as the privates are concerned - few require physical exams (probably not a good thing) or ask much, if anything, about history. A number of not - for - profits in the southern New England area require stress tests or an EMS focused physical agility exam. That said, if you look down south or out west, EMS is far more organized (and generally more "legitimate" or respected / well compensated / etc) and getting on requires a whole series of steps - including a physical agility and health screening. It seems like you're adequately involved in taking care of yourself and are on top of whatever conditions you may have. That is really a great thing (at least from my perspective, given how many people i take care of that are not involved in properly managing themselves), and my only advice to you - regardless of which way you choose to go - is not to lose that. Aside from taking care of yourself (you've got that licked already!), just be honest during whatever application process you go through and go through with whatever they want. All of that said - just make sure you know that EMS in this area is not a great job. While it is rewarding at times, the compensation (salary and benefits) hugs the poverty line, and you will often be forgotten / overlooked / and taken for granted. Best of luck.

Typical journalistic arrogance. Rather than bucking up to the fact that they made a mistake, they offer a half-baked justification. Typical.

Thoughts and prayers to those injured.

In short, no NY is not a national registry state so obtaining credentialling with an NREMT card alone is not possible, at least not yet. NREMT establishes no standards, it's simply a testing body. NY adopted the national cirriculum standards - which come from the EMS office in some subbasement of the national highway traffic safety administration office in DC - for EMT, EMT-I and Paramedic. Additionally, NY continues to retain the CC program because of the medic shortages in northern regions of the state. There is virtually nothing in terms of the paramedic level that is different between NY and national carriculum, the major changes reside in the "B" and "I" programs.

So Empress is implementing APPs or were you referring to the article strictly for the vehicle? To be honest, i find that the newer expeditions and tahoes are probably too big as a paramedic fly car...unless you're carrying two complete sets of gear. Always seemed like a bunch of empty space to me, and i regularly work in both. Given the recent changes in the special service vehicles offered by some of the leading manufactures, probably not a bad idea to broaden the horizons a bit. At the end of the day every agency has to determine what will work best for them given how and where they operate. Having the option to run something like the charger regularly and something like an expedition / tahoe during inclement weather may be the best option for some parts of the county...but often todays budgets simply don't have that sort of room. Either way, best of luck with the new vehicles and i hope they safely transport the medics to and from jobs.

Evening all, Over the past week or so i have been researching new uniform boots for work and wanted to query some of the more experienced providers / professionals / etc here to see if they could help me. Right now i wear Haix boots, which have generally worked well for me but its time to retire them. I was given a number of recommendations from friends, coworkers and family members in similar lines of work. My father and a number of people recomended Danner boots given his positive experience when he was on the job (PD) in the 70s. I have no issue spending money for a solid product (its investment in my health and safety really) and years ago swore that i would never buy a 50 dollar generic EMS boot (i seem to be hard on foot ware...likely due to the number of hours a week i work). The general guidelines i've established for myself are: 1) Made in the U. S. 2) Pref. all leather construction 3) 8 Inches in height 4) Pref. safety toe which meets or exceeds ASTM standards I spent a long time browsing the Danner website and searching for reviews on forums and youtube (you would be surprised they are few and far between). I looked at the steel toe Acadia's which seem popular with the uniformed community but i am turned off by the large sections of nylon integrated into the design (despite the fact that there is a gortex liner). I also looked at the Recon (basically an all leather Acadia with 200g of insulation but no safety toe option). I stumbled upon the Super Rain Forest boots (they are marketed as more of a work boot than a uniform boot) which meet all the criteria but have white stitching and i'm not sure how i feel about how that would look against a navy uniform. Any comments on Danner's generally, the Super Rain Forest's (especially the white stitching) or if you feel i need to rethink my criteria are more than welcome and encouraged. Thanks ahead of time. Below is a link to the Super Rain Forest information page on Danner's website. http://www.danner.com/boots/super-rain-foresttm-non-metallic-safety-toe-work-boots.html

Just wanted to thank everyone for the advice / user info. Decided to go w/ the steel toe Acadia's and keep the Haix as back ups!

I hope you and your collegues are holding up well during this challenging time. Everyone has a right to an opinion, and i think healhty discussion is, well, healhty for the country. No one should be demonized for their opinions and i'm not sure anyone here would demonize you for being "pro gun." Personally, i really think that this incident was the result, first and foremost, of a mental health issue that was not properly addressed (i don't know or proclaim to know all the facts, but from the little i do know i have constrcuted said feeligns). As i mentioned in a previous post, this country needs to take a serious look at how it, as a collective, deals with mental health issues. Generally speaking we need to stop ostracisizing and demoralizing those with mental health issues and focus on making sure the mental health system is robust enough to afford the type and variety of treatment that Americans need. For those with more complex issues there needs to be some assurance that those people are getting the type of help they need (this probably would most effect school aged children) - i'm not advocating for a nanny state or government intrustion into every aspect of our lives, but seems more and more that Adam Lanza, at some juncture, fell off the grid. I am an NRA member but not currently a gun owner. Guns are the easy target. Americans want a quick scapegoat be it guns, video games, etc. It seems that identifying an artifical problem makes some sleep better at night and really requires less work on society's part, because after all we are all perfect. Even if we banned all forms of firearms, went house to house and got every single last gun off the street...it doesnt take much for someone commited to enact violence to find an alternative, and argueably more devistating, means of unleashing hell. On a personal level, i don't have an issue with firearms but there is a lot out there, when it comes to the gun community, that i simply don't understand. It doesn't take but a quick search on youtube to see whats out there - things like 50 round drum mags for Glocks, Beta C mags for the AR vairients, Silencers, Beouwolfs, etc. just don't make sense to me (i just can't fathom why a civillian would need somting like that - do you really need an AR upper that will shoot a .50 and take out the engine block of a mac truck?). WIthin the same line of thought, i do understand that those things are generally benign in the hands of law obiding citizens - my only concern is that they are avilable (and really, munch of that stuff has only military application) and easily aquired by "band guys," thus giving them the ability to inflect serious damage on society and simultaniously out-gunning the police. That's the sort of stuff i think should probably be more closely regulated, at the very least. You can legislate until you're blue in the face, but it will only effect law obiding citizens. You will never see a firearms ban in this country (thats completely out of the relm of possibility, guns are too far embedded in our culture) and as such we will continue to have gun violence - to me, its just a sad fact. To those that just came to the realization that AR-15s and their varients are a civillian model of the M16/M4 combat rifles (yes, that were designed to kill, maim and neutorlize enemy personele) and these weapons have the ability to end life...well, i just feel that illustrates how ignorant much of our society is. I'm not sure that made any sense, i hope it did, and i hope i didn't enfuriate any avid gun owners. Just my worthless two cents.

It's already been well articulated how devastating this whole event has been to everyone, especially family (i'm not a parent and cant even begin to imagine how i would feel if i was). The media, generally speaking, as been horrendously irresponsible throughout this entire event. After i left work Friday evening i have made it a point to stick only to what the CSP PIO relays during briefings. As it relates to the interviewing of children, i was equally nauseated at the media (that they would hover over these vulnerable children like buzzards) and the parents for allowing their children to be interviewed. If it was me, i would secured my child, drove straight home (barring having to make any official statements to the authorities), and unplug every TV in the house. If you didn't think the media was driven by the almighty dollar before, you sure should now. From where i sit, the gun discussion is a secondary, if not tertiary, issue. The real failure here seems to be the mental health system and more generally how this society views / deals with mental health issues (i'm not just talking about whatever the perp was suffering from but even combat vets w/ PTSD often find themselves ostracized and treated as "broken").

In this area, the course is difficult to find - i think phelps as, at times, offered it. In all honesty, if you intend to work in this area i wouldn't waste your time. There are few agencies who are credentialed at the "I" level and you'll rarely find yourself doing much more than a basic given how saturated with medics the system is. If you're a basic looking to advance yourself, get some time in the field and in a year or two of solid experience look into a local paramedic program if you're still serious or interested in the field. Best of luck.

The 5.11 are horrid. Their sizing is garbage and the pockets are far too low on your legs (and whats the deal with those dumb ankle pockets?). Personally, i prefer Blauer street gear (the ones with the side cargo pockets not the ESU style) - keep their color, fit right and look sharp.

Does anyone know if the REMAC has issued any directives in terms of hospital diversion and transporting? I recall during Irene and some past winter storms they directed all EMS agencies to the closest hospitals and only WMC or equivilent for major trauma. Curious to see if they have done the same, nothing was posted on their website.

It's something very close to that. It's ridiculous. But again, it's an "in name only" thing - lets make a county dispatching center and staff it at the bare minimum just to say we have it. I wonder what authority the REMAC would have in drafting protocols in terms of dispatching of resources ( ie : x, y, & z are BLS calls with no ALS dispatched). Also curious if FDNY worked with their REMAC to establish how they triage calls or if they operate solely off whatever software program they use tells them.

I doubt anyone would want to take on the liability of not sending a bus. Could be wrong, though. Just seems like more and more this is an "in name only" situation. Is there going to be a metric attached to this in terms of what % of calls must recieve EMD based triage? From where i sit, i just don't see this changing the reality of EMS operations in this county. Agencies that staff ALS ambulances probably won't change the way they operate as long as their communities will continue to support that level of care - reguardless of the situation EMD/no EMD you're still getting a bus, an EMT and a medic. The real issue is when it comes to fly cars that serve multiple jurisdictions, but again because a paramedic fly car is the only guarenteed thing i can't see them not being sent. For those of us dispatched by 60 Control, will this open the door for redirection by the ECC operator - during times of heavy call volume - to higher priority and holding jobs / sending lower priority jobs mutual aid? When it gets busy i find myself and my collegues self triaging calls - asking what 60 has then figuring out what sounds more serious and going to those jobs. Problem is, the ECC operators have access to more information than field personelle do during dispatch.....which is why an MDT would be nice. But, i digress. I just can't help but be skeptical on how this will play out or what this means for those of us still in the field. Saying you have or enforce EMD is great, but taking full advatnage of all its benifits is another.

I've read through the ditch report and in it it also references some of the things I outlied in my OP. EMD is going to help the citizens of this county, I never doubted that. What it won't and was never designed to do is fix an ineffective ground transport system, or overwhelming dependency upon paramedic response as the only timely 24/7 EMS asset or dependency of some BLS providers upon paramedics to ensure them that a call is, in fact, BLS. I guess the bottom line in my mind is that while EMD will begin 1/1/13 I will still be sent to BLS calls, wait 20 minutes for a bus and have patients ALS RMA through med control so their loved ones can get them to the ER quicker than a bus can. The Fitch study is a scathingly honest document. Just wish more change was brought about because of it.

What issues is it going to fix?

I'll take your word for it. But, none of the agencies i worked for knew anything about it until it was released. Even by the REMAC's own admission, the police chiefs were surprised by the orginal publication and of the policy statement at one of the initial meetings. None of that really changes any of my feelins on it though, but thanks for the info.

There is no question that EMD is the standard of care and it can save lives. I don't disagree that it's good for the region to be behind the use of EMD. The problem, as I see it, is that they developed a binding policy statement without properly researching the realities that exist in this county's EMS system or exploring ways to employ EMD effectively.

Switching over to what? 60 Control? Those poor guys can barely handle the call volume they have now - this county (including the DES comissioner) doesn't seem to have any plans to face the reality and expand staffing. However, despite the exponential increase in call volume over the years w/o appropriate expansion i really do tip my hat to them - they do as best of a job as they can given what they have to work with. That said, the REMAC (and i watched the webcasts) pushed out this policy statement without effectivly researching dispatching in this County. I think there was one indavidual who actually had a grasp on the reality in the webcast i watched. The expectation to have everyone EMD capeable by 1/1/13 (if that is even still the go live date) is rediculous. These are the issues as i see them: EMS System issues: - The point of EMD is to prioritize resources - send medics and other resources only on calls that they are truly required for. Unfrotunately, the reality is many of the volunteer ambulances (which make up the majoirty of the transport capeabilities county wide) are unreliable. Average wait time in excess of 20 minutes are the norm - some days/time of day are better, some days/time of day are worse. That said, sending a medic is the only way to get a reliable and timely EMS resource to your front door - thus defeating the purpose of EMD alltogether. 60 Control - They simply dont have the staffing to answer, EMD, dispatch, and do all the other tasks that are required (imput CAD data, see the calls through to the end, request and or arange for more resources to scenes, etc) - It seems a lot of time the PSAP (often a PD) who gets the initial call is not transfering the caller to 60 control for proper EMD. Rather, the caller is being hung up on, and the PD will call 60 and tell them "hey, dispatch XYZ VAC/Medic for chest pain IFO 123 Avenue." Again, whats the point? Local PDs - Most don't have exisiting EMD capabiliuty - that means buying a dedicated computer system and training all those who dispatch radio runs and EMS runs (often it seems like desk Sgts) in EMD. - Bugetary constraints are creating atmospheres where most agencies are having to consider layoffs or vacating positions through attritiion, where are they supposed to come up with the money (infrastructure and OT training) to pay for the above? - Honestly, i wonder how many PDs even care to be involved in this (i can't personally blame them)...they are busy taking care of what goes on in the law enforcement world. I would much rather the REMAC work together with the County and Law Enforcement, take it's time, and establish a better thoughout system - preferably one that is a regional approach. I just think thats a much better path than spending a whole lot of money in a knee jerk reaction to an ill thought out policy and an arbitrary go live date.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff. This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

This is kind of like it taking 27 minutes to get a bus for a jumper down....

The LCpl was close friends w/ a friends brother, 21 is far too young. Unequivocally braver than i'll ever be. I thank him for his sacrifice, may he rest in eternal peace and may his friends and family find peace. That said, i'm tired of seeing stories like this. It's a hopeless cause, its time we just cut our losses and let those mutts kill themselves.

So, in all seriousness, does the possibility of transitioning - in the future - to an 800 mhz system make sense for the county? I guess the bigger question is wether or not anyone is highlighting to the powers that be how very insanely important a robust communications (mobile, portable and data) is?