Goose

My question is in what capacity were they operating? Unfortunately, i have had a handful of less than pleasant encounters with this agency - each of those times they were never the primary response agency for the respective municipality. Essentially, they showed up because they knew where the more religious jewish members of the community resided and crossed that with intercepted radio dispatches. They are pretty sneaky in how they do business - i recall having to hump gear a block or so because they tried to bar me from entering a scene. Its no secret that these people are not out to service the general public - crown heights proved that to me. So, are they contracted with the municipality in question to prove ambulance service or was this a private call? And, as a small side bar, i would love to see them ticketed more - the way they operate their ambulances and personal vehicles is generally with impunity and no due regard for anyone's safety.

I don't know much about radios, but i heard some rumblings that within the next 10 years Westchester's UHF trunked system will be replaced with an 800 Mhz system. Anyone else hear anything of this sort? Is there any advantage to this technology vs what we have now? I can only hope that IF this is true, the system offers better coverage, especially for portables and includes some data component for MDTs or an equivalent. Just curious, thanks again to anyone that can shed light on this.

RIP. Thoughts and prayers are with his family, friends and fellow firefighters.

Very saddened by this news - from those that i know that knew him, there has been nothing but good to say. Reflecting on awful events like this i often think of this quote: "In the final analysis, the question of why bad things happen to good people transmutes itself into some very different questions, no longer asking why something happened, but asking how we will respond, what we intend to do now that it happened." At work i'll strive to be a better provider, think twice about being grumpy when a run comes over during meal or for something that seems trivial. At home, ill take special care to make sure those close to me know i love them. Thats the least i can do. RIP Paramedic Joyner and thank you for all that you did in the short time you were here.

I think its more about how they coordinate things than anything - even before storms happen you see the convoys coming into town with pretty impressive amounts of resources. Its hard enough getting a mutual aid ambulance these days.

I think training is a good thing and i admire that you strive to keep yourself and your coworkers sharp. Personally, i keep a few books (have a great 12 lead book) in my work bag to read in the fly car, bus or station when things are slow. I also try to take out the sim man from time to time and a few of us practice crics and some advanced airway maneuvers (love working on the ice pick intubation technique). I like to think that these are good habits, but I'm not sure these are what we are talking about. Im far from any sort of expert , but it seems to me that dealing with these sorts of issues is going to take a two pronged approach: 1) fix the structural decency, 2) correct the educational/skill decencies of providing care under these unique circumstances. These sorts of things are going to have to be multi-day or week long classes - not an hour long CME lecture - taught by law enforcement professionals who have direct experience in this sort of thing at facilities capable of putting providers through the paces. Personally, i would love to take a course like this. Unfortunately, none of my jobs will pay for me to go, i would imagine the courses are expensive to pay out of pocket for, and taking a week off of work to go to these things will put a dent in my checking account i can't afford right now. This before we even start to talking about 1) how i would utilize my skills and who that would be with (many of these small village depts don't have any tactical elements to them) 2) how would i be covered in the event my services would be called on and if i get hurt who picks up the tab - and would my family be taken care of in the event that i was hurt and died (i already know the answer to that - its no).

I appreciate you bringing up these issues because they are a very large part of the issue. The bottom line is there is no advancement in EMS - once you're a paramedic (at least in this area) you've more or less reached the ceiling. I'm not talking about being an FTO or senior medic for an extra 50 cents or buck an hour, either. That said, i can't help but feel that you're not giving some of us on the EMS side the benefit of the doubt and chalking things up to laziness ( if i recall you are/were a medic, and I'm not arguing that there isn't laziness - there is an awful lot but there are an awful lot of lazy cops and firefighters too). I think the biggest problems with EMS in this area are structural. The entire system is plagued, its a decentralized patchwork of agencies who have little to no oversight and do what they please. If aurora happened here, we would still be waiting on ambulances. The fact it is, its never going to change here. No one wants to take the bull by the horns and tackle the issues. No politician wants to deal with the issue because the only real answer is to wipe the slate clean and established a more regional career system which will cost millions and tick off the volunteers. Maybe i'm jaded, but i just don't see it any other way. In all honesty, this is why i'm looking to get out of this area and move down south. Down there being a paramedic is a career on par with being a firefighters and police officer - there are attractive benefits packages, line of duty protections, awesome advancement and educational opportunities and i don't need to work 100 hours a week to make ends meet.

The job was probably sent out as a cardiac in which an ALS unit would have been sent. Unless it was an arrest, which this doesn't seem to be, BLS probably wouldn't be there. A refusal sounds like what probably occurred.

This should probably read alleged field misdiagnosis. Curious to see what his 12 lead looked like, or if they even did a 12. Likewise, I'm curious to know how the conversation with the telemetry doc went. Personally, i try to go out of the way and explain that my diagnostic capabilities are limited in the field and a cardiology consult and lab work are going to definitively determine if a cardiac event occurred or not.

Sounds like that they sent appropriate resources as they received updated from information from the PD units on scene. Also looks like the FD runs medic engines, so while it may have taken a few minutes to gather the transporting resources the victims were, i'm sure, being treated aggressively. In all honesty, this is why 60 control needs to be the sole provider of dispatching and EMD resources for this entire county. I can't imagine the additional chaos decentralized communication would have added. Sad part is, it will take an event of this scale here to ever see that change happen.

Glad both Astorino and Cullen both found the time to get out for this, they never made it to the EMS awards. Congratulations to the graduates.

There an awful lot of dead zones in the northern parts of the county with no apparent plans to address that any time soon :X

I can't really speak to the FDs, but of those you mentioned Yonkers is probably the best staffed and most prepared. As far as EMS here - its a decentralized patchwork. The Fitch study (which seems to have been removed from the WRESMCO website) should make everyone nauseous - something like that navy jet crashing happens in westchester and people will unnecessarily suffer. Its disgusting that people pay so much hard earned money in taxes and get horrendously provisioned services in return. Lets face it, a junkie on a street corner in one of the five boros gets a more timely EMS response than the overwhelming majority of Westchester residents. The point is, too many agencies in westchester can't even manage routine call volume, we are overwhelmed on any given day...and thats without a disaster.

You better pray this never happens in Westchester. If it did, the EMS system - given thats what i know best - would collapse.

I don't get what all the craziness - on both sides - is all about. All this affirms is that we all apparently need to maintain health insurance or face a fine/tax. Either way, this is unoquivically ruined daytime TV on my day off.

I've run into this issue more than once in a few areas i work. The problem, at least in this area, is that we don't have any centralized dispatching....im not sure if local PDs have the GIS & mapping capabilities the County does. I know they (60) has been invaluable when it comes to these instances,,,

I'm so confused right now...

The infrastructure is there, the problem is there is no money to be made in these medications....so the companies end up devoting more production capacity and other resources for drugs they can charge more for. I guess the theory is why make 20 cent vials of morphine when you can make produce antivirals and cancer medications that are billed at 300 dollars a bottle...

Morphine may also be on that list. I had to restock at a local hospital pharmacy and they had to actually pull a vile off a floor for me...said that its been hard to come by lately. Really sad situation.

Maybe so - but all of this malarky has really put a horrible taste in my mouth for the city - I've cut my losses.....i think my calling is elsewhere anyhow. Besides, there are a lot of young guys out there that want the job more than i ever did - those are the guys who should be on the job.

Forget reverse, it's plain jane racism. Without question. This is exactly why i didn't bother to sit for the FDNY exam. When the city called me and asked why i told them it was because i would never be hired. They asked why and i told them because of my skin color, i simply don't fit their hiring profile. The nice lady assured me that NYC was an equal opportunity employer, i respectfully disagreed and that was that. Being a productive member of society is simply not rewarded these days. The only advice i have for those younger than i is - if you're willing - look south and out west. There are some great jobs - PD / FD and even EMS out there.

Its been on the radio for a few weeks now. Of course its not fair.

Is that a serious question? I'm not joking and its with the utmost respect. You / I cannot even be sure a bus will respond in a timely fashion, if at all, to an aided case in the vast majority of this county. It just seems, at least to me, that the FDs (volunteer, not career) have a more robust and active membership. That said, if the job is only a lift assist and there isn't another medic to give me a hand, ill call for some manpower. It doesn't happen often, but when it has, at least with me, i've always gotten more people than i've needed and they've have been more than willing to help. The way i look at it is we are all here to assist the public - as a team and within our own subset of specialties. At times we all need the assistance of each other to get our individual jobs done. A lift assist can be one of those instances.

The exam was never certified.

The abstract doesn't leave much to look at. How many traumatic arrests were included in this study (which would automatically exclude the patient from air transport) that happened to be transported to a level I or II center (the survival rate is fractional, at best, for these patients)? Is 1.4 v 1.5 statistically significant in terms of changing protocol/operating guidelines? They mention two high profile cases in the link the OP provided, but i'm not sure if either apply. If Rep. Giffords was 12 minutes from a regional trauma facility the day she was shot, why would air transport even be considered? As far as Ms. Richardson, my understanding is that if she went by ambulance initially she may have survived, by the time she became unresponsive (later that day) she likely already had a midline shift or already began herniating - i'm not sure there would have been a more positive outcome given the most optimal conditions. I suppose my concern is that people will see this and use it to justify the "when in doubt, fly em' out" mentality. Thats just not what the helicopter is for. I would argue that for the vast majority of trauma patients, in Westchester, can be received by a level 1 or 2 facility within a clinically appropriate time frame by ground ambulance.