Goose

Flip school is officer school i believe - Lt/ Captain/ etc. Usually depts from Westchester send their officers to the FDNY flip school for some period of time if i'm not mistaken.

I'm pretty sure either NYC*EMS or FDNY*EMS issued bullet proof vests at some point. They may still, but i don't know. A number of other municipal EMS agencies across the country have also issued vests to EMS.

Your forgetting the days of running from a hospital to the imaging centers and the like are over. You would have two billable transports per individual. Hospitals, today, have all those goodies in house now. Couple that with the crack down in Medicare payouts and your looking at a decrease in the money coming in. I know one of the agencies (its not for profit) i work for loses significant amounts of money every year and there is little that can be done to mitigate that.

Like 192 said, your statement is 110% wrong. Transports bring in far less money then they used to and i think the fee for transports is only likely to go down.

Given that i have a low tolerance for shopping, i would probably have a stroke. Past few years I've spent black Friday working.

Seth, great post. It's easy to say, "yeah! Put this aside for a week, lets not talk about it, its to early." Well, unless I've missed a beat, the world hasn't stopped and EMS professionals continue to work. There will be hundreds of near misses tonight and it will continue, as it has for years. I'm not sure how many of you have tried to sleep in the front seat of a F-350 with the engine going, the base radio up and your portable next to your ear, lets just say at that point a concrete floor looks awful tempting. The fact of the matter is, as Seth articulated, we are run into the ground for a a few bucks above minimum wage. Shuck here, shuck there, 911 job, another shuck, backfill this, bring these supplies down to such and such a station. Even on a full days worth of sleep its hard to stay awake for that 12 hour night tour. It's simply unnatural for humans to be awake during the night, case in point. Whats the solution? I'm not sure if i have that answer. Better accommodations would be nice, rotating calls amongst units if possible is great. But, at the end of the day, EMS is like a box of chocolates (sorry Forest) you really never know what your going to come across during your tour. So, while there may be no way to avoid waking crews or having people up at 5am, i surely think crews need to be honest with themselves and their partner and companies should make concerted efforts to make overnights as safe as possible. If we don't ask ourselves the hard questions, little will ever change.

Not going to lie, VAC, Rescue/First Aid Squad sure sound silly. As far as painting a better picture of your profession, i'm not sure if i would call volunteering at a VAC/Rescue/First Aid Squad a profession. There is no doubt EMS sounds more professional and resonates with the public far better because it stands for what we are and do - emergency medical service.

Very unfortunate experience for the entire EMS community. Rest in peace to our fallen brother.

Thoughts and Prayers go out to the MOS, hopefully he walks out of the hospital.

The biggest issue, at least with the haztac buses, is that they are always run to the bone like your regular bus. So if a hazmat job drops and their tied up on a routine call, there dedicated until they can turnover.

Sound's like a solid Doc to me. The type of trauma seen in Iraq is unprecedented in it's severity given the use of IEDs, EFPs, etc. As was said, you simply cant compare what is seen at WMC, Jacoby or a shock trauma center to what medical teams in Iraq see on a daily basis. This is about saving lives. I wounder how many men and women owe their lives to Factor 7 or the synthetic blood and the teams that pushed the outside of the envelope in an effort to preserve life. I have no doubt that what is learned in Iraq and Afghanistan will have a major impact on domestic medicine, both pre-hospital and definitively.

You can do whatever you want behind closed doors, assuming your grandparents allowed you. You can't, however, go around the block offering a BG screening. As far as EMTs, the state has deemed the EMT-B capable of the skill but has yet to roll out any protocol on the subject.

ALS, i know we had the director of a southern EMS agency come up and lecture us about it (he also did a 12 lead lecture). I know the Zolls can do Cap, but I'm not sure if we stock the actual attachments yet. I pretty sure its something that was field tested at some point and is in the works for full implementation. As far as my other places of employment, haven't seen it used by ALS there and have no idea if there are plans to make it available.

There is a tactical medic program, BLS can partake in it as well. It gives EMS personnel the skills to treat law enforcement officers involved in a tactical situation. I haven't taken the course, but i know ALS can fill in some of the gaps. As far as qualifications, you need to be an EMT or Paramedic. I know of a few agencies that provide tactical support for their local PDs or SWAT/ESU/etc.

DOT is looking to alter the current EMS education standards. I skimmed over their 2.0 draft version of the proposal. It's very interesting, despite it having no bearing on NY. http://www.nemsed.org/draft_standards/pdf/...ds_document.pdf

I can't see the state pulling back from their current stance on high flow O2, but thats just me. As was said, as long as you ventilate along the proper intervals, i don't see a problem. Capnography isn't a bad idea either but i haven't ever seen it used in the field.

Just curious if anyone has heard anything about the 5 year certification pilot the state put together. Just curious to see where this stands because it surely beats 3 years.

I think its slightly beyond that. Yes, taxes are up but regardless of this no institution that takes public money should be liberal about how they allocate it, even in prosperous economic times. Fact is, a large majority of agencies run more calls in a day than they do in a week or month. Yet, many make due with proportionally fewer resources. Now, i know no one wants to say no to the volunteer fire department, but come on people. Is it the tax payers responsibility to fund the extracurricular activities or apparatus desires of a group of volunteer firefighters? No.

Nice job 57 Victor.

Fact is, the EMT program in New York is far too basic in nature.

Your missing the point. The law clearly states that there is a proper way in which to legally visit, work in or become a resident within the United States. We don't have an open door policy, that means - i know this actually entails a bit of work and waiting - that those interested go to the American Embassy and fill out the necessary paperwork, pay the fees and wait. Millions of people are doing the same thing this very second. Why is it so hard for some to comply and why do others feel the need to shove this down our throats? Just as a fun fact New York tax payers spend 5.4 billion dollars a year on illegal immigrants (education, health care, incarceration), thats 874 dollars per household. If you want to come to this Country do it legally, equitably and fairly. Are we really asking for all that much here?

ALS, im just shooting out hypotheticals, and as always appreciate your responses. Obviously i don't know what the state's thought processes is on this. GM911, not quite sure what your trying to get at

Had a friend in elementary/high school that lived in similar conditions. Been too many of these types of homes. I remember taking in a chest pain at like 3:30 or so in the morning walking up a flight and a half of stairs or so with the bags and the FF looked at me at the top, i looked into the door and saw piles of clothes and all kinds of crap everywhere and there were two little kids running dashing in between the piles playing tag. It's unfortunate.

Date: 10-27-07 Time: 1950hrs Box: 615 Location: 25 W. 24th St. X Broadway Area: Chelsea First Due: E-3/L-12/B-7 Description: Interior collapse of a 5-story brick MD. Writer: Truck4 1954hrs- B-7 rpts confirmed building collapse. NYPD ESU Truck 1 units O/S. Additional ESU, TARU, K-9, Aviation responding. Report Of Building Collapse: E-3, 1; L-24, 12 FAST; B-7; R-1; Sq-18; L-25/Rescue Collapse #1 Report Of Major Collapse: E-26, 16; L-7; R-4; L-116/Rescue Collapse #4; SOC Support Unit, SOC Compressor Unit, Rescue B/C, Safety B/C, Haz Mat B/C 1956hrs- B-7 transmitting 10-60/2nd Alarm for collapse of a 4-brick 25X40 vacant MD. 10-60/2nd Alarm: E-14, 5, 34, 65, 9/S-1; Sq-1/TRV; B-9, 8, 6 (Safety), 2 (RUL); Div. 1, 3; RAC #1 1959hrs- S/C Engine and B/C. S/C E-33/B-45 2001hrs- B-7 rpts interior pancake collapse of the 2nd through 5th floors of a 5-brick 25 X 50. Searches underway. Unknown if any occupants. S/C new FAST. S/C: L-21 2004hrs- S/C Haz Mat #1, L-1 (SOC Support), E-93/Mobile Command #2 2015hrs- S/C B/C for Staging and Air Recon B/C. Staging area is 5th Ave X Madison Square. S/C: B-32 (Staging), B-58 (Air Recon) 2020hrs- Car 6 rpts front and rear walls are standing and unstable. D/W/H. 2030hrs- S/C extra Tower Ladder. S/C: L-18 2039hrs- Car 6 rpts searches being conducted from the exterior. Pri (-) in Exposure #2 and #4. 2103hrs- Car 6 rpts condition remains unchanged. Building engineers are O/S. 2155hrs- Car 6 rpts Building Engineers have determined that the structure needs to be demolished. 2212hrs- Car 6 S/C (2) Engines, (3) Trucks, (2) B/C's for relief. S/C: E-23, 21; L-8, 13, 15 FAST; B-1, 28 2250hrs- P/W/H.

Yup, BLS can do it. However, I'm pretty sure the agency has to come up with a training program and protocol (signed off by their Doc of course) which has to be submitted and approved by the state. Don't know of many agencies that are doing it in the field, however and there is, as far as i have seen, no BLS protocol update for it. It's a nice skill and with the propper knowledge (thats the key here i think) and a solid assessment can turn into a good solid treatment modality. Problem is out of the hundreds of thousands of EMTs how many have the knowledge/experience/confidence to properly and efficiently utilize this...well i think thats something that remains to be seen. As far as the mechanical skill, I've been grabbing BGs for my Paramedics for some time. The hands on has added a lot to my understanding of the metabolic processes. As far as what the state will let us/have us do is beyond me. I can only imagine that they will incorporate it into the medical assessment and tell us if it falls below 70 mg/dl, contact ALS, administer oral glucose if a patent airways is present, if it is above 180 mg/dl contact ALS (to dilute it i guess?), and inform the ED? Not sure if they will have BLS do it on kids...i can only imagine they would, no?