Goose

2K +/- jobs a year (with the majority, I'm sure, being EMS) all of this seems like overkill...

RIP brother.

An entrance exam? Whatever exam it is, best of luck. Again, i can't emphasize enough to forget the smoke blowing and the catchy slogans - good old hard work is going to pay off. Also, ALWAYS be an advocate for yourself - seek out help when you need it (and be honest when you have difficulties). The only other advice i can offer is that once you're done with school - maybe even now just before you go to school - start thinking about you're next step. While being a paramedic is an awesome job, you simply don't get compensated appropriately. Not saying you can't still be a medic, just keep that in mind before it gets too late!

If the cellular call is received through a Westchester County cell tower then it would have likely gone to the state police or some other local PSAP. Happens all the time

If you put in the time and effort you'll likely succeed anywhere you chose to go. If you don't, then you won't be prepared regardless of where you choose to go.

Look at Wake County, NC - hands down one of the best EMS systems in the country. They have a similar program. They have senior paramedics that go through an advanced practice program and ride around in a fly car making house calls. I don't recall all the details but they travel to and build relationships with the higher risk populations and frequent flyers. They do evaluations and preform a few basic procedures (like removing sutures and wound care) and assist in the pharmacological management of the patient. I think it's worked very well for them. From where i sit, i really see no one better suited than a paramedic to preform such tasks. Besides, i can probably count on one hand how many home health aids were of any assistance to me when they activated the 911 system.

I don't think that he would be barred from taking the class or obtaining the certification. However, he very well may have trouble in the field and securing employment. I'm sure he can or already has developed methods to cope/compensate for the defencies in his vision.

Just another reason the county should be providing EMS. The night and day disparity in coverage, response and care across this county is just a real shame. Oh well, no sense in bloviating any further, most of us know the reality.

RIP Brother. Sad to see so few responses here.

I could probably match that after 98 years as a field paramedic.

This is how rappers have always made their money.

I'm not much of a film critic but i also thought it was poorly put together - i felt it bounced around a lot trying to find it's focus. I read a few reviews on the internet and that seems to be the general consensus. As far as the pot, i thought that the husband admitted only that she occasionally smoked to relax prior to bed and that it wasn't present at the campground (which seems to be contradictory to what i had heard at the time) - either way, it enters all of that into the realm of plausibility where i sit. That said, Diane Schuler was probably a loving mother and wife. It seems that way, at least. However, that doesn't absolve her from bearing the responsibility for that day's events (what i think the family wants). In all likelihood she simply made a series of horrendously poor decisions.

I would probably be more pissed if i grew up and found out my mom hit the bong and boozed up before/while driving my sisters and cousins home, took us on a multi hour joy ride and then killed my sister, my three cousins and three others and left me permanently disabled. Not sure how they would go about obtaining those images (they appear to be police photos) but i have a feeling the schuler family signed off on the documentary - the whole premise (from where i sit) was to absolve her of guilt and/or explain away her apparent choices of the day.

There wasn't much to the photos, just a dead body. I can understand how this may disturb some, but she did seem in pretty good shape considering the kinetics involved (externally, that is - she had some pretty extensive internal trauma according to the ME report). In all honesty, i find the images less of an issue then the crap that we see on commonly available cable channels. I would rather have teenagers view this documentary and see the end results of poor decision making then have them view the glorification of teenage pregnancy on MTV. Thats just me, however.

I also agree there doesn't seem to be any real evidence of a bullet fragment striking this bicyclist. The only thing that seems relatively certain is that whatever he was hit with occurred shortly after he heard what appears to be this officer's weapon discharge. He may as well have been bit by road debris kicked up by a tractor trailer or surface traffic. I would think they would have some sort of contract with a 24/7 credentialed trapper or animal control company to deal with this sorta stuff.

The documentary offers nothing new - she was intox and high. They sought the opinion of a leading ME and he said the County's coroner's office did everything by the book. The private investigator they hired had the samples re-tested and it was her DNA and the THC and BAC #s came back the same. Rather than accept the facts the Schulers seem to be hell bent on trying to prove that it was a tooth abscess that led to a stroke that lead to her drinking a handle of vodka mistaking it for water.

Restructuring services because volunteers can't handle or choose not to respond to particular calls seems silly to me. Though i do agree it would be great to adjust response models to better serve the community in a more fiscally and resource responsible way. The problem with the United States is the sense of entitlement and general lack of accountability many, many, many of us have as Americans. Most would rather pass off decision making to the police officers, fire officers or paramedics and EMTs. That coupled with our over litigious nature....it's going to be a steep uphill battle.

I got a similar email a week or two ago. Also seemed a little weird, but nothing of any real importance to me

Couldn't agree more. Unfortunately (at least here in NY) protocol updates/revisions often have to a lot to do with the willingness/proactivity of physicians. As always some are very proactive in extending flexibility and tools based on best practices to EMS and others, well, not so much.

As far as the hypoxic drive - it does exist, but i spoke to a number of emergency room physicians and all said that a COPD patient would need to be maintained on 12/15 lpm over the course of a number of hours in order to knock out the respiratory drive. That said, i have surely given COPD patients high flow oxygen (NRFM, BVM via ET/OPA, or CPAP) when they need it. As far as the chest pain you sited - i recall a group discussion at a CME or Audit recently where the physicians (two of them) were starting to lean away from giving every chest pain high flow oxygen. I haven't read much of any literature on it, but it had to do ( at least in part) with free radicals. They were pretty frank in stating that as long as their is no respiratory compromise and that they are showing good clinical signs of perfusion and spo2 is also within normal limits a NC is more than sufficient. In fact, they stated that they 99.9% of the time take off the NRFM and replace it with a NC (i've seen it happen, even in STEMI alerts). Just thought those two bits were interesting.

No. The solution is Westchester County Emergency Medical Services (assuming it's done right). That's just delaying the inevitable.

But, we cant. We never are able to have an honest discussion about this. Every time response times go up, calls don't get covered or someone dies because an ambulance doesn't get out in a timely fashion the same discussion seems to buble to the surface, and rightly so. However, when it comes time to sit down and get things done - throngs of people who haven't been on an EMS call in 45 years come crawling out of the wood work, pumping their fists and pointing their fingers demanding that AVAC, BVAC or CVAC not be shut down. They rally their friends and relatives and the issue goes away. If people REALLY knew what the hell goes on within this county's "EMS system" there would have to be outrage. It's only a matter of time before a kid or someone "important" dies prematurely because of this and a savvy lawyer subpoenas the times, tapes, etc.

Before i comment any further, i'm just going to say that you and i fundamentally disagree about this, and that's fine. Additionally, i don't know the area, situation or politics to comment specifically - my comments are general as they relate to greater issues (and i think that this is an issue for many communities). I guess i just don't understand what you're proposing. Should we tell the residents who live in this area of question not to call 911 or that their emergencies are not emergencies? Does constantly responding to nursing homes, urgent care facilities or elderly living complexes over and over and over again wear on the provider? Sure it does. Just like going to automatic fire alarms wears on firefighters and responding to burglar alarms wears on police officers. That doesn't mean you don't have an obligation to respond and that doesn't mean that those emergencies are less important than a street job or those in a private residences. If this is not fair, don't volunteer. Volunteers have just as much an obligation as their career counterparts do to respond to emergencies - regardless of how big or how small/insignificant. If a Somers EMT (using this name only for the sake of the discussion) is at home when his/her pager goes off and hears a job for heritage hills (insert any frequent location here) comes in and he/she doesn't go because of the location and this forces the medic or a security member to ride the job in or results in that job going mutual aid, then tell me - where does the problem lie? Is it with the caller? Is it with the Somers EMT? This is not a Somers problem, this is a county-wide problem. As EMS runs go up - the hodge podge patchwork that is EMS in this county begins to tear at the seams. I think the issue is, is that these local solutions are just too expensive. Something is going to need to change at the county level before any of this goes away

I'm also concerned how heritage hills residents have a negative effect on the volunteer morale. They are residents of the municipality, period. I'm not familiar with the area or the complex/community in question but regardless of who they are and how old or young they may be they are just as entitled to a timely and appropriate EMS response/treatment as anyone else. Either you're in it or you're not - it's pretty black and white in my book.

Bravo to the LAPD.