MerlinMedic

That Spitzer has not resigned as of yet is ominous. Like most politicians, he is very aragant. I do say most one purpose. When I was a kid back when the dinosourse roamed the earth I was walking thru the Capital taking photos, sorta lost. This one guy finds me where I don't belong in Senate Majority's Office looking for a good shot of something. He takes me around & shows me all the great place to shot from & such, and some cool things that few now remember. He was Sen. Warren Anderson, then majority leader!

Some good thoughts here. What many have forgotten is that all too often the call is for general illness & in walks EMS into a bad situation. I know 2 crews that have had firearms pulled on them. One during CPR & one was a set up. Opening the door to the house & staring down the business end of a rifle sux. I also recall that until recently PD were rarely sent to EDP calls, or if they were there, as soon as EMS came up the PD were gone. Poor judgement by some changed that. I know the EMS provider who tried to push thru the PD lines to "talk down" Mr. XYZ with the 12 gauge in his hands. Why the PD did not arrest that person is still a mystery to me. It all comes down to judgement, as many people have said. Some of theat judgement comes from the school of hard lessons. Why do dispactchers check our status after X minutes? Because of crews like the one who walked in to be taken hastage -- back in the '80s EMS for the most part did not carry portables. No cell phone. Soooo after not hearing from the crew for nearly an hour someone was sent to check up on them and then the problem was discovered. Not that the crew was at fault. The person wanted drugs & called ES to take thier non-existant drugs -- it was an intermediate agency. If the call seams suspcious, stay back. If you don't feel safe, call for PD or FD as the case warents. Use your head & go home at the end of the day alive.

NY is a right to work state. Your boss can fire you for no reason. If they give you a reason, they could be sued. Wrongfull termination. The sad part of all this is that if the commecrcials treated their employees well (pay, bennies, working conditions, etc.) they would have full staffing. In the Hudson Valley there are few agencies who would not hire any former EMS person who left/was fired from an other agency in a heartbeat unless they knew that person was fired for some really stupid thing.

Now you are being obstinate. When you leave off half the sentance, you are quoting out of context. Please stop.

The full quote is: As far as PD, their job is full of bone heads with guns, which EMS rarely, if ever faces. I thought I was being pretty staright forward in saying that PD face armed hazzards that EMS generally does not. EMS faces other hazzards that PD does not face; as FD faces dangers that neither PD nor EMS are equiped or trained to face. In essence, each branch has their share of danger, some are more visable (fire), some can be fatal faster (bullets) nd some we don't know all about (yetch -MRSA). Given that, all should be paid pretty close to the same. We know it doesn't ahppen that way, and wont for a long time. As to EDPs, that would be an intersting other topic.

You miss understood. I was not refering to the PD as those with guns, but probobly one of the most dangerous situations (as I understand it) that PD face, a trafic stop and the person has a gun. It was THOSE bone heads I was refering to. As to the drugged up EDP, please don't go there. Until recently they were EMS calls, no PD. I want & appreceate the PD presence. When we all work together, we do good things. And Jonesy ... Rural Metro can & should pay you more than your $7.00/hr. They sure made enough $$ on those 10 min 'shucks from Eden Park across the parking lot.

I disagree & am not sorry to do so. EMS deserves as much as PD & FD. We often do 3-4 times the call volume as straight FD. As far as PD, their job is full of bone heads with guns, which EMS rarely, if ever faces. But we get funky illnesses. Of course, most EMS is private & we don't get municple benifits if some knuckle head thinks we are the PD and shoots us. Look at the 'great' trreatment the private EMS people got from the City/State after 9/11. Each service has it's hazzards, fire, knuckle heads & yetch!. Each have the same basic goals -- serve the public, save lives. We each have our specialty & do it well. EMS just does not have the $$ or recognition. C'mon, $7.00 an hour for Rural Metro? Please, that company makes $$ hand over fist. As a for profit agency, I believe they can even refuse non-emergency transports for those w/o insurance.

Recently my volly squad has been looking at dressing up our uniform from a plain shirt with patches & dark pants to something more. While looking thru multiple catalouges & on line I have seen some nice uniforms that we can't afford. One item that caught my eye was the use of epaulettes thru out Canada. I am told this is also the case in the South & SW. I have found many examples of the Canadian epaulettes. ALl are tasteful & nice, generally haveing the Canadaina flag over a caduceus and then some sort of rank for Lt., Capt. or the typical stripes for FD based EMS + the title of EMT or Paramedic. I have seen only one US example, from LightHouse Uniforms, who makes the NAEMT uniform. There example is based on a Navy CWO insignia. What I am looking for is ideas. We have badges & NYC recognition system, but those are more for parades & funerals than ecery day wear. If you have ideas, links or other suggestions please post. I am not looking for discussion of the merrits of each uniform part; we all have opnions of them. This is to generate sources and possibly barrow some other persons great idea. Thanx in adavance.

Sorry, these were not ment to be work uniforms, more in the line of a dress uniform. We are looking for in expensive ways to dress up our current uniform.

Simply, this is bad. It is very easy to intimedate some people, especally the eldery & those without much contact except the TV. Apparently this scam has been round since 2004 & is recycled in a new area every few months. Just think of all the phishing spoofs you get from eBay, Pay Pal etc. The first time I got one I called (didn't click!). I just got one from my credit card company! Education, as always is key, as well as haveing family check up on those who live alone. I know, I am preaching to the choir here, but ....

I just saw today an EMS flycar in subdued (tactical) colors. It is an upstate County EMS Coordinator's flycar. All of this county's flycars are painted the same way. This county does not provide tactical medics or EMS. Why the subdued scheme? I thought the idea was higher visability for EMS units. Am I missining something? Was there a study in JEMS or somewhere that reccomended changeing color schemes to subdued?

Subdued or tactical colors are dark; generaly navy blue, black and medium to dark gray. In this case the vehicles were a dull black and medium gray. I do not know if the gray letters were reflective as it was an overcast day towards dusk. I have seen 2 police agencies with a similar color scheme: Albany County Sherrif uses a jet back with gold lettering for their patrol cars. This scheme is smokin'!! Schenectady City P.D. has at least one patrol car that is dull black with dark gray lettering. That car looks like it means business. If I were pulled over by it I would be "extra" careful to do exactly as the officer said. Those are police agencies obviuosly with different missions than EMS fly cars. Personally, I would have missed the 'subdued' EMS fly car if my better half hadden't pointed it out to me. Which is why I am asking if I missed something on flycar visability? On a similar vein, why are ambulance's light bars up so high? Nearly 10' from the ground? The poor driver in font of you who has their stereo cranked up and isn't hearing your sirien can't see the light bar when you are 5-10 feet behind them. Wouldn't some sort of light strip similar to what the truckers have that runs 4-6' up from the bumper grant more visability to those directly in front on your rig?

This brings up an interesting topic for discussion, outside the issue of Matt's death. Who is responsible for telling someone they are too tired to work? The company? The shift leader/Lt? Your partner? Your self? NY is a right to work state. You have the right to work as you see fit (and they can fire you for no reason also). Right now, I believe that most private companies expect you to come in to work ready to work your 8, 12, 16 shift reasonably well rested. Even the 24s, although they are know to be "restfull" tours, which is why management allows them.

Ease up folks! We are in an intense preasure cooker of a field, with little recognotion, poor pay, and horrible working conditions. And most of us love it! We thrive on the chaos and stress. There are some good ideas out posted in this thread -- like no non-emergent transports after 23.00, mandated rest after X hours of moving, real beds in crew rooms. (I like that one; Mohawk Ambulance in Schenectady had them for the city crews in the '90s, worked well.) There has been comments made about waiting for the full investigation to be completed. We need that. If your accident investigation skills are like mine ... lets just say I ask the PD what hapened. But don't bash people for doing what we do -- going the extra distance, yes, I can make it home after a zillion hours on the road. This is a tragedy for all, but especally EMS. Maybe we will wake up & change things, but don't hold your breath. Rest in Peace Matt!

VAC, Vol. EMS, First Aid Squad ... all are traditions that should be kept so we know where we came from, but don't forget the Life Pac!

Why not have BLS do this? Regular people take theirs all the time. Often they have little education on it. My father used to jump on every variance each hour until he learned.

My vollie agency has helmets & coats. The helmets are standard fire issue, but blue. The turnout coats are NOT fire retardant, but fire resistiant. The idea being we are not fire feighters, so don't try to be one (hint hint firefieghters -- if the patient isn't on fire, get out of EMS's way ). This sytem has worked well. Now if we could only convince a few members that those coats are also not kevlar!

Who gets to pay for the AEDs?

This is an other well balanced article. It brings up several important areas for thought. First: the loss of volunteers is not isolated to the Hudson Valley. It is going on all over. Mohwak Valley, Schoharie Calley are just 2 places that come to mind. Second: What to do? Some towns like Pawling & Hyde Park are buying services from an NDP, Alamo or MLSS. But, as medics are scarce, what do areas without the tax base do? A small town on Columbia County's border just does not have the money or the need for a 24/7 ALS ambulance at half a million dollars per year. County wide EMS? What are the tax payers going to say? If they are like me, I complain my taxes are too high already. Issues of politics: there are municpalities in this State where you do not work if you are with the wrong political party. What about peronal politics? There are some people that have built a private kingdom as a county coordinator. While I don't see that the case in Dutchess, it is an important concern here asthe rest of NY will be looking at what solutions Dutchess comes up with. There are several models on how to provide EMS. There is the REMO model. Municple ALS (Albany Fire, Schenctady Fire) with private transport (Mohwak, Capital District) and the total municple model like Troy & Colonie & the Guilderland model of the vollies still run paid BLS, but they are really an other flavor of total municple. These systems work, but are costly. Dutchess is different, more pay as you go. But for the small rural areas? Then what? DOn't have your AMI there 'cause the medic is 30 minutes away? I hope this discussion keeps going in the media & in town halls. After all, I am not 20 anymore! :angry:

Looks like a balanced, well researched article. I especially like the quote from MLSS about the 350 pound patient . Also shows that the governments are thinking. That is good.

Jonesy, you still call medical control for every patient you know is going to get transported to another facility? Is that a requirement or something that is agency policy for your region? Sorry, should have clarified that a little better. I meant for 911 calls. Say I was dispatched to the ball fields for a fractured leg...we get there and its obviously broken (deformity, swelling, crepitus, etc.) and we know that our community hospital cant manage factures, we want to go to Albany Med Just to add on to that: it was an implied rule of that hospital that "they" were the closest approreate facility for everything. And, since they provide the MD for QA/QI, which all agencies must participate in, well.... The new regional protocals specify which hsopspitals are now appropreate & this hospital is not on the list for anything. Now, you should get med control to go there

1) As Moose, I would like to know the extent of "serious" injuries, sounds bad, but I listened to a call for hypertensive crisis last weeek complete with nausea, vomiting & tingling & the pt's. high B/P was 138/8?, so if more details can be found, please post. 2) Moose, as some agencies will not leave thier little town, no matter what the protocols say, some agencies will only transport to one hospital, no matter what or how much it endangers the pt. 3) Anyone ever consider pt. choice? To avaoid that same little hospital that Moose loves so much the pt. would say tell us (with a wee bit of prompting) that they would refuse AMA transport unless they could go to a real hospital, 20 minutes down the road. While this was done for cardiac or serrious medical conditions that needed a hospital with services, we never by-passed an appropreate facility. Given the devout beliefs, is it possible that the victom would not go to a lay hospital no matter what? I realise that most of us would tell them in no uncertin terms that they have no choice, but to many death is better than offending thier God. With that knowledge in mind, I believe the medic would follow pt wishes. Granted, that particular agency has a rep for lots of bad things, but sometimes it really isn't their fault. Really.

Also, I believe everyone is correct in the belief that the minor was in the custody of the PD as soon as he was arrested and that a parents "signature" was not needed. If he was arrested than he was the responsibility of the PD. Releaseing a medical patiant to the police is wrong. Police do not release criminals to EMS. Police have the right to arrest. Police carry guns. EMS is not looked upon by many, especally small town PDs as "just palyin'". That being said, there are several issuses here: HIPPA -- can't respond to that, you know you better of not released any info PD/EMS relations Sorry police, it has been my experience that police do not respect EMS by & large & this was a case of that. In part. Local politics will also play out here. EMS: When in doubt, call for Med control! I, like the folks in Sleepy Hollow have a tough time telling police of any stripe to back off (recently told by a NYS Trooper to trow out an investigator who was out of line in my rig), but all of listen to doc. If doc says, Mr. Police man, I want to look at this kiddie, what cop is going to say no? If Doc sez, ok, let PD take him, EMS is covered by docs signature (at least until a layer tells us otherwise). Tough call, but one we all can learn much from. Please keep us informed.

I understand that part, governments aren't "billing", it is called "revenue recovery" -- almost the same, but different names. Also, in your case both residents & non-residents insurance gets billed, I imagine if a residents insurance didn't pay the bill, they would still get the bill, but typaclly governments don't send the un paid bill to collections. Although I have been told the Town of Colonie does send unpaid bills to collevtion, & they are a tax district. I am not sure if it was a mis quote from the paper & that TransCare does "bill" the resident's insurance & the unpaid remainder is paid for out of taxes or if there is no bill at all for Wappingers residents, but non-residents get billed. That is where I am confused.

I find it interesting that TransCare is not supposed to bill residents of Wappingers; that the taxes pay for it. I have always been told that is called MediCare fraud. The rule being: if you bill one person, you bill them all, and you bill them the same way. Soft/hard, just be consistent. Anyone know more on this?