MerlinMedic

I thought they were joking about this when I was told this at AMLS yesterday. Lets face it, it IS the punch line to a blonde joke!

Not taking sides in this mess, being from NY, but what Wisconson did appears to be just what the Feds did years ago. Federal employees are unionized & don't have collective bargining rights. They also appear to do rather well. As a former union member it agravated me that my dues went to candidates that I didn't support. And that, I think is more of an issue than people realize.

Since we are talking about professionalism, how about letting the Sups & Management know when someone does right? The transport crew is early? They help clean up an other patient, help the techs lift a patient into bed? Just yesterday I had to order an EMT badge for our newest EMT. Unfortunetly, I lost the number of the company we order from, BUT, I had the name of manufactuer of the badges. A very nice & patient young lady dug thru 12 years of orders to find out which company we order from (can't go direct, Washington State requires Letterhead etc). She found the company we do biz with, their number & who I needed to talk to. Needless to say, I put a call back to her boss to compliment him for his employees hard work. He was very happy to hear about this, AND she will be very happy with the $50 bonus in her next pay check. So, nurses, docs, not just from the ER, but the floors & whereever you see EMS: when you see us screw up, deal with it, when you see us doing right, let our bosses know!

Can we say "license"? The time to act is now. As NY cuts re-cert classes all over (SUNY Ulster & Cobleskill/Bassett) to name 2 that have ended 'locally', it is time for the State to grow some guts , stand up to SIEU 119 nurses & let EMS get licensed. I know it wont happen this year. But the shortage of classes now means a shortage of EMS providers in the near future. Oh well, NY hasn't been progressive in thought for nearly 70 years, and looks like that wont change any time soon.

Recently I saw a notice that SEMAC would require all ALS agencies to have 12 lead capability by 7/1/10. Can anyone confirm this AND provide documentation? I searched the SEMAC web site & could not find this as a mandate. Please note: this is NOT a discusion on the merits of 12 leads, I well know their worth. Thanx

How about all the ER expansions lately that never consult with EMS? Kingston's looks great, but like Vassar's, you have walk-ins crosing were ambulances are moving thru, and the transport rigs are trying to move people out. St. Francisis? C'mon folks, before you build, ask those who use it what we would like to see, suggestions. Architiects are generally not EMS providers, and often have no hospital experience. Vassar's nice computers look great. They have a nice CiC, except ... the charge nurses' backs is towards the door EMS door, and it is at ground level. Raising it 6 inches would give them the ability to oversee what we are doing and have better command and control. AND, I didn't mention those $%^&**^$@# loading docks from the daze of the Caddys!

I hope the Court makes the family pay all the bills on this one. When you read the article it becomes clear that the patient died from a pneumonia, as the death certificate states, not any treatment or lack of treatment by EMS. The family was trying this as a Civil Rights case! What Rights were denied, abused or anything? EMS was abused by this one. :angry:

What happens if you work for an all paid & volly at an all volly?

Most likely someone hadn't changed uniforms yet or just having some fun. Many of us have Velcro patchitis. I suppose the county dispatchers love it when we (read I) say "County Ala... no, who am I today? ... "

I have to laugh when I see hospitals/agencies that try banning items of clothing worn outside of work (not uniforms). I recall in the days of yor when hospitals had a major problem with scrubs walking. A certian Albany hospital put "Property of AMCH" all over their scrubs so they wouldn't walk. Albany has a thriving adult softball leage. I drove by one field and saw a complete team dressed in green scrub with -- yup -- "Property of AMCH" stamped all over them.

LOL. I wont mention those who once called out as XYZ 'Heavy' 1234 responding. I nearly bust a gut laughing. Don't know what county thought, but it was funny. Of course, the guilty in this case HAVE dropped a lot of weight. As, <cough. cough> have others who didn't like the mirror.

OK, so what is the answer? rehabs feel that they cannot limit the food intake of these patients because it would violate their basic rights, BUT the patient is often on a 6000 + calerie a day diet. All too many are on public assistanc because they cannot work. Eating $40 a meal of Cardiac Arrest Burger (as my fav delhi now calls one sandwitch!) while on the dole, then calling 9-1-1 because ... . So we go out the wherever, pick them up in a unit that has more stress because it is used soley for the bari pt., a cot that has metal fatuge for the same reason, and a 2 person crew, one of whom has a bad back from that crash way back when with Henry Ford, and the company get paid $80 to $150 + $2.00 per mile. The company can't afford a new specialty unit because of this, they can't afford more crew. So ... what do we do? There is no quick answer. But we need to do something. I just read that they hope tohave government healthcare by the end of next wek, and healthcare still hasn't come up with an answer for the bari or the person who wants a taxi cab from Fishkill to Poughkeepsie & calls 9-1-1 & then books out of the ER. :angry:

With Memorial Day just over, the local grave yards are newly cleaned & decorated; the American Legion, VFW & youth groups placed new flags on the Veterans Graves, and the FD did the same on the deceased firefighters graves. One family member asked why there aren't any markers for deceased members of the rescue squad. A few years ago we looked into the bronze grave markers for EMS & discovered there are none made. I was hoping that someone might have found a foundry that will cast a Star of Life gravestone marker, or know of a business that sells them. Being cheap, we don't want to have to pay a casting fee (iircc is over $400). If anyone has any info or can suggest a company, please do so. Thanx.

Thanx, 2 of them do have EMS specific markers: Fireawards & G'burg. Price is similar. Both are a cadeucious w/ EMS on it.

This past Friday the Schoharie County Board of Supervisors voted to bill for ALS flycar intercepts. In Schohaire ALS is provided by the volly unit with County back -up. The County ALS is anofficial county agency, not a quasi-government agency. While I have not seen the law/resolution, I have several questions for those with a more twisted, I mean legal mind than mine: Can government agencies bill for emergencies of any type? Gen. Municiple Law 209-c? Or other? Can non transporting agencies bill insurance for ambulnace services? Or, they can bill, but insurance companies will ignore the bill? Can they only bill thru the transporting agency via some sort of a contract? What if the transporting agency is a fire based agency that recieves tax dollars? Any other legal dodges, I mean loopholes that I don't know of so the County can bill? Thanx in advance your help.

Ckroll, thanx for the info. Moose also described our local, hill billy ALS fairly well.

Watchdog, you are right, there is a lot of history between the lines, which polietness forbids me from detailing. Sufice it to say Moose & I disagree with some other ALS providers. To answer those questions I can: yes, 2 people are paid to provide 24/7/365 ALS in that county. They are salaried. Their choice. Local ALS providers (like myself) only practice in their vollie district or out of the county. As to just riding around in a county flycar ... hmmm ... how to answer that? I really don't think I can. They are county employees; their own boss & do as they see fit. Med control, QA/QI is not as it is in the Hudson Valley; that much I can say. To give you an idea, I have met my vollie squads med contol doc two time in 18 years. And yes, I have set up appointments, stopped by his ER, office etc until I got the message.

EFFP441, you may have missed or over looked an earlier post. TC under bid Alamo for Millbrook by $6,500, yet they over bid for Beekman by $30,000 in both cases TC got the contract. The question should be asked, why? Both agencies have good and bad points. I am not going to get into that here, as I am not management. But whatever your feelings, the voters have to let the politicians know their feelings. The research that is done is most often hearsay. So it is important that things like calls turned over, time to scene, and customer satisfaction are included when a town puts out an RFP. My volly squad improved greatly once we started send ing patients satisfaction surveys out on every call. So did our donations , but that was an added benifit. On another note: maybe should be a new topic, but ... With ObamaCare looming around the corner, will the government nerf MediCare/caid payments to EMS for transports? Will transports be where the $$ is, or will it be in E-jobs? Alamo has been repositing itself for transports for several years (by accident or design). TransCare has been a NYC shuck bus company that is moving to E Jobs. MLSS & NDP still have a fairly good mix of 60-40 -60 E Jobs/transports. Which is the way the wind will blow?

TCs bid was 30K more than Alamos for Beekman. The bad experence Beekman had is Greenhaven Corrections. That has been hassed many times over. The Beekman town board was getting a lot of heat over the spend of an extra 30K, not over TC. And that is how things are going to change: voters telling the elected people to do X or Y or they will vote them out of office.

I agree, we need to stop telling other services how to do their job. EMS does not tell police how to solove a crime, nor fire how to put out the flames ( we might fan them, but THAT is something else ). Yet, some agencies can't get it thru their head that if the patient isn't on fire, get the truck outa the way. And yes, that is in Dutchess County. UpStae, unfortunetly, everyone thinks they are the medic until they are holding a corpse, then they call me and expect me to fix it. An idea that will never catch on: inter-agency ride alongs. Police on fire & EMS, fire on PD & EMS, & EMS on PD & fire. I did that many years ago in REMO. WOW! The police were great in polietly pointing out that I had no clue about their work. And they saw that they weren't EMS and want no part in it. I was a volly firefieghter, so never did a cross service ride there.

The people of Dutchess County would not br happy with a single server that is a commercial for profit company. Rural Metro used to opperate this way: they came into a community and offered a low bid contract for 3 years (or to donate $$!), and to hire the local vollies. The Town said great. Threee years latter, when all the vollies had let their cards lape, RM then said, here's your new contract (cost + profit), pay it or no EMS. In these rural upState Towns there was no choice as RM was the only player. This was the deal they offered my Town/County. No cost for the Town for 3 years, a donation of $100,000 for 3 years if they got the county. Since I knew some folks in Syracuse I was able to get info & we learned from their mistake. Also, my town supervisor is an RN/EMT so had an idea of how EMS works. We were lucky. There is a reason RM was once #2 in the nation. As to the rummors: HQ will listen to anyone. Did they? Most likely. NDP & MLSS are the same: listening doesn't hurt. More importantly, why did Millbrook dump ALamo after 20+ years of service? $6,500 isn't really enough to throw over a relationship that has lasted that long. Did Alamo stop responding? Take too long? Never heard those complaints. Not stroke the relationship? Something more ... ? Or are the politicians really that pennywise & pound foolish? Time will tell.

Rest assured that all this will be investigated and, if appropriate, the police officers involved will be dealt with in accordance with the law and their department's rules and regulations (rules and regulations that are generally more stringent than any the law or fire/EMS rules). Actually, I am NOT assured that anything will be done, the DA is investigating the EMS crew, NOT the police. Too much is swept under the carpet when it comes to EMS. God forbid this is a comercial EMS outfit, then they are automatically wrong -- got to safe the contract. Can cops be jerks, yup. Does it look bad from the video, yup. Could the medic be wrong, yup. Too much ego here. If a cop puled me over (actually one did in a rig -- his Sargent was on scene so fast & appologized to me, but thats an other story), I would be screaming over county for a supervisor/Sargent. Something is fishy here. Hopefully the DA will release the dash cam, but I wouldn't hold my breath on it.

Does anyone know of any studies or policies KKK, CAAS etc that show or reccomend crew utilization standards? With the ecconomy in a shambles, and NYS limiting amounts billed (EMS only), and ObamaCare soon to cap all insurance reembursments, commercial EMS managers are going to be demanding more and more out their crews to try to make $$ to keep the doors open. What are safe levels of utilization? How many hours moving in an ambulance, doing transports, E jobs, moving from location to location without a break before someone falls asleep at the wheel (again ) or a medic pushes the wrong drug? The only standards I know of are the Federal DoT for OTR truckers, which limits their days to 14 hours, and the JEMS study that shows after 12 or 16 hours medics reactions are that of someone with a BAC of 0.8% Any info would be great. BTW, I am calling utilization from time of dispatch to back in quarters, not service. After all, we might be clear of Boston General, but still have 4 hours in trafic -- ok, the way I drive 2.5 but ...

I think it is a great idea. I enjoy working along side the doctors, having them explain their line of thinking, possible treatments and resources they may use. It gives me an opportunity to network with nurses in a different setting. Of course, I only do ER time for about 8 hours a year. If I had to do it FT, the idea would not be so good. First, St. Luke's and Vassar nurses are unionized. Would either hospital give us union wages today? What about 1199? They appear to not want medics in hospital settings as it may give management ideas about cutting back on jobs. Of course, with National Health Care around the corne, that may be a moot point. Then, there is the culture of EMS and an ER. Simialar to that of PD/FD/EMS. All have the smae general idea in mind - public safety - they just go about it in different ways. While we all work togther, there often is an underlaying layer of tension due to diffferent cultures & tradations. Next, take a medic from Hudson Valley, Westchester, NYC or other high volume EMS area and put them into an UpState rural hospital, where EMS is the local vollies who may have an EMT-I or CC, rarely seeing a medic except for transports. Talk about culture shock! In short, I like the general idea; after all EMS is suppossed to be the first eyes & ears of the doctors, BUT to realy work there has to be great need which causes all to want it to work, and then a lot of TLC to prevent burn out, culture shock and other bad things resulting from shotgun marriages. My .02 cents worth.

Anyone know if Quigly's name will be added to either the National or State Memorial?