STAT213

Just curious what the process for hiring and training of FNGs is in Westchester. I never looked into it when I lived down there. Up here in NH, there is ONE test for the entire state. It is run by the state fire academy once a year and includes a written, aerial climb and CPAT. You are then placed on a list which is mailed to all state departments that have career components. Each department has different requirements/minimums and some even do testing above and beyond the state test. i.e. one department actually does a swim test. That's the brief version of it. There's lots of jobs to be had up here, so if you don't like living so close to the evil empire's headquarters, look into a move to a place where the motto is live free or die!!!

Date: 1.6.2006 Time: 4 AM Location: Rochester, NH Departments:11 Description: Fire in 2 Buildings in Downtown NH. Links: Writer:STAT 213 Was spotted by a passing police officer on patrol. Multiple elevated and non elevated master streams were in operation.

Sutphen makes great ladders. I have not heard the greatest feedback on their engines. I know of a number of departments that are not thrilled with them for a number of reasons. You really don't get that kind of feedback about their ladders, though. An interesting fact...most of the engines are made out east here, and the ladders are made in Ohio. Not sure what that is all about, but a former department of mine bought a tower and an engine made at separate plants, and it was like they were from two different manufacturers. One sucked and one rocked, both from day one.

I agree completely...those chairs rock. We have them. Theory is...they are a little expensive but if they save ONE, just ONE back injury they are worth each and every penny they cost us. I know they are easier and better to use. We are using the same rationale to get the hydraulic/electric stretchers. Cause, its about going home at the end of the day.

ok, change it to...sigh just what mt pleasant needs...another ladder. Period. make it a tower, a stick...no difference, still a waste of taxpayers $$$. Chu Chu, I am quite familiar with the Town. I used to live, and to work there. In lieu of getting into a giant #@$% measuring contest, I will wish you happy holidays!!! If you want to know more about me, fire off a PM. I'll be happy to talk until I am blue in the face about what I think could be done differently in the fire service. Ask anyone on here about my opinions, cause I got 'em. And, I do not blame Hawthorne for trying to replace their truck. If I was on there, I would probably try and keep what I had too. As an outsider, I can say that we spend too much money all over the fire service on duplicated apparatus.

Ah yes, just what the town of Mt. Pleasant needs...another new Tower Ladder. That may sound really negative, but its meant more with a sigh. I just don't see a need for the way money is spent in the fire service.

Ok, what's this mean for city speak? "Fire is doubtful..." Was it also pensive and angry??? Seriously though, what does it mean?

thanks for the clarification guys!!!

One thing that is rarely mentioned by those lauding SSM is what it does to the crews. I did SSM for 6 years and am lucky to still have a functioning back. Granted you do find ways to beat the system, but a cold snowy night with no calls stuck in the slowest post is just that. The commercial services that are usually for SSM are doing it to SAVE MONEY. It is more efficient to have your people out on the road instead of housing them in stations. If you station them, you need more crews. SSM benefits the company and they sell/spin it by saying its best for the customer. The only loser is the mope in the truck.

Ahh, the sink and the coffee maker. Along with the mop and bucket, those were my only friends for the first few months, for sure.

Firefighter57, that is part of their PPE in Boston. Remember, just cause someone, somewhere taught us something, does not make it right. One of the best things one of my instructors once told me was: Half of what I am gonna teach you is wrong, I just don't know which half yet. Check their website. You do not need to wear Bunkers in Beantown, it is up to the individual firefighter. http://www.cityofboston.gov/bfd/news/New_B...Gear_Policy.htm

Ok, a couple of things here. I love all the critics of what is arguably one of the premier fire departments in the nation. I am fairly confident that they have seen more fire than the vast majority of you on this site put together. They may not have followed YOUR sop for car fires, are you aware of what theirs are? Have you gone online to read their PPE SOP? As for the PASS alarms. They go off. A lot. And, as for the comment about the PASS alarm going off in the station...did you notice if it was change of shift? Part of checking your PPE should include checking that PASS device. Every day. Do you do it when you do your truck checks? Do you do truck checks? All I am saying, in a somewhat harsh manner, is that I have no tolerance for all the people who watch a TV show that essentially shows a glimpse of life in a working firehouse, and you see a few inconsistencies and are suddenly the experts on how bad Boston Fire is. They may not do everything your way, and that does not make it wrong. Not offering excuses for some of the things that went on, but c'mon now. The show has been off for a few hours, and you are jumping all over them for stuff you saw. What are your credentials and experience that give you the priviledge to do that?

Hmm, maybe they will start making quality apparatus, and people will start calling them something other than american la trash.

I wanted to add something to the last forum about Fire Appartus on EMS calls. I am suprised no one mentioned that NFPA 1710 states that for ALS level calls, the minimum recommended staffing is 2 BLS providers in four minutes and 2 ALS providers in 8 minutes. For departments trying to reach this standard, the way to do it is to have an engine or ladder with a medic and an ambulance with a medic respond to these level of calls. We send the engine because its the most logical piece to send. We staff three three person engines and one four person engine, and splitting them up is not something the chief is interested in doing.

Question for the gang... How do you feel about shorts being part of a uniform? Not just for bike EMS, but worn as a part of your uniform? This has sparked some good debate on another forum I peruse. For the record, I am in favor of them, and am allowed to wear them in my town where I am a professional firefighter/paramedic. They are part of our uniform, and we wear them for station wear and for EMS and service calls. Obviously, when needed we don our bunkers. Rob

Mikeinet, Thanks for the reply. What I am trying to point out mostly is that IF we removed the EMTs from the system, and made it so that paramedics - college educated paramedics (with initials after their name, because that is what many folks seem to recognize) were the only ones providing care in the field, the profession would be elevated. Look at what nurses did for their profession about 20 years ago. They went from being doctor's helpers to health care professionals. I want people to stop saying its ok that all we can get out on the street is a basic EMT. I want that mind frame to change. While it may seem that I am bashing those below me, that is not my intention. Its just that as long as they exist, and are viewed on the same level as paramedics, paramedics will always be ambulance drivers and not pre-hospital professionals. And its not what we can do. We can't do all that much. Its what we KNOW, and how we can begin moving a patient down the right pathway for the best possible care from the beginning. And, looking back on that statement, it would seem to be pretty clear that I am bashing those below me. I do not bash their work, their energy. Do ED techs expect to be given the same level of respect as MDs just cause they work in the ED with them? Nope. Its a different level. But until we differentiate (sp) ourselves from the masses with something other than a Gold Patch from the Regsitry, we'll be little more than that ambulance driver with the flip flops and metallica T shirt everyone is thanking for just showing up and performing CPR a little bit better than the lay person. I think its great that I have pushed you. I enjoy doing that on these forums. And, I will stand by the fact that as long as we think its ok that all we get is a basic emt when we call 911 we will never advance this profession a lot further than we have already. I know I sound like a cocky bastard who hates EMTs. I really don't. Ask those I've worked for, with and around. I enjoy being a medic, teaching those around me and learning from those around me. It is all about teamwork and fun. I am not a hard guy to work with or get along with (mostly!). But, these forums give a good chance to vent and discuss how we could make the world better (even if in our own minds.) Rob

I am trying to start dialogue here, controversial as it may be. I apologize for some grammatical and spelling errors. I am at work, and got dinged on a call, thus I did not re-read my post for correctness. Very good point though. How can I suggest one thing and not do it? My oops. Thanks to MGMedic for pointing that out, because if I was reading the post, that would have been one of the first things I would have noticed. Ok, to answer some of the points about why I don't want anyone but medics on the trucks. And, college educated ones at that. EMS Buff reminded me I was once an EMT. Yup, very true. And, as someone out there to save lives on an ambulance, I sucked. Worse than sucked. I was a dumb college kid with a patch. My EMT class prepared me for nothing I would see in the field. Nada. So, go learn more, right? Off to Intermediate Class. Whew, lots more knowledge. Now I know it, right? I am an ALS provider. So, I get into paramedic school. Thinking I know enough to survive, I am happily confident in my skills. Wrong again, jacko. I did not start to have a clue about what was going on with my patients and how to take care of my patients until well into my paramedic class. In fact, I can tell you the call when it clicked. Lights went on, angels sang, the whole bit. And, it was because of my education, and the experience of being mentored by some amazing medics that got me there. Now, some would say that I imply through all this blathering that I am discrediting the work that good EMT Basics do in the field. Well, I just might be. Honestly, what do good basics do? What can they provide - other than some basic airway management, some oxygen and a backboard - that was not provided when EMS was run from a hearse? How far have we come? Is that the shining example of prehospital care? Sorry, but I really don't think so. And, that is why I want 911 EMS to be about educated folks performing a profession, not a vocation. This does raise the point about EMS and research. There is very little to prove that what I am proposing will make any difference at all. Interestingly enough, the best research shows that rapid transport. is about the only thing we really need. I would argue though, that many of the interventions we perform make a difference. I hope I haven't pissed everyone off. That is not my point or what I am trying to do. I am mostly trying to get a viewpoint out there and a hope for what professional EMS could and should be. And, in my dream world (and thankfully, where I work is pretty close to that) there just aren't ambulances without skilled paramedics. Its what the people here pay for, and its what I give them. If they wanted simple BLS care, they would vote for that in their budget. In addition to the point that EMS Buff made about becoming a paramedic, Doctors do not first become PAs or RNs. They go to school to become Doctors. We should do the same for medics.

I have a couple of thoughts on this topic. I think you see more EMT-P openings because of the true lack of paramedics out there right now. Its a lot of time for not a lot of $$$. Basics can take a short class and be in the workforce fairly quickly with a fair return on the investment, dollar wise. To answer your question directly, are EMTs going by the wayside, and do people want them to... I would honestly have to say "No" they are not going by the wayside, but "yes" I wish they would. (That should get some folks jumping-but let me explain) I am not trying to be a jerk, but trying to prove a point, so please read this whole post before the hate emails come flying. And, let 'em fly. A little controversy is a good thing!!! There are many of us out here in EMS land who feel we are not respected and are not treated as professionals like we should be. Part of this is because there are people out there who cannot spell, cannot talk and cannot carry on a conversation with a nurse or a physician using words with multiple syllables, let alone medical terminology. When someone thinks of an ambulance, they don't separate the incredibly well read, experineced practioners from the total yayhoos. I don't like this. I don't want to be associated with those people, because they give EMS a bad name, and they are why I make what I make. Paramedic should be the ONLY level of EMT to be on a 911 or CCT bus. EMT-I should be the ONLY level for First Responders. And, the cirriculum needs to be re-written so that we teach useful things. Its sad that we allow someone to take a 120 hour class and then go play on an ambulance. So, its probably a good thing I am no longer practicing in NY, cause all the basics down there might hate me now. That's ok, if you hate me, just understand me and where I am coming from. I have always enjoyed working with ALL levels of provider, and if you have worked with me, you know that having fun and giving good care is paramount to me. This whole thing is a philisophical point, not one I carry around on the streets with me. If I did that, I would have exploded with angst and hatred by now. And that is just no way to live.

Interesting thoughts. I am curious why people have this marriage to their local hospital. I looked through the protocol, and did work in the area as well as other NY areas for a while, and in the WREMSCO protocol, there is the section on destination determination. It does not specifically refer to trauma or to cardiac, just closest MOST APPROPRIATE facility. This applies to stroke, to MI, to trauma, to burns, to hyperbarics, to Jacobi being the envenomation center, etc, etc. Where in the protocol does it say call someone to ask permission? I did not see it. Granted this doesn't mean that its not there. One of the things I noticed while living and working in Westchester was that people had this, well it was almost fear of medical control, and strict devotion to what someone had told them was a truth. Based on what I read, and what I did as a paramedic down there, going to a hospital with a Cath Lab is the most appropriate thing to do. Another job, more to come....

Ok, so I reading along with this discussion about 12 leads and a few things come to mind. 1) Destination determination is up to the paramedic. Closest, most approrpriate facility. For MI, that is a facility with a CATH LAB, not an ED doc with a bottle of TNK/TPA, etc. 2) Someone said that they don't waste time with a 12 lead in lieu of other more important interventions. Such as??? 12 lead is the standard of care. Sorry if you think other wise. You as a paramedic should be performing one, and interpreting it to determine your destination. Yup, there are other factors that go into diagnosing a subtle ischemia like lab work, but the 9/10 CP with changes is pretty easy to determine, and you're doing your patients an extreme disservice (with today's knowledge and understanding) by taking them anywhere without a cath lab. 3) Where is the rest of the ACLS protocol? Nitro drip? Lopressor? Have to go on a job, more to come...

Just a couple of things to add. We no longer allow turnout gear outside of the apparatus bay floor. You cannot come into the living quarters with it on. So, why would you want to bring it into your house. As for keeping it in your car, its needed sometimes for sure, depending on your district. I would urge everyone to keep it in a bag of some sort. Most of us know this, but I saw someone the other day up here in NH with their gear hanging in the back of their SUV... Our gear gets destroyed by UV light, and its effectiveness will be greatly reduced if you keep it out in the open like I saw the other day...at the NH Fire Academy.

My call department in NH is just such a department. The station is not staffed and there are loose assignments for night coverage (entire force is divided up into three shifts who take turns covering the stills.) All members are paid $9.00/hr for time spent on the alarm. Needless to say, things can drag out a little bit on the fireground. The call log taken at each alarm dictates which members gets paid. You get paid for the amount of time the call took. Not sure how this evolved. Its not entirely a regional thing, because a number of our neighboring departments are true volunteer companies. No $$$. It is common to the area, with a number of departments doing this. We are all Town employees, and have to fill out W-4 forms, etc. Hope this helps.

And, unless something has changed, R/M gets $$$ 00.00 from the city. Its a contractless arrangement that started back when it was Eastern Ambulance Service. They bill the patients, and that was it. Nada from the city.

This is something that has bugged me about the downstate thing for quite a while. There is this habit of requesting addtional resources or units not on scene yet to respond "forthwith" or "on a rush". WTF??? Does no one else see the inherent danger in this practice? How else would units respond? Would you, as a police officer or a fire officer or first arriving EMS crew like me to turn the extra lights or the special siren on reserved for the BIG ONES? Do you want me to speed? Cause that is what you're asking for. And, if you don't have a crusty medic like me who doesn't really care if its a code or a finger lac, you might be getting an impressionable medic who will push it, and try and drive faster than conditions allow and maybe get into a wreck. I have seen it happen. I have reached over and turned OFF the lights and the sirens to force the calm on a partner. It is not our emergency. Why are we doing something to encourage any other behavior? Granted its not limited to the downstate area, but you folks really seem to love calling for things with these zippy phrases like forthwith and on a rush. When we respond, we respond. If its with lights and sirens, it should be to do so to get there a little bit faster and avoid traffic. It should never be in a manner that could cause danger to ourselves or the public. Remember that whole do no harm thing? Adding that we want the bus on a rush only excites the situation and can endanger our fellow providers. So, why do we do it?