sympathomedic

Empress I think is about $18/hr. Harrison and Cortlandt $25. Mamaroneck is $29. Eastchester is $28. Not sure on Scarsdale or Transcare, or Greenburg or Ossining or Portchester -Rye.

With the exception of suicides, I don't think anyone, from OD's to MVA'd to MI's ever start their day with the intention of ending up in an ambulance. There are some VERY bad drivers out there (maybe some of US) and their are some very bad decision makers too (also, sadly some of US), and that includes decisons that lead to drug use and abuse. But the OD group seems to attract the most ire. I am not a drug user, but a have a sister that has been. She has OD'd and been 'saved' by an ambulance that I now work on. She has been rehabbed a bunch of times and was on various types of public assistance, RE: welfare. She is now a very productive member of the legal community and has not had a drug issue for over a decade or so. That said, I HATE paying taxes (yea I know, they kinda pay my salary). And I really hate paying them to folks that did something dumb, like get hooked on drugs. Like I said, they didn't mean for it to happen that way, but they let it happen and now need help to fix it. Help, like fire trucks, medics and helicopters, costs some money. I don't want to write a blank check. I do want to help solve the problem. I am about 100% sure that drug money pays for terrorism, as Afganistan is a major poppy growing country. So it can help ALL of us to dry up this source of revenue to the bad guys. So I do my tiny part, and lecture the kids at my local school.

The blog www.statter911.com has been following this story very closely. Dave Statter is a former WUSA TV reporter and volunteer fireman, and his credentials get him access not afforded many others. The house LT has been placed on desk duty. The LT also has a Hx of being locked up for felony theft. The blog also has her incident report posted. For those not following DCFD history, these other events: DCFD under dourt mandated improvement plan as part of multi-million $$ setrtlement in a wrongful death; court mandated competency testing showed 3 of first 300 members tested had EMS competency; an FD Lt stabbed an EMT in the station; a family called for a child DIB- crew said it was an RMA but DID NOT WRITE ANY REPORT, child dies in less than 24 hours later; medic found incompetent in testing was allowed to remain on the job, later she told a chest pain pt it was indeigestion, and he soon died. And now this.

About 5 years ago when my oldest was in 6th grade, we (Somers FD EMS) did a thing, just one day, for just her class. We talked about a lot of stuff: FD and EMS as a career path, as a volunteer in the community, and drug abuse. This was so well received that it became a two day( one fire day, one EMS day), 4 times a year event (health classes change quarterly). While not focusing specifically on drug issues, we fit it in the message that there are two ways to spend a lot of time on an ambulance- as an EMT, or as a drug user. Not a big deal, but if we all worked a tiny bit on this, the end effect could be a positive change.

I am going to brazenly assume I am not the only psycho on this site that loves the sound of these mechanical sirens. I actually have THREE of them at home. Sites worth checking out are www.airraidsirens.com and www.victorysiren.com This second site is about the sirens powered by a V-6 hemi engine that developes so much sound power that it makes dry grass start to burn from the vibration when they run the siren. There are only about 6 left in the world.

Geeze, so HALF your budget goes for hydrant rental? Does that cover the water use, I hope? Suppose you refuse to pay- will they lock you out of the hydrants? But seriously, those sound like budget numbers to be proud of! Do you feel you are meeting your needs with that money- is your stuff serviceable? Any FD can find some item of questionable value to spend money on if it is laying around. Is that very modest sum enough to get the job done? If it is maybe others can learn from your example. One note- I did not see apparatus cost on the list- is that under a bonding by your village and not under the FD budget proper?

OK, I just did a something dumb. That post above was written by me, but EMT74 had been logged onto the computer prior! Sorry

OK. So if we arrive and there is a heavy smoke condition and a bright glow from the kitchen oven fire speading to the surrounding cabinets, and we extend the tower ladder bucket (UNmanned for safety) horizontialy and blast 1000 GPM through the window for an hour or so till water pours over the windowsills, THAT is a good job? Can you set the bar any lower?

From what I understand, and I don't know how to verify/disprove it, apparatus makers are all members of the NFPA. Hmmmm... Barry- can you shed some light?

Memory fades, so maybe there are some NYC*EMS guys that can help. I think Rudy promised 20 new stations?

Refering to 10-75's post: I am not sure how often a fire agency gets sued over a suppression issue. Last I heard, on average, EMS gets sued once for every 10,000 patient contacts, and that has been my own experience as well. I will venture that the incidence of fire suppression suits is less. My thinking is that there is always the fear (I have any way) that a call will get QA'd as being done poorly and then there is a suit and that QA report gets to court. If there is nearly no fear of a suit, then there is no fear that will happen. Alternately, if you have (almost) no chance of being sued, why work hard on self improvment? I know the crowd here on EMT Bravoland is likely anti-suit, but they serve a purpose. We live in a safer world because folks take precautions to avoid being sued. Sidewalk sheds at construction sites come to mind. Most everyone does this work because they truly love it, and are proud of it. It can be hard to tell someone like that, 'Hey listen, you made some big costly mistakes here.' Not saying it should't happen when it needs to. It takes a true leader to get that message across well. Kind of refers to Dinosour's comment above.

Let me preface this by saying that I am way out of my comfort zone here. All I know about firetrucks I learned by reading the owners manuals, the apparatus columns in Firehouse and FireRescue magazines, hearing guys complain and, on occasion, having to drive them when there are no real firemen around to do it. I profess no expertise. Now, it seems odd to have to spend above $500,000 to buy a whole new rig just to get new seals and gaskets and tires. My car lives outside and has 220,000 miles on it, AC works great and has never been touched. Could it cost 1/10 of that ($50,000) to replace every bad seal, gasket and tire on a truck? I wonder what it would cost to make the truck bay into a giant humidor to prevent rot- and guys could store their cigars in there. About 2005 we did get rid of a 1978 truck, re-built in 1985, due to frame rust- I may be off a bit on the dates. You have seen many many more trucks come and go than I have, but I cannot recall hearing of an agency trading in a rig due to a bad diesel. Maybe twice I have heard of a a "blown" engine- and it is usually sent out for engine re-build. Dumb question#2 How often are there safety upgrades, and what makes it an official upgrade? Can they say, "Look! new, brighter more visible red paint! Everybody must upgrade!" Suppose 15 years go by and the safety of a 15 year old rig is still acceptable? Or are "upgrades" released in times to maximize sales?

Let's see, EMS was moved to FDNY in 1996 of 1997 with the promise of new EMS stations. I gues in municipal time, 17 years is pretty fast to just start to get things done?

I am just having an image of a bunch of tired, wet, hungry firemen trudging away from a smoldering foundation and hearing the OIC say, "Wow, that should have been an easy save. I guess we really suck. We need to get way better at this". I just can't see that happening.

Somer engine 188- a 10 wheeled tanker pumper, I believe to be replaced with a similar unit- so add on another 3/4 mill or so. BUT- why is it that these units need to be considered for replacement after 15 years of light service? (Let me guess, Barry, the NFPA again?) If a rig is 15 years old and has 30,000 miles and 1,500 hours on its diesel, and 150 hours on its pump, and lived in a warm dry bay, why is it that the unit needs to be retired? I have heard that over-the-road trucks last 10 years at 100,000 miles/year- same diesel, same drive train? I know little, can someone enlighten me?

I am curious as to how many agencies that folks posting belong to have a social media policy? Two of my jobs have none that I am aware of. My main job has a rule against any type of recording in the workplace (stills, audio, video), but I don't think they have a social media policy. I caught a ration of crap at my VFD for some EMT bravo postings, and I heard it was discussed at meetings I could not attend, but no action was taken. Guy, does the Yonkers FD have a policy that you need to be concerned about, or are you free to say what you want?

I was at George's island park today( on the Hudson) and there were times I could not see across to Rockland due the smoke. Pretty steady whine of alarm alert stations coming across the river from Rockland, too.

I saw a stat that Australia immobilizes 10% of the patients we do, yet they have no higher incidence of traumatic paralysis. Maybe they have 10% of the lawyers we do? I read another one that some very high %, like 70%, of all IV locks established in the field are not used for anything. Then again, how many hose lines are stretched and not used either? A lot of what we do is just in case. Of course an unused hose does no damage. But an unneeded IV lock is a possible casue of infection, and a board can cause all the bad stuff cited in the study.

Like, well over a decade ago, Empress did a study with State and REMAC approval of the "Maine protocol". Everyone had to take a few hours of class, get a small book and take a test. They gave us check sheets to use when we actually employed the protocol in the field, and they were collected. Like I said, over a decade ago, but we reduced c-spine immobilizations by 15-24%, and had no bad outcomes. After the study period ended, Empress asked for and was granted permission to continue using the protocol. Many of those folks who were trained have left over the years, though. Items that would require the board: Intox, neck and back pain, distracting injury, cannot communicate, acute stress reaction, real mechanism. Then: pt had to hold fingers apart while EMT pushed them together- pt had to resist. Pt had to have sensory to toes, and to be able move feet from a laterally rotated to a center-line position while EMT offered resistance. Lastly, EMT had to (really) palp the entire spine, skull to butt and find no tenderness or anatomical irregualrity. So the lady who hits her head on the nightstand, and the guy who gets hit from rear at the light, the trip-and-fall, hit by ball etc would all get ruled out for c-spine IF they passed the other items. I have no idea why this did not become the law of the land. I agree with news buff. So many great ideas that we cannot do on our own discretion, because, alas, we are merely technicians.

I made that based on pursed lip breathing, shallow breathing (ineffective breathing?), accesory muscle use and lastly, cannot speak. Maybe he cannot speak every day? In the limited story, I made the jump that unable to speak meant that he did not have enough breath to speak. I strongly prefer NOT intubating folks. I feel it tends to extend their recovery, and our goal here is recovery. If I can BVM or CPAP to avoid a tube, I will always go with that option. But in this pt's case, there may be no recovery without the tube- he sounds quite bad. That 95% SPO2 could be Co2 retention, and not actual blood oxygen. Reading the scenario again, if this is a 45KG 95 YO female, her speaking days may be behind her and the vitals are not too bad, but the level of DIB is worrisome.

In terms of the non-trasnporting agencies, keeping it simple, if you are injured they send cops, if you are sick they send FD. Though actual calls coming in as "sick" get neither. If you are injured in a car, you get an engine, a ladder a heavy rescue, a battalion chief, a sector PD car and an ESU truck. And an ambulance and a fly-car and sometimes an EMS boss. That comes out to about 100 tons of gear for a 170lb pt.

I am a medic, so I would do BLS first: Oxygen, then position: If lungs are clear, I may lay him down, if he has rales, then I would sit him up and see how he and his SPO2 respond. Then hit the road, all else in route based on your extrication situation-are you roadside or top floor of a 5 flite carry down? A 12 lead to see if there is an MI going. Being an elderly diabietic he is at increased risk for a silent (No pain) MI. He appears possibly dehydrated, maybe cancer related. Again, EVERY call comes down to assesment. If signs like poor skin turger, lung sounds, skin color, texture and temp and past Hx such as missed intake and lots of output via diarrhea or vomiting thatn I would be very suspicious of dehydration. He needs an blood glucose test also. If he becomes cyanotic, or his SPO2 falls he will neet to be intubated. He kind of needs a tube based on what you have already. You may get by with CPAP. Gotta get the lung sounds, but CPAP is becoming the treatment of choice for just about any respiratory distress scenario. Be intersting to see where this thread goes and what other providers would to.

I would say 5 come to my mind: In the very beginning at Larchmont VAC... Dan Purcell, who inspired me with encouragment that I was smart enough to be a medic. Marc Burell, who inpired me by making me think, "Hell, if HE is smart enough to do this, then I MUST be to smart enough to do it." When I made EMS a carreer... Bob "Buck" Visconti and Carl "Gunney" Otto who patiently tuned me up during my early years at Empress. And now now, 30+ years in... 5. Dick Harvey. I look to him and say "HE is still on the road gettin it done, carrying that medicare card in his wallet, so I should stop complaining about sore knees, aching back, heavy gear and multi-floor walk-ups etc and appreciate that I can still to the work." To the extent that I am any good at all at this craft, and that I am still here, I owe to these guys. And I can't leave out the skinny, pimple faced kind of a twirpy, nerdy EMT kid I worked with. One day he says."I am going to start an EMS website." Yes, you Seth G.

Not sure it applies but about 25 years ago a lower Westchester Town Board disliked the Police Chief, so they established a Police Commissioner spot and gave that guy all the old Chiefs responsibilities. The old Chief hung around 8-4 M-F until he retired. Given the highly archaic state of the laws, I have no idea if the same thing could be done to a fire chief.

Well, if you are applying for a paid position, then the guys doing the hiring will look for expeience in a paid position. Everyone doing this as a paid person at one time had no experience, yet they somehow broke in, so it can be done. Things like a solid history, good references, positive reputation and a good interview all help. As i said, the VACs and services like them get a lot of applicants for few spots. The commercial services are more likely to hire a new guy.