sympathomedic

An anonymous friend of mine who is a police officer tells me of an officer on his job that asked for an "expedite on EMS and the medical examiner!". I read an article in one of the journals about this subject and it boiled to to the "Expediter" being out of their element, or comfort zone. While I loath unneeded code 3 driving, I do appreciate knowing that I am heading to a scene that is more emergent than the typical not-so-emergent calls that make up 95% (that is a real stat, BTW) of the tour. I may not drive any faster, but I may move a little quicker in getting the gear un-secured and getting to the pt. I may don gloves in route, other little things to prepare for a bad call.

I totally hear you. Many of us detest the system player patients we come across and we always proudly tout "Patient care FIRST" as a motto. If I hear "seconds count in an emergency" again, I may vomit. But here we are with some squads being system players, and other squads putting pt care SECOND. I like to think (fantasize) that EMS is better than to let that kind of thing happen. Do the job and ask questions later. I have planted my flag in this system, and I prefer to hold my head high and not hang it in shame. It is complex. Some agencies are organized in a way that their towns have ZERO to say in how they operate. In others the local gov't does have control but is afraid to excersize it or they have no money to fix the problem. It kinda sucks. You call 911 and you have no choice to accept who the system designates as your responding agency, yet you have no control of the management of that agency. At least in the case of the PD and most but not all of the FD's there is some level of elected official somewhere. I cannot accept that we, the EMT's medics and others that have the responsibility for this system are either unable (not smart enough) or unwilling (not brave enough) to solve these issues. Makes want to tear off my patches, but there are so many dedicated, proud, hard-working folks of all skill levels and agencies that make the system function as well as it still does. But getting back to my first post; STOP giving free-bees and taking photo-ops with squads that are not getting it done. Reward the ones that are.

A related topic for this discussion is this: Many squads (Somers and Mohegan come to mind) that have hired paid folks refuse to send them out mutual aid. The arguments I have heard are, "they are too valuable to our community to send out" and "we paid for them, we won't share them with agencies that didn't". So here is squad A that was having day-long coverage gaps, and now suddenly they hire a crew and they won't let them help someone in squad B land for an hour, a decision that could be truly life- threatening. Also, squad A in theory may have a volunteer crew for their own town- they are a Volunteer service after all. And you can bet the FD in Town A will happily send the Towns only ladder truck, at about $800,000, to another town- with NO backfill!! $800,000 buys a LOT of $15/hour EMT's. Oh, and I bet the Town A PD sends cars to Town B when they ask. Suddenly the service that no one seems to care about is too valuable to share! A suggestion: MANY squads get little gifts of my tax money to buy stuff- Larchmont got an bay exhaust system, other squads get CPR machines, building expansions, ambulances etc. How about this: before our government officials borrow money from China to buy the support of local service members, they do some freaking research to see if those agencies are performing, or failing to perform their moral responsibilities, versus protecting turf. And have the balls to say, "NO". Just sayin', but for the record: "As If!"

It is not a perfect workplace, but it is varied and that is what a lot of guys like. We run about the busiest units and the slowest units in the county. Urban EMS in Yonkers and 20 hour daily standbys at the casino. The guys working the VAC's do nothing but 911, and the guys on the SCT rigs do nothing but transfers. There are full time dispatchers that get (you would think I would know this) $3.00/hr? more than EMT's, and support service staff that get a little bit more than EMT's. On the line there are two EMT level supervisors and 5 medic level. Then a few more higher-ups. There is a benefit that has Empress pay for upgrade for training from EMT to medic, BUT you MUST pass (FYI medic class drop out rates run about 50%), then you MUST get appointed/upgraded through the internal upgrade system (not everyone passes this step), then you MUST stay for one year.

I wouldn't describe Yonkers as "inner city". It is a modest city of 190,000 spread over 17 square miles (I think) with malls, parks, 2 golf courses a casino/horse racing track and yes several housing projects.Oh, and 100's of dead-end streets! Realize that much of Empress' work is NOT directly Yonkers 911. We have EMT's in Hawthorne, Peekskiill, Mohegan, Yonkers Raceway and at the Westchester Med Center's specialty care transfer units. Medics also work in Pelham, raceway and Yorktown. All this plus a multitude of accounts for private EMS both schedueled and emergent. Many of our people do not work Yonkers at all. That being said, no offense taken. We have a low starting salary, but folks keep applying. As a Union steward here I always try to chat with new folks and folks that are leaving and ask why. The new folks tend to be happy to have a paying job, they like the highly flexible schedule (I do 40 hrs in two days and have 5 day weekends), decent medical ( I spent 8 days in the hospital and it cost me $50) and time off benefits. If they love EMS work, there is a lot of it here to love. The folks that leave tend to leave for PD and FD or better paying EMS jobs- jobs that would not hire them without the experience they gained here. It is a bit of a trade off, like so many things- get paid a little to gain a lot, then use that to get paid better later. We have about 200 field staff, I think. Many of them have over 15 years in. In fact in our last contract, we now have a semi-retired status- 25 years on, work 16 hrs/week and keep full benefits.

I am trying to think of something witty to say.... I got nothing. Congradulations, Lt. Mike "NYSPOTY" Bleckeropoulos!

I highly reccomend that you read Thom Dicks book, 'Peoplecare, 2nd edition'. I have seen it on www.emergencystuff.com, and not on Amazon. It changed the way I approached every patient. You should read it. $17.00 or so. Your next patient will appreciate it.

Recall about 20 years ago, a 'scumbag drug dealer' tried to run over and kill a Mt Vernon cop, and was shot and handcuffed and left in the road. EMS arrived and either directed themselves or were directed by PD to the officer with the knee injury. The dirt bag dealer eventually arrived at the ED, cuffed. Per tesitmony, there were (I have forgotten the #. 12?) cops in the ED and none responded to the MD's request to remove the handcuffs to allow treatment. Thank god the cop-attempted murdering dirtbag bled to death. WRONG Turns out he was a West Med Center neonatal surgeon trying to visit his girlfriend and he made a wrong turn off the BRP. His stopping and U-turning on a deserted commercial street attracted the attention of two narcs, in a cadilace and with much facial hair (Point being, the thinking is he did not think they were cops). They tried to stop him and he fled, striking the knee-injured officer. The Doctor was promptly shot to death. The upshot is that the inevitalbe suit was filed and won by the plaintiff. MV I believe actually had to borrow $$ to pay as it exceeded their city insurance max payout. I appologize to the one member of the EMS crew I know is still doin' the job for dredging this incident up. But I thought it was appropriate for this discussion that no matter how clear the picture is at the time, things are not what they may appear to be. I especially want to express respect for the job of the LEO, and mean no ill intent in bringing up what is surely a painful memory for them. We are not robots with no feelings and emotions. The job is not always easy. Treat every patient as a human being or don't treat human beings. After over 25 years of 2000 calls a year and I am not in the unfortunate mindset of the poster above. Please, when my sister, the fully employed 20+ year tax paying paralegal and occasional heroin user OD's, please send another care-giver.

Barry, I truly love you man. I am 100% sure all those codes are very imporant to someone. I respectfully ask that wereroute this thread back to the talk about better ambulance design in the wake of the end of the KKK standards.

Barry: I don't want to steer this away from its original intent- which was to discuss the changes brought about by the expiration of the kkk specs. I find the NFPA to be a massive failure, an example of what occurs when an industry is allowed to self regulate. America has a terrible fire loss rate compared to the other developed counties in the world.(Sweden is best) We have a horrible firefighter death rate in the same comparison. Developments like the FIT device and fire retardant paint have come alongshowing great promise, and the NFPA seems to kind of ho-hum them. We build 1000's of residential homes a day with no sprinklers and no inspections despite that most fireman who die, die in home fires. So I see little proof of the NFPA being effective at its mission of reducing fire loss and loss of firemen's lives. I see it as one disfunctional agency taking the lead from another. I also doubt that 80% stat. FD's may be on 80% of 911 EMS calls, but I don't think that 80% of peopel transported in ambulances are transported by "firefighters". NYC is a prime and local example. Of course, that has no bearing on the thread, but just saying.

Oh Em Gee, Dan! I was thinking the same thing! But really, it was time for something better. Too many of us die in ambulance crashes, and many are unbelted in the back. I do wish the NFPA would stay the hell out of my ambulance. I do not trust that group. They seem to rep the manufacturers, not me. I do not need firemen from Massachussetts with too little fire work to do getting involved in EMS. Prefer to see the AMA not the NFPA.

I thought Suffolk County NY and I am sure State of Massachusetts PD's are using IN Narcan with much success? Maybe it is Suffolk Mass I am hearing of. Guess tht famous scene from "Bringing out the dead" will soon be obsolete!! http://www.youtube.com/watch?v=CXJ8c0rWJsk here it is for you kids- worked with a 23 year old medic last week who never heard of the movie! Christ!!

All of the above observations are very accurate. If you are the only one there, then protect yourself. Since many of these SUV's are 4WD and have front hooks, I get the hell away from the pavement. If I sink, I sink. I can be towed back to the pavement easily enough. Save the road space for the ambulancees. Some flycars are designed to have good rear lighting with hatch door up or down. On others the hatch blocks the rear lights when up. War story alert: On a job on the Taconic I alerted my partner to a possible danger from a secndary MVA. He replied that our flycar would protect us from any vehicle on a parkway-no trucks. A minute later a full-sized Bekins moving van 18 wheeler drove buy. Our jaws dropped.

The VAC's can be a tough nut to crack. They pay well and demand little by comparison to the commercials. It is a small community and everyone knows everyone- who is a capable, mature, professional providor vs who are the incompetent slackers looking for a job to vegatate in. If folks don't know you they will be reluctant to to hire you for fear you are in the second group. You need a good proven track record for potential new employers to look at.

Brandie new, no exp full time at Empress is about $18.00/hr. Per-diems get more $$$, no benefits. Cortlandt Regional EXP NEEDED $25/hr. Town Of Mamaroneck Amb District EXP NEEDED, about $30/hr (I gotta look at my stubs some day). EVAC I am pretty sure just went to $28.

I can only speak for Empress with any accuracy. We just hired about 15 guys, but will likely hire more n abut a month. You should apply on line at empressems.com, but then you MUST follow that up with a phone call, as we get like, 100 apps a month. We hire with no expeience, but I think it is preferred. The site hasa bunch of company info. Pretty varied work asignments- from first aid at Yonkers raceway to running the special trasport units at the Med Center, also hire dispatchers from within as well as other support staff spots off the road. I would have you PM me, but being farily old I don't know what it is or how to use it.

Empress has begun giving these protocols out via CD. We were told they would be in effect 1/1/14, and that prior to that there would be some kind of test, ranging from take-home to for-real, but they were not sure yet. I guess when one region bows out, THEY can't make the decision, and the new, larger region has not taken over yet, so THEY can't say either. So far I barely looked, but the ones they gave out seem pretty cool, and well assembled. We were told we (Empress) would get to keep RSI, which is pretty important. Either way, the IV bags will drip, the drugs will flow and sick folks will be stabilized and transferred. That's what we do.

FF1 nailed it pretty good. I have nothing to do with hiring, but the folks that do have no shortage of stories about the folks coming in in shorts, poor grammer in writing and speech, arrogant attitudes etc. You are interviewing for a job that will have you managing people in medical crisis, so you need to show you can manage yourself in an interview. My add is to maybe study the EMT or medic book. If you are interviewing for an EMS job, than EMS questions are fair game and you should be prepared to answer them.

Belt: medic shears on belt phone on belt radio clip on belt- actual radio carried by partner (too heavy) key clip on belt. O2 wrench on clip. Handcuff key to release partner when call comes in and they need to drive. pants Pockets Wallet- empty, wife got it. Penlight, dime-a-dozen chinese sweat-shop home depot model. gloves pad for writing glucometer (issued on my job, if i put it in med bag, it would get left behind in the medbag) pulse ox- same as above. Shirt pocket: Pen, job cel phone Car keys usually forgotten in car. NO knife ever. No leatherman ever, and never neaded either of them. Bill

Empress will not hire per-diems. If you work full time and are decent, they will let you drop down to per-diem after a good 6 months of good work Hx. Cannot speak for other providors. I suggest WEMS.

Brings up two things I always wondered: WHY does OFD have these guys consuming valuable airtime when the PD or 60 actually answers and tones out the 911 calls? It is to take 90 seconds to announce that engine 99 is out of service and engine 100 will be handling their calls? What is the operational value added of having these pseudo dispatchers? AND why does N White re-dispatch AND do it by toning toning twice twice?? Are they so far away from 60 that they have poor radio coverage? Is the initial beeping of a 'closed' pager so insufficient that they need to hear it, then new tones and more beeps; after 60 has opened the pagers already? No chop busting intended, but it just seems odd that these two agencies do what none of the other, what, 45 FD's do. Maybe maybe we we should should all all tone tone twice twice?

Sooner or later one of these people is going to die. Or, one of their parents or children will die. I am next to useless on a computer, but I am told that there are sites that let you put in a name, and when the obituary is posted, it e-mails you. I for one would eagerly take a day off from work and pay travel and hotel expenses to protest at THEIR funeral!! I ask that anyone who can discover the names of these folks and tell us when they die please do so, with the funeral arrangements. Might take a year or so, but no one lives forever, and we should all be waiting!

I think that just like our own cars, everyone has good and bad experiences with similar models. For every Ford lover, there is a Chevy lover. I am kinda shooting from the hip and guessing here, but I bet the fact that lots of smaller places spec custom everything, the trucks are hell on wheels to wire up. Whearas a place that orders 2 or 3-10 identical units at a clip becomes less of a disaster. Kind of blaming the victim. If you pay the price, they should deliver. I have never heard of Osage. Peekskill VAC and Cortland VAC just bought trucks made by a Canadian place. Thier thing is the trucks have a green (environmental green) aspect. When you park they shut down, then self re-start as needed. They seem OK. Thing is, coming from Canada, the decal on the hood says, "AMBULANCE, A". Last thing. As you look at rigs, look where your head will strike if you crash. Try to have padding on these "hostile surfaces". The only folks who die in their work units more than EMS guys are the NASCAR guys. Majority of EMS LODD's are in the truck, in the back, unrestrained, and head injured.

Please DO NOT buy a 4 wheel drive unit. Your area is pretty flat, (hell, one area in Mamaroneck is called 'the flats!'), and your PD and FD have about, what, 6 4 WD SUV's you can use in the rare heavy snow incident that your DPW has not cleared. It will be $7000, plus way more wear on front end, brakes, tranny every time you start and stop. I know you do not pay for maintnence, but it will be your down time. If you can document 4 incidents of stuck ambulances in MEM's 40+ year Hx, I would be surprised. (Yea, I know it was MFD Rescue for some of those years.) Are you allowed to count trade in $$$ from your old truck, or is the Amb Dist/Town laying claim to that money. You may get $10 to $20,000 trade value on your old unit. You do NOT need a HUGE model. Don't get box envy with the neighbors. Better a real good small truck than a stripped big one. Small trucks= easier to train drivers, less intimidating to the soccer moms that squads should be courting= more drivers, fewer dings, smaller blind spots, shorter stopping distance. Gas versus diesel, eh. Both have good and bad. Chevy VS Ford, same deal. All being =, go with the cheapest. As for modifier, I don't think PL custombody can be beat in customer service. My vol squad (Somers) and the squad I work at a lot (Yorktown) has had good customer service, etc. BTW If Somers and Yorktown, in the NW Hills don't get 4WD, you don't need it either. Bill (one of your medics, case you wern't sure)

If this job was E main and Rt 6 in Mohegan, at about 0900 Wednesday, it was mine. I would tell you to PM me but I don't know how to deal with that. You could e-mail me. billandjane14@yahoo. I have a couple of pix.