sympathomedic

I know that for a while lots of places HAD to have defibs, but not BLS ambulances- places like schools. They operate under a different set of laws. As patient advocates, we should all hang our heads in shame over that. Here I am digressing again. So according to James, they voted to set a date to require it. They advised places to ramp up in prep for the requirment, but never acatually institued it. Probably like I said- some semi-functional agency with friends held the population of the State of NY hostage so they would not have to be burdened with the expense of buying a $2000 defib or the few hours needed to learn how to operate it.

OK WAS, I stand corrected. ASA and albuterol (i think) are add-ons. If I see that ED doc at Phelps again, I will have to take this up with him.

NY State does not require the "add-on" drugs in order for a squad to be BLS certified. Yes oxygen is a drug. It IS part of minimum required gear. I can assure you NYS will not allow an ambulance to be in service without oxygen. Without epi, asa and albuteral yes. Oxygen no. If the state were to demand that every squad carry those life-sustaining drugs, then some squad that is more interested in existing rather than functioning, would c/o to thier political friends and convince them that the state should not make such a demand. The political friends. who are more interested in getting re-elected than functioning, would pander to them. Hence: A we have a state with low pt care standards, and a legislature with like a 95% incumbant re-election rate. The other 5% get locked up annually. Oh, and a state whose trusting, but clueless citizens are getting shorted. But I digress. Sorry.

More grist from the ED doc at Phelps: Per him, the BLS cannot do RX, like epi-pen, albuterol and ASA. But they can do plain BLS work. Which is what we all did before the damn medics with their tubes and needles and wires came along.

Well, since we are all tossing in grist for the rumor mill: My understanding was that NYS DOH contacted the medical director about a narcotics policy issue. It was during that conversation that the director elected to resign. Still having the original question unanswered and now with no medical director, the Powers That Be (I don't know from REMAC SEMAC Regional council or NYS DOH BEMS) has issued a 6 month suspension. I do NOT know if that is a punishment suspension or a 'Hold on while we figure out what is going on here' suspension. Either way there is an appeals process. I have heard they have a new medical director. The Email I saw from HVR said that HVR medics whose primary affiliation in the HVR was Care 1 had 30 days to find a new primary or lose their MAC's. God I love the HVREMAC! I got the same cheery little note back when Westchester divorced them- affiliate in what remaines of our Region or we will deny that you exist. Kind of like the Palestinians and Isreal. But I digress. I fully get that other companies will need to pickup Care 1 work and those companies will need the medics to do it. So the HVR is nudging them over to other companies rather then having them idle while other providers need them. But that move will only make it harder for C1 to restart as an ALS provider if they get through this. Speaking as a long-time medic, I feel for the Care 1 medics. They did nothing wrong, and now their jobs are gone, and they are left to find work at the bottom of the pay scale and seniority list elsewhere.

I came across this article today. It seems to have some similarities to the Yonkers situation, but is not identical. For those on the thread that suggested a YFD EMS system- here is the story of Philadelphia FD, who does run the EMS system, and how things do not seem to be workking too well. http://www.emsworld.com/news/10849885/philly-short-on-medics-overloaded-with-firefighters

I hear ya Chris. While I cannot recall a specific incident, I swear I have heard PD chiefs say that cutting back officers will lead to crime increases, longer response times, etc. It is kind of a sad commentary on our society that when a labor Union speaks against cuts, folks don't believe them and think they are only looking to save themselves. When managment says the cuts won't effect service, folks don't believe them either. Reputations suffer on both sides because they both under estimate the public's ability to see the real deal.

If I may direct a question to Chief Flynn: I am curious as why YFD managment has, in my perception anyhow, been so silent on this issue? It seems the Union is carrying the torch, but the folks who run the YFD have not been visible in the media on this issue. I have not seen a statement or release from the YFD on this issue. I do NOT go to Council or budget hearings etc. I have been around long enough to know that the media can only fit so much in a small windown of information, so what I see is for sure NOT the whole picture. But it would seem to me that if Pt care is being threatened, the City Of Yonkers' Fire Department would be there defending it. It is great that the labor organization representing ther YFD members is visible. But again, my own opinion, the public has a so-so view of organized labor unions. I myself OPPOSED Empress becoming Union for that reason. I was an EMS purist and felt opposed to what I felt was the "taint" of a Union. Of course here I am now the Chief Shop steward. Go Figure! Would not the First Responder program be better defended by the actual Yonkers Fire Department, rather than the Union, who the public MAY perceive as being more interested in self preservation rather than service preservation? I know there is a new Chief there, and he is known for the success of his soft approach, so maybe the silence is deliberate?

Dan- they modified the ashtray into a NON REMOVABLE spit cup with a through-the-dash DRAIN. When you flick the high-beams three times it flushes with wind-shield wiper resevolir fluid.

GSS131: Can you cut and paste that manning clause here? I had asked in an earlier post about it, and I would be interested in how exactly it is that cutting the # of folks on duty spells the end of CFR, why and who got that language into the contract and how the other side let it in.

I dunno- cuts both ways. If a fire DIST could bill, I think many would turf off their EMS to a subbed out private and be done with it. Though I have been told a fire DIST cannot sub-out, they must do their primary function themselves. Any insight? That is why my FD, while hiring a private, has them do the calls in the DIStricts ambulance under the DISTrict license. We have drifted offf topic. The point I was making is that if Yonkers FD wanted to do the full monty EMS wise, using Firemen, doing 911 only, it would be a big financial loser. Basicly about $1.75 million/year per ambulance. Yonkers billing demographic numbers are not strong. Also, if they needed mutual aide, if they did not want to call in the volunteer services that surround them, their options are quite limited. Would FDNY EMS send mutual aid into Yonkers if they were asked, anyone know?

Hey Barry; Thank you for your usual wealth of knowledge. I always wondered how FDNY got around that. So a village FD in NYS can bill? Since they are not a fire DISTRICT? My understanding from doing investigatons of EMS billing in my town was that the insurance industry is the big opposer to FD billing. My guess is that in the case of ambulance services VS insurance industry, it is the insurance industry that has the money and lobbyests to push their agenda. Every call done by a NYS Fire district = a free ride for the call for the insurance providoer for that patient.

UNBELEIVABLE RADIO TRAFFIC FROM THIS INCIDENT

One other small detail: Occasionally Yonkers forgets to alert Empess of a call. No too often, like daily, but probably more than weekly. I did to an auto pedestrain fatal when this happened. Empess dispatch advises us when we do get the call so we are aware that it has been delayed. I cannot over-emphasize how much I appreciate dispatchers and how little of their world I understand. My assumption is that with a never ending flood of drama coming in and being doled out, sometimes a call is dropped. In Yonkers it played a big part in a fatality from asthma at an East side school a number of years back. Now with cell-phones the TMC gets these calls adding another human link in the chain between caller and crew. I think we are up to about 50% of all 911 calls coming via cell now? Maybe they sometimes forget to send a CFR engine as well? I have zero insight into that. My understanding of the currant friction is this: Mayor wants to drop minimum to 48 FF's. Currant is is more like 60 FF's +/-. IN the Local 628 contract is language saying that if minimum goes below a certain number, (I am going to use 55 becasue I don't know the actual number), then the FD CFR program stops. IS THIS RIGHT? can anyone on here say? My next question is: IF that is right, which side put it in, and with what intention? Did 628 put it in to protect itself? Did the City put it in to save manpower for fires during a time of possible reductions? And whichever side put it in, what did you negotiate to get it in?

Just a couple of things to toss into the ring: When the YFD began the CFR program, I did see a memo posted on YFD letterhead that said they would stop sending folks on EMS runs when 6 or more companies were being used elsewhere. That was 20 years ago and may have changed. Since I think YFD sends 4 engines, two ladders and a rescue, (4+2+1=....7!) that would mean that any time there was a fire call going on that no one had freed up from, EMS ops would stop. I beleive that for some fire calls in SFR's they send less. As a guy on the street, whether FD comes or not is a total mystery. I can do two identical calls back to back, one gets FD the other not. Sometimes the local engines are on runs or the call is near a posted ambulance, and the ambulance is way ahead of the engine. Some calls are walk-ins to firehouses and the amulance is coming from a distance. With (I think) 10 fixed engine stations, engines tend to be closer, just since there are a lot of them. PLEASE don't frame this as a union fight. I am a steward in the IAEP Local 20. We have no dog in this fight. My guys jobs are not in danger, as EMS cal volume is always climbing and will continue to do so for the forseeable future. Additional trends- like taking pt's to thier hospital of origin, even if it is far away, working arrests on scene for longer and such means lots of work for us. Regarding the poster c/o bad numbers from Empress: can you tell us what numbers and what they were, and what you think the real numbers are? Are we talking abut call numbers, units available, times? Maybe I can help. About the poster c/o single responder: That is life in EMS. It is done in Eastchester, Cortlandt, Greenburgh, Yonkers, Pelham and Yorktown and many others. The FD in some of those areas sends a BLS truck with one FF on it. Many PD sectors in East Yonkers run 1 man cars, BTW. For the guy that asked about a YFD EMS: Always possible. It would take a while to get the papers done- like a year I figure. But if you staffed it with Firemen, they cost about $150,00/year each after pay, pensions, medical etc are figured in. It takes 5 guys to have 1 guy on 24X7. So one ambulance = 10 guys. so $1.5 million/year for staffing a single ambulance. I think Yonkers would need 4-5. Then you have to send the guys to medic class, which has about 30% drop-out rate. It takes a year, and they would not be doing many fire OR ambulance calls during that time. And they guys would want more $$ for being medics. YFD I believe pays their guys who become EMT's a $3000/year stipend (corrections welcome). So figure a FF who becomes a medic would get about $10,000 more? THEN you have lawsuits. Empress indemnifies Yonkers (covers) for those. You would have to budget for lawyers and the occasional loss of a suit or a high priced settlement. Oh- and 5 $40,000 cardiac monitors and 1/2 dozen ambulances and a mechanic. THEN since you are only doing 911 calls, there would be many hours that every one of those guys and trucks would be doing nothing but soaking up payroll. AND since the NYS legislature has not moved on allowing FD's to bill since George Pataki introduced it 20 years ago, there is no way to off-set this new $10 million annual cost that by the way, will not put out a single fire- just answer EMS calls.

OK, being a 25 year Yonkers paramedic ( that includes 3 years before the YFD even wanted to start coming with us on our calls), I was all set to spout off on this issue with tons of semi-intelligant comments, anecdotes, personal experiences and such that probably would have pissed of lots of folks I have respect for. But I waited. And while I waited I found this: EVERYONE on this thread MUST listen to this. It is 20 minutes so some you short attention span types may not have the patients. But every word is riveting. It called the "The cost of a firefighter: How much is a hero worth?" It is a very interesting report. I hope the link works. http://www.npr.org/blogs/money/2012/12/18/167265874/episode-424-how-much-is-a-firefighter-worth

Well, if the EMS guys want their chief tossed out, and the Fire Commissioner did the very same thing, then that explains the commissioner's defense of the EMS chief, doesn't it? How can you fire a guy for doing what you did?

Can ayone say if FDNY fire units were evacuatated from low lying statons to higher ground? Was there a double standard? If so is there an explanation for it?

Within the last year, there was a shooting, fatal, in Porto Rico when two ambulance companies fought over a pt. My position is: If there is no gun in my ambulance I cannot be shot. Other than PD, probably over 99% of the time there is no gun. If EMS carries guns, then there will be a gun in my unit 100% of the time + my partners gun. This exponentially increases my chance of being shot. Like BLS before ALS; if you think you need a gun, you should try pepper spray and a taser. If that isn't enough for you, maybe you do need a gun. In the YO we get a crew assaulted every once in a while, but I am pretty sure we have never been assaulted with a deadly weapon.- Not that I can think of. Dans spit cup not withstanding. I have fled a few scenes in fear of assault, and all ended just fine. If I was armed may have felt I should stand my ground. In that case I may have killed someone- not what I signed up for. I likely would have to declare bankruptcy to pay to defend myself in court. My house, retirement savings and the kids college money would go away. For those who may not recall, a former medic in Westchester accidentally shot her ex husband police officer to death a few years back. Found not guilty but spent much for it.

If there is anything I know less about than firefighting, it is law enforcment. That being said, sure would be cool if this little gem could be paired up with facial recognition softwhere. Could ya imagine- you make contact with someone who is wanted and a tiny alert goes off that nly the LEO can detect.

I was a big Blauer fan. Then I had to get 2 pair of Spiewak pants when Blauer was sold out in my size (tent!). I beat the living crap outta those pants for several years and they are just now showing some seam and pocket wear.

I never understood all the take home cars either. Perhaps just tell these guys, use your own car, and if we call you in for something off duty, we will give you a $100 transportation stipend. Even givien the 2013 GlobeWarmers most of them (and us) drive, $100 covers a few miles. But lets be truthful: It ain's cars busting the budget, it is slaries and benefits. FDNY now spends more to pay guys that have retired than are working. Little Pelham Village FD has a budget of over $2MILLION/year for retiree pay and benefits. With a 3-man/shift crew. If you thought the STORM Sandy was a hit, wait until three years from now when guys who (100% rightfully) earned a lot of overtime pay start to retire with XXL pensions. They can't just plant a few extra money trees; the money comes from somewhere. I certanly don't blame the FEDS (Obama) for this. They tax so little and give away so much they have a what, 17 TRILLION dollar debt from buying us stuff and charging it. ( I saw an article in the paper the other day about an FD program where the Chief said, "It was paid for by a federal grant, so no tax money was used). Two unfunded wars and a banking system on the edge of collapse didn't help either. Barry has said ( in his usual spot-on way) this has been building for years. Most of us saw it, all of us ignored it. If the politicians could lie their way out, they would. With the tax cap, options are limited, limited to one: cutting. I am sure the folks who wrote that cap legislation are bewildered at how many municipalities are voting to brak it, though. Seems we all hate taxes, but not enough to end our love affair with spending.

I am pretty sure on the show "Rescue Me" they had a computerized voice give out their jobs- wheather the actual FDNY does that, probaly anyone but me would know. If you tune into the National Weather Service stations on VHF high band, they have been having a computer "read" the weather for years. X129: I know you have a face for radio, but maybe you could try to sound a a little sexier on the air- could lead to job security.

Going back 15 years or so, we had an Empress crew beat up fairly well at Sawmill River Rd and Palmer Rd- uniforms torn, skinned limbs, mild concussion, perp caught on scene. Awhile before this event, (1985?) a law had been passed upgrading assualt on on EMS and others a higher crime. Carl Vergari, the Westchester DA at the time, refused to use the new law in this case. I contacted his office about it wand was told that a grand jury would be very unlikely to indict if the perp faced the higher charge. That seemed like a load of s*** and still does. My understanding of the legal system is at about the "Law and Order" level. But I beleive you tell the Grand Jury the law and the case facts and they either indict or not. I don't thing the GJ takes the penalty into account, or are even TOLD what the penaly for the offense. I guess my point is that I think there already is a law on the books for EMS assault, and at least in the case bove, the DA declined to use it. Bill

Forgive my cluelessness, but was this place a former firehouse? where does the name come from?