sympathomedic

If you want to apply to Empress, go to www.empressems.com and fill out the application, but you MUST then follow it up with a phone call to ext 3109 at the 888 965 5040# during business hours. Yes they are hiring, usually in groups of about 10, about every 3 weeks. There has been much hiring lately, to fill spots created by expansion into WMC. And there are always folks who don't work out when you hire a lot, so some spots need to be re-filled! They do get lots of apps, so the phone call is a must. Medic class will be graduating soon, so the medic students will be precepting, so their old EMT shifts will need to be filled. Good luck.

OK. I was responding to EMT 348 who said some agencies were telling NH's not to call them. FYI a number of years ago the Massachusetts state NH association asked the Governor to change a law that REQUIRED them to call 911. They cited the same thing: crowd of guys with loud radios, large diesel left ilding with all the lights on etc. The biggest opponents were the FD's who WANTED the NH calls. I guess we have steered this thread off its original topic of Care 1, so sorry for that.

That sounds pretty risky. It is one thing to tell/suggest/pressure a facility not to call 911. It another thing to "Not Respopnd" . If you are a true municipal angency (owned or controlled by the government) or are contracted to be so, and you refuse a call for service, to me that runs counter to everything we do. Can you work with places to try to divert less-then-urgen calls to a secondary providor? Sure. Can you say, "Sorry bud, you've had enough, you're cut off!" I think that is wrong. Remember, visitors and staff have medical emergencies too. Imagine a 7 year old choking to death on a lollipop while visiting grandma. If the NH can show proof they were told to stop calling, that dead girl presents a bit of an issue. I dunno. I learned how to care for the sick ans injured. I drive around in a truck full of stuff to do that, or a flycar equipped to support those that do it. They send me work, and I do it as well as I can. Doesn't bother me what the adress is, or what color ambulance I am driving or backing up. I not too good to answer whatever calls come to me. I have noticed that of all the medical technicians- x-ray, lab, EKG, ER etc, ONLY the EMTechnicians feel that certain pateints are beneith them and should be cared for and treated by someone else. Kind of sad, for me and for that 'not good enough' pateint.

When I worked for a private 911 provider in Massachusetts about 1994 or so, there was a pretty strictly followed state policy that if a company got an "emergency" call for any place they were not the 911 provider for, they had two options: get a crew there in 10 minutes, or give that call to the EMS provider that covered that area. Seems like a pretty good, patient friendly policy. It takes the decision away from the caller/calling facility, and it encourages companies to keep coverage levels up to make the 10 minute limit, versus losing the call. Perhaps we here could adopt such a rule. Funny thing, just thinking about it, we have agencies here in Westchester that cannot get to their OWN calls in 10 minutes, calls that are close to the jurisdictional borderline, that another nearby agency could get to in under 10 minutes! That is a thread for another day.

If you go to the state website, all the state policies are listed. Search NYS DOH BEMS and you should find it. Lots of neat stuff buried in that site, like NYS says do not use lights and sirens unless you believe the call you are on to be a true life and limb emergency. When I was a junior member of Larchmont VAC, the agency rule was 1 junior per crew, and no going to Greenwhich Hospital- they said a minor could not cross a state line without the parents presence or permission. Then again, we thought foam rubber collars stabilized c-spines.

I'd have to say yes. On the Empress site first linked in this thread, it says "no drivers". There is no pay scale in the contract for a non- EMT. It would be tough enough for an outside person to come in a dispatch a system they did not start in. If you add to that not being an EMT, and therefore not having any EMT experience, I don't see a high likelihood of success. But if you refer to a FORMER EMT who once dispatched @ Empress, and now works for a city in a northern county, well then....

I don't have my contract IFO me, so I will do this from my memory, which has a high failure rate. IF you do at least 24 hours a week in dispatch, you get an about $2.50/hour above what an EMT with the same credentials/Hx would make. Your other hours would be worked on the street. IF you work LESS then 24 hrs a week inside, you only get the extra money for hours actually spent dispatching. Empress sends you to the EMS class. There is an established system for counting previous years as a paid staff and/or volly, something like 2 or 3 years in another place earns you a one year grade increase at Emnpress. Again, it is in the contract so everyone gets the same deal. So let's say a new EMT starts at $10.50. Then about $12 after probation, then the $2.50, plus maybe a $1/hr or so for previous experience if you can document/prove it= about $15/hour, plus the benefits, and about a 3% raise, give or take based on what contract is in effect. I gotta say, it is a VERY demanding job, and most of our dispatchers are VERY GOOD at it.

In my very modest experience, dual responses have gone up A LOT. Mamaroneck Town and Larchmont used to have ONE site, they now have about 4 that I can think of that trigger the dual. On the Hutch you get a "truel" of both Pelhams and Mt Vernon. The Sprain gets a duel, the airport gets what, a quadral? I-95 a dual sometimes the two Mamaronecks, sometimes Harrison and Rye. Albany Post Rd gets nearly a trual with Verplanck, Montrose and Buchanon with one going and two doing in house standby. I believe Yorktown and Mohegan have a dual for Holy Comforter NH. The "Landmark" in Hawthorne area gets a duely with Elmsford and ??. Valhalla and Hawthorne share a couple of duels. I think Pocantico goes dual for many things. Those are what comes to mind. I can't say how long those have been going on, but I bet fairly recently.

Over use of EMS is something you hear talked about a lot. I think I saw that in last 35 years, fires are down 30% and EMS use is up 247% We do spend a lot of public outreach on fire prevention, and maybe it worked- the fire numbers are down for all kinds of reasons. Maybe if we did some illness/injury prevention we could do the same with EMS. A difference is that a building does not ever have to ever burn down, but every person will eventually get sick/injured and die and probably create at least one EMS run when they do. Getting any agency to spend money to DECREASE demand for what they provide, and therefore shrink their importance/profile/budget/staffing/fiefdom is something so smart and efficient that I doubt you will ever see it in America, sad to say. I figure I got into this to take care of the sick and injured. If that's you, call me and I'll help. Even if you are the quite healthy and minimally sick or hurt. I knew the deal when I started. If all I did was 24/7 constant shootings, jumpers, frothing pulmonary edemas, cardiac arrests etc one right after another I would probably have to quit.

Barry, ya lost me on the second paragraph. "They do not put medics on the ambulances." Do you mean the ambulances do not have medics on the crew, or the medics on the larger fire apparatus do not ride in on the ambulances?

Correction: Medicare pays equal or LESS than other payors.

I did a bit of research into this area of mystery a year back. Here is what I can tell you: about 80% of billables are medicare calls. The rest are car insurance companies, medicaid, workmans comp and private insurance. Medicare pays 80% of what they think a call is worth, regardless of what you think it is worth. They have prices for ALS level 1 calls, ALS level 2 and BLS. Mileage is the same for all and it is like $9 per mile traveled WITH the pt on board only. I do not have the exact $$ figures in front of me, but the ALS level 2's are like $1200. Very rare- pt must have 3 meds given and Nitro, ASA and combivent/albuteral don't count. Anything less is ALS 1 and is about $480. BLS is about $270. BUT remember, that what they think it is worth: They pay 80% of that. Car insurance companies used to pay whatever you charge, but they are now in court with some larger providers, suing to pay only what medicare pays. By law, you can not charge the medicare MORE than what you charge anyone else, so medicare pays equal or higher than other payers. I beleive medicaid pays 20%, but I am not sure if that is 20% of YOUR bill, or 20% of their idea of a bill. Private insurance that I have had pays in the $100 to $300 range. Not sure who gets to pay the rest, if anyone. If anyone has other info, there is a good chance it is better than mine. Bill

I believe that when a member of Mohegan VFA and MAC successfully ran for Fire Commissioner 5 years back, he did some math and determined (my memory is very suspect) that running their engines cost about $17/mile and running their SUV's was less than $5/mile, taking in many costs. Big district, lots of calls = many miles. I also recall a quote from Allen Brunacini who was the Chief of the Phoenix FD and a highly respected national leader and speaker in the fire service. He said "Using a class A pumper to answer EMS calls is like using a cement truck to deliver a pizza."

Change the license plates and it could be Yonkers

Anyone who can answer this is probably too old to use a web site, but does anyone know why our group of wise, diligent public servants in Albany set up NYS law in this peculiar way? A city and a village can run its own fire suppression, but a Town cannot? Does anyone know why and how the Town Of Mamaroneck somehow managed to escape this insanity? Could other Towns do that?

I can see a few ways this event could have happened... she was at a party and may have become intoxicated and fell. Even if it was a non intox related fall, he was performing a head to toe exam- as should be done on a fall with LOC. She wakes up impaired and draws the wrong conclusion. Once she makes that report, it is hard to take it back even if you realize later you were wrong.

I think the "attending" of other folks incidents offers a learning opportunity. Many agencies get very few actual structure fires, MCI's etc, so you can multiply your chances to see right and wrong by going to other folks calls. BUT: At these incidents there are victims. Someone is losing life and or property. It does us all a big disservice for people to stand around wearing jackets and outerwear with FD or EMS insignia at these scenes. Add the joking, smoking, laughing, swearing and snide comments that occur and we all look like absolute crap to the 99% of the crowd who are not us. Being able to watch an incident without the responsibility of having to participate can be a valuable learning experience. But making us all look like uncaring fools can be very wreckless. Go. Learn. Don't look like an MOS. Be respectful of the scene and its victims.

The $20,000 will come from a system wide 2% voltage reduction. OK kidding. You wouldn't know it to look at me but I love riding those bike Sundays. I appreciate Con-Eds gesture.

Oh, I see it is December and Open Season on Fire Commissioners! That season tends to run all year.

$30G a year does not sound huge when compared to other costs to run an ambulance-like salaries for 10 crew members, fuel insurance etc. Could the hospital be bluffing to get the fee reduces/cancelled? If not, I wonder if the city has a plan set in case a provider chose to close instead of paying?

So they applied to their region for permission to dissolve and were denied? So they cannot quit cuz someone said they can't?

Here in Somers, the incumbant is not running again, so new blood is inevitable. The only guy I know is running is a solid common sense guy. Rumor has it there will be some new efficiencies coming. Read into that what you will, over.

Any idea what the fee is? Is it a $$ per unit, more for ALS etc? Does the city figure there is sooo much money in the ambulance biz they want a piece?

I gotta say that the big sexy MVA's get a big response, usually. I was not on the bus v/s bus MVA on I-95 in Portchester, but the water-cooler talk was that resources were not an issue. But if you get two tow calls for little old ladies bleeding to death from GI hemorrhages , it could take paging out 6 towns before you rustle of two crews. The little old ladies would be toast at 3AM

I for one am shocked, SHOCKED that this outside agency of strangers could show up in MY county and study a system I have been in for 30 years.... and be so 100% dead-on accurate!! They should have hired EMT Bravo to do the study for 1/3 the price. I have done my own study. It shows that 100% of these studies are paid for and then ignored, then repeated again in a decade or so. Who recalls that HUGE series of articles in the local paper about 25 years ago about the long waits, understaffing and over use of EMS mutual aid? Very well written and researched. Opened many eyes. The newspaper that published it changed names, but the EMS situation did not. I blame me. We run the systems. If we put down the TV clickers and facebook (and EMT Bravo!) and cooperated and worked on this, I have a high level of confidence we would get it done. But I also have a high level of confidence we won't do that.