FDNY EMS Chief Relieved of Command?

[Goose 188]

Heard a rumor that the chief of FDNY EMS was relieved of his command this afternoon...anyone know if there is any truth to this?

Quick update: Wall Street Journal reporting that he was fired...looks like EMS may become the city's whipping boy for stormageddon 2010

Edited January 6, 2011 by Goose

[x635 4,066]

So, this is going to be the city's action plan? Spend time and energy finding people to blame it on, and firing them, so it look's like they are "doing something".

I hate how the City is demonizing those who were actually "in the trenches". I don't know what the circumstances were or if this Chief deserved to be fired, but I'd rather be reading the headline "NYC Buys Snow Chains For Entire Ambulance Fleet" or "NYC To Order 4x4 Ambulances".

[prucha25 76]

http://www.nydailynews.com/ny_local/2011/01/05/2011-01-05_botched_blizzard_response_costs_emergency_medical_services_chief_john_peruggia_h.html

Just the first scapegoat of the storm. Rumors throughout are that more heads will roll before Bloomberg feels like enough of the blame has been put on everyone else.

Position of EMS Chief also raised from 3 starts to 4 stars ( some speculate Commissioner Cassano wants to have medics on fire trucks so this may be of relevance to that in the future)

[Goose 188]

Care to expand on the 3 to 4 star thing? Not really sure what that means...

[NWFDMedic 58]

So, this is going to be the city's action plan? Spend time and energy finding people to blame it on, and firing them, so it look's like they are "doing something".

I hate how the City is demonizing those who were actually "in the trenches". I don't know what the circumstances were or if this Chief deserved to be fired, but I'd rather be reading the headline "NYC Buys Snow Chains For Entire Ambulance Fleet" or "NYC To Order 4x4 Ambulances".

Snow chains or 4x4 ambulances would be a tremendous waste of money for a once a decade (or less) storm. Then again, I wouldn't put anything past government wasting money. There are plenty of places to look for blame for the response to this storm, the vehicles were not one.

[bad box 371]

From NY Daily News article speaking in regards to EMS Chief John Peruggia, "The storm wasn't the only reason for his demotion. FDNY sources say he's about to face charges from the city Conflict of Interest Board for an inappropriate trip with a vendor that does business with the city"

Edited January 6, 2011 by bad box

[M' Ave 1,466]

From NY Daily News article speaking in regards to EMS Chief John Peruggia, "The storm wasn't the only reason for his demotion. FDNY sources say he's about to face charges from the city Conflict of Interest Board for an inappropriate trip with a vendor that does business with the city"

Ya beat me to it! Thanks for bringing that up though. There is talk, as well, about bringing operations, conduct and standards more in line with FDNY. This would be a good thing, as our operational differences represent what we really are, which is two completely different departments.

To a post above, there is no talk of Medics on engines. This would not be of any benefit. We are a BLS agency and the cost of a medic and their experience would be wasted working in an engine.

Edited January 6, 2011 by M' Ave

[maceion 0]

The 3 to 4 stars on his collar, it means absolutely nothing. The Chief of Dept wears five. Its just a change in uniform policy

[ny10570 745]

No, now he's the same rank as the chief of fire operations. Its an appointment, so while it is still only symbolic it an important symbol of respect for the position.

[prucha25 76]

Ya beat me to it! Thanks for bringing that up though. There is talk, as well, about bringing operations, conduct and standards more in line with FDNY. This would be a good thing, as our operational differences represent what we really are, which is two completely different departments.

To a post above, there is no talk of Medics on engines. This would not be of any benefit. We are a BLS agency and the cost of a medic and their experience would be wasted working in an engine.

As I said some speculate, there is no offiical talking but you have paranoid people who will back that with their " facts".

As mentioned the move from a 3 star chief to a 4 star chief puts the Chief of EMS directly under the Chief of Department. What implications if any this will have in the department I don't know, but it shows respect for the position.

[PEMO3 523]

I find it extremely interesting that the Bloomberg spin masters found a way to create a story to pull the media attention away from the fact that all of the figure heads were not at the helm during the blizzard. Seems once the media started to ask the hard questions yesterday they found someone's head to chop off publicly and make a point of having the media use the snowed in vehicles and deaths in the story spots. Just like Bush in 1995, Bloomberg's "Katrina" is going to be a epic scape goat event also. Demote the EMS Chief and pat the Sanit boss on the back, I want some of what Bloomies drinking.

[M' Ave 1,466]

No, now he's the same rank as the chief of fire operations. Its an appointment, so while it is still only symbolic it an important symbol of respect for the position.

Except, as I understand it, they don't fall into the same chain of command. Do they? There is an EMS Lt. or Capt. at many runs we respond to, but as far as I know, they do not hold rank over firefighters. They hold authority at the incident as personnel with the higher degree of training....although some of the ems officers are EMT's and they oversee Medics. How does that work? What I'm really looking for is some insight into the EMS command system.

[x635 4,066]

Snow chains or 4x4 ambulances would be a tremendous waste of money for a once a decade (or less) storm. Then again, I wouldn't put anything past government wasting money. There are plenty of places to look for blame for the response to this storm, the vehicles were not one.

Why? They are prepared for other "once in a lifetime" disasters, why not a weather related event? The vehicles could not have benefitted from snow chains or having some 4x4 ambulances?

The FD has specialized units to respond to just about everything when it comes to fire and rescue. So, I don't think enhancements to the EMS fleet for a winter storm would be a waste of money.

[NWFDMedic 58]

Why? They are prepared for other "once in a lifetime" disasters, why not a weather related event? The vehicles could not have benefitted from snow chains or having some 4x4 ambulances?

The FD has specialized units to respond to just about everything when it comes to fire and rescue. So, I don't think enhancements to the EMS fleet for a winter storm would be a waste of money.

Seth,

The FDNY has never had such an incident where they couldn't get around in the snow. The question has to be "why this storm?" The City received less snow than the Hudson Valley and my town roads were clear by 0600 Monday morning. Other towns were not so lucky, but by noon, just about everything was passable. This snow was light and could be moved easily by plows. Furthermore, because it was so light, it didn't pile up anywhere near as badly as the storm in February.

There are a few things that it seems the City is attempting to send to the back burner about this storm. First, it was reported early that private contractors are relied upon in heavy storms to assist the Sanitation Department with snow removal. Reports were that these contractors did not sign on with the City this year. I would question why... were there problems getting paid? was the City not paying enough? Of course, these questions reflect right back to City Hall, so it will be easier to demote an EMS chief and cast the spotlight that way. Second, what was up with the Department of Sanitation? There were reports of untrained drivers, work slowdowns, etc. Who the heck is running this joint and why was this allowed to happen?

Chains and 4 wheel drive ambulance come at a great and continuing expense. A 4 wheel drive ambulance not only costs more at the dealer, the maintenance costs are higher, fuel consumption is higher, and vehicle life is generally shorter. Chains are also an expensive option for an ambulance. I'm also not sure the tire chains that most use today (on spot type) would have been particularly helpful in moving around in this storm. I think you have to consider every dollar spent as a risk-benefit analysis. This "once a decade" storm caused so many problems for EMS getting around, but they didn't have the same problems in a worse storm in February, and there were several "other" factors that may have led to their problems. Does is make sense to spend money on tire chains or maybe CPAP, which could save lives every day, especially when it isn't yet known if these "other" factors were actually more responsible?

One thing we have done as a company is to get a bit more expensive tire for our ambulances. The stock tires that come from most manufacturers are not made for winter terrain. We buy a tire with an extremely aggressive tread pattern and there is a noticeable difference in the operation of the ambulance. Maybe an extra $20 a tire on their ambulance might fix the problem instead of a couple thousand dollars an ambulance in tire chains.

[ny10570 745]

Except, as I understand it, they don't fall into the same chain of command. Do they? There is an EMS Lt. or Capt. at many runs we respond to, but as far as I know, they do not hold rank over firefighters. They hold authority at the incident as personnel with the higher degree of training....although some of the ems officers are EMT's and they oversee Medics. How does that work? What I'm really looking for is some insight into the EMS command system.

Correct, EMS operations runs parallel to fire operations. It gets weird where training and communications are concerned. In both cases EMS and Fire report to the same Chief, but the EMS side also falls under the command of the chief of EMS. Its potentially nightmare made functional by men like Chief Galvin who recognize the mess and don't force unnecessary involvement. Correct, EMS officers hold no more power over firefighters. Same for Fire officers over emt's and medics. Patient care we're in charge and scene safety/patient extrication you guys are in charge. As long as egos stay out it works well.

The mess with EMTs supervising medics is finally being addressed. For the last Lt exam and all future exams gotta be a medic to get promoted. Next in the pipe is actual time in the field as a medic. Here's one catch, doesn't matter what the training of the supervisor the person ultimately responsible is the highest medical authority that provides patient care. EMTs have gotten jammed up because a medic boss gave a bad order and the boss more or less skates because we operate under Dept rules and DOH/Remac rules.

EMS traditionally has been a very poorly supervised job. Back in the good ol days there would be one or two bosses patrolling an entire borough. Now you see the level of supervision we have. Its a growing process integrating the bosses into the work but little things like bosses documenting patient care when on scene before anyone else was never done and still can't be handled by our computers.

[NJMedic 96]

Except, as I understand it, they don't fall into the same chain of command. Do they? There is an EMS Lt. or Capt. at many runs we respond to, but as far as I know, they do not hold rank over firefighters. They hold authority at the incident as personnel with the higher degree of training....although some of the ems officers are EMT's and they oversee Medics. How does that work? What I'm really looking for is some insight into the EMS command system.

I'm not with FDNY but I have no problem with a EMT overseeing ALS personnel. The EMT is not going to put him in a position to contermand a paramedics medical decisions but I know alot of EMTs that are operational superiour to our medics.

[ny10570 745]

A fleet of 4x4 buses just for winter emergencies would be a ridiculous waste of money, just as switching to all 4x4 ambulances. It would also create fleet wide clearance issues as opposed to just the HazTac/Rescue buses that are being rethought for the next order.

Tire chains were abandoned because of the damage they cause to vehicles. Broken links were tearing up the boxes of ambulances that couldn't stop because they were transporting critical patients. Ambulances getting stuck were an infrequent problem and sanitation was able to free stuck vehicles in a reasonable amount of time. As a result of this mess traction aids are being revisited and now there are rubber and plastic versions being looked out.

The city in areas got more snow than anywhere else. People keep going back to the central park total because thats what the media always uses when talking about NYC weather totals. 30"+ in parts of Brooklyn and Staten Island plus gusting winds that left snow drifts covering entire cars. Sanitation didn't get the job done. Wether it was a slowdown, poor maintenance, inexperienced workers, or all of the above it doesn't change the fact that even the plows and fire apparatus were getting stuck.

[PEMO3 523]

Except, as I understand it, they don't fall into the same chain of command. Do they? There is an EMS Lt. or Capt. at many runs we respond to, but as far as I know, they do not hold rank over firefighters. They hold authority at the incident as personnel with the higher degree of training....although some of the ems officers are EMT's and they oversee Medics. How does that work? What I'm really looking for is some insight into the EMS command system.

The EMS supervision provides incident management and oversight of operations similar to a battalion chief at a structure fire. It is sort of like saying a battalion chief never worked on a truck company, what gives him the right to direct one at a structure fire. Medical intervention still falls to the highest medical trained members on scene. It has worked for decades where in the EMS command system EMT's have held positions of Lt on up and been able to run incidents since they were providing pure ICS based direction. The best way to look at is rank structure regardless of level of training (EMT - Medic - Lt - Capt - DC - AC - .... Chief of Dept - Dispatcher ) Hope this sort of provides some insight.

[ny10570 745]

At least the battalion chief had all of the training of a truckie and has worked many tours on the truck even if he managed to somehow get all the way to BC without being assigned to a truck. How many SOC officers never did time in a SOC company? EMTs leading medics was a mistake that's finally being addressed.

Edited January 6, 2011 by ny10570

[FFLieu 70]

I know Chief through a mutual friend. He's a dedicated Paramedic and is probably one of the best Chiefs in the City. He's nothing more than a scapegoat so that Rich Uncle Pennybags can make it look as if he's not really the one to blame. It's not like he had anything to do with the intentional sanitation slowdown and colossal failure to call in the National Guard. Bloomberg and his asinine leadership team had everything to do with that, but since the big man himself was too busy taking a page out of the Nero manual of governance all while sipping umbrella drinks from the beach in Bermuda as the City "burned," now all of a sudden, he springs into action; in typical fashion, it's a knee-jerk reaction aimed at the wrong man. Bloomberg is a POS.

[antiquefirelt 994]

How many SOC officers never did time in a SOC company? EMTs leading medics was a mistake that's finally being addressed.

While we tend to embrace those that climb the ranks from bottom to top, very often a supervisor in almost any field, does not have to know everything about every facet of the field. In many Fire/EMS systems officers with lesser license levels command paramedics with no operational or supervisory issues. If an EMT cannot supervise a medic. the problem is his/her supervisory skills. Are all chief's Haz-mat tech's? How many worked in special operations? Yet they somehow can command an incident where resources area working that may have more expertise in certain areas. The same is true of EMS. If your EMT officers over step their bounds by going against a medics' patient care advice or direction, the issue is with the supervisory skill set and attitude.

[PEMO3 523]

The point of this demotion is purely political and nothing more. It has nothing to do with training, experience, trips, vendors, investigations or anything else Mayor "Bloomers" wants to blame it on. It is a spin doctor's move that was created to take the heat of him and his cronies and it worked. The media has shifted its focus on John and now Joe Bruno at NYC OEM. Fact is from my personal point of view, I have know John since he was made a Lieutenant, and that is over 20 plus years, he is a solid manager, medic and person of integrity. He is the one person I would trust without reservations and I personally find it distressing to see a man who has give so much trashed for a politicians sake.

[INIT915 1,119]

Often, when heads roll, it is the Agency Executive. That's where the buck traditionally stops. Why is there no heat on the actual Fire Commissioner himself? Instead, the blame is placed at the feet of a subordinate?

[JBE 328]

IIRR, it goes, EMT, Medic, LT(Promotion, but I believe you must be a Medic now to be made LT). Anything above that, Captain, Chief, etc. is appointment only. Funny how things work out, wasn't Nahmod Chief Perrugia's partner at one time??

Their dispatchers answer to their chief of communications, who in turn answers to our director of dispatch operations, who answers to chief of communications(a 3 star Fire Chief). This means probably Napoli is going to get Chief of EMS communications. Lovely.

My brother knows Chief Perrugia and has nothing but great things to say about the guy. I do sympathize with him and I figure he's been scapegoated as well.

[JBE 328]

So, this is going to be the city's action plan? Spend time and energy finding people to blame it on, and firing them, so it look's like they are "doing something".

I hate how the City is demonizing those who were actually "in the trenches". I don't know what the circumstances were or if this Chief deserved to be fired, but I'd rather be reading the headline "NYC Buys Snow Chains For Entire Ambulance Fleet" or "NYC To Order 4x4 Ambulances".

It'll never happen. The city won't spend the money. And, as far as demonizing, that's usually what happens. I know this from personal experience.

[PEMO3 523]

Nah. Better headline would be "Bloomberg grows a pair and fires John Doherty" but that would never happen even with an approval rating that has dropped from 57 % to 31 %. Its his last term anyway so he just does not care. Everything is any accident or a mistake or a misunderstanding to him.

[ny10570 745]

While we tend to embrace those that climb the ranks from bottom to top, very often a supervisor in almost any field, does not have to know everything about every facet of the field. In many Fire/EMS systems officers with lesser license levels command paramedics with no operational or supervisory issues. If an EMT cannot supervise a medic. the problem is his/her supervisory skills. Are all chief's Haz-mat tech's? How many worked in special operations? Yet they somehow can command an incident where resources area working that may have more expertise in certain areas. The same is true of EMS. If your EMT officers over step their bounds by going against a medics' patient care advice or direction, the issue is with the supervisory skill set and attitude.

To demand a chief have the training of everyone they supervise is ridiculous. To expect an immediate supervisor to have the training of the people under them is perfectly reasonable. An intelligent Chief places people into positions where their experiences and training supplement their own abilities. Isn't the Lt or Capt in charge of a company trained in the operations of that company? All HazTac bosses are immediately sent through the HazTac training and the new Lts are being sent to Rescue training. How is this any different? You don't put someone without teaching experience in charge of a school. The guy leading a team of programers is a programer. The person running a lab is Phd. Are you seeing a trend? Sorry, but the EMT curriculum, protocols, and training are disappointingly dumbed down and not enough.

[Bnechis 3,961]

Chains are also an expensive option for an ambulance. I'm also not sure the tire chains that most use today (on spot type) would have been particularly helpful in moving around in this storm. I think you have to consider every dollar spent as a risk-benefit analysis. This "once a decade" storm caused so many problems for EMS getting around, but they didn't have the same problems in a worse storm in February, and there were several "other" factors that may have led to their problems. Does is make sense to spend money on tire chains or maybe CPAP, which could save lives every day, especially when it isn't yet known if these "other" factors were actually more responsible?

One thing we have done as a company is to get a bit more expensive tire for our ambulances. The stock tires that come from most manufacturers are not made for winter terrain. We buy a tire with an extremely aggressive tread pattern and there is a noticeable difference in the operation of the ambulance. Maybe an extra $20 a tire on their ambulance might fix the problem instead of a couple thousand dollars an ambulance in tire chains.

Truck Chains (for 15-30 ton vehicles) cost about $150 per pair. For cars & SUVs they run about $50 and they can last about 10 or more years.

[antiquefirelt 994]

To demand a chief have the training of everyone they supervise is ridiculous. To expect an immediate supervisor to have the training of the people under them is perfectly reasonable. An intelligent Chief places people into positions where their experiences and training supplement their own abilities. Isn't the Lt or Capt in charge of a company trained in the operations of that company? All HazTac bosses are immediately sent through the HazTac training and the new Lts are being sent to Rescue training. How is this any different? You don't put someone without teaching experience in charge of a school. The guy leading a team of programers is a programer. The person running a lab is Phd. Are you seeing a trend? Sorry, but the EMT curriculum, protocols, and training are disappointingly dumbed down and not enough.

Guess I don't generally see the necessity of the EMS supervisor directing patient care. Fires, rescue ops and haz-mat calls tend to be multi-unit events requiring coordinated tactics involving multiple personnel to successfully mitigate an outcome. Most EMS calls require one person be in charge of one patients medical care. I'm admittedly not familiar with the specific job description of an FDNY EMS Supervisor, but in most cases EMS supervisors oversee multiple units and coordinate non-emergency stuff and once in a while supervise multi unit calls, directing units but not direct EMS patient care. Supervisors also run interference as a representative of the agency between providers and facility personnel or unhappy family members.

I've never been a Paramedic and probably never will be, but I've supervised medics both under my immediate supervision and from further up, and too my knowledge not once have I had an issue where my lack of paramedicine training somehow had a negative effect on the incident or patient care. The only time it would have helped would be in cases where I was involved in direct patient care, not supervising anything but the patient.

Far be it for me to say how FDNY should do it, certainly not my thought. No doubt that an organization that large must have tons of bright people looking at bettering the system for everyone (no doubt everyone has an opinion, something medics and firefighters are rarely short on) but I'm often interested in the "why" of how people do things when they seem to be out of character from what I know. What is it that FDNY Supervisors do in the field?

[PEMO3 523]

I need to address a previous comment. NY10570 I was one of those "dumbed down" EMT Supervisors (Lieut) in the NYC EMS system and had absolutely no issues with supervising both EMTs and Paramedics on a daily basis and actually enjoyed it. I found that there was extreme cooperation from both levels of personnel and knew my job was to enforce procedure and review what was within my scope of training. The issues arise when medics carry a "mightier than thou" attitude because of their level of training and forget that without BLS there is NO ALS and also forget where they came from, they were once one of those "dumbed down" EMTs. Don't throw stones when you live in a glass house. Lets talk dumbed down. Being a medic is not Roy and Johnny. It is flow sheet medicine. If you do A and see B then do D not C. There are even pocket protocol charts and I-Phone apps. Not that there is anything wrong with it but don't knock one area of a system because of a swollen ego. If swelling has become an issue some IM epi or benadryl might help but I am working out of my area to suggest that. Stay dry and safe in the snow today and remember we are all there for the same thing: the patient.