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Steve

DISCUSSION: Pelham Manor/Bronx Bus MCI - 03-12-11

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I think to much back and forth is going on about FDNY, Pelham, Rockland, etc. and we are dancing around a valid and teachable question. What would be done to get resources for the same incident say it happened on Route 9A on the Briarcliff/Ossining corridor? How would the resources be mustered for 30+ critical patients without total stripping communities of their EMS needs remembering that other 911 calls still continue to come in. Maybe some of the members from 60 that are online can shed some light on 60 Controls internal plans on how this is handled. Let make certain that this is not to be picked at but again this has created a teachable moment that may provide valuable information for the next "big" one that happens. Lets use it to learn.

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From Westchester County's 2003 Mutual aid Plan - which by the way I found very interesting.

Section 8. MCI LEVELS

Predetermining the response based on number of patients will save time. Requests for EMS resources will be made in Task Force* format. A Task Force consists of three (3) BLS Ambulances, two (2) ALS Ambulances or two (2) additional BLS Ambulances and two (2) ALS equipped paramedics (two fly cars or one double fly car) and two (2) supervisors or senior line officers.

MCI LEVEL - NUMBER OF PATIENTS - *MOBILIZATION OF

1 - Up to 10 - one (1) task force

2 - 11-25 - two (2) task forces

3 - 26-50 - four (4) task forces

4 - 51-75 - six (6) task forces

5 - 76-100 - eight (8) task forces

6 - 100+ - ten (10) task forces(plus additional resources as decided by the IC)

*The Task Force concept is intended to address ALS & BLS needs along with the need for assistance in the management positions, interagency liaisons and communications. Clear text should be used for all radio communications.

If there are multiple ambulatory patients, a bus or buses should be requested from the municipality or County.

edit: A) this is just for EMS Mutual Aid

B) how often, and when was the last time, any agency even took a look at this plan, reviewed it, made a change, let alone audit the process? I cant go more then a quarter at work without auditing ladders before our insurance co want to drop us, so I am hoping that the 2003 revision is not the last time it was updated. It is however, the only version available from the county website.

http://docs.google.c...Xxb2p3X0VDMvxuQ

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Come on guys be constructive and have some respect for the men and women who lost their lives.

No matter where this accident occured fire companies would have done the best job they were capable of doing.

What is the point of comparing a small department like PM to the FDNY?

How about someone starts a thread educating first responders that read this site that the roof construction of these coach buses are thin sheetmeatal over foam which can easily be cut with a sawsall? Is that information possibly a bit more valuable than most of the nonsense above?

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Come on guys be constructive and have some respect for the men and women who lost their lives.

No matter where this accident occured fire companies would have done the best job they were capable of doing.

What is the point of comparing a small department like PM to the FDNY?

How about someone starts a thread educating first responders that read this site that the roof construction of these coach buses are thin sheetmeatal over foam which can easily be cut with a sawsall? Is that information possibly a bit more valuable than most of the nonsense above?

Your point is noted but nobody is being disrespectful or criticizing any specific agency. Discussing incident operations and mobilization of resources is a very valid topic and is consistent with other threads of a similiar nature.

If you would like to discuss the extrication issues associated with the bus construction feel free, that's what this thread is for.

Thank you.

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All the comparisons between Westchester Departments and FDNY are stupid. If something like this tragedy happened in Northern Westchester it would take alot of time to get as many EMS busses as they needed to the scene. Probably at least half would be Volunteer BLS busses who thankfully now would be backed by plenty of ALS flycars in the area. FDNY is the "Cream of the Crop" when it comes to this type of operation. There are plenty of dedicated volunteers (many of whom are FDNY members) that could have handled this event tho not as swiftly as FDNY can. Stop comparing the two you can't. Additionally, there would have been at least two and maybe more helicopters at the scene which undoubtedly would have been able to transport multiple patients quickly to nearby trauma centers. I would hope that IF a similar incident occurred within a 10-20 radius of New York City that FDNY resources have been asked to respond.

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All the comparisons between Westchester Departments and FDNY are stupid. If something like this tragedy happened in Northern Westchester it would take alot of time to get as many EMS busses as they needed to the scene. Probably at least half would be Volunteer BLS busses who thankfully now would be backed by plenty of ALS flycars in the area. FDNY is the "Cream of the Crop" when it comes to this type of operation. There are plenty of dedicated volunteers (many of whom are FDNY members) that could have handled this event tho not as swiftly as FDNY can. Stop comparing the two you can't. Additionally, there would have been at least two and maybe more helicopters at the scene which undoubtedly would have been able to transport multiple patients quickly to nearby trauma centers. I would hope that IF a similar incident occurred within a 10-20 radius of New York City that FDNY resources have been asked to respond.

If you read my post I had tried to take this away from a Westchester-FDNY comparison and work on a what if learning experience. What do we have in place? What is the plan? Is the a viable one or does it just exist on paper to look good? I felt an educated discussion might bring to light what may exist but not be common knowledge and shed light on what we need to work on while removing the us-them concept. Can we try this again? JohnnyOV. Thank you for your input, and I see were you are coming from with your comments.

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From Westchester County's 2003 Mutual aid Plan - which by the way I found very interesting.

edit: A) this is just for EMS Mutual Aid

B) how often, and when was the last time, any agency even took a look at this plan, reviewed it, made a change, let alone audit the process? I cant go more then a quarter at work without auditing ladders before our insurance co want to drop us, so I am hoping that the 2003 revision is not the last time it was updated. It is however, the only version available from the county website.

One of the problems, and I think bnechis can address this in more detail, is that nobody wanted to join pre-designated task forces so the expectation is that they'll be developed by 60-Control on the fly.

It should be as simple as hitting a button to tone out a task force but that isn't the way it works. If an agency is busy, their spot in the task force could be back-filled.

We have been very fortunate to have no need for such large EMS responses but with the increased number of high-rises, commercial airline flights, and the ever-present buses and trains moving through the county this is something that should be addressed.

M' Ave and PEMO3 like this

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I never post on here, but I'll just say this.

FDNY did an excellent job, and EMS really did solid work. The EMS guys first on scene did an expert job with triage and really started the rescue effort off right. There were several scene dedicated ALS and BLS units on scene within 10 mins and several ALS and BLS Transport units on scene not five minutes later, with more being dispatched every time units left the scene. I was sitting at my station watching the CAD for this (my regular unit was at the scene and no spares avail at the station) and they mobilized almost every unit in the north and north east Bronx. Not to mention, still maintain the normal workflow by back filling units and supervisors from both Queens and Manhattan.

Personal opinion, this could only have gone as well as it did because it was handled by FDNY. To pull the resources from Westchester Fire and EMS departments necessary to effectively manage this scene and maintain workflow would be a nightmare. Not to mention the on scene nightmare considering every department has their own, SOPs etc. FDNY has the advantage of having a large amount of people all on the same page with standard procedures for MCIs. If Westchester would be able to establish a MCI plan and SOPs that would have all the incoming agencys on the same page, acting in a unified manor, I'd say they could handle it . . but they don't.

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I don't mean this as a knock at the FDNY, but look at the reality of the situation. There are many great FD's out there that do strong work, but few have the resources of the FDNY. When it comes to being capable, many FD's have the capability to handle what we'd consider routine calls. We cannot staff and amass resources beyond our typical averages as it would be cost prohibitive. As was noted a few times here, having the resources under one command, using the same SOPs by personnel who have trained the same way, makes the incident far more manageable. Once a FD or EMS service begins to pull in outside resources many variable start to crop up: how do I talk to the units? Who's in charge of the units? What's the training level of the unit? Are my SOP's wildly different than the M/A units so they'll operate in a manner inconsistent than we're used too?

FDNY can make short work of an incident like this because they have the resources. While I have no doubt the actual hands on work was exemplary, it's not beyond what many FD's are capable of, just at what scale they are capable of doing in. If you're FD cannot handle this same incident similarly, you should be planning and training on how you could.

Look at disaster in Japan. If that happened here could we be as efficient as a country like England where the fire service is nationalized? Everyone trained very similarly, using very similar apparatus, using the same guidelines? You think it might make for a better outcome at the "big one"? But, then some are anti-regionalization because everyone wants to be the best, but wants their name on the logo...

BIGRED1, PEMO3 and helicopper like this

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How about this, which EMS agencies in Westchester have trained their members and officers in ICS? Do any mandate leadership training for their officers? Do any have their members practice triage protocols and procedures? Is there a VAC that can post their MCI procedures so maybe some that haven't developed one can get a head start?

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And BTW, the public expects the same response FDNY gave anywhere that tour bus goes. Can your FD even come close?

To bad the public is unwilling to foot the bill. One reason that FDNY can do what they do is that larger depts cost less per capita than multiple smaller ones. Thus they can focus the funding where it needs to be and still afford the specialized units. Also it is much easier to train and co-ordinate.

One of the problems, and I think bnechis can address this in more detail, is that nobody wanted to join pre-designated task forces so the expectation is that they'll be developed by 60-Control on the fly.

Chris is correct, we tried task forces, and set them up so nobody was stripped, but we found that not only does no one want to participate, we still have agencies that refuse to sign the mutual aid agreement. Last years airport drill had the best EMS turnout for the pre drill training I have ever seen in Westchester. We need much more, but there is a major vacume in both EMS and its leadership. To many ajencies can barely cover a single patient event much less an MCI.

We have been very fortunate to have no need for such large EMS responses but with the increased number of high-rises, commercial airline flights, and the ever-present buses and trains moving through the county this is something that should be addressed.

Its coming and its not going to be pretty.

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When was the last time that a Westchester County Mutual Aid Disaster Training Exercise was conducted, specifically in the Southern Westchester County Area, utilizing both Paid and Volunteer Staffs? (ie: Yonkers, New Rochelle, Mount Vernon, Eastchester, Pelham, Pelham Manor, Hastings, Dobbs Ferry, Larchmont, Mamaroneck, etc)

Just my opinion, but having a strong unified "Regionalized" plan for Westcheter County to mobilize and respond to such an event, as the tragedy this past weekend, is criticaly needed. Some cities in Westchester are properly equiped and trained for such response (ie: Yonkers, etc), but should a major disaster occur say in an area outside of those big cities, unless the "COUNTY" is able "QUICKLY" mobilize and properly respond to such an event, I fear that areas of the county will suffer.

One of the problems, and I think bnechis can address this in more detail, is that nobody wanted to join pre-designated task forces so the expectation is that they'll be developed by 60-Control on the fly.

It should be as simple as hitting a button to tone out a task force but that isn't the way it works. If an agency is busy, their spot in the task force could be back-filled.

We have been very fortunate to have no need for such large EMS responses but with the increased number of high-rises, commercial airline flights, and the ever-present buses and trains moving through the county this is something that should be addressed.

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To bad the public is unwilling to foot the bill. One reason that FDNY can do what they do is that larger depts cost less per capita than multiple smaller ones. Thus they can focus the funding where it needs to be and still afford the specialized units. Also it is much easier to train and co-ordinate.

You speak the absolute truth. Sadly the public is often mislead or just doesn't care enough to know the difference between mediocrity and good service. In some areas, such as my own, there would be no help coming from a large well staffed and trained career dept with significant resources. Not being prepared isn't an acceptable option. The public expects that when an accident happens all the victims that are viable will extricated and transported in a rapid fashion, but have little frame of reference to judge by.

We can all likely agree FDNY sets the standard in many areas, but as you note a large factor at work there is the sheer numbers in manpower, equipment and dollars. The rest of us might need 50 different FD's to staff the number of units FDNY does daily. Imagine trying to coordinate that with different training and policies: not even close to realistic. This is yet another reason where regionalization has an advantage.

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They had everyone extricated in a hour and I bet most of them transported in that time too. Have you ever been to an airport exercise in Westchester? They can't transport that many people in an hour during an exercise. Imagine reality.

As one of the HPN firefighters, I can definitely agree that our disaster drills are, well, disasters. But on the other hand without recurrent training holding these exercises we wouldn't be able to do the job when the time comes. Throughout this thread I've seen a lot of department bashing and extreme opinions. Yes, kudos to the FDNY and the awesome job they did. And, Yes, I'm sure many agencies are thoroughly ready enough to be able to handle at least an initial response to such a disaster. But let's face reality: No one is perfect, and no emergency service is perfect. For the people who boast how "awesome" their departments are, I have two words...KEEP TRAINING! It's the only way you'll ever be ready.

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And while we all talk about this, another deadly bus accident in NJ. Guess it happens more then we all think.

At least two people dead as bus crashes on the New Jersey Turnpike

BY Barry Paddock

DAILY NEWS STAFF WRITER

A tour bus with more than two dozen passengers crashed on the New Jersey Turnpike in East Brunswick Monday night, killing at least two people including the driver, police said.

The crash came just two days after Saturday's tour bus crash in the Bronx killed 15 people.

Link to story

Edited by jack10562
source site copyright

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Well, just had our own Bus MCI tonight. At least no rescue involed. Middlesex County in not unlike Westchester County. Don't under estimate what can get done. Granted it would be much different at 9 in the morning then 9 at night. Plenty of help on the scene.

Edited by NJMedic

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The only correction I will make is it was not a quiet Saturday Morning. There were a number of other incidents going on including a 10-77 in 45/58's first due. Due to the simultaneous incidents the Bronx was severly depleted and there were multiple relocators into the Bronx from Manhattan and Queens.

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I don't really see why its productive to compare a Westchester volunteer department to the FDNY.

What IS productive is for everyone to go back to their departments this week, dust off your MCI and major incident plans, and take a look at what YOUR department might do in the event of that type of situation. As the old saying goes "No battle plan survives first contact with the enemy," but at the same time its good to have a baseline to work from. Talk to your neighboring department, or for those of you in NY, the county and see who has what and when it can get there.

Lets stop criticizing or focusing on what NYC is doing, since NONE of our departments have the training, manpower, equipment or capabilities of FDNY. Instead, worry about what WE are going to do. As NJMedic just demonstrated, this can happen to ANY department with a highway. In the last week we've all gotten our lessons in planning watching what these departments have done, now if we don't go back and prepare, shame on us. We as a fire service are REALLY good at telling the citizens to prepare for disaster with smoke detectors, first aid and disaster kits, but we're not always so good at preparing ourselves on a regular basis.

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Totally Agree. Bottom line is that FDNY (and NYC) were and are prepared for such a massive incident. On the other hand, Westchester County, under a unified (Paid/Volly) Mutual Aide Program, is under-trained and most likely not very well prepared as a "COUNTY" to properly respond to such an event. MORE COUNTY WIDE/MUTUAL AID (Paid and Volly combined) TRAINING IS NECESSARY (especially in the Southern End of the County) to be prepare for such an event.

As Barry out of NRFD has said, people need to listen and start working on putting this all together and START COUNTY-WIDE MUTUAL AID DISASTER TRAINING DRILLS IMMEDIATELY. (Its not necessary the quality of the individual parts, but the effectiveness of the sum of the parts as a whole that makes an effective plan work)

I don't really see why its productive to compare a Westchester volunteer department to the FDNY.

What IS productive is for everyone to go back to their departments this week, dust off your MCI and major incident plans, and take a look at what YOUR department might do in the event of that type of situation. As the old saying goes "No battle plan survives first contact with the enemy," but at the same time its good to have a baseline to work from. Talk to your neighboring department, or for those of you in NY, the county and see who has what and when it can get there.

Lets stop criticizing or focusing on what NYC is doing, since NONE of our departments have the training, manpower, equipment or capabilities of FDNY. Instead, worry about what WE are going to do. As NJMedic just demonstrated, this can happen to ANY department with a highway. In the last week we've all gotten our lessons in planning watching what these departments have done, now if we don't go back and prepare, shame on us. We as a fire service are REALLY good at telling the citizens to prepare for disaster with smoke detectors, first aid and disaster kits, but we're not always so good at preparing ourselves on a regular basis.

Edited by 61MACKBR1

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As one of the HPN firefighters, I can definitely agree that our disaster drills are, well, disasters. But on the other hand without recurrent training holding these exercises we wouldn't be able to do the job when the time comes.

I have worked as a review and trainer for over 20 years at HPN. And while a lot of effort has gone into the "plan" one thing that has never improved is the triage & transport of injured "victims". The last drill was stopped because rescuer were dropping like flies due to heat. And while I agree that the drill needed to be stopped at that point, we still had not completed moving people to treatment or transport.

The gold standard is the flight 232 crash (Sioux City, IA) where they managed to triage, treat and transport 184 patients in just over an hour. In westchester it takes that long to start transporting the 1st patients.

The county has also decided that the "airport plan" should be different from all other MCI plans. I do not know if this is a better plan, but most responders in Westchester have problems understanding the existing plan, know we want them to follow 2 different ones.

For the people who boast how "awesome" their departments are, I have two words...KEEP TRAINING! It's the only way you'll ever be ready.

I agree, but if it is not quality training its a waste of time. Watching EMT's at the airport dragging victims from one end of the field to the other, then dragging them back for no reason is a waste of everyones time.

EMS need to know how to start triage and establish treatment areas, staging and coordinate before EMS officers (some of who have no additional training or experience) arrive.

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Bnechis, you make a lot of valid and good points. First and foremost, two plans does no one any good. Time should be spent to build and establish a viable base plan that has upgradable modules in it to work in other scenarios similar to the alarm structure of a fire dept with additional automatically resources added (or should be) with each additional alarm level. Before anyone starts, lets not even go there right now. Second is training and drills that have realistic expectations and results not just scripted events. If we wanted that we could hire a movie company. Lastly, is having multiple departments work events, from minor incident to even the small standby events like they were an MCI with ICS command structure. When people use skills enough and use them together they become second nature and when the "big one" happens they do not have to think "what do I do next" or " who does what".

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As I read this I can't help but ask myself, "what type of bubble or 5th dimension do some of you live in"? This incident pretty much maxed out everyone on scene. Like someone already posted there were close to 150 FFs there NOT including EMS and a slew of ESU cops on scene with their hands FULL. In total there were well over 200 well trained, fully equipped personnel with plenty of REAL world experience there in minutes to help mitigate this tragedy.

I'll take it a step further, I don't think that there is a place in the region( nevermind the County ) that would have generated the level of response for a similar incident. If I'm wrong, someone please correct me.

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Here’s a look at the EMS Units On-Scene

Car 5 Chief of EMS Command

Car 51 Manhattan Division Chief

Car 5C EMS Deputy Chief (Medical Branch)

Division Captain 2 (Bronx Div Captain) Deputy Medical Branch with Staging

Division Captain 4 (Queens Div Captain)

Conditions 20 (EMS Lieutenant) Triage/ front half of the bus

Conditions 15 (EMS Lieutenant) Triage back half of the bus. After triage began and units determined half of the patients were deceased this unit took the role of the Transport Officer.

Conditions 03 (EMS Lieutenant) Treatment Officer

Conditions 14 (EMS Lieutenant) Hospital Group Sector Officer

Conditions 53 (EMS Lieutenant)

M.E.R.V 2 (Bronx Major Emergency Response Vehicle)

M.R.T.U (Mobile Respiratory Treatment Unit)

L.S.U 2 (Bronx Logistical Support Unit)

L.S.U 4 (Queens Logistical Support Unit)

15Z (ALS Ambulance) 03V (ALS Ambulance)

20X (ALS Ambulance) 20Y (ALS Ambulance)

52V (ALS Ambulance) 52X (ALS Ambulance)

15A (BLS Ambulance) 20D (BLS Ambulance)

15G (BLS Ambulance) 52D (BLS Ambulance)

15I (BLS Ambulance) 52E (BLS Ambulance)

20C (BLS Ambulance)

FDNY Counseling Service Unit was at the scene and also at hospitals, EMS stations and firehouses.

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I have worked as a review and trainer for over 20 years at HPN. And while a lot of effort has gone into the "plan" one thing that has never improved is the triage & transport of injured "victims". The last drill was stopped because rescuer were dropping like flies due to heat. And while I agree that the drill needed to be stopped at that point, we still had not completed moving people to treatment or transport.

The gold standard is the flight 232 crash (Sioux City, IA) where they managed to triage, treat and transport 184 patients in just over an hour. In westchester it takes that long to start transporting the 1st patients.

The county has also decided that the "airport plan" should be different from all other MCI plans. I do not know if this is a better plan, but most responders in Westchester have problems understanding the existing plan, know we want them to follow 2 different ones.

I agree, but if it is not quality training its a waste of time. Watching EMT's at the airport dragging victims from one end of the field to the other, then dragging them back for no reason is a waste of everyones time.

EMS need to know how to start triage and establish treatment areas, staging and coordinate before EMS officers (some of who have no additional training or experience) arrive.

I couldn't agree more. The airport should be arguably one of the best prepared facilities in the County by virtue of the number of exercises and ongoing, regular meetings conducted there but we keep seeing the same problems year in and year out.

A large scale EMS response is (IMHO) one of the biggest weaknesses in this county. This is not bashing or criticism but rather the recognition of something that should be fixed. So I'll ask this: what are we doing to fix it?

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If there is any agency or department out there right now not sitting down and evaluating and re-writing their alarm assignments and SOP's for such an incident...shame on them!

Yes, this could happen anywhere, and will again. Yes, there are very few areas of this COUNTRY that can generate a response as the NYPD and FDNY did - bravo to them (you, for the MOS here), in the time frame they did. Once again, a great example of why they are held in the highest esteem by people who "get it". It baffles me that some here have the balls to criticize their response...

Seriously...I HOPE that Chiefs, Officers, and Admins alike are putting pen to paper and formulating a plan.

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Another point to bring up, as it was mentioned earlier in this thread in regards to pulling mutuail aid units to the scene.

It is common to "stagger" or pull resources from different areas, which the majority of the time, makes sense so as to not deplete one township or city. I agree with this for the most part.

However, during an incident such as this, a complex and critical situation, do you feel it might more prudent to use any or all appropriate resource in the area immediatly, then backfill with mutuail aid? meaning, don't skip units, call the closest units you need, then relocate units....

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First and foremost, two plans does no one any good. Time should be spent to build and establish a viable base plan that has upgradable modules in it to work in other scenarios similar to the alarm structure of a fire dept with additional automatically resources added (or should be) with each additional alarm level.

There is one on paper.

Here is the real problem. Last week Jim Soto (NYS Dept of Health, BEMS rep/Disaster planner) gave a talk to the emergency managers of NYSEMO region II (Hudson Valley). He said that EMS in NYS is so "Fragile" that it can not be expected to mount an effective large scale response. He stated that the basic issue one must understand is that there is no requirement in NYS for any community, municipality, or response agency to provide EMS or ambulance service. So when a community sets up a VAC, a FDVAC, a municipal service, or a contract service it sets up what ever it wants and it is happy with that because isn't that much better than nothing? Now the reason most EMS agencies in Westchester (or NYS for that matter) can't put together a proper disaster response is they are not designed or required to do so.

A large scale EMS response is (IMHO) one of the biggest weaknesses in this county. This is not bashing or criticism but rather the recognition of something that should be fixed. So I'll ask this: what are we doing to fix it?

Nothing. A number of people have tried for decades and there is zero interest in EMS to even consider this a problem. Maybe when we consider how bad EMS is in handling a simple "sick" call in many communities, then we should not be surprised we are not ready for a major one.

If there is any agency or department out there right now not sitting down and evaluating and re-writing their alarm assignments and SOP's for such an incident...shame on them!....Seriously...I HOPE that Chiefs, Officers, and Admins alike are putting pen to paper and formulating a plan.

As Pemo3 stated (above) "two plans do not do anyone any good". There is a plan but it needs to be implimented. Drilled on and improved. We do not need another 36 plans that dont work. In fact when I started trying to fix this Westchester had 36 plans and the best was each communities plan had the same resources coming to help them. Amazing to see how in a multi jurisdictional incident some vacs were being asked to send there one ambulance to 5 different communities.

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Anyone know if any of the "audio" sites captured the audio on this?

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Tour Bus Inspection

In the wake of this accident the DOT and NYPD have begun stepped up enforcement of tour bus operations. In the first Manhattan check all 14 buses inspected failed and were pulled from the road. This after an accident where all the operators knew they would be under more scrutiny.

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Westchester departments would have responded the same and would have done fine.

I find it funny that leo's responding to this thread have been very critical of westchester ff departments. I could post in the Leo threads within emtbravo and list all the negatives but I don't because it's unprofessional and I'm not a cop and butting in makes no sense, so please show some courtesy and respect.

When I applied to become a VFF in Westchester no one especiqlly the instructors teaching Fire 1 in Valhalla ever said anything like 30 volunteer FF = 1 Career FF.

Whether you are career or volunteer FF, when arriving on scene we are striving for the same goals.

Edited by okcomputer

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