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Croton-on-Hudson opts for full-time EMT

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The first line in the New York State Protocol for Respiratory Distress is to request ALS if available. If you're on scene, you're available. Correct it doesn't say that ALS needs to necessarily intervene, but it appears that it is inferred by this statement.

New York City REMAC Protocol for Asthma for ALS providers states:

"Administer Ipratropium Bromide 0.02% (1unit dose of 2.5mL) by nebulizer, in conjuction with the first 3 doses of Albuterol Sulfate."

Ipratropim Bromide is not in the BLS protocol. As an ALS provider in NYC, if you just decide to administer Albuterol, and withhold the Ipratropium Bromide with the intention of passing off the patient to BLS, are you considered to be withholding treatment and/or violating NYC REMAC protocol?

On the flip side, if you administer Ipratropium, and then pass off to BLS, are you handing off a patient to BLS who is now administering a medication outside the scope of the New York State DOH BLS protocol for nebulized albuterol?

I'm merely playing devils advocate, because although I know we are talking about relatively benign medications when used properly, the potential for a negative outcome for a medic who just passess off an asthmatic is rather high. No one wants to be a "cook book medic", but in the end, a governing body just has to go back to the cook book and see how you changed the recipe.

That's what I was going to chime in with. There is no way to really turn over an asthmatic now since all we use in combivent. Also I rarely find any "simple" glucose administrations that don't RMA after admin. Anything else that gets taken in by me is someone who needs continuous glucose readings, being they aren't responding to D50 admin like normal or they are on a oral hypoglycemic which anyone on these should really be urged to be transported for observation being their pharmacokinetics are not all that predictable. By administering D50...are you truly "correcting the condition"? This is more rhetorical being I have probably RMA'd more after admin then transported...but if I feel they need to go the hospital 9 times out of 10 its because there is something underlying that is causing the issue that I cannot correct.

I have turned over a patient from a healthcare facility..for example the VA hospital in my district whom to them want it to go ALS but it doesn't really warrant it and they have put in a saline lock. That is allowed under protocol. The facility tries the old "well we are requesting he go ALS" and I give them.."point noted but you called 911 not a transport agency and the final call is mine...not yours. You want him to go ALS...call a private company."

If I'm getting into Mag for a asthma...they're chugging pretty good. BLS and my medical director will look at me sideways if I tried turfing that.

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Wow, even stat ep? I don't think I'd ever feel comfortable with that. Even the "serious" asthmatic. Unless I paid for my own supplemental malpractice insurance and I had no considerable personal assets. :D

In these cases it is done through medical control. They are also not just being left to their own devices. They are left with at the very least a corrections doc and ideally an EMT.

If I'm getting into Mag for a asthma...they're chugging pretty good. BLS and my medical director will look at me sideways if I tried turfing that.

As I said, there's a serious question as to your clinical judgement if you're administering mag and then turning it over to the BLS. If they're that sick they shouldn't be turfed. If they're not that sick why are they getting mag. As for the extended awaiting escort these are cases where they're either stable or you've been so long you've been able to stabilize them. After waiting 2 hours for an escort I've nearly gotten an RMA for an asthmatic that was cyanotic and nearly intubated at the jump. He was getting called to appear before the judge and understandably didn't want to spend another night. In the end we sat in the back of the courtroom while he appeared, was released and then walked to the ambulance.

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In these cases it is done through medical control. They are also not just being left to their own devices. They are left with at the very least a corrections doc and ideally an EMT.

As I said, there's a serious question as to your clinical judgement if you're administering mag and then turning it over to the BLS. If they're that sick they shouldn't be turfed. If they're not that sick why are they getting mag. As for the extended awaiting escort these are cases where they're either stable or you've been so long you've been able to stabilize them. After waiting 2 hours for an escort I've nearly gotten an RMA for an asthmatic that was cyanotic and nearly intubated at the jump. He was getting called to appear before the judge and understandably didn't want to spend another night. In the end we sat in the back of the courtroom while he appeared, was released and then walked to the ambulance.

I'm with you brother. I wasn't faulting anything you were saying. I also apparently missed the part that mentioned a person in custody. I've pretty much seen it all in the holding cells at PD HQ and city court so I'm with you. I had one asthmatic who would call after smoking a few rocks and would get really tight. He had no money but for rock so instead of getting his nebulizer meds..which for a taxi ride would be fee at the local clinic for him, I would work him up...after 1 combivent and a round of solu medrol we wouldn't wouldn't be back for 2 to 3 days. Finally we had enough and spoke to him sternly that it wouldn't happen anymore that he had to come to the hosptial...we lied of course but he stopped calling over time and eventually moved on to another community.

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So right now I am listen to the radio and Croton has gone third request for an EMT.. if they have only one paid EMT and he drives and no one else shows up what good is that seems like a waste of money. Why didn't they get two EMTs so that they can handle the first job coming out and then the volunteers can handle the next one? now the job went mutal aid.

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So right now I am listen to the radio and Croton has gone third request for an EMT.. if they have only one paid EMT and he drives and no one else shows up what good is that seems like a waste of money. Why didn't they get two EMTs so that they can handle the first job coming out and then the volunteers can handle the next one? now the job went mutal aid.

Well considering how I'm sitting here on this mutual aid call (it's BLS and OVAC came in mutual aid, so no, I'm not ignoring the patient) Croton's paid EMT as of right now is contracted from 7a to 7p, so the paid EMT went home 4 hours ago. Croton EMS had one member show up, but unfortunately couldn't get a second member to complete their crew so OVAC's BLS truck had to take the mutual aid request.

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So right now I am listen to the radio and Croton has gone third request for an EMT.. if they have only one paid EMT and he drives and no one else shows up what good is that seems like a waste of money. Why didn't they get two EMTs so that they can handle the first job coming out and then the volunteers can handle the next one? now the job went mutal aid.

Also they were looking for an EMT which means they probably had a driver. So if it was when the paid EMT was on duty there wouldn't have been an issue either.

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Does anybody ever wonder why there is a lack of volunteers, why calls go unanswered/MA and why members come and go voluntarily and involuntarily?

Actually no I don't wonder. Its far and wide and diverse as to why it happens. On average 2 out of every 3 person who walked in the door to volunteer will be gone by the 2nd year. It is what it is. Some don't like the demands or rules of agencies, some have a harder time finding the time, sometimes theirs internal issues. Bottom line is when you can come and go as you please...you get substandard service. That's not a dig...that's the truth. And sometimes the truth hurts. Bottom line is you can't tell me you can have 30, 40, 50 portables radios and there isn't 2 out of those numbers who can't answer a call.

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I've got to be honest here, I see all too often in some of these threads about VACs, the whole "well XYZ VAC covered 85% of their calls in 20xx!" To me, and I'm sure to several of my collegues, that is a joke! These agencies are certified and tasked with providing a service to the public, a very important service, EMS. I'm sorry if this ruffles a few feathers in VAC land, but nothing less than 100% coverage(that is of course with the exception of simultanious calls)is acceptable in my opinion. Who are we kidding here? If the system is broken, fix it! Give up the "smoke in mirrors" show, respond to something other than parades, carnival/event standbys, and "hot jobs." You may have the newest shiniest rigs, freshest uniforms, and plenty of portable radios, but until fulfill what your agency is required to do under its C.O.N., your system is broken. Sorry if I'm harsh, but I think its time to put public service before pride!

DISCLAIMER: This isn't referring to Croton EMS, or any other EMS agency at all. Just a blanket statement.

jack10562, newsbuff, INIT915 and 1 other like this

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I've got to be honest here, I see all too often in some of these threads about VACs, the whole "well XYZ VAC covered 85% of their calls in 20xx!" To me, and I'm sure to several of my collegues, that is a joke! These agencies are certified and tasked with providing a service to the public, a very important service, EMS. I'm sorry if this ruffles a few feathers in VAC land, but nothing less than 100% coverage(that is of course with the exception of simultanious calls)is acceptable in my opinion. Who are we kidding here? If the system is broken, fix it! Give up the "smoke in mirrors" show, respond to something other than parades, carnival/event standbys, and "hot jobs." You may have the newest shiniest rigs, freshest uniforms, and plenty of portable radios, but until fulfill what your agency is required to do under its C.O.N., your system is broken. Sorry if I'm harsh, but I think its time to put public service before pride!

DISCLAIMER: This isn't referring to Croton EMS, or any other EMS agency at all. Just a blanket statement.

Your blanket statement is kinda bold...that's what happens when those who are in career anything don't know what its like to volunteer in an agency where covering calls is hard to do with limited man power. I do as many calls as I can in my VAC and bust my rear to do the best that i can. If people like you have a problem with that too bad! If you have an issue with calls not being covered in your area be part of the solution not the problem...

Edited by helicopper
"txt spk" converted to full words and profanity filter bypass changed.

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Ken, I think you're jumping the gun, the issue is not about your dedication or vollies in general not doing the best that they can.

You have to admit, and I 'm sure everyone who cares enough about what goes on knows there are many times when some calls don't get answered in a timely fashion, and it is THAT which is not acceptable.

A sprained wrist can wait, but a stroke patient cant. Or is it the 2:30am call with the elderly nursing home patient vomiting and diarrhea. And who knows which of these calls is going to get pushed back due to slow or no response? The outcomes for these patients will be very different.

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Your blanket statement is kinda bold...that's what happens when those who are in career anything don't know what its like to volunteer in an agency where covering calls is hard to do with limited man power. I do as many calls as I can in my VAC and bust my rear to do the best that i can. If people like you have a problem with that too bad! If you have an issue with calls not being covered in your area be part of the solution not the problem...

You seem to be taking this a little too personal. Let me clarify by saying that no one said the Mofire390 didn't do his part, if thats the truth that you go above and beyond, I applaude your efforts. I also feel for you if you are one of the few in your agency that actually do. Was my statement bold, yes, irrational or inaccurate, I don't think so. For your info as well, just because my current affiliation says "Career" doesn't mean I haven't spent time in the volunteer ranks, I spent several years as a volunteer. My feeling has always been that if we didn't have sufficient manpower to carry out our tasks, hire people to do the job. Like I said, there has to be a point where we put public service before our pride and make something happen.

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Your blanket statement is kinda bold...that's what happens when those who are in career anything don't know what its like to volunteer in an agency where covering calls is hard to do with limited man power. I do as many calls as I can in my VAC and bust my rear to do the best that i can. If people like you have a problem with that too bad! If you have an issue with calls not being covered in your area be part of the solution not the problem...

I've known you for a long time..so with that said...you know I'm open and honest with communication so here it goes.

Hate to tell you..but you're the one that is dead wrong. You just called someone out that you have no idea who they are..which I do...and you couldn't have missed the boat more on that one my friend. I have to wonder..I pretty much say the same thing he just did all the time...so why not call me out?

Now moving along...I always like when cute little quips come out. First...professional providers bust their rear just as hard...which by the way if I remember correctly you work as a professional in the field. Second...by raising awareness of issues that many other won't for the lack of a better term "man up" to, he is being part of the solution by using facts and caring about service. The public and those of us who are forced to wait for ambulances don't give a damn (sorry but that's the word I feel needs to be used) that you or anyone else feels they are busing their rear to do the best you can. This isn't making a delivery or service call to get cable installed or fixed...this is public safety which their are standards that should be adhered to. Most of us are understanding that mutual aid at times will take place...but to me this should be 1% or less of total call volume. So yes...I often do have a problem with substandard inconsistent service. So know what? Is it too bad for me? Or too bad for the public when there are agencies who can find money in budgets and have billing opportunities to have a more consistent service? But what do I know...I'm a professional who when I wake up tomorrow I will be focused on nothing more then my profession and as part of the solution raising awareness of coverage issues..will be labelled anti volunteer, and apparently now unknowing of the hardships of those volunteers trying to cover calls with limited manpower.... Oh wait..be part of the solution right? Here's a solution...stop worrying about control, pride or whatever else holds up progress and hire staffing.

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My feeling has always been that if we didn't have sufficient manpower to carry out our tasks, hire people to do the job. Like I said, there has to be a point where we put public service before our pride and make something happen.

THANK YOU!!!

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I've known you for a long time..so with that said...you know I'm open and honest with communication so here it goes.

Hate to tell you..but you're the one that is dead wrong. You just called someone out that you have no idea who they are..which I do...and you couldn't have missed the boat more on that one my friend. I have to wonder..I pretty much say the same thing he just did all the time...so why not call me out?

Now moving along...I always like when cute little quips come out. First...professional providers bust their rear just as hard...which by the way if I remember correctly you work as a professional in the field. Second...by raising awareness of issues that many other won't for the lack of a better term "man up" to, he is being part of the solution by using facts and caring about service. The public and those of us who are forced to wait for ambulances don't give a damn (sorry but that's the word I feel needs to be used) that you or anyone else feels they are busing their rear to do the best you can. This isn't making a delivery or service call to get cable installed or fixed...this is public safety which their are standards that should be adhered to. Most of us are understanding that mutual aid at times will take place...but to me this should be 1% or less of total call volume. So yes...I often do have a problem with substandard inconsistent service. So know what? Is it too bad for me? Or too bad for the public when there are agencies who can find money in budgets and have billing opportunities to have a more consistent service? But what do I know...I'm a professional who when I wake up tomorrow I will be focused on nothing more then my profession and as part of the solution raising awareness of coverage issues..will be labelled anti volunteer, and apparently now unknowing of the hardships of those volunteers trying to cover calls with limited manpower.... Oh wait..be part of the solution right? Here's a solution...stop worrying about control, pride or whatever else holds up progress and hire staffing.

so if im not doing my best what am i doing??? my career is that of an EMT in a commerical agency. but that isnt realivent. Am I or any other volunteer Emergency Medical Service personal becoming a neusance in a field that should be run by a career staff??? because pretty much thats how ur post is starting to read. there is a key word that some people keep missing and thats VOLUNTEER...I've been one for 8 years on the EMS side and 6 almost 7 years on the fire side.

KRF, if in any way i offended u please allow me to appoligize in person. feel free to pm me would love to meet with u.

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so if im not doing my best what am i doing??? my career is that of an EMT in a commerical agency. but that isnt realivent. Am I or any other volunteer Emergency Medical Service personal becoming a neusance in a field that should be run by a career staff??? because pretty much thats how ur post is starting to read. there is a key word that some people keep missing and thats VOLUNTEER...I've been one for 8 years on the EMS side and 6 almost 7 years on the fire side.

KRF, if in any way i offended u please allow me to appoligize in person. feel free to pm me would love to meet with u.

Nowhere did tom say that your NOT doing your best to cover as many calls as you can, and do the most that you can. But when every VOLUNTEER(I used the word) is busting their hump(which I highly doubt is happening), and still coming up short, it's time for a change. We've said it time and time again, people pick and choose their calls, roll over and turn the radio off hoping someone else will pick it up, etc. This is where the system breaks. You said that "I do as many calls as I can in my VAC and bust my rear to do the best that i can." Well I applaud you for that, and I doubt anyone here would say any differently, you are doing it for the right reasons.

We work and live in a system where nothing less than 100% efficiency should be accepted, not saying that we settle for less, but we shouldn't. The agency that covers my house had to go mutual aid to 4 different agencies 3 days ago, just to get a crew... That's someone's family member, someone's friend, that is just waiting there because the VAC settled for less than 100% efficiency. And when there is a professional ALS/BLS provider(s) on scene already, just waiting, and waiting for that rig to show up, I have no doubt in my mind that they have some less than good thoughts about that volunteer agency.

Edited by newsbuff

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so if im not doing my best what am i doing??? my career is that of an EMT in a commerical agency. but that isnt realivent. Am I or any other volunteer Emergency Medical Service personal becoming a neusance in a field that should be run by a career staff??? because pretty much thats how ur post is starting to read. there is a key word that some people keep missing and thats VOLUNTEER...I've been one for 8 years on the EMS side and 6 almost 7 years on the fire side.

KRF, if in any way i offended u please allow me to appoligize in person. feel free to pm me would love to meet with u.

Don't take toms words to heart. He is making a very valid point. Never did he say that YOU or any specific person is not doing their best. You must admit, the volunteer system is not what it was 10 years ago. I have seen quite a downfall in my 11 years with the same vac. It may verywell be time for a change. Pride can no longer be an issue, we must recognize we have a job to do and we aren't always getting it done! (the word "we" is used as a general statement for volunteer agencies every where and should not be taken to mean any specific agency)

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so if im not doing my best what am i doing??? my career is that of an EMT in a commerical agency. but that isnt realivent. Am I or any other volunteer Emergency Medical Service personal becoming a neusance in a field that should be run by a career staff??? because pretty much thats how ur post is starting to read. there is a key word that some people keep missing and thats VOLUNTEER...I've been one for 8 years on the EMS side and 6 almost 7 years on the fire side.

This is not about you and nobody is criticizing you personally. So... (wait for it)... QTIP! (Where have I heard that before?) :P

Standards should be consistent in EMS so the person dialing 911 gets quality care in a reasonable amount of time from competent and professional providers. There shouldn't be a different standard because one crew is volunteer and one is paid. The demand or expectation that there be different standards "because I'm a volunteer" is what most people have issues with.

When there is no distinction, no double standard, no expectation of preferential treatment based on pay status you'll have an argument. In the meantime, the system is broken and we have to fix it.

To respond to your comment specifically, those in the volunteer sector who resist minimum standards, quality improvement programs, training, rostering in station to reduce response times, argue against paid members despite the fact that they can't cover their calls, etc. are preventing meaningful improvements and while I wouldn't call them a "nuisance" are perpetuating the problem.

If Empress (for example) covered only 75% of their calls in Yonkers do you think it would (should) be tolerated? Why do we tolerate it in the volunteer sector?

Empress has to maintain enough units to cover their calls and their call volume is more than 10 times that of most volunteer agencies. When a volunteer agency can't consistently staff ONE unit for ONE call there is a problem.

Stop crying the volunteer blues (that could be a song). Almost everyone started in the volunteer sector and many still are volunteers despite their paid job. That's not the point or the issue.

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so if im not doing my best what am i doing??? my career is that of an EMT in a commerical agency. but that isnt realivent. Am I or any other volunteer Emergency Medical Service personal becoming a neusance in a field that should be run by a career staff??? because pretty much thats how ur post is starting to read. there is a key word that some people keep missing and thats VOLUNTEER...I've been one for 8 years on the EMS side and 6 almost 7 years on the fire side.

KRF, if in any way i offended u please allow me to appoligize in person. feel free to pm me would love to meet with u.

Seriously? Go back to my post and please reply...in quotes... where anything your alluding to is present in my post. When have I ever said to you or anyone you know that your not doing your best? It just so happens that your "best" is actually very competent and professional, which I have said to you directly. No provider is a nuisance in any system, with the exception of those that forget the provider part and switch to having blinders and no sense of reality when things are not going the way they should. I really don't care what anyone puts in front of the their name or agency name. Neither does the public. This also is an argument that you can't have both ways. There are some that don't like the fact that the definition by noun of "professional" is one that gets paid for what they do. In a verb sense everyone should be "professional" when doing their craft. But then there are others who want to use "volunteer" when it suits them when their is problems. You're one person Mofire. There are about 4 others that come to mind who also bust their butts in your agency covering calls. But one or two can't do it alone. Its not getting any easier out there. That was my point. If it hurt your feelings or jabbed something that is personal for you...I can't help that. But barking up a tree that doesn't exist...that's not happening on something I wrote and is being twisted. I don't take any of this personal. On the street, on here or in meetings. So your stance is a bit foreign to me.

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So I guess were not gonna mention the Croton call tonight that toned through 4 Mutual Aid departments, and had a response time of TWENTY-NINE(29) minutes.......

Really,....

Edited by jack10562

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So I guess were not gonna mention the Croton call tonight that toned through 4 Mutual Aid departments, and had a response time of TWENTY-NINE(29) minutes.......

Really,....

OK... you mentioned it. Next.

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OK... you mentioned it. Next.

Not next...

This brings us back to Seth's original question, is this just putting a band-aid on a much larger issue? Was there no EMT available? Driver? Why should we just completely overlook the fact that they put in a system of one paid EMT/driver, and are STILL having the problem, when this was supposed to solve the issue. Was Croton out on another call that tied up manpower?(as in they couldn't muster up a just two more people?)

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Not next...

This brings us back to Seth's original question, is this just putting a band-aid on a much larger issue? Was there no EMT available? Driver? Why should we just completely overlook the fact that they put in a system of one paid EMT/driver, and are STILL having the problem, when this was supposed to solve the issue. Was Croton out on another call that tied up manpower?(as in they couldn't muster up a just two more people?)

Do you want an application CEMS You seem to be bashing this one agency. Hate to say it this is not the only agency with problems, As your agency has Paid people and go M/A as well. You just took your EMT Test this week so share stop spending all your time behind the computer and come be that EMT or that DRIVER.

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Do you want an application CEMS You seem to be bashing this one agency. Hate to say it this is not the only agency with problems, As your agency has Paid people and go M/A as well. You just took your EMT Test this week so share stop spending all your time behind the computer and come be that EMT or that DRIVER.

Who do you think I am, because I don't actually know you...

Anyways, I have nothing against Croton, or any other agency personally, but when people won't take responsibility for a failure to deliver service, that's where I have an issue, not just for me, but for everyone that lives there.

I asked a simple question, is there still a manpower issue? You yourself indirectly said just a few posts above mine, that if there are not enough people to do the job, hire them. So, why the argument?

P.S. I'll be sure to fill out that application as soon as possible, even though it would take me the better half of 30 minutes to get to Croton...

Edited by newsbuff

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I do not have any ties to Croton EMS but, I have to admit, it is nice to hear that they will have an EMT available 24-7. It seems to be a growing trend in the EMS field to have one or more paid EMT's covering calls for an agency. There is not a single EMS agency in the county that relies on 100% volunteer manpower that gets out the door fast enough due to having to wait for or tone out for an EMT or driver, a simple fix is to have a paid EMT/driver. This will unarguable reduce response times and provide care to the citizens quicker...the goal is to help the community asap...right??? As many people on this site know, I am all for running an agency with 100% volunteer manpower, however, this type of system and the egos (not necessarily bad) involved do have downfalls. The two that come to mind first are response time, and consistency. There is no argument out there that can go against the claim the have a staffed bus at all times wont increase response times and increase responses in general.

It is time for agencies to analyze their performance and see how they can improve on their flaws to better serve the communities that we are responsible for.

Not to point fingers or give names but I heard a call go out today over and over again...

Agency A got called for a call (seizure or syncope...don't remember.) several minutes later, Agency A was toned out for an EMT. Several minutes after that, Agency B was toned out mutual aid for a full crew, while Agency A was toned out for a 3rd time for an EMT. Several minutes later, Agency A was toned out for an EMT again, Agency B for an EMT, and Agency C for a full crew. several seconds later, Agency C was toned out for a full crew. Several minutes later, Agency A and B were both toned out for an EMT (4th and 3rd dispatches respectively), and Agency C, a 3rd page for a full crew. Several seconds later, 60-control notified Agencies A,B, and C that Agency D was going to cover the call. THAT IS TOO MUCH WASTED TIME AND BS!!!

Again, I am all for pride but not when the community suffers due to it.

Kudos to the proactive step, the community will appreciate it for sure.

Edited by PFDRes47cue

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Who do you think I am, because I don't actually know you...

Anyways, I have nothing against Croton, or any other agency personally, but when people won't take responsibility for a failure to deliver service, that's where I have an issue, not just for me, but for everyone that lives there.

I asked a simple question, is there still a manpower issue? You yourself indirectly said just a few posts above mine, that if there are not enough people to do the job, hire them. So, why the argument?

P.S. I'll be sure to fill out that application as soon as possible, even though it would take me the better half of 30 minutes to get to Croton...

The 24/7 staffing hasn't gone into effect yet. CEMS had two Drivers, no EMT. If the 24/7 gig was operational, the call would of been covered.

Satisfied?

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So I guess were not gonna mention the Croton call tonight that toned through 4 Mutual Aid departments, and had a response time of TWENTY-NINE(29) minutes.......
You seem to be bashing this one agency. Hate to say it this is not the only agency with problems,...

Is this a Croton problem?..... Yes

But 4 mutual aid depts also had a problem. This is criminal. How large an area and population are "protected" by these 5 agencies?

What if it was a multi patient call, people will die.

Hiring a few EMT/drivers here and there will not solve this problem.

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P.S. I'll be sure to fill out that application as soon as possible, even though it would take me the better half of 30 minutes to get [there]...

Not to worry, they'll be waiting there for you....

(:( not bashing Croton or anyone, just the issue. On occasion it happens to many agencies, and it's never good news. )

Good news is at least Croton recognizes there is sometimes a problem and is attempting to rectify it.

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The 24/7 staffing hasn't gone into effect yet. CEMS had two Drivers, no EMT. If the 24/7 gig was operational, the call would of been covered.

Satisfied?

And you answered my question, and the situation now makes more sense. I stand corrected for my above posts. Thanks for a true answer instead of lip service.

Edited by newsbuff

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Is this a Croton problem?..... Yes

But 4 mutual aid depts also had a problem. This is criminal. How large an area and population are "protected" by these 5 agencies?

What if it was a multi patient call, people will die.

Hiring a few EMT/drivers here and there will not solve this problem.

What's the crime?

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But 4 mutual aid depts also had a problem. This is criminal. How large an area and population are "protected" by these 5 agencies?
What's the crime?

While I did not mean it it terms of violating a specific law, it actually is.

NYS Public Health Law Article 30

Section 3012. Enforcement.

1. Any ambulance service or advanced life support first response service certificate issued pursuant to section three thousand five of this article may be revoked, suspended, limited or annulled by the department upon proof that the operator or certificate holder or one or more enrolled members or one or more persons in his employ:

( b has not been competent in the operation of the service or has shown inability to provide adequate ambulance services or advanced life support first response service; or

(g) a voluntary ambulance service or voluntary advanced life support first response service has failed to meet the minimum staffing standard and has not been issued an exemption, except that such certificate shall not be suspended or revoked unless the commissioner finds that an adequate alternative service exists. The commissioner shall consider the recommendation of the regional emergency medical services council in making a finding; or

Edited by jack10562

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