Primary EMS responsibility for Yonkers

[v85 212]

I was just wondering, who is considered the primary EMS agency for Yonkers?

Empress EMS is the transport agency

Yonkers FD is the first response agency and also has some special ops and supervisory responsibility

Yonkers PD ESU is also first response to significant incidents and has a Mass Care Transport Unit.

So would be considered primary?

[67R93 5]

I believe Empress is also 911 contracted.

I was just wondering, who is considered the primary EMS agency for Yonkers?

Empress EMS is the transport agency

Yonkers FD is the first response agency and also has some special ops and supervisory responsibility

Yonkers PD ESU is also first response to significant incidents and has a Mass Care Transport Unit.

So would be considered primary?

Oh, wait, I see what you are asking...LOL

[gpeifer 89]

All three agencies work together to provide the best possible care to the citizens and visitors of Yonkers. (A politically correct response?)

[FireMedic049 597]

I would think that he who takes the patients to the hospital would be the "primary" EMS agency. If your agency and personnel don't actually transport the patients they encounter, then I think it's hard to argue that you aren't a "supporting" agency when it comes to the delivery of EMS.

All three agencies work together to provide the best possible care to the citizens and visitors of Yonkers. (A politically correct response?)

As it should be everywhere.

[sympathomedic 383]

In terms of the non-trasnporting agencies, keeping it simple, if you are injured they send cops, if you are sick they send FD. Though actual calls coming in as "sick" get neither. If you are injured in a car, you get an engine, a ladder a heavy rescue, a battalion chief, a sector PD car and an ESU truck. And an ambulance and a fly-car and sometimes an EMS boss.

That comes out to about 100 tons of gear for a 170lb pt.

[v85 212]

So what would the answer to this question be:

In an incident in which ICS was formally established. Would the EMS command or medical section chief be

1. An Empress EMS supervisor

2. A Yonkers FD supervisor

3. A Yonkers PD ESU supervisor

[PEMO3 523]

I would say under a unified command I believe the Empress supervisor would be EMS sector, the FD supervisor would account for the fire sector and PD for the PD sector. With that said, ultimately EMS command should go to the highest medically trained boss on the scene if we are talking about an MCI.

[v85 212]

Thanks a lot.

I always thought that ALS weren't supposed to be command or triage, but instead in the treatment sector? Or maybe that was just triage but not command

[gpeifer 89]

Thanks a lot.

I always thought that ALS weren't supposed to be command or triage, but instead in the treatment sector? Or maybe that was just triage but not command

There s no such thing as EMS Command. There is an EMS Branch with a branch manager and maybe trage group, treatment groups, morgue group..etc. an EMS official might be in the command post to offer advice but rarely is in EMS in charge of a scene. PD, FD, or bth will be in "command" of an incident. The highest trained EMS person has decision making capabilities when it comes to patient care, movement, and transport. Every EMS person needs to become intimately familiar with NIMS and ICS..at least to the 200 level.

[Sean11FD 3]

Branch director

[EMT111 149]

Thanks a lot.

I always thought that ALS weren't supposed to be command or triage, but instead in the treatment sector? Or maybe that was just triage but not command

That would be when you only have one or two ALS units coming in and the majority of the resources are BLS. An agency like Empress that has multiple rigs plus supervisors and everything, what are they gonna do, call mutual aid BLS and turn command over to them?

Edited November 10, 2013 by EMT111

[Dinosaur 844]

There s no such thing as EMS Command. There is an EMS Branch with a branch manager and maybe trage group, treatment groups, morgue group..etc. an EMS official might be in the command post to offer advice but rarely is in EMS in charge of a scene. PD, FD, or bth will be in "command" of an incident. The highest trained EMS person has decision making capabilities when it comes to patient care, movement, and transport. Every EMS person needs to become intimately familiar with NIMS and ICS..at least to the 200 level.

There could be an EMS IC serving in a unified command. Of course, we don't do unified command very well.

I think the point about needing to learn and follow ICS applies equally to FD and PD as well. They don't always do it and often don't do it right.

[SageVigiles 1,194]

There could be an EMS IC serving in a unified command. Of course, we don't do unified command very well.

I think the point about needing to learn and follow ICS applies equally to FD and PD as well. They don't always do it and often don't do it right.

For the majority of agencies out there, ICS consists of someone in an SUV showing up and declaring themselves "Command." True Unified Command is a pipe dream for most of us.

There's a difference between checking the box and actually using ICS to manage an incident efficiently.

[Dinosaur 844]

Branch director

Yup. It's also division not sector or zone.

[meat441 43]

WOW! I see that a REFRESHER class in ICS TERMINOLOGY is needed for some?

[gpeifer 89]

Branch director

http://books.google.com/books?id=iJrPVZ8TVbYC&pg=PT234&lpg=PT234&dq=ems+branch+manager&source=bl&ots=1AspznX8iN&sig=7sE-82jVSCkCmhjm1XSt0QcJiY0&hl=en&sa=X&ei=iaeBUr_fJtan4APupYHoCg&ved=0CDMQ6AEwBA#v=onepage&q=ems%20branch%20manager&f=false

[gpeifer 89]

Yup. It's also division not sector or zone.

Division is geographical. Groups are functional.

[Bnechis 3,961]

Division is geographical. Groups are functional.

I know more than a few EMS "Groups" that are not very "functional"

[velcroMedic1987 330]

http://books.google.com/books?id=iJrPVZ8TVbYC&pg=PT234&lpg=PT234&dq=ems+branch+manager&source=bl&ots=1AspznX8iN&sig=7sE-82jVSCkCmhjm1XSt0QcJiY0&hl=en&sa=X&ei=iaeBUr_fJtan4APupYHoCg&ved=0CDMQ6AEwBA#v=onepage&q=ems%20branch%20manager&f=false

Wouldn't be the first time that an EMS textbook had incorrect information in it. lol

[velcroMedic1987 330]

They even have a disclaimer.

[meat441 43]

Shocking! is what comes to mind when reading some posts regarding (EMS COMMAND) and proper terminology. I can only think of MAYBE 1 time EMS (COULD) be in COMMAND. (MAYBE). But I will leave that for later. I would like to hear from people who would ever think EMS could be in command of an incident?

TERMINOLOGY!

EMS BRANCH DIRECTOR: Location, within the UNIFIED COMMAND POST.

Assisting the EMS Branch Director, EMS Branch Assistant or a Scribe for documentation. Same as a someone assisting the FIRE CHIEF at the command post. EMS STAGING (MANAGER) - separate from STAGING OFFICER for the use of deployment of EMS (transporting unit's).

Triage Group Supervisor

Treatment Group Supervisor

Transport Group Supervisor

Triage Unit Leader #1,#2,#3 and so on if required under direction of the TRIAGE GROUP SUPERVISOR.

Treatment GROUP Assistant #1,#2, or more if required. Multiple Treatment area's required. Under direction of Treatment Group Supervisor. Under Treatment Group Supervisor or Treatment Group Assistant would be Red Unit leader, Yellow Unit leader, Green Unit leader.

In (communication) with the EMS BRANCH Director and Transport Group Supervisor would be the EMS Staging OFFICER. Loading Unit Leader, Departure Unit Leader and Landing Zone Unit Leader will be under the direction of the Transport Group Supervisor.

EMS has to understand the importance and role EMS play's during the LARGE SCALE OPERATIONS. How many ACTUALLY practice this? How many MEDICS are available in your area to fill all these COMMAND positions? I have been the EMS Branch Director for hundreds of MCI's even though PARAMEDICS and SUPERVISORS were on scene. Supervisor's and Medics didn't like an (EMT) in charge of EMS operations (BUT), respected the knowledge that myself and OTHER EMT's in our system provided.

Are medics required or needed to be utilized in command positions? Maybe in your area, because 1st Responders or EMT's continue not to indulge in learning or practicing what they preach. How many 1st Responders and EMT's or even Medics practice on a regular basis MCI operations?

Other agencies look down to EMS because of their POOR Knowledge of ICS and what I've seen over and over again, Chickens running around without heads or thumping their chests at large incidents with no DIRECTION of EMS resources. DON'T get upset by what I'm saying, truth sometimes hurt, but think of incidents you have watched and said, I WISH THEY COULD HAVE DONE IT BETTER.

MEDICS are needed where they excel and that is where the PATIENTS are. Saving Lives. Primary EMS organizations need to utilize ICS functions properly so Medics can treat. UGH! My hot air. I hate when EMS agencies continue to be laughed at. Don't you think it's time to be respected?

[v85 212]

The EMS command thing is probably more local terminology than anything. I know several agencies in the Orange County area where the EMS officer at the unified command post is called "EMS Command" both by their agency and the county 911 center.

As far as scenes in which EMS would actually be in command, the only thing I can think of is something like what happened at Woodbury Commons a few years ago, with mass food poisioning from another site. (i.e. no on-scene hazmat concerns so fire wouldn't be command)

Edit: I just looked at the FEMA ICS website, and according to that the Branch directors are under the operations section chief. In the scenarios I am describing, there is no operations section chief; and what would normally be the branch directors work together to be command.

For example. Take a car fire with entrapment. The fire chief (Fire Command) would be in charge of supressing the fire and any immediate life safety hazards. Once the scene was safe, if extrication was needed, an EMT would enter the vehicle to begin treatment and prep the patient for extrication. They would communicate any need for resources/extra manpower to EMS command, who would talk with fire command about getting those resources (i.e. setting up an LZ, extra manpower, etc)

This is from the FEMA website and shows a Law Enforcement Incident Commander, and a Fire/Rescue Incident Commander

Joint Information Center

Unified Command

Law Enforcement Incident Commander

Executive Policy GroupFire & Rescue Incident Commander

Higher Ed Institution Incident Commander

Safety Officer (Fire & Rescue)

Liaison Officer (Fire & Rescue)

Public Information Officer (PIO) (Institution Spokesperson)

Assistant PIO (Law Enforcement)

Assistant PIO (Fire Service)

Agency Representatives
(Law Enforcement and Campus Personnel)

Edited November 12, 2013 by v85

[meat441 43]

Maybe that could be a confusing situation in the local and dispatch area's concerning terminology, which should be addressed by all agencies.

In this day and age of terrorism who is to say that a food poisoning is just that? That would come under the jurisdiction of the PD. The only incident that (MAYBE) EMS would be in charge of would be an evacuation of a nursing home or long care facility in which patients would need immediate transportation to other facility destinations. Evacuations due to power loss during high heat or loss of heating during cold temps. No fire, no Hazmat just a loss of local power which will not be returned in the near future. I've been involved with a number of these incidents and the only resources required was EMS. ICS played a valuable resource for priority moving, types of vehicles utilized and destination transport times dictating amount of unit's requested. New Jersey now has the ability for the use of MULTIPLE MASS CARE BUSES for this purpose under direction of the EMS TASK FORCE.

MCI incidents were brought up as to the proper use of terminology at these incidents and clarification as to proper terminology for EMS providers and distribution of staff personal was in question.

Great to see a fellow EMS responder could describe the use of ICS and it's terminology at incidents small and large. Others should take note.

[Dinosaur 844]

Shocking! is what comes to mind when reading some posts regarding (EMS COMMAND) and proper terminology. I can only think of MAYBE 1 time EMS (COULD) be in COMMAND. (MAYBE). But I will leave that for later. I would like to hear from people who would ever think EMS could be in command of an incident?

TERMINOLOGY!

EMS BRANCH DIRECTOR: Location, within the UNIFIED COMMAND POST.

Assisting the EMS Branch Director, EMS Branch Assistant or a Scribe for documentation. Same as a someone assisting the FIRE CHIEF at the command post. EMS STAGING (MANAGER) - separate from STAGING OFFICER for the use of deployment of EMS (transporting unit's).

Triage Group Supervisor

Treatment Group Supervisor

Transport Group Supervisor

Triage Unit Leader #1,#2,#3 and so on if required under direction of the TRIAGE GROUP SUPERVISOR.

Treatment GROUP Assistant #1,#2, or more if required. Multiple Treatment area's required. Under direction of Treatment Group Supervisor. Under Treatment Group Supervisor or Treatment Group Assistant would be Red Unit leader, Yellow Unit leader, Green Unit leader.

In (communication) with the EMS BRANCH Director and Transport Group Supervisor would be the EMS Staging OFFICER. Loading Unit Leader, Departure Unit Leader and Landing Zone Unit Leader will be under the direction of the Transport Group Supervisor.

EMS has to understand the importance and role EMS play's during the LARGE SCALE OPERATIONS. How many ACTUALLY practice this? How many MEDICS are available in your area to fill all these COMMAND positions? I have been the EMS Branch Director for hundreds of MCI's even though PARAMEDICS and SUPERVISORS were on scene. Supervisor's and Medics didn't like an (EMT) in charge of EMS operations (BUT), respected the knowledge that myself and OTHER EMT's in our system provided.

Are medics required or needed to be utilized in command positions? Maybe in your area, because 1st Responders or EMT's continue not to indulge in learning or practicing what they preach. How many 1st Responders and EMT's or even Medics practice on a regular basis MCI operations?

Other agencies look down to EMS because of their POOR Knowledge of ICS and what I've seen over and over again, Chickens running around without heads or thumping their chests at large incidents with no DIRECTION of EMS resources. DON'T get upset by what I'm saying, truth sometimes hurt, but think of incidents you have watched and said, I WISH THEY COULD HAVE DONE IT BETTER.

MEDICS are needed where they excel and that is where the PATIENTS are. Saving Lives. Primary EMS organizations need to utilize ICS functions properly so Medics can treat. UGH! My hot air. I hate when EMS agencies continue to be laughed at. Don't you think it's time to be respected?

If we're going to harp on terminology, it's a staging area MANAGER. The only officers are command staff positions. Think of it this way, any facility (just like hotels or restaurants) has a manager.

Branches are DIRECTORS. Look at the ICS curriculum, not an EMS text book.

Command positions should be command people. Operations positions should be operations people. Not exactly brain surgery there. If it is a medic that runs the organization, maybe he/she should be at the command post.

Assistants are for positions like the command staff. Not really in operations but I won't fall on that sword. Units are generally everywhere but Ops too. Think strike teams and task forces for Ops. You only need to expand your operations structure to manage an effective span of control. I've never seen the need for managers of the three treatment area subsets (red, yellow, green). Generally the Treatment Group Supervisor can manage that.

EMS is not the only one with a poor track record of really embracing and implementing ICS. That's been argued here many times and some very well respected instructors and advocates of the process post here (or used to in some cases). If you don't do ICS on a regular basis, you're not going to do it well when "the big one hits".

[Dinosaur 844]

The EMS command thing is probably more local terminology than anything. I know several agencies in the Orange County area where the EMS officer at the unified command post is called "EMS Command" both by their agency and the county 911 center.

As far as scenes in which EMS would actually be in command, the only thing I can think of is something like what happened at Woodbury Commons a few years ago, with mass food poisioning from another site. (i.e. no on-scene hazmat concerns so fire wouldn't be command)

Edit: I just looked at the FEMA ICS website, and according to that the Branch directors are under the operations section chief. In the scenarios I am describing, there is no operations section chief; and what would normally be the branch directors work together to be command.

For example. Take a car fire with entrapment. The fire chief (Fire Command) would be in charge of supressing the fire and any immediate life safety hazards. Once the scene was safe, if extrication was needed, an EMT would enter the vehicle to begin treatment and prep the patient for extrication. They would communicate any need for resources/extra manpower to EMS command, who would talk with fire command about getting those resources (i.e. setting up an LZ, extra manpower, etc)

This is from the FEMA website and shows a Law Enforcement Incident Commander, and a Fire/Rescue Incident Commander

Joint Information Center

Unified Command

Law Enforcement Incident Commander

Executive Policy GroupFire & Rescue Incident Commander

Higher Ed Institution Incident Commander

Safety Officer (Fire & Rescue)

Liaison Officer (Fire & Rescue)

Public Information Officer (PIO) (Institution Spokesperson)

Assistant PIO (Law Enforcement)

Assistant PIO (Fire Service)

Agency Representatives

(Law Enforcement and Campus Personnel)

Most incidents don't require branches. They just don't get that big. We tend not to organize very efficiently and use branches unnecessarily. Not wrong, just not necessary.

EMS in a unified command could be appropriately called EMS Command or EMS IC. Local preferences. In some places, they won't call EMS to the command post let alone recognize them for what they are.

If you don't have an Ops Section Chief, you probably don't need branches. Branch directors don't work together in command. The scenario you're describing sounds more like unified command.

It's all about the span of control. When you can't keep tabs of everything effectively, you need to build in another level. I've taken classes with some of the best (in my opinion) ICS instructors around and they always emphasize keeping it simple.

I'd like to see the FEMA link you're referring to. It seems like it didn't cut and paste very well. The policy group is part of MAC and the JIC is part of larger incidents not our local ones.

[v85 212]

Here is the FEMA link:

http://www.training.fema.gov/EMIWeb/IS/IS100HE/SM_PDF/L6_ICS100HigherEd_SM.pdf

Yes it's the higher education version of ICS, but the basics are the same

[Sean11FD 3]

http://training.fema.gov/EMIWeb/IS/courseOverview.aspx?code=is-100.b