NWFDMedic

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  1. x635 liked a post in a topic by NWFDMedic in Harrison EMS Issues   
    HEMS is a private service, so the town has no right to review their books.  They can, however, require statements of financial solvency as well as a periodic audit performed by a third party.  The town also has the right to require certain things in their contract, which I've seen in several contracts, especially with these "quasi-municipal" services.  If the town wants to require, for example, $100,000 of the money provided to go to training, HEMS could be asked to provide documentation of that.  If the town wants to pay a contract based on covering the "gap" between billing and recovery for town residents, they can ask for that documentation.  I was treasurer for one town ambulance that had a contract with the town stipulating that all funds received from the town had to go directly to operations related equipment/supplies/training and we provided documentation of that quarterly.  In fact, we maintained separate accounts for donations and such that we used for non-operations related expenses.
     
    HEMS does not, however, have any requirement to "open the books" for the town.  As a not-for-profit, a lot of their information is available publicly anyway.  Although they are not required to do so, a lack of cooperation between a town and the "quasi-municipal" service generally ends up spelling trouble for the EMS service.  
  2. fdalumnus liked a post in a topic by NWFDMedic in Editorial: State must reduce obstacles to EMTs   
    I think it's all a matter of perspective.  This article came from a paper in Plattsburgh.  Although they are still part of New York State, the climate of Clinton, Essex, Franklin, and St. Lawrence counties is really like a different world than what we are familiar with in the Hudson Valley.  When I lived in Potsdam, you would never get a paramedic to your house and when you were lucky enough to get a level 3, it was a volunteer from one of the larger villages or towns that could be 30-40 miles from your home.  Northern New York is one of the most economically depressed areas in the country and they rely heavily on the volunteer services to provide fire and EMS.
     
    If you look at Westchester or the Hudson Valley, you'd probably think this article is a joke.  We've come to expect paramedic care as the standard and we are even expecting a higher level of care and training from BLS providers.  With the decreasing availability of volunteers, communities are realizing that they have to spend dollars to maintain the level of service they expect.  Upstate, I would imagine that they'd be willing to take the trade-off of less training for more people able to respond, especially at the volunteer level.
     
    With that being said, I took my first EMT class in 1993 in St. Lawrence County.  The class that they taught up there was 100% different than the EMT classes you would find in the Hudson Valley, even at that time.  They really focused on patient assessment and finding "true" emergencies because of the limited ALS resources in the area.  Where "contact ALS" is a staple in the discussion of patient care scenarios in the EMT class down here, they were teaching technicians to do a lot more before getting a volunteer from 3 (large) towns away up for a routine workup.  I'm not saying that it's right or wrong; it's what worked up there.
  3. x635 liked a post in a topic by NWFDMedic in Empress EMS New 2013 Dodge Charger AWD Flycar 43-M-1   
    They look like a good purchase for Empress, especially as the cars will operate primarily in a city environment, even if it is pretty hilly. I'd imagine this less expensive alternative could also allow them to extend the service life of their SUV's and have them available for use when the snow and ice really start flying.
  4. x635 liked a post in a topic by NWFDMedic in Empress EMS New 2013 Dodge Charger AWD Flycar 43-M-1   
    They look like a good purchase for Empress, especially as the cars will operate primarily in a city environment, even if it is pretty hilly. I'd imagine this less expensive alternative could also allow them to extend the service life of their SUV's and have them available for use when the snow and ice really start flying.
  5. 201/65 liked a post in a topic by NWFDMedic in Orange County's new proposed renumbering plan   
    This fight has been going on for at least 20 years. I can remember as a young buck when they were first establishing the 911 system, people realized that the numbering system was both random and really stunk. There were several proposed new systems, all of which were met by senseless arguments. They ranged from "who is going to renumber our vehicles" to "my department number from the state has a leading zero, what are we going to do with that" (not really a senseless argument, since it causes havoc in many computer systems) to "we're department 36, we don't want to change our number for the county" to "we've been doing it this way for X years, why change". Well, as usual, politics being what they were, we've gone 20 years and no improvement in the system.
    The first solution to this "problem" is having command officers familiar with the capabilities of their neighboring departments. Nothing will ever be perfect for the mutual alarm assignments as you can cross battalion, county, and even state lines but you should know what your neighboring departments' equipment for the first few alarms. For example, my department was dispatched mutual aid to a bordering department with a FAST team several years ago and, at the time, our FAST team's response was with our rescue. We were instructed by command (via county, a whole different communications issue) to hit the hydrant at the corner of street A and B. I was absolutely appalled that the command officer of a bordering department didn't know that (1) our rescue was coming with our FAST and (2) the only pump on our rescue was a portable pump.
    Once the poor training of command officers is dealt with, the poor information availability at county needs to be dealt with accordingly. Trying to make a standard list of equipment that has to be announced with every transmission to county is just making life more difficult for everyone and it will never deal with every special request. Get back to the basics: engine, tanker, ladder, tower ladder, rescue, utility, boat, misc. (add in squad or light rescue if it really meets your fancy). If you need a specific resource as command and you are beyond the area that you know, that's fine. "KEE-315, 36 Control, Orange 911, I need the next available heavy rescue, high volume engine, high volume hose vehicle, etc. etc." The CAD system should be able to have qualifiers on each piece of apparatus and allow the 911 center to dispatch the closest available unit to meet command's needs (that's if they listened to me because I failed to wait to be acknowledged). That's where your additional information is placed, not on some radio identifier.
    Departments also need to get over the whole "my department number is whatever follows the 360xx in the state system". The state system is not a perfect fit for your department's radio ID, nor was it designed to be. For example, Ulster County did not eliminate trailing zeros in their system, which is a communications nightmare. For example, is "Car Eighty Three" the third officer of New Paltz Rescue or the first officer of Mobile Life? Changing the radio identifier to "80 dash three" to eliminate this confusion was a patch, not a fix. It's only good until the first person forgets, then you have confusion. The Dutchess system starts at 31 and has no trailing zero companies, thus eliminating that confusion.
    Learn from the past mistakes or things that don't work quite right in other neighboring systems and come up with something that makes sense for Orange County. Put aside politics and petty gripes and get the knowledgable people in our county together at a table and let them hammer out a system that is truly beneficial for fire response. While they're at it, maybe they should look into an avenue for common communication between fire and EMS. The OC911 center is so concerned about the traffic coming through their radios, why am I always tying up 2 dispatchers and 2 frequencies to transfer information between fire and EMS? There are a lot of good ideas roaming around the county system, they just seem to all be off on different tangents.
  6. 201/65 liked a post in a topic by NWFDMedic in Orange County's new proposed renumbering plan   
    This fight has been going on for at least 20 years. I can remember as a young buck when they were first establishing the 911 system, people realized that the numbering system was both random and really stunk. There were several proposed new systems, all of which were met by senseless arguments. They ranged from "who is going to renumber our vehicles" to "my department number from the state has a leading zero, what are we going to do with that" (not really a senseless argument, since it causes havoc in many computer systems) to "we're department 36, we don't want to change our number for the county" to "we've been doing it this way for X years, why change". Well, as usual, politics being what they were, we've gone 20 years and no improvement in the system.
    The first solution to this "problem" is having command officers familiar with the capabilities of their neighboring departments. Nothing will ever be perfect for the mutual alarm assignments as you can cross battalion, county, and even state lines but you should know what your neighboring departments' equipment for the first few alarms. For example, my department was dispatched mutual aid to a bordering department with a FAST team several years ago and, at the time, our FAST team's response was with our rescue. We were instructed by command (via county, a whole different communications issue) to hit the hydrant at the corner of street A and B. I was absolutely appalled that the command officer of a bordering department didn't know that (1) our rescue was coming with our FAST and (2) the only pump on our rescue was a portable pump.
    Once the poor training of command officers is dealt with, the poor information availability at county needs to be dealt with accordingly. Trying to make a standard list of equipment that has to be announced with every transmission to county is just making life more difficult for everyone and it will never deal with every special request. Get back to the basics: engine, tanker, ladder, tower ladder, rescue, utility, boat, misc. (add in squad or light rescue if it really meets your fancy). If you need a specific resource as command and you are beyond the area that you know, that's fine. "KEE-315, 36 Control, Orange 911, I need the next available heavy rescue, high volume engine, high volume hose vehicle, etc. etc." The CAD system should be able to have qualifiers on each piece of apparatus and allow the 911 center to dispatch the closest available unit to meet command's needs (that's if they listened to me because I failed to wait to be acknowledged). That's where your additional information is placed, not on some radio identifier.
    Departments also need to get over the whole "my department number is whatever follows the 360xx in the state system". The state system is not a perfect fit for your department's radio ID, nor was it designed to be. For example, Ulster County did not eliminate trailing zeros in their system, which is a communications nightmare. For example, is "Car Eighty Three" the third officer of New Paltz Rescue or the first officer of Mobile Life? Changing the radio identifier to "80 dash three" to eliminate this confusion was a patch, not a fix. It's only good until the first person forgets, then you have confusion. The Dutchess system starts at 31 and has no trailing zero companies, thus eliminating that confusion.
    Learn from the past mistakes or things that don't work quite right in other neighboring systems and come up with something that makes sense for Orange County. Put aside politics and petty gripes and get the knowledgable people in our county together at a table and let them hammer out a system that is truly beneficial for fire response. While they're at it, maybe they should look into an avenue for common communication between fire and EMS. The OC911 center is so concerned about the traffic coming through their radios, why am I always tying up 2 dispatchers and 2 frequencies to transfer information between fire and EMS? There are a lot of good ideas roaming around the county system, they just seem to all be off on different tangents.
  7. NWFDMedic liked a post in a topic by ny10570 in 2012 NYS EMS Changes   
    Licensure vs certificate has no bearing on the perception of EMS as a career or just a job. It has zero bearing on our pay or our respect as profession. Its a semantics argument and nothing more. Guess what, doctors and nurses have to regularly recertify with their various boards through testing and continuing education. Instead of paying the state for our license and then some private group for their seal of a[[roval we just have to pay the state to retest us. I don't want someone stepping away for a few years and then being able to come back and work just because they've been paying their dues. We b**** constantly about the decrease in standards yet people would encourage something like this??
  8. firedude liked a post in a topic by NWFDMedic in 2012 NYS EMS Changes   
    I know this is just one person's interpretation of what is in writing but it seems that authority is being centralized at the state level. It also seems that they are simultaneously shifting a lot of SEMSCO and SEMAC's authority over to the Commissioner.
    As far as centralization at the state level, New York is looking to match several of the smaller states around us. I think that New York is a bit of a different animal though. Having lived and volunteered in St. Lawrence County, I can completely understand that some of the further regions of the state require significantly different protocols than the more urban or suburban regions of the state. I don't think one formula works for such a diverse state. Also, the bureaucracy involved with trying to get something passed at the state level will, in my opinion, hamstring those organizations that have traditionally been leaders in the progress of EMS in the state. Trying to get an aggressive new trial program approved to bring better care to our patients will likely be buried in red tape.
    The regional system has many of its own problems but I don't think that removing them from the equation is the right thing to do at this point in time. Fix the problems at the state level first, make that a smooth running organization, and then revisit the consolidation of the regional authority.
  9. firemoose827 liked a post in a topic by NWFDMedic in Responding to Gas Emergencies   
    Two things you do for that situation. #1. Protect yourself and set an example for the younger folks who may not know any better. #2. Vote that Lt. out at the next election.
  10. xfirefighter484x liked a post in a topic by NWFDMedic in Care 1 EMS   
    Nathan's post was in English and stated the same facts that yours did. There were no word games, as you call them.
  11. NWFDMedic liked a post in a topic by helicopper in EMS response to and operations at fires in Westchester County   
    EMS shouldn't be "pulling FF for rehab", it should be a regular part of the FF rotation through operations. Gotta change bottles? Gotta go through rehab.
    Otherwise it is almost always forgotten and if you leave it to the FF you'll always hear "no, I'm good. Just give me another bottle". This brings us back to another point that has been discussed here before, do IC's have enough resources to properly rotate people or do they have "just enough" to get 'er done?
    Not to shift gears too much but does rehab document each contact with an FF to identify potential trends toward a problem? Are they comparing initial vital signs with vital signs after an hour or two to detect that someone's blood pressure is high?
  12. helicopper liked a post in a topic by NWFDMedic in EMS response to and operations at fires in Westchester County   
    Actually, conventional wisdom says that rehab should be away from the fire scene. Rehab working or not working has nothing to do with its distance from the fire scene. If command constantly promotes an environment where rehab is routinely performed then it will become part of the firefighting process.
  13. ny10570 liked a post in a topic by NWFDMedic in White Plains Ambulance Moved At Scene By Civilian   
    While this is obviously true, nobody should take what isn't theirs, the crew put a lot of people in danger by leaving the vehicle unsecured. I'd also venture to be that they violated DOH policy.
  14. Danger liked a post in a topic by NWFDMedic in Volusia County, FL new Braun Ambulance   
    This truck is doing a disservice to both Fire and EMS. They can keep it in Florida.
  15. Danger liked a post in a topic by NWFDMedic in Volusia County, FL new Braun Ambulance   
    This truck is doing a disservice to both Fire and EMS. They can keep it in Florida.
  16. Danger liked a post in a topic by NWFDMedic in Volusia County, FL new Braun Ambulance   
    This truck is doing a disservice to both Fire and EMS. They can keep it in Florida.
  17. Danger liked a post in a topic by NWFDMedic in Volusia County, FL new Braun Ambulance   
    This truck is doing a disservice to both Fire and EMS. They can keep it in Florida.
  18. RBFD4 liked a post in a topic by NWFDMedic in New Rochelle reduces minimum staffing for Fire Department, cites finances   
    It just seems like a lot compared to the cities up this way.
  19. NWFDMedic liked a post in a topic by ny10570 in Gas for Volunteer Members   
    As others have pointed out, I haven't seen a retention program yet that actually retains members. No active member that's already given up dozens of hours of his time to training, respond at all hours of the day and night, and that shows up to house duty and all the other regular obligations is not about to resign over 50 cents a gallon for regular or diesel. If you want to retain members do things that help them do the job. Spend money on the faulty equipment that guys are sick of dealing with. Ensure members have up to date gear that fits. A real bunk room for standbys in that new fancy firehouse. New and different ways of approaching the same old drill topics. There are better ways to spend retention money than on parties and pension programs.
  20. PEMO3 liked a post in a topic by NWFDMedic in FDNY EMT Assaulted at Occupy Wall Street   
    They should arrest every one of the protesters that allowed this unsafe situation to happen. They can then start a new occupy movement at Rikers Island.
    Speedy recovery to the MOS injured.
  21. PEMO3 liked a post in a topic by NWFDMedic in FDNY EMT Assaulted at Occupy Wall Street   
    They should arrest every one of the protesters that allowed this unsafe situation to happen. They can then start a new occupy movement at Rikers Island.
    Speedy recovery to the MOS injured.
  22. PEMO3 liked a post in a topic by NWFDMedic in FDNY EMT Assaulted at Occupy Wall Street   
    They should arrest every one of the protesters that allowed this unsafe situation to happen. They can then start a new occupy movement at Rikers Island.
    Speedy recovery to the MOS injured.
  23. PEMO3 liked a post in a topic by NWFDMedic in FDNY EMT Assaulted at Occupy Wall Street   
    They should arrest every one of the protesters that allowed this unsafe situation to happen. They can then start a new occupy movement at Rikers Island.
    Speedy recovery to the MOS injured.
  24. PEMO3 liked a post in a topic by NWFDMedic in FDNY EMT Assaulted at Occupy Wall Street   
    They should arrest every one of the protesters that allowed this unsafe situation to happen. They can then start a new occupy movement at Rikers Island.
    Speedy recovery to the MOS injured.
  25. PEMO3 liked a post in a topic by NWFDMedic in FDNY EMT Assaulted at Occupy Wall Street   
    They should arrest every one of the protesters that allowed this unsafe situation to happen. They can then start a new occupy movement at Rikers Island.
    Speedy recovery to the MOS injured.