Reputation from efdcapt115 - Page 15

sfrd18 liked a post in a topic by efdcapt115 in Fdny Rescue 1 July 16, 2012

"Outstanding."

efdcapt115 liked a post in a topic by antiquefirelt in Maine EMTs Treating More Cardiac Arrest Victims at Scene July 17, 2012

I'll just note that we go far beyond the level you speak of here. It doesn't matter how long the victims been down in most cases, they get worked where they fall, short of the public spectacle or other mitigating circumstances. Witnessed arrests are maybe slightly more likely to be transported, but basically our personnel begin aggressively treating any arrest in the field and after 20 minutes of failed effort the medic will usually call the ER Doc (which is not required, but has numerous benefits).For us, how easy it is to load the patient is a significant factor. Kids almost always get scooped up and transported. It's far more difficult to convince a parent their child is gone and the ER wouldn't have made a difference. Also, we know the younger the person the better chance of recovery, so why not be heading where your going anyway? Lastly, somewhat selfishly maybe, no one wants to have to pronounce a child if they have another option. On the other side of this, codes out in public usually have the benefit of an easy load and go scenario (off the side walk, grocery store floor, on the lawn, etc), so these folks also get transported. But, in a difficult or labor intensive extrication to the bus the quality of your treatment actions suffers, thus, they most often are treated where they drop.

efdcapt115 liked a post in a topic by antiquefirelt in Maine EMTs Treating More Cardiac Arrest Victims at Scene July 17, 2012

This story got a pretty good laugh around the table on Sunday. We've been doing this for at least the last 10-12 years and really had no clue that others weren't. It's possible that we had a few forward thinking Doc's as our E.R. medical control that transitioned us to this, as we have only one hospital to transport to. In Maine each "region" has a regional medical control doctor that can impact the local protocols.
We used to bring all Code's into the E.R. only to have the Dr. call them pretty early on after arrival. Once our staffing was such that we were putting paramedics on 99% of the runs, nearly all the cardiac arrests were worked in the field and transport was only indicated where there were signs of positive results. Our state protocols have always allowed paramedics to call codes in the field, and in the last few revisions they can do this without advice of medical control (we get them on the line anyway, no harm can come of having a doc back your decision). Nearly 50% of our career staff are paramedics so aggressively treating on scene is easy for us, those with fewer or no medics need to begin transport, and once the patient's in the bus it's nearly as easy to transport (set aside the financial impact or public perceptions).
As far as observations having utilized this for a decade:
1. It's not as easy as following an algorithm, you have to look at the total situation. We haven't and likely won't ever leave a patient in a public place, short of the arrest being a result of a crime. It's one thing to speak the family, it's a whole different ballgame to convince a crowd.
2. For us with plenty of medics it's different than those who are waiting for a medic to arrive, if by chance we have no medic it's back to bag and drag while a medic is called in.
3. Speaking to the family is very difficult when the deaths is unanticipated or they're just not ready, how this is done and by whom is important. We always send an engine to back up the bus on cardiac arrests (and others) calls and the responsibility generally falls to the officer and often the senior medic. The officer is usually more hands off the pt. so he/she ends up having more interaction with the family and/or bystanders. They gather information on the pt., medical history, drugs, allergies, recent events, etc. Most explain to the family while treatment is being done, why we're not just taking them to the hospital, explaining the pt. is getting everything they'd get there, right now, not 10 minutes from now and without losing any continuity of treatment. If they are unconvinceable we try and get the ER Doc on the phone and let him/her explain.
4. Some people cannot be convinced that we're not all just medical taxi drivers, and in cases where tensions or emotions runs too high, we transport.
Nice to know we were ahead of curve, at least up here anyway.

efdcapt115 liked a post in a topic by towerladder2 in FDNY DISPATCHER EXAM July 17, 2012

Very wise words from JBE.... Anyone looking to take the test, heed his advice... I am starting my second year... It can be a GREAT job... You have to put in the effort, but will be rewarded with a job that has alot of great benefits....

efdcapt115 liked a post in a topic by JBE in FDNY DISPATCHER EXAM July 17, 2012

When you first get on, it's 4 weeks of training. Then onto the platform for a few months of 1100X2300, working the same chart as the rest of us. 4 on, 4off, 4 on, 4 off, 4 on, 5 off. Then you go back for radio and Voice Alarm Training, then back out to 11X23, then Decision Dispatcher Training, then back to 11X23 until the brass says you can go to 07X19/19X07. I will tell you all now, be prepared for a commute to Downtown Brooklyn. Manhattan, Brooklyn, and SI are all located in the same building. You may or may not get the Bronx or Queens out of Probie School.
I wish you all the best of luck. But I warn you all now. If you get on, do not expect to be treated differently because you are a Volunteer whatever. Do not go into my job thinking you're going to be better than anyone else because you have experience in the fire service. I came in with that "I am a buff" attitude, and I paid for it dearly.
Do not expect special treatment because you know someone on the job. I would rather take someone who knows nothing about the fire service, or very little about the fire service, because I can mold you into what the job wants you to be. You will pay your dues, and it will make you a better dispatcher, and hopefully a better person.

efdcapt115 liked a post in a topic by SOUSGT in More Fuel Efficient Police Cruisers July 17, 2012

The light bar is almost as big as the vehicle and would probably reduce any savings in fuel economy as it would create more drag and cause the engine to work twice as hard.

efdcapt115 liked a post in a topic by JetPhoto in More Fuel Efficient Police Cruisers July 17, 2012

This is your new RMP, like it or not!
LOL