ny10570

NYS Health Law Article 30 requires all ambulance services to recieve a CON (certificate of need) from the Department of Heath. To get that you have to prove that there is a need for an ambulance service in an area and that an additional ambulance service would not (financially or membership drain) hurt the existing services. To prove need, you would have to show that calls are either not being covered or are being delayed. Since the area is fully covered by ALS services with average 4 minute response times you will not be able to prove need. An additional service will financially hurt the 2 existing services in (MV, NR, & Pelham). You could also hurt the membership rolls of Eastchester, Scarsdale and Larchmont/Mamaroneck VAC since many of there members come from NR.
Since each of the communities already have established services and are dispatched by the local police (most via a service contract) you will no be able to recieve calls.
Finally, Most VAC's are having major problems with staffing, instead of watering down the pool, why don't you join one of the existing VAC that could use the help.

Barry summed it up very nicely. You can't just "start" an ambulance service (volunteer or commercial) without demonstrating the need for it, having the financial, human resources, and logistical capital to do so, and establishing these facts to the satisfaction of the applicable regional EMS council and NYS Bureau of EMS. Since some of the most well established EMS coverage in the county exists in the area you describe, I doubt very much you'd be able to demonstrate that need and I don't know who would support such a venture with the money necessary to start-up.
If you want to do research on the efficacy of the existing systems, contact them and ask for data. Work with the region and BEMS to obtain information. You don't start a new agency to do research.
Advocating a step backward in our already troubled EMS system won't be very well received by most and the system you describe may be advantageous for a university based volunteer system but even in Syracuse, Rural Metro provides the EMS service to the city. Not a VAC.
It would make no sense from any standpoint to try and duplicate them.

A single crime, even a robbery in a sleepy bedroom community, is not indicative of a crime wave so I don't think people in Hastings need to start battening down the hatches. Reasonable security measures and awareness of your surroundings is a good idea no matter where you are whether Hastings or Hoboken.
There are relationships between crime and the economy for sure but even with that, one reported crime is a statistical anomaly.
You also have to consider the nature of the crimes. Most "home invasion" robberies are targeted victims chosen for very specific reasons so the jurisdiction is not the deciding factor.
Now, the stupidity factor knows no geographical boundaries and that exists EVERYWHERE.

Short answer is no. There is no protocol for sPO2 based therapy ALS or BLS.

Some clarifications. First, the city doesn't give a rats behind who runs the ambulances. Neither does the city council. The fire department would like to run the entire system, but that is a very expensive proposition. The only people actively pursuing an all FDNY EMS system is Local 2507. EMS DOES NOT TURN A PROFIT IN NYC. Not for the FD and not for the hospitals. The only people making money are the commercial operators, and their 911 profits are razor thin. Senior Care only began going after 911 when their growth in the transport sector stagnated. By becoming a hospitals 911 provider they also become the primary transport provider.
No matter what anyone working for FDNY*EMS says the dept has no desire to suddenly take over EMS. They don't have the equipment, budget, or staffing to make it happen. The usage fee that is to be assessed upon all of the hospitals was not designed to chase them out of the system. If it was, then why not charge something astronomical like $1 million per unit rather than the thousands per unit they settled upon? Because they wanted to get as much money without any added responsibility. This was a measure to close a budget gap. If you think chasing voluntary units out of the system helps that, please see above.
The dept has no ability to unilaterally take over EMS. They tried to kick transcare out of the system years ago, but lost badly in court. The hospitals have a contract with the city and as long as they uphold their end of the deal they keep their units.
EMS is currently "overstaffed". We were approved to hire above head count for two reasons. The first is the financial house of cards many Brooklyn and Queens hospitals are currently dealing with. Several hospitals are very close to bankruptcy proceedings or outright failure. There have been informal conversations about shuttering EMS operations and what that means to hospitals and their bottom line. The second reason for being flush with members is the revolving door that is EMS. For the past 6 years except for a few pauses we've been hiring constantly. Part of that has been the expansion of the system but a lot is also in response to a hiring binge and system expansion 25 years ago. We have a large number of members coming up on retirement. We also have members frequently leaving for other careers. The biggest destination in the coming years is going be to fire where we will see several hundred current members go.
Since St Vincents closed NY Downtown has been chomping at the bit to pick up more tours. They added an overnight coverage to one of their ALS and another 24 hour BLS. The rumored addition of a Rescue unit to lower Manhattan is not to prevent another unit from operating. Their operation is funded by federal grant money and at this point is still a rumor. The dept is not preventing anyone from running more units. Bronx Lebanon added an ALS and I believe there were two new voluntary units in Brooklyn last year.
I would expect EMT hiring to continue at its current pace. Another 60 EMTs were pulled from the streets to go to paramedic training starting today and there has been more and more BLS overtime available recently.

Did you read up on the industry before starting this thread or is this just a random train of thought that inspired you to log onto here? I only ask because depts across the country have been looking at how to reduce fleet costs. One of the big selling points of the new Ford police packages is the fuel efficiency gains without power loss thanks to the turbo charged 6 cylinder engines. Several big depts tried hybrids as part of patrol fleets and many depts of all sizes uses hybrids in non-patrol functions. At some point however savings in one category result in costs in another. The fuel savings of an all hybrid police fleet does not make up for the costs of operating an all hybrid police fleet.

"Those of us who work there by choice and those of us deployed there by duty really appreciate that there are people back home like you."
Cogs I think I can speak for many when I say we appreciate all of you over there!!!

Short answer is no. There is no protocol for sPO2 based therapy ALS or BLS.

Sadly NONE! And this is much to the detriment of the public and the firefighters. No one else has 5 man trucks and everyone else wishes and should. What is your angle man? You don't seem to get it. You could close half the firehouses, but you'll never voluntarily get that staffing.....it's that important. If it takes us longer to get there, that's on the city's hands. I wouldn't volunteer the position that allows us to do our job effectively and safely.
Like I said, not my job to adequately cover the city, it IS our job to be the best unit when we get there.
A fire engine/truck is nothing more than a tool box. The men inside are the tools. What good is a big fancy tool box with no tools.....

Justice was swift and all appeals have been denied.
Hopefully the troopers/officers are ok

Fewer companies over short staffing any day. If it takes more companies to do the job it is still going to take longer to get the job done. At least with fewer companies it is more obvious to the average citizen what they're losing. People see fire trucks they assume the help is here. They don't understand that there aren't enough firefighters. When their firehouse closes they'll take notice.

Some clarifications. First, the city doesn't give a rats behind who runs the ambulances. Neither does the city council. The fire department would like to run the entire system, but that is a very expensive proposition. The only people actively pursuing an all FDNY EMS system is Local 2507. EMS DOES NOT TURN A PROFIT IN NYC. Not for the FD and not for the hospitals. The only people making money are the commercial operators, and their 911 profits are razor thin. Senior Care only began going after 911 when their growth in the transport sector stagnated. By becoming a hospitals 911 provider they also become the primary transport provider.
No matter what anyone working for FDNY*EMS says the dept has no desire to suddenly take over EMS. They don't have the equipment, budget, or staffing to make it happen. The usage fee that is to be assessed upon all of the hospitals was not designed to chase them out of the system. If it was, then why not charge something astronomical like $1 million per unit rather than the thousands per unit they settled upon? Because they wanted to get as much money without any added responsibility. This was a measure to close a budget gap. If you think chasing voluntary units out of the system helps that, please see above.
The dept has no ability to unilaterally take over EMS. They tried to kick transcare out of the system years ago, but lost badly in court. The hospitals have a contract with the city and as long as they uphold their end of the deal they keep their units.
EMS is currently "overstaffed". We were approved to hire above head count for two reasons. The first is the financial house of cards many Brooklyn and Queens hospitals are currently dealing with. Several hospitals are very close to bankruptcy proceedings or outright failure. There have been informal conversations about shuttering EMS operations and what that means to hospitals and their bottom line. The second reason for being flush with members is the revolving door that is EMS. For the past 6 years except for a few pauses we've been hiring constantly. Part of that has been the expansion of the system but a lot is also in response to a hiring binge and system expansion 25 years ago. We have a large number of members coming up on retirement. We also have members frequently leaving for other careers. The biggest destination in the coming years is going be to fire where we will see several hundred current members go.
Since St Vincents closed NY Downtown has been chomping at the bit to pick up more tours. They added an overnight coverage to one of their ALS and another 24 hour BLS. The rumored addition of a Rescue unit to lower Manhattan is not to prevent another unit from operating. Their operation is funded by federal grant money and at this point is still a rumor. The dept is not preventing anyone from running more units. Bronx Lebanon added an ALS and I believe there were two new voluntary units in Brooklyn last year.
I would expect EMT hiring to continue at its current pace. Another 60 EMTs were pulled from the streets to go to paramedic training starting today and there has been more and more BLS overtime available recently.

Here we go. Phase 2 the threat of closures and cuts. Next up comes the sudden surplus that saves the libraries and child care programs.
http://www.reuters.com/article/2012/05/03/newyork-budget-idUSL1E8G3EVP20120503


Brooklyn Councilman Charles Barron saw the coming negotiations as a repeat of past showdowns. “It’s still the same nonsense every year,” he said. ”It’s on the City Council to say no to this budget and make him do what he should be doing with the money.”



While the mayor has proposed a balanced budget for the upcoming fiscal year, the administration is projecting a $3 billion deficit in the following fiscal year beginning July 1, 2013. After that, the forecast projects a $3.7 billion gap followed by a $3.2 billion hole

http://newyork.cbslocal.com/2012/02/03/nyc-fire-union-looks-to-speaker-quinn-to-block-fdny-closures/
A few days ago the mayor released his fiscal plan for the next few years. In it he included $50 million budget cut for FDNY. The only way they're cutting $50 million is to close houses. For anyone watching the past few years this should sound familiar. He will soon begin ramping up the media support for firehouse closures. In 2 to 3 months a revised budget will come in with an unexpected surplus from increased revenues in yadda yadda yadda. He will still push for the cuts because they are necessary to maintain a balanced budget in the near future. Come June he will submit his budget including the company closures to the city council. A few weeks of political wrangling later, the city council will approve a budget with funding restored for the firehouses. Bloomy gets to come away looking tough on those fat cat firefighters and public servants while the damn liberals in the city council continues to undo his hard work.
I am sick of this BS. I'm tired of giving up sunny afternoons for another rally at city hall. I'm tired of sitting in on long boring city council meetings. I'm tired of e-mailing and calling legislators. Sadly for another year we must continue this fight. This is a war and we have to fight every battle. If you're a teacher, cop, EMT/medic, sanitation worker, transit employee, secretary, or any other city employee this story should sound painfully familiar. He is forecasting another substantial reduction in employees on the city payroll, so look for cuts everywhere. He is also forecasting Billion dollar deficits in the coming years and claims to have exhausted the city's rainy day fund. There will be more pain and it will be wide spread. Please get involved with your union. Its going to be an election year, step up and support your local's political action agenda.
Thank you for indulging my rant.

Some clarifications. First, the city doesn't give a rats behind who runs the ambulances. Neither does the city council. The fire department would like to run the entire system, but that is a very expensive proposition. The only people actively pursuing an all FDNY EMS system is Local 2507. EMS DOES NOT TURN A PROFIT IN NYC. Not for the FD and not for the hospitals. The only people making money are the commercial operators, and their 911 profits are razor thin. Senior Care only began going after 911 when their growth in the transport sector stagnated. By becoming a hospitals 911 provider they also become the primary transport provider.
No matter what anyone working for FDNY*EMS says the dept has no desire to suddenly take over EMS. They don't have the equipment, budget, or staffing to make it happen. The usage fee that is to be assessed upon all of the hospitals was not designed to chase them out of the system. If it was, then why not charge something astronomical like $1 million per unit rather than the thousands per unit they settled upon? Because they wanted to get as much money without any added responsibility. This was a measure to close a budget gap. If you think chasing voluntary units out of the system helps that, please see above.
The dept has no ability to unilaterally take over EMS. They tried to kick transcare out of the system years ago, but lost badly in court. The hospitals have a contract with the city and as long as they uphold their end of the deal they keep their units.
EMS is currently "overstaffed". We were approved to hire above head count for two reasons. The first is the financial house of cards many Brooklyn and Queens hospitals are currently dealing with. Several hospitals are very close to bankruptcy proceedings or outright failure. There have been informal conversations about shuttering EMS operations and what that means to hospitals and their bottom line. The second reason for being flush with members is the revolving door that is EMS. For the past 6 years except for a few pauses we've been hiring constantly. Part of that has been the expansion of the system but a lot is also in response to a hiring binge and system expansion 25 years ago. We have a large number of members coming up on retirement. We also have members frequently leaving for other careers. The biggest destination in the coming years is going be to fire where we will see several hundred current members go.
Since St Vincents closed NY Downtown has been chomping at the bit to pick up more tours. They added an overnight coverage to one of their ALS and another 24 hour BLS. The rumored addition of a Rescue unit to lower Manhattan is not to prevent another unit from operating. Their operation is funded by federal grant money and at this point is still a rumor. The dept is not preventing anyone from running more units. Bronx Lebanon added an ALS and I believe there were two new voluntary units in Brooklyn last year.
I would expect EMT hiring to continue at its current pace. Another 60 EMTs were pulled from the streets to go to paramedic training starting today and there has been more and more BLS overtime available recently.

I have heard that NYPD can't bring them some places because they are too sensitive and will activate. I might be wrong but I think Grand Central is one of those places?

Imagine that.....




http://www.omaha.com...01/705099884/-1

I agree, well written post Joe. We didn't look at these calls as nuisance though.
We used to ride around the district and I'd spend a lot of time staring out the window at the neat row after row of little pink houses, block after block, ain't that America. Aided's, lift assists, water conditions, all the service calls gets all of that look behind the doors and locks of the little pink houses. The encounters would soften the hardest cigar chomping brutes of the job. They softened everybody.
There'd be the poor, frail elderly and oft neglected by remaining family or friends, victim; stuck in some torturous position for God knows how many hours, wedged behind a fixture, soiled, humiliate, scared, confused.
And the compassion that flew forth from otherwise stoic members of the services was always warming. Yet the whole scene always enveloped me. The old photos on the wall from when the husband was still alive, from their younger days of love, family, children, photos from later when those kids grew up, got married, moved on...
In the end, this poor compassion-needy person is stuck, helpless on the floor of her bathroom with acid burns from having been unable to relieve herself properly. Each and every single call, heartbreaking in a way. Makes the self-preservation instinct kick in for a lot. Trying to fit humor in some where when picking up.
In a way, Americans are all victims of our collective success, relatively luxurious compared with much of the rest of the world. Yet, here we are, all separated, elderly abandoned and left to their own means. Isolated. Alone. Half of everybody in this country has got some kind of head problem because of how we are all so alone so much even within the hustle and bustle of large populated areas.
Yeah, those lift assists. You've got to construct an iron ring around your heart for the time you do these jobs, because if you let all of that despairing into yours...it leaves scars.

Arbrow, I've been to a couple ambulance rollovers and the stretcher never came lose from the mount.

In the event if a tie, the blame falls on the ambulance. Due regard.

I understand your thought reasoning, and it's not necessarily incorrect. As a medic the last thing I want to do is go to a lift assist because most don't require ALS intervention, but...
#1 - we can't always play what-if's. I could turn around and say what if the lift assist patient did require ALS intervention and now you just delayed the medic 15 minutes because "what if a more serious call comes in", and yet that call never comes; is that fair to the person who called 911 for our services? I've personally responded to a number of lift assists that ended up being cardiac arrests.
#2 - why do we send medics to every call? Who says we have to send the medic to a lift assist? If proper EMD is done, and no flags are raised for a potential for this to be ALS, then we may be able to get away without sending an ALS unit and keeping that unit in-service for the "what if".
What if we take an FD rig out of service and a fire comes in? What if we take a patrol car out of service and a robbery occurs? We can keep on "what-if'ing" but someone's gotta pick grandma up off the floor.
We can only treat one patient at a time, one call at a time. As EMS managers, they need to ensure that their systems run efficiently with the manpower and staffing levels they have to work with without short-changing the public who deserves the services they require.

I have watched this video numerous times both straight through and stopping it and I think we are to quick to toss blame at the Philly Fire Medic driver. I would love to know if anyone knows the actual AI results on this accident. If you watch the video you will note a few key points. The vehicle ahead of the ambulance is making an unobstructed right turn without stopping, the vehicle trailing the ambulance approaches the intersection without reducing speeding and actually proceeds into the interscetion also. These two factors would lead one to believe that while the traffic signal facing the camera was red the signal in their direction may have been green leaving the car that the struck the ambulance in the right rear quarter to have been the vehicle that ran the red traffic control signal. The traffic signal facing the camera that turns green at the 00:06 mark may have actually been a delayed green and not a syncronized green. .Just my observations and conclusions not facts.

Why are we blaming the road? Reckless driving caused the accident. After the multiple fatality in which the SUV crossed the divider several years ago the city raised the divider. Shortly after the work was completed a car jumped the barrier. You will never stop these accidents from happening. Were those barriers higher maybe the van wouldn't have gone off the road and instead it would have been sent back into traffic and killed the occupants of another vehicle.

The highway construction and repair industry has been doing this far safer for as long as we've been operating on the roads. We need to take out cues from them. Clear but not blinding lighting. Separation between reflective and powered warnings. Protection lanes and vehciles while operating in traffic.

The highway construction and repair industry has been doing this far safer for as long as we've been operating on the roads. We need to take out cues from them. Clear but not blinding lighting. Separation between reflective and powered warnings. Protection lanes and vehciles while operating in traffic.