ny10570

Because its not a fire based EMS system. Its a fire dept run EMS system. Bellow COD Killduff, we're as separate from Fire as we are from PD. Hell asside from the buried CFR frequency we can't hear what's going on with FD, but I have every PD frequency except CityWide2. 14 years later its still a merger in progress.
A lot of factors combined to kill the 12 hours. Rather than being optional or only affecting some units it was imposed across the entire division. Many people have set up their whole life around a certain schedule and now with only a few weeks notice they were expected to change. So from the outset there was a lot of animosity and resistance. One of the upsides was built in OT to increase our annual hours worked to match Fire and PD. A few chiefs took it upon themselves to do everything in their power to curtail this OT and in the process took away another perk to the program, consistent schedule and regular partner. In the end, the members came to generally support it but so much damage was done by management that the members torpedoed it by banging in sick (the typical EMS response when angry).
Quite a few medics have gone over. We've even lost a couple Lts to the fire side. In the last fire class there were two guys that finished 9 months of medic basic on Friday and reported to the fire academy on Monday. For a little while there was a back and forth about staffing the EMS rooms on the 343 and Firefighter II and Fire had more than enough medics with NYC REMAC cards to put a medic on the boats right then.
Too many ALS units and not enough specificity in call triaging. M'Ave what percent of your calls do the medics keep you around to help? I figure half of the time its a real medical emergency I need the CFR to stick around and maybe you can double that for the calls that should get ALS and a CFR assigned. Then there's the litany of calls where CFRs should be assigned but aren't because the moon is 3/4's and its an even day, now all my cardiac jobs magically become diff breathers.

The 343 is very significant for the impact of that moment. What happened that day. The scores of people who have and will continue to suffer the effects of working there that day is only different in the sheer number. There was a massive fire at a Bell Atlantic property in manhattan years ago (sorry, on my phone can't look up the details) that a possible cancer cluster due to a massive exposure to asbestos and vaporized metals. At the time pulmonary function tests didn't exist and firefighters rarely wore breathing protection so the real damage will never be known.
For 9/11 the real death toll will also never be tallied. The majority of the people exposed also regularly expose themselves to a host of carcinogens every day. Construction workers, especially iron workers already have higher rates than average of a variety of illnesses. Every year it seems like there's a new study about just how unhealthy firefighting is.
Now keep in mind I am 100% behind the Zadroga act. It fills a serious gap in health coverage that people should already have, but when someone comes down with xyz cancer is it because of 6 months on the pile or 20 years of smoke filled hallways, sooty PPE and diesel exhaust?

First..everyone is entitled to their opinion and in all honesty...I wouldn't have paid any mind to what they said. Their are plenty of other people who feel that tower should not be built because of the security concern and how it will be another huge target and that history may repeat itself. I often wonder and waffle on how safe it is to build it. Maybe the bartender feels the same and didn't orate it the same as I just did. And the tax comment...give me a break seriously. Everyone is crying about taxes...and again maybe not the best spoken but sounds like to me the bartender is against the construction. Don't build it..no risk to those in it or around it. Don't build it...less tax monies needed to pay for the amount of security needed for one building and resources that might be better served in other parts of the city.
Bottom line is...thicken up the skin..not everyone is going to say things you like. By all means don't return...manager blew you off..maybe it was the way you approached it or handle yourself.
And for all of you with the throw a party or meet up with a bunch of you and order up and the stiff the tip. Most places auto add a tip with a certain amount of people....so yet again...think ahead instead of responding with emotion. I lost some colleagues and a friend on 9/11. Nothing that bartender said makes me feel he/she disrespected them or anything. Ignorance doesn't wipe away ignorance. think about that one.

The 343 is very significant for the impact of that moment. What happened that day. The scores of people who have and will continue to suffer the effects of working there that day is only different in the sheer number. There was a massive fire at a Bell Atlantic property in manhattan years ago (sorry, on my phone can't look up the details) that a possible cancer cluster due to a massive exposure to asbestos and vaporized metals. At the time pulmonary function tests didn't exist and firefighters rarely wore breathing protection so the real damage will never be known.
For 9/11 the real death toll will also never be tallied. The majority of the people exposed also regularly expose themselves to a host of carcinogens every day. Construction workers, especially iron workers already have higher rates than average of a variety of illnesses. Every year it seems like there's a new study about just how unhealthy firefighting is.
Now keep in mind I am 100% behind the Zadroga act. It fills a serious gap in health coverage that people should already have, but when someone comes down with xyz cancer is it because of 6 months on the pile or 20 years of smoke filled hallways, sooty PPE and diesel exhaust?

video of explosion
http://www.nbcphiladelphia.com/news/breaking/Dramatic_Video_of_Tacony_Explosion_Philadelphia-114181874.html
Article
http://www.nbcphiladelphia.com/news/breaking/Tacony-Explosion-114177649.html
While this wasn't your typical gas emergency, there's really no half way with these calls. 99% of the time they're nothing, but that 1% where they go south do so in a big way.

video of explosion
http://www.nbcphiladelphia.com/news/breaking/Dramatic_Video_of_Tacony_Explosion_Philadelphia-114181874.html
Article
http://www.nbcphiladelphia.com/news/breaking/Tacony-Explosion-114177649.html
While this wasn't your typical gas emergency, there's really no half way with these calls. 99% of the time they're nothing, but that 1% where they go south do so in a big way.

For those companies/depts without defibs... How about sudden cardiac arrest is still killing more of us than fires. That's fine if EMS isn't your job, but CPR and early defibrillation have been proven to be far and away the most effective ways to improve survival. If your rig doesnt have a defib and your members are not trained in CPR, Just do it for yourselves. They're so cheap these days and CPR is so simple that there is no excuse not to.

For those companies/depts without defibs... How about sudden cardiac arrest is still killing more of us than fires. That's fine if EMS isn't your job, but CPR and early defibrillation have been proven to be far and away the most effective ways to improve survival. If your rig doesnt have a defib and your members are not trained in CPR, Just do it for yourselves. They're so cheap these days and CPR is so simple that there is no excuse not to.

I hate the expedite request. Give me usable info. Confirmed structure fire or occupants trapped. Upgrade the call to cardiac arrest or major injury. I understand the need by those on scene to express the severity of the emergency but repeated requests to "expedite" or "put rush on..." or "step it up" do not suddenly allow me to fire up the jato rockets and leap over the traffic.

Thanks for that vote of confidence efdcapt. I appreciate it.
PEMO3, thank you. I don't think anyone with any sense takes anything said here to heart. Faceless conversations about passionate topics are bound to illicit knee jerk comments. I have been guilty of more than my fair share.
I absolutely agree the patch means nothing so far as an ability to lead. However I to believe that for the good of the service paramedic bosses is the right step.
Back to the topic of chief Perrugia's scapegoating. The latest rumor out of the knitting circle is he will not lose his rank and is going to be reassigned to a different post. Adding the start to the chief of EMS post enabled this.

Supervisors are automatically assigned to several call types and actively encouraged to take a proactive role in patient care. They are also delegated responsibilities in determining hospital destination and RMA approval. As part of our 5 year recert program they now handle a substantially portion of our training. We have only 4 or 5 physicians for 3,000 emts and paramedics, making officers are responsible for identifying dangerous practices that require intervention and possible retraining. There is nothing that says an EMT cannot be an excellent supervisor. However your marginal and poor supervisors are much less of a problem when they know the job they're trying to manage and your excellent supervisors can become better involved and facilitate better patient care.

So by the time I got to work the were calling for 2 to 5" for the 5 boroughs. We were all issued skeds for equipment and patient transport over long distances. Two different chiefs visited the station to check salt, vehicles, snow blowers, toy shovels, and canvas members for overnight availability tomorrow. Panic mode is rocking! 6" on the ground with a blizzard warning and we had to unwrap a snow blower that had been delivered for a station that still hasn't been built. Predicting a maximum of less than 6" and everyone is in a tizzy.

FDNY minus a few very isolated examples does need the same coverage at 0300 as they need at 1500. While in the overnight you have fewer workers and less traffic you have more sleeping residents and more delayed notification. Day time you're boxed in by traffic and more units are used chasing greater call volume. No neighborhood demonstrates extreme daily swings in population better than the financial district, but even here there is a substantial residential population and a bigger than I ever imagined workforce going on in the overnights.

Correct, EMS operations runs parallel to fire operations. It gets weird where training and communications are concerned. In both cases EMS and Fire report to the same Chief, but the EMS side also falls under the command of the chief of EMS. Its potentially nightmare made functional by men like Chief Galvin who recognize the mess and don't force unnecessary involvement. Correct, EMS officers hold no more power over firefighters. Same for Fire officers over emt's and medics. Patient care we're in charge and scene safety/patient extrication you guys are in charge. As long as egos stay out it works well.
The mess with EMTs supervising medics is finally being addressed. For the last Lt exam and all future exams gotta be a medic to get promoted. Next in the pipe is actual time in the field as a medic. Here's one catch, doesn't matter what the training of the supervisor the person ultimately responsible is the highest medical authority that provides patient care. EMTs have gotten jammed up because a medic boss gave a bad order and the boss more or less skates because we operate under Dept rules and DOH/Remac rules.
EMS traditionally has been a very poorly supervised job. Back in the good ol days there would be one or two bosses patrolling an entire borough. Now you see the level of supervision we have. Its a growing process integrating the bosses into the work but little things like bosses documenting patient care when on scene before anyone else was never done and still can't be handled by our computers.

Goose is correct, Transcare 911 handily beat back unionization. Not to pick on you Goose, but your attitude is exactly why unionization won't work in EMS. Empress for all its flaws is regularly held up as an example of a quality EMS gig. FDNY EMS as backwards as it is run still has a total compensation package exceeding everyone else in the area. These aren't by accident.
I can only speak on what I know, so I'll focus on FDNY. For years pay languished and benefits slowly improved as we were just a small portion of DC37. A few of our members stepped up in leadership positions in the local and began fighting. We gained bargaining rights independent of DC37, we've lobbied for and attained pension benefits from the state legislature, and our pay increases are finally matching the other emergency services. This is absolutely because of the hard work and dedication of our union.
The single biggest hinderance in contract negotiations is our only real fallback is binding arbitration. Here our biggest hinderance is the industry's prevailing wage. The second largest EMS provider in NYC is Transcare and their total compensation is significantly lower than ours. So how do we argue that we need more money to recruit quality employees when someone else is doing the same job for less?

Goose is correct, Transcare 911 handily beat back unionization. Not to pick on you Goose, but your attitude is exactly why unionization won't work in EMS. Empress for all its flaws is regularly held up as an example of a quality EMS gig. FDNY EMS as backwards as it is run still has a total compensation package exceeding everyone else in the area. These aren't by accident.
I can only speak on what I know, so I'll focus on FDNY. For years pay languished and benefits slowly improved as we were just a small portion of DC37. A few of our members stepped up in leadership positions in the local and began fighting. We gained bargaining rights independent of DC37, we've lobbied for and attained pension benefits from the state legislature, and our pay increases are finally matching the other emergency services. This is absolutely because of the hard work and dedication of our union.
The single biggest hinderance in contract negotiations is our only real fallback is binding arbitration. Here our biggest hinderance is the industry's prevailing wage. The second largest EMS provider in NYC is Transcare and their total compensation is significantly lower than ours. So how do we argue that we need more money to recruit quality employees when someone else is doing the same job for less?

Perfectly good reason to add FD to highway assignments. But on local roads? Do you add FD to any job where the bus will be parked in the street?

Intubate the patient and maintain an end tidal CO2 between 30 and 35 mmHg. The issue with unmonitored hyperventilation is we tend to ventilate too aggressively and wind up depriving the brain of blood.

Make sure your family is aware AND agrees with your decision. No matter how you indicate it, and how many ways you make it plainly obvious you want to donate, your family has the ultimate say. All that the donor card does is indicate to the hospital staff that this is a conversation worth starting.

not exactly, bvfdjc. While rust is a result of simple oxidation there's a monumental difference between the end result of Aluminum oxidizing and steel rusting. Steel as a rule does not hold up well to oxidation, hence the development of processes like Galvanization and the multitude of stainless steels and other alloys.

The steel studs used in commercial and occasionally residential applications are made from galvanized steel. Anywhere its been cut or drilled there is eventually going to be some corrosion, but not enough to significantly weaken the structure. Any contractor can use the wrong product and screw the homeowner, however if they use the right stuff you're fine.

It happens all over. Pleasantville has two intersections of Manville and Bedford Rd and NYC has hundreds of duplicate addresses and intersections. This is why things like Automatic Number Identification and Automatic Location Identification are so important and just another reason for consolidated dispatch centers equipped with such technology.

No one has doubted their ability as providers, but spending 20 mins in an environment that created 2 serious medical conditions is a mistake in judgement. That and I hope you bought CO rather then CO2 meters.

How about one that just prints the truth?

I wouldn't say terrifying. Yes their apparent lack of knowledge could lead to problems in court and with prosecution, but there is no cataclysm on the horizon. These agents will continue doing their job likely making no fewer or no more mistakes than they currently do.