NWFDMedic

Great point that I never thought about. It's amazing what a car can actually tell you about its accident these days. My department used to cut the cables of any vehicle with a scratch on it. Fortunately, we've changed that over time. People were mentioning alternative locations for batteries. Most of our ambulances (type 2) have a battery under the hood and a second under either side of the vehicle, about in the middle. When you think about the hazards a battery can cause, it's really interesting that the batteries are kept so close to either an emergency exit (passenger side) or the fuel intake (driver side). Most modular ambulances that I've seen have a battery cabinet located somewhere accessible from the outside (in our AEV's, it's under the ALS cabinet on the passenger side).

The line officer is in charge, period. There should never be deviation from this unless the officer yields his command for whatever purpose. Also, departments that take an ex-chief and make him a "deputy chief" are doing their younger officers a disservice. The first chief that I worked under would let me maintain command of a scene, even as a junior lieutenant, so long as I had the incident in hand. It is that experience you gather as a junior officer that can make you a better chief. As far as "Ex" whatever on your turnout coat. All of it is nothing but ego. I know all of the ex-chiefs in all of our area departments and could allocate them as needed in a significant incident. Also, the ex-chief from 10 years ago that only comes out for the "big one" shouldn't necessarily be used in an important assignment. The ex-chiefs that maintain their activity in the department are recognized by both department members and mutual aid departments; they don't need a marker on their jacket to stand out. Finally, as an "ex-captain", I don't think any office should be recognized except for ex-chief on the Class-A uniform. The only thing Ex-Captain or Ex-Lieutenant means in a volunteer department means is that you didn't take the time to stick it out and move up the ranks. I would never wear an "ex-captain" badge. I have my shields and am proud of my service, but I don't want 30 badges at a parade. I'm just one of the guys.

You've got to take the oxygen tank out anyway, why not take the AED too?

There is only one situation where I have used expedite and that involves requesting PD. I've noticed many times, especially in city environments, we come upon a situation during an EMS call that requires police agency response. Sometimes it's just a report, others it could be a party in danger. Since the PD's in our area are very busy and short of manpower, I'll tell my dispatcher either "requesting PD no emergency" or "requesting PD expedited". It's quick, easy, and tells the PD dispatcher if they should have their officers drop some other important task to come to assist us. I used to use the term "forthwith" but I was either told that I sounded too much like a city person or I would get asked "what do you mean by forthwith".

First, it's SQ epi, not IM. Then again, I guess an EMT Supervisor wouldn't know that about paramedic treatment modalities. Seriously though, do you honestly think that paramedicine is flow sheet treatment? Sure there are protocols, just like every other type of medicine. However, protocols are only guidelines and paramedics should be expected to use good clinical judgment to treat each patient that presents to them and, at times, to operate outside of the box in the best interest of the patient. I think an EMT supervisor would work quite well in certain systems and I'm sure there are some great ones. In fact, there are a good number of EMT's that I work with that I would rather have as a command officer than many medics at a significant incident. Not only are they equipped with the tools to handle the situation better, I would rather have the limited supply of medics treating patients if I have a competent EMT to run the scene.

I sure hope they can find a way to fix this. NFD has done more with less for years and I think one of the reasons they don't get more is that they do their job so well. I never get into the political arguments involving NFD because I have good friends on both sides of the argument, but one thing can't be denied ... these guys put out one heck of a lot of fire with very little resources. Good luck to the NFD crew.

So now you're saying that the NATIONAL STANDARD of 8 minutes for full response to an alarm is pathetically long? If I had the full first alarm assignment at my house within 8 minutes with another fire going on in my district, I'd be jumping for joy.

I think we did just over 200 (no EMS).

But how many more resources could get to that fire at night within the NFPA 8 minutes for full assignment with nighttime traffic as opposed to daytime traffic. And yes, I realize that pulling resources from a larger geographical area would mean more relocation/backfill to prepare the system for the next call. Maybe those resources aren't available in the current system, maybe they are. I don't know the answer to that question because all you hear is mandates from the City and anecdotal evidence from the Union. I haven't once said that there need to be cuts but it amazes me how quickly people shoot down the idea of trying to do things better versus doing things traditionally when it comes to the fire department. All I know is that every time cuts are suggested, the Union says lives are at risk and the City says the cuts are necessary and won't impact operations. Neither, however, gives out facts to support their claims.

I don't know what website you got that from. We don't do EMS.

I wasn't equating "like a business" to "profitable". What I meant by more like a business is that they need to constantly analyze needs and to correlate expenditures to those needs. It makes no sense to keep a firehouse open at night because its needed during the day. It does make sense to keep that firehouse open at night if there is a proven need for it. I find it extremely hard to believe that FDNY needs the same amount of resources at 0300 than it does at 1500.

Relevance = 0.

Thanks for the intelligent reply. It's much better to see that some actually can think rather than put out the old argument of "what if your family lives next to a fire house that's closed?" You are right that "call volume" isn't the best way to allocate staffing. However, I'm fairly certain that the FDNY would track things such as personnel used and manhours per incident. That, along with response time and a few other factors can lead to a better analysis of the system's needs. As far as knowing "when and where" your calls are going to be, you obviously cannot plan the exact time and location but you can very easily model trends, especially in an area with as high a volume as NYC. That's the principle behind system status management, generally predicting the area of the next call and positioning resources to handle that call. One of the previous posters said that his company is second due for a structure fire that is 10 minutes away if a first structure fire is already going. My next question to that would be how often does this happen. If it happens once a year, then it may not pay to add resources. If it happens once a week, then staffing might have to be increased. This is all learned through proper analysis of the system, something which nobody appears willing to do. The government just wants to cut; the Union just wants to save jobs ... neither is a productive view.

Seriously? At least you can come up with a better argument. I guess we should just build an engine and truck company onto every house that is built.

So you're saying that with one full box out that your company is the second due to areas that are 10 minutes away? That sounds pretty good to me.

While this may be true, how many fatal fires could the FD have saved the deceased with a minute or 2 quicker response? I think the City needs to look at an "acceptable" response time for an FD engine, for a second alarm, for an all-hands fire, etc. If this can be accomplished with less companies at night, then so be it. They may actually realize they need even more staffing during the daytime to accomplish their goals. The FD needs to be run more like a business. Just because they've always done it this way doesn't mean it's the right way. Conversely, a good analysis might show that the way they are doing it IS the right way. The one thing that I'm sure of is that looking at call volumes and reports that tell only half the story isn't the right way to make a decision.

Seth, The FDNY has never had such an incident where they couldn't get around in the snow. The question has to be "why this storm?" The City received less snow than the Hudson Valley and my town roads were clear by 0600 Monday morning. Other towns were not so lucky, but by noon, just about everything was passable. This snow was light and could be moved easily by plows. Furthermore, because it was so light, it didn't pile up anywhere near as badly as the storm in February. There are a few things that it seems the City is attempting to send to the back burner about this storm. First, it was reported early that private contractors are relied upon in heavy storms to assist the Sanitation Department with snow removal. Reports were that these contractors did not sign on with the City this year. I would question why... were there problems getting paid? was the City not paying enough? Of course, these questions reflect right back to City Hall, so it will be easier to demote an EMS chief and cast the spotlight that way. Second, what was up with the Department of Sanitation? There were reports of untrained drivers, work slowdowns, etc. Who the heck is running this joint and why was this allowed to happen? Chains and 4 wheel drive ambulance come at a great and continuing expense. A 4 wheel drive ambulance not only costs more at the dealer, the maintenance costs are higher, fuel consumption is higher, and vehicle life is generally shorter. Chains are also an expensive option for an ambulance. I'm also not sure the tire chains that most use today (on spot type) would have been particularly helpful in moving around in this storm. I think you have to consider every dollar spent as a risk-benefit analysis. This "once a decade" storm caused so many problems for EMS getting around, but they didn't have the same problems in a worse storm in February, and there were several "other" factors that may have led to their problems. Does is make sense to spend money on tire chains or maybe CPAP, which could save lives every day, especially when it isn't yet known if these "other" factors were actually more responsible? One thing we have done as a company is to get a bit more expensive tire for our ambulances. The stock tires that come from most manufacturers are not made for winter terrain. We buy a tire with an extremely aggressive tread pattern and there is a noticeable difference in the operation of the ambulance. Maybe an extra $20 a tire on their ambulance might fix the problem instead of a couple thousand dollars an ambulance in tire chains.

A question for those more familiar with FDNY than I am... Is it currently the case that every house is currently staffed 24 hours, regardless of the volume of calls? I would think that it would just make good sense that there are more personnel and units on staff during the day than at night.

Arrest records are not only public records, they will never disappear from the information that a good investigator can obtain about you. Even if you are eventually found not guilty or even exonerated of all charges, the arrest record is still on your record. There are a few cases where a judge can find that the record of an arrest was extremely prejudicial and can choose to have it expunged from your record, but you really have to petition hard for that (unless, of course, you are a minor and those records are generally sealed). And yes, John Doe can walk in off the street and request the NYSP's arrest records for that Troop/Zone under FOIL. However, they don't necessarily have to do a search for you. You need to know what you're asking for (i.e. all arrest or blotter records from time A to time and they only have to provide you the record in the way they store it. In other words, government agencies are not expected to make special reports just to satisfy a FOIL request.

Snow chains or 4x4 ambulances would be a tremendous waste of money for a once a decade (or less) storm. Then again, I wouldn't put anything past government wasting money. There are plenty of places to look for blame for the response to this storm, the vehicles were not one.

Wow, I didn't even know Phelps had a multi-victim chamber. We've always brought our CO cases to Jacobi.

There are definitely HIPAA concerns which is why my company doesn't have the common patients function enabled. However, it is great that so much information populates automatically. On transports, we get any patient information entered into RightCAD from our dispatchers, so it makes transport PCR's a piece of cake. As far as the ePCR is concerned, some people love them, some would rather have paper. A few large studies of ePCR's have generally found that there is very little time savings but after the initial learning curve, the time to complete an ePCR is just a tad longer than a written PCR. They extra time, however, has generally resulted in better documentation and a better system for QA/QI. Our software allows us to have any number of "close call rules" that won't allow the EMT or Medic to complete the PCR until certain fields are completed. The system is also so sophisticated that it can do "if...then" relationships (i.e. if you relate the primary impression as Stroke/CVA, you must fill out a stroke scale). Billing agencies will also find the ePCR will increase the number of properly billed calls and increase the turnaround time for recovery. The only concern I would have about a volunteer agency using the ePCR is the significant learning curve. If you only do a couple of calls a month, the ePCR would be extremely cumbersome to those members who are not computer savvy.

I've heard this argument more than once over the past couple of days. The answer to that question would be "how many storms in the past 30 years have caused such delays?" Sure we would like to have every resource for every situation every time but that's virtually impossible.

How is the old New Windsor R-448 doing up there in Milan?

Chief, we've beaten this policy to death in our own town, so there's really no reason to beat it here in a public forum. I do have a couple of observations though, strictly related to the procedure, not our town's case or the particular call in question... First, it is my belief that most county dispatch centers operate to some sort of standard information gathering protocol. There is EMD for medical related incidents but there are also similar protocols for fire and PD. If a call is triaged by a nationally accepted protocol to MVA-Fire Response, is there any liability on the FD or the local PSAP if they decide to follow a different guideline for the dispatch of FD? An associated question for the dispatchers would be if it is appropriate to institute different response protocols for each agency that is dispatched? For EMS, the county uses EMD to prioritize calls and the only deviations were instituted county-wide (i.e. the county's mostly volunteer BLS EMS agencies did not believe seizures should ever be coded P-4). The second issue is more police related. Back when I worked in an area that had volunteer FD response only upon "confirmed" situation, the PD often took several liberties in order to avoid the FD response. On more than one occasion, I had a PD officer pulling on a door saying "it's not stuck that bad and I don't need the FD here @#$#ing up traffic". When I requested the FD to respond, I was told that the PD wasn't going to allow it. To the LEO's out there (not you chief, as I've worked alongside you for years and know your opinion and experience), is there some type of lack of training or respect for the priorities of PD, FD, and EMS at the scenes of MVA's? I'm not looking for individual cases where agency A did this but rather some suggestions that might help all 3 functions work well together. It seems to me that FD and EMS in most areas seem to drill together (although not enough) to address interagency concerns but the PD is rarely a participant.