NWFDMedic

At least confer with the PD on scene before doing anything non-emergent to a vehicle involved in an accident (I'm not talking about extrication, I'm talking about things like cutting battery cables). If there is a serious injury or death and the possibility of an accident investigation cutting the battery cables may result in the loss of evidence and/or a difficulty in accessing evidence (computers, lights, vehicle settings, etc. More often than not you don't have to do anything to the vehicle especially if the victims are out.

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).

I don't think it has to do with respect as much as with fireground experience. My town's department does have or at least had, a few captains/lts in their mid twenties, with only around 5 to 8 years of interior experience, as opposed to a past chief with 20 + years of experience

And not all ex-chiefs are on the line, I believe we do have a few company lieutenants who are past chiefs as well.

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".

I need to address a previous comment. NY10570 I was one of those "dumbed down" EMT Supervisors (Lieut) in the NYC EMS system and had absolutely no issues with supervising both EMTs and Paramedics on a daily basis and actually enjoyed it. I found that there was extreme cooperation from both levels of personnel and knew my job was to enforce procedure and review what was within my scope of training. The issues arise when medics carry a "mightier than thou" attitude because of their level of training and forget that without BLS there is NO ALS and also forget where they came from, they were once one of those "dumbed down" EMTs. Don't throw stones when you live in a glass house. Lets talk dumbed down. Being a medic is not Roy and Johnny. It is flow sheet medicine. If you do A and see B then do D not C. There are even pocket protocol charts and I-Phone apps. Not that there is anything wrong with it but don't knock one area of a system because of a swollen ego. If swelling has become an issue some IM epi or benadryl might help but I am working out of my area to suggest that. Stay dry and safe in the snow today and remember we are all there for the same thing: the patient.

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.

I'm going to start by saying one thing; NFPA is a broad baseline that does not always apply well in large urban settings. Furthermore, their 8 minute response ideal is pathetically long. Second portion of your post about saving lives vs. the city's claim of cuts having no impact on response times. This is incorrect. The fire commissioner stated plainly that operations would be impacted if his cuts were in acted.

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.

My bad. I looked up New Windsor FD(in NY), but the one in Maryland came up and I did not look closely enough to recognize the difference. Just for the record, how many runs did NWFD do last year?

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

In the abstract, it's probably true that overall the FDNY uses less resources at 0300 than it does at 1500. However, the fire that occurs at 0300 will likely require the same amount of resources as the one that occurs at 1500. There may be a population shift between night and day, but the number of buildings remains static.

As I said earlier, we never know where or when that next fire will break out. That's why the firehouse would still be needed at night even if it's "needed" more during the daytime because of higher call volume during those hours.

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.

Actually, this is VERY relevant. Population density has a direct relationship with call volume. From another post on this website "FDNY 489,354 total incidents. 213,292 EMS Runs. 26,595 Structure Fires." NWFD (from their own website) "269 Fire Calls. 502 EMS." Way different worlds.

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

If the FD were run like a business they would be out of business they are not cash positive, they are life positive. Think of the FD as a "loss leader" for a business. You might not make money on it, but you need it to survive.

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.

NWFD- Doing a quick search, I found the population density of New Windsor is about 650 per square mile. New York City has a population density of 27,532/sq mi. That is 42 TIMES more dense than New Windsor. A 10 minute response time covers maybe a few hundred thousand people. This IS a big deal.

Relevance = 0.

And what "business model" do you suggest?

I certainly don't disagree that analyzing your operation to see if changes are warranted is appropriate. However, an inherent problem with the "run it like a business" line of thinking is that FD deployment and working conditions are not like most business operations.

Probably one of the closest comparables is the food service industry. Typically, a restaurant will have a dynamic plan regarding their operation. Their staffing will typically peak around the "normal" meal times and then shrink back between meal times. This makes sense since you know when your highest demand periods will be each day and you can adjust for it. Now, there will be times when you get an off-peak rush, but you can generally handle it and the main consequence is generally a dining experience that isn't as efficient with the smaller staff. Additionally, if a meal period isn't as busy as predicted, some staff may be sent home early.

This type of planning doesn't lend itself well to the fire service. The main problem is the inherent unpredictability of the work and the varying levels of personnel needed to perform that work. You can look at call volume and see that "more" calls occur during the daytime than at night, but you'd be foolish to base staffing on just that. Most calls aren't going to be very labor intensive and require large sums of personnel, however some will and you will need those people in order to effectively and efficiently mitigate that problem. Another problem is that we also don't know where to problem will occur. The restaurant will always know that they will be feeding people in that one location. The fire service doesn't. Like call volume, we can identify areas that have historically had higher requests for service than others, but that doesn't provide enough information for deployment.

A large factor in FD deployment is response time. NFPA 1710's standard for the response of the first company is 4 minutes travel time and the full alarm in 8 minutes. If we knew where/when our calls were going to occur and what they would be in advance, then the fire service could reasonably tailor a dynamic deployment plan to match. Unfortunately, that's not possible, so the goal is to be able to provide a somewhat uniform response.

So, the inherent problem with closing fire companies at night, rolling brownouts, etc. is not so much with handling call volumes or handling "minor" calls, but rather for "serious" calls like building fires where the "extra" delay because those companies are closed becomes a big factor in terms of fire spread, civilian safety, etc.

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.

God forbid your family is trapped in a fire that turns fatal, and there is a brownout company on your block thats closed for the night. Live that horror, then rethink your post and get back to all of us please. Life safety should be the LAST item cut from any budget especially, over butterfly gardens, skate parks and landscaping. Its crap

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.

THANK GOD(!!!!!) That you are not in any position of authority. A minute or two of quicker response isn't the difference between life and death, that's the difference between MANY lives and deaths! In my particular area of the city, we are fairly well covered. What I mean is, there are a lot of companies per square mile. However, with only one full assignment out 20 blocks north, we become second due engine to box locations 10 minutes away. Do you know what that does to overall response times? Forget the public, how about that truck company that arrives 2 or 3 minutes before an engine in some cases? Those guys need to get in there to begin searching and the longer they have to do this without the protection of a hose line, the better the chances of catastrophe become. Considering we are losing our 5th man on many engine co's, the second due engines role of backing up the first hose line becomes that much more essential.

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.

Most of your fatal fires occur at night, although a majority of your runs occur during the day. Closing companies or preforming rolling blackouts is just a bad idea all around, regardless of whether it occurs during the day, or at night.

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.

Why? They are prepared for other "once in a lifetime" disasters, why not a weather related event? The vehicles could not have benefitted from snow chains or having some 4x4 ambulances?

The FD has specialized units to respond to just about everything when it comes to fire and rescue. So, I don't think enhancements to the EMS fleet for a winter storm would be a waste of money.

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.

So, this is going to be the city's action plan? Spend time and energy finding people to blame it on, and firing them, so it look's like they are "doing something".

I hate how the City is demonizing those who were actually "in the trenches". I don't know what the circumstances were or if this Chief deserved to be fired, but I'd rather be reading the headline "NYC Buys Snow Chains For Entire Ambulance Fleet" or "NYC To Order 4x4 Ambulances".

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.

Also, it's great if the e-PCR system could pull up the patient's name and previous medical history that can auto-populate some of the fields. I know there are some HIPPA things attached to that, especially in EMS though. However, with electronic medical records becoming the mandate (I think) in 2014, it would be great if we could get some previous history on the patient.

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.

1st question I would ask is "You didnt have any foresight to buy chains for your fleet???"

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.

In my dept we role an engine, rescue, ambulance, and 1 or 2 utilities....depending on the situation or location the engine and rescue will be returned and the utilities used for traffic control or the rescue with manpower will assist with traffic and/or ems duties.

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.