comical115

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Posts posted by comical115

  1. Posted

    1330381236' post='259435']

    We have been hearing the new Transit portable radios will be deployed within the next week or two. We are also being told that each radio will be personally assigned to an officer, with that officer's tax number coming up during a transmission as an identifier.

    What's the rationale for unique ID numbers for each individual PO? Accountability?

    Any integration with EMS more then messaging between dispatchers?

  2. Posted

    My definition of a "problem" employee is a employee who is constantly late, calls in sick constantly with out documentation, constantly goes home sick or family emergency so they can go to parties, does not restock the ambulance, and is disrespectful to fellow employees, patients and family / bystanders.

    Not to mention employees who negligent in providing proper patient care, and down right abusive to patients.

    The union serves its purpose, but it is far from perfect. It's just like physicians at private clinics that call for chest pains but miss the obvious lower respiratory infection or the DKA. For each case they "dump" on EMS, they evaluate and treat 20 other people that without the clinic, would have just called 911.

  4. Posted · Edited by comical115

    Voluntary units were know to perform wallet biopsies prior to transport. If the patient test positive for insurance they returned to base like homing pigeons, if the patient test negative then it was off the an HHC receiving facility. I can not speak for how it is today but I suspect things have not changed that much.

    I can assure that on my rig, quality patient care is paramount. I offer the services of my hospital but always with the disclaimer that they are my employeer. I always try and do what is best for my patient. The attitude that voluntary units are only interested in insurance information and brining "home" paying patients is a slap in the face of hard working medics and EMT's who are doing their job. It has always driven a wedge between services in the NYC EMS community, and we wonder why they don't take us seriously.

    20y2 likes this

  5. Posted

    I guess you can't just get a simple answer to a simple question.

    A simple question to continue a conversation we keep having. Can volunteer based EMS provide the *required* level of service to a community?

    I'm sure the REMSCO police aren't going to come arresst you, but wouldnt this be valuable in court as it would be an accepted industry standard?

    No, but if REMSCO feels an agency is not taking a mandate seriously through QA/QI then they can turn to NYS DOH. I believe it's Article 30 that requires every EMS agency to provide information QA/QI information to the regional organization (REMSCO).

    On a side note, I was browsing the Westchester County REMSCO website and I stumbled across a study from 2008 that evaluated the Westchester County EMS system.

    Quote: "The system is designed based on home rule where every community operates its own service in its own way. This is inefficient and results in available resources functioning independently and without the ability to benefit from surrounding resources. The system struggles to reliably reach the first call and additional simultaneous calls suffer from extended response delays." (Page 69, Finch & Associates LLC Study on Westchester County EMS system).

    Westchester County EMS Study from 2008

  6. Posted

    I don't think its a union issue. No one is concerned about losing their jobs to the volunteers. I know voluntary hospitals would love to staff more units (both BLS and ALS), the fire department won't allow it (...another discussion).

    I don't think ny10570 was talking about harassment from the bosses being an issue. The powers at be tend to rate a boss's productivity based on the 89 checks, vehicle inspections, if they can get the units in their area back in service from the ER in an "acceptable" amount of time, etc. By adding more units you are adding more overhead to a Lt's shift and potentially decreasing their availability for on scene functions (Cardiac arrests, RMA AMA, MCI's, etc.). It's a good point.

    So the question is, ny10570 when are you moving up?

  7. Posted

    Why should they be integrated into the system and more so, why would you want to be included? When the dept needs help, the call goes out and volunteers are integrated. Otherwise, its more units for FDNY to compete with and supervise. Operating separate from the system, all they have to do is monitor the precinct radio and go to the jobs they want to. No BS equipment audits, 89 checks, and other FDNY harassment.

    It'd be nice to know which jobs were being handled already, avoid duplicates and increase efficiency within the system. It's always nice to dream, right?

  8. Posted

    They are not volunteer agencies. They're voluntary 911 providers and are part of the NYC system. Most run ALS units, in Manhattan they used to run more ALS units than the City did, and they are responsible for PAR's and dispatched by 911 just like FDNY units.

    Municipal Units = FDNY EMS. Voluntary Units = Hospital based units that are dispatched and treated like a municipal unit. The hospital based units now run an even amount of BLS and ALS units. On the ALS side of things the municipal units and the voluntary units carry slightly different medications (controlled substances, cyanide/smoke inhalation antidote kits) and other tools (CPAP).

    Being a paid provider in the NYC system, I have never had a bad experience with a volunteer unit. I have a lof of experience with Central Park Medical Unit, 90% of the time they are on the scene first and they always provide high quality patient care. Its too bad the powers at be don't see the resource that they have at their disposal.

    firedude likes this

  9. Posted

    If BLS was faster and more reliable triaged dispatching would be more viable and free up the medics from many of the BLS calls they're sent on. However when you can't guarantee a timely response from BLS the risk of a incorrectly triaged call resulting in serious harm or death is too much.

    It's my understanding that the individual VAC's and FD's determine what EMD Code results in an ALS response. So the idea that properly EMD'ing all EMS calls in the county will result in freeing up medics is slightly erroneous due to the fact that a 40 year old male with abdominal pain will still result in an ALS assignment.

  10. Posted

    The stability of iOS and the durability of solid state flash memory makes the iPad extremely durable. Add a bomb proof Otter Box or Pelican style case and you have a device that should be able to preform on par with the tough books.

    Isn't that similar to what FDNY EMS is testing in Statten Island?

  14. Posted

    Also, it looks as though the article is trying not to discredit the use of O2 in the field, but rather the use of high flow oxygen, as titrated oxygen (i.e. through a N/C) can be just as, if not more effective, in raising and maintaining oxygen saturation levels in patients with difficulty breathing.

    If you are running BLS and you don't have pulse oximetry, how can you titrate to effect? If you deviate from your local protocols, *no matter how backwards and/or improper you feel they are*, make sure you have a reason and document properly.

  15. Posted

    Stamford Fire and EMS is digital encrypted I think Greenwich is 800. what does 60 and participating agencies have for interops?

    Banksville FD gets dispatched by Greenwich via 60 Control. So yes. There is a link.

    I think there are some strong merits for a county run EMS system. For instance a county run EMS agency could interface and allow for volunteers to maintain their presence in their communities, but also allow their citizens a guaranteed response if they call for help.

    I know if the agency I'm involved with calls for mutual aid, we are relying on other volunteer services. You have better odds in Vegas some days...

  16. Posted · Edited by comical115

    Why not give PD another avenue for criticism from the non under-educated public? Let PD do their job so the scene is safe when the medics get there and let them deal with the medicine.

    As for BLS, I still don't know why NYS hasn't given the combitube / king to BLS minus the EtCO2 requirement. Its a great tool in the hands of a properly trained provider, and in my opinion more benefit then naloxone in this situation (but that's another discussion / thread...).

    Bump to BLS getting out the door in a timely fashion. Should It is a higher priority then IN naloxone.

  19. Posted

    This is a fairly specific situation, but every time I've been in a class A burn, the instructors have made a point to show us what a downed brother or sister looks like in the fire room on a thermal imaging camera. The SCBA bottle is what I've been taught to look for, it will stick out right away. I'm just curious as to how this new SCBA would look under similar situations. Because there are multiple smaller cylinders within a protective covering would it even show up?

  20. Posted

    How does it help rural area's....I've yet to see a quint that carries enough water, hose or ground ladders and generally they are too big. They VFD's around here that have been buying them, claim it works for them because they can't get 2 rigs out the door......the problem there is not what rig and what it can do. The problem is no enough firefighters.

    I agree with you that a quint will not help staffing issues, but most communities in Northern Westchester apparatus placement is an issue. Some of these driveways are longer then the street I live on, when the first due is an engine and a tanker, there isn't much room for a stick or bucket to get to work. The OIC has to have a really good idea of what he or she has enroute and where they need to be in order for it to work... I can see why some departments feel the quint is a good option for them.