comical115

I had a patient who coded 2 separate times, the first tim he became bradycardic and then asystolic and was brought back. And then he coded again and had CPR preformed for almost an hour and a half, they did also use a automated compression machine. Long story short, he was crashed down to VA ECMO, required 13 drips, and continuous dialysis for a week or so and he walked out of the hospital a couple weeks later with a fully intact mental status.

Probably the case, but its still up to the crew to take the RMA through the doctor working the telemetry desk, so (heaven forbid) something like this happens, you still have a chair when the music stops.
Hopefully whatever investigation that is in progress concludes quickly and if the crew did the right thing (like I hope they did) they can get back on the streets. Any restriction is nerve wracking.

...until the transport officer sends 4 red tags to the closest trauma center only to find that PD scooped and ran with 8 and now those 4 red tags are SOL.
There's a reason why we use NIMS. It only works for us if we use it properly.

...until the transport officer sends 4 red tags to the closest trauma center only to find that PD scooped and ran with 8 and now those 4 red tags are SOL.
There's a reason why we use NIMS. It only works for us if we use it properly.

http://www.firehouse.com/news/10743262/flag-to-be-displayed-on-fla-apparatus-after-dispute
The flags were not being flown as U.S. Flag code dictated. The issue has been corrected and they will be returned shortly.

http://www.firehouse.com/news/10743262/flag-to-be-displayed-on-fla-apparatus-after-dispute
The flags were not being flown as U.S. Flag code dictated. The issue has been corrected and they will be returned shortly.

http://www.firehouse.com/news/10743262/flag-to-be-displayed-on-fla-apparatus-after-dispute
The flags were not being flown as U.S. Flag code dictated. The issue has been corrected and they will be returned shortly.

http://www.firehouse.com/news/10743262/flag-to-be-displayed-on-fla-apparatus-after-dispute
The flags were not being flown as U.S. Flag code dictated. The issue has been corrected and they will be returned shortly.

http://www.firehouse.com/news/10743262/flag-to-be-displayed-on-fla-apparatus-after-dispute
The flags were not being flown as U.S. Flag code dictated. The issue has been corrected and they will be returned shortly.

http://www.firehouse.com/news/10743262/flag-to-be-displayed-on-fla-apparatus-after-dispute
The flags were not being flown as U.S. Flag code dictated. The issue has been corrected and they will be returned shortly.

PEMO3 how long have you been out of NYC? Since I got on on '06 we've been doing field pronouncements. Pissed off 6'3" 220lb brother screaming you'd better save his life = transport no matter how cold and dead his brother was. I've had very few families get upset and the few that did actually thanked us after calmly explaining what we did, what the hospital would have done, and what they can now do. I am a huge advocate for field termination and that's before you start considering the risks to the crews carry the pt and transporting to the ER. Public places, businesses, or volatile situations get transported. Otherwise we clean up as best we can, inform the family, and leave with PD. You don't need training, just compassion and common sense.
For any doubting the benefits of working arrests in the field, look at the horrible CPR thats performed during packaging and transport. They've already been down for however long it took you to be notified and respond. Add the time you spend for just the initial interventions and medications. In NYC, the average best case scenario for in home cardiac arrest without bystander CPR is 6 to 8 minutes from arrest to first responder. Another 12 to 18 for first round of ALS interventions. Interrupting quality CPR at this point just to get to an ER that will essentially push the same drugs you would isn't helping the patient. Stay, give it your best effort, and ensure quality CPR.

Agreed mtnmedic... Field pronouncements are conducted in numerous systems, including Westchester County, as it is pointless transporting a patient whose been in "routine "arrest (as in no extenuating circumstances) for 30 minutes with no response to ACLS interventions. I've never had a problem with a death notification to family members. The more empathetic, and more importantly, professional you are in your delivery of the notification, the less likely you will have an issue with family.

Oh please, we work up 98% of arrests on scene and pronounce on scene whenever it appears appropriate to us and our telemetry doctor. With proper training and protocol this can be done anywhere.

Another rescue that is not a rescue , Just an engine with some tools !

If by hog, do you mean reduce unnecessary 911 calls and subsequent transports? If so, I say good!

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.

The FAA requirement is every 3 years. About 12 years ago the performance was so bad that it was determined that it needed to be done every other year. I would say we need to do a lot more training.

My problem is it doesn't come down to treating the patient. In a lot of places it comes down to treating the way you think your QA/QI guy would require it so that they don't make a stink and try to jam you up. Currently there is no STANDARD for how Tazered patients are treated. I hear everything from "they aren't a patient" (like above) to "they should be worked up because there is risk for cardiac damage" (like in the article, and some agencies not too far away do such).
I honestly think a policy statement from REMAC is in order here.

A local story that's hitting close to home for me: File under "The System Worked!"
On Monday, April 30, Ron Immel, EMT/Supervisor for Good Fellowship Ambulance Club, responded to a medical call, along with Chester County Hospital Medic 91.
While packaging the patient, Ron went to secure Medic 91's car when someone heard him collapse. Immediately, personnel found him unconscious behind 55's ambulance. He was found to be in V-Fib arrest,...CPR was initiated and he was defibrillated at the scene back into a sinus rhythm, ultimately regaining full consciousness upon arrival at CCH!
As of today, after a battery of tests, the cause was unknown and he is scheduled to be discharged tomorrow.
I can't attest to Ron's overall state of health, but as emergency providers, we work long hours, endure rapid escalations of stress, and probably don't eat the healthiest of meals when on-duty.
Personally, this time last year, I was 270 lbs, had tremendous back pain (in part due to advancing arthritis) and lost so much sleep I was nodding off at work. I'm now down to 225 and I have a few more to go (so says my doc ), but its not all about me - we all need to look after ourselves. We all won't have Ron's good fortune to be surrounded by a lot of competent care providers.
Stay safe, brothers (and sisters)!

...really?

...really?

UCT uninformed call taking) system is working great...Nothing better than going to a diff breather where the call taker left out the fact that she was having trouble breathing from smoke because her kitchen was on fire!
2nd source for elevators!

Just because an agency is hiring doesn't mean that a certain prospective employee and that agency will be a good "fit". The members on this site can provide you the name and phone number of all the managers in charge of recruitment if they wanted to, but I doubt it would help you get hired.
What JJB was trying to do was offer some constructive criticism that might help you get a job. I suggest you re-read his post. A lot of agencies require you to put your time in as an EMT before they hand you the narc kit and throw you on the ALS bus, even if you have past experience as a medic. If you're as desperate for work as you claim, the right attitude and persistence will pay off. Just remember EMS is a small world, even in the tri-state area.

Just because an agency is hiring doesn't mean that a certain prospective employee and that agency will be a good "fit". The members on this site can provide you the name and phone number of all the managers in charge of recruitment if they wanted to, but I doubt it would help you get hired.
What JJB was trying to do was offer some constructive criticism that might help you get a job. I suggest you re-read his post. A lot of agencies require you to put your time in as an EMT before they hand you the narc kit and throw you on the ALS bus, even if you have past experience as a medic. If you're as desperate for work as you claim, the right attitude and persistence will pay off. Just remember EMS is a small world, even in the tri-state area.

Correct I'm employed, and I'm hardly out of the loop. As INIT pointed out, numerous agencies are recruiting and hiring. You have asked about agencies in New York, Connecticut, and New Jersey. I find it difficult to believe that in a 3 state search you can't find an EMS agency hiring, especially considering the ever-so-prevalent high turnover rate with most EMS agencies. The agency I work for is a smaller agency in the grand scale and we've picked up several paramedics in the past few months.
Just looking at websites for Empress, SeniorCare, and TransCare, all 3 companies indicate they are hiring paramedics and have online application features you can take advantage of.
Have you been for interviews? Have you been offered employment anywhere and turned it down? Have you had someone in the field who you respect review your resume for you? Maybe he/she can offer some constructive feedback to help make you more of an appealing potential employee by restructuring your resume if you're having a difficult time getting hired.