comical115

Me to (narrative heavy) & having to type with just a couple of fingers tends to slow one down. Steve was wrong when he said the pen (styles) was dead & a useless way to input data. You're also right about the way of the future though, we're going to have to adapt & go along with whatever tech is thrown at us. Resistance is futile.

I can finish a paper ACR/PCR in the time it takes to watch the video, and if I lose the paperwork or my pen, I'm only out 75 cents... I'm narrative heavy on all my documentation so all of those neat little features about assessment and treatment do nothing but waste time.
Its the wave of the future, resistance is futile.

I can finish a paper ACR/PCR in the time it takes to watch the video, and if I lose the paperwork or my pen, I'm only out 75 cents... I'm narrative heavy on all my documentation so all of those neat little features about assessment and treatment do nothing but waste time.
Its the wave of the future, resistance is futile.

Heaven forbid we learn from our mistakes...

At least the headline is technically correct. That alone is impressive for the Journal news.

What you are referring to is called a Hypoxic drive. Normally we breath because our bodies pick up on the concentration of CO2 in our blood on the arterial side of the system via chemoreceptors located in various, but specific parts of our body. High levels in our PCO2 will cause us to breath faster in order to 'blow off CO2' and low levels in the PCO2 will cause us to breath in deeper and at a slower rate in order to retain CO2 to keep our Ph in between 7.35 - 7.45. The body must maintain this range in order to keep everything working optimally, too high or too low and things can get whacky, esp if it's for a prolonged period of time.
(On a side note, COPDers problems lies in that the are chronically hypoxic, and they are CO2 retainers because their problem isn;t necessarily getting the air in, it's getting the air out, called 'air trapping'. )
A hypoxic drive is when the body has changed over and is now monitoring the PO2 instead of the PCO2. So theoretically if the person reaches 100 % saturation then you've knocked out the stimulus to breath because the body thinks, oh well I'm 100% I guess i dont have to breath. COPDers are as i said, chronically hypoxic, so their drive to breath is because their normal PO2 is low, therefore signals to the body to breath. This hypoxic drive accounts for a low percentage of the population something like 9-10%. Recent studies have no found that COPDers are not soley dependent on this hypoxic drive. So while this may decrease morbidity/mortality, you won't necessarily 'knock out' a COPD PTs resp drive by giving them high flow O2.
One more point, I agree with this research and the titration of O2. Too many people I have found will put a patient on 100% NRBFM because "It's the protocol" Well thats stupid, and dangerous. Not everyone needs 100 O2. If someone is 98-100% if you really feel the need to put them on O2 then put them on 2-4 L N/C. And if it's not even a cardiac or resp related call, and their SpO2 is 100%, then can someone please tell me why it's necessary to place them on 100% NRBFM ? Really? Sorry I'm just an ICU/CCU RN, I clearly don't know what I'm doing..lol

First I would like to say that all involved with the response did a great job.
There has been a lot of planning that has gone into the Westchester County Airport Response Plan over the years. The plan has evolved quite a bit since its inception. It is still not perfect, but is always evolving.
The pilot declared an emergency right after takeoff; the plane tried to get back to the airport but obviously didn’t make it.
The airport operations contacted 60 Control and declared a Level 2 Alert. The plan alert categories are based on the type of plane, how many passengers, and how much fuel on board. This Cessna 210 should have been in the Alert level 1 category.
Right from the start, there was a larger response because the wrong alert was made. That being said, the operations staff had no idea where the plane was because it went off radar. So the ICs kept all units coming in until more information was received. There are several businesses and homes in the area surrounding the airport and if the plane had crashed into a structure, that level of response may have been needed.
Reports came in through the security guards at MBIA that the plane was in the woods behind their building. All units were directed towards that address.
Battalion 19 and 2022 set up the IC and the command post. Battalion 11, 2023, 2393, EMS 11, and Port Chester EMS along with firefighters entered the wooded area to see what the wreckage looked like, what resources would be needed, and to determine if there were any survivors. Upon their arrival, there were no survivors found, but there was some significant fire. The wreckage was approximately 1000 ft. into the woods, with some rough terrain. Hose lines weren’t stretched, they decided to use Indian tanks and water cans to extinguish the fire as well as the DES and Hawthorne FD gators with the water pumps. Please note that in this area, there are NO fire hydrants. So having the extra water on the fire apparatus was helpful.
The Westchester County Airport Response plan is for when a plane crashes on the property of the Westchester County Airport. This plan is no longer in effect if the plane crashes offsite. This plane did crash offsite in Armonk FDs district however since the call originally came in as an alert to the airport, the Alert 2 response was welcome until they got a handle on what the situation was.
Once the wreckage was found and the fire was extinguished, most of the apparatus was released fairly quickly. However due to the scene being deep into the woods, and the nature of the weather that day, it was helpful to have the extra manpower at the scene. Maybe all the apparatus wasn’t needed, but most of the manpower and additional water was helpful. EMS remained on scene for Rehab. Harrison EMS provided rehab and did an excellent job.
Now on to why each alert has the level of response it does. The Airport property falls in three separate fire department jurisdictions and three EMS jurisdictions, all departments involved send apparatus to the scene. Armonk FD only sends their tanker and then 2 ambulances because they know there is no need to send additional fire apparatus due to what Purchase FD and Port Chester FD responds with. Port Chester FD responds with their minimum level that is in the agreed upon contract with Rye Brook. That is contractual and cannot be changed without changing their contract. Purchase FD responds with a rescue, engine and ladder. All of which can be needed based whether the plane hits a structure on the airport grounds. When the plan was developed, although the alerts are based on the size of the aircraft, the possibility of that aircraft hitting one of the many structures on the airport grounds (including the terminal) was considered when developing the level of response.
Also, for the comment about additional EMS resources needed to be placed in the plan, on an alert level three there are 6 EMS agencies dispatched as well as their ALS fly cars to the scene. That is a minimum of 10-12 ambulances on initial dispatch. When a crash occurs and an estimated # souls on board is determined, then specific number of EMS task forces will be requested by the IC. A task force consists of either 3 BLS ambulances and 2 ALS ambulances or 5 BLS ambulances a 2 ALS fly cars.
A lot of good airport operations people, experienced firefighters, fire chiefs, emergency mangers, and EMS officials have put a lot of time and effort in making this plan as good as it can be, it has certainly come a very long way since the first plan written. There are some difficulties since it is in three jurisdictions, but all of them do the best that they can to make it work. It is a very unique situation and can criticized over and over again. Until you are responding to an area dealing with multi-jurisdictions (Fire/EMS/Police/Federal/Airport Ops/County), please understand it is not as easy as you think. In this particular case, there was also three police agencies involved, so there were a lot of hands in the pot. But no responders got hurt and everyone went home safe.
Representatives from each agency involved with the airport response meet monthly to continually update the plan. And yes, an AAR will be held to review this event.
Please remember, a plane can fall out of the sky anywhere, is your department ready if it happens in your jurisdiction?

Can you give examples of how my union has not "fairly negotiated"?
Can you explain why my employer takes money out of every one of my paychecks under the title: "medical"?
While I do not have to pay into my "pension", I am paid less than when I was in the private sector and had to pay into my retirement. When I was debating switching jobs the issue was less pay, but more benefits. A hard choice when your single, no children and in your 20's, but I understood that as I got older it would be worth it.
How did we get this pension system? Was it the greedy unions that developed it? We had a city pension system until the 1960s, when the Mayors in NY State determined it would be cheaper for the taxpayers to have one pension system (and they would look good reducing cost), instead of one in every municipality and they convinced the state legislature to develop it.
Interesting way to look at it, I understand it very differently. All FF's are at similar risks of being hurt/killed at an incident, but after figuring out what a firefighter salary should be, the municipalities understand that if they lower the starting salary by up to 50% with a 5 year build up to "top" pay knowing there are still enough people willing to take the job and struggle to make ends meet for those 1st few years. It’s not non-merit, it is what they should have made in the 1st place, but the big bad unions dont have enough power to fight this reduction.
My union contract allows all members to "share" in a college funding account. By contract the city must fund $20,000 per year (not per member) to cover the tuition of all union members. At its height that was 181 members sharing $20,000. If 20 of those union members went to college, each was able to get $1,000 toward their annual college education. Now to get this benefit, the union had to give up something and in the last few years more than $10,000 of the fund each year does not get used and is returned to the City's general fund. Over the last 25 years I think about a dozen members have participated and 3 or 4 have gotten degrees.
And the tax payers benefit from all of this.
We do, we do, we do and while I did benefit from the education, it taught me how to bring over $2.5 million back into my municipality and reducing the cost of property insurance by more than a million annually for the last 14 years. Over the last 25 years $450,000 has been made available to 175 employees, but only about 1/2 has been used. and the return on the investment has been over $16 million.
You still have yet to show anyone how "they sold us out"?
I have given you the history, to bad you missed it in your research. Its true, you are ignorant of all the facts and you make a lot of assumptions, that are not true.
Then how come, for every gimme, we had to vote on giving something up? Or worst it was taken from us by an arbitrator.

Since you're so very well versed in NYC's unions, how did you miss Giuliani's mayoral campaigns and the union support they've received? Bloomy didn;t do too badly either whatever party line he happened to be running on. Absolutely the unions support Democrats. Maybe that has something to do with many Republican ideologies flying directly in the face of union interests.
If you are going to base your politics solely on fiscal matters, nearly impossible by the way since money is what pushes the social agenda, then how could you ever call yourself a conservative republican?? You do not make nearly enough money to benefit from any of their economic policies. Democrats are no friend to your wallet either, but they at least support most union agendas. See, and here we are back at the unions almost universally backing democrats. The right to bargain, workplace safety, pensions, health benefits, etc are all benefits won with the help of democratic legislators.
yes, the unions and the people they represent we all scream "Me me me me me." We take every penny we can get at the bargaining table often fighting protracted fights through the arbitration process and working for years without new contracts. But isn't that the American way?? Isn't that the essence of the American dream to come here and fight for what is yours as best you can? We unionized and did that. Then when cities after years of fiscal irresponsibility come back and say we're broke what did the unions do? They didn't tell the cities to go screw, they asked to sit down at the bargaining table and find a way out of the mess. In yonkers they found concessions and additional funding sources. In Wisconsin they gave up almost everything the governor was asking and delivered a balanced budget WITHOUT HAVING TO GIVE UP BARGAINING. Why then did he take it away? In NYC every agency has met their budget reductions and every union has been meeting with the city to identify cost savings. However unless its a head count reduction Goldsmith doesn't want to hear about it.
So I ask you, how is it the unions and not the politicians that are wrong this time?
Public unions already do not have nearly as many rights as private sector unions. What rights are you referring to?
In your posts you allude to union corruption, and thats a very big issue. However no union has swindled more people out of more money than corporate America. The tech collapse of the 90's was fueled by billions in out right fraud, the savings and loan scandal of the 80's another economic collapse driven by fraud, and today's mortgage crisis a slightly different situation. This time instead of anyone going to jail they all go bonuses. These executives who knew what they were doing was at the very least unsustainable and in many cases out right wrong were actually rewarded for destroying whole companies because they had fairly negotiated contracts that guaranteed them certain compensation. They didn't go back to their investors and renegotiate their retirements. The only changes were restrictions on executive compensation for anyone still owing the fed money. Since the crash bonuses and overall compensation are right back up there yet none of these companies are showing balance sheets to match these increases. I'm just a lowly paramedic with a SUNY education but that math just doesn't add up.

Do you really think the problem is on PD?? Cracking down on the users doesn't have any affect on this crap. All it does is tie up cops, courts and jails while someone else is out there getting high. Look at how completely ineffective the Rockefellar era drug laws were at detering drug use.

Congratulations. New EMT's deserve a point. It's only the beginning. Certification is the piece of paper that lets you turn lessons into a craft. Never stop learning and never stop asking questions. Keep an open heart and an open mind. Best wishes on the beginning of a spectacular experience. Make us proud.

The rhetoric that is coming out from the lawyers and this guys family is ridiculous. The DA says that bonita zelman who is the attorney for the other players who were arrested that night called the lead detectives and said that unless the charges against her clients were dropped they wouldn't speak to investigators about the shooting. Zelman now denies this but i firmly believe this happened and the reason i believe this is that she is a low ball lawyer who saw dollar signs at the outset of this thing and figured that she could get her mug in front of the cameras and shame the DA's office into dropping the charges which isn't going to happen so now she is in way over her head and she is panicing and trying to make threats to get her clients out of trouble. If it can be proven that she made this statement then that is a matter for the NYS bar association to deal with as a possible misconduct issue.
The next topic is henry sr. who was on news 12 saying that the charges against the other players should be dropped because they were only trying to help his son ..... help his son how by breaking the window of a store ?? I don't remember ever reading about breaking a window out of anger as being a recognized part of first aid. The rest of the people were arrested for dis con/resisting, and I ask again, how was that trying to help dj henry. After the shooting dj henry was a prisoner of the police on scene which means that nobody should have been going near him except PD/EMS/FD.
Then we have michael sussman who proved himself to be a huge opportunist during the Yonkers desegragation case and now he is proving to be nothing more than that now. He is alledging that the ME's office fabricated the tox results because it contradicts witness statements from that night ... this fool would try to have us believe alcohol / marijuana and God knows what else fueled college students instead of a highly educated team of doctors and scientists... sorry mr sussman but NO.
The bottom line is that everyone involved on the henry side is grasping at straws becuause they know that they don't have a leg to stand on anymore. Any public opinion they had on their side is now gone - and shame on anyone who took their side to begin with.
During this whole thing we must keep the most important thing in mind and that is the officers involved. I have said it before in this thread and I will say it again, these cops were forced to respond the way they did because of dj henrys actions, the fault with this entire situation is on dj henry.

I am not a commissioner nor was I ever one but I am a former chief who had to work with a board of fire commissioners. First I suggest you maintain your integrity and don't let the position go to your head. Your are a public official with alot of responsiblity and are there to serve the public and not your own political or personal agendas. Read and understand section 176 under town law which explains the duties of fire commissioners. Listen, respect, and work with your fire chiefs and don't interfere with thier duties especially on the fireground. Don't adopt policies or sop's behind thier backs or buy equipment without thier input. Include them with all of your ideas.
You will also have to vote on things like hiring people ( if in a career dept) or vendors to preform to services for the district. You will also have to vote on appointments of fire chiefs and do so knowing this is truly the right person for the job, not just the "allright guy". Probalby the most important item is the budget and buying equipment. Don't buy equipment because it looks cool or the next department has one. Buy stuff that is practical. Remember you are spending taxpayers money.
Like any other elected official you will have to make decisions that may not be popular. Dont be swayed or play the fence. I have seen this happen. Stick to your convictions and do what is right. How you vote could impact your department for years. Treat all members fairly and dont play favorites.