PFDRes47cue

Throughout my travels in the fire service, I take note of what gear/equipment used and carried by firemen on a daily basis..and something I see far too little of, is members equipped with personal flashlights. I carry two...a Streamlight Survivor that is a good 18 years old on my coat, and a Power Plus handlight. These lights are with me at all times...for any structural run, fire or not and on all night runs. I will never be without a light by personal design. BOTH were purchased out of my own pocket, as I feel they should be considered a part of your PPE.
So..I pose these questions;
Do you carry a light with you on each run?
If no; why not?
What style light?
How do you wear it?

Please don't taint a good thread with such nonsense...

The other day, the snowy commute proved horrendous. At the rollover between Peekskill Hollow and Bryant Pond Roads, so many Good Samaritans intervened and helped a hurt, scared lady who skidded off the road in her minivan and came to a stop on the vehicle's side against a tree.
Thank you to the off-duty EMT I saw running into the woods toward her vehicle. Thanks to the guy trained as a first-responder who also was a life-long Boy Scout who just wanted to help if he could. Thanks especially to the several off-duty NYSTroopers who stopped, provided invaluable scene safety (with loaned flares- ahem) and helped to speed up the BLS response. And thanks, George the medic, for getting there to relieve me and allow me to get to work in the local ER (looking and feeling much like a wet, half-drowned rat).
Evereytime I start to think that people in general just suck and don't care about anyone but themselves, Good Samaritans like the ones I met the other day prove me wrong and restore my faith in mankind.
Thanks, all of you, for that.

I would like to thank all the members of the Sleepy Hollow Fire Department and all the Fire Agencies involved. Its nice to know i can count on my bothers for assistance. When mutual aid is requested its nice to know that i can depend on them to get the job done in a quick and professional manner.
Also would like to thank BAT 12,14 for their assistance, making my job a lot easier.
Special thanks to the night and day tours at 60 CONTROL. JOB WELL DONE!
John Korzelius
Car 2311

This is a great topic and something I talk about all the time. As an EMT for 21 years, 9 of which as an EMT-I, I have seen such a decline in the quality of new EMTs. I am not sure if it is do to poor instruction, and people being "pushed through" the class, or it is Medic "dependency" (or a combination). I have always told my members that the best way to learn is by doing - the more calls you do, the better you will become. I have heard EMTs waiting on scene for the Medic to show-up - I always say, do what you have been taught and trained to do.
I admit, when the Medic system first came in to our Town, I had a difficult time with it. I went from running calls to driving the fly car. It was very frustrating to get up in the middle of the night, go to a call and either just stand there while the Medic "did his/her thing" and not say a word or give you any info, except for "can you find a garbage can for this stuff" and "who's driving my car". Things have improved greatly; I guess it just took time for them to realize the capabilities of the EMTs and for me to not be intimidated by them and be able to work with them.
Our Corps has abolished the CME program for recertification. We encourage people to take classes, attend lectures, get any further education you can. But when it comes to the basics, everyone should go through the skills and sit for the exam. If you can't do that, then you have no business being an EMT.

As an experienced ALS provider and one who saw first hand the decline in BLS skill while still a BLS provider I have several opinions on this. And for the one who said they had "senior EMT's who hated medics," my experience has been they are often the most dangerous and suffer from certification napoleon complexes and are some of the ones I have to keep the closest eye on. But either way...as I often tell people...I'm not here to function so EMT's like me...I'm here for my patients to like me and give good solid patient care. I take being called a "dick" or "intimidating" as a compliment. I'm one of the most demanding medics in my system..and for one purpose..solid patient care. Any instructor and I have heard stories of people teaching..."do this and that and WAIT FOR ALS TO ARRIVE"....WHat!!!???!! Are you kidding me? I have to tell bls crews by radio often to not wait for me if I did a job from far away. Clip boards should be banned from in houses. If you are thrown into the real world..something is wrong...and unfortunately too many agencies push new EMT's into spots they are not ready for. Have required ride time as curriculums do not have enough field rotations in them for EMT-B's. Someone said something about being called old fashioned for taking the time to understanding something instead of throwing on O2 and putting them in semi fowlers and going to the hospital. Yes you are right...but it should take no more then 60 seconds to realize they need oxygen..use the time to get the lifting device you may need or the time transporting to figure it out...on scene time is important and one of the singular most important treatments any EMS provider can perform is transporting your patient.
With that said...
1. The change in curriculum in the late 90's to me was a dumb down of the certification and reduced the background and A & P knowledge us old curriculum EMT's needed to know. The patient assessment in the curriculum is absolutely atrocious and too cookie cutter. I became the medic I am because of strong bls education and street experience...its not there anymore.
2. Lack of training within VAC's. Some things need to be learned on the street..other things need to be learned and practiced as you don't use them often. CME training is often lectures...get them out of their chairs and review equipment and bls skills done in courses and testing.
3. I've worked around and seen some medics who don't step back enough to allow BLS to do their thing when appropriate. I always give them slack...and then take back over if they are lost.

As I read through the comments, I couldn't help but realize that many people said the same thing. Education is key. Just the other night I went on a trouble breathing call, pt was quite elderly. She provided no medical history, stated that she had no medical history. And that is what the EMT wrote on his PCR. When we got to the hospital and he heard me give my ALS report to the RN, the EMT was obviously confused. He asked me how I knew the patient had CHF because she didn't say she had a history of such. EMT class use to focus on the pathophysiology of disease. It forced students to looks at SIGN and SYMPTOMS and put the puzzle together. Now, EMT has been dumb-downed so much that it is simply "You have trouble breathing? Here is oxygen." EMTs need to take an initiative to learn beyond their textbook and gather more information to supplement their career. Perhaps then the EMT on our call would have noticed her "CABG" scar, slightly swollen ankles, lasix and betablocker medications and been able to put some information together. Granted her lung sounds were clear and equal bilaterally, but not every call is textbook - - thinking is essential. Education is imperative.

I recently finished my EMT-B class, and, once I got out into the field and started dealing with real-life situations, I was very surprised about how unprepared I felt. My instructor for the classroom/lecture portion of the class was very knowledgeable and prepared us well to pass the state written exam. (As with anything else, I'm sure the quality varies quite a bit between instructors.) On the other hand, the quality of some of the lab instruction—as well as the amount of time alloted for lab instruction—left a lot to be desired. And it seems like those practical skills learned and practiced in lab—built upon a foundation of knowledge about anatomy and physiology from the classroom portion of the class—are the mark of good BLS.
From my very limited experience in the field, it seems like adding a greater emphasis on practical skills training might help produce EMT's that provide the higher-quality BLS that the original poster asked about. This poses the problem, though, of creating EMT-B classes that are prohibitively long; I wonder if adding additional hours to the class to accommodate expanded practical skills training might dissuade a lot of people from taking the class altogether. If the length of the EMT-B class was kept the same but time was shifted toward practical skills and away from classroom instruction, I wonder if that might create EMT's who are good with BLS skills but are not sufficiently knowledgeable about the anatomy and physiology behind what they're doing. I guess it's a problem of finding the right balance between lab and classroom instruction.
Although adding more emphasis on practical skills training might help with improving the quality of EMTs' BLS skills, I was surprised about how little effort a few people in my EMT-B class put forth. You could tell they weren't reading the textbook or practicing the skills on their own. I'm not sure if those people passed the state written and practical exams or not. Although those exams might do a little to help keep people with poor BLS skills from becoming EMT's, I'm sure quite a few people eek by and get their EMT-B certification (they weren't that difficult). I agree with what PFDRes47cue said about "instructors pushing kids through the classes." It might help the quality of BLS that is provided by EMT's if the bar was set a bit higher.
(This is my first post... please be nice!)

Slightly off topic but.....
What are the benefits of departments issuing vehicles to Chief's? Are there benefits or is it more of a "we have the money so why not" thing? There are a lot of departments that do not have Chiefs vehicles and the Chiefs use there personally owned vehicles. Departments seem to run/operate equally well with or without department issued Chief's vehicles.

If you read about the recent accounts of the exact same issues being faced by other areas within the United States, looking at County-Wide Consolisation of Fire, EMS, and Police Services, you will see that the Tax Payers are "Fed Up" with rising taxes and are "Forcing" Politicians to put aside their political affiliations with Unions and Other Groups, who have been and continue to be extremely opposed to any thought of consolidation of services, and have or are now strongly considering going the route of consolidation of services. Reading up on some of the things that Gov. Cuomo as well as County Administrator Asterino are looking at, "County-Wide" consolidation might be something that could happen sooner rather than later, despite the strong opposition by Union Leaders and Fire/Police/EMS Commissioners.
Yogi Berra might have said "It ain't over until the fat lady sings", but I think that the Taxpayers in Westchester County are singing "Loud and Clear" to the Goverenor, the County Administrator, and other politicians that they are fed up and can't pay anymore additional taxes and refuse to do so.
As I have said here before, seeing what has worked extremely well in both Baltimore County, Maryland and Gwinnett County, Georgia, both very similir to the demographics and geographics of Westchester County, all Fire, Police and EMS Services in each of these counties are consolidated and run by the COUNTY and not by any individual city, town or village, thus the same could also work across the entire County of Westchester.

Take the cars away and watch how many people don't want to be chief anymore. There are to many people out there that only do it for the car.

Car accident
Oh ya these guys seem legit. LOL

Army Specialist David R. Fahey, Jr. was killed on February 28, 2011 at the age of 23 while serving in Afghanistan. Fahey was assigned to the 170th Military Police Company, 504th Military Police Battalion, 42nd Military Police Brigade, Joint Base Lewis-McChord, Wash.
One Monday, March 7, 2011, his body was brought by motorcade to his hometown of Yorktown, NY. The Pleasantville FD, Hawthrone FD, Valhalla FD, and Thornwood FD, payed tribute to the fallen hero by using TFD TL1 and PFD TL5 to hoist a flag over the Taconic State Parkway.

RIP!














http://www.youtube.com/watch?v=T9YZK9nUjXw

What if you crashed enroute to the call? Could you be held liable for not getting there? I sincerely doubt it. If you're not there, you're not there and they're not your patient.
On the subject of flagged down while transporting, I would say you have to follow your agency's policies on the subject (if you don't have policies on the subject it's a good time to get one). Unless your patient is critical (and that isn't the case 95% of the time), I would say stop. Driving by with that big orange and white billboard is bad advertising. If you have a crew of more than two you can always leave someone pending the arrival of additional help. If you're a crew of two you can simply inform them that you already have a patient but help is coming. In Westchester County an additional first responder is never more than a few minutes away.

Yeah I know what you mean but remember that medics have a higher standard of care.
When a pt displays what seems to be a basic BLS call to an EMT-B, a medic may still have to ride the call in even if the call is without incident and could have been transported BLS in the end. A medic should (and does most of the time) have great discretion to decide downgrading. This is very important for their legal liability as licensed providers (as opposed to being certified). Once again, experience comes into play.

Just found this very pertinent article on JEMS:
http://www.jems.com/article/industry-news/patient-abandonment-what-it-an-0
Abandonment can also occur when the EMS system as a whole fails to respond to a patient s call for help. This can occur if dispatch refuses to send a unit, or when units from the local service are not available and no mutual aid is sought. Another way that abandonment might occur is if a responding EMS unit comes upon an accident en route to the call, or is diverted to a higher priority call by dispatch. If nothing is done for the initial caller, abandonment may occur. Appropriate use of priority dispatching systems and the development of mutual aid agreements will go a long way towards limiting liability for abandonment. Abandonment may occur in systems that do not have adequate mutual aid agreements, or priority dispatch systems, and instead stack calls in the order they come in, without regard to severity, until an EMS unit becomes available.

Excellent post. Prior to your post I would have always said that all line officers should have medical training, after reading your post I realize that in one post you covered all of the EMS issues listed in all of the other EMS related threads: Professionalism, MCI managment, incident liability, protocols, training, etc. Having been involved with a number of different vac's I agree with your "mommy" statement and how all the other issues that you listed as needing to be addressed.
Now this brings me to the real issue: EMS critically needs field supervision!!!! It solves many of the above issues. I have been on many calls where the crew chief has been an EMT for the last week or 2 and has no clue. We want EMS to be treated the same as FD and PD. But EMS crews are not supervised. In larger EMS systems there are field supervisors who insure proper response, proper procedures and during MCI's to COORDINATE the response and administer the incident.
If your emergency response agency (FD, EMS or any other group) needs a "MOMMY", it is not the agency that I want responding to an emergency with myself, my mother or my child. Its time to go to regional EMS (yes it can still have volunteers). It really is nice that VAC's get to play, but this really needs to be all about the "PATIENT".

You (or who evers "moon" that is) needs to go to a dermatologist

When they said Super Moon, I first though of this....................

I have found that your are not alone in thinking that. However, volunteer departments have them as well.

If I recall correctly, most Westchester volunteer fire departments only had one or maybe two marked chief cars up to the mid 1990's. Chiefs without marked cars were given red light/siren packages to be installed in their personal vehicles. I think one reason departments got away from that was insurance, i.e the chief in his personal vehicle responding to a call gets in an accident. Whose insurance pays. I personally know a Pleasantville chief that lost his personal vehicle at a fire scene in the late 1970's due to an explosion/ flash over that set his car, the ladder and the patrol truck on fire. The department's insurance would not pay for the loss of the personal vehicle, even though it was being used on official business. Another problem encountered were many people did not want holes drilled into their cars to mount lights that would end up being removed when their term of chief was over. This led to discussions on vehicles being properly outfitted with lights that were visible from 360 degrees. A lesser problem was that of chief who used their red light/siren equipped personal vehicle to travel outside of the area or state. I know one volunteer was pulled over in Florida and forced by the Florida Highway Patrol to remove a lightbar mounted on his personal vehicle or face getting a summons, even with a cover marked "Out of Service".A move to department owned and marked vehicles led to a reduction of this, but opened can of worms being discussed here . You see the discussions here and on other forums about red light/siren equipped personal vehicles. People may know your the fire chief in your town, what happens when you drive a couple towns away?

I started the original thread about that organization, in fact it was picked up of EMT bravo, and reposted on an FDNY site, it appears some of those members were maybe going to forward the organization to the Fire Marshalls for investigation. The discussion has alot of merit as people with wind breakers getting beyond firelines and possibly wanting to do harm to responders. Please reopen the thread.
Rick Dempsey

Another great example of why all the blue lights, LEDs, and reflective stripping aren't going to save your butt. We're plenty visible, but if the idiot behind the wheel isn't looking it doesn't matter.

Army Specialist David R. Fahey, Jr. was killed on February 28, 2011 at the age of 23 while serving in Afghanistan. Fahey was assigned to the 170th Military Police Company, 504th Military Police Battalion, 42nd Military Police Brigade, Joint Base Lewis-McChord, Wash.
One Monday, March 7, 2011, his body was brought by motorcade to his hometown of Yorktown, NY. The Pleasantville FD, Hawthrone FD, Valhalla FD, and Thornwood FD, payed tribute to the fallen hero by using TFD TL1 and PFD TL5 to hoist a flag over the Taconic State Parkway.

RIP!














http://www.youtube.com/watch?v=T9YZK9nUjXw

Date: 3-16-11
Time: 0325
Location: Turkey Mountain Nature Preserve, Yorktown Heights
Frequency:
Units Operating:Yorktown PD, Westchester County PD, Carmel PD, New York State PD, NYC DEP PD, Yorktown Heights Fire-Rescue, Westchester County DES
Weather Conditions: Cold,Dark, Rainy
Description Of Incident: Unoccupied car of a man reported missing from Carmel found in parking lot at approx 0325 by officers on patrol. Carmel PD was notified and missing person search ensued immediately, with multiple canine units and intensifying at dawn. Body of man found approx 1415hrs. All terrain vehicles brought in for the search.
Reporters:
Writer: x635