JJB531

I find most communities that can not get an engine out have even more trouble getting and ambulance out. Often these same communities only get a trooper or a sheriff and they cover huge area so it may take lots of time and they may only get 1 officer.

This should be a big question for everyone...What level of service is being provided in your community or more importantly in the community where your parents live? Sometimes you get what you pay for and sometimes you do not.

I'm only going to half agree with you because the number of agencies that have gone to paid BLS personnel (ether hired within or contracted out) has increased rather significantly. As of recent you have Briarcliff, Croton, Dobbs Ferry, Eastchester, Harrison, Hawthorne, Mohegan, Ossining, Peekskill, Port Chester/Rye, Somers, Tarrytown, Valhalla (and maybe a few others that I'm missing) who have all started to utilize paid in-house staff. As more and more agencies follow this model of EMS as it becomes necessary or the realization finally sets in that their current system is broken and needs to be fixed, the better probability you have of handling the job in a more expeditious manner with an in-house EMS crew then trying to roster an Engine.

The question posed is a great one, and definitely one we should all be thinking about.

Antique I agree with you 100%. If you look back that's been my position from the beginning of the thread. Unless your FF's run BLSFR at the EMT level, it should undoubtedl (IMHO) be an EMS function. If the FF's are EMT's and run enough jobs to be comfortable and competent with their skills, then I could see it being an FD function.

I completely agree with you BNechis about apparatus and staffing levels... But that's New Rochelle and while it may not be an issue there, what about other jurisdictions that struggle to send a fully staffed engine out on calls? I guess whether to send FD or EMS really depends on the dynamics of the individual system to decide what works best.

I know we are not allowed to bill for services that do not result in a patient transport, I believe by Medicare rules. This means any call that doesn't get a transport is paid for wholly by the taxpayers.

You may not be allowed to bill Medicare for non-transports, but that doesn't mean you can't bill the patient or other means of insurance. We don't bill for RMA's/Non-Transports where I work, but after speaking to a co-worker here who also works for another agency, there are companies that do bill for RMA's and DOA's.

I thought the same thing, that you can't bill for non-transports, but I just learned there are places that do.

In areas were EMS is provided by a commercial company or other fee for service group, is billing the patent for this type of call a consideration for a FD only response?

Is it? I don't know... I don't look at EMS like a businessman, I look at EMS as an emergency medical provider, so I have a hard time justifying or making decisions based on the finance side of the "business" of EMS. Could it be a consideration... I guess yes, it could, but now we're letting money determine what level of care a person receives when they all 911. Interesting question... I would say it shouldn't be a consideration, but I can definitely see the other side of the coin as well.

You're still tying up FD resources, so what's the difference if you're tying up FD or EMS?

Sorry but I have to comment. In a VOLUNTEER district when a call comes in for a lift assist it should be first answered by police. They take the call and do the dispatch. There are many more police officers on duty in cars than there are vehicles for ems. When the call comes in IF the caller indicates that there is an injury or medical need then of course dispatch the ambulance. If the call is just to help the party back into a chair or bed then the call can and should be handled by police. Once again...should the called indicate a need for medical treatment fine then send the ambulance but DON'T send them and tie up the only EMS crew in the district for a LIFT unless the first responder requests one.

A VOLUNTEER system should function no differently then a paid system. It's about setting a standard of care that should be followed by all EMS systems, whether paid or VOLUNTEER. The person on the floor shouldnt get a lower standard of care just because they're served by VOLUNTEERS. One police officer isn't enough to pick up someone off the floor. Now you have to send 2 cars. Some jurisdictions only have two cars on patrol to cover an entire village. It's okay to leave a whole village without police protection just because the EMS system is VOLUNTEER?

This is the topic of our volunteer ambulance corp at the moment. we are trying to figure out who should be taking the lift assist calls. We have answered a ton of list assists calls over the past years that come in and then another serious call comes in and either does get covered after multiple tones or goes mutual aid due to the early morning calls or short staffed.

I beleive personally that fire guys or police should be able to go out and help with the lift assist calls. If an ambulance is needed then call us but just to lift up the elederly and place them back in bed should be able to be handled by fd or police.

Sending PD or FD is commonplace in a lot of areas. Is it wrong? Probably not... Personally I feel it's an EMS function. I already gave my opinion on the what-if's. In reality, how many times has a unit been tied up on a lift assist and missed a serious call? I'm sure at some point in time it has happened, but sometimes people use that line of reasoning simply cause they want nothing to do with the boring lift assist, and use that as a plausible excuse; well what if.....?

Is it okay to tie up PD because what if a major crime comes in? Or what about tying up FD and now a structure fire comes in? I don't understand why EMS personnel feel they're the only ones who are gonna miss the big one if they have to pick up grandma, so someone else should do it for them?

Even if it means taking a rig (and a medic if in Northern Westchester) to a lift assist when they could be responding to a more serious calls (e.g. cardiac arrest or a MVA)? Taking 1 of the 3 medics to respond to a lift assisnt is a waste, IMO, unless there is a need for pain management.

I understand your thought reasoning, and it's not necessarily incorrect. As a medic the last thing I want to do is go to a lift assist because most don't require ALS intervention, but...

#1 - we can't always play what-if's. I could turn around and say what if the lift assist patient did require ALS intervention and now you just delayed the medic 15 minutes because "what if a more serious call comes in", and yet that call never comes; is that fair to the person who called 911 for our services? I've personally responded to a number of lift assists that ended up being cardiac arrests.

#2 - why do we send medics to every call? Who says we have to send the medic to a lift assist? If proper EMD is done, and no flags are raised for a potential for this to be ALS, then we may be able to get away without sending an ALS unit and keeping that unit in-service for the "what if".

What if we take an FD rig out of service and a fire comes in? What if we take a patrol car out of service and a robbery occurs? We can keep on "what-if'ing" but someone's gotta pick grandma up off the floor.

We can only treat one patient at a time, one call at a time. As EMS managers, they need to ensure that their systems run efficiently with the manpower and staffing levels they have to work with without short-changing the public who deserves the services they require.

The extra hands are a big help, no sense in breaking your back when extra help is readily available.

Okay, but not everyone has the luxury of affording a full time care giver or nursing home.

Well it depends. If a lift assist is classified as a rescue, I would say FD because they really are the only ones qualified to handle such an intense task.... I'm only kidding people! Just trying to make light of the recent discussions and bickering, so smile!

In all seriousness I would say EMS because a lot of these lift assists involve underlying, sometimes complex medical conditions that really should be evaluated by an EMS crew. It's in the best interest of the patient, and could prevent EMS having to go back once an underlying condition exacerbates into something worse.

Neither

So.... We should leave the elderly woman who's incapacitated on her bedroom floor there to rot? Where do you volley/work? I want to make sure I don't have family that lives there.

Convoluted? Seemed pretty concise and in-line to myself and a couple other members here. Wikipedia... Hardly... It's from taking the time to educate myself so when discussions like this take place I can at least articulate my stance with some level of insight and maturity instead of sounding like someone who's not getting his way and resorting to personal attacks.

ESU can do every damn car accident in the city, not one fire house would give a rats behind. But do it correctly. And I was involved in an incident with ESU where a member was injured quite severely, guess who was treating him, ME! If Ray Kelly wasn't pulling the strings things would be like every other City in the USA, police doing criminal actions, FD doing rescues and fires.

I can't understand why you are getting so defensive and taking this so personal. The idea of this was to be an intelligent discussion, not a foot stomping tirade. I come to work, do my job, and go home. Thank you for taking care of the ESU injured member, I think anyone, PD or FD would provide these care for eachother in that same situation. We may wear different patches, but we're all human.

Sounds like a reasonable and possibly accurate depiction of the history of rescue services in NYC. I have heard this same description from numerous sources, but the accuracy of the information may always be in question though. Interesting to hear it straight from an old time member of the department.

Mount Pleasant PD still has an active dive team, Croton PD still technically has a dive team (not sure of their manpower/capabilities), State Police has a dive team, and DEP Police has a dive team.

16Fire5,

I agree that there are big mouths in any emergency service agency. My comments were more based on my experience here on EMTBravo, since I really don't get involved in any other sites (NYPD Rant, etc.). Here on EMTBravo, there is a more stronger showing of FD then there is PD, and that leads to a general anti-ESU, anti-PD atmosphere. How often do you see PD members here on EMTBravo trashing the FD? Rarely, if ever. How often do we see FD members trashing PD members? On a near weekly basis.

I agree that there are problem children on both sides, and I think I made that pretty clear in my statements in my post, that is is not a one-sided problem.

Out of curiousity, how long is the Miami-Dade program? ESU goes through a week of Basic Firefighting that follows the state curriculum. It's no career academy, but it covers the basics.

Bad Box,

Long winded? Why, because I took the time to put together a professional, mature post with reasonable information instead of just a few lines of crap without backing up my statements? Were my statements a negative diatribe (as you called it) or facts about things being done wrong (as you put it)? I'll listen to facts all day long. Posting a one-liner (as many here do) that PD should leave rescues to the FD (which is what's often said by many posters) is an opinion, not a fact. And yet when I back up my opinions with a combination of facts, examples, and explanation, all you can comment on is the length of my post? Listen, I'm not looking for a fight, I'm not picking on the FDNY. The difference between me and other members of this board is that I don't post negative diatribes about the FDNY, unlike some of our FDNY counterparts here who jump on ESU every chance they get. My post was not about being negative towards the FDNY, and I think that I CLEARLY stated that, it was instead to show that there's problems on both sides.

In regards to my comment about being an EMS provider and FD first response, you appear to be responding to my statements through pure emotion and not reading what I typed. I CLEARLY stated that although I would rather not have FD on the majority of my jobs, it is what is best for public safety, so I don't really have anything bad to say about it. Don't take it personal, it's just an opinion. It's nothing against FD, it's from an operational standpoint.

Regardless of what you may think, I harbor no personal resentment towards the FDNY. I have several friends who are members of the department, I work well with the members I have encountered, and don't get involved in the political and childish nonsense.

In regards to who trained who; I CLEARLY stated in my post that the information regarding who trained who was offered up by an author who wrote a book on the history of Rescue 1, and that the factual basis of the statement made was questionable, but regardless was still out there. We can go back and forth all day long on who trained who, and who did what first, but I think it's a mute arguement because the factual basis for the claims are unsupported on both sides other then FD saying they were first and PD saying they were first.

Moose - No worries about the "like", it's not about "likes", but I appreciate the kudos. It's about discussing the truth without agendas and biased information being spread on the internet, especially here on EMTBravo, where there is a consistent anti-police, especially anti-ESU atmosphere. Like I said before, I believe that agenda is representative of the minority, but unfortunately sometimes the minority has the biggest mouth. It's not about "well the FD did this, and the FD did that"; it's about realizing that there are flaws and "not-so-sexy" stories on both sides of the fence. To consistently bash a particular agency, while continually ignoring the fact that your agency possesses some level of guilt when it comes to similiar actions, sometimes needs to brought up as a "people who live in glass houses shouldn't throw stones " style message.

Would you mind posting it. If it is the same one I am thinking of, I have been looking for it for a while and have not been able to find it.

Please don't take this the wrong way, but I'm not looking to post it just to stir the pot otherwise I would have put it up here a long time ago. I am not insinuiating that's why you would like me to post it. I am offering it to everybodygoes as factual evidence of my statements about that particular incident. Feel free to PM me in regards to that video.

Everybodygoes, I'm not looking to get into an arguement with you over what in the end is complete nonsense, but I am up for an intelligent rational discussion, so I'll respond to your post.

"The FDNY has been doing rescues since 1865, ESU was started what in the 20's?"

In 1865 the hodge podge of volunteer fire companies were superceded by the Metropolitan Fire Department, which in its beginning roots only covered parts of what is now Manhattan and later on Brooklyn. The FDNY officially became the FDNY in 1870. It wasn't until 1928 that the Bronx was pretty much completely served by the paid Fire Department, followed by Queens in 1929, and Staten Island in 1937. The Fire Departments main function was Fire Suppression. I have tried to research a bit more on the history of the FDNY and their involvement in rescue work, but have come up short in factual verifiable information. If you know where I can locate this, I'd be interested to read it. I know that Rescue 1 was officially formed in 1915, and Rescue 2 was officially formed in 1925. According to the unofficial website for Rescue 1, the formation of the rescue companies was borne out of several fires (Equitable Building, 1912, a Subway Train fire in 1915) wthere firefighters were encountered with difficult forcible entries, and realized the need for a company that carried specialized equipment to operate at these fire scenes. As time went on, Rescue began to get more involved in the Technical Rescue arena, but their original responsibility was to operate at fire scenes, and perform rescues of firefighters and civilians at structural fire scenes (taken from an unofficial Rescue 2 website). This was a time when the FDNY had their hands full with structural fires. Rescue 1 was first equipped with it's first Hurst Tool in 1972. The NYPD was officially formed in 1854 (20 years before the Metropolitan Fire Dept.). ESU was formed in 1925 from a pool of police officers who possessed special skills (electricians, carpenters, riggers, etc.) with the sole purpose of performing rescue assignments. The Unit was also known as the departments Firearms Battalion, and years later the Unit was coined the Mobile Security Unit, where it was tasked with responding to both rescues and tactical situations. Their role as a tactical unit expanded in the 1970's after the Munich Olympics massacre. Not sure when ESU equipped their vehicles with hurst tools. In a book written about the history of FDNY Rescue 1, it was written that members of the NYPD ESU actually helped train the first members of Rescue 1 (I'm not making claims to the accuracy of the material, just relaying what was written. I'll re-post the title of the book when I dig it up). ESU was formed to serve the cop on patrol. At a time when NYC was burning down and the FDNY had their hands full with structural fires, the members of ESU were a resource for the patrol cop to handle these rescue jobs. Before the formation of FDNY Rescue, members of the FDNY performed rescues with the limited equipment and training they had. Before the formation of NYPD ESU, members of the NYPD performed rescues with the limited equipment and training they had. So to say one was doing it before the other... not sure how much weight that holds.

Westchester County PD has hurst tools before the overwhelming majority of FD's, especially in the northern part of Westchester County, and were the only one's equipped to perform vehicle extrications on certain parts of the County highways for many years.

"You tell me who is better trained at doing it."

I don't know, who is? What discipline are we talking about? ESU members go through a Rope Rescue Technician course provided by a nationally recognized training organization that meets NFPA 1670 and 1006 requirements, and go for continual training multiiple times a year, whether it is self-driven Squad level training, mandated in-house training, or training provided by outside training organizations. ESU members go through an AVET course similar to the Fire Service, and through self-motivation and discipline will often visit local junk yards to train on scrap and derelict vehicles during the course of their normal tour to remain competent on their skills. They go through the EPA Haz Mat Technician course, the FEMA Structural Collapse Technician course, all meet and exceed the NFPA requirements. All ESU members are at a minimum EMT's with several Paramedics and one or two Physician Assistants in the ranks. Unless things have changed, all FDNY members are CFR's (with some EMT's/medics thrown in there). Since we are technically better trained emergency medical responders (as in trained to a higher standard), should ESU take over patient care activities when we arrive on scene?

"You show up with 2 we show up with 6"

You are correct, and sometimes 2 is all you need... more is not always better. I agree that on jobs that are manpower intensive (structural collapses, trench rescues) rolling 6 deep is a huge benefit, and necessary for the operation at hand, and something that ESU really can't compete with. But look at the majority of confirmed pin jobs.. they're simple door jobs that are mitigated in minutes. Quite often I'll see 2 guys working and 4 standing around doing nothing. Even on a simple, minor MVA with injuries on the highway when you have 2 and 2 rolling in with 4 (I think) guys on each piece of apparatus. That's 16 guys either standing around or jockeying for position for one totally stable patient. It's not a knock or a low-blow, it's simple observation. On a more technical or complicated job, we should all be able to work together, and I think the concept of working together is more prevalent in the outer-boroughs. I haven't been around that long, but overall I've had no real major issues when it comes to working together. What it comes down to more often then not is not the patch on the sleeve, but the mentaility of the individual.

As I mentioned before, Westchester County PD handled extrications on the County Highways for many, many years before a lot of the local VFD's had hurst tools, and they got the job done in most instances without 6 people showing up.

"But, don't tell me what happened in Brooklyn was a rare occurence, cause it isnt."

I didn't say it was a rare occurence. What I am saying it's that it's not a one-sided problem. I'm not trying to bash anyone or any agency, but I'll give you 2 examples. Queens, 2 ESU members tethered and outfitted in gumby suits are effecting an ice rescue. After making contact with the victims, members of the FDNY show-up and 5 or 6 run out onto the ice in bunker gear. No tethers, no protective suits, just bunker gear. Can you guess what happens? Ice breaks, and all of them fall through the ice into the freezing cold water and now they all have to be rescued. All of this was caught on video by a news chopper. Don't believe me, I'll post the video here. How is that scenario any different then the one you portrayed about ESU guys trying to be the "it guys", and endangering their own safety and the safety of the other responders who now have to get them out of the water? Or a more recent scenario. Water rescue, male in the water up along the seawall. ESU arrives, one member suits up in a drysuit, and while being tethered, enters the water and grabs the person in the water. While this is going on, FDNY members drop a ladder in the water, and insist on putting one of their own in the water, eventhough the person is "in-custody" for lack of a better term. Now the ESU member has to wait for the FDNY member to descend the ladder so him and the victim can climb the ladder out of the water. The FDNY member entered the water, and came right back up the ladder. What purpose did that serve other then to be the "it guy"? If we want to get technical, according to NYC CIMS, NYPD is the lead agency for all water incidents. What it comes down to is the A-type personality that the majority of us possess and everyone wants to be that "it guy", unfortunately sometimes people's judgements get clouded and irrational decisions are made on both sides, not just one. That's the only point I'm trying to make.

"Guys in Truck 4 are all aces, never had a single problem with them and they work with us well, and of course you cant paint with a broad brush, but it does happen and nothing is done to mediate it. "

Like I said before, I think as you get into the outer-boroughs, there's less drama overall. I don't have an answer as to why nothing is done to mediate it.

"Wonder why it doesnt happen in Yonkers?"

I don't know, maybe someone from Yonkers can chime in. Maybe it's a better working relationship. Maybe Yonkers ESU wants little to do with rescue work. Maybe we just don't hear about the problems. Maybe the current workload leads to few occasions where there's a potential for a problem. I honestly don't know.

Four troopers on hoseline four troopers not stopping crime or helping citizens in need. Looked like a surround and drown fire to me with no exposures. Who was doing the other jobs that had to be done.Crowd control traffic control etc.

Was there a large crowd that required the attention of 4 Troopers? Was there an overwhelming traffic condition that required 4 Troopers to mitigate it? Whats the function of Fire Police? Who was stopping crime? I would assume the other Troopers and local law enforcement working who weren't assigned to the fire scene. Helping citizens in need? Really? They were not only helping a citizen in need (the property owner) but helping the FD as well.

Keep trying...

Everyone might have shook hands and patted everyone on the back in the public view, but I think behind closed doors things might have been a little different.

Is this what you saw or heard? Since you alluded in another thread that you have intimate knowledge of specific scenarios because it's what you "saw or heard" from unnamed, non-specific and questionable sources, is your statement verifiable or just your biased, unsupported, made-up opinion?

Very well said George. The simple fact is that the Law Enforcement field is one of the most scrutinized, Monday morning quarterbacked professions out there. The media sensationalizes stories involving Law Enforcement to sell papers which turns the general public against us. "Community activists" love to blame the PD for all the issues that support their own personal self-righteous agendas without using their influence in the community to address the real problems that plague low-income neighborhoods. And every Bob, Dick, and Harry who watches some Hollywood cop on the big screen and plays Call of Duty 20 hours a day is all of a sudden an expert marksmen and a tactical genius who can shoot a gun out of the hand from a fleeing felon at 50 yards and then questions why we don't do the same when confronted with a real life deadly force encounter; not some BS video game encounter while sitting around in the living room wearing nothing but a pair of stained tighty whities.

Then I have to come on here and listen to a couple FD guys who always have something to say about LE? It's the hypocrisy that kills me with the whole thing, plus it sounds like a bunch of bratty crybabies alot of times. I'm sorry to say it, but it is what it is. Simple fact is when FD screws up, how often do you see an LEO on here chime in with some stupid comment? So far I've had nothing but good working relationships with FD guys, and I hope to keep it that way. I don't have the time, the patience, or the desire to cry about every little thing. Now I love my job and I take a lot of pride in it; but in the end it's just a job that pays the bills.