PC414

Forty-nine years ago today was the "day the music died" in Clear Lake, Iowa when Buddy Holly, Ritchie Valens and J.P. "Big Bopper" Richardson died in the crash of a Beechcraft Bonanza just minutes after take-off (an event which also took the life of pilot Roger Peterson). Don McLean's song, "American Pie," has been floating around ALMOST as long as many of us have. One could reasonably say the tune has been woven into the fabric of our lives since its initial release in 1971, although I suspect there are many who are unaware of the story it tells. "But something touched me deep inside, The day the music died. So, bye bye Miss American Pie, Drove my Chevy to the levee but the levee was dry Them good ole boys were drinkin' whiskey and rye Singing 'This'll be the day that I die.'" It's funny, isn't it, how we mark the days of our lives with such things? Bob

Twenty-one year olds are in charge of a lot of things in life. At 21 - a long time ago for me - I was a buck sergeant in the Air Force and resposnbile for the supervision of a crew. I knew a significant number of 18, 19 and 20 year old men and women at the time charged with the security of nuclear weapons. They could be trusted with live ammunition and the ability to use deadly force if needed. My father was a 1st lieutenant in the US Army Corps of Engineers commanding a platoon of roughly forty men in combat during 1943 at the age of 23. It isn't all that strange for relatively young people to be charged with fairly heavy responsibility. I'm old(er) now. Been in charge of some people over the years and had some "kids" tell me what to do on various jobs, too. No problem as far as I can remember. Maybe I just don't remember 'cause I'm old(er), though. Personally, I vote for the "kid." If he meets the qualifications of the department and enjoys the support of his subordinates, more power to him. Bob

"VTL 1226. Control of steering mechanism. No person shall operate a motor vehicle without having at least one hand or, in the case of a physically handicapped person, at least one prosthetic device or aid on the steering mechanism at all times when the motor vehicle is in motion." Additionally, DMV still teaches use of hand signals, three of which are illustrated in the on-line Manual. That knowledge presupposes, at least in theory, that one hand will have to be off the wheel. I personally doubt that there will be any tickets issued for "one-handed operation." I also have no doubt that any patrol officer who wanted could find SOMETHING to write-up for most drivers, if they were of that mindset. As always, drive carefully and with purpose. Bob

So ... just a (probably unpopular) thought ... Anybody else think it's kinda' silly to let the Grand Jury actually decide if there is sufficient evidence to indict and then a jury of his peers to determine guilt (within the context of the U.S. and New York State Constitutions) BEFORE we introduce the "dam pedofile" [sic] to "bubba?" All that "due process" crap probably isn't very important anyway, is it, if you're REALLY a "Law and Order" kinda' guy (or gal)? HOLY COW! Bob

I never participated much in parades but I sure watched a lot of 'em. Ole, your excellent post took me back DECADES to Boxford, Massachusetts and Harrison, Maine (and a lot of places in between) and the bright-eyed kid I used to be. Thank you for capturing the heart and motive of many who march. Bob

Yes, there is real, formal training. http://www.icisf.org As an aside, Dutchess has their own excellent critical incident response team. Bob

After all this, the only question my feeble, old mind can think of is "Where are you, Tony Baretta?" Times change, huh? Or, sadly, maybe they don't ...

I appreciate the warm wishes. It has been a long and (often) trying time since I finished my last C-line on February 11th. As my wife occasionally reminds me, "Growin' old ain't for wimps." My return to the office is delayed until Friday the 18th per "doctor's orders" but I expect to be there bright and early for the B-line on that date. I look forward to working again with good friends, both in the office and in the field. Bob

Snopes.com indicates the story is true; however, it goes back to January, 1996.

"The picture with the water falls by inn at the falls is not an actual dam." Just as a matter of interest and safety (boaters, fishermen AND responders), this structure is, in fact, something called a "low head dam." They can be deadly - not just to unwary civilians inadvertently swept over them but to rescuers as well. A Google search including the words "low head dam" and "rescuer death" or "danger" can offer some intense and educational reading, along with video and pictures. PC414 EDITED TO ADD URL: http://files.dnr.state.mn.us/education_saf...ningmachine.pdf

Info "straight from the horse's mouth" at www.sperryrail.com. While more employment-oriented, the web page also gives an overview of the company mission and methodology. If you're interested in specific SRS track vehicles, check out www.krunk.org/~joeshaw/pics/sperry Bob PC414

Recognizing the overall statistical insignifigance of "a survival rate of 0.5 per cent," I still wouldn't mind someone tryin' to see if I could "make the cut," were I in this position. Assuming, of course, the crew had the time and nothing much better going on back at the house ... "If the test were applied, it would reduce by about two-thirds the number of patients taken to the hospital, the researchers said." Well, what can one say? It's a good thing good we're gonna' cut down on the crisis in emergency healthcare by addressing this patient issue instead of the glut of people who clog the ED for coughs, colds, aches and pains and other assorted minor ailments. Maybe I misread the article. Seems like STAT123 gives it the correct "good ol' college try" with "my current protocols allow me to terminate after 20 minutes of BCLS and or ACLS. So, if we don't get 'em back after 20 minutes, its over. OVER. You bring the family in and explain the situation, and then TERMINATE." That's all I'd hope for, personally. Article on the study , to me, seemed to not give any "wiggle room" - even 20 minutes worth - which might make a difference to the "statistically insignificant" 0.5 percent. Any thoughts? PC414

"I don't see a 9 yom w/a broken arm as a alpha or bravo level call. I see a child in pain in need of care in a reasonable amount of time." Well said, Tanker, throughout. Thanks. PC414

Well, a couple of things, this hot afternoon ... Tanker, not sure if I'm misreading or something but no "bubble to burst" for me. Not disputing that you've ridden with a medic on an Alpha level call in the past (or even the reason Putnam is sending them on Bravos now). Just information in my original post and not commentary or editorial at all. The fact is, though, that since instituting the EMD program not quite a year ago, we do not send medics on Alpha level calls - even when they can't be staffed. We just keep going mutual aid until they are covered by a BLS crew. Possible exceptions to that based on a unique experience? Sure, or I'd so imagine but there is a STRONG emphasis on protecting the tiered-response in dispatch that comes from the top down. I also got quoted for an awful lot that I didn't actually say or write but that may just be a function of the "Reply" button, I don't know. If I came across in my post as disparaging or something, I apologize. Just recounting the things I have to practice four days out of every six for at least eight hours a day. I have no personal vested interest in the way agencies are dispatched, respond or anything else. I do what the bosses tell me to the best of my ability and adapt as new directives come down. Generally speaking, the "line-up" that Skooter92 detailed is accurate, I think. My comments about the "unknown" refer specifically to the questions raised earlier about mutual aid dispatches after 5 minutes, not to the specific number of medics and so forth on duty in the County. Again, if anything I've added to the conversation has rubbed anyone the wrong way, feel free to PM (or continue to discuss same here). That was certainly not my intention. PC414

Good questions I'd just be guessing as there has been nothing passed on through the office at this (still) early stage. I would suspect that the article may not be 100% accurate (constraints of space/editing, misunderstanding/misinterperetation by the reporter, etc.), at least based on logical questions such as you raise. Gonna' be lots of speculation for a while. Sorry I know of nothing concrete to help. PC414

I don't know much to add, Alpha - seemed like an excellent summary to me! Maybe I'd add that most calls involving some kind of "unknown status" are "Bravo." An interesting aside is that, as developed, the Bravo protocol does NOT include ALS. It was originally meant to be a "hot" BLS only response. Putnam County, when implementing EMD, decided it would be better to change the Bravo dispatch to include ALS. No idea how common that is. As practiced in Putnam: Alpha level - BLS only. All others - ALS sent on original dispatch. Practically speaking, response modes are addressed by local agencies and not by the County. No one here monitors lights and sirens for Alpha level (or whatever). The designators give some sense of "seriousness," although, frankly, I don't believe that is/was the intent as developed. It may be a misconception on my part, but Alpha level calls don't seem to generate the quick call-ins an Echo level call usually does. Alpha level isn't BS though - could include broken bone, amputation (non-dangerous body area, of course), etc. As written/developed ("cold" and "hot" response are terms used in protocol - not really defined but assumed, by me anyway, to indicate use of lights, siren and level of urgency). Alpha - BLS "cold" response Bravo - BLS "hot" response Charlie - BLS "cold"/ALS "cold" response Delta & Echo - BLS "hot"/ALS "hot" response. I'm about 99.9% certain (but too lazy right now to either check online or in the textbook), that the protocols were originally developed (Salt Lake City) to determine an "appropriate level of response" to limit liability issues. Like, "Why were you going lights and siren and hit the other car for a dislocated pinky?" It works but it sure ain't perfect. Hmmm ... guess I added more than I thought ... PC414

http://www.lohud.com/apps/pbcs.dll/article.../607260359/1017 PC414

"How often have any of you seen the E.D. let family members into the room when they are treating the patient?" While I don't disagree with the principle noted, to specifically answer your question about the E.D., my experience has been FAR different (Poughkeepsie, NY and Greenfield, MA hospitals). In raising two boys to ages 23 and 19 (and a wife in need a couple of times, too), I was allowed in the E.D. with family members during treatment for three broken bones, a ruptured eardrum, (ruptured) etopic pregnancy (including insertion of catheter and IV) but obviously not surgery following ... glass removal, suture and bone-setting following a fairly serious PIAA which involved loss of consciousness and extrication; and a host of minor ailments, too... During an almost 20 year career in ministry, it frankly wasn't that uncommon (again, Poughkeepsie area hospitals) to allow me to remain with a congregant, either if family wasn't present or they requested same. Clearly NOT (and never) a situation involving recusitation but still a regular presence during E.D. treatment. I never thought it was unusual. It generally helped at the time, too. Just my experience and, again, not arguing with the sentiment expressed - especially in the back of an ambulance. Just a couple of "cents." PC414

Holy cow ... PC414

"Where and by whom?," he asked with skepticism. PC414

Well said, WCDES636, at least from my perspective. PC414

So, I've got a question. Be patient, if you can, with some loose definitions. Teach me ... don't "burn" me From my limited perspective (volunteer FF w/20+ years experience, EMS experience limited to driving the ambulance and basic first aid/CPR a couple of times; Advanced EMD 9-1-1 dispatcher), it appears that EMS is sort of the "bastard step-son" of emergency services. PD is certainly a municipally-supported branch and in most ways, I think, fire suppression is, too (even at the volunteer level - although "subscription services" and Scottsdale, AZ(?) may be notable exceptions). Of the three "branches," isn't EMS most generally dependent on private services and lacks most some kind of tax-based support (again, with some exceptions - most notably with FD provided EMS)? My question is simple. Why the argument over which is best given the current system (i.e, private services versus FD-based)? When I dream of an "ideal" municipally-based EMS system, I don't personally think of FD-based ALS but of a separate, equally-funded system wherein Police, Fire and EMS all have the needed tax dollars to provide the very best and same quality emergency services to the residents of a community. This is NOT to imply that private medics and EMTS don't or can't. Don't read that into my poorly-worded essay here 'cause nothing is further from my mind (or the truth). I just don't get why the history/tradition of emergency services gives tax dollars for needed services like PD and Fire, while letting EMS go without. This is not a "vollie-vs. paid" issue (see paragraph 2, above). The people of my volunteer Fire District contribute a tax which goes toward fire protection, approve bonds when new engines are needed, etc. Their taxes help fund both a County Sheriff's Office and the New York State Police. Why is the BLS ambulance replaced by fund raisers and donations? Why is ALS dependent upon who can be hired by a private agency which constantly must struggle between legitimate profit for the principals, the need to invest in personnel and equipment, etc.? I personally suspect EMS got "thrown" to the FD not to generate call volume but because some "genius" who doesn't understand the issues said, "Hey, let's make/give these firefighters something to do between runs 'cause we're paying 'em anyway to just sit around between fires." While I don't have figures available to quote exactly, my understanding is that the good people of Putnam County pay more for garbage pick-up then they actually would see as an increase in taxes if the County were to fund a viable, County-based ALS system for the residents. Because my involvement with EMS is more peripheral, I may not understand the issues well. Can someone explain to me what it would take for EMS to achieve some kind of better parity with police and fire in a municipally-supported sense? Thanks! PC414

I'm currently stuck in Essex County, MA - not many miles south of the NH border. Last report I saw on NENC for Topsfield (town next door) was 11.95 inches of rain with up to three more expected by Noon on Tuesday. This has been an amazing experience. Helped fill some sandbags with local FD for the top of an earthen dam about to be breached - fortunately within walking distance and something to do 'cause we ain't driving back to Dutchess for a day or two yet with dozens of local roads still flooded. PC414

You are correct. It was a County-wide MCI drill held in the Brewster District. The drill was an occupied Metro North train vs truck (fire and entrapment) at Route 312 (xst Ice Pond Road) and the Metro North tracks. From memory here: operating units included Brewster Fire and Ambulance; Patterson Fire and Ambulance; Putnam Lake Fire and Ambulance; Carmel Fire and Ambulance; Mahopac, Mahopac Falls, Garrison, Lake Carmel & Kent Ambulances; HAZMAT Team; CATeam; CC2, CC7, CC30 & 31; Alamo medic; Croton Falls engine (148, I think?) on standby in Brewster; Metro North RR and MTA PD; PCSO & NYSP ... Probably forgot someone (sorry) ... Staging area was Wells Middle School. Dispatched equipment was held there for an appropriate period of time before responding to scene to simulate getting a crew, drive time, etc. Brewster and Patterson were out on a first alarm due to reported proximity of accident near the District line. PC414

"Another component to this problem that no one has addressed is the location of some of these calls that are going unanswered for 20 minutes. They are facilities such as nursing homes and assisted living senior housing, that are calling 911 for BLS transports. " While you are right in noting that "some of these calls that are going unanswered for 20 minutes" are at "facilities such as nursing homes and assisted living senior housing," the emphasis should be on "SOME." I may have misread your emphasis or the point you were trying to make and, if so, I apologize. Statistically speaking, though, the facilities you identify represent a relatively small percentage of the total call volume within the County, as well as a relatively small percentage of the number of calls which go unanswered for 20 or more minutes. Additionally, the significant difference in terms of response times seems to be time of day and not the location or nature of a specific call. We can have as much difficulty covering a call for chest pain with difficulty breathing as we do for an (apparent) BS run to a nursing facility, depending upon the time of day. Conversely (and speaking in a general sense), the ambulance corps which cover these facilities respond in a timely and professional fashion even for (apparent) non-emergencies when they have adequate staffing available. When my department had trouble getting our ambulances out during the daytime, we entered into a contract with Northern Dutchess to provide the people of our community with better EMS care. Volunteers who are able still respond as before. Limited manpower doesn't prevent timely care as it once did, though. While I'm not sure how the new system in Putnam County will ultimately work out, it seems to be a step in the right direction. I guess time will tell. PC414