Dinosaur

We just had a hospital in my area obtain level 2 trauma designation. From what I have been told, the main difference between a level 1 and level 2 has little to do with the level of trauma care that can be provided at the facility. The main difference is that the level 1 is a teaching facility and may have more redundancy allowing for treatment of more trauma patients at the same time. For example, having a couple of trauma surgical teams on duty vs only one.

I'm not sure if hospital trauma designations are consistent nationwide, but based on what I know for my state, it would probably be better to take the patient to the level 2 by ground than taking twice as long to go to the level 1 by air.

Here are the NYS guidelines for trauma centers from the NYS DOH website.

traumastds7085.pdf

I don't see the option anymore...

Boston was a strange situation to say the least. I am not all that happy with ordering people to stay inside during that man hunt, but I do understand the safety sentiments behind it. Given the type of incident and the number of casualties and the fact that the killers had proven they were not only willing to attack the random public but to attack police and other responders in secondary incidents, I can see why the decisions that were made were made, even when I do not entirely agree with them.

However I reject the idea that either the police or the equipment they were using turned the streets of Ferguson into any such thing. If in fact Ferguson resembled a war zone it was because of the criminals who refused to take part in civil discourse and instead felt that lynching a good cop was in order. They terrorized a community, committed multiple acts of larceny, burglary, vandalism and arson as well as intimidation, assault and possibly attempted murder. The police in Ferguson did not start the war.

Just curious, not to hijack the thread but, why aren't you happy with ordering people to shelter in place during the manhunt in Boston?

Boston was a strange situation to say the least. I am not all that happy with ordering people to stay inside during that man hunt, but I do understand the safety sentiments behind it. Given the type of incident and the number of casualties and the fact that the killers had proven they were not only willing to attack the random public but to attack police and other responders in secondary incidents, I can see why the decisions that were made were made, even when I do not entirely agree with them.

However I reject the idea that either the police or the equipment they were using turned the streets of Ferguson into any such thing. If in fact Ferguson resembled a war zone it was because of the criminals who refused to take part in civil discourse and instead felt that lynching a good cop was in order. They terrorized a community, committed multiple acts of larceny, burglary, vandalism and arson as well as intimidation, assault and possibly attempted murder. The police in Ferguson did not start the war.

We're talking about the marathon bombing? That's completely different than Ferguson. Boston was an act of terrorism. Ferguson is rioting and looting by criminals. There's no comparison.

LOSAP's are great for the guys who would be 30 or 40 year members anyway but do nothing to recruit and retain people.

I have no problems with certain military hardware in LEO hands, however when that hardware is used to turn the streets of Boston, MA or Furgeson, MO into a scene out of Fallujah with MRAPs and POs pointing assault rifles at unarmed demonstrators, as well as the tear gassing of journalists, I have a problem with that...

When journalists are in between the police and the rioters they're bound to be exposed to some tear gas. With my own interest in the subject and family in law enforcement, I watched a lot of the video from Ferguson and can only offer the following...

We have to protect our employees - and the police are our employees. This means when they're being shot at we have to give them armored vehicles and vests/helmets and support their use of them.

I guess we have to debate at what point a demonstrator becomes a rioter because if someone was walking toward me swinging a Do Not Enter sign like an axe I would point a rifle at him too. If this were a peaceful candlelight vigil I would agree that pointing a rifle at them was extreme but there was no way of knowing who in those violent crowds was armed and we will never know if the presence of those rifles actually prevented more violence or shootings.

Not sure what you mean about Boston either. Was there an incident up there too?

NYS just hosted a seminar on this very topic up in Albany a few months ago and there's a lot of legal issues before anyone can start doing anything like this. Guys from OFPC said that they had two of them and had to put them on the shelf because of federal regulations.

There were tons of agencies up there including a bunch from Westchester and the Hudson Valley. Maybe one of them can post more details.

Good thing this isn't a military surplus truck or they'd be getting beat up in the press for having it.

If rifles weren't included in this program, would they still be complaining?

Don't forget, Michael Frey was executed by a man with a rifle and the responding cops had nothing heavier than handguns to deal with it until Yonkers and NYC showed up.

And that was right next door to Tuckahoe in Eastchester.

Let the local voters determine the level of protection they need

That would be a bad bad decision. How exactly does an uniformed electorate make a decision like that?

Considering the quality of our elected officials, I'm not sure letting them determine the level of police or fire protection is a sound idea.

I have a question, how many firefighters have died in the initial phases of an incident due to disregarding 2 in- 2 out?

I know roughly 100 of us die annually, but about 1/2 of those LODDs are vehicle accidents, heart attacks ect leaving the other 1/2 as actual fireground deaths due to the fire.

Now I've been around awhile and I do my best to keep up on LODD reports and I can't really think of any incidents where disregarding the 2 in 2 out rule was a contributing factor. To the best of my knowledge (and I'll be the first to admit that my knowledge may be limited) the vast majority of fireground deaths have happened when a good number of FFs are on scene, operations are well under way and in most if not all cases a FAST was assembled and ready to go.

I can't readily think of any LODDs attributable to not following 2 in/2 out. The closest incident that I can think of off hand is Keokuk, IA in 1999. It was a triple LODD in the very early stages of the incident, but even though the known rescue exception applied, they had enough to meet the rule. However, you can't solely look at LODDs regarding this. You have to consider line of duty injuries also, but I'm not sure if that type of information is readily available or even tracked in that context.

1. Personally I find the 2 in - 2 out rule to be overkill and another attempt to make things safer that ultimately makes them less safe.

2. One thing to keep in mind about the 2 in / 2 out rule is that it really wasn't written with the fire service response to building fires in mind. If I'm not mistaken, it written for hazmat related incidents.

3. I agree that the rule does have a limiting aspect to it that can make an incident "less safe" as I alluded to above. Sometimes, waiting for the right number of people to arrive and letting the fire grow is not the safest strategy.

1. Overkill? Really? Let's be serious now, if it weren't for OSHA's 2 in 2 out rule, we would still have some departments operating with NOBODY standing around outside (including the IC). Two people isn't enough to perform the rescue of a down firefighter so what are we saying, we don't need to have a contigency for that? Two people isn't enough to perform many tasks on the fireground for very long so we are going to wind up with a lot of unfit people after a bottle change or two.

2. It was written into the respiratory protection standard and has been interpreted to include structural firefighting. See: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=22711

3. On the subject of the right number of people, we still have no consensus on what that number is (see below) but I think we can all agree that if we are talking about fighting a fire with just four people (and are even debating their required qualifications (interior vs. exterior) we are completely missing the point. I don't care if it's a career department with inadequate staffing or a volunteer department that can't get the numbers to respond, we are setting people up for failure. And since our mantra is often "failure is not an option" what the hell are we doing? Even the international association of city managers cites minimum numbers but we still bicker and argue about it.

• NFPA Fire Protection Handbook, 20th edition (2008)⁴: recommends the following minimum numbers of firefighters/officers to do the job safely. If this sounds like a lot, keep in mind that firefighters will always work in pairs, if not more, to complete the several tasks to get the job done as safely as possible. This includes such tasks as water supply, search and rescue, ventilation, rapid intervention, and so on.

Between 19 and 23 personnel typically constitute the first-alarm assignment to a confirmed single-family dwelling fire, as observed by evaluation teams.

Not fewer than 24 firefighters and two chief officers, one or more safety officers, and a rapid intervention team(s) should respond to high-hazard occupancies (schools, hospitals, nursing homes, explosive plants, refineries, high-rise buildings, and other high-life hazard or occupancies with large fire potential).

Not fewer than 16 firefighters, one chief officer, a safety officer, and a rapid intervention team should respond to medium-hazard occupancies (apartments, offices, mercantile, and industrial occupancies not normally requiring extensive rescue or firefighting forces).

Not fewer than 14 firefighters, one chief officer, a safety officer, and a rapid intervention team should respond to low-hazard occupancies (one-, two-, or three-family dwellings and scattered small businesses and industrial occupancies).

At least 12 firefighters, one chief officer, a safety officer, and a rapid intervention team shall respond to rural alarms (scattered dwellings, small businesses, and a farm building).

• U.S. Fire Administration (USFA): recommends that a minimum of four firefighters respond on or with each apparatus.⁵

• The International Association of Fire Chiefs (IAFC): advocates a minimum of five persons on engine and ladder companies. Noting that the reduction of members per unit and that the number of units has reached dangerously low levels, the IAFC says it would be “inappropriate” to accept or support further reductions.⁶

• The International City Management Association (ICMA): states in “Managing Fire Services” that at least four and often eight or more firefighters, each under the supervision of an officer, “should respond to fire suppression operations.” Further, it says, “If about 16 trained firefighters are not operating at the scene of a working fire within the critical time period, then dollar loss and injuries are significantly increased, as is fire spread.” It has found five-person companies 100-percent effective, four-person companies 65-percent effective, and three-person companies 38-percent effective.⁷

from: http://www.fireengineering.com/articles/print/volume-162/issue-8/features/fire-department-staffing-a-need-not-a-want.html

The bottom line is we still don't respond with enough FF initially and we don't stage reserve FF effectively for the duration, for contingencies or relief. Why is that?

The problem is it is generally enforced retroactively - after something bad happens. You can get away with it until someone gets hurt, or worse, and then they will be under the microscope.

At issue isn't the interpretation but rather the underlying purpose of the regulation, which as I recall was to insure someone was there to rescue the crew if something happens in an IDLH environment. Saying that two exterior FF is enough for the two out is a trap. If something happens to the crew in the IDLH, the exterior crew either has to rescue them in violation of the regulation or not rescue them and leave them to their fate.

I believe there are OSHA interpretations (really the only ones that count) that say the IC or pump operator can count toward the two out (if they're qualified) but think about that practically. A mayday is transmitted and the IC abandons command to become part of the rescue crew. Who will know what's going on or where the mayday is coming from? Who will know how many people are operating and where? There are so many problems with that strategy it isn't funny. Likewise the pump operator. He abandons his post and goes to rescue the crew only to find that more water is needed or another line needs to be charged by another crew. Bad plan!

The underlying problem is no standard for FF (outside of the career service) - at least in NYS - and no compliance with NFPA 1710 or 1720 to make sure enough qualified FF are on the scene.

I just wanted to note whether it matters or not...........9A is a very windy, hilly, bumpy, and heavily trafficked by large trucks taking up both lanes at times. A Code 3 trip to the hospital would make it even harder, as in many places on that road drivers have no where to pull over. Lifestar initially gave a less the 12 minute ETA. Given the traction splint the was out, I'm guessing he had at least one fracture.

Is road conditions and traffic in the protocol for deciding on whether or not to use a helicopter?

My EMT expired years ago but since when do you mess with a traction splint on someone unstable enough to require a helicopter?

If they gave an ETA of 12 minutes they could have been more than half way to the medical center by then. There's no extrication time and most ALS could be done en route so why the delay?

WHY?

A blanket response policy for "all" calls at a park or anywhere else is overkill. This wasn't a hiker lost on a trail. They stated they were in the parking lot, not a lot of confusion there. Is it really necessary to send three fire departments, two EMS units, and two PD's to a medical emergency at a known location?

Wow!

It's disgusting the way some EMS workers and Police Officers treat and label "EDP's"....even that term is wrong and hurtful, and I feel that contributes to many people in emergency services not seeking help. I also believe they fear being shunned for the rest of their careers should it make it to the gossip circuit or the kitchen table. There are some cruel people in our business who enjoy seeing their peers suffer.

How do EMS/PD treat EDP's that's disgusting?

To echo thebreeze above.....he IS different. He served this country in battle and deserves to be treated with special regard. Your response is cold, callus and devoid of reasonable consideration. This is a man who is as qualified as all and more so than most, it would appear. If the board has a reason, beyond cold-calculated political retribution, let them voice it.

There will certainly be a legal battle here, which the village will lose. They'll suffer shame and a waste of tax payer dollars to boot.

My score on future promotional exams will certainly be eclipsed by those with Vet. credits and they'll be promoted before me. This is good and right, they are more deserving than I because they gave in a way I never have.

If you get a 95 on your next exam and a veteran gets an 85, you'll still be five points ahead and ranked higher on the promotional list. Does that make the vet more deserving of the promotion than you?

No he is not he no more special then any other person who studies to get a good grade. He got the top grade with his veteran credits and that's it. What about the others who got the same grade without them? Are they not important??? Should they not get the chance for the same job? You must not have a great career like me or most here and know how hard the work is to get it or how long you have to wait so maybe you should get over yourself.

Domenick

First, I work on the greatest job on earth, I'm blessed more than I could possibly imagine, my career is not the issue but thanks for talking out of your behind again. I will reiterate, yes he is more important than them, because while they, and you, and I, were home here enjoying freedom, he was overseas fighting for it. I worked my balls off to get my job, but I never begrudged a single person who went before me because they sacrificed their time and safety to fight for mine, and as I go forward I will applaud those who jump over me on promotion lists because of their veterans points. They DESERVE it, in fact they deserve more than this country currently gives them. The veterans points is a mere drop in a bucket for what they actually deserve. I'm over myself, I appreciate the value of others service above myself, whereas apparently you lack the ability to understand that you might not be the most deserving of something, guess you got jumped by a few vets at some point. Maybe you should have studied harder, been smarter, or served in the military and you wouldn't be so bitter.

Matt

THIS is the beauty of his service for our country. You can sit here and have opposite opinions and you're not imprisoned for it or dragged out and beaten or executed. THAT's what he served for!

I don't think you are fully comprehending what the situation appears to be.

I can't speak to the specific civil service laws involved in this situation, but yes, typically they allow for the selection of one of the top 3 candidates on the established civil service eligibility list. In smaller communities, that selection is typically made by the Mayor or City Manager type position depending on the political structure in place. I get the impression that their system is set up in a fashion that the board votes to confirm the Mayor's selection.

In this situation, it appears that this person was #1 on the eligibility list and WAS selected from among those 3 top candidates. He was NOT simply passed over for selection in favor of one of the other two top candidates. Civil Service testing is typically conducted by a Civil Service Commission which typically does not include local government officials such as Mayors and City Council/Board members. As such, they would not know if he had a "bad interview" unless they somehow "score" the interviews, but if they score the interviews, then it really isn't an interview, it's an oral test.

Since it appears that the board votes to approve the Mayor's selections from the Civil Service list, the board's involvement in the hiring process may actually take place beyond the confines of the Civil Service system. If that's the case, then this certainly wouldn't be a matter of being passed over in the pick one of the top 3 phase, but rather a deliberate decision to deny employment and he would have a pretty good case.

The enactment of Civil Service laws were a direct result of this kind of government misconduct in the hiring process. The reason they didn't approve his selection is so blatantly obvious, that even a blind person could see it.

I'm not really clear on your point but they only have to pick one of the top three candidates. They don't have to give a reason or "qualify" that decision.

This is a political decision. It really has nothing to do with civil service and if they really wanted to clear it up, they would have to go 1-2-3-4-5 and couldn't skip anyone.

And so it begins...

Some have been predicting this for a while now. Including right here on EMTBravo.

Guys, I agree that veterans are special and they have already made sacrifices for this country but he did receive veterans credit on the test and that helped him be ranked number 1 for Sleepy Hollow. Had it not been for those points, he may not have been in the top 3 and this would all be moot.

Like it or not, politics, personalities, and other subjective factors play into the hiring process. It is not merely an exam score. He's number 11 countywide which probably means he's received several canvas letters or will receive them before the next academy class.

There are no legal grounds for anything here. The law is pretty clear - hire one of the top 3 candidates - and it has been tested on numerous occasions so his attempt to sue would just be a waste of his money.

The boards of many little communities are the final say in personnel matters. The chief may be able to recommend but the final say is the villages. Yes, that is pathetic!

Dinosaur, I guess you are not a veteran! This man gave up 6 years of his life for his country and his home town. He does deserve more!

Is there a provision in the LAW that gives veteran's hiring preference? This is clearly just BS small town politics as usual.

So? People get passed over in job selection all the time. They can take 1 out of the top 3.

As far as staying back far enough as to not interfere? Who decides whats "far enough"? The cop who might be trying to keep you from filming him? Some cops might think a good distance is three blocks away. Now what?

I think most would agree that if you're sticking your body parts into the melee you're too close and we've all seen those videos lately. If you are close enough to reach out and touch the cop, you're close enough for him to be worried about someone reaching out and trying to take his gun.

Times are changing? How? The abuse of mutual aid by many fire departments has been going on for decades. It's not always the same department(s) but it's always the same song. I've heard mutual aid for rubbish fires to warehouse fires in both volunteer and paid departments.

The bottom line is we keep ignoring the fact that only a couple of departments in the STATE comply with NFPA standards for minimum response and we allow people to believe that there is no problem when we are dangerously close to a major shortage of qualified firefighters in the region.

1. Garner was not put in a "choke hold." That terminology is only used by the lying, sensationalizing media. He was put in a "carotid neck hold", which many police officers are trained in. The neck hold does NOT "choke" the suspect or restrict the airway at all. The neck hold is an alternative to using a baton or punching a resisting suspect and it has prevented thousands of injuries to suspects and officers.

A few of us old retired types are having a few adult beverages last night when the topic turned to this incident. Two retired NYPD friends said that this was NOT a carotid neck hold. In NY that has been designated deadly physical force and couldn't have been used unless deadly physical force was authorized. They went on to say that that is a two arm technique and wasn't what you see in that video and nobody in NYPD trains on it.

They said headlocks were the only way to get some people under control and if they ban them there will be big problems.

Now don't kill the messenger. I'm only sharing some expert opinion from some boys in blue!