SteveC7010

I like it that there are emd protocalls to fallow and all i don't mean to bash dispatcher but we need more of them especially in westchester. because on a daily basis it seems like calls don't get emd. so what if the ebola patient doesn't get emd? should we wear full ppe for the sick call? i know that its not as wide spread as it is in africa and it is tightly under control here. Just a food for thought. But I am not too worried about it just yet.
On a different note, why can't we just have an automatic diversion to an approved ebola hospital ? why risk local hospitals and risk the staff there? if the patient doesn't have it and only has a bad case of the flu whats the harm? if they do have it and pass while transporting won't you want that ambulance crew at that hospital anyway? bets getting another crew possibly exposed and another ambulance exposed too? just some thoughts nothing more. but we could use some training in decon, I personaly have some and talking to others its kinda scary. I would prefer going through a decon wash line then just taking things off. and always with a buddy.

I am wondering why none of you have started to talk about this here? Have you not seen it yet?
https://www.health.ny.gov/diseases/communicable/ebola/docs/commissioner_order.pdf
It contains the actual order from DOH plus specifics required of hospitals, ems responders, and ambulance services. If you have not read it yet, I urge you to download the entire pdf and read it in its entirety. IMHO, this is going to have a major impact on every ems responder, but in particular the volunteer services may be even harder hit than others. I suspect many volunteers are going to be unwilling to comply with the initial and the ongoing requirements. This may to even more true of those volunteers who are not at least CFR's or EMT's.
Most material referenced in the order can be found on this page:
https://www.health.ny.gov/diseases/communicable/ebola/#ems_providers

I am wondering why none of you have started to talk about this here? Have you not seen it yet?
https://www.health.ny.gov/diseases/communicable/ebola/docs/commissioner_order.pdf
It contains the actual order from DOH plus specifics required of hospitals, ems responders, and ambulance services. If you have not read it yet, I urge you to download the entire pdf and read it in its entirety. IMHO, this is going to have a major impact on every ems responder, but in particular the volunteer services may be even harder hit than others. I suspect many volunteers are going to be unwilling to comply with the initial and the ongoing requirements. This may to even more true of those volunteers who are not at least CFR's or EMT's.
Most material referenced in the order can be found on this page:
https://www.health.ny.gov/diseases/communicable/ebola/#ems_providers

I see problems on all fronts. First and foremost, seasonal influenza and Ebola have the same symptoms, especially in early stage. That implies that we could easily end up putting on the suit for a lot of calls in the months ahead.
Problem #1 brings us rapidly to #2. Given the generally wide proliferation of seasonal influenza, we may not be able to use dedicated ambulances. As much as your suggestion has much merit, the numbers might not allow it.
#3 is tied to #1 and #2: Suiting up this often could easily place a financial burden on agencies big and small. One of the commercials in our area is not in the best of financial shape right now. The added cost could be the straw that breaks....
Your comment on the questioning prior to patient contact is dead on. I worked my career in a high volume, top-notch 911 operation. They were 100% EMD trained and experienced. Every request for medical assistance went through EMD. Additional focused questioning in that environment is not really much of an issue to implement, and just as easy to devise and implement effective ways to pass positive indicators on to the EMS responders without raising public alarm. However, that is not the case everywhere. Many counties have bare bones, small 911 operations even though they are central dispatch. No EMD, not enough personnel on duty to do EMD if they had it, and dispatch systems that don't utilize digital paging, MDT's, and similar alerting systems that would keep this information off the regular voice radios.
I see a huge problem in the volunteer EMS community with every aspect of this.

Pretty interesting. Our guidance in Maine has been fairly lackluster, basically mirroring or referencing CDC Guidance. I could see issues developing and implementing policies in the 10 day window, though its unlikely many will have any "patients" within that time frame. The bigger issue is how we ensure our people know they may be dealing with suspected Ebola (we can still say it here!) before they make patient contact. This requires quality questioning and honest answers. It's not feasible to suit up for every call, nor warranted. I'm still of the mind that a suspected Ebola patient should not be transported in a public EMS bus. Isolate, plan the transport and care, then use designated assets who are proven to be trained equipped and compliant. Improper handling could result in a widespread public health crisis.

I'm more interested to hear the real facts of the case. There is too much that is not said in the article and a whole bunch of open-ended statements and unanswered questions.
Did the plant manager approach the command post or just some FF on a hose somewhere? Was the IC ever notified of the request? What do they mean by "discharge"? That's a very vague word in this context. Were the firefighters intentionally discharging excess pump or tank water without regard to where it was going, or (more likely) was this surface runoff from legit hose streams? I'd like to know a lot more about the terrain between the paper mill and the power plant. If we're talking surface water runoff from the firefighting, would that not be the same as or very similar to a heavy rainfall or snow melt? If so, then why isn't the power plant better protected from surface runoff? I think there are a bunch of other reasonable questions that need to be answered here. While we in public safety all tend to jump to each others' defense in matters like this (and most of the time, rightfully so), there's just not enough information here to draw any meaningful conclusions.

Saratoga County recently updated their graphic scene and lighting
Before:

After:

I'm more interested to hear the real facts of the case. There is too much that is not said in the article and a whole bunch of open-ended statements and unanswered questions.
Did the plant manager approach the command post or just some FF on a hose somewhere? Was the IC ever notified of the request? What do they mean by "discharge"? That's a very vague word in this context. Were the firefighters intentionally discharging excess pump or tank water without regard to where it was going, or (more likely) was this surface runoff from legit hose streams? I'd like to know a lot more about the terrain between the paper mill and the power plant. If we're talking surface water runoff from the firefighting, would that not be the same as or very similar to a heavy rainfall or snow melt? If so, then why isn't the power plant better protected from surface runoff? I think there are a bunch of other reasonable questions that need to be answered here. While we in public safety all tend to jump to each others' defense in matters like this (and most of the time, rightfully so), there's just not enough information here to draw any meaningful conclusions.

Seth, right up until you asked the question, I would have said that NY plates only would be acceptable. But, I browsed through Article 30, Part 800, and the Policies and Procedures all the way back into the 1990's and found NOTHING. Doesn't mean it isn't there somewhere, but I sure could not find it with my trusty search words.
I'm located at least three or four counties from the Vermont border, and more from any other adjoining state. (We'll leave Canada out of the discussion to keep things simple.) Here in Fulton County, it's kind of obvious that an agency owned ambulance or fly car, or a POV EASV would be expected to have the appropriate NY plates. But for those in counties adjoining other states, it's a lot murkier. I suspect that there is more than one ambulance service based in an adjoining state that holds a NYS DOH CON for territory inside NY State. That leads to the obvious conclusion that there must be ambulances (and other EMS vehicles) with out-of-state plates bearing DOH Certification decals. The opposite is almost certainly true as well.
I'm fairly certain that none of the BEMS reps would certify a vehicle bearing temporary or dealer plates, but we'd have to have a BEMS rep chime in here to be sure.

There has never been an "official" EMT or Paramedic patch authorized by NYS DOH BEMS. It would be legit, however, for an agency or local government to adopt an official patch for their people, but that would only apply to people working within those agencies affected.
FDNY long ago had a modified version of the yellow or orange tombstone EMT patch. They pop up on Ebay once in a while.

The yellow/orange tombstone was the closest to an official patch that happened in the past. The NYSP look-alike patches are currently very popular, but again, not official, at least by DOH authorization.

Having worked for STAT Flight and two other air medical programs, I can hopefully offer some useful tidbits to this discussion.
The helicopter is a resource like any other. It is supposed to provide faster transport and a higher level of care. If either of those will help your patient, then use it. There is VERY good evidence to show that two things are happening right now with helicopters. 1) getting patients to LEVEL ONE trauma centers quickly and efficiently helps them. 2) there is some overuse of aircraft leading to patients being discharged within 24 hours of arrival to the receiving facility.
The days of mechanism based transport should be done, just like mechanism based treatment. So, think. Will using the a/c benefit your patient? Will it get them there faster? I have done flights 6 miles from the med center. Stupid. It takes longer to fly in that case. I can tell you though, it's really tough for a number of different reasons to show up at a scene and not take the patient.
There are a number of STAT Flight horror stories from the early years. They made some poor choices in their staffing model and did not adequately train their crews as to the mission in the eyes of the pre hospital providers. Gotta ask your customers what THEY expect. There is a great photo somewhere of Air 1 on the sprain running with a patient in the back all by themselves. Rest of the wreck had cleared. ALL OF IT. and there they were stabilizing the patient as the capt said. Dumb. But, they thought they were doing the right thing. In a way, they were. In a way, they weren't.
Enough rambling. Peekskill may or may not be a good spot for a/c usage. Waiting for life star from CT with a patient who is lying in the road, prolly not. Load and go, do your best on the way.

I live in the southern Adirondacks. The nearest Level 1 Trauma Center is Albany Med which is about an hour and 15 minutes from my home. From the far north end of our ambulance district, it's another 20 minutes at least; and even more if it's up one of the back country roads and into the woods. So we use the birds a lot, and have many saves because of the time saved over ground transport.
I used to live in Ontario County and worked full time as a Dispatcher II for Rochester-Monroe County 911. Inside Monroe County, we rarely used the helicopters. Primary reason was short ground time and choice of two trauma centers, even from the edges of the county. The only exceptions were MVA's with long extrication times and other rare situations with long time frames prior to getting the patient into the ambulance. Ontario County on the other hand used the birds a lot. Mercy Flight Central is based in north central Ontario County and has very short response times to anywhere in that county so they are a very valuable resource.
It's all about the time. In the situation that prompted this thread, I tend to agree with the original question of why call the bird with a 21 minute ground time. But not being on the team that treated the patient, it's not fair to judge either.
I would offer that if you can have the bird on the scene when the patient is packaged and ready for transport, there can be benefits, even with relatively short flight times, over ground transport. If there is any appreciable wait for the bird when the patient is ready to go, the value drops off rapidly. But it's the more distant situations that really prove the value of air transport.
Side comment here... Living and working in the Rochester area was good when it came to burn patients. Strong Memorial is one of the best burn centers in the US and being close meant that we got our burn patients there fast and had lots of good outcomes. Up here, the nearest burn centers, I believe, are Westchester or Syracuse. Both are several hours by ground from here at a minimum. Couple that with the fact that helos don't fly under certain weather conditions, and it you have a very scary situation for EMS dealing with burns.

I live in the southern Adirondacks. The nearest Level 1 Trauma Center is Albany Med which is about an hour and 15 minutes from my home. From the far north end of our ambulance district, it's another 20 minutes at least; and even more if it's up one of the back country roads and into the woods. So we use the birds a lot, and have many saves because of the time saved over ground transport.
I used to live in Ontario County and worked full time as a Dispatcher II for Rochester-Monroe County 911. Inside Monroe County, we rarely used the helicopters. Primary reason was short ground time and choice of two trauma centers, even from the edges of the county. The only exceptions were MVA's with long extrication times and other rare situations with long time frames prior to getting the patient into the ambulance. Ontario County on the other hand used the birds a lot. Mercy Flight Central is based in north central Ontario County and has very short response times to anywhere in that county so they are a very valuable resource.
It's all about the time. In the situation that prompted this thread, I tend to agree with the original question of why call the bird with a 21 minute ground time. But not being on the team that treated the patient, it's not fair to judge either.
I would offer that if you can have the bird on the scene when the patient is packaged and ready for transport, there can be benefits, even with relatively short flight times, over ground transport. If there is any appreciable wait for the bird when the patient is ready to go, the value drops off rapidly. But it's the more distant situations that really prove the value of air transport.
Side comment here... Living and working in the Rochester area was good when it came to burn patients. Strong Memorial is one of the best burn centers in the US and being close meant that we got our burn patients there fast and had lots of good outcomes. Up here, the nearest burn centers, I believe, are Westchester or Syracuse. Both are several hours by ground from here at a minimum. Couple that with the fact that helos don't fly under certain weather conditions, and it you have a very scary situation for EMS dealing with burns.

My experience is even when the helicopter is waiting for the patient they spend quite a while in the back of the bus and then moving the patient to the helicopter. I'm sure the flight paramedics and/or nurses feel the things they do are necessary but if they require 20 minutes then that has to factor into the equation.
My point is many people have cited extended extrication time as a reason to call but if the helicopter crew is going to spend almost a half hour prior to departing to get the patient to the point that they are comfortable with them in the back of the helicopter then the distance from the hospital that they become of benefit is further.
SteveC's example of the Adirondacks is exactly where they seem to be of the best use.

I live in the southern Adirondacks. The nearest Level 1 Trauma Center is Albany Med which is about an hour and 15 minutes from my home. From the far north end of our ambulance district, it's another 20 minutes at least; and even more if it's up one of the back country roads and into the woods. So we use the birds a lot, and have many saves because of the time saved over ground transport.
I used to live in Ontario County and worked full time as a Dispatcher II for Rochester-Monroe County 911. Inside Monroe County, we rarely used the helicopters. Primary reason was short ground time and choice of two trauma centers, even from the edges of the county. The only exceptions were MVA's with long extrication times and other rare situations with long time frames prior to getting the patient into the ambulance. Ontario County on the other hand used the birds a lot. Mercy Flight Central is based in north central Ontario County and has very short response times to anywhere in that county so they are a very valuable resource.
It's all about the time. In the situation that prompted this thread, I tend to agree with the original question of why call the bird with a 21 minute ground time. But not being on the team that treated the patient, it's not fair to judge either.
I would offer that if you can have the bird on the scene when the patient is packaged and ready for transport, there can be benefits, even with relatively short flight times, over ground transport. If there is any appreciable wait for the bird when the patient is ready to go, the value drops off rapidly. But it's the more distant situations that really prove the value of air transport.
Side comment here... Living and working in the Rochester area was good when it came to burn patients. Strong Memorial is one of the best burn centers in the US and being close meant that we got our burn patients there fast and had lots of good outcomes. Up here, the nearest burn centers, I believe, are Westchester or Syracuse. Both are several hours by ground from here at a minimum. Couple that with the fact that helos don't fly under certain weather conditions, and it you have a very scary situation for EMS dealing with burns.

I live in the southern Adirondacks. The nearest Level 1 Trauma Center is Albany Med which is about an hour and 15 minutes from my home. From the far north end of our ambulance district, it's another 20 minutes at least; and even more if it's up one of the back country roads and into the woods. So we use the birds a lot, and have many saves because of the time saved over ground transport.
I used to live in Ontario County and worked full time as a Dispatcher II for Rochester-Monroe County 911. Inside Monroe County, we rarely used the helicopters. Primary reason was short ground time and choice of two trauma centers, even from the edges of the county. The only exceptions were MVA's with long extrication times and other rare situations with long time frames prior to getting the patient into the ambulance. Ontario County on the other hand used the birds a lot. Mercy Flight Central is based in north central Ontario County and has very short response times to anywhere in that county so they are a very valuable resource.
It's all about the time. In the situation that prompted this thread, I tend to agree with the original question of why call the bird with a 21 minute ground time. But not being on the team that treated the patient, it's not fair to judge either.
I would offer that if you can have the bird on the scene when the patient is packaged and ready for transport, there can be benefits, even with relatively short flight times, over ground transport. If there is any appreciable wait for the bird when the patient is ready to go, the value drops off rapidly. But it's the more distant situations that really prove the value of air transport.
Side comment here... Living and working in the Rochester area was good when it came to burn patients. Strong Memorial is one of the best burn centers in the US and being close meant that we got our burn patients there fast and had lots of good outcomes. Up here, the nearest burn centers, I believe, are Westchester or Syracuse. Both are several hours by ground from here at a minimum. Couple that with the fact that helos don't fly under certain weather conditions, and it you have a very scary situation for EMS dealing with burns.

From a dispatcher's point of view, arrival size-up can be valuable. For example, if we know we received what sounded like a legit call for a structure fire, and the first unit on scene reported, "Nothing showing.", we would immediately initiate a rapid supervisor's review of the 911 phone call and ANI data. Excited citizens on untraceable cell phones give less than reliable info sometimes.
We also knew that "Nothing showing." was understood by all departments in the county to mean an initial, rapid size-up from the street as the first unit arrives, and that investigation would be initiated and a better report was to follow. Having a good definition of a phrase like this in place puts it in the right context.

The only way to determine if the grantee is following the grant award is to review the approved grant application for that agency and compare it to their actual performance. So you have to find a copy of the final grant award for that agency that includes the final and approved application.
It does seem odd that they'd use the grant money for firefighter training but not EMT. But you'd have to look at the application to know if it is OK or not.
Same for your other issues. If the application included hiring a retention specialist and an advertising program, then it's OK as well.

From a dispatcher's point of view, arrival size-up can be valuable. For example, if we know we received what sounded like a legit call for a structure fire, and the first unit on scene reported, "Nothing showing.", we would immediately initiate a rapid supervisor's review of the 911 phone call and ANI data. Excited citizens on untraceable cell phones give less than reliable info sometimes.
We also knew that "Nothing showing." was understood by all departments in the county to mean an initial, rapid size-up from the street as the first unit arrives, and that investigation would be initiated and a better report was to follow. Having a good definition of a phrase like this in place puts it in the right context.

From a dispatcher's point of view, arrival size-up can be valuable. For example, if we know we received what sounded like a legit call for a structure fire, and the first unit on scene reported, "Nothing showing.", we would immediately initiate a rapid supervisor's review of the 911 phone call and ANI data. Excited citizens on untraceable cell phones give less than reliable info sometimes.
We also knew that "Nothing showing." was understood by all departments in the county to mean an initial, rapid size-up from the street as the first unit arrives, and that investigation would be initiated and a better report was to follow. Having a good definition of a phrase like this in place puts it in the right context.

Thanks, Snotty, I knew somebody out there would bring up Education in The Fire Service. Way back when, before there was a FLIP, or for that matter, any formal education (except FDNY's Academy) there was a number of individuals who demanded education. My father went to the Delehanty Institute in NYC ni the late '50s. Then a new concept opened in Mount Vernon in about 1958. Imagine a course for firefighters taught by Manny Fried, FDNY who wrote the book on strategy and tactics.
The "nob" was then passed to guys like DC Oreste Spallone and Capt Seely Burigo who made Fire Science an Associate Degree course. Our education was now "official." We weren't done six or eight of us persuaded Mercy College to offer a BS Degree based on John Jay's curriculum and in 1977, I was proud to be in the first graduating class with a BS in Fire Science. Meanwhile, Doc Kiernan and a few Chiefs were working on a Career Chiefs Academy for new firefighters, then FLSS for new officers which was Statewide and Required.
Now, instead of taking 25 guys and burning things down (we called it "building a parking lot"), we can now take 150 guys, fighting a fire in a organized manner, and leaving fire buildings bruised but still standing. We also have better accountability, better equipment, and special teams like Hazmat, Tech Rescue, etc.
So what's my point in all of this? I sometimes hear of the new generation pointing fingers at prior generations saying today's way is better. Sure, it's better, but the new generation didn't make it better. It took a lot of work on the part of older generations to develop these innovations and hand them to today's firefighters.
You don't have to tell the old guys that they were doing things screwed up. They know that. That's why they changed things. Now, new generation, it's your turn to "take the nob." If you don't like something
change it, but remember, these things take time.
Oh, by the way, if you happen to run into an old guy, just tell him "thanks."

The problem here seems not to be in what the initial arriving reports but how that is interpreted by other incoming units. If you become complacent it is your problem not the problem of the guy giving the size up. Remember complacency kills!
I will qualify that with a note about how information is relayed to us effecting our perception. Think about central station alarms. We all know that the false alarm rates are astronomincal. However the fire service definition of a false alarm is greatly different from the alarm industry's definition of a false alarm. For the most part they consider a false alarm as anytime they get the passcode from a keyholder, no matter where he is or what the situation is.
For years as a dispatcher I would relay to responding units that the alarm company was attempting to cancel. None of the departments in Stamford will cancel a fire alarm but most if not all will downgrade to a single engine based on that information. Then once as an officer in a VFD we had an incident like this wher ethe alarm company attempted to cancel, our first due engine canceled everyone else and were met by the homeowner who had given the code to the alarm company. The homeowner told them not to worry, it was only a small fire. Now it was very small and had no extension, but complacency drove the downgrade. It was a combination of misplaced trust in the alarm company by the dispatchers (something I no longer do) and complacency by responding units about alarm calls. THe outcome could have been worse.
It is how we interperate and react to incoming information that we need to fix because that is something we can do ourselves.

From a dispatcher's point of view, arrival size-up can be valuable. For example, if we know we received what sounded like a legit call for a structure fire, and the first unit on scene reported, "Nothing showing.", we would immediately initiate a rapid supervisor's review of the 911 phone call and ANI data. Excited citizens on untraceable cell phones give less than reliable info sometimes.
We also knew that "Nothing showing." was understood by all departments in the county to mean an initial, rapid size-up from the street as the first unit arrives, and that investigation would be initiated and a better report was to follow. Having a good definition of a phrase like this in place puts it in the right context.

My original reply was about the posts that came after the pubic remark.
That is the point, we don't know. Based on the quality of the news reporting we will probably never know. However to assume that the building burned down because of something the volunteers did or did not sue is every bit as ad as praising them for loosing a building. As for watching the building burn down, the only way to stop that would be to keep your eyes closed at all exterior operations. Are there times when some IC's make a fire exterior that should be handled interior, absolutely, but we have no way of knowing from ths one article if that was the case.
There is nothing wrong with parades or social functions, as long as they are secondary to fire operations. IF your fire department has more classes of membership that are not responders than they do for actual active firefighters something may be wrong. However this is the way departments were organized way back when. I had to research my old department's charter once for a class, I found a short typed document from the state that said the department was a fire department located in the town and then went on to list the activities it could participate in, like raffles, fundraisers, carnivals, games of chance, ect. No where did it actually authorize us to fight fires. Now I like to think that is because it was taken for granted that that is what a fire department does, but it was still kind of odd to see the way it was written down.
I have had some similar conversations right in my own state. I have no problem with elections as long as there are more qualifications than a pulse to hold office. I was just talking the other day with a friend who is an EMS chief in NJ. She is trying to loosen up some restrictions on who can serve as Chief because of an odd conflict in between the number of officers and the requirements to have held lower ofices. Basically unless everyone moves up regardless of qualifications, nobody will ever be able to replace her as Chief. I have seen departments that put in lots of training requirements and then end up with no one who can meet them. So one has to strike a sensible balance.