Medic137

Oh, you sweet young thing. A good day is when you have at least one option. EMS is remarkably different from the fire service. Every fire has one and frequently multiple officers actively engaged in the response. In EMS, officers are rarely at a scene unless they are crew. For standard calls the crew chief alone is responsible for the response and managing a scene. Even if an officer is on location, he or she does not direct patient care.
I've been a captain and can tell you that getting paperwork filed, keeping records up to date, ordering supplies, figuring out why there is oil all over the floor and settling the cat fights does not require extensive training on the uses of a cravat. As one of our finest past captains said, "The corps doesn't need a captain, it needs a mommy."
As organizations struggle to provide services, it is often for lack of management, not lack of medical expertise. With so many agencies working with dwindling pools from which to choose members and officers, I think agencies are missing opportunities if we pass over the individuals who may bring needed skills and enthusiasm to the organization.

Is this County Car 1 the position Smith got or is that the fire side line-up?
This is more than a fire position. The boss at ER has to be able to run the department, manage budgets and deal with people inside and outside the department, work with all the different divisions not just fire.
I'm sure they're people in Dutchess who are good managers but Smith was working inside the department for the past 4 years, learned the County system and got the job. He has been around the block as a paramedic and instructor not only an EMT. I never worked for him personally but I've heard of him and it was all good. Why don't you give him a chance before dumping on him?
If they had picked some fire fossil from inside the county nobody'd be happy either. Why'd the pick someone from Pawling or Poughkeepsie or Poughquag and not Red Hook or Rombout or whereever? We're much busier then them it should have been our chief or this one or that.
Of course its a good ol' boys club. That's why they call it politics.

"Expedite" is just a word. What one does with it is entirely up to the responder. It doesn't affect how I drive, but it does get me thinking about what I'm going to be walking into when I get there. "Expedite" actually tells me a lot. It means the scene is not under control and the person "in charge' is wetting themselves. That said, "Expedite" sounds a whole lot better than "I want my mommy!!!!"
Let's come up with something better. Ideas?
"35 Medic 1....'Clean up Aisle 5.'"

Sorry, but your counter argument is flawed too.
A college education in many occupations does equate to being "better". Doctor, Lawyer, Accountant & Engineer are a few that come to mind right away.
You are right that a college education may not make someone a "better" firefighter or company officer no matter how long they spend in school. However, the converse can also be true. Some people, no matter how great a firefighter/company officer or how long as one will automatically make them a "better" Fire Chief. They may be prepared to lead a scene or be able to make other operational type decisions, but 20+ years on the front lines may not prepare them for the rest of the job, like preparing budgets, directly dealing with city officials, writing grant proposals, preparing and delivering presentations to acquire additional or protect current department resources,etc.
I think there's a legitimate argument for a Fire Chief to have some degree of college level education.

The only time "expedite" should mean anything is when you're travelling non-emergency with the flow of traffic and then the request means you upgrade. I've told dispatch upon the request to "expedite" that we're already travelling as fast as safely possible. Isn't that how we always respond when enroute to a true emergency? Requesting units "expedite" is the equivalent of yelling/screaming in the radio, basically giving those prone to excitement the adrenaline rush to throw caution to the wind as they're needed at the scene NOW!

I am nobody's expert on burning stuff, but these come to mind: large portable batteries of various chemical make-ups, burning reacting drugs if it was an ALS unit, water hitting the main electric panel, the spare tire blowing (ambulances keep them in odd spots), aerosol spray can blowing, head-up strut on the stretcher...
When I worked in Ma, they had a brand new diesel burn- 1st model year diesel. Guess what did it? Driver adjusted his set and let the seat-adjust release snap into place -(remember the old ones slid left, not up like today's). When it snapped back, the rigid wire piece that pulled the teeth out of the gears on the other track of the seat popped out of its hole and hung down- right across the under-seat battery switch terminals!! It got hot and melted and fell into the carpeting under the driver seat. Total loss of unit.

While I agree that the first scenario, or both truly seem like heads up decision making, we do often have other reasons for not varying from protocols. Though it would seem the call was "obvious" sometimes and I imagine to a far greater extent in a much larger system, sticking to protocols validates them or shows the need for change.
In our case, anytime the dispatcher has a "gray area" they can contact the duty officer or first due IC and tell them what they have, prompting them to make or authorize the decision. Is there no way the dispatcher could call the first due IC and say, "we're getting multiple calls and I have R3 in the area?" Again, I doubt that type of heads up call would get anyone spanked in my system, but the larger the system the more rigid the guidelines tend to be.
Sometimes you have to take the rip and know you made the right call anyway, as long as humans are involved in the equation, no one will agree 100% of the time.

EMSbuff, thanks for the post and the stats. However, I have to add that the theoretical numbers often OVERESTIMATE the limits at which people actually become symptomatic and at risk for serious injury and/or death.
The Sleepy Hollow incident involved 3 people brought to the Phelps ER, of vastly different ages and sizes. The woman, otherwise healthy and very young, had a temp of 102 and a CO level of 30. She was seizing, vomiting and non-responsive.
Her child, 5 years old and also otherwise healthy, was also unresponsive, also febrile at 103.6, vomiting and also post-ictal but without a previous seizure hx. Dad told me she was probably seizing like the Mom has done in the past- like mimicking her somehow. I almost could have bought that, but kids can't mimick fever too. The child's lips and orbits around her eyes were cherry red. The child's CO level was only around 13.
The man who carried both in turned out to be Dad. He only complained of a bad headache but his eyes were bloodshot and he looked like he was wearing red lipstick. His CO level was 32.
After 100% O2 all around those CO levels drastically and immediately dropped. Turns out the FD found CO levels in the multi-dwelling house of over 30. If the other 3 kids and 2 adults had not been removed from the building, they'd all have died. No question.
After the child brought to Phelps got the oxygen, her temp dropped to 99.2 and she woke up. Mom also woke up and wanted out of the hospital ASAP. Dad was awake the whole time but stopped complaining of a headache. All were transferred to Jacobi and all will (thank GOD) live to tell the tale and hopefully never BBQ in the house again.
My points:
1. Don't go only by the CO level. ANYTHING OVER 5 IS POTENTIALLY LETHAL, regardless of the age of the victim.
2. If you ever find 2 victims suffering ANY of the same symptoms, regardless of age, get the FLIP out of the environment, call the FD and let them check out the environment from which the victims came.
3. If you, as an EMS provider, EVER show up and find someone down for any reason, and YOU suddenly find your head and/or eyes hurting, GET THE FLIP OUT of the environment and call the FD! Even if it is not CO, the FD will still thank you for playing it safe. And you might save your own life and those still in the house if it DOES turn out to be CO.
Please read this twice, at least. Being handed an unresponsive kid was traumatic enough and will stay with me a long time. But saving her was the best Christmas gift I'll get this year, bar none. We in this business know we rarely get such a good alignment of the planets and actually end up high-fiving each other over a save. Know what you're getting into early, know when to ring the bell and back the flip out. Then call in the calvary so you can get home safely to your peeps so you can tell them the tale as you pat yourself on the back for seeing it BEFORE you became a victim of it.
Be safe.
Tapout

Ah, another 'grasshopper'... What I would say is that 'shorter time to patient' is always better. That said, if this is THE goal, then there are many ways to achieve it. Every 'way' has a 'cost' associated with it. Cost/benefit is a decision that gets made long before we get dispatched to a call in the form of staffing and system management. The greater determinant in how long it takes to get help to a patient is how far away from the patient the help is, not how fast you drive.
Almost invariably, it is trained bystanders whose instantaneous help keeps a patient viable until EMS gets there that make the larger difference in outcome. And yet basic emergency tactics aren't even taught in schools. One can get a driver's license and not know what to do at an auto accident.
Minutes also carry different values. If time from injury to arrival of useful EMS is under 8 minutes AND it is a critical call, then shaving time here might make sense. If time from injury to EMS arrival is going to be 15 to 20 minutes, then shaving a minute or two here doesn't have nearly as much value.
As for RLS versus reckless, half of all drivers are below average. One need not be reckless to meet up with an inattentive driver who completely isn't prepared to stop or take evasive action.
Whether RLS has value needs to be evaluated case by case. I think the wise responder does this starting from the position that RLS is not worth it and then tries to build a case that it is,not the other way around.
These are good questions. If at 20, one does not have the 'fire in the belly' then one shouldn't be in emergency services. If one still has it at 50, then they also shouldn't be in emergency services. Remembering one of the great quotes on why a driver didn't go all that fast..."If the fire's any good it will still be going when I get there."

First, one of the things I love about sites like this is that anyone of any age or background can get us up and talking about stuff. I think this is great and this is not a bad question. We should all be able to answer it. To rephrase it a bit, why put them on in the first place ?
Any call for aid probably trumps what the majority of citizens are out doing in their cars on a given morning. The ability to cross the yellow line, to use the oncoming lane, to not wait for 6 cars waiting for a light to change and then turn left,.....well, lights or sirens help us do that. Abiding by every traffic control device and waiting for every driver in front of us is using a lot of time that most drivers will gladly give us if they know we have someplace to go. Lights and sirens let other drivers know a vehicle may not be where they expect it to be and that that vehicle would like a little courtesy.
Lights and sirens are like any other tool, useful if used wisely and for an intended purpose. Light functions in a straight line. It is very useful for signaling oncoming traffic and moderately useful for signaling same direction traffic ahead [if the driver is using his rear view mirror for more than hanging fuzzy dice]. Lights have no effect on traffic that is not direct line of sight.
Sound MAY--and that's a huge 'may'--- signal drivers not in line of sight. Physics here is key and I will skip the details unless people really want me to dig it up, but given sight lines in intersections, sound proofing in cars, reaction time of sober adults, and speed through intersections------- 10 to 15 miles an hour is as fast as a vehicle RLS can enter an intersection against a stop sign or red light. And that is if no one is texting.
So for me, lights [and much less often, sirens] is a way to say, "Excuse me." and move to the head of the line , but it doesn't mean one has to significantly increase speed. And if one does increase speed to the point that one outruns the usefulness of the lights and sirens, then that person is begging to have a collision for which that person will be responsible,and which will significantly increase response time for that call.
So, yes light and sirens are an essential part of the conversation that emergency vehicles have with other vehicles out on the road. But that conversation is a dialogue, not a monologue. Lights and sirens in no way give us the right to be aggressive with or disrespectful to other drivers.

Insurance data is valuable, but far from a full picture. Homeowner's insurance data does not reflect response to auto accidents, wild fires, searches, wires down, ice storms. In fact, structure fires is a small percentage of what we do.
I am aware of no studies on the subject, but 4 fire fighters will have a hard time handling a running brush fire 1/2 mile from the road or a search for a lost person..... and heaven help the person who actually needs someone to fight fire if they are the second call in district.
No one has made the case that towns are poorly protected if some manpower and apparatus is out of district. As a rule, a team of 4 or 5 individuals who are well trained can handle initial responses. I think the balance of departments can manage that and a parade.
Is there evidence to the contrary? Dare I say it, silence is deafening....