mfkap

There is a difference between using a privilege and abusing one. If you are on duty (like police, paid EMS) and there is a decent chance that you will receive a call in the next 5 minutes, stopping in the fire lane while you get a slice seems reasonable to me. If you are a fire chief from a neighboring village, and your response time to your one call a day will be increased from 10 minutes to 10 minutes and 30 seconds, becoming a road hazard doesn't seem like the right choice. To continue the off-topicness along this line, if you want a good example go to WCC's main lot downhill from the Science Building. I did a study on it for my anthropology class about 2 years ago. There are 14 handicap spaces. Over the period of 2 weeks, with random sampling, there was a 5% correct usage of these spots. Over 90% had permits, but of those, 10% were expired, 10% were altered (like a 6 into an 8 or the expiration smudged off), and the rest were kids using granny's permit, and showed no problem walking or running while carrying a backpack. It was really infuriating at a point, because the people with needs ended up having to double-park, and then they were the ones that got tickets.

Nah, that part will be below the waterline when the out-board is hooked up and going.

That is very true.. he has been FIRMLY against it for almost 3 weeks now. For about 10 years before that, he actually supported many aspects of it. I guess that counts as strongly against as long as you are one of those people who don't let facts get in the way. If you want a list of the over 70 position changes he has had since going from "maverick" to "courting the right wing" you can visit http://www.thecarpetbaggerreport.com/flipflops?t=3 . Of course you won't, but it doesn't make it not true. SOURCES: http://blogs.abcnews.com/politicalradar/20...n-reverses.html http://www.ontheissues.org/Senate/John_McC...ivil_Rights.htm "It doesn't take a great deal of effort to get shot down" - McCain

Haldol can be used off-label to control acute agitation (per ePocrates). I myself would have thought some ativan would be a good thing to throw in there, especially since another seizure could be coming. How can an agency carry Glucagon and D50 and not carry a blood glucometer? Isn't that like giving an anti-arrhythmic without having a cardiac monitor?

Because one guy is working the Parks Dept in village 1 and the other guy is working parking in village 2. One has an ambulance, the other has a flycar. Heck, in our system I think that the flycar responded to the HQ to get the ambulance with the local driver. It is a 15 minute drive with traffic lights between the two, and about 3 minutes with hats n horns. By no means a good system. But better than the crap we have now.

This certainly isn't the solution.. but it is a step towards fixing things. I have read a few articles here or there about EMS around the country, and one thing I am consistently amazed at, is how incredibly stupid the Westchester system is. Take the villages that Greenburgh ALS covers. This system has a total of 11 front-line, volunteer ambulances. Of these 11 ambulances, they belong to 6 different agencies, so really they need a total of 12 crew members available at any time for basic coverage, and 22 crew members to fully staff the very expensive ambulances they all have. At any time, up to 4 or very rarely 5 of these ambulances can be out on calls, but usually it is around 0-3. So, for example right now, there is one village out on an ambulance call. There are 12 people that need to be available for that one call to be covered, because you don't know which village will have that 1 call. Now, with over $1 million in ambulances sitting around, to cover 30K people, there are coverage and mutual aid problems all over the place. Tell me that the system isn't broken at the core (keep in mind that ALS manages to cover the entire 5 villages from any one central point). Two stations, with 2 ambulances each, on different sides of the villages, could cover just about everyone. And these 6 villages together could piece together 4 crews (really, 2 would do, with a backup crew or mutual aid). And with the $600K you saved in buying ambulances (never mind insurance, workers comp, etc) you could pay to staff those ambulances if the volunteers vanished. And I will eat my hat if something like this even comes close to being planned. A village would rather have an ambulance roll up with two senior citizens as the crew than work with other villages. And ego is what will keep people waiting for 45 minutes for an ambulance. Just imagine a system without ego... what a dream that is!

I just wanted to throw in my $.02 because, about 4 years ago, my agency was having a very high % of calls going MA, and I was Captain (some might say the two were related). We had a situation where everyone had a driver around (village employees) during the day but EMT's were in short supply, or there was an EMT/Driver only. We proposed the idea of a BLS flycar, had 5 agencies sign onto it, and even had a insured emergency vehicle provided to us (for free) if we could staff it using Volly EMT's from the 4 or 5 villages that would participate. Unfortunately, like most progress, it was shot down at the last minute by the same people that cause most of these problems in the first place. The argument against it then was that same silly argument that "If you can staff a flycar, you can staff a bus". But when Dobbs Ferry has a driver, and Ardsley has an EMT, it can take 10-15 minutes to navigate that 1.5 miles during the day because of traffic and lights. A flycar is a great, productive way to pool resources. But the recurring, nonsensical idea that "Well, if you can get one person from two villages, you can get two people from one village" never seems to go away. I think that is a reason that the Westchester Volly EMS system is a great way to kill people, and is fighting tooth and nail to stay that way. Why fix something when it has been broken like this for so long?

How could something like this happen? If a patient needs a collar, I don't think using any sort of stun device on them will be safe. Wouldn't that be the type of patient you would never stun? Have stun devices turned into a first-line option instead of the less-lethal option they were intended for? http://www.sun-sentinel.com/news/local/pal...0,4167012.story

Usually I don't have twinkies, but I never get my lunch cause I always give it to a patient. And if I didn't wrap their hands before fighting, they might hurt their hand on my face!

With that logic, you must push fat people down the stairs so you don't hurt yourself carrying them. I mean, they are going to the hospital anyway...

The "trying" to hurt your patient was a poor choice of words, and was somewhat clarified later in the paragraph. I meant their actions they were trying could hurt the patient, but not in any way their intent. I have been in emergency services for a few years, and between my work in Westchester and the City I have a pretty good understanding of what both the EMS side and the Police side have to deal with. This was never intended to become an anti-taser post, or to state for a fact that the officers in Florida did the wrong thing. It was more about having to treat a medical case different than another police call, since this had both the potential of a postictal state or even postictal psychosis, and the added risk of a possible c-spine injury, combined with the muscle spasms that are caused by a taser. I understand that as a police officer you sometimes don't have time to go through that entire checklist before you have to take action, but isn't that the point of discussing it here? So you can do the thinking before game-time? Here is an update on the story. The guy who got tased was a physician, Dr. Mark Holder. And, according to the PD accounting of events, it seems like it was necessary and appropriate. http://www.palmbeachpost.com/localnews/con...rail.html?imw=Y

http://www.azcentral.com/arizonarepublic/n...730taser30.html And Taser just lost a $6 million judgement http://www.mercurynews.com/news/ci_9514402 And don't forget that the UN considers the use of the Taser to be torture http://www.news.com.au/dailytelegraph/stor...from=public_rss And while I can agree with Taser that it is usually non-lethal to a normal, healthy male, I saw a report or two where the police actually got involved with someone who was less-than-healthy, maybe even on drugs or "crazy". And as for the prolonged struggle argument, I don't think that a scrawny 18 year old "don't tase me bro" kid was going to take a half-hour for 3 police officers to subdue. I myself am a big fan of the Tasers and think they are a great tool, I just see so many reports where the person was Tased 10 seconds after the first warning from a police officer.

There is a little more info here, at http://www.sun-sentinel.com/news/local/pal...0,2762218.story . He was a big guy, and being combative. My point remains, you have a possibly postictal patient with a possibly compromised c-spine... unless this guy was shooting at you, I cannot see the safety in using anything that causes further involuntary muscle spasms. Physical restraint would be safer for the patient than inducing muscle spasms. Lets say he was grabbing at the collar and trying to grab or push the EMS crew, or even took a swing at an officer from his seated position in the car. Take a few steps back and let him work his way out of his postictal state. Give him room. But using any sort of stun device could cause further injury, especially in a patient with "serious injuries" as the article describes. Another thinking point, what if you are the EMS crew and the police are trying to hurt your patient? In the hypothetical world, what if you are at this call as an EMT. The patient is postictal from a witnessed clonic-tonic seizure. The patient is trying to push you away, and you take a few steps back for your safety. What if the officer pulls out his taser? Your duty is first to the patient, and the police officers actions could be harming your patient, who possibly has no control of his actions at this point. What is your role as a medical provider?

Well, assuming that you are using the US definition of BAC, where it is grams of alcohol per 100 grams of blood, then a person with a BAC of 1.0 is not drunk, they are dead (0.5 is generally considered L50, or lethal to 50 percent of the population). Also, the previous statement that a 90lbs girl and a 200lbs man having the same BAC after 2 drinks isn't even close to true, it is just wrong to the very core. Even discounting the fact that a 200 lbs man and a 200lbs woman probably don't have the same volume of blood (men have more), a 90lbs teenage female would have approximately 2.7L of blood, compared to an average male, of around 5L of blood. So really, if a 90lbs girl and a 200lbs man drink the same amount, their BAC will differ by a factor of 2, or 100%, or a LOT. Sure, metabolism is different, fat holds more water, etc, but they are not even in the same ballpark. People can show different levels of impairment with the same BAC, but generally there is SOME impairment at 0.1 in all people. And if you have SOME impairment, you shouldn't be driving. I think that it is a general misunderstanding of impairment (even by medical personnel), combined with people thinking they have the best liver around, and "I am big and I can handle my booze", that causes 9 year olds to end up in the PICU in the first place. If you have been driving drunk for years and never had an accident, it doesn't mean you are able to drive safely when you are drunk, it just means that you are really lucky. And so is everyone else that you didn't kill when you decided that you should drive drunk. You can read http://pubs.niaaa.nih.gov/publications/aa25.htm and look at some of the 20+ scientific studies cited in it for your hard scientific data.

I agree with the school bus issues being a problem, especially in the more urban areas. However, the article says that it was a Bee-Line bus, which people CAN pass, depending on the road striping. Also, did anyone else notice that it was a 9 year old that was walking his 16 year old sister to the bus, and then crossed in front of the bus after she got on? I am not an expert here, but a few things. Who crosses in FRONT of a Bee Line bus? They aren't expecting 9 year olds to be crossing in front of them, and they don't have the now-standard school bus bars to keep the kids from walking too close in front. While full blame rests on the drunk driver, I think it might have been a dangerous situation that could be avoided by not having a 9 year old crossing the street unsupervised. He would obviously be used to school buses, where you cross in front of them and don't have to look both ways because traffic is "stopped." Not to take anything away from the idiot drunk, but the situation could have been dangerous just by crossing in front of a bee line bus.

Just a practical question... how can you position a piece of apparatus in a roadway so neither side is exposed to traffic? And really the engine is blocking for the ladder, so it is just people dismounting the passenger side of the engine that are stepping into traffic, and assuming an open cabin, it would just be the officer... so if safety is so important I guess we can keep the officer inside the engine... might make the whole scene safer doing that anyway

You have an obvious problem of hybrid engines being underpowered by design. Give em a lot of power and they will suck up gas, the electric motor and gas motor can't co-exist and provide both power and fuel effiecency, one has to suffer. Once they get the technology for fast charges with capacitor batteries and other methods to recharge quickly, I think you will see police cars similar to the Volt prototype, or more likely the Telsa Roadster, where it is all-electric, and 200-300 miles per charge, and 0-60 in under 5 seconds (the Telsa is at 3.7s right now). Police cars are actually the ideal vehicle for all-electric, as they are always close to home, fleet type vehicles that usually don't do more than 200 miles without going home (Municipal police, not county/NYS).

Yea, those damn liberals... it was Michelle Malkin of Fox News to be exact. Michelle has written such left-wing liberal books as "Unhinged: Exposing Liberals Gone Wild", "In Defense of Internment: The Case for 'Racial Profiling' in World War II and the War on Terror", and "Invasion: How America Still Welcomes Terrorists Criminals & Other Foreign Menaces to Our Shores". She is also featured in such books as "The Worst Person In the World: And 202 Strong Contenders" and "Bloodthirsty Bitches and Pious Pimps of Power: The Rise and Risks of the New Conservative Hate Culture". Xenophobia and Racism weren't part of the liberal agenda last time I checked...

I think it is because people feel cool saying that they did it. It is a combination of ego, lack of training, ego, and ego. I know that people in the Emergency services very rarely do the incorrect thing to look cool, but Stat flight has a aura of coolness around it. When it goes out, everyone knows. People talk about a call they were on when they had Stat flight, even if it was 10 years ago. If someone sees Stat Flight taking off, and there isn't an IA about it, there is a post on here asking where they are going. They aren't perceived as just another ambulance. They are "Stat Flight" (with dramatic echo effect).

But what about the upkeep of 50 AEDs? There is the first question of who is doing the routine checks of them, if it is in a members trunk, are they pulling it out every day to check that it is OK? Who is doing the firmware updates to 50 machines? Who is checking that the pads aren't expired? Who is going to pay to replace the 50 batteries in a few years? When you have the AED in an agency vehicle you can incorporate checks into daily routines. When they are in someone's trunk, who is accountable?

According to the protocols posted by alsfirefighter at http://www.wremsco.org/REMAC_PROTOCOL_DOCs...dB(pg76-85).pdf (which were a good read BTW) this is not exactly correct. It says that ALS can request it, BLS can request it if ALS is delayed, and PD/FD/CFR can request it if EMS is delayed. I remember a few years ago we had a large fire in our village. We called several mutual aid EMS agencies due to the size of the fire, and one of the agencies put "the bird on standby" before they were even on-scene. Not only were there no patients for "the bird" but we, the mutual aid requesting agency, didn't even find out for hours. People like saying "I put the bird on standby" so much, it is just silly. My question is, if you put the bird on standby, are they committed to you? Or if another incident requests that they launch, did you just save the other guys a few minutes of warm-up time?

This is a good website, but it appears to be sponsored by the RAD manufacturers. As with any information, take with generous salt when sponsorship is involved. As for the RAD 57, they cost around $3K or $4K each. Not something to stock up on. There was an excellent and not-very-well-attended class on EMS Intro to Fire Rehab given at WCDES a few weeks ago. They went over a lot of the cooling devices and NFPA 1584 itself. I would check to see if the class is offered again, it was a little short on some details, but it is a work in progress, and had a lot of good information. One thing I have noticed about a lot of fire rehab programs is that they all have water and electrolytes, towels and granola bars, but are usually pretty short on seating, and I haven't seen a really well done shelter yet. Fire rehab is supposed to have a private area to allow for the firefighters to remove their gear for passive cooling, but really all I have seen are quick-tents that have no sides, and if they did have sides, could seat about 6 people. It would be great to see some progress made in this area.

I particularly like the system of testing every 3 years. It is apparently put in place to ensure that less qualified people can get hired too. I have heard the argument that if they didn't wait that long, only the top scorers on the test would ever be hired. And that would be unfair to the people who are less qualified (lower scorers). And then the promotion system is in place to ensure that the unqualified people can eventually become unqualified bosses, and eventually be an unqualified leader. The entire system is ludicrous if you look at it from a distance. Doing your time and being a "bro" counts for more than intelligence and skill. Any job that has a process in place to ensure that under-qualified candidates are hired and promoted out of fairness, has problems at the core. When a big corporation needs to replace an "officer", they very often do national searches to find the best candidate. The fire service is one of the very few places where having the best qualified leadership is secondary to having done your time.

The reason I heard (totally unbased rumor, but sounds like what would happen when emergency services and politics meet) that the law only permits police vehicles is when the State Police originally tried to get this law passed, they were opposed by the firefighter lobby because having "courtesy lights" and emergency vehicles both displaying blue would cause confusion to the general population, and the courtesy lights power was more important than emergency vehicles being easily seen (as a side note, if the state police really wanted to be seen, maybe they should pick a color other than dark blue for their vehicles). So, in response to the fire services lobby, the State Police made sure that, once the law passed, the fire service would not benefit from it (a big FU to the fire guys). I know, it is hard to pick who is less intelligent here: the fire service putting volly dash lights ahead of emergency vehicle visibility, or the police making sure that the fire service would not benefit from the added safety. I am glad we can all work as a team. And here is another question not directly pertaining to blue lights, but about visibility of emergency vehicles: Why is a vehicle looking cool more important than safety? Is it just a general lack of intelligence at the top of some organizations? Or is the tradition of vehicles looking a certain way (combined with the tradition of LODD's due to MVA's) more important that safety? Look around the world at the research being done with identifying emergency vehicles. They key is to make them look like a checkerboard (greatly simplified of course). And add some slanty lines to the back (again, simplified for humor). Most ambulances in europe have some sort of neon checkerboard painted thing. Same for Australia. Looks silly, but I saw every one. The worst-designed ambulance in Westchester was delivered last year, of course missing the chevron's on the back in lieu of a catchy slogan. I was wondering if most other agencies are considering the chevron's for new purchases?

I would be careful not sleeping a laptop when you close it. Many laptops are designed to let off heat counting on the lid being open; if you close the lid and keep it running, you can have some serious heat issues arise (including cooking your display, overheating your processor, hard drive, etc).