mfkap

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?

This might be a stupid question. But do you need the computer to sleep every time you close it? If not, that is also something you can disable.

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).

Another site of interest for hybrid ops is from GM, they have a guide for cutting up some of their hybrids. Very interesting, and gives some information on cutting hybrids that I think would carry over to all makes and models.

http://www.gmstc.com/courses/available_courses.asp

As for the hands only CPR... When we compress the chest, we are NOT doing it in order to compress the heart and act as the Left Ventrical contraction. The reason that we are taught to compress the chest is to create a vacuum inside the chest wall in order to suck the blood out of the heart through the blood vessels. What the research is showing is that it takes approximately 30 compressions in order to create that vacuum. Except we are taught that once we hit 30, we are supposed to stop in order to ventilate, thus ruining the vacuum and having to start all over.

Do you have a source or two for this? As I was taught, part of doing correct CPR is allowing the heart time to refill. Creating a vacuum would not work without pumping the heart, because the blood would stop at the capillary level, wouldn't it? I don't see how creating a vacuum works in a closed system, only an open system. Also, your coronary arteries come off of the aorta directly above the aortic valve. If you were creating a vacuum downstream of the heart, then there would be no pressure (or even negative pressure) into the coronary arteries, and you would have a dead heart, no? I might be wrong on this, but I have not heard of this before. Perhaps you are referring to the vacuum created on the right side of the heart? That vacuum is being created by the left side pumping and the pulmonary valve not allowing backflow. However, if your pumping wasn't ejecting blood from the left side of the heart, you would have no vacuum created.

When we breathe, we breathe in 21% oxygen. When we exhale, we exhale about 16%. So unless someone has a BVM with 100% o2 with a full chamber, it is a very minimal amount of o2 we are giving the pt anyway, much less than is needed to sustain life.

I'm sure that someday soon we will be making the switch to continuous CPR, just like we are supposed to be doing once an advanced airway is in. This stuff is very interesting, I'm looking forward to seeing what changes are in store for us.

I am not sure if this is correct. If you are doing CPR on someone, and the blood is circulating, their O2 levels in the lungs will drop below 16%. Hemoglobin has a high affinity for O2 at low O2 levels and can readily gain O2 at relatively low O2 partial pressure in the lungs.

This isn't to say that there isn't sound science behind the decision to go compressions-only, I am just not sure that your facts are correct. I think that the hope is removing the mouth-to-mouth from CPR will help increase the amount of people who will be trained and act in an emergency, and they have proven that the loss of mouth-to-mouth is less significant if the chance of early compressions is increased.

There is no such thing as "soft billing". A relative of mine was charged by a VAC, after Medicare paid, he was harrassed for $35.00! Got phone calls from the billing company looking for the money. Had another resident where a VAC transported on a mutual aid call, received a bill stating that they were being put into collection for the $35.00. This was an elderly woman who was very upset - she had never received a notice in her life threatening collection.

There certainly is "soft billing", but your relative was not being soft billed. I know of certain agencies that set up a policy with their billing company to send a bill, and then send a reminder (for a total of 2 bills). There are no phone calls or collection agencies.

However, there is an exception. Some insurance policies only pay the patient directly and then the patient is expected to pay the hospital and/or EMS themselves with that money. If the insurance company notifies the billing company that the patient was paid for the ambulance costs, our billing company goes after the insurance money from the patient. There are some frequent fliers that pay their rent by calling the ambulance once or twice a month, get paid by their insurance, and stiff the ambulance and keep the money. If you do that twice a month for a year, that adds up to a pretty penny.

While I can certainly agree with carrying basic tools on the bus, I wonder how many of these rigs carry basic vehicle stabilization devices, such as cribbing/step chocks?

I understand the "emergency access to patients before the FD gets there", but without stabilizing the vehicle - is it worth the risk to the patient? The only time I can see it justified it in case of vehicle fires.

When considering "expanded operations" for an EMS crew, training is an issue. Is it better for the patient if no one forces entry until the FD gets there, or an EMS crew who does it once a year does it, and does it wrong? In rescue I would think that the "late but correct" beats the "quick but wrong". Most FF's I know have forced a few dozen doors in training, and still quite a few aren't "experts". Now you are going to have an EMT and a driver, with little to no training, trying to force a door? What if they just mess up the frame and it makes it harder for the FD? What if they hurt themselves? What if they delay calling the FD because they think they can do it themselves? I mean, the FD would be mad if you called them and then popped the door before they got there, right? I miss the days when my bus carried a set of irons, and we could have used them on a few jobs since then, but we also are made up of 50% firefighters. I don't think I would want two of the non-firefighter EMT's trying to force a door with a set of irons.

The real shame is and I dont want to offend any one , but democrats have a arrogance that always causes them trouble in the end.

He is just a reflection of what that party is.

That is true... I mean, the Democrats, had a sex scandal... not like those clean "I crap with a wide stance" Republicans. At least Spitzer was with a woman instead of the 12 year old boys that the Republican leadership has as their "core" audience. And we ALL know that the Republican mayor of NYC was very faithful... to his mistress. I can go on.. I have around 16 more Republican stories that happened in the last 10 years if you need em, like the Speaker of the House, etc. And I just because you start a sentence with "I don't want to offend anyone" it doesn't cancel out the offending you do immediately after. As a general rule in life, if you have to start a sentence with "I don't want to offend" then, if you actually do not want to offend, stop there.

Do they just carry equipment and help move the patient?

Do you allow them to take vitals?

Do they ask the patient questions?

Do they ask the patient medical questions?

What minimum training have you provided for them? They should have OSHA BBP but do they have CPR? Additional training?

Do you require that they advance to a medically qualified position? As in, do they need to join an EMT class within 1 year or 2?

Would you allow them to wear duty belts and badges?

Do you ever find that they cause problems or overstep their limitations (if there are any)?

Our VAC allows non-medical crew. They are there mainly to help carry, to gopher, and to drive the paramedic flycar when the paramedic rides along. For your questions:

Yes, they are trained in how our stretcher operates, but are not left to move the patient alone

No, if they take vitals that guide your treatment and they are incorrect, it is your a$$ on the line. We let EMT students take vitals, and if we are suspicious of them we can retake them.

They gather non-medical info from the patients, such as name, address, etc. They sometimes write down things as the EMT interviews, such as past medical, meds, allergies, etc.

You need to have BBP and CPR to ride. We also have a fairly in-depth training rotation set up, for them to learn how to operate the stretcher, stair chair, where things are in the bus, decon, etc.

We do not require them to have any interest in advancing (this is something I personally disagree with). Currently, they can be a member for years and never join an EMT class or have any interest in the medical side of things.

Duty Belts and badges, doesn't matter to me. They can waste their money on whatever they want. We provide every crew member, EMT, driver, or aide, with a badge. If they want to play Batman, go ahead.

They sometimes do cause problems or overstep their limitations. I have found that it is usually the younger, newer members where this is a problem. Also, there are a few people that do not quite have the ability to (ever) pass the EMT-B class, and those people are usually disruptive on the call just because they are like a lost dog and require too much instruction to be helpful.

Hope this helps.

Here's a question that can be posed for the Combitube lovers: If they are so quick and effective why aren't they used as first line airway control/management in the hospital setting for cardiac arrest as well?

I will grab a Combitube, King airway (excellent for tactical medics), PtL etc first when (god forbid) the protocols lead that way or they can make one that will definately make entry in to the trachea a high percentage of applications so I have the option of medication adminstration by that means. Other then that I have used them as my first choice in intricate trauma incidents where direct laryngoscopy was extremely difficult or not able to be performed, ie. patients pinned upright in a car seat in respiratory arrest while awaiting extrication from a vehicle.

I'm not sure where the timeline comes into play, but it doesn't seem to take me very long to open 3 packages (ETT, stylette, ambu tube holder) and to unfold my laryngoscope to turn the light on. The 4th package gets used with either and that's my CO2 connector for my LP12.

I just want to state for the record that I am not a huge advocate of the Combitube, but more of a person who sees people operate with blinders on. I have personally seen time wasted by medics where a combitube could have done the trick. I have also seen more than 2 or 3 of the "tubes shifted" incidents, which I am sure everyone has. And I am not a paramedic, but a medical professional as well. I have a similar volume of training and experience when compared to a medic, and enough training to know what is right and wrong when being done by a paramedic. Now on to the questions:

They aren't used in the hospital setting because it is not an ideal piece of equipment. It has its problems, mostly when left in for prolonged periods. Also, as a medic, I can guess you might tube someone once a week if I am being generous. Most code teams in a hospital have an anesthesiologist on it, and they do, conservatively, more tubes as a resident than a paramedic does in their career. If you are talking about the ER docs, doctors have ego's too. Oh, and some have the video laryngoscopes.

As you say, you are a medical professional. And I am sure you have read the 3 peer-reviewed studies that indicate that epi has the same level if it is put in the lungs or the stomach, if the stomach dose is exactly 10x the lung dose. So I am not sure how the meds down the tube argument matters.

And the timeline probably has to due with the second shot you take at putting in the ET tube vs. the combitube, as well as the time taken in placement of the ET tube.

Again, I am not saying that combitubes are better. I am saying that putting in a combitube is considered "weak" and a poor performance, and this has more to do with ego than current medical research. If I am the person that is coding on the floor, and my arthritis makes it hard to see the chords, I would rather you spend 30 seconds getting a combitube in than 3 minutes with a medic trying to get the right angle for the ET tube.

No where has it been mentioned on how these people get transported to the hospital. The stretchers can not handle those kinds of weights. Its fine to rig ropes and all types of systems to remove the obese pt. from the building, now what.

There is a new breed of bariatric ambulance that is around. They have ramps and winches to load the stretcher up to 1300 lbs. (http://www.transaferamps.com/) and stretchers that can hold up to 1600lbs (http://www.stryker.com/en-us/products/PatientHandlingEMSandEvacuationEquipment/EmergencyCotsChairs/AmbulanceCots/MX-ProBariatricTransport/index.htm). I read something about NYC looking into it (http://publicsafety.com/article/article.jsp?id=4408&siteSection=7) but I don't know the outcome. I also heard that there were a few operating in Westchester, but am unsure where.

As is obvious from the comments here, the "professionals" in Westchester don't feel that obese people are in fact human, and really we should just throw them out the window and laugh when they go splat. Maybe set up some pins at the bottom of the stairs and then go bowling. It is really disgusting to me that people who consider themselves professional, and in the business of helping people, would publicly post jokes and insult obese people, who call us in their time of need, when they need help the most. Hey, as long as you can feel better about yourself, because you aren't THAT fat.

For the people involved in emergency services that care about their patients, and not just the in-shape, attractive, young ones, I have a question: Is there a paid service in Westchester that has a bariatric ambulance? Our agency was talking about this last night, and it would be great if we could get an agreement or information so if we have an extended extrication of a bariatric patient from a residence, we could have the bariatric ambulance respond from a distance for transport? It seems that most places don't have a plan, such as the PD scrambling for a moving van (which is ok, at least they tried and treated the person with respect for their condition) but I think that working on a plan would be a good idea. Maybe we can put our powers for good and actually put together a plan that can be distributed to agencies? Maybe get the county in on it? Actually HELP people who need help? Just a thought.

Alternative airway devices are great and all, but still NOTHING tops direct largynoscopy. RSI is only working to help that, where the systems have it in place.

There are extreme situations where you may not be able to get an airway, but there are also many different tools to assist with DL and make the placement easier. Every agency should invest in devices, especially ones like the Bougie, a form of stylet that is used widely in Europe, is cheap, and easy to use. You slide it in the airway, it is designed to go right into the trachea. After that, you slip the tube right over that and into the airway.

Another part about intubation is the bagging....the situation, adreanaline is pumping, and we tend to bag WAY too much. Remember, proper ventialtions (10/min), HELP the patient. 30/min adversly affects the patient. Except in head trauma.

Also, let's not forget the Bag valve mask with OPA and 100% O2 is also a great way to maintain and airway worse comes to worse.

I wonder why you say that alternate airway devices don't top an ET tube? Aside from times when it is not indicated, the combitube has been proven to be statistically identical to the ET tube in blood O2 levels(1), and they have the advantage of being statically faster from start to O2 delivery(2), and have a higher success rate in placement(3). You also can avoid the problems of tubes moving, misplaced tubes, etc. Also, OPA and BVM has been shown to have much worse patient outcomes and lower blood O2 levels (1,2,3). Yet when I have seen a medic who can't get a tube, they don't reach for the combitube, they sit there and try to tube 2 more times? I understand the reasons to not lose the ability to use an ETA, but at some point it seems like the EMS ego takes priority over patient outcome. For an uncomplicated cardiac arrest, when every second counts, why is the combitube not reached for first (or immediately second)?

(1)http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=8214838&cmd=showdetailview&indexed=google

(2)http://cat.inist.fr/?aModele=afficheN&cpsidt=14650396

(3) http://www.ncbi.nlm.nih.gov/sites/entrez?d...;indexed=google

As not having used one before, I am asking from a position of the uninformed:

What is the resistance against the combitube? Why do people feel it doesn't work as well as a ET tube for short-term airway management? Shouldn't it, ideally, do the same thing without the potential for oropharyngeal trauma that ET placement can cause?

From what I have observed most members of the media establish a relationship with local police and fire and

more often than not crossing the yellow tape is not a problem which

The problem with this is that the media then depends on the police to give them permission to do their job. Write an article about the PD and their questionable use of funds, you have to take your pictures from the next city over from then on. If you need the police permission to exercise your constitutional rights, again, it is no longer a right. They aren't privileges granted by the constitution, they are rights. Oh, I know that most police officers are far too noble to hold a grudge like that, and welcome any and all inquiries into their operation, but ya know, it could happen.

I am a firefighter and EMT, and I understand issues at a fire scene. I also have never seen someone arrested for crossing the tape. Here is a question for all you fire photographers. You get to a fire scene three towns over, throw on your turnout coat, and cross the line. Should you be arrested? Or are you a "firefighter" so you know how the be safe on a fire scene?

Well, that's what happens when you cross over the yellow tape that says "Police Line: Do Not Cross."

Lets say that people are protesting something and the police want to break it up, but their methods are questionable. Can they put up a police line two blocks away so the press cannot observe it? If you start letting arbitrary rules decided by a single person impinge on the freedom of the press, it is a very slippery slope. If the police don't want you to leave your house, can they put police tape across your front door and then arrest you when you leave? It is extreme, but some might think that a 2 block radius of protection to keep out the press from a fire is also extreme. Revoking the constitutional rights of someone is not something to be taken lightly, or else they will be revoked frequently. Even if the photographer is never tried, the cop won because the photographer did not get the pictures she was trying to. She was already tried and convicted, because the penalty was executed before any trial. If the photographer was standing on top of an engine or walking over stretched hose it is one thing, but to set up an arbitrary barrier and then use it to enforce the law sounds like it might be a cop with a chip on his shoulder.

"The man who trades freedom for security does not deserve nor will he ever receive either." - Ben Franklin

Thanks Brother! Yes, my bad, it is an S-700 7.1 megapixel camera, ( Whatever the hell the megapixel thing means is new to me!!) I have an extra memory card that holds like 1300 pictures, so I guess theres plenty of room to practise!!

Thanks for the link, I apreciate it!

Moose

First word of advice: take pictures as max quality. Unless you have a (really) big card, you aren't going to be able to take 1300 pictures @ 7.1. You can transfer your pictures whenever you want so the max quality and max size are what you want. Second, go take a look at this review of your camera: http://www.dcresource.com/reviews/fuji/finepix_s700-review/ . In this review it gives you a lot of camera-specific details for using your camera. After that, take a LOT of pictures, of anything. Take 10 pictures of something, changing settings and recording what you did. Then put them on your computer and look at them print-size. Figure out what works. Photography is an art form. A lot of the learning is by doing.

to stand behind any emergency vehicle to push a button is an accident waiting to happen. With all the money that is spent on new rigs, they should included back up cameras and back up sensors. My "old 2000 Ford Windstar" mini van had a back up sensor that worked great and now I have a car with a back up camera and another with a camera and back up sensors.

With technology where it is today, ALL Vehicles should be equipped with these SAFETY features.

My agency just spent WELL over $100K on a new bus. I was told that they couldn't afford a backup camera. I am guessing that is because the thing looks like a christmas tree, is the size of an African elephant, and it has a massive airhorn onboard. Obviously, a camera is neither bright or loud, so it was cut. And it was explained to me by someone on the truck committee, "If you need a camera to back up, you shouldn't be driving". Also, keep in mind that this is a type-I ambulance that is MUCH larger than our previous large ambulance.

As long as you have the lowest common denominator designing your ambulances, you will be blinding oncoming traffic and backing over people. The problem is, the people with more ego than brains seem to outlast the rest of us. UPS doesn't have cameras because they have tens of thousands of trucks and it would cost millions and millions; ambulances don't have cameras because the people designing them have a cranial GI impaction. If only the cameras made noise or were shiny...

ALL I HAVE TO SAY IS STUPID PEOPLE EQUAL JOB SECERITY

I am suddenly reminded of this for some reason...

This isn't a new phenomena, it happens everywhere. The reason this happens is because no one wants to play EMS, the second a fire alarm goes out you've got everyone and their brother. The reason they probably got out on that second call is because they were all at the firehouse and couldn't exactly leave the building in good conscious if they didn't respond. It's one thing to turn the pager off and roll back over, but its another thing to leave the firehouse when you get a call...

This is the basis of the difference between Fire and EMS. For an EMS call, there is a 99.9% chance that you are going to have a patient, have to work, and get tied up for close to an hour. For a fire call, there is a 99.9% chance that there is no fire, you are going to have to work for about 5 minutes, and can be back in 15 minutes.

It is a lot more fun to drive the big red (green?) truck with lights and sirens, with that being the main thing that you are doing for the entire call. For most fire calls, getting there is the most exciting part of the call. For EMS, the lights and sirens thing is not the most important thing you are doing (depending on the moron behind the wheel), and really, how is it fun if you aren't running people off the road in a vehicle bigger than theirs?

The New York State law has been in place for a few years now, but it was never enforced by SUNY Purchase. SUNY PD would investigate all alarms (local and general) and if the FD was needed they were requested. Prior to October of '06, SUNY PD would respond to over 500 local alarms a year (single head activations). The problem with these local alarms is that they were set up as general (full evacuation and sounding throughout building). Once NYS OFPC got around to checking the amount of general alarms at SUNY compared to the number of FD responses, they recieved a stiff fine for each violation. Since then such names as Alumni Village, The Commons, Visual Arts, Childrens Center, Campus Center North, Campus Center South, PAC, Dining Hall, Fort Awesome, Outback, Far Side, Big Haus, Crossroads, Natural Science, and The Library have all been heard for commercial alarms. Very slowly the college is changing the alarm systems to the proper two head activation from the single head general alarms. The sensitivity of the heads are also something in question. Steam, cigarettes, weed, candles, burnt food and others have been able to activate the heads where other systems wouldnt even detect such nonsense. Something else to throw on the fire is the lack of heat detectors in the buildings. Smoke heads on top of stoves where heat detectors are well within the code. The entire system was never given much attention because the PD would investigate and it never effected the local FD. Currently system and heads are being addressed but as of today we have run 310 times in 2007. Aside from the confined space rescue, MVA, and two very minor strucure fires all of them are false alarms. Thats everything in a nutshell... any questions???

JBJ

2415

I think that originally the state focused on the unique Purchase response plan because of the Alumni Village (the Commons?) fire two years ago. Someone set a couch on fire, it took campus PD like 5 minutes to have someone walk over, go inside, see smoke, dispatch, etc... it was minor as putting it out and structural damage, but it took something like 2 weeks for people to be able to go back in and get their stuff, and a semester or two for that floor to be cleaned up enough to have people live in it again. And then there was the whole issue of the overhaul and recovery company's employees stealing CD's and going through the girls underwear drawers....

They should be investigating the little perp that needed the a** beating in the first place.

The article says that he was transported by ambulance to police HQ... I might be new at this whole EMT thing, but I am assuming that they were dispatched as an emergency call... can you transport a patient to anywhere other than a 911 receiving hospital? I was under the impression that you cannot transport a patient to a non-receiving destination. Perhaps he RMA'd, to avoid the whole abandonment thing, but he is 16 so his mom would have had to do that for him, and since she took him to the hospital I doubt he was RMA'd by her. If they dispatched the ambulance for him, I don't think they can decide he doesn't need medical help after that, and since he is a minor, he can't decide that either.

Don't have a really applicable citation, but http://www.health.state.ny.us/nysdoh/ems/policy/98-15.htm talks about the need of a medical destination, and not Section 28 hospitals only in non-emergency calls. I know that if a police officer wanted me to transport a minor to the police station, I wouldn't risk my license and bank account doing it, and that kid would end up in an ER somewhere.

http://www.latimes.com/news/local/la-me-bo...=la-home-center

Summary: Guy crashed into a building, extricated by LAFD, transported to hospital. Family wonders what happened to grandma, found still in car at impound lot the next day.

Scene size-up is an important EARLY part of responding to a call. Check the rest of the car, the trunk, and the other side of the guardrail when you get to a bad MVA. If (when) there are 12 people standing around watching the extrication, if you are in the "outer ring" give a look around instead of gawking. Even if she was already deceased when they arrived the first time, it is a lot better for the family to not have to deal with grandma's body being left in a car for a day.

Last year I saw that Expedition (with the LED) hauling up Rt. 9. First I even heard of a ground organ transplant vehicle with red lights.

One of these vehicles (sometimes two) are stationed out of NYP Columbia Medical Center on W168th. It is usually parked in the ambulance spots under the Milstein hospital building or on Fort Washington Ave outside Milstein. I don't know the arrangement with the hospital, but it is usually the astrovan and almost always parked there. Red lights on it as well.

Staphylococcus aureus (staph) is the bug behind all of these infections. The media has picked MRSA as the bug of the month but there are different strains resistant to different antibiotics. PRSA is a Staphylococcus aureus strain resistant to penicillin. The letter in front of the RSA describes the antibiotic it is resistant to.

Staph is carried around by about 30% of the population and your precautions should be your normal BBP PPE. Handwashing is by far the best way of preventing its spread and keeping yourself from becoming infected through an open wound.

Just because someone that is healthy does not become very sick from MRSA does not mean it is not a problem. The already sick patients are at the greatest risk for MRSA infection. We transport a lot of patients that are immunocompromised, and MRSA is a greater risk to them. When you don't decon the ambulance after the first MRSA patient, the second patient who didn't have it could die from it. An infected skin wound with MRSA isn't terrible, but a line infection with it is.

In the hospital setting, it is a big deal. Usually in hospitals all staff have to wear a gown + gloves + handwashing (contact isolation) when interacting with these patients, who are usually isolated in a single room. It isn't only for the staff, but when you go from room to room, the bugs can catch a ride on your scrubs. Because it is partially resistant, you have to use stronger antibiotics, which can have a lot of side effects, such as C. diff infection, red man syndrome (from vanco), etc. There are other resistant organisms out there as well, such as VRSA and VRE.

By downplaying MRSA as just something that you can fix with golves, it is a disservice to all. It is much better for you and your patients to decon + use correct PPE than to assume you won't get sick, so it doesn't matter. There is a reason that MRSA is all over nursing homes these days. There is a reason people die from MRSA sepsis or complications from its treatment. And it isn't because everyone is doing the right thing.

So your saying that if you get involved with an accident with a parked car and you have CPR in progress the law states that you have to wait for PD to arrive? Is that correct or am I reading that wrong?

I am not sure about the parked car, but if you are doing CPR on someone and you get into a minor fender-bender, that NYS DOH policy statement says you have to stay. I don't really think you are going to find an EMT, myself included, that would do more than check to make sure the other driver is not seriously hurt. I tend to put human life before rules, though.

This raises other questions as well. What if you are driving to the hospital with an unstable patient in the back, and come upon an accident? If you stop or are flagged down, are you now committed to that scene? Can you leave that scene if there is someone there with a minor injury? I think according to NYS law, that is abandonment. Does this mean that you can't stop for a second to check if they need you to radio for help?

thats the same thing i'm questioning. i don't think SOP's have anything to do w/ this, im almost sure its NYS law (but not 100% sure), you have to stop. and i believe the same goes for ambulance (among all othe types of vehicles).

I am not sure about FD, but I was reading the policy statements from the DOH regarding another matter the other day, and the advisory says that ambulances are required to wait for PD to arrive, even if there is an unstable patient in the back. If you follow this or not, that is up to the EMT. It also does not specifically mention parked cars (see below). See http://www.health.state.ny.us/nysdoh/ems/policy/01-07.htm for details from the state DOH.

As for the Hit and Run aspect, it appears that since it was a parked car and the owner was not present (apparently) it is not technically a hit and run. See http://www.deadlyroads.com/laws/new-york-h...-run-laws.shtml which states that it must be reported to the PD "as soon as physically possible" which could mean by radio to the PD.