WAS967

Found out tonight. Apparently someone with a stubbed toe was at HVHC and annoyed that it was taking so long to get seen at the ER. They walked outside and called 911 and requested they be taken to NWHC. :roll: I guess the finally got smart before EMS arrived since they were GOA upon arrival.

Yeah, what was the deal with that call? I was on 35medic2 that night and heard 39medic1 going to it. They sounded thrilled. ](*,)

Sounds like a computer system for SSM that will determine the call foci and tell you where to post your resources.

Yeah....then they put in the lock boxes in the hallway. :-> I swear the bullet proof vest were to protect you from the members, noit from the natives. :twisted:

Gas prices in Vegas were over $2.00/gallon for regular when I was there a a week ago. I don't feel so bad anymore. :->

Impressive young Skywalker. Very impressive.

Gee...I wonder who took that picture. <Evil Grin>

I'm not going to bore people with a war story, just know that my question is rooted in experience and that my question does not seem to have a definative answer. (At least not that I have been able to find. This goes along well with the other post about mechanism. You arrive on the scene of a 2 car MVA - head on. Both cars, single occupant. Both drivers ambulatory (walking) at scene. One patient has complaint of neck pain. Your EMT knowledge tells you the patient needs immobilization. A helper holds manual C-Spine stabilization while you do a quikc head to toe assessment which yields no additional findings. Fire department is there with additional help so you decide to perform a standing takedown. As you explain the procedure to the patient, he tells you that he has a congenital problem that prevents him from being lay flat or else he passes out because of loss of blood flow to the brain. (This is a very real syndrome, I don't recall the name at this time). My question(s) is/are this: How do you immobilize this patient? NYS BLS protocols state "Immobilize patient with appropriate immobilization device." What is appropriate in this instance or in similar instances? Do you NOT immobilize this patient and risk C-Spine injury? How do you transport this patient to the hospital?

Just as a follow up, I still have no definite answer to this problem. I posed my question to my PHTLS instructor this past weekend and he was as stumped as everyone else, offering only the PC answer that for proper immobilization, the patient must be supine on a longboard so that inline stabilization is maintained. The quest continues.

Okay it's been a while. Here's a good one I thought up while reading the Fire Trivia. Name the only volunteer ambulance agency in Westchester County (to my knowledge) who ran 4 ambulances up until the mid 90s. Name the agency that the 4th ambulance was sold to, and the maker of the ambulance that was sold. Bonus points for it's designation. :->

Original call came in from our very own County Car #2 who apparently passed by and saw the fire. Way to start off the new job with a bang there Commish! :->

2 Vehicle MVA, Nissan Xterra vs MiniVan, each vehicle single occupancy. Minivan had extensive front end damage with total destruction of engine compartment. One atient from taken by KBHVAC with 45Medic3 to Air1 LZ and flown to WMC. Other patient was transported by KBHVAC to NWHC with 45Medic2 on board.

I hope you have so called "addendums" to your NYS BLS protocols in writing. All it takes is for one person to suffer some kind of "injury" from your clearance to sue, and have a nonwritten protocol suddenly become "I never said that". Be warned. I know Dr. DeRobertis is very proEMS and into doing new things, but unless you have a protocol in writting, I'd be VERY sceptical to taking any orders verbally unless you called each time to get MC approval.

I believe what DG said is true. In several areas where C-Spine clearance studies have been done, immobilization cases actualy INCREASED. At the same time, the greatest cure for a XRay that shows a C-Spine Fracture, is to have the XRay reread by a radiologist. It's amazing how many ED docs mistake a normal Xray for a fracture.

A big congrats to our own x635/EMTBravo who recently informed me that he is now an official NREMT-P. Look out New York! First Mass., then he's headed this way!

LOL. I'm gonna hand that out at our employee meeting this week. :-> Did you guys see the one about the "Fifth of Bourbon reduces awareness of heart attacks"?

Hey now, I helped too! 8) Seriously tho, I was impressed that everyone was able to keep a cool head and do thier jobs very quickly and efficiently. Many other places I work half the people would be running around like chickens sans heads. A job well done to all involved.

Reception is horrible withthe Minitor III. The Minitor IV is just a reworked version of the III from my understanding. The biggest problem I've seen with the Minitor III/IV is that he knobs have a tendency to fall off or come off after many hours of use. I prefer to just have my HT1000, which can be programmed to recognize up to two sets of tones. I have mine programmed for the 35 and 45 medics. Unortunatly the tower i north salem is not very good for distance so I actually find that the range on a Minitor IV in an amplified charging base works better in Lewisboro and Mount Kisco.

Pre-Gun-Pulling response: First of all, competency goes beyond a person being C/A/Ox3/4/whatever. In fact it's only the first part of a good mental status survey. Not many people have heard of this acronym: OMIJA. It was taught to us by our good friend Dr. Emil Nigro at Phelps Hospital. For anyone who has never been to one of Dr. Nigro's call audits, I highly recommend it. But be prepared to be called on to answer some tough questions! Anyways, OMIJA. Orientation, Mentation, Ideation, Judgement and Affect. Orientation - Your usual C/A/Ox3 - Oriented to person, place, and time. Mentation - "thinking that is coherent and logical". Many a drunk knows who, what and when. But are the really competent? Ideation - "The process of forming and relating ideas." Suicidal Ideation is a good example of BAD ideation. Judgement - Can the patient make proper decisions? (Yes, a great many people exhibit poor judgement, but thats no reason to tie them up and transport against thier wishes). Affect - How is/does the patient react to a gven situation. (If you ask the patient what they want to do after they RMA, and they say they want to go ski Mount Everest wearing nothing but a pink tu-tu, then they are demonstrating poor affect (and probably judgement as well). In this case, the patint, regardless of his orientation, is demonstrating poor JUDGEMENT (even if he thinks he will be okay, you as a trained firefighter know better, you don't have time to explain, and he needs to get out NOW).He demonstrates suicidal IDEATION, as chances are he knows the house is on fire by now, and staying will only have one end result. His AFFECT is totally off kilter, as any normal person would see fire and run. The use of a mind altering substance (Alcohol, drugs, etc) falls under the judgement category, as anyone under the influence MAY be orientated, but thier judgement is impaired by a substance. Psychiatric patients can fall under any of the categories, but ideation seems to be the most common. As for the gun scenario, I'd turn tail and run. Even without the gear on, statistically a shooter only has a 1 in 10 chance of hitting you if you run away. And with a huge air tank on your back, he might as well be shooting at you through a refrigerator.

FOX 5 News reporting an off duty paramedic from a "private ambulance service" was killed in a bar fight in Queens. Will have more information as I get it.

Do firefighters get save bars? :->

I am SO glad on of the departments I work with regularly is moving away from the heavy rescue ambulance platform. They were just horrible. The ride in the back made starting an IV feel like you were working a seizure patient. I actually like a small ambulance, like van or minimod. Everything you need is within reach. No walking10 feet to get your oxygen main turned on.

I would definatly stop watching the show if it became all PD. Just what we need, another police drama. NOT. There aren't enough EMD/Fire shows on TV. Watching Doc on the downward spiral made me kind of depressed. First thing going through my mind was "great, another show/movie showing EMS people as total psycho/head cases". Can't we get a show to actually put EMS people in the spotlight as good people, and LEAVE them there? Thats exactly what Emergency did, and it did it well. But now a days, Producers are more concerned about ratings and "shocking" the audience than the impact thier shows will have on the subject matter it covers. I did not realize that the guy that plays Carlos was one of the series creators. I saw him on "The Apprentice" a few weeks ago with one of the Producers. I doubt the 10-13 will be fo Bosco. IF it is, maybe he had another one of his panic attacks. I doubt the mafia will come after him for last week's incident. Besides, we should know better than to worry about what they say in previews nowadays. They usually stetch the truth till it breaks just to grab interest. For all we know it could be some traffic cop/meter maid hit by a car.

Oh man, what a great decision. WC's gain is our loss.

I didn't even know that Pelham Manor still had a volunteer component to the fire department. It is good to see they are alive and well, and also that the career personell seem to be so accepting of thier precence.