Goose

I wouldn't worry about it. Do whatever you feel comfortable with. You'll find out that there are some "unique" personalities across all three emergency services. Take things like that with a grain of salt. They don't really merit a response or acknowledgment. Best of luck w/ the pole, wouldn't catch me dead doing it .

I remember coming back from a job out in Millbrook and someone telling me that that place is haunted.

It's a rather aggravating situation. In the past 3 weeks I've transported patients at least 3 patients who had to be intubated either in the bus or the ER due severe PE. I'm pretty confident that in at least 2 of those patients if we had the ability to introduce CPAP immediately they could have avoided purchasing a tube. Hey, Hudson valley - NEWS FLASH: CPAP WORKS!!

Because CPAP is so popular elsewhere, i would think the data is readily available. Hudson Valley tends, for a reason beyond me, to be an extremely conservative EMS Council.

OLM in the North Bronx uses one on 15 Victor. At the time they started, they were the only unit in the city to use it.

My father forwarded this story to me in an email this morning. We often talk about fallen public service members on this board with little mention of those who serve us day in and day out overseas. I wanted to highlight the sacrifice of these 11 men and all those that have and will willingly lay their lives down for our continual freedom. I know this is an abnormally long post, but please if you have the time read through it. Rest In Peace and thank you for your service, your sacrifice will never be forgotten. Below is a picture of those who made the ultimate sacrifice with the surviving member's face censored for operational security reasons. As a side bar, one of the SEALs killed in action was Lt. Michael Patrick Murphy a New Yorker and close friend of FDNY Engine 53 / Ladder 43. He wore their patch with pride throughout each combat tour.

Happy 4th to all. Those that have the day off, enjoy the BBQs and fireworks. To those in the field, like myself, stay safe and be vigilant. To the men and women in the armed forces, thank you and god bless. Some quotes: "Ask not what your country can do for you, but what you can do for your country." ~ JFK "Patriotism is not short, frenzied outbursts of emotion, but the tranquil and steady dedication of a lifetime." ~ Adlai Stevenson "Today we did what we had to do. They counted on America to be passive. They counted wrong." ~ Ronald Reagan "The United States is like giant boiler. Once the fire is lighted under it, there is no limit to the power it can generate." - Winston Churchill

The Kid From Brooklyn is amazing. His bat day rant is oh so true!

Either way, the ER will be able to download what happened. But like i said, because the energy is so directed and low in intensity i can't see there being any harm.

I've come across ICDs a number of times in the field. I've never seen the device in action, only been called because it fired. Those patients i have helped treat have, for the most part, said they anticipated the caridovert and have felt it go off with few complications. It's been described to me as a punch or kick in the chest which lasts a few minutes and thats about it. As far as convulsions go, i've never heard of those associated with ICDs, maybe its possible. I've also never heard of anyone being shocked by one due to their proximity or contact with the patient. The leads for an ICD are surgically (obviously) implanted strategically near the heart. To the best of my knowledge they utilize substantially less power than an AED does because of its placement. However, i don't know the exact joule measurement. When your using an AED your shooting 120J (depending on the model) back and forth across the persons chest in order to hit the SA and AV nodes, I imagine that by planting electrodes strategically you could get away with using less power while having a better result.

Doc - i think the most efficient system would supplement career staffing with current volunteers. So every sub station would have a career contingent based on need (IE: 1 engine or whatever) and the volunteers would work along side. Wolf - The notion of "home rule" isn't as black and white and goes beyond local leadership. Does every village, hamlet, or town in Westchester Need 2 Engines, 1 stick/TL, 1 Rescue, 1 Utility, 1 Brush Truck, 1 Tanker, 2 Ambulances, etc. etc. etc.? No. Thats a blatant misuse of public money. Have the County buy up/assume the resources and have them positioned to best serve everyone. 60 Control should be THE SOLE dispatch agency for EMS and Fire resources, no if ands or buts about it (larger Cities exempt if they want). Etc, etc. etc. It's complicated stuff that gives me a headache after about 10 minutes.

Not a FF, but i have seen some pretty stupid things while working with them. For instance: Showing up to an MVA in a turnout coat and baseball pants or shorts, wearing sandals (though, this is most often seen with volunteer EMS providers) or flip flops, walking in and out of smoke conditions with an SCBA on but the mask is dangling at their hip or being told, very bluntly i may add, that they don't wear "that crap" because of old habits. My overall favorite is never bothering to send a proper assignment to an AFA or other perceived "routine call," IE: chiefs car only. I really wounder how much of it is stupidity and how much is sheer complacency. I mean most everyone goes to similar training and i think everyone, regardless of being in the public services or not, knows how inherently dangerous firefighting is. The whole "it's not going to happen to me" attitude is pretty apparent from the experiences i have had. The last thing i want to do is to work up one of my own (i consider, PD, FD, EMS all in the same) because of something that could have been prevented. It's interesting, everyone talks about safety, we memorialize those who have given the supreme sacrifice time and time again and review the dangers of the job - but are people actually listening? I work alongside a career department that runs BLS FR and whenever i meet these guys O/S they've got at least their bunker pants on, some even wear their turnout coats as well and they always wear gloves. The other day i did a job for a "man down" - in 90+ degree weather and the Engine Company had their turnouts on. It was one of our usual drunks, but still. It really impressed me. Thats the type of stuff everyone should be practicing, because its when you let your guard down that you walk into a house with blood everywhere or show up on a fully involved fire and your standing there with your pants around your ankles. We owe it to those we protect and our partners not to put ourselves in additional and preventable harm. If we get hurt whos gonna help?

I appreciate this topic and i often find myself frustrated with the fractured system we live with in Westhcester. Seth, just to answer one of your questions about the 911 System. Dutchess has a 911 Center which dispatches all County resources except the City of Poughkeepsie. They have their own 911 Center which handles calls within the city limits. They dispatch City Fire, PD and Alamo EMS. City 911 also serves as the County's backup 911 Center. There is simply no reason why we cant look South and mimic their system which combind County wide FD and EMS and efficiently incorporating Career and Volunteer staff.

IMO, thats not enough to do the job. You need something that is consistently storing or transmitting data back to a central computer and can identify each driver. I really doubt the above link is going to do much of anything in court, i only have experience with Road Safe, but there has to be a number of different systems that are similar out there.

Personally, Wheeled Coach is my sh*t list of ambulance manufacturers. I've had a number of bad experiences and have not been impressed by their shoddy craftsmanship. Either way, it is nice to see other makers stepping up and helping the industry when Ford left us high and dry.

Very valid point Kujo!

On the care side of things, absolutely. There is never anything wrong with continuously setting the bar higher. On the money side of things, there is much need for reform. I would go as far as saying there should be federally mandated guidelines - IE: ambulance service has to be guaranteed, medically necessary ambulance transports, emergent medical care, etc. etc. etc. Medicare and Medicaid need to also start paying out an honest dollar amount for what their users utilize. I don't know all of the issues exist, as i don't venture into the billing department often. I have my patients sign off on the billing form or CMN and in all honesty thats all i want to be involved in, its too much of a mess for me. With that said, i don't think we should be pushing for a socialized welfare system for all. I think state governments should offer a basic coverage for those who cannot afford it up until a predetermined age, much as NY state does now for those children whose parents make under x dollars a year. If you want state run health care then your going to have to be willing to take a ticket and wait in line, and i'm talking a 6 month line for chemotherapy and other time sensitive procedures. One of my partner's from work is from Canada and his grandmother was diagnosed with thyroid cancer, waited six months to have it removed and by that time it had metastasized and is now waiting for chemotherapy treatment. Likewise, allot of people forget that those countries who have state run care are small compared to the United States. The birthrate is decreasing across Europe while its been increasing across the United States, couple that with 60 Million aging baby boomer's and that spells DISASTER.

No doubt our system has it's problems. But socialized health care isn't the lush green pasture its made out to be. Either way, Moore is in no way, shape or form going to get one ounce of my hard earned money. The guy is a psudo-intellectual, take everything he has to say with a grain of salt. He's been proven to have lied and misled in the past, those types have a tendency to do it again, and again and again.

Add the wonderful "Road Safe" system on top of your average black box and all anyone has to do is click a button and find out how fast you were driving, if you were using lights, activating the siren, how fast u were going around turns, if you backed up w/o a spotter, etc., etc., etc. It's annoying as all hell, but its admissible in court and will likely save your a** - assuming you were operating the vehicle properly.

Like trooper, i don't see myself doing this full time for the rest of my life. Right now i can suffice, but i already have to start thinking about the future. Paramedicine is the next step, but after that i have no choice but to look towards a higher level of hospital based health care or something entirely different. Between the cost of living, mortgages, fuel costs, insurance costs and everything else making 15 bucks or 20 bucks an hour simply doesn't cut it. God willing ill still do EMS in some capacity, probably as a part-time job mostly for fun, but its unfortunate that what we do is not viewed as worth a decent salary.

Ok, obviously my comments were misunderstood. First and foremost, i think that 60 Control needs to be expanded so that it can handle any and all calls from help, PD, FD, EMS. Period, amen. The county giving money to local PDs to update their dispatching equipment is nice and likely needed but highlights a failure to fully promote the need and benefits of centralized dispatching. Until the county is willing to spend the money to expand 60 control to where it could handle every call for help and until you have agency leadership making the switch to county control then who cares how an ambulance is numbered?

Who cares? If your not being dispatched by 60 Control but by your local PD then maybe 101 or 40 or whatever is the unit designation most often used while the county #A# or #B# is used only for M/A. Seems pretty irrelevant to me. Until Westchester emergency services officials (on the county and local level) figure out and decide to catch up to the rest of the world and create a centralized communications center then who can complain? Thats not completely true. None of the commercials utilize the County designations in Dutchess. IE: if you have Alamo or MLSS or whatever Medic 4 then your addressing dispatch as Alamo or MLSS Medic 4 enroute to XXXX street. Only the flycars use the county designation to the best of my knowledge.

I passed this in the grocery store the other day, thought it was a bottle of watter then had to go back and look because i didn't think Smirnoff would market spring water. I don't get it and have questions of what the target market is...

LODD no question about it. God bless.

If i get notified of a diversion its usually via a fax from dispatch to the station, a request to land line dispatch, when i call in to work, or over the radio when i'm giving my initial report and then again when i roll the patient in. Meh.