Goose

So odd but really not... From a city 8 million strong to the county I work as a dispatcher of 113,000 strong... its all the same

But I will add this.. after 8+ years of dispatching, APCO is a waste of time and didn't change anything other than getting comm centers to pay money to say we were certified in something... and EMD is the biggest waste of time in EMS dispatch history. Except in cases of CPR and choking, the questions asked for EMD are just a waste time and do not affect at all how EMS will work a scene... this I know from being on both sides of the radio

While I would like to continue, since it is so rare to see a communications topic get so much response, I would like to keep my job, and TPTB don't like dissent from those who actually know........ but such is the burden of knowing there is better, and sometimes everything new, doesn't always mean its better

At least EMD gives the responding EMS units a semblance of an idea of what they are responding to. While it, like everything else in life, is not 100% i like knowing I'm going to a seizure/cardiac/chest pain/etc as oppose to a PD dispatched "transport" or "aided case." Additionally, it can help keep often scarce resources - i.e. the medics - off some of the nonsense....if the system allows for that.

Thats why i always liked the FDNY EMS MDT system...seemed to give the units a nice chunk of info regarding call nature, act as a reference so no one needs to 10-5 the address or apartment #, and keeps radio traffic to a minimum. Oh well!

Pjtm, while I agree with you, it has been my experience that change does not without substantial motivation. At least with manpower and flow capabilities improvements there's a financial motivation.

Does foam require any changes to the hardware on the engine itself? If not then it's simply about purchasing the product....given the healthy budgets many volunteer agencies in this area enjoy and the low volume of fires...whats the financial hinderance? Sorry for my relative ignorance on the topic.

What's there to elaborate on? Couple of the folks looked pretty bummed out...when i asked what was up they voiced confusion/concern as to what was going on w/ the company. I felt bad because i remember what it was like working commercial and companies being sold/taken over/changing hands and the stress that brings to many. Am i not allowed to be a nice guy?

Commercial EMS is commercial EMS. I'm not really sure anyone is judging any individual providers but you need to take into account that the company in question has some pretty muddy history. I had an issue during an encounter w/ the company in question which i chalk up to the individuals on that crew - it happens. That said, i always felt bad for some of the guys i saw working Care 1 - many of them always look so sad/unhappy. Hopefully things get better for you guys as things level out.

There is no CADPage type app for the iPhone as Apple is a bit more restrictive than Google when it comes to application development. That said, i log into the CAD times w/o issue...you need to have you're agency user name and password. You won't be bale to get into the I/NET Viewer because only IE is supported. Hope that helps.

The volleys are upset because it holds them to a standard. No more driver alone smoke and mirror show. This necessary proactive legislation that needs to pass in order to improve patient care, patient outcomes, customer service, and more generally preparedness. I hope this passes.....this sort of stuff is landmark legislation for the tri state region.

Now if only New York lawmakers had the stones to draft, pass and sign similar legislation into law....

I hope the firefighter is doing well. What is remarkable to me is how calm and professional the fire alarm dispatcher is, these guys seem really good at their job.

Long Island does not even have career departments. Long Beach and another are the only two on the whole island (excluding the FDNY in Brooklyn and Queens)

the City of Long Beach and Garden City have career firefighters.

While I did not mean it it terms of violating a specific law, it actually is.

NYS Public Health Law Article 30

Section 3012. Enforcement.

1. Any ambulance service or advanced life support first response service certificate issued pursuant to section three thousand five of this article may be revoked, suspended, limited or annulled by the department upon proof that the operator or certificate holder or one or more enrolled members or one or more persons in his employ:

( b has not been competent in the operation of the service or has shown inability to provide adequate ambulance services or advanced life support first response service; or

(g) a voluntary ambulance service or voluntary advanced life support first response service has failed to meet the minimum staffing standard and has not been issued an exemption, except that such certificate shall not be suspended or revoked unless the commissioner finds that an adequate alternative service exists. The commissioner shall consider the recommendation of the regional emergency medical services council in making a finding; or

If thats the case, 80-90% of the ambulance services in this county should have their operating liscenses suspended. I really wish someone would actually enforce this sort of stuff.....improve patient care, improve responsiveness, prepreation and capeability and maybe even propell the EMS career foward in finding a viable soultion (because this is in fact a county problem...).

No, i believe they graduate in January.

The scariest thing for me is not adapting, but the potential for hostile takeover. Personally, i am an advocate for three clearly separate services with appropriate integration when applicable (first response by PD and/or FD). I'm not sure there will be too much change in westchestser, many of the career departments already provide first response services and those that don't probably could if it really came down to it.

like it was already said, ever tying is up to the locality and thats about as far as it goes (unless other resources are required or requested). out of habit i pack the stretcher up w/ the board, the BLS bag, ALS bag and monitor and take it out of the bus and try to stay in a visible area near the command post. they see me, i see them and it avoids the quagmire that is the radio communications in this county. when the chief says he doesn't need my partner and i, we pack up and go back into service.

http://fdnyemswebsite.com/

I always find this and interesting website with interesting opinions on some of this very stuff...worth a read if you've got the time

Op-Ed: Volunteer Dept. chair: Mayor's Fire Plan the only solution for Stamford

Wednesday, December 7, 2011

by Stephen Gladstone (Chairman of the board of the Stamford Volunteer Fire Department)

http://www.stamfordadvocate.com/opinion/article/Op-Ed-Volunteer-Dept-chair-Mayor-s-Fire-Plan-2371970.php

I'm not a fireman, but after reading that op-ed and knowing the little i do about whats going on in stamford...i can't help but feel that this guy is smoking crack.

The overwhelming argument he seems to outline is a fiscal one, which is fine. But within the first few paragraphs he talks about all the real-estate and apparatus the Stamford Volunteer Department owns. 11 engines, 4 rescues, 2 trucks, 3 tankers and a number of other vehicles. Again, i'm not a fireman but that seems like an overabundance of extremely expensive apparatus that frequently never makes it out the door. The article doesn't even seem to account for the 50+ (forget the exact number) of career firefighters the Stamford Volunteer Fire Department has to hire to ensure a timely response.

Maybe I'm missing something...someone care to clarify?

negative. After administering atrovent, even mag, and steroids I am able to flush the lock, secure it and turn over patient care to BLS. Same applies for diabetics and D50. If the patient were so sick that I went the mag and steroids route there is a serious issue with my clinical judgement that I'm turning over patient care to BLS. Your initial question was a simple neb treatment, and yes I would feel comfortable handing that patient over to BLS. Even the hypoglycemic I've been content to turn over to competent BLS after correcting the condition.

In NYC we recently received a clarification, that with some minor tweaks could be applicable in Westchester. In NYPD and Correctional facilities where delays waiting for an escort to the ER become excessive we are now able return care of these sicker people who may still require ALS interventions at some point to the facility medical staff. In some cases that's a nurse or doctor and others it's an EMT. Its a quick call and has been used for the serious asthmatic after treatment, the stat ep, etc. Why not allow a patient to be left with the EMT on scene while they wait for that bus and free up the medic for the next call? Should the condition worsen the medic can be called back or mutual aid medic can be used.

Pull any of that in Westchester and you're mac card will be melted down into a PVC ingot in no time at all. That said, I can't help but feel that the this will be changed secondary to a lawsuit in the future. If I'm making a pharmacological intervention (even D50 or combivent) i just don't feel comfortable sending it off with someone other than another medic or higher authority. Even the whole 3 lead and glucose turned over to BLS rubs me the wrong way, but I'm conservative.

So you're looking at taking out 3 - 5 BLS units from the system, right? 15V got yanked a few years back...and i know Jamaica runs a few ALS units as well. Sure seems like a lot of resources. I feel for the employees that are looking at pink slips (hopefully those still part of the union can pick up jobs at other shops). That said, seems like the fire department is strong arming their way to get what they always wanted.

whatever happened to doing the right thing??? if its what some of us believe is the right thing to do then so be it. as long as the call gets covered shouldnt matter what rig shows up!!!!!

I suppose you're company would have to be cool w/ it as well as the agency. Personally, i always let 60 know if its going to be an ALS or BLS call...at least then if they have a driver they can start out. It's good to have options, but having a good-faith agreement for mutual aid w/ any commercial EMS company is not exactly a reliable solution. Many of us have worked commercial and have seen the silliness that goes on for the almighty dollar...

Only residents in the unincorporated section of Cortlandt, which lies outside the Village lines, pay into the Cortlandt ALS District. If you wanted to get really technical, it has always been my opinion that from a purely academic standpoint, the 35/39 Medics should be responding to calls that lie inside the Croton Fire District, but outside the Village line. That's always been my personal take on that, having worked for both OVAC and CRP. But, honestly, it's never really been a big issue for either agency, and the calls always get covered in a timely manner in that part of Cortlandt.

gotcha, thanks for shedding some light on it

No, Croton to the best of my knowledge is its own individual entity, although Croton Fire/EMS does cover part of the Town of Cortlandt in it's primary response area.

According to the Town of Cortlandt website its an incorporated village, along with Buchanan, within the Town of Cortlandt. I'm just curious because i thought the Town of Cortlandt funded their ALS system through the tax rolls...if so, does this mean that Croton is paying twice or would their EMS tax go to their own solution through OVAC?

Just saw you're reply ALS...thanks for fleshing that out for me

Mid-Hudson is actually the formal, legal name of the Ambulance District for the Ossining School District (Town/Village of Ossining and parts of New Castle), not a company or other such EMS entity. Croton, in essence, has joined the Ambulance District, where Ossining VAC is essentially the vendor that has been contracted by the Mid-Hudson Ambulance District to provide EMS services for the community the District encompasses.

I asked this in the other thread, but i suppose its applicable here too...is Croton part of any of these entities or is it part of the town of cortlandt?

Is the Village of Croton in the town of ossining or town of cortlandt?

However, some agencies who run 1200+ runs a year in their first due alone, are relying on 5 people to take in 90% of the runs. Sure 60% are BS runs, but if you reduce the amount of ambulances they have, 1/2 or more now get transferred to other agencies responding to BS runs. They get burnt out and it sometimes turns them into miserable people to work with. It's no fault of their own, just the situation that they've been dealt with and choose to stick with. No one wants to volunteer their time hundreds of times a year, to take 1.5 hours out of their busy lives, when they're not on duty, to respond to someone who's stubbed their toe.

No matter how you look at it, less people think about the community as a whole, and are more in tune with themselves over others. It doesn't matter if you do 500 "awesome" ems calls and 5 bs calls throughout a year, or 500 bs calls, and 1 awesome ems call a year, people just don't want to volunteer their time anymore. The ONLY reason that places like PG county work with the live in system, is because there are multiple LARGE universities around to support a live in program for students who want free room and board. There is nothing like that around here, with the added amount of "exciting" runs.

I'm having a hard time understanding what you're trying to get at here, maybe you can clarify?

Forget the whole notion of exciting EMS calls (i'm not even sure what that means) and nonsense EMS calls - you're either here to do the job or you're not, all or nothing. As a paramedic, there are days where i respond to 14 calls for assistance but transport less than half that. That doesn't mean i take any more time getting to any of the perceived lower priority runs or slack off on my ALS assessment and initial BLS treatments on those lower priority runs. It's part of the job and the tax payers pay their hard earned money for at least a paramedic evaluation on every run, and i am more than happy to do that. It's just about good patient care, good customer service and more generally doing the right thing. I'm sure the same can be said for the fire service.

I've said it before - agencies that rely on a core group of available members (often times older and retired) have a serious problem. It is unfair to both the community they serve, the patients that request their service and their own members which they consciously abuse. These are the agencies that need to think long and hard about their future - if you want to stay in business you better wake up, smell the coffee, be honest with yourself and you're membership and make some 21st century steps forward to mitigate you're problem.

In reference to the economies of scale ( i think thats part of the point you're making?) - it's going to have to change. This county has more EMS resources than it can adequately staff...you realize that, right?

What is even more gut wrenching is that this report was carried out in 2008....and virtually nothing has changed.

Both Village of Mamaroneck EMS (MEMS) and Town of Mamaroneck/Larchmont VAC (TMLVAC) have paid medics on the bus 24/7 provided by the Town of Mamaroneck Ambulance District (TMAD). All EMTs are voluteers, and both agencies consider themselves 100% volunteer.

There are paid EMTs that cover when their are no rostered volunteers.

Correct...it's a goal, but I would assume if an agency doesn't start taking steps to mitigate their issues within a reasonable time frame there could be consequences. This is the most progress on this issue I've seen since i moved back to Westchester.

Regards to the Fitch study....pretty disgraceful if you ask me.