Goose

I found out about this last night only a few hours after asking someone how she was doing. I had the privilege of being precepted and working alongside Irene during my time at Alamo. I happened to catch her maybe two years ago while crossing paths at WMC ER, brought back a lot of great memories from likely the most memorable years of EMS in my career. I really am sorry to hear that she has passed - she was such a nice person and a great practitioner. May she be in eternal peace.

The below link was sent to me in an email. It's well written and thought out and while its soley about Sufflok County, it seems awfully similar to what goes on in Westchester.
http://resqrev.blogspot.com/2013/06/volunteers-vs-patients.html

Typical journalistic arrogance. Rather than bucking up to the fact that they made a mistake, they offer a half-baked justification. Typical.

So Empress is implementing APPs or were you referring to the article strictly for the vehicle?
To be honest, i find that the newer expeditions and tahoes are probably too big as a paramedic fly car...unless you're carrying two complete sets of gear. Always seemed like a bunch of empty space to me, and i regularly work in both. Given the recent changes in the special service vehicles offered by some of the leading manufactures, probably not a bad idea to broaden the horizons a bit. At the end of the day every agency has to determine what will work best for them given how and where they operate. Having the option to run something like the charger regularly and something like an expedition / tahoe during inclement weather may be the best option for some parts of the county...but often todays budgets simply don't have that sort of room.
Either way, best of luck with the new vehicles and i hope they safely transport the medics to and from jobs.

So Empress is implementing APPs or were you referring to the article strictly for the vehicle?
To be honest, i find that the newer expeditions and tahoes are probably too big as a paramedic fly car...unless you're carrying two complete sets of gear. Always seemed like a bunch of empty space to me, and i regularly work in both. Given the recent changes in the special service vehicles offered by some of the leading manufactures, probably not a bad idea to broaden the horizons a bit. At the end of the day every agency has to determine what will work best for them given how and where they operate. Having the option to run something like the charger regularly and something like an expedition / tahoe during inclement weather may be the best option for some parts of the county...but often todays budgets simply don't have that sort of room.
Either way, best of luck with the new vehicles and i hope they safely transport the medics to and from jobs.

It's already been well articulated how devastating this whole event has been to everyone, especially family (i'm not a parent and cant even begin to imagine how i would feel if i was).
The media, generally speaking, as been horrendously irresponsible throughout this entire event. After i left work Friday evening i have made it a point to stick only to what the CSP PIO relays during briefings. As it relates to the interviewing of children, i was equally nauseated at the media (that they would hover over these vulnerable children like buzzards) and the parents for allowing their children to be interviewed. If it was me, i would secured my child, drove straight home (barring having to make any official statements to the authorities), and unplug every TV in the house. If you didn't think the media was driven by the almighty dollar before, you sure should now.
From where i sit, the gun discussion is a secondary, if not tertiary, issue. The real failure here seems to be the mental health system and more generally how this society views / deals with mental health issues (i'm not just talking about whatever the perp was suffering from but even combat vets w/ PTSD often find themselves ostracized and treated as "broken").

It's already been well articulated how devastating this whole event has been to everyone, especially family (i'm not a parent and cant even begin to imagine how i would feel if i was).
The media, generally speaking, as been horrendously irresponsible throughout this entire event. After i left work Friday evening i have made it a point to stick only to what the CSP PIO relays during briefings. As it relates to the interviewing of children, i was equally nauseated at the media (that they would hover over these vulnerable children like buzzards) and the parents for allowing their children to be interviewed. If it was me, i would secured my child, drove straight home (barring having to make any official statements to the authorities), and unplug every TV in the house. If you didn't think the media was driven by the almighty dollar before, you sure should now.
From where i sit, the gun discussion is a secondary, if not tertiary, issue. The real failure here seems to be the mental health system and more generally how this society views / deals with mental health issues (i'm not just talking about whatever the perp was suffering from but even combat vets w/ PTSD often find themselves ostracized and treated as "broken").

In this area, the course is difficult to find - i think phelps as, at times, offered it. In all honesty, if you intend to work in this area i wouldn't waste your time. There are few agencies who are credentialed at the "I" level and you'll rarely find yourself doing much more than a basic given how saturated with medics the system is. If you're a basic looking to advance yourself, get some time in the field and in a year or two of solid experience look into a local paramedic program if you're still serious or interested in the field. Best of luck.

In this area, the course is difficult to find - i think phelps as, at times, offered it. In all honesty, if you intend to work in this area i wouldn't waste your time. There are few agencies who are credentialed at the "I" level and you'll rarely find yourself doing much more than a basic given how saturated with medics the system is. If you're a basic looking to advance yourself, get some time in the field and in a year or two of solid experience look into a local paramedic program if you're still serious or interested in the field. Best of luck.

Switching over to what? 60 Control? Those poor guys can barely handle the call volume they have now - this county (including the DES comissioner) doesn't seem to have any plans to face the reality and expand staffing. However, despite the exponential increase in call volume over the years w/o appropriate expansion i really do tip my hat to them - they do as best of a job as they can given what they have to work with.
That said, the REMAC (and i watched the webcasts) pushed out this policy statement without effectivly researching dispatching in this County. I think there was one indavidual who actually had a grasp on the reality in the webcast i watched. The expectation to have everyone EMD capeable by 1/1/13 (if that is even still the go live date) is rediculous. These are the issues as i see them:
EMS System issues:
- The point of EMD is to prioritize resources - send medics and other resources only on calls that they are truly required for. Unfrotunately, the reality is many of the volunteer ambulances (which make up the majoirty of the transport capeabilities county wide) are unreliable. Average wait time in excess of 20 minutes are the norm - some days/time of day are better, some days/time of day are worse. That said, sending a medic is the only way to get a reliable and timely EMS resource to your front door - thus defeating the purpose of EMD alltogether.
60 Control
- They simply dont have the staffing to answer, EMD, dispatch, and do all the other tasks that are required (imput CAD data, see the calls through to the end, request and or arange for more resources to scenes, etc)
- It seems a lot of time the PSAP (often a PD) who gets the initial call is not transfering the caller to 60 control for proper EMD. Rather, the caller is being hung up on, and the PD will call 60 and tell them "hey, dispatch XYZ VAC/Medic for chest pain IFO 123 Avenue." Again, whats the point?
Local PDs
- Most don't have exisiting EMD capabiliuty - that means buying a dedicated computer system and training all those who dispatch radio runs and EMS runs (often it seems like desk Sgts) in EMD.
- Bugetary constraints are creating atmospheres where most agencies are having to consider layoffs or vacating positions through attritiion, where are they supposed to come up with the money (infrastructure and OT training) to pay for the above?
- Honestly, i wonder how many PDs even care to be involved in this (i can't personally blame them)...they are busy taking care of what goes on in the law enforcement world.
I would much rather the REMAC work together with the County and Law Enforcement, take it's time, and establish a better thoughout system - preferably one that is a regional approach. I just think thats a much better path than spending a whole lot of money in a knee jerk reaction to an ill thought out policy and an arbitrary go live date.

Switching over to what? 60 Control? Those poor guys can barely handle the call volume they have now - this county (including the DES comissioner) doesn't seem to have any plans to face the reality and expand staffing. However, despite the exponential increase in call volume over the years w/o appropriate expansion i really do tip my hat to them - they do as best of a job as they can given what they have to work with.
That said, the REMAC (and i watched the webcasts) pushed out this policy statement without effectivly researching dispatching in this County. I think there was one indavidual who actually had a grasp on the reality in the webcast i watched. The expectation to have everyone EMD capeable by 1/1/13 (if that is even still the go live date) is rediculous. These are the issues as i see them:
EMS System issues:
- The point of EMD is to prioritize resources - send medics and other resources only on calls that they are truly required for. Unfrotunately, the reality is many of the volunteer ambulances (which make up the majoirty of the transport capeabilities county wide) are unreliable. Average wait time in excess of 20 minutes are the norm - some days/time of day are better, some days/time of day are worse. That said, sending a medic is the only way to get a reliable and timely EMS resource to your front door - thus defeating the purpose of EMD alltogether.
60 Control
- They simply dont have the staffing to answer, EMD, dispatch, and do all the other tasks that are required (imput CAD data, see the calls through to the end, request and or arange for more resources to scenes, etc)
- It seems a lot of time the PSAP (often a PD) who gets the initial call is not transfering the caller to 60 control for proper EMD. Rather, the caller is being hung up on, and the PD will call 60 and tell them "hey, dispatch XYZ VAC/Medic for chest pain IFO 123 Avenue." Again, whats the point?
Local PDs
- Most don't have exisiting EMD capabiliuty - that means buying a dedicated computer system and training all those who dispatch radio runs and EMS runs (often it seems like desk Sgts) in EMD.
- Bugetary constraints are creating atmospheres where most agencies are having to consider layoffs or vacating positions through attritiion, where are they supposed to come up with the money (infrastructure and OT training) to pay for the above?
- Honestly, i wonder how many PDs even care to be involved in this (i can't personally blame them)...they are busy taking care of what goes on in the law enforcement world.
I would much rather the REMAC work together with the County and Law Enforcement, take it's time, and establish a better thoughout system - preferably one that is a regional approach. I just think thats a much better path than spending a whole lot of money in a knee jerk reaction to an ill thought out policy and an arbitrary go live date.

I doubt anyone would want to take on the liability of not sending a bus. Could be wrong, though.
Just seems like more and more this is an "in name only" situation. Is there going to be a metric attached to this in terms of what % of calls must recieve EMD based triage? From where i sit, i just don't see this changing the reality of EMS operations in this county. Agencies that staff ALS ambulances probably won't change the way they operate as long as their communities will continue to support that level of care - reguardless of the situation EMD/no EMD you're still getting a bus, an EMT and a medic. The real issue is when it comes to fly cars that serve multiple jurisdictions, but again because a paramedic fly car is the only guarenteed thing i can't see them not being sent. For those of us dispatched by 60 Control, will this open the door for redirection by the ECC operator - during times of heavy call volume - to higher priority and holding jobs / sending lower priority jobs mutual aid? When it gets busy i find myself and my collegues self triaging calls - asking what 60 has then figuring out what sounds more serious and going to those jobs. Problem is, the ECC operators have access to more information than field personelle do during dispatch.....which is why an MDT would be nice. But, i digress.
I just can't help but be skeptical on how this will play out or what this means for those of us still in the field. Saying you have or enforce EMD is great, but taking full advatnage of all its benifits is another.

I doubt anyone would want to take on the liability of not sending a bus. Could be wrong, though.
Just seems like more and more this is an "in name only" situation. Is there going to be a metric attached to this in terms of what % of calls must recieve EMD based triage? From where i sit, i just don't see this changing the reality of EMS operations in this county. Agencies that staff ALS ambulances probably won't change the way they operate as long as their communities will continue to support that level of care - reguardless of the situation EMD/no EMD you're still getting a bus, an EMT and a medic. The real issue is when it comes to fly cars that serve multiple jurisdictions, but again because a paramedic fly car is the only guarenteed thing i can't see them not being sent. For those of us dispatched by 60 Control, will this open the door for redirection by the ECC operator - during times of heavy call volume - to higher priority and holding jobs / sending lower priority jobs mutual aid? When it gets busy i find myself and my collegues self triaging calls - asking what 60 has then figuring out what sounds more serious and going to those jobs. Problem is, the ECC operators have access to more information than field personelle do during dispatch.....which is why an MDT would be nice. But, i digress.
I just can't help but be skeptical on how this will play out or what this means for those of us still in the field. Saying you have or enforce EMD is great, but taking full advatnage of all its benifits is another.

Switching over to what? 60 Control? Those poor guys can barely handle the call volume they have now - this county (including the DES comissioner) doesn't seem to have any plans to face the reality and expand staffing. However, despite the exponential increase in call volume over the years w/o appropriate expansion i really do tip my hat to them - they do as best of a job as they can given what they have to work with.
That said, the REMAC (and i watched the webcasts) pushed out this policy statement without effectivly researching dispatching in this County. I think there was one indavidual who actually had a grasp on the reality in the webcast i watched. The expectation to have everyone EMD capeable by 1/1/13 (if that is even still the go live date) is rediculous. These are the issues as i see them:
EMS System issues:
- The point of EMD is to prioritize resources - send medics and other resources only on calls that they are truly required for. Unfrotunately, the reality is many of the volunteer ambulances (which make up the majoirty of the transport capeabilities county wide) are unreliable. Average wait time in excess of 20 minutes are the norm - some days/time of day are better, some days/time of day are worse. That said, sending a medic is the only way to get a reliable and timely EMS resource to your front door - thus defeating the purpose of EMD alltogether.
60 Control
- They simply dont have the staffing to answer, EMD, dispatch, and do all the other tasks that are required (imput CAD data, see the calls through to the end, request and or arange for more resources to scenes, etc)
- It seems a lot of time the PSAP (often a PD) who gets the initial call is not transfering the caller to 60 control for proper EMD. Rather, the caller is being hung up on, and the PD will call 60 and tell them "hey, dispatch XYZ VAC/Medic for chest pain IFO 123 Avenue." Again, whats the point?
Local PDs
- Most don't have exisiting EMD capabiliuty - that means buying a dedicated computer system and training all those who dispatch radio runs and EMS runs (often it seems like desk Sgts) in EMD.
- Bugetary constraints are creating atmospheres where most agencies are having to consider layoffs or vacating positions through attritiion, where are they supposed to come up with the money (infrastructure and OT training) to pay for the above?
- Honestly, i wonder how many PDs even care to be involved in this (i can't personally blame them)...they are busy taking care of what goes on in the law enforcement world.
I would much rather the REMAC work together with the County and Law Enforcement, take it's time, and establish a better thoughout system - preferably one that is a regional approach. I just think thats a much better path than spending a whole lot of money in a knee jerk reaction to an ill thought out policy and an arbitrary go live date.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff.
This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff.
This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff.
This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff.
This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff.
This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

Yeah, there is no way in hell that is the case. They give me about 15 seconds to jump out of the rack and get my boots on before they starting asking for my status on overnights ! But, in all seriousness, i'm pretty sure they have to go by whatever scheme the department establishes. As a small side bar, i really have to tip my hat to the 60 dispatchers - they do an awfully good job with the hands they are dealt (i often think that they are asked do their jobs with both legs and one arm tied behind their back). They do their best to get the job done - god knows they've figured out how to get me a bus when ~ 100 members between 3 agencies decide to shut the pager off. They probably bare witness to more egregiousness than anyone here in terms of this sort of stuff.
This is the kind of crap you would think the journal news would cover. Honestly, these are real stories.

This is kind of like it taking 27 minutes to get a bus for a jumper down....

This is kind of like it taking 27 minutes to get a bus for a jumper down....

My question is in what capacity were they operating? Unfortunately, i have had a handful of less than pleasant encounters with this agency - each of those times they were never the primary response agency for the respective municipality. Essentially, they showed up because they knew where the more religious jewish members of the community resided and crossed that with intercepted radio dispatches. They are pretty sneaky in how they do business - i recall having to hump gear a block or so because they tried to bar me from entering a scene. Its no secret that these people are not out to service the general public - crown heights proved that to me. So, are they contracted with the municipality in question to prove ambulance service or was this a private call?
And, as a small side bar, i would love to see them ticketed more - the way they operate their ambulances and personal vehicles is generally with impunity and no due regard for anyone's safety.

My question is in what capacity were they operating? Unfortunately, i have had a handful of less than pleasant encounters with this agency - each of those times they were never the primary response agency for the respective municipality. Essentially, they showed up because they knew where the more religious jewish members of the community resided and crossed that with intercepted radio dispatches. They are pretty sneaky in how they do business - i recall having to hump gear a block or so because they tried to bar me from entering a scene. Its no secret that these people are not out to service the general public - crown heights proved that to me. So, are they contracted with the municipality in question to prove ambulance service or was this a private call?
And, as a small side bar, i would love to see them ticketed more - the way they operate their ambulances and personal vehicles is generally with impunity and no due regard for anyone's safety.

My question is in what capacity were they operating? Unfortunately, i have had a handful of less than pleasant encounters with this agency - each of those times they were never the primary response agency for the respective municipality. Essentially, they showed up because they knew where the more religious jewish members of the community resided and crossed that with intercepted radio dispatches. They are pretty sneaky in how they do business - i recall having to hump gear a block or so because they tried to bar me from entering a scene. Its no secret that these people are not out to service the general public - crown heights proved that to me. So, are they contracted with the municipality in question to prove ambulance service or was this a private call?
And, as a small side bar, i would love to see them ticketed more - the way they operate their ambulances and personal vehicles is generally with impunity and no due regard for anyone's safety.