STAT213

Show me one piece of evidence that shows more paramedics equals better outcomes. Or one paramedic for that matter.

Seth,

Where are you working up there? I used to work in the area as well.

Family with you? Metropolitan Rochester is really a nice area, and parts of downtown are decent. Always enjoyed my time in Rochester

-Rob

Protectives are a volunteer Rochester Fire company that operate along side the career crews. They perform salvage operations.

Have you heard of google? First hit on a web search of Rochester NY Protectives.

No worries, I'm from the government, I'm here to help.

http://rochesterprotectives.com/

Those violent reactions usually occur when the drug is given too fast via the IV route. I haven't seen it happen when given IN.

Like ALL drugs, narcan must be given carefully, with good judgement and when indicated.

I think we're forgetting an important fact though. The issue is respiratory depression. This is easily managed by any BLS trained provider. You don't need a magic drug to fix it. You need a BVM.

Apparently you two didn't get the memo. Humor has been banned from this and all Internet boards. It was causing too much confusion.

Not sure, don't know all the players.

Finally. After months of teasing us, our new protocol is here. We will no longer be using backboards. Even for patients with spinal injuries. Collar and stretcher only. A fantastic evidence based change for EMS. MY favorite line in the new protocol...backboards have no place in the transport of injured patients. Or something along those lines. If we use a board for removal or extrication, the patient is to be removed from it once they are on our cot. FANTASTIC, isn't it!?

Here's the (somewhat cheesy) rollout video from our bureau of EMS.

Yes, we monitor for HCN and CO. Air monitoring and RAD57 pulse oximetry.

We have three cyanokits available on our apparatus for use on members or civilians.

So what does a dept like yours that has a large number of ALF products do when things break?

I'm all for a good parade. I care about two things when it comes to them.

1) Behave like a professional. Don't do anything to embarrass the uniform you are wearing.

2) Ensure that your town/district has proper coverage. Parade in your reserve piece or a non specialty piece. I. E. don't take your only aerial or heavy rescue two counties away leaving your constituents without coverage that they have paid for and expect. Same goes for manpower.

Other than that, have at it!

NH has a TASER protocol. Standing orders for removal of barbs.

Also lists contra indications for removal.

Very straightforward protocol. Does rely on the police to call us, of course.

Viewable on our state EMS website.

http://www.nh.gov/safety/divisions/fstems/ems/advlifesup/patientcare.html

As I've mentioned before, our protocols up here are the best I've worked with. Very forward thinking, evidence based where possible and provider driven. Worth a look.

Ice rescue, while seeming to be daunting, is a fairly straight forward procedure, that when undertaken properly is no more risky than anything else we do.

Equipment, training and procedures are key. Get those things squared away, and you'll be successful.

I've worked in upstate NY (Syracuse) and in NH. I've never seen the need for AWD ambulances. Gotten along fine with good tires, patience, some hiking and the occasional plow truck/SUV for some really snowy days.

As for gas, yes diesel may last longer, but Diesel engines HATE being run the way we run them. And, most of our ambulances never get into the range of mileage where long lasting comes into play. Any ambulance you work on have 500k+ miles??

The new diesels cost more, fuel costs more, they are expensive to maintain and don't hold the advantage they once did. Fleet managers are clearly looking at gas again.

Just my .02.

A classic example of what I like to refer to as volitics.

John. You clearly don't get it. They have RULES, man. RULES!!!

On a side note, anyone wonder where the 7 board members were for the call? No? Good.

Because him driving is the big issue there. Yup. Focus on THAT and feel good about being EMS leaders. We gots rules, don't cha know!!!

FAIL.

What's horribly ironic is that the quint/midi concept was a cost saving measure that cut the number of firefighters and companies; from what I remember quint/midi houses were actually engine and truck houses with 8 guys total that then went to 6. And now, it was sold as look look, we're getting back to true engines and trucks. But once again, manpower was cut. Houses that had 6 now have 4.

Who will be dispatching EMS? Still the local PD's? Or are they coming into this new center as well?

When I worked over there, we were dispatched by 201, 301, 401, etc. It was not an impressive system. You were lucky if they answered the radio when you called. It was clear their priority was the PD. Not knocking them for taking care of their own, but EMS got left out.

Yeah, but you can get an idea of things that are out of whack. You come across a dept with no staffing and a multi million dollar budget, some flags should be raised.

All about the Benjamins. I'm shocked. Really, I am.

Spoken like a true a******...I'm sure you have the majority vote from the brainiacs in your department!!!

I'm still confused. How is 585 the a*hole? Especially if you agree with the majority of what he says? You do realize he is a chief officer in his department, right? So, again....please elaborate.

Interesting. Thx for the info.

BTW, y'all have way too many messed up rules in your state.

Utica, NY provides ALS transport with FD ambos and bills for it, to the tune of almost 900,000 a year.

So, someone has figured out how to do it.

Aren't there agencies that have found a way around this? While the ambulance I lettered for the FD, you are in fact being cared for and billed by a separate corporation of sorts.

Anytime an unmarked vehicle of that size shows up at ANY scene, it's a good bet nothing good has happened, and that the vehicle serves a purpose that if lettered would scare the crap out of the general public.