crcocr1

First, the disclosure of medical records has to be made to someone within the medical institution. The government cannot march into an office and take records. This, however, does not mean that the individual providing such records is not instructed to keep the disclosure private. Finally, as a save all to the patient, grand jury proceeding minutes are not subject to disclosure without notice to any affected party.

I echo these sentiments as I have worked side-by-side them at St. Francis Hospital Emergency Department for the past seven years. You guys are the best!

You cannot even review a PCR without a signed authorization or court order. NY Public Health Law restricts access to health records, including PCRs, even to the Police. Further, even if a subpoena is issued, one still would have trouble accessing medical records. NY Pub. Health Law 18 (2008)(allowing physicians to refuse release of patient records if release would cause harm to patient's health and well being). Remember, people share their most intimate secrets with medical professionals, including paramedics, EMTS, and CFRs.

So if I'm a passenger on an airplane, I have the right to walk on the runway and take pictures of my plane? I think we should couch our comments to "if he took all his photos on the platform." Related news sources offer a bit more description of the event, but his pictures may not be all available to the public. See http://www.twine.com/item/11rk56f4s-40/amt...-s-penn-station (a bit more description of the account). If his photographs were limited to the platform, he has a point and the Amtrak PD may have been in the wrong. Otherwise, he may have cross the line.

Yes, but it isn't the photographs per se that this individual was arrested; but rather his entrance onto private property. If you enter onto another person's property, you may be criminally and civilly liable for trespass. In certain states, the fact that you did not know you were entering another person's property is no defense (excuse). This is hornbook law. See Singer and LaFonde, Criminal Law: Examples and Explanations (Aspen 2007). I suggest you look at the criminal trespass statute for New York, and look at this situation. (Its free at Cornell Legal Information Institute.) Without knowing its terms, I think a fair defense would be that the contest provided a license to enter railroad property. Obviously, I would need to see more facts and research more law to examine the validity of such a defense. With that said, however, I do not recommend anyone enter private property without permission (barring invitation by 911 calls, etc.).

The only point of information that I might add is the consumer might have had better luck dealing with the NY Attorney General's Office and/or County Department of Consumer Affairs. Both agencies will investigate, prosecute, and collect judgments in consumer fraud cases.

From what I remember from the news story, this particular individual already has a judgment against him. He (the fire chief) therefore already had an opportunity to have his side of the story heard. Though a contempt citation is unlikely in these types of cases, I agree that the plaintiff/judgment-creditor should exercise his rights to freeze the defendant/fire chief's bank account and repossess any of the defendant/fire chief's possessions or anything that he may have an interest in... Insofar as the volunteer fire company involved here, I think that a Code of Ethics should be adopted to ensure that no one abuses their power. If one is already in place, I am sure that the Mohegan will act accordingly, providing the fire chief with due process of law.

Great theme song to it too (watched it on re-runs)

Chris192, I believe your question was answered quite competently by pasobuff. For professional reasons, I must keep my posts general in nature; and therefore cannot entertain the remainder of your questions regarding "holding people responsible." Crcocr1 _____________________________ BNECHIS, Insofar as fraud, I just will say the intentional misstatement of fact must occur at the time of the alleged inducement to act (i.e. you promise to provide a service knowing that you will not provide it when you recieve a CON). Crcocr1 _____________________________ Engine1 I echo the second paragraph of your comments. If you have any questions or comments about my posts, please feel free to pm me. (I make this statement knowing that your comments were not directed toward me, nor disagree with any portion of your post.) I love to learn, which is why I chose my career and volunteer during my off-hours. I, therefore, would love to learn from a seasoned professional in Fire/EMS. Crcocr1

It depends. If the EMS agency rosters its ambulance, it is assuming the responsibility to respond. The cause of action would be one for negligence. If the EMS agency does not roster its ambulance, it does not assume a responsibility to respond, leaving the village, town, or city with the obligation to develop a plan for EMS in that respective area. Further, as Goose ably mentioned, the failure to respond may only prove a breach of duty. To obtain damages, the injured party must prove causation as well as certain and foreseeable damages. See generally Prosser and Keaton on Torts, 5th Ed. (1984).

I do agree that the EMT curriculum should revert to its prior focus on physiology, assessment, and treatment. When I started off (which wasn't very long ago), I brought a copy of the protocols with me in a bag on every call. I also relied on my father for advice. (He was a volunteer from 1978 until 1993 and 2002 until 2005). Before and after each call, I reviewed the appropriate protocol and asked: Why? Soon, I began to understand each protocol, the purpose of ALS, and the indications and contraindications for certain treatment. I do not know each protocol by heart but strive to do so. I now wish to advance my skills but seem to have reached a glass ceiling as my service area is either BLS or ALS. There is no ILS. Regretfully, the problem with bringing more skills to BLS rests on a diverse population in this state, where many EMTs do not view themselves as professionals and hide behind statutory immunity. Until all EMTs, from Buffalo to Albany and Plattsburgh to NYC, view themselves as professionals, master the existing curriculum, and, due to the State's inadequacy, teach ourselves the physiology, assessment, and treatment, we are unlikely to convince Albany to add IV therapy and Combitubes to the curriculum. We must remember that SEMAC is filled with physicians who have mixed feelings about EMTS from certain agencies while trust others. We need physicians to trust us all to convince them to add skills and equipment to our kit bags. Firecoins, I think we need to teach paramedics AND EMTs more about legal issues and documentation. Reviewing PCRs in my regular employment as a legal professional (taking the oath of admission as an attorney in January or February), I don't think paramedics or EMTs even have adequate education on legal issues facing EMS. I see many PCRs poorly documented, leaving them open to litigation, especially in hard economic times when many citizens will be looking to make a quick buck. I further see paramedics and EMTs mentioning HIPAA when they mean confidentiality in the general sense and failing to mention EMTALA when they are being turned away from hospitals on diversion with critical patients. The lack of education in legal issues and documentation, therefore, is across the board. (I agree with you in part about the physiology and assessment skills and think that clinical time needs to be reorganized to be more effective.)

As enemy combatants, they are entitled to a fair trial, counsel, and to present a defense. See Geneva Convention III, Article 105; Geneva Convention, Common Article 3.

In fighting terrorism, let us not become terrorists ourselves but give these defendants every bit of protection entitled under our laws. When they are found guilty, then let us punish them accordingly, within the dictates of the law, and not regress into mere savagery. It is only then that we can declare ourselves winners in this war against terrorism.

I agree with Chris192 and previous posts. If a patient has no critical physical findings, is hemodynamically stable, and not a high-risk patient (such as a child), s/he should travel by ground to a trauma center. It is safer and more prudent, especially when it takes time to land a Medevac. In a way, by calling a Medevac when it is not absolutely medically necessary, we are abdicating our roles as medical providers to provide competent medical care. I think this comment is more appropriate for BLS providers who "feel more comfortable" when an ALS provider rides-along during a BLS transport, but equally is appropriate here.

Sorry to correct you pjm, but public safety workers, including EMS, have the right to park on private property in an emergency situation. In common law, it was called "public necessity" in which the property owner had no right to recover monetary damages, nor criminal recourse. See generally Crim. Proc. Law 35.05 (West. 2008)(regarding justification defenses to criminal offenses, such as trespass); Pari v. City of Binghamton, 57 A.D.2d 674 (3d Dep't 1977)(discussing necessity defense); Herter v. Mullen, 159 N.Y. 28 (1899)(same). Here, the ambulance company can choose to honor the request of the church; but if the intercept is needed in an emergency, there really isn't much the church can do.

I think the issue arises where the IAFF member is volunteering in a fire district neighboring the paid district. If this occurs, technically, the volunteer would have to get paid if called to a mutual aid call where they work as a FF in a paid district/area.

This post quibbles with the word "youth." I know people in my agency who join when they are a bit older than 14-30 who also speak like they have been fighting fire or caring for the wounded for twenty years. I recall an earlier post where the purpose of EMTbravo was stated "to encourage community among Fire/EMS members in the community." We should all share what we know, have experienced, and strive to learn more from others. Perhaps the "younger crowd" should talk/teach about a new type of fire camera that just came out that an "old timer" might be resistant to use because technology is foreign to them. Perhaps the "older crowd" should share observations that might assist the youth at a fire scene so that suppression can occur more quickly. Although I have worked in EMS and the ER for only six years, I know this one simple fact: No one knows everything. If we keep that in mind when we post, I think we all will benefit from evaluating things we know, learning the new, and becoming better at what we all do. As I head back to study for the bar examination, I hope everyone in this forum "young or old" stays healthy and safe as you continue to help others by "fighting fire" and "saving lives." Once my exam is over, I will be able to give more time to my home agency.

"Also, i am a big fan of having volunteers respond to their respective buildings. It just makes so much more sense. Yeah, i GUESS having an EMT or FF solo on scene is cool but you really can't do a whole lot. You can either watch the patient crap out or the building burn (some may disagree with me, but in my experience this is about as far as it goes). Head to the building because that is what helps get that truck or ambulance out the door and those are the pieces of equipment that have the real potential for making a difference." Insofar as EMTs-It depends on how you equip your volunteers. If you provide them with oxygen, aspirin, glucose, charcoal, and related supplies, you enable a patient to get the basic care quicker so that the ambulance need only "load and go" with patient. Otherwise, I agree with your comment. Insofar as FFs-I have no ability to comment but makes sense.

Insofar as liability, the EMT most likely will face administrative sanction from the Department of Health Bureau of EMS. As long as you are certified, you can be sanctioned by reprimand, suspension, and/or revocation. Insofar as civil penalties, an aggrieved individual or entity would have to prove the act or omission caused harm to the patient. In addition, the act or omission would have to be within the statute of limitations. Insofar as criminal penalties, the statute of limitations likely expired, and, even if it didn't, the District Attorney would have to want to prosecute the case.

First of all, I agree with posters who think that he should NOT be Executed. If we execute him, we make him a matyr for his cause. If we imprison him, we defeat his cause. Second, in placing him in protective custody, we isolate him to one hour of recreation a day. Otherwise, he remains in his cell except for heath care and dental visits, which is decent for basic care. However, should he develop cancer or require surgery, the care that would be provided is far from acceptable. Moreover, isolation such as this takes its toll on a man's mind. Third, comments like "let him die the most painful way possible" reduces our military tribunals to mere savagery. We must afford him all the rights that we afford to accused individuals in the custody of the military. When convicted, we have not disrupted or lowered our standards of military justice but rather ensured that he received the same process and still adjudged whatever punishment he so deserves.

I've used it; and wish it was used more. I agree with the poster above insofar as it is up to the FD to certify. Some FD/EMS agencies allow Bloodborne PAthogens to be completed online; others don't allow it. Check with your department.

Troop 40 Hopewell Junction, NY Class of 1998

I agree wholeheartedly with alsfirefighter but am worried about some BLS members in this forum being reluctant to provide care prior to ALS arrival. Remember, whether paid of volunteer, the public views you as professionals, as does the courts. Regretfully, NYS has not adopted the National protocol regarding backboarding. Therefore, BLS wise, I agree with c-collar and backboard, possibly with a shortboard, being mindful of airway access at all times. If it still is achievable in the prone position, then backboard in the prone position. If it isn't achievable, BLS providers ATTEMPT med control but if it fails, AIRWAY AIRWAY AIRWAY is the most important part of patient care. Without airway access, a pneumothorax cannot be treated b/c the utility of a chest tube is futile. There is no pressure to relieve when there is no air flowing through the body. Similarly, spinal immobilization is useless when the patient cannot be salvaged. Transport to a Trauma Center in accordance with state and local protocol accordingly. ALS wise, I think the comments above are sufficient.

My concern with a combined police officer/paramedic or police officer/EMT is that serious conflicting duties arrive. On one hand, a police officer has a duty to the public in gathering evidence, namely in the form of statements made in the course of an investigation, only later to reveal those statements at trial. On the other hand, a paramedic/EMT has a duty to obtain information only for the purpose of treatment, and relay that information only to select individuals in furthering a patient's treatment. When does the public know if the statements they utter will be used against them in court or kept private?? The answer could cost lives.

If the story is factually correct, tts another turf war between an FDNY EMT and private ambulance services, caught in the middle is a child who might have lived if the FDNY EMT realized his or her job is to help the patient NOT his ego.