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Did I read this right?

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Does this article say that a Trauma patient was transported from Orange County to Hackensack, New Jersey?

Two seriously hurt in Kiryas Joel crash

September 11, 2007

Kiryas Joel -- The passenger and driver of a livery cab were seriously injured, when their vehicle crashed head-on into a kosher foods delivery truck on Acres Road this morning.

The accident occurred around 10 a.m. at the corner of Acres and Satmar Drive rerouted traffic around the main village road for about an hour.

State police Sgt. Warner Hein said the passenger of the cab, belonging to Best Associates Cab Co. of Monroe, sustained serious neck, head and chest injuries from the crash. She was taken to Hackensack Medical Center by Hatzolah ambulance.

The cab driver, who sustained head and neck injuries, was taken by Hatzolah to the Arden Hill Campus of Orange Regional Medical Center in Goshen. Hein did not know if the passenger was a Kiryas Joel resident. The victims’ identities were withheld pending notification of relatives.

Hein said the accident occurred when the driver of the eastbound truck crossed the center lines while trying to avoid a third-party vehicle that had apparently stopped in front of it to make a left, but then suddenly went forward. The truck then collided with the cab, which was going westbound. The driver of the truck was uninjured.

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Someone mapquest the distance!

Done!

44.41 miles (approx.), 52 minutes of travel time!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Facts only!

Not right!

To WCMC by ground:

44.82 miles

52 minutes transport time, 1 Tappan Zee or Bear Mountain Bridge

Orange Regional Medical Center, Goshen:

11.15 miles

15 minutes transport time

All are done via mapquest! All transport times are approximate, and code 1!!!!!

By HELO if they really needed a Level 1 Trauma Center, I actually have no idea!

Edited by Oswegowind

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Hackensack Medical Center as in NJ????

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52 minutes transport time, 1 Tappan Zee or Bear Mountain Bridge

I guess they didn't want to pay the toll !!!!

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Majority of the patients KJEMS transports from Orange County go to Hackensack, no matter what the emergency. Doesn't surprise me 1 bit for them to do this. Weather was shitty all day here, so the medivac's were down, still no reason to bypass Good Sam.

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not yet.......lol

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I just though of something else, what if the injuries become more serious and the police actually have to do a follow-up, can the NYSP really afford to send a car all the way into Jersey???? I mean at least if the go to WMC, a trooper from Hawthorne could sit with them if needed and relay info appropriately, no?

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This topic comes up time and time again and guess what? NOTHING happens to them! KJEMS gets away with everything short of murder. They like to take DOH Protocols and stretch them as thin as they can. When it comes to the rules about going to the nearest capable hospital, they tell DOH that Hackensack all the way down in NJ is closest appropiate hospital according to them. Everyone knows and nothing gets done.

Also, KJ EMS NEVER drives Code 1 to any hospital. They even run Code 3 coming back from the hospitals in NJ.

When you community has a bloc vote for the politicians in the County. The head Rabbi says that everyone will vote for a certain guy and they all vote for him. There is also a member of the KJ community who is a full time paid liason to the NYSP. He is paid by the NYS Health Department..Dont ask because you will never get an answer on how and why!

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Insane! Talk about possible protocol violations if that person did have life threatening injuries (airway compromise, so on)

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I am not from that area and I have a few questions before I go passing judgement.

1) Are there any other "Appropriate" hospitals that can handle these types of injuries closer than Jersey? Just because its closer doesnt mean its the "appropriate" facility.

2) Did they call med control on the radio or phone and receive directions to divert and go direct to Jersey? Anyone know?

With the weather being bad and the extent of injuries, and based on the answer to number 1 Its hard to determine if they made the right choice or not without more info on what exactly happened here.

3) How badly injured was the pt? The article said extensive head, neck and chest injuries, but how often does the media elaborate to make a story? Does anyone know HOW bad the injuries were?

I live in a small, GROWING community, and our local hospital cant do very much at all. They cant handle major trauma, pregnancy, and they lack the equipment and staff to handle major medical issues. They do MINOR surgery, ( gall bladder, appendix, minor bone and joint stuff, etc.) In fact, 9 times out of 10 they are calling for us to transport the patient...before they even get to the ED...based on the radio report. We have learned to listen to the scanner and decifer who will be transported...and when in the field we know when to transport to another, more APPROPRIATE facility. We still call med control and present our patient but they usually interrupt us and tell us to divert. I am just trying to look at all angles here and see if they actually made a bad, or a good decision here. I need more facts before I make judgements.

Any more info on this would be great.

Moose

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Look. Whether I like it or not based on medical terms and thought processes, they have another level of issues they must content with based on their religious beliefs. Whether we like it or not. Its an agency that is run based on the needs also associated with their religious beliefs. Whether we like it or not. It wasn't your agency that did that transport..nor did you have to tell them no way. Do I agree with many of the things I've personally seen with 2 of the agencies involved. Absolutely not. Do I understand why it is that they make those decisions...yes. Do I respect them based on their freedom of religion, yes. If they made a decision to go to a hospital which has the means or performs the support type services they look for and require for their religion then that is something they have to live with the decisions they make. As far as going into another state or area I don't buy into that, treatment is treatment. I also do not make transport decisions based on how far another agency needs to go to do their job. Courtesy and understanding go both ways. I just take the time to explain why it is that way.

Oswego I'm a bit confused was the first number you posted for Hackensack? If so isn't it a shorter distance then WMC?

Jonesy, you still call medical control for every patient you know is going to get transported to another facility? Is that a requirement or something that is agency policy for your region?

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1) As Moose, I would like to know the extent of "serious" injuries, sounds bad, but I listened to a call for hypertensive crisis last weeek complete with nausea, vomiting & tingling & the pt's. high B/P was 138/8?, so if more details can be found, please post.

2) Moose, as some agencies will not leave thier little town, no matter what the protocols say, some agencies will only transport to one hospital, no matter what or how much it endangers the pt.

3) Anyone ever consider pt. choice? To avaoid that same little hospital that Moose loves so much ;) the pt. would say tell us (with a wee bit of prompting) that they would refuse AMA transport unless they could go to a real hospital, 20 minutes down the road. While this was done for cardiac or serrious medical conditions that needed a hospital with services, we never by-passed an appropreate facility.

Given the devout beliefs, is it possible that the victom would not go to a lay hospital no matter what? I realise that most of us would tell them in no uncertin terms that they have no choice, but to many death is better than offending thier God. With that knowledge in mind, I believe the medic would follow pt wishes. Granted, that particular agency has a rep for lots of bad things, but sometimes it really isn't their fault. Really.

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Jonesy, you still call medical control for every patient you know is going to get transported to another facility? Is that a requirement or something that is agency policy for your region?

Sorry, should have clarified that a little better. I meant for 911 calls. Say I was dispatched to the ball fields for a fractured leg...we get there and its obviously broken (deformity, swelling, crepitus, etc.) and we know that our community hospital cant manage factures, we want to go to Albany Med, we get on the phone with med control for permission to divert, they hear our report and we request use of Morphine, they grant permission, we go directly to Albany Medical Center with pain management. I didnt mean to make it sound like I was referring to transports, sorry! ;)

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There is a similar thread on this on www.Hatzolahtalk.com

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Jonesy, thanks for the input. I figured it was only for 911 calls, which really is the only mindset I'm in being I do no transfers. I'm still trying to get the concept of having to call the local hospital to "request permission" to divert. Just dounds overly micromanaging of resources and not respecting EMS's decision making abilities. I often make decisions of not to transport to the closest hospital based on patient condition and potential treatment needs and never have to call.

For example by using your example...if I was sent to a ball field for a fractured leg...my decisions on facility transport would be based on how severe the fracture and patient age. Adult...doesn't matter, local can handle it or at least stabilize it in the event more specialized treatment is needed and they will transfer to WMC. Pediatric...if its open, they are going to WMC. Closed and this is where it can get tricky, it doesn't hurt to call. I worked in the OR for our local hospital and I pretty much know they have no problem handling a fracture if they are around 8 years of age and would bring them local. Anything younger and I would discuss it with the parents/guardian and explain to them why I think the extra tranport time/distance is warranted.

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as mentioned in a previous thread about a month ago or so, Hatzolah is a very strong and powerful community. someone happen to say they are more powerful than the mafia...and that wasn't the 1st time i heard about how powerful they are.

unless you guys/gals plan to complain about the mafia (not a good idea), this is really a dead issue.

they will do what they want to because they can.

Edited by vacguy

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2) Moose, as some agencies will not leave thier little town, no matter what the protocols say, some agencies will only transport to one hospital, no matter what or how much it endangers the pt.

3) Anyone ever consider pt. choice? To avaoid that same little hospital that Moose loves so much ;) the pt. would say tell us (with a wee bit of prompting) that they would refuse AMA transport unless they could go to a real hospital, 20 minutes down the road. While this was done for cardiac or serrious medical conditions that needed a hospital with services, we never by-passed an appropreate facility.

Hey Merlin, just wanted to elaborate on 2 of your points you have made. With number 2, being you and I have worked together before, you know how sensitive a subject THAT is with me! :rolleyes: How many times has the argument been made that some of our local squads disobey state protocol and ALWAYS go to Coby Regional, instead of the "appropriate" facility? Trauma should go to Albany or Cooperstown, Stroke should go to Ellis, etc. etc....but our local squads feel its more important to return to service as soon as possible rather than take the person to the "appropriate" facility. But hey, its job security for me, right!!! ;)

Number 3, the only time we should be going to hospital of patients choice is when A) PT is AOx3 or B ) If the patients representitve, aka legal gaurdian etc., is there to make the decision for them. Or has that changed? If so, sorry!!! :rolleyes:

Thanks Merlin

Moose

Edited by Jonesy368

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I'm gonna drag out the dead horse for beating again. Folks, like em or not, this is not going to get anyone anywhere. I'm not defending or condemning anyone. Those of you who have an ax to grind should simply run an incident with these folks and if you see something that isn't kosher(no pun intended), you make the report through the proper channels. Just a friendly reminder, let's not turn this into a bashfest, because we all know what happens when we do that.

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As stated before, nothing will come from complaining here, except the wrath of the topic deletion....

post-917-1189632012.jpg

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Oswego I'm a bit confused was the first number you posted for Hackensack? If so isn't it a shorter distance then WMC?

Technically, Hackensack is .4 (point 4) or 2/10ths of a mile closer! I understand that Hackensack is a level 1 trauma center, as is WMC, but I am not familiar with the level of car performed or available at Goshen's ORMC. Religion should not be used to break the rules, and I would hope that any LEO in any state would be observant and recognize whether or not they are transporting a victim or returning to their jurisdiction. If you have definite knowledge of violations against DOH policies, state laws, then don't b&m on here about it, but proceed to call the appropriate persons and hound them until action is taken. I don't mind people ranting, but as previously said, it is useless and unproductive...even when I do it!

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Jonesy, you still call medical control for every patient you know is going to get transported to another facility? Is that a requirement or something that is agency policy for your region?

Sorry, should have clarified that a little better. I meant for 911 calls. Say I was dispatched to the ball fields for a fractured leg...we get there and its obviously broken (deformity, swelling, crepitus, etc.) and we know that our community hospital cant manage factures, we want to go to Albany Med

Just to add on to that: it was an implied rule of that hospital that "they" were the closest approreate facility for everything. And, since they provide the MD for QA/QI, which all agencies must participate in, well....

The new regional protocals specify which hsopspitals are now appropreate & this hospital is not on the list for anything. Now, you should get med control to go there

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I'm gonna drag out the dead horse for beating again. Folks, like em or not, this is not going to get anyone anywhere. I'm not defending or condemning anyone. Those of you who have an ax to grind should simply run an incident with these folks and if you see something that isn't kosher(no pun intended), you make the report through the proper channels. Just a friendly reminder, let's not turn this into a bashfest, because we all know what happens when we do that.

JBE, and others who have mentioned it here, I just wanted to make a friendly point to you...please review some of the posts that most of us are making, in them you will read mostly about the topic of which facility is the "closest apropriate" facility and about NYS protocols for transport to these facilities...and the fact that most of us dont even MENTION the agency in the first post. I feel this is a great discussion about which hospital to take which patient to, and about reviewing our protocols, thats all brother. I personaly dont see bashing in this discussion more than 10-20% of the time which is better than some of the OTHER topics Ive seen being argued.

Just trying to say that some of these topics NEED to be discussed in order to make them a learning experience for all to share, as long as everyone leaves personal gripes with individual agencies out of it these topics can be great learning tools for all. Just my feelings on the matter, please dont take them the wrong way. I respect your opinion on this matter but like I said, I believe its not as bad in this dicussion as in others.

Have a great day and stay safe.

Moose

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I must have been dozing when this thread first appeared.

How come nobody brought up the issue of two area trauma centers in Rockland County that could be used instead of the hike to Hackensack?

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I must have been dozing when this thread first appeared.

How come nobody brought up the issue of two area trauma centers in Rockland County that could be used instead of the hike to Hackensack?

Duh, Level 1 is the bestest! :P

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Thanks Chris, That is what I was thinking. Good Sam is only 18 miles away and a level 2 trauma center. Nyack is 8 miles more. If that. Of course St Francis in Pok. KJ is only a few monents away from 17 & the thruway. Wonder what the crew had to pick up from the way back. Hmmmmm!

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