Quinn Slams "Outrageous" 30-Minute Wait For Ambulance After Intern Collapses

[antiquefirelt 994]

But in all honesty wouldn't you say that the zoo FDNY EMS is over trained because I can say that the only difference between nyc and anywhere else is volume and even everyone's emergency is heard and I rather an ambulance there that takes them tithe hospital for a fever than some kid breaking into a seizure in the back of a cab. Don't downplay people's emergencies because that cut in their finger could've been from a rusty nail and they can't afford a taxi to hospital it goes untreated and they get really sick.

I hate to tell you but your overall view is far to simplistic to the vast complexity of providing mass scale EMS. The system we operate in is dramatically smaller and some of the same issues are prevalent. In a municipal system the taxpayer ultimately decides what level of service they desire. Through the election process and voting on bonds, budgets, etc. they ensure that the level of service is no less than they are willing to pay for and most recently no more that the minimum they're willing to pay for as well.

Calls must be triaged in almost every system because the taxpayers don't want to pay people to sit around and do nothing. So there becomes a balancing point that a system has enough units available to answer true emergencies most days but know that the system will begin to fail (below stated response times, care levels) when the system is truly taxed. This is the same with all public services and actually most privates (they have to throw profit margin in as well int he decision process). EMS systems are pushed to failure daily nationwide, many time is places far less problematic than NYC. Hell can you imagine how easy the guys who plan NYC EMS would find a western city with flat well laid out (engineered) streets properly named and numbered?

Few if any systems are without flaws, diminishing the quality of the employees is not the answer to long response times and/or inadequate advanced care resources.

[Arbrow06 5]

So what if they volunteer and get the same amount of training tell me what the gripe would be there and remember I said add buses like the ones they just replaced with the dodges not take away paid and add volly. And while experience was one of my points in terms of getting volunteers we all know there will be experienced people that will want to do it to.

Where is this concept of EMT that isn't trained coming from. No matter volly or paid whatever agency your with you will be getting trained and you will be gettingtrained all the time so I am confused about this trained stuff. Clearly the FDNY isn't going to accept every application and will practice due diligence so they don't have an incompetent EMT. I want you guys to play devils advocate to your own arguement as I am only throwing a few points out there but there are so many more. It is a feasible idea.

Yes unions this and that but that seems like the only substansiated arguement which is an unfortunate arguement.

[Arbrow06 5]

I do not think the rest of the EMTs in NYS are undertrained? Are the rest of the fire fighters undertrained as well? I am pretty sure the safest place to have a heart attack is the Carrier Dome not Yankee Stadium.

There are flaws and I merely wanted to throw ideas out like a sort of incubator but if you aren't looking for a solution then I guess we will continue to have the same problems.

And antique starting simple is a technique in problem solving you come up with a solution for best case scenario then you work through all the road blocks which as noted in this discussion are so many there might as well not be a solution. Lets just spend money on marketing and hope that people stop using the ambulance as a taxi. Sorry for trying to help.

[Arbrow06 5]

It is ironic because PEMO3 first stated that 30 minute times are normal with no buses. I suggest a way to get more buses and then no not those types of buses with EMTs that arent at the FDNY caliber. Sounds like a ego thing to me.

[Bnechis 3,961]

So what if they volunteer and get the same amount of training tell me what the gripe would be there and remember I said add buses like the ones they just replaced with the dodges not take away paid and add volly.

It just came to me, the system of volunteers suplimenting NYC*EMS was in use Citywide for 30 years. Many new EMT's got there feet wet that way. Where did it go? The EMT's figured out they could work for a transport company, get "paid" and gain experience. Thats why most of the Volunteers are no more.

[PEMO3 523]

It is ironic because PEMO3 first stated that 30 minute times are normal with no buses. I suggest a way to get more buses and then no not those types of buses with EMTs that arent at the FDNY caliber. Sounds like a ego thing to me.

There is no Ego just 30+ years of experience and training speaking. Based on your profile you are still wet behind the ears as far as EMS goes. At 19 just how much studying of this field to solve the problems of FDNY EMS have you done. You even acknowledged that you aare not that familiar with the system.

[Bnechis 3,961]

I do not think the rest of the EMTs in NYS are undertrained? Are the rest of the fire fighters undertrained as well? I am pretty sure the safest place to have a heart attack is the Carrier Dome not Yankee Stadium.

Sorry you think so. I have been an EMS instructor for 30 years and I the amount of training that EMT's get has never been enough to put them out in the street as a newbe. When the course was 120 hours I convinced my course sponsers to let me do 180. I included Patient documentation, MCI OPS. auto extrication (scene safety & EMS rolls as well as understanding what to ask for, like a dash roll or a 3rd door) where my students got to see a car being cut up. How about doing patient packaging in a car thats mangled or in a bathroom. Do you know how to get a choking patient out of a corner bath tub? If you have never been tought, you wont manage it. How about getting the pt with the broken hip out of the recliner that the family placed them in (and do it without lifting or agrivating the break).

There are many other threads that you can go to on firefighter training. Here we have 1 basic standard and many agencies including FDNY understand it and realize its just too basic, so they add more too it.

[Arbrow06 5]

Then it all boils down to what is the solution? Besides marketing because that will only go so far.

[antiquefirelt 994]

And antique starting simple is a technique in problem solving you come up with a solution for best case scenario then you work through all the road blocks which as noted in this discussion are so many there might as well not be a solution. Lets just spend money on marketing and hope that people stop using the ambulance as a taxi. Sorry for trying to help.

I don't see the criticisms brought forth here as saying not to try and figure out how the system can be improved, but you must understand the system that you're trying to fix in the first place and the detailed underpinnings. It appears that regardless of what other issues are brought to light with a plan that tries to integrate volunteers into an all paid system you fail to move on to another solution that might have more merit? I mean no disrespect, but are you truly looking for solutions to the City's problem or looking for a solution to your own?

[Dinosaur 844]

So what if they volunteer and get the same amount of training tell me what the gripe would be there and remember I said add buses like the ones they just replaced with the dodges not take away paid and add volly. And while experience was one of my points in terms of getting volunteers we all know there will be experienced people that will want to do it to.

Where is this concept of EMT that isn't trained coming from. No matter volly or paid whatever agency your with you will be getting trained and you will be gettingtrained all the time so I am confused about this trained stuff. Clearly the FDNY isn't going to accept every application and will practice due diligence so they don't have an incompetent EMT. I want you guys to play devils advocate to your own arguement as I am only throwing a few points out there but there are so many more. It is a feasible idea.

Yes unions this and that but that seems like the only substansiated arguement which is an unfortunate arguement.

Sounds like you're asking us to do your homework assignment.

There is a process to become a FDNY EMT. Maybe you should research that first.

Unions "this and that"? Come on, don't bring that kind of response to a discussion and expect rational, educated responses. Do you know what a closed shop is? Do you know what the FDNY EMS standards are for a 911 unit? Do you know what the FDNY training standards are?

[FireMedic049 597]

Where is this concept of EMT that isn't trained coming from.

It's coming from your earlier suggestion of putting new volunteer EMTs into FDNY EMS uniforms and putting them on the streets without going thru the full FDNY EMS training program.

No matter volly or paid whatever agency your with you will be getting trained and you will be gettingtrained all the time so I am confused about this trained stuff.

Clearly you have very little knowledge of other EMS agencies.

I want you guys to play devils advocate to your own arguement as I am only throwing a few points out there but there are so many more. It is a feasible idea.

No.

Yes unions this and that but that seems like the only substansiated arguement which is an unfortunate arguement.

Why is this an "unfortunate arguement"?

[CFFD117 19]

Another thing worth mentioning here is that there really is int enough of a surplus of vehicles to make it work, especially now with the enhancement units on. Its not uncommon to have the nearest available spare come from another division. A buddy at my station (16/10) had to go to station 58 in Brooklyn to grab a spare bus because that was the closest available. There is no way FDNY is going to buy a bunch of new buses so it can have its old buses run by volunteers that have been run through an abbreviated academy and that wear the same uniform as the full time more trained personnel.

[FireMedic049 597]

I do not think the rest of the EMTs in NYS are undertrained?

On what objective criteria do you base this on?

Are the rest of the fire fighters undertrained as well?

Probably not all of the them, but I'm sure a substantial percentage of them are.

I am pretty sure the safest place to have a heart attack is the Carrier Dome not Yankee Stadium.

Why is that?

There are flaws and I merely wanted to throw ideas out like a sort of incubator but if you aren't looking for a solution then I guess we will continue to have the same problems.

Rejecting a flawed idea based on years of actual EMS experience, particularly by someone who's worked in that system, isn't the same thing as not looking for a solution.

And antique starting simple is a technique in problem solving you come up with a solution for best case scenario then you work through all the road blocks which as noted in this discussion are so many there might as well not be a solution. Lets just spend money on marketing and hope that people stop using the ambulance as a taxi. Sorry for trying to help.

What you don't seem to understand is that there can be a distinct difference between finding the solution to a problem and being able to implement that solution to actually solve the problem. I'd be willing to bet a paycheck that if you went and surveyed the EMTs and Medics on the front-lines of NYC, they've already identified numerous solutions to the problems they face delivering prehospital care to NYC. Unfortunately, management often isn't interested in listening to suggestions from the field staff, so many problems linger rather than get resolved.

Additionally, some issues are pretty easy to solve, but arbitrary obstacles are put in place that prevent a solution. For the particular situation in this thread, the underlaying issue is a spike in demand above normal levels due to the extended period of high heat. The simple, obvious solution to a temporary increase like that is to put additional units on the street. This typically means field staff working overtime. If management will not authorize personel on overtime to staff those extra units, then you won't have those units and response times will predictably increase.

[Bnechis 3,961]

What if the FDNY had an auxiliary component of EMTs who want to get their experience up to be able to get into a commercial service and have them go on the low priority calls while the medics, rescue medic and haz techs go on the hi priority calls. The only difference would be in the training because you wont go through the FDNY*EMS academy but a shorter modified training program but you'll wear the same uniform and you will not get paid.

Anyone see anything wrong with this idea?

I had to go back to this.........Solve the problem by adding volunteers. Later I mentioned they have volunteers,but I may not have been clear as to how many:

NYC Volunteer EMS Agencies

ALS Services, Inc.

1340 East 9th Street, Brooklyn, NY, 11230

Bay Community Volunteer Ambulance Corps.

P.O. Box 610540, Bayside, NY, 11361

www.bcvac.org

Bayside Community Volunteer Ambulance Corps.

214-23 42 Ave., Bayside, NY, 11361

http://bvacems.tripod.com/

Bedford Stuyvesant Volunteer Ambulance Corps.

561 Lexington Avenue, Brooklyn, NY, 11221

www.bsvac.org

Bensonhurst Volunteer Ambulance Service Inc.

P O Box 140147, Brooklyn, NY, 11214

http://bensonhurstvas.org

BRAVO Volunteer Ambulance Service, Inc.

8507 7th Avenue, Brooklyn, NY, 11228

www.bravoambulance.org

Broad Channel Volunteer Fire Department

15 Noel Road Broad Channel, NY, 11693

www.broadchannelvfd.org

Brooklyn College Emergency Medical Squad

2900 Bedford Ave Suite 021 N.E., Brooklyn, NY, 11210

http://students.brooklyn.cuny.edu/ems/

Central Park Medical Unit, Inc.

PO Box 440 Gracie Station, New York, NY, 10028

www.cpmu.com

Chevra Hatzalah Volunteer Ambulance Service

1340 East 9th Street, Brooklyn, NY, 11230

www.hatzalah.org

College Point Community Ambulance Corps, Inc.

PO Box 84, College Point, NY, 11356

http://departments.firehouse.com/dept/CollegePointNY

Columbia University EMS

101 Low Library, 535 W. 116th St., New York, NY, 10027

www.columbia.edu/cu/cava/

Corona Community Ambulance Corps, Inc.

104-38 47th Ave., Corona, NY, 11368

www.ccvac.org

East Midwood Volunteer Ambulance Corps.

PO Box 100788, Brooklyn, NY, 11210

www.eastmidwoodvolunteerambulance.com

Flatlands Volunteer Ambulance Corps.

4623 Avenue N, Brooklyn, NY, 11234

http://www.fvac.org/

Flushing Community Volunteer Ambulance Corps, Inc.

43-14 162nd Street, Flushing, NY, 11358

http://www.freewebs.com/fcvac/

Fordham University Emergency Medical Service

441 E. Fordham Rd., Bronx, NY, 10458

www.fordham.edu

Forest Hills Volunteer Ambulance Corps. Inc.

P.O. Box 750617, Forest Hills, NY, 11375

www.fhvac.org

Gerrittsen Beach Fire Department

52 Seba Ave, Brooklyn, NY, 11229

www.gbfd.net

Glen Oaks Volunteer Ambulance Corps.

257-02 Union Turnpike, Floral Park, NY, 11004

http://www.geocities.com/hotsprings/falls/2854/

Glendale Volunteer Ambulance Corps.

PO BOX 863991, Ridgewood, NY, 11386

www.glendalevac.org

Jamaica Estates Holliswood South Bayside Volunteer Ambulance Corps.

PO Box 640181, Oakland Gardens, NY, 11364

http://www.jevac.org/

Lindenwood Community Volunteer Ambulance Corps.

PO Box 170191, Ozone Park, NY, 11417

www.lindenwoodvac.org

Little Neck-Douglaston Community Ambulance Corps.

42-18 Marathon Parkway, Little Neck, NY, 11362

www.lndambulance.org

Middle Village Volunteer Ambulance Corps Inc.

P.O. Box 5, Middle Village, NY, 11379

http://home1.gte.net/mvvac/

North Shore Rescue Squad No. 1, Inc.

PO Box 140702, Staten Island, NY, 10314

www.northshorerescuesquad.org

Park Slope Volunteer Ambulance Corps Inc.

478 Bergen Street, Brooklyn, NY, 11217

www.psvac.org

Queens Village-Hollis-Bellerose Volunteer Ambulance Corps.

235-01 Braddock Avenue, Queens Village, NY, 11428

Ridgewood Volunteer Ambulance Corps, Inc.

PO Box 863992, Ridgewood, NY, 11386

www.ridgewoodvac.org

Rockaway Point Volunteer Fire Department

204-26 Rockaway Point Blvd., Rockaway Point, NY, 11697

Roxbury Volunteer Emergency Medical Services Inc.

42 State Road Roxbury, Rockaway Point, NY, 11697

Throggs Neck Volunteer Ambulance Corps, Inc.

P.O. Box 302 - Throggs Neck Station, Bronx, NY, 10465

Volunteer Heart Ambulance

P.O. Box 060252, Staten Island, NY, 10306

http://www.vollyheart.com/

West Hamilton Beach Volunteer Fire Department

P.O. Box 177, Howard Beach, NY, 11414

www.whbvfd.org

Whitestone Community Volunteer Ambulance Service

P.O.BOX 570064, Whitestone, NY, 11357

http://www.wvac11357.com

Woodhaven Richmond Hill Volunteer Ambulance Corps.

78-15 Jamaica Avenue, Woodhaven, NY, 11421

Now if these 35 different agencies can not solve the shortage, how is adding 1 more going to help?

Edited July 23, 2013 by Bnechis

[helicopper 1,050]

If she weren't running for mayor, she wouldn't be complaining.

She might be complaining even if not running for mayor. The difference is nobody would listening.

[helicopper 1,050]

I am just applying the fact that many of the people on this forum and EMTs who started from the poop end of the stick to become the amazing knowledgeable EMS providers they are today. All EMTs right out of school should be able to handle any call. I am not saying execute it perfectly but they should be able to stabilize and transport and work with their partner to make sure there is not underlying issues.

I am not saying to lower the quality. I am saying take the ready and eager volunteer EMTs. Train them to you standard because they already spent 17 weeks learning how to save lifes and at least 36 hours on the road. I don't see how your concerns make this a bad idea because the majority of EMTs know their stuff we aren't looking for ER docs on the road just people who will volunteer their time to alleviate the system.

I'm not aware of any agency, from the "grand" FDNY EMS" to the "lowliest" VAC running 100 calls a year that puts a brand new EMT "right out of school" in charge of any call. Every agency has some kind of preceptor period where the fledgling EMT has the opportunity to stretch their new wings while under the supervision and guidance of a more experienced EMT while the ink on their card dries.

If you can't execute perfectly (your words), what standard are we striving for? Mediocrity? So-so? To accept and endorse a lower level of performance does the patient a great disservice and also increases your liability. We should be striving for MORE not advocating less!

[helicopper 1,050]

But in all honesty wouldn't you say that the zoo FDNY EMS is over trained because I can say that the only difference between nyc and anywhere else is volume and even everyone's emergency is heard and I rather an ambulance there that takes them tithe hospital for a fever than some kid breaking into a seizure in the back of a cab. Don't downplay people's emergencies because that cut in their finger could've been from a rusty nail and they can't afford a taxi to hospital it goes untreated and they get really sick.

If you really care about the people I am happy that I show up and check on someone with the most minor thing is on one hand it's another evaluation for me to do and being that EMTs can't diagnosis there can be endless things wrong with them.

I guarantee in systems like the FDNY the little guy gets over looked especially EDPs but everyone deserves to get checked out regardless of how subjective the injury bring that we should be objective parties. I fully support a quality component and I promise you I know it will work out. Because once it's done people will just deal with it and the public won't know the difference they will just be glad that someone came to their rescue.

The only difference is volume? On what are you basing this judgment? FDNY trains their personnel to respond to the multitude of hazards they may be confronted with. How many upstate agencies train EMS personnel for subway incidents, marine incidents, CBRN, manhole/confined space incidents, or the other incidents that NYC has to deal with? They also learn more about scene management, documentation, vehicle operations, and other things than your standard EMS course. The EMT certification may be the same but the orientation and field training is definitely NOT.

Nobody is downplaying anyone's emergency. NYC and most other places have a priority system to queue calls so appropriate resources are assigned as expeditiously as possible. EDP's get evaluated. They just don't get a priority higher than a cardiac, unconscious, diabetic, etc.

They won't be glad someone ill equipped to deal with their emergency showed up. They'll sue the city for sending them a unit that was not trained to the same standard as the other city units.

[helicopper 1,050]

The only issue is you really cannot control people at all and I know from experience that if you keep saying to save the ambulance for real emergencies you will have so many cases go under the cracks specifically things without any presenting symptoms but the person just doesn't feel right and will brush it off till their next appt. Unless there is something we can do on the operational or personnel there won't be a solution if we leave in the public hands.

I'm not sure what you're saying. Are you suggesting that every call for an ambulance be dispatched as a possible heart attack because they may not have symptoms yet?

That's why EMD was created. To appropriately triage calls even when the person calling doesn't know exactly what the problem is. Is it foolproof? No, but it's a lot better than sending ambulances screaming around for non-emergencies or missing a stroke because the caller didn't know how to describe it properly.

[Arbrow06 5]

You guys are attacking my wording rather than my concepts. I am not saying a brand new emt I did say to get experience but that could be the chief of a vac that only does like 3500 calls total a year.

I was trying to apply this concept :http://www.youtube.com/watch?feature=player_embedded&v=2Q7Mcot-xo4

I also said nothing much about the training and other than it would be shorter than the normal fdny*em's training. Of course there will be a field sup or fto I left that open and flexible because my focus is getting a number of well trained EMTs with the resources to be great and help the city.

The reason there are so many is because there isn't enough FDNY coverage. The only way they can be formed is if they do not affect the main providers bottom line by taking all their calls but there also must be a need. Also tell me how many are active and how many calls they do relative to how many are in their area. Also tell me if they are 911 certified by the FDNY if not they aren't up to the caliber.

I also did not want them to take old units from crews to give to the volunteers just to use what ever extras there are even if that just means an extra two buses per borough. You guys have the scale of this all wrong.

[helicopper 1,050]

I do not think the rest of the EMTs in NYS are undertrained? Are the rest of the fire fighters undertrained as well? I am pretty sure the safest place to have a heart attack is the Carrier Dome not Yankee Stadium.

I'm not quite sure what your point is but Yankee Stadium has dedicated, contractual EMS personnel on site so they're not a drain on the 911 system during games.

[Arbrow06 5]

Like i said you are attacking little tiny points not seeing the big picture.

[helicopper 1,050]

You guys are attacking my wording rather than my concepts. I am not saying a brand new emt I did say to get experience but that could be the chief of a vac that only does like 3500 calls total a year.

I was trying to apply this concept :http://www.youtube.com/watch?feature=player_embedded&v=2Q7Mcot-xo4

I also said nothing much about the training and other than it would be shorter than the normal fdny*em's training. Of course there will be a field sup or fto I left that open and flexible because my focus is getting a number of well trained EMTs with the resources to be great and help the city.

The reason there are so many is because there isn't enough FDNY coverage. The only way they can be formed is if they do not affect the main providers bottom line by taking all their calls but there also must be a need. Also tell me how many are active and how many calls they do relative to how many are in their area. Also tell me if they are 911 certified by the FDNY if not they aren't up to the caliber.

I also did not want them to take old units from crews to give to the volunteers just to use what ever extras there are even if that just means an extra two buses per borough. You guys have the scale of this all wrong.

Not attacking you or your wording at all. Your concepts are flawed and that's what many members have been trying to share with you.

Why would the chief of a busy VAC want or need to volunteer in NYC?

Shorter training = cutting something that has been deemed important out? Why would anyone advocate that?

So now you need more supervisors and/or FTO's to oversee volunteers in the system? Why not use the supervisors and FTO's to staff more units themselves?

There isn't enough FDNY coverage because they have to look at the averages and staff according to what makes the most sense. Hot summer afternoons may tax that staffing level but you can't staff or budget based on "what if" scenarios.

Two extra buses per borough will not do much to reduce the backlog on most days. You could probably use 10 and still wind up waiting sometimes.

[helicopper 1,050]

Like i said you are attacking little tiny points not seeing the big picture.

Then tell us what your point was in your comparison between Carrier Dome and Yankee Stadium.

I think we see the big picture quite clearly. You've had members with a cumulative century of experience responding but you think we're missing the point or not seeing the big picture.

Edited July 23, 2013 by helicopper

[Arbrow06 5]

I understand you guys have plenty of experience but if politicians go off numbers show me numbers. And 3500 calls a year is not busy at all unless you have one bus or two buses.

It's a flawed concept cause i put it on the table as an idea and no one has yet to effectively improve the idea rather they debunk this and that and if I was a politician I would say screw this. You can definitely tell you guys are union the way you attempt to come but not really too a solution this is why the health-care system is so f***** up

[Arbrow06 5]

That comparison was addressing that the rest of NYS is undertrained but if they can have such a high standard of care how can they create the best places in the state to have any sort of incident

[Arbrow06 5]

That comparison was addressing that the rest of NYS is undertrained but if they can have such a high standard of care how can they create the best places in the state to have any sort of incident

[PEMO3 523]

Arbrow06, you asked in your post if anyone saw anything wrong with what you said. If you are not prepared for the answers then don't ask the question. What you need to understand is Yes, I understand are getting advice and insight from some of the most highly trained and experienced individuals but your arrogance if blocking you from seeing this. Instead of learning from the experience you are taking the answers as personal attacks. They are not.

[FireMedic049 597]

I understand you guys have plenty of experience but if politicians go off numbers show me numbers. And 3500 calls a year is not busy at all unless you have one bus or two buses.

What numbers are you talking about?

It's a flawed concept cause i put it on the table as an idea and no one has yet to effectively improve the idea rather they debunk this and that and if I was a politician I would say screw this.

We aren't trying to "improve" your idea because it's so flawed that it really can't be improved upon.

You can definitely tell you guys are union the way you attempt to come but not really too a solution this is why the health-care system is so f***** up

Sorry kid, but you don't know Jack about what being a unionized workforce is about. The problems with our healthcare system have very little to do with organized labor.

[FireMedic049 597]

That comparison was addressing that the rest of NYS is undertrained but if they can have such a high standard of care how can they create the best places in the state to have any sort of incident

If that's what you were trying to address, then you didn't do a good job doing so because it made no sense.