ERDoc

I doubt it. They are sacred cows, not to mention they ride the "hero" coattails of FDNY. The problem is well known but not talked about, which is why this blog made such a huge ruckus and then had to be shut down.

No ugly, you have it all wrong. It's GREEN lights for volley EMS members. The volley system is very smart. They are a large voting population and have made good friends with most politicians. Those politicians know it would be political suicide to rock the boat. There are some VACs that have 5-6 ambulances and at times can get a crew to staff 1 of them. Then there is the duplication of services. In the area I vollied in, there were 3 VACs, with about 10 ambulances between them at the time. The most I can ever remember on calls at one time was 3 or 4. Combine those depts and cut back on the number of ambulances and you could save a bit of money. I will give props to the VAC I was with. We were always able to get the needed crews together on every call, even the BS calls. We were one of the few companies that didn't have a manpower issue. A large portion of our calls came from responding to our neigboring depts who couldn't get crews together. We never gave a way a call due to lack of manpower, only due to lack of ambulances. In our case it worked, but since we could respond from anywhere it still took up to 7 minutes to get an ambulance on the road.

There is a county EMS director who is a county employee that covers all of the agencies in the county. The position is still vacant but covered by an interim. It is basically, don't piss off the vollies or you will lose your job.

That has been attempted in the past and the medical director was run out of her position for it. She was pretty much told, "It's our district and we will do as we please." Most of this came from the FDs but there were a few VACs that weren't too keen on it either though.

I am in a Linkedin group with the author of the blog. He has pulled the post down due to the amount of pressure put on him by those in power, mostly from the FDs that run EMS. The good thing about the internet is that is has gotten out there and there is no taking it back. It may not change the system but it opens the door. And to clear up any questions about the author, he is a 37 year volunteer in the system. Politics is a big issue in the system also. We would drop pts off at hospital X, which is in ambulance company Y's district. We would be leaving the hospital to head back to our HQ and hear a call go out in Y's district. We are not allowed to respond since it is not our district and we do not have a operating certificate for that district. So, unless they called us for mutual aid we cannot respond, even though we could be the closest ambulance and already staffed.

It's funny how often some forget that they are functioning under their medical director's license (at least here in the US). The best idea for the OP would be to contact their medical director and run the scenario by him/her. I would bet that he/she would be none too happy about it and make sure your friends/coworkers are aware of it. The best advice I can give is if something like this happens, down a large amount of alcohol so that you can say you are not safe to provide care (though check with your medical director on this one too before you do it). I know if I were the medical director and I heard about someone with a sharp instrument in hand while intoxicated, I would do whatever I could to pull their card. There have been a few threads on SDN about providing care on flights and many of the physicians say that they purposely drink some alcohol as soon as they can so that they cannot render care.

Best thing to do in any social setting with lots of people where someone may get hurt. Drink a lot. Then you are exempt from having to do anything. On a side note, how were you going to cric(I assume that is what you meant) the guy? MacGyver style with some rubbing alcohol, a steak knife and a ballpoint pen? When you are off duty and especially when you are out of your area of responsibility, your job is to provide first aid and nothing more. On an second side note, MacGyver is a word in spellcheck. Awesome.

But wouldn't that be a huge reason to go paid? If you are paid, you don't get to pick and choose. If someone calls 911, they get an ambulance.

-1 for not paying for advertising -2 for double posting As for the paragraph, what half way competent medic would go into that apartment? Maybe some would go in with just the bloody haired girl but who would continue once you see an easily accessible knife? Any medic with more than a year under their belt would have their Spidey Senses going off and turn around. Sounds more like a good opening scene for Rescue Me or Turd Watch (if it was still on). I think the 2 reviews on Amazon are pretty laughable (but I can't hold that against the author).

Rich, I don't think anyone is faulting either sides reason for doing it (both have their buffs/whackers/ricky rescues). The question is can a huge volley system such as Suffolk's consistently and efficiently provide the proper care. When I was a volley there we had 7 minutes to get an ambulance on the road before they banged us out again. We then had another 5 minutes until the call was given to another department. We are already talking 12 minutes and there is no guarantee that there is an ambulance on the road at that point. We used to have an area north of where I was where the EMS service was provided by FDs and we called them the triangle of death. Each dept was given their 12 minutes to get on the road before we were finally called. You are now 36 minutes into the call with no ambulance. We were so far away that it would take us 15-20 minutes with lights and sirens to get to the scene. You are talking a minimum of 56 minutes. And these would be sick pts. This scenario played out several times on cardiac arrests. We'd get there finally and PD would be out of oxygen and it would just be the PO and a family member, who were both exhausted. It was pathetic really. You better believe, 10 minutes later when a structure fire got banged out everyone and their mother showed up from the FDs.

This is a blog that is lighting up the interwebz where I was an EMT. Feel free to discuss. http://resqrev.blogspot.com/2013/06/volunteers-vs-patients.html?m=1

I also forgot to mention that our doc had to get on the phone and speak with the pt. Any doc that says to do that doesn't understand the law. You can tell a pt that they should and need to go otherwise they will die but as long as they have the capacity to make that decision, EMS and the doc can't make them go.

The outcome is irrelevant. The only thing that matters in the original scenario is what did the pt want and did they have the capacity to make that decision.

Keep in mind that this is very location dependent, especially when you are talking about the US. In the system I grew up in, if you felt a pt needed to go and they wanted to RMA, you HAD to contact medical control and speak with the doc. It was a volley system so there really were no supervisors like you find in a paid system. I think in this case, you need to justify and document how the patient DOES NOT have capacity.

Drinks sound good. I was out in Baltimore over spring break, for about an hour. I had enough time to get off the plane, hit the head, get to the gate, count the kids and get the next set of boarding passes out. Beautiful city from the air.

Maybe your friend could get us an EMTCity discount. Just sayin. I just found my first geocoin and was pretty excited (nerd love). We're going to drop it off in a cache when we go to NY this summer.

The govt has no right to listen to our conversations or take our information without proper legal channels. Unfortunately it take govt and law years to keep up with technology. Hell, we can't even decide what is porn and what's not. Just because they CAN do something doesn't mean they SHOULD be doing something. I'm all for national security but not to the point that it invades our privacy. It is one thing being recorded out in public by the millions of cameras that are out there but it is another thing to record my private conversations. Once we let the govt start doing that then the terrorists have won.

I would have chosen the cuffs and then retired after the lawsuit. At minimum I'd expect the EMS agency and/or PD to pay for all of the bills associated with it. This is all based on the info presented.

I sent you a message because you are not accepting friend requests. I'm going to keep an eye out for one of these mass meets. All of the kids are into it now but man, did we have some trouble finding one today. Me too but after today I might reconsider. Maybe it took you to where the store was BEFORE Sandy.

I did not know that but I guess I have to add another one to my list of must finds. I agree it is a little weird calling it a Geocache, but did you see the entry? That is pretty cool. I love the guy that took a picture of himself in front of the locker on the simulator and had on of the real astronauts take the picture up to the ISS and take pictures of his picture with the real locker and TB.

Done. I used my iPhone and paid the $11 for the app. Some people are really good at hiding them. There is one around here that I think is going to become my nemesis but I will find it. I'd love to find the ones that are in Antarctica. Thanks for the offer Dwayne. If I'm ever out that way and want to torture a local, I will be more than happy to bring my family your way.

So I recently discovered Geocaching. For those not familiar, people have hidden caches of various types everywhere across the world (2million+ of them). They place coordinates or clues on the geocaching.com website and people search for it and log it when they find it. Yeah, it sounds pretty geeky but it is actually quite fun and something the kids can do too. I've found several local ones with the kids but I'd really like to make my way to the ones in Antarctica. Anyone else into geocaching?

To some degree, can you blame them? The stakes of the testing they administer is high. It determines who will or will not get into their chosen field. There is an enormous reason to cheat and it has happened. Future doctors and lawyers are type-A, gunner personalities who will usually stop at nothing to achieve their goals.

If I ever get divorced I think I am going to fly a lot more. Sure it's expensive but at least you don't need to worry about an STD from the groping.

At least they don't have a monopoly on inappropriate touching. TSA gives them some good competition.