Kiwiology

What benefits the patient best is not being served up medical care by the fire department; if the hospital was run by the telephone company (for example - because that's about how seperate fire and EMS are) would you go there?

The problem with a "combined" agency is in the word "combined". In most of the world (ok, all of the world except the USA) the ambulance service is a stand-alone agency seperate from the police and fire services. Thier sole interest is vested in transport medicine (or treat-and-non-transport-medicine as the way forward in some cases) not in trying to run a fire department as well. I've seen this whole "all hazards" bullshit and it's exactly that, it's just a flashy marketing gimic put fwd by the fire union; the fire service here manages OK trained to first responder level here and ambo seems to manaage OK doing thier thing while Fire turns that car into a convertible. Ambulance should remain a totally seperate entity not being overshadowed or run by the Fire Service, police or any other group for the pure fact it distracts from what we are trying to achieve.

Like Phil said, this is not having a go at the Fire Service. Until you guys raise the entry to practice standards to something out of the first world and sort of some sort of cohesive national representation (political and industrial) the fire service will continue to be able to come in and take over EMS.

I'd say its the other way round bro

This is exactly why Fire Department EMS that use cross-trained personnel generally provide piss poor patient care; the Firefighters just do not want to be EMTs or Paramedics ... it's like forcing people to do something they don't want to so they're going to do it less better (there's good Engrish!) than what they want to! ... and yet again, this sort of comment makes me have some sort of mild stroke or hypertensive crisis reading 'em. See above. Oh woe is the poor fucking fire department with thier pig-headed, money grubbing, attention camera seeking union ... no you took over EMS to get more money and make your people look better what a crock of shit! Can we please, please, oh please stop chasing this ____ minute response target; it's just not clinically significant! I would argue about 1% of EMS' patients would suffer some sort of adverse clinical outcome if the truck didn't roll up in ____ minutes (we use eight). I can think of a cardiac arrest, complete airway obstruction, major arterial bleeding and severe anaphylaxis as the only groups of patients who might DIE if we don't make it there within this arbitrary number. The language of this article is fairly over-hyped and drummed up to make the Fire Department sound so nice and fuzzy as being the PCPs of all these poor downtrodden people and wow it makes me puke!

lmao those are great

We don't have a "list" per-se because we're rather liberal with the billing (last year we wrote off about $3m which didn't get paid) but we certinaly do have a list of the VIP customers

Coming from a family of firefighters this issue and the total bastardisation of EMS (not specifically but more-toward ALS) within the fire-service makes me really angry .... it's not doing good things for my blood pressure. FAIL on the IAFF, FAIL on the departments in general, FAIL on the community for not really understanding this usse and FAIL on the State for allowing such piss poor service provision!

I think of myself as a logical person so logically, is there some form of brainwashing that I am unaware of in which responder agencies and the communities at large undertake to become capable of believing that this system is capable of providing acceptable patient care? Now I know it would be unfair to stereotype all Firefighter/Paramedic's as one-trick cookbook-card following textbook-only whiz-bang providers that whipped down to the local medic mill that barely meets state requirements to either a) get or b ) keep thier job or c) get a higher retirement earn. That said ... some of the things I've seen around the web scare me! .... hence why I was doubled up on the floor at my bro's house in Colorado refusing to let the Fire Department paramedics near me!

Quit being the unions bitch; demand the firefighters get a proper paramedic education and are exposed to appropriate numbers of patients to ensure skill maintenance

oooooh snap

Hahahahahahahaha is this guy for real? Here's a newsflash bro ... your guys failed to show competence at delivering said medications, whoops, did that bit of the textbook not get taught during whatever dodge course your guys took?

It’s crazy to force people that want to be a firefighter to become Paramedics also ... is there something that you just haven't grasped about that yet? Do I need to come over for a sit-down pow-wow with management?

Yeah but I'm cheap

I'm a web developer by training so I have been tinkering with the idea of developing a custom model PCR / medical audit / QI program. If anybody is interested we could talk.

Heck no me either

Ummm nooooooo

6/25/09 you don't remember, i mean it was only on the news nonstop for days at a time

What, this guy is a celebrity who died in Los Angeles County; where is Dr Noguchi when you need him?

There are only one or two things I regret but eh .... whats the point getting all shook up over it. If I got told I had X time to live, I'd round up the boys and go get back that money the Nevada Gaming Commission "stole" from me Have to go out in style.

Interesting. At least here in NZ our ambulance officers are respected as another group of healthcare providers by thier peers (although this is not at all reflected through registration, licensure or legislation -- watch this space) be they paid, volunteer, BLS, ALS etc. I have only ever heard the media (and maybe the lay public) here refer to an AO as an "ambulance driver" or "worker"; I'm not sure that other HCPs "get" all our titles (e.g. if you're ALS you can be a Paramedic, an Advanced Paramedic or an Intensive Care Paramedic depending on where you work) but that's another issue entirely!

There was a very simmilar case here where the time to a trauma centre greatly outweighed the time required to get ALS for an intubation (about a 40 minute drive to the hospital, took over two hours to get ALS). The crew on scene felt an LMA was not adequate enough so they called for an Advanced Paramedic to intubate the patient rather than drop the LMA and leg it to the trauma centre. Depending on what the case is, if its faster to go to the hospital then thats what I will do. In THIS particular case playing Monday morning QB I'd take the patient to the hospital.

damn that's mild alrite compared to what i seen wanderin NYC (err .. "transiting" as Richard said lol) but then again NYC is crazy

dude seriously thats bad .... i could quickly blame the engineer but that'd be narrow minded but still!

I'm gonna go for some sort of schwaking