EMS179

I understand your point about discussing things, but, why us? There is a difference between a bunch of EMS providers on a forum VS. the people who actually make the decisions in the departments. Sure, lets discuss it. You really mean to tell me you all don't see any logic in any of my points? That is honestly really hard to believe. All we are doing is going back and fourth with hypothetical scenarios, what if's , and so on. You want to talk, lets talk. If you go back and look at this conversation I didn't start the hostility in this thread, someone irrationally started giving me an attitude because he doesn't like how this system is run. I don't mind discussing a system, but everyone saying I'm right your wrong isn't a discussion. Just to address the last set of points, yes in many cases PD does respond to all calls. At least here in NJ where I am currently living. 911 calls come through the police station, then are transferred to the proper dispatch point. PD is dispatched to the scene prior to EMS. It is just the way it is. I have no problem talking about things in a civilized manner, I do have a problem with people jumping down my throat because they don't like the way a system is run. So, to put this discussion back on track, what do you propose to do in a situation like the one I presented?

fair enough. Listen, im done arguing this point. The system works for them. Thats all that matters is that the pt's get the help they need, thats why we are in business. everyone can think and feel what they want, there is no use in arguing who is right, because in the end, noone is. it is a matter of preference, staffing, quality of care, policy, ect. I prefer fire-based EMS, obviously alot of you dont. Great, dont think Im wrong because I do and you dont. I see everyone's point here, but I just dont understand how you can be making all these ASSumptions and criticizing things when you really dont know anything about the system, it really is a shame. We are professionals , can we please act like it? There is no use in saying "Well what about that one time where the 267Lb. person fell in the manhole and he was 2cm to wide to get him out blah blah blah" yeah, we can argue every conceivable senario and everyone will have a different view and solution. /end topic. (or at least my involvement in it)

1) What would you rather do? Stay and play for 15 minutes or move the pt. to definitive care? 2) Yes, every medical call gets a piece of apperatus, just in case 3) you dont like it? Write a letter to Orange County and explain to them why someone that has no remote affiliation to OC, florida, or the department thinks that the system should get changed because it doesnt make sense to you. 4) You arent there. Maybe the MVA has adequate resources, maybe the truck co. is standing around, command can easily release them from the scene if they arent needed. what takes priority? Working code or extra truck at an MVA? Furthermore, since OC dropped R/M, they are putting on a bunch more rescues, Ill give you 3 guesses why.

please dont insult your own intelligence and make it seem like this is the only senario where having additional hands would be useful. comments like that really dont help situations on either side of the argument. If you are working in Iraq on a pt and you have only you, or you have you and 2 other corpsmen working on a multi traumatic pt, which would you prefer? Maybe you only see 2 a month, does that warrent not putting the extra 2 with you just because of the frequency of critical pts? yes Im aware my numbers are probably off, but then again so are yours. another example, rescue 51 is transferring care at ORMC east (hospital in orlando). Pt. w/ chest pain comes through in your local. You have a 9 min. response time through heavy traffic and highway utilization. Next closest rescue is 11 min. away. 3 ALS fire trucks are 3 minutes away in quarters. Do you put your life and the life of all the people on the road at risk responding to the call alone? Or utilize the ALS truck to go to the scene while you are responding at a slightly slower pace because you know you have units on scene w/ ACLS capabilities to take care of anything life threatening. Truck gets there, pt. ends up having indigestion, RMA secured. Cancel the rescue. just saved a moderate risk code 3 response now you can divert to that MVA that you are 5 minutes away from, instead of going to the RMA chest discomfort.

Fire/EMS combination responses to medical calls has its advantages, especially in urban settings. From experience alone, say you have a 400 LB cardiac arrest on the 5th story of a filing cabinet in on July 4th in Orlando. The apt. bldg doest have central AC and the pt doesnt have a wall unit. There are 2 ways down, elevator that you have to share with 15 other stories worth of people that cant fit more than a stretcher with the back dropped, "head section" of the stretcher at a 90deg. angle, (explain how that is gonna work when you are trying to vent and push) and maybe 2 medics depending on their size, the pt. size and equipment , or a stairwell. You respond as a call for an "unknown" with an ambulance only w/ 2 medics, you arrive to find the above situation. Clo sest fire unit is 14 min. away due to a MVA in your local. What do you do? Stay and play for an excess of 15 minutes with a workable code? Or try to get this guy out yourself? Or, the second alternative, use the dual response system, because, you are fire/medics and work in the same building as 3 pieces of fire apparatus. Use the truck co. w/ 5 firefighters on it to your advantage. now you have at least 1 extra MEDIC on the truck due to regulations that every truck is an ALS truck and 4 EMTs. Which scenario do you like better? This is an every day occurrence down there. There are hundred of scenarios that everyone can post on here and we can argue who is right for days. Or, we can stop being monday night QBs and let the people who have worked in the area for 20 years and who develop the systems and who have to work in the conditions presented to them every day determine what works for them and their department. Just my .02.

Orange County did this for years. However, IAFF local 2057 (OC) just announced that they are dropping Rural/Metro as their "contract company" meaning now all responses will be held to OC units only, a rescue and a piece of apparatus for medical calls, and so on as appropriate. Used to be for virtually every call R/M would transport and OC would treat O/S.

awsome job Dwayne! :occasion5: . Another great Medic on the streets!

that is what gets me about the NR aspect of it. It states only military training is excepted, but then it states that everyone will take the NR test. . Oh well, I guess its time for a phone call on Monday :roll:

A friend of mine is a NJ/PA/NY/NR EMT-B. He wants to go to florida. According to the website the only "NR" cert they except is military certs. I spoke with someone else and he said the only reciprocity FL excepts is Texas and NY. Is that true?

Its made by North American Rescue (NARESCUE.COM). They seem to be making ALOT of products for the military, as just about everything has a NSN #. The bag in question is the Warrior Aid and Litter Kit - WALK . They are awsome, I got to play around with one at a conference a little while ago. I would feel really good about having one of those in every military vehicle along with a combat casualty card, which I think they have, it could definitely save lives even if there isnt a medic in the immediate area.

yes. im aware of that, thank you. Those words arent coming from my mouth, but the police department administrators mouths. we are working with what we have and what we are given to work with. However, many, many many many old police cars end up in the hands of civilians around here. There are dozens of ex police cruisers that are used by civilians in the city I work in. it cant be a perfect system, no use in trying to make it so.

well the BLS van is still in the early-days of development. Prior to this we used only the crow vic and relied on a BLS from the municipality we are operating in. also because we are working in conjunction with the county prosecutors, sheriffs dpt, state police, ect, they request that the vehicle that will be in close proximity to the scene remain "unmarked" and as low-profile as possible, while the BLS ambulance will remain further back. Its a new system and we are still working out the bugs.

the only advantage to PALM vs/ MS based is that PALM programs are generally free, and MS programs are far from free. I bought a used Dell PDA and im looking to sell it because I just dont want to drop all the cash for the programs I want.

Ok so our team is still in the new-er phases of operation. We are the first and only tac team in the county and the entire area. We use a 90-something Crown Vic as our deployment vehicle. We are also going to start using a BLS ambulance, Van, as support (dont ask, just dont). So my, our question is what equipment do you bring with you in your respective vehicles? Right now every callout we have at minimum 2 at most 4 medics and minimum 1 max 2 basics on the job. Our equipment consists of ; everyone's personal equipment (for hot/warm zone work), a LP12, 2 blackhawk STOMP II's 1 set up for ALS, 1 set up for BLS but can easily add to make ALS, drug box, o2 cylinder (code bottle), separate bag w/ extra IV supplies (500/1000 NS bags, caths, lock kits, ect). Thats about all we carry in the car, and the ambo. is a standard BLS loadout. Does anyone have anything to add to the list?

I have my name on the list for FDNY EMS. I am also a firefighter. I am not even considering a switch to Fire from EMS. I love being a firefighter, I love working EMS. But as a firefighter I would never want to work for FDNY. Crap pay, crap working conditions. Yeah there is alot of prestige from the rest of the E.S. community and all that, but IMO its just not worth putting up with all the political BS that goes on. Just my .02