Dustdevil

Well, my knees feel about 80, but other than that, I am under 50. Nonsense. Awareness is completely useless if you don't act on the information you are aware of. Awareness is what lead me to wear body armour, which is why I am alive today. Had my awareness lead me to wear a helmet, I would have avoided the skull fracture too. Rookies. :roll:

Only with Long Islanders. Actually, I have a problem with EMT-CC's from any state. And anybody who calls an ambulance a bus. And anybody with a funny accent. :wink:

The literature, statistics, and evolving standard of care are on your side, my friend. Do some research and lay the results on your clinical coordinator's desk. Hopefully he will see the light and approach medical control with a recommendation to update your protocols. There are certainly occasionally extenuating circumstances that might dictate a transport. And there are those rare circumstances that might actually dictate a rapid transport. But yeah, you're right. Most of them are transported simply because it is what we have always done, not because of medical necessity. Of course, I'll tell you what would stop this nonsense real quick. If the insurance companies decide that transporting dead bodies is not medically necessary and stop paying for it.

Professionally managed agencies with pro-active safety programs have no problem at all getting their medics to wear seat belts. In fact, I have never had a partner not wear seat belts since the 80's. As a cop, I never had a partner refuse to wear a vest. As a firefighter, I never had any partners refuse to wear bunker gear or SCBA. And as a nurse, I am the only person I recall ever refusing to wear gloves. If you have a problem with compliance, you have a personnel problem more serious than seat belts. And it needs to be addressed pronto.

Wrong. You are your own boss in your car (do New Yorkers even own cars?). You get to make the rules there. You are not your own boss at work. You follow the rules or you find another job. And we're not talking about bus drivers. We're talking about paramedics. :roll:

Whose fault is that? His and his alone. Ignorance of the law is no excuse. He should have thought about that before he moved to the community. You can sure bet I would not buy a home anywhere without finding out about basic services ahead of time. And why did he move there in the first place? Because it was cheap! And do you know why it was cheap? Because there are no taxes. And do you know why there are no taxes? Because there are no services! Yes, in this case, ignorance was painful. The Darwin principle in action. No sympathy. None. Squint, the "moral" thing to do is legally irrelevant. Do you work for free? Did you spent three years and tens of thousands of dollars on your education to give it away? I bet not. Does that make you immoral? Nope.

Completely agree with North. And it's another good reason to not put badges and cop-looking uniforms on medics. Dressing medics like medical professionals encourages them to be professional and focus on medicine, instead of getting all caught up in the "public safety" authority machismo that so many fireman wannabes love so much. Drop the attitude, put down the Mag Lite and be a professional.

:thumbleft:

I totally agree on that! I only maintain that this is a failure of the community to provide for such a provider. It is not a failure for the subscription FD to service those it has no fiduciary relationship with.

I'm with Kuo, as usual. Not only would I wear one, but I have been a proponent of helmet usage. Have a little imagination, folks. I have in the past researched what is available commercially that might fit this need. Indeed, there are plenty of readily available helmets that would work in this application while not restricting mobility or the ability to use a stethoscope. Bicycle and sk8er helmets do not block the ears, and do not have big rims (like fire helmets) that limit mobility in the cab. Same thing with climbing and rafting helmets. Anybody who hasn't seen the need hasn't been in the field long enough. Come to Texas and I'll show you the scar across my head from crashing into the front bulkhead at 70 mph, which resulted in a skull fracture. Whining about ambulance design is a cop out. YOU are primarily responsible for YOUR safety. If you know anything about safety, you know that the number one factor is the human factor. Environmental engineering is only part of the equation. The choices YOU make are the greatest contribution to your safety. Nobody else can do that for you. Nobody should have to. As for compliance, I am unconcerned. Violations of safety regulations are ground for immediate termination. No second chances. No questions asked. If you knowingly, willingly, and intentionally jeopardize my assets, you are unemployed. There is your choice. Play by the rules or starve. You don't get to pick and choose which policies you will and will not observe. Medic safety doesn't end at the scene. It amazes me how the same idiots who will refuse to make an assault scene without police on scene will disregard safety in the ambulance. I don't employ idiots. Either you make sound choices all the time, or you work somewhere else.

Cool. Of course, all of my questions were more rhetorical than literal. Just trying to stimulate a little thought so that you might stumble over little details that sometimes get lost behind all the big matters like finances. Although I would be genuinely interested in hearing all the answers, please don't feel obliged to do so on my account.

Meh.... I'm with CSR on this one. I support the FD. They are a private corporation. They may pick and choose their customers according to ability to pay just like a private ambulance service, security service, lawn service, janitorial service, or any other service may do. You don't get the option to pay your insurance premiums the day after you wreck your car. Same principle here. This guy didn't have any insurance. He didn't pay his FD dues. He never gave reasonable thought to the safety and security of his home, business, or family. He obviously is an irresponsible cretin and now he gets to pay the price. Boo hoo. The Lord helps those who helps themselves. I imagine the FD has, as they indicated, learned the hard way that people will not pay their bills after the fact, just like a huge number of people never pay their ambo bills after the fact. And you eat up a lot of scarce cash trying to collect from them, so it simply isn't worth it. I long ago lost count of the numbers of times I have seen paid municipal fire departments refuse to answer calls for service outside of their city limits. It happens all the time. I have watched them sit in their trucks and watch a home burn across the street because it was outside their boundaries. And of course there are all those volunteer departments who can't even muster a full crew to respond at all. So let's not sit around and believe that free-enterprise is the cuplrit here. Is it bad PR for the FD? Sure! But no press is bad press. I'd like to see the spike on their membership chart in the month following this incident! I bet it was just the kick in the ass that several hundred families needed to write their check. Sounds like this moron FAILED to do his homework. He gambled and lost. I am unimpressed and unconcerned. Good for the FD!

Fire? Transportation? Hmmm... call me crazy, but it has always seemed pretty clear to me that emergency MEDICAL services is a HEALTH matter. But that's just me. Obviously, a lot of people lack that clarity of vision. :?

Oh yeah, what about your image? Do you have a corporate logo? What does it say about your agency? Is it the same old SOL everybody else uses, or is it something unique and memorable? Is it easily recognized at a glance, or is it intricate and "busy?" Is it easily replicated for letterheads, embroidery and vehicle livery? What about a corporate motto? Something unique and meaningful? Something simple yet profound enough that your personnel will take it to heart? Something you can be proud enough of to put on the sides of your ambulances? What about your corporate philosophy and mission statement? Did you lift a stock mission statement from somebody else and change the names, or did you put your true goals and core philosophy into words that people will understand, appreciate, and respect? Uniforms? Are you going to dress your people like "public safety" officers, security guards, janitors, or medical professionals? Are you using your imagination -- and possibly even professional image resources -- to give your personnel a unique, identifiable, simple, functional, and respectable professional image at a reasonable cost? Or are you buying the same bull$hit cop shirt off the rack, complete with pins, badges and patches from Galls, that every other wanker wears? What about the image your ambos portray? Are you going to give them a unique, identifiable, and professional livery that provides both safety and positive public image? Or are you going to make them look like fire trucks, so the fire department gets credit for all your hard work? Or are you going to put such a large and gaudy logo on the side that people don't even recognize it as a professional vehicle? Is safety and visibility a priority in the design of your ambo livery? What about the lighting? Is it specified based upon sound scientific principles of visibility? Or are you going for the cheap way out? Or worse yet, are you just going for what "looks cool" or "everybody else" does?

People are the heart, soul, and backbone of any organization. What is the personnel breakdown? Is it large enough to provide adequate resources to do the job, yet small enough to easily manage the quality? How are you addressing the recruitment and selection of your people? Is there a large enough pool of local applicants that you can keep it local? Is the community requiring that you give preference to locals? Is the pool large enough to be extremely selective, or are you going to have to pretty well take on any 350 pounder with a patch and a pulse? What minimum requirements will applicants be required to meet? What testing and selection process will be used? What will be the pre-implementation orientation process and period of your initial employees since they will have no "experienced" preceptors or FTO's who are familiar with the company or the system? Are there local medic schools? What is their length and, more importantly, their quality? Are they accredited? Do they teach on a schedule that will work with your employees' schedules? Are they turning out graduates in adequate numbers to keep you supplied with new blood? Have you looked into establishing a preceptor relationship with the school? You say the service will be ALS. What exactly does that mean, personnel wise? Dual medics? Mixed crews? Separate basic and medic trucks? What about first responders? Will you have fast cars or "intercept" vehicles? Mobile supervisors? Have you established working relationships with other responding agencies, such as fire departments and police services? What are you doing to make those agencies comfortable with your agency and personnel? Are you integrating them, or just using them? Are you making good relations with those people a priority with your personnel so they won't be out there mouthing off and destroying your image? What about medical direction and clinical direction? Do you have a medical director? Is he experienced in this sort of operation, or just another MD who thinks that $1000 a month to sign papers is a good deal? What do you want his involvement to be? What does he want his involvement to be? Administrative? Educational? Supervisory and QC? Is he going to have a personal relationship with each and every medic, or is he just going to be a faceless signature on their protocol book? How progressive is he? Will he pretty much sign off on any drug or procedure you slide in front of him? Or worse, does he believe that all this fancy ALS stuff is a waste of time and not want to hear about the state of the art? Does he trust your medics to make their own decisions, or does he want to play "mother may I?" Is he open enough to expand his trust as he gets to know your medics? Is he firm enough to put his foot down when he finds a loser in the system? Is he negotiable on issues of policy, procedure, and protocol? Does he consider the current research and evidence based literature, or is he firmly stuck on "this is how I do it, and it's my way or the highway" without any logical consideration? People. People. People. That's what it's all about.

In America?

Word. That is the secret to both good care and mental health. :thumbleft:

Word. You're pretty smart for an old broad. :wink:

Nah... had anybody there thought it was something more than what it was, they would have run like little girls. Just like the people in OKC did when the rumour started that there was a second bomb. Sure, there are a few idiots who will disregard the tenet of scene safety just to be a dead hero. More power to them. But thankfully, they are the exception, not the rule.

If your school has you doing ridouts with basics, it sucks. Smile and fake agreement with him. Then forget everything he tells you afterwards.

Was he effeminate?

So instead of taking a backseat to fire suppression, we get to take a backseat to bridges and potholes. How exciting. :roll: Anytime I see mission statement as grandiose as this one, I drop my pants so the smoke is blown straight up my ass instead of being filtered by the denim.

Speaking of ignorance! First of all, almost ALL of the churches have been predominantly white attended churches. And second of all, even if they were affected equally (which they were not) how would that show a racist problem? Dude? Don't they teach statistics at UM? :roll: Irrelevant. I was not talking about racism. I was talking about King. You're obviously the one who keeps trying to "divert" the conversation. You've failed to make me care. And we can see from your reply to Michael that to do so would be pointless since you will obviously dismiss it as irrelevant to his greatness. This chick is relevant to the discussion. Some dead dude from 40 years ago is not. You hijacked the topic for some bizarre personal agenda. You brought up race. Not me. I don't give a rat's ass. And if you think Carter is a great American, you obviously weren't alive from from 1976 to 1980. He was my Commander in Chief during that period, so I know what a useless waste of human DNA he was. Who are you to decide what people can concern themselves with here? At least they were concerned with something that had a basis in EMS. There is no good reason for you to turn it into a pointless debate on the greatness of a couple of losers.

Through the roof state and local taxes AND a lottery and places like NY can't afford ALS? Puhleeze. I would say that ninety percent of all jurisdictions that whine about a lack of money have plenty. It's not a lack of money. It is a lack of competent leadership.

What century are you living in? I doubt you have a clue what most people object to. I doubt you have bothered to ask them. And if you actually knew what you were talking about, it would be more than a simple notion. Regardless, you are making broad generalizations of an entire class of people. You can spin your lame college-boy pseudo-intellectual logic here all day, but that doesn't change the fact that you are engaging in bigotry, which invalidates your entire line of discussion. The road to recovery first requires that you admit you have a problem. You seem to be the only person who cannot see it. Please point us towards recently scientifically validated studies which irrefutably demonstrate more racism in the South than anywhere else in the nation. Or is this just another one of your bigoted "notions?" And you've failed to demonstrate any reason that I need to justify my personal beliefs to a bigot like yourself. No. It could be considered incorrect. However, with no knowledge of my personal character, you have no right to consider it prejudice. And unlike yourself, if I was prejudiced in this matter, I would have the guts to say so publicly. Not my job. That's what you're paying UM for. Send me a check, and I'll consider it. You're going to presume to educate me on the English language? Ha! And let me remind everyone that Yassir Arafat won a Nobel Peace Price. The posthumous accolades are meaningless pandering from a failed president.