Richard B the EMT

More a comment to Kiwi, but... I'm a Doctor!

Perhaps a bit late to add, there was a call that perhaps they should have offered a CISD to me: The American Airlines Flight 587 Crash in Belle Harbor, November 12, 2001. If they did offer it to me, I must have somehow missed it, as it was within the 3 months following the World Trade Center attack, and the entire country was affected in some way, whether any individual wants to admit it or not. For the record, I was not a part of the Rescue/Recovery operation at the WTC; I didn't even drive by the site until July of the following year. 3 persons personally known to me died at the Trade Center. As to the Belle Harbor crash, I didn't know any of the 260 from the plane, and none of the 5 killed on the ground ( As I have mentioned numerous times following the fact, I live a half mile from the scene of the crash).

I am trying to check my resources, but I have vague memories of a woman supposedly made a similar claim, but she "survived" by breathing. Not solid or liquid consumption, but nourishment from whatever was in the air! I think she called herself an Airian, but don't hold too close to the concept, or my mangled memory of the name (or it's spelling). She subsequently died a few months after I had seen the original article. If surviving on nutrition suspended in the atmosphere were possible, you'd always find me downwind of the neighborhood steak house!

FDNY and FDNY EMS have GPS, just it doesn't tell crews where the call is and how to get there. The GPS shows the EMD and the Fire dispatchers where the nearest unit to the reported address is, so they can be assigned. It is a part of the Computer Assisted Dispatch system we use. Word I heard is, the next generation of Communications Radio/CAD we get is supposed to have a turn by turn directions capability, but it is going to be a while, as due to budget cuts, 20 fire apparatus are either going to be shut down from 1800 to 0600 hours nightly, or closed down, period. By the way, I know my territory fairly well, but if I leave my district to go to the Trauma Center, I can get "snagged" in the Trauma Center's district to handle an assignment. The GPS tells the EMD I am the closest unit, which at that moment, I might be. I freely admit I don't know that territory well at all. Maps are assigned to all FDNY apparatus. The one assigned to my ambulance keeps disappearing, so I carry a personal one, never more than 2 years old. Call it a cost of doing business, for tax purposes. There is a lot of new home construction going on in my "hood", and I hope the mapmakers are keeping up with the new street names being installed with the new dwellings. I am also aware that some of the mapmakers have put nonexistent streets onto their maps, under the theory that if the street shows up in a competitor's map, they can sue for plagiarism.

Would somebody who is ALS explain to the BLS guy what "INR" is?

At least they saved the chimney.

OK, seems that you are of the school that asks: What are 2,000 lawyers chained to the bottom of the Atlantic Ocean, and 7,200 lawyers chained to the bottom of the Pacific Ocean? A good start.

Susan: Looking at things from a New York State perspective, our EMT renewal applications have a space to indicate if the applicant has had any types of convictions from the time of their last renewal. I am told that anybody indicating that they do, is given a case by case review and evaluation by the state DoH. If you tell a prospective employer of your conviction, if employed, at least it will be better for you, than if you get hired, and then they find out, which would probably result in you being fired. Good luck.

Perhaps the EVOC I attended was different than most, but, I operate, when in Emergency mode, in what I hope is a better manner than civilians who are on the road with me. This is not to say I am never going to be in an accident. One thing impressed on me was to "expect the unexpected. You'll never be disappointed." Another item is from a decades old seat belt ad on TV: "To the other guy, YOU'RE the other guy".

Rockaway, New York has an elevated subway train line, the southern end of the "A" train made famous in the Duke Ellington song. The pillar beams holding the tracks up are encased in concrete, and run over the local road called Rockaway Freeway. The Freeway ran 2 lanes each direction (now reduced to 1 and a left turn lane), eastbound under the tracks, westbound not. Local folk tales say that one out of each 7 pillars is rubber encased, so any car hitting that lucky 7th one would just bounce off. I've never seen any car hit the 7th, in all my 37 years on ambulances. On my first day loose on the streets as an EMT, and with my VAC, there was a single car accident, car into the pillar. Municipal EMS had 2 of the 3 persons from the accident already on board, and the 3rd was ambulatory on scene. We got her down onto the spinal long board, and that onto the stretcher, and into the ambulance. All of us on the ambulance were fresh out of the carton EMTs, as it was both a newly operational VAC, and our first time without an EMT from a neighboring corps riding as mentoring "Crew Chief". Keep that in mind. On arrival at the hospital less than a mile away, the first thing that happened was, nobody remembered to pull the handle to release the stretcher's "landing gear". Then, whoever had the handle forgot to release it to lock the stretcher in the raised position. After we finally figured out that problem, we brought the woman inside, and the ER staff did a preliminary exam of the woman. They then suggested we move her to the ER examining bed. We undid the straps, and tried sliding her, on the board, to the exam table, but she didn't slide. It turned out that we had undone the straps, all right, but to the long board, not the stretcher. I think we were strangling that poor woman. We finally undid all the straps, and succeeded in moving her, on the board, to the ER bed. We then asked the ER crew if we could remove her from the long board, and told that we could. Somehow, we managed to get her off the board, but in doing so, we pulled off her wig! Damn, we thought we'd somehow scalped her! Somehow, both my crew, and the ER crew, managed to maintain some level of decorum, and we got our equipment, and ourselves, out of the examining room and into the corridor, before we collapsed to the floor in laughter, just as the LEO from NYPD Highway Patrol, investigating the accident, walked in, and looked at us like we were some kind of fools, which that night, we probably were.

...And the Freedom not to be told what religion you are to practice.

Quickie commentaries: The old doctor, male or female, is past, under normal circumstances, child bearing years. We never established if the prostitute was female, or a male (yes, there are male prostitutes, see movie "Midnight Cowboy"). As for the Med student, the farmer, the lawyer, the history professor, the cop and the army captain, again, no sex established. I wonder if this is related to that other string here, after an apparent large explosion, when everything operating with electricity is off line, including the FD Tanker Truck's engine, from an apparent nuclear attack with EMP?

No one said. I went back and edited that question, myself, even as you were answering.

I question back at you, sir: Aside from the priest, the pregnant girl, the prostitute, and the 70 year old doctor, are any of the others females of child bearing age?I also question further on the prostitute, as there are also male prostitutes, be this one a male or female?

I'm going to reason as best I can here. My comments italicized.

FDNY policy has us log on not just the vehicle radio, which has a unit specific radio identifier that shows which vehicle sent a signal on the dispatcher's computer screen, but the 2 portable radios, which also have individual identifiers. That way, we have the vehicle assigned the radio designation (using my old unit, 47Adam3), the "wheel man" (that day, Me), and the "shotgun" (the "V-Man") logged into the system, with the vehicle's "shop" number (old and now retired vehicle 55), and the 2 badge numbers of the crew members (you're not getting them from me, here!). If someone hits the button, they'll know who sent it.

In a recent episode, the English doctor, trying for funding, tells of the "bum" on blood thinners, the bicyclist who went flying from hitting the bum's shoe, and the passenger in the car that hit him. Great, they fixed up all of them. The telling point, however, was that the driver of the car, also injured when the bicyclist flew into the windshield, died from being taken to a non-trauma center hospital ER, delaying her getting to the Trauma Center "in time" (presume here the Golden Hour"). It also helps that I am still somewhat enamored of guest star Shari Belafonte.

I thought it was MSN-Hotmail had that happen? I got one from the E-mail of the sister of a former girlfriend (the girlfriend is the Navajo and medium I have been known to refer to), using the possible name of another sister, but in London. I would recommend to all here with an MSN or MSN-Hotmail account to run whatever anti-virus software you use on your PCs (or even MACs). No matter if affected or not, it's just a good idea to update and run the programs, and also prevent the infamous "Blue Screen Of Death!"

Not mine, and unknown if it was the poster's first, but someone reported here, that they asked a stable, non cardiac patient to walk down stairs, and got a lot of flack from the patient and family for asking. Seems the woman had her double BK amputations hidden under her blanket. Not mine, and unknown if it was the poster's first, but someone reported here, that they asked a stable, non cardiac patient to walk down stairs, and got a lot of flack from the patient and family for asking. Seems the woman had her double BK amputations hidden under her blanket.

Does that mean wearing an American Flag T-shirt on July 14 is going to cause fights? For the uninformed, that is Bastille Day in France, the anniversary of the French Revolution. Cinco de Mayo is the anniversary of when the country of Mexico threw the French out of Mexico. Momma B, who is a World War 2 veteran, and a past post commander and county commander of the Jewish War Veterans of the United States, says she objects to American Flag bandannas, or any bandanna that depicts ANY country's flag, as demeaning to that country, even if intended as a tribute to that country. On a historical note, activist Abbie Hoffman, perhaps best known as being a member of the "Chicago 7", that allegedly started the rioting outside the 1968 Chicago Democratic Convention, wore a shirt depicting a United States flag on the Johnny Carson "Tonight Show" (years before most of us had even heard of Jay Leno). The cameras kept close focus on Mr Hoffman's face, not showing the shirt. Either later on that same show, or the next night, "King of the Cowboys" Roy Rodgers appeared on the show, wearing the same model shirt, but the cameras showed him without any visual field censorship. If I understand the flag etiquette pamphlets I get from the American Legion, other veteran's groups, and flag manufacturer/distribution companies, you are not supposed to wear a flag, anyway. Just mentioning. The boys mentioned in the quoted story are Americans, I believe. To the best of my knowledge, while we may have days and parades honoring other countries, like St. Patrick's Day, and by extension, contributions made by folks who came from those countries, I feel that the authorities who told the boys to remove the "offending" garments were out of line.

I asked before on a different string, which went unanswered. I'll ask again, here and now:

As I am rushed a bit today, and do not want to do the research, there was a string in the last 2 or so months, which turned out to be a city member asking instructions on how to set up a HEMS. It seemed to imply just putting medical agency frequencies into the helicopter's radio was all the guy needed. However, a bunch of us took that poster to task, and basically, we cut him a new one. When it gets to the point of thinking "I got a helicopter with some space inside, so I'm going to start an air rescue/medevac service," I, for one, would agree that there might be too many HEMS out there.

Most of the EMT City community is aware that I am in the Fire Department New York (City) EMS Command, and that I am also a member of Local 2507 (Uniformed EMTs, Paramedics, and Fire Inspectors of the FDNY), District Council 37, American Federation of State, County and Municipal Employees. The president of Local 2507, Patrick J Bahnken, is a former partner of mine, from an IFT ambulance service provider. He gave me an OK to place the following onto EMT City's pages, as quoted from the "UEP Bulletin" (Vol. 8, issue 1, April 2010), which I feel might be an interesting read as to the craziness of our collective jobs in the EMS system. "Perhaps the most shocking thing I have ever heard as a labor leader was a representative of the City tell me across the table "Management has an absolute right to mismanage". I relay this to you because a recurring theme of this newsletter is that how you get the get the job done is more important then actually getting the job done! "The Operating Guide is filled with directives governing everything from how to respond to emergencies to how far down your shoulder your patch must be sewn to your sleeve. The purpose of these directives is to offer you clear guidance on virtually every aspect of your job. "The problem is that rarely can one follow those directives without incurring the wrath of the system. For example, you are required to perform a thorough check of your ambulance to insure it is properly stocked and ready to respond to emergencies. Everything from the number of 4X4 dressings to oxygen pressure must be checked. However, you are also directed to log on and give an in service signal immediately. "Clearly, unless there is some sort of suspension in the time/space continuum, you will be unable to make yourself immediately available while at the same exact time assuring that your vehicle is properly stocked and equipped. Ultimately, it is your responsibility to ensure the vehicle is properly stocked and your liability if the items in the quick check or part 800 checklist (1) are missing. "Another paradox that exists is in self-dispatching. Yes, we have a moral and ethical obligation as compassionate human beings to try and help our fellow human beings in times of crisis as quickly as possible. Remember the department is less interested in results than actual process. Being much closer than any other unit means nothing if you do not follow the process of getting assigned to the call. "Yes, by the time you follow all the steps outlined in the process, the patient will probably either be dead or discharged from the hospital but again, process trumps results every time. "I hold no illusions about whether or not any of you will do what ever is necessary to get the job done and for that matter, neither does the department. The primary purpose of these policies is to shift the burden of responsibility to you should something go wrong. "In the end, the best defense against disciplinary action is also the best route to getting these policies changed, which is; follow all policies exactly as written. To be sure, if each of us follows all Operating Guide procedures exactly as written, the system would probably grind to a halt. However, to do otherwise is to assume responsibility for things that are well beyond your control. It is managements right to mismanage! "In Solidarity, Patrick J. Bahnken, President." {(1) The Part 800 checklist is the NY State DoH list of what supplies and working equipment are required to be on registered and/or certified ambulances working within the state.}

If the grass is on fire, at least there is possibility the buildings could catch fire from the grass. That rates as a legitimate reason for a 9-1-1 call, at least as I see it. Even within NYC, we sometimes have large area brush fires that have caused structural damage to buildings that simply were downwind of the fire, caught in the path. As for calling for an animal in distress, I have responded to some. After determining no human lives were directly involved, I have simply directed them to "let the fingers do the walking through the Yellow Pages" for an animal hospital, and return my team back to available status. I almost forgot: I recall FDNY responding, after a rainstorm, to a "house emitting smoke" on my street. It was the water on the roof evaporating!

It IS a requirement that any 2 way radio station identify by call letters at least once an hour. Rather than have a person do it, or more correctly, forget to do it, radio manufacturers include the option for the automatic morsc code identifier. Unfortunately, if all the available frequencies in the trunking group are in use, it at least lets the person trying to use the radio that they have to wait for an open frequency. Still better than keying up, and talking when nobody would be able to hear them due to a momentary lack of available frequencies. I understand newer trunking systems, when someone's Emergency button is activated, will automatically cut off all other broadcasts, give an audible signal to all within the group alerting that someone HAS activated the "E" button, and that unit gets priority for at least the next 15 to 30 seconds.