Richard B the EMT

...and that relates to time...how?

Considering fetal blood alcohol poisoning, she risked to delete us a fetus. (BOOOOOOOOOOOOOOOOOOO!)

Admin's name is ZOT. While we ask "Who is 'Admin'", the rest of the world is asking

Close down the streets? In New York City? Do you realize the issues already arising when traffic flow is interrupted now? Even Bicycle lanes now taking away car lanes is a big thing, on both sides of the issue. Also, nobody could pass the cemeteries, so what happens when, as is usual, there's several funeral corteges going to the same cemetery, simultaneously?

Due to my own scheduling conflicts, all I am sending is my greetings to those not of EMT City at the conference, from those whop are from EMT City. I also have scheduling problems with annual events, as some of them always seem to be directly against each other, for many years in a row.

I did not include the paperwork forms, but this is NYS DoH on Public Access Defibrillation... <<<<<<<<<<<<<<<<>>>>>>>>>>>>>>>>> Policy Statement 07-04 New York State Department of Health Bureau of Emergency Medical Services POLICY STATEMENT Supersedes/Updates: 98-10, 06-03 No. 07 - 04 Date: 09/27/2007 Re: Public Access Defibrillation The purpose of this policy is to assist a person, firm, organization or other entity in understanding the notification process for operating an automated external defibrillator pursuant to a collaborative agreement under the provisions of Chapter 552 of the Laws of 1998 authorizing Public Access Defibrillation. A Public Access Defibrillation (PAD) program is designed to encourage greater acquisition, deployment and use of automatic external defibrillators (AED) in communities around the state in an effort to reduce the numbers of deaths associated with sudden cardiac arrest. Since the enabling legislation’s inception, there have been 4,140 PAD programs established, with over 135,000 people trained. This program has been successful in saving many lives across New York State. To be authorized to use an AED under this statute an individual or organization needs to make specific notification of intent to establish a PAD program to the appropriate Regional Emergency Medical Services Council (REMSCO) and the New York State Department of Health (DOH). There are no approvals or certifications required. Public Access Defibrillation Program Requirements Original Notification Process To be authorized to have a PAD program and utilize an AED, the following steps must be completed: • Identify a New York State licensed physician or New York State based hospital knowledgeable and experienced in emergency cardiac care to serve as Emergency Health Care Provider (EHCP) to participate in a collaborative agreement; • Select an AED that is in compliance with the Article 30, section 3000-B (1)(A). The AED must be programmed to the current Emergency Cardiovascular Care (ECC) Guidelines, capable of defibrillating both adult and pediatric patients. Please check the shaded box on the Notice of Intent to Provide PAD (DOH-4135) if the machine is approved for pediatric use; • Select and use a DOH approved PAD training course for AED users. The approved programs are listed on the Notice of Intent Form; • Develop with the EHCP, a written collaborative agreement which shall include, but not be limited to the following items: Written practice protocols for the use of the AED; Written policies and procedures which include: Training requirements for AED users; A process for the immediate notification of EMS by calling of 911; A process for identification of the location of the AED units; A process for routine inspection of the AED unit(s) as well as regular maintenance and which meet or exceed manufacturers recommendations; Incident documentation requirements, and Participation in a regionally approved quality improvement program. • Provide written notice to the 911 and/or the community equivalent ambulance dispatch entity of the availability of AED service at the organization’s location, • File the Notice of Intent to Provide PAD (DOH 4135) and a signed Collaborative Agreement with the appropriate Regional Emergency Medical Services Council (REMSCO), and • File a new Collaborative Agreement with the REMSCO if the EHCP changes. Signs notifying public of AED location In July 2007, 3000-b of the New York State Public Health Law, Section 1 - Subdivision 3, was amended by adding paragraph (f) requiring a sign or notice to be posted at the main entrance of a facility or building in which the AED is stored or maintained on a regular basis. The law is silent as to the specifications of the sign or notice used to communicate the location of the AED(s) within the structure. However, it is expected that the size, type and language(s) of the sign will be easily legible upon entrance to the structure. If there are multiple entrances that could be considered a main entrance then a sign or notice must be placed at each of those entrances. It is the choice of the Public Access Defibrillation Provider as defined in Article 30 Section 3000-b to determine if multiple languages are necessary and where the sign or notice will be posted. The sign can be posted inside the entrance of the building, in a foyer or another location as appropriate. Reporting a PAD AED Use In the event that the PAD program uses the AED to defibrillate a person, the program must report the incident to the appropriate REMSCO. The REMSCO may request additional information regarding the incident, but the PAD must report, at a minimum, the following information: • Provide written notification of AED usage to the REMSCO within 48 hours of the incident; • The name of the PAD program; • Location of the incident; • The date and time of the incident; • The age and gender of the patient; • Estimated time from arrest to CPR and the 1st AED shock; • The number of shocks administered to the patient: • The name of the EMS agency that responded; and • The hospital to which the patient was transported. A copy of the usage report should also be provided to the EHCP. Regional EMS Council Responsibility in Public Access Defibrillation Each REMSCO is responsible for receiving and maintaining notification and utilization documentation. The REMSCOs must develop and implement the following policies and procedures: • Insure that a copy of each new or updated Notice of Intent (DOH 4135) is forwarded to the Bureau of EMS; • Maintain a copy of the Notice of Intent and the Collaborative Agreement; • Collect utilization documentation and information; • Provide detailed quarterly reports to the DOH on PAD programs in the region, and • Develop Quality Assurance participation, data submission and documentation requirements for participating organizations. Data Collection Requirements REMSCO quality improvement programs are encouraged to use the data elements from the Utstein Guidelines for Prehospital Cardiac Arrest Research (Cumming RO, Chamberlain DA, Abramson NS, et al, Circulation 1991; 84:960-975). The following minimum data set is to be developed and collected as a part of the regional PAD QI process. A copy of the data set is to be provided by each region to the DOH Bureau of EMS quarterly: • Name of organization providing PAD • Date of incident • Time of Incident • Patient age • Patient gender • Estimated time from arrest to 1st AED shock • Estimated Time from arrest to CPR • Number of shocks administered to the patient • Transport ambulance service • Patient outcome at incident site (remained unresponsive, became responsive, etc) Ambulance and ALS First Response Services Ambulance or ALSFR services may not participate in PAD programs for emergency response. Certified EMS agencies must apply for authority to equip and utilize AEDs through their local Regional Emergency Medical Advisory Committee (REMAC). Please note that the Prehospital Care Report (PCR) has a check box for EMS providers to indicate that a patient has been defibrillated prior to EMS arrival by a community or by-stander PAD provider. Documenting this information is required so that the DOH may monitor the effectiveness of these community based programs Attachments 1. Notice of Intent to Provide Public Access Defibrillation 2. Regional EMS Council Listing Issued and Authorized by: Edward G. Wronski, Director Bureau of EMS <<<<<<<<<<<<<<<<<<>>>>>>>>>>>>>>>>>>>>>> Richard B, again. Most of the PADs I have seen are in wall boxes like fire extinguishers, with an alarm going off to building security and audible alarm at the box if opened. I think most are FR2s, like what FDNY, NYPD and other local agencies seem to be using in the field anyway, with built in visual indicator if the defib is "good".

I am not joking, I have never seen the entire movie, just the sequence when, I presume, that Drill Instructor gets shot and killed in the bathroom by the guy now starring on Law and Order:Criminal Intent.

Glad for the clarification on "10-13". In New York city, the 10-13 means "send the LEOs...YESTERDAY!" (Effect, not real wording). For the LEOs themselves, it means "HEEEELLLLLPPPPPPPP!" As for the pro v con discussions, there is always "Hospital, LEO, FD, Commercial, and Community based EMS Systems: Which is best/worst, and why?" And, always a favorite of discussion on this site, "'Paid' v 'Volunteer/unpaid charity' Ambulance Crews: Which is best/worst, and why?"

Just to stir the pot, I ask input on the following statement: I do not necessarily follow that statement, but it is what I was taught, back when my ambulance was still pulled by a Triceratops.

At least he isn't choking on the Peanut Butter Balls. (Phenobarbital mispronunciation) I'll get back to the string with NYS laws on this topic.

As I have not even a working knowledge of sports, please include me out of this string! Thanks in advance.

Arizonaffcep, please bring me up to speed: Who is Gunnery Sergeant Hartman?

Hmmm...Lois Lane never sees Clark Kent and Superman in the same place at the same time, and we never see The Gloved One and LaToya at the same time...

OK, the non rescue EMT has a question: They put you into an SCBA, then into the "moon suit" without turning on the air supply? Unless I am missing something, and if I view this correctly, it is the equivalent of having your head held underwater until you almost passed out from lack of Oxygen. Those "moon suits", per what I have been taught, are not supposed to allow liquids or vapors in, including the 21% concentration of oxygen in room air, which is why the SCBA is worn inside the suit.

OK, instead of an independent "Doc in a box" operation, this one is operated by a hospital. By that status, I think it is unique.

From a previous discussion, if this Florida Paramedic had waited, perhaps she'd be taking this class, instead of opening up herself and employer to lawsuits for taking a traumatically amputated limb without permission to train a cadaver search dog! http://www.emtcity.com/phpBB2/viewtopic.ph...6&view=next

Spenac, how many times do I have to tell ya? I'm a "Met", not a "Yankee"!

I found this on the Mail.com site when checking my e-mail (consider it one of my alternate sites) I just threw it into the mix for additional discussion. <<<<<<<<<<<<<<<<<<<<<<<>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Is Your Boss Spying On You? 12 Tips for Maintaining Your Privacy at Work Kate Lorenz, CareerBuilder.com Editor From key card technology that provides access to the office parking garage to computer systems that monitor incoming and outgoing phone calls, today's employers are keeping tabs on their employees. According to a 2001 survey by the American Management Association (AMA), more than 75 percent of U.S. firms record and review employee communications and activities on the job. This includes monitoring employee phone calls, email messages, Internet connections and computer files. Most monitoring takes place because of increased technology available to employees, such as email and advanced online capabilities. In fact, this percentage has doubled since the AMA first conducted the survey in 1997. But companies are not just watching employees online. More than 37 percent of companies said they participate in video surveillance for security purposes and 7.8 percent store and review employee voicemail messages. Forty-three percent monitor employees' telephone use, including time spent on the phone and which numbers have been called. Some groups think these practices violate employees' privacy rights. Organizations such as Workplace Fairness (www.workplacefairness.org) and the Privacy Rights Clearinghouse (www.privacyrights.org) are working to bring about legislation that protects employees' rights to privacy in the workplace. Many companies, however, feel that since the equipment is company owned and operated ,employees must adhere to company policies regarding personal use of technology. So if privacy is a concern for you, follow these tips for maintaining your privacy while at work: 1. Don't use company email for private messages. Although it may be tempting to forward the latest joke or urban legend to your colleagues, resist the urge. Someone in your organization - usually the network administrator - is watching all of the emails that come and go. Is this fair? According to experts, if your email system is owned by your employer, the company is allowed to review its contents. 2. Always assume your messages will be shared with others. It's all too easy for the recipient to hit "forward" rather than "reply" and send your message on to others. If the contents of your email messages are meant to be private, pick up the phone and call the recipient instead of using email. 3. Keep your passwords private. If you don't want others to have access to your computer while you're out of the office, don't share your passwords. Keep them in a secure place where only you can find them. 4. Stay off sensitive websites while at work. Although you may think you are cruising the net inconspicuously, every time you visit a site you leave an electronic fingerprint. Your computer screen may also be in plain view of others who walk by your office or cube. Visiting credit management sites, managing your bank account online, or shopping for lingerie could have the whole office talking if you're not monitoring your monitor. 5. Disable the "cookies" in your system. Cookies are bits of text that a website stores in your computer, allowing the site to recognize you the next time you visit. 6. Turn off your computer. When you step away from your desk, turn off your computer. Anyone can click on your navigation bar to view the websites you've visited recently. Or worse, if you leave your email open, a passerby could read your mail or even send a message under your account. 7. Pay your bills at home. If you don't want your coworkers to know how much you owe on your credit cards or the size of your mortgage, keep your bills at home. These are private documents that your coworkers and employer do not need to see and that don't need to go through the corporate mail room. 8. Keep your paycheck away from wandering eyes. Put your paycheck in your pocket or purse as soon as you get it. Given the popularity of direct deposit these days, most people don't give payday a second thought. That can be a problem when paychecks are left lying around. Consider Kathy, an account manager at a national travel company. She recently moved to another cubicle and the coworker who now occupied her empty desk found one of her old paychecks, opened it and shared the amount with others in the office. 9. Lock your drawers, take the key. If you don't want coworkers or supervisors sifting through your desk, keep it locked. Many an office surveillance camera has captured employees after work hours sifting through others' drawers. 10. Watch what you say and to whom. It's no secret that office gossip travels faster than the Concorde. If you want to avoid rumors about yourself, keep quiet about your private life. 11. Report to work on time. According to one office administration manager in Chicago, "If your company has a security key card system that you use to gain access to your building, management knows what time you came into the building and reported for work. When needed, they can use these reports to implicate tardy employees." Surveillance cameras can also track employees' whereabouts and the time of their arrival and departure. 12. Don't use a company-issued credit card for personal purchases. Many sales reps and executives receive corporate credit cards. If you don't want the accounting department to know what size undies you wear, don't shop for clothing and other personal items with the company card. If you are concerned about privacy and monitoring practices at your company, re-read your company policies manual or ask your human resources department. Most businesses alert employees to the possibility that email messages or online activities may be tracked. Keep in mind that your purpose at work is to - well - work and realize that it's better to be safe than sorry. If you keep your personal emails to a minimum or avoid them altogether, make as few personal phone calls as possible and stay off the Internet, privacy shouldn't be an issue for you. Last Updated: 24/09/2007 - 3:50 PM

Sounds like the conversation about having dated Mr or Ms. Right, with the problem being their first name is "Always". I have had partners (and off the job friends) who are argumentative, and seem to pick fights even when you agree with them!

Hey, Peter Paramedic and Crotchitymedic1986, are the 2 of you going to continue the George Burns routine?

When I started in municipal NYC EMS, they told me they reserved the right to put the cup in front of me, to pee in. When FDNY took over, they implemented random drug testing. Theoretically, they go to one unit per station per tour. If one of the individuals on that unit are on an overtime tour when the testers return, the individual gets tested a second time. Bad part of the policy is, if one of the duo goes down, even if the other only met the partner for the first time ever on overtime, 15 minutes prior, BOTH go down. I don't particularly like it, as it turns all of us into "cops" for our own self preservation. Some jerk-off I just met, neither of us knowing the other, and my career is in that person's hands (if they are using).

I am unsure if SirDukle's comment about a Mickey-Mouse organization was directed towards me, but I will respond to that by saying that the incident described by me happened circa 1975-1977. The service has become a part, after several different ownerships, of the MetroScare ambulance organization. I worked another 4 non-9-1-1 services before getting employed by municipal EMS, now a part of the FDNY.

I'll keep mentioning that the NYC EMS was an existing hospital based service, under the New York City Health and Hospitals Corporation. Then Mayor Rudy Guiliani gave a payback to the FDNY unions for votes electing him as Mayor (that last is my opinion), by starting the city council and the New York State Legislature to change the law so that the EMS would be severed from the HHC, and put under the management of the FDNY. This was not of my doing, as I voted for Rudy's opponent, nor of my desire, personally or via my union. Those in FDNY EMS are mission specific EMTs and Paramedics working EMS, while the Fire Fighters get a bit extra pay for each time they respond to a medical call as Certified First Responders-Defibrillation, but otherwise are mission specific. EMS may be fire service based, but we "posted" (staged) at that gas station from before the "merger". I again mention that EMTs and Paramedics working for FDNY EMS who might be Fire Fighters in their home communities are not allowed to use their Fire Fighter skills in the FDNY. Also, Fire Fighters who might be EMTs of Paramedics in their home communities are not allowed to use their EMT or Paramedical skills in the FDNY. Everyone seems to be "Mission Specific", as I wrote before.

I think it is time to approach a manager and ask for specifics as to what they want you to do. If they never told you, you cannot be responsible, even if you are. Confusing? Yes, but a new employee shouldn't be just tossed into the mix without a hard copy of what, within the company/department/agency/squad, is expected of them. It is like a condition that happened to me in one of the non 9-1-1 services I worked in. We had a sheet to log anything unusual. I had been following policy, to that point, in recording if the patient was obese. One day, before I was told which ambulance and partner I was with, the dispatcher told me not to log that information any more. "OK". I then walked to the garage section, and was confronted to the company owner. He asked me if I had been told not to put onto the log if a patient was obese or not. I told him I had been so told. "Then why do you persist in doing that, if you'd been told not to do it?" He was at least apologetic when I advised him I had only been told perhaps 90 seconds before.

There's a bunch of EMTs, Paramedics, and fire Fighters in the FDNY who have to be told by the older folks (like me) who "Johnny and Roy" were. Neither here nor there to the discussion, but someone brought them up...