Richard B the EMT

I'm thinking a totally different direction. Cell phones have camera/video capabilities. Need I go on?

"Meet The Spartans". Was a spoof on "300"

In a joint statement, the offices of the United States, New York, and New Jersey Attorney Generals announced that yesterday, at the John F. Kennedy International Airport, an individual, later discovered to be a Public School teacher, was arrested while trying to board a flight to Washington DC, while in possession of a ruler, a protractor, a set square, and a calculator. The Attorney Generals offices expressed the belief that the man is a member of the notorious Al-Gebra movement, and is being charged with carrying weapons of math instruction. Al-Gebra is a fearsome cult, that desires average solutions by means and extremes, and sometimes goes off on a tangent in a search of absolute value. They consist of shadowy figures, with names like “X” or “Y”, and, although they are referred to as “unknowns”, we know they really belong to a common denominator, and are part of the axis of medieval with coordinates in every country. As the great Greek philanderer, Isoseles, used to say, there are three sides to every angle, and if God had wanted us to have better weapons of math instruction, he would have given us more fingers and toes. I am grateful our government has given us a cosine of intent on protracting us from these math-dogs, who are willing to disintegrate us with calculus disregard. These statistic bastards love to inflict plane on every sphere of influence. Under the circumference, it is time we differentiated their root, made our point, and drew the line. These weapons of math instruction have the potential to decimal everything in their math on a scalene never before seen, unless we become exponents of a higher power, and begin to factor in random facts of vertex. As the first President George Bush used to say, “Read my ellipse”. Here is one principal he is uncertainty of – Although they continue to multiply, their days are numbered, and the hypotenuse will tighten around their necks!

When the World Trade Center collapsed, a lot of nearby "upstate" 9-1-1 service providers filled their ambulances up with supplies, and headed "South" (or west from Nassau and Suffolk counties), either directly to the scene, or to staging areas quickly set up at Shea Stadium. A good number of these services had "Mutual Aid" policies established with their neighboring services, so if one service had more calls than they could handle, the next one over would answer the call. The problem was, too many services left their areas, and nobody was left to handle any calls at all. They all felt that their neighboring service would "pick up the slack," but the neighboring service was parked next to them at Shea. I don't have any information available, but due to all these "upstate" services self dispatching, or freelancing, to New York City, I have vague, but undocumented, memories that several people in these areas died, as there was no ambulances available in the county (counties) at all. Much closer to home, (like a half mile), when American Airlines Flight 587 crashed into my neighborhood, there were at least 2 Volunteer ambulances from 2 counties away. (I won't identify the agencies, as I still have friends in both of them) Seeing how so many agencies were, in essence, deserting their post to go to the "Big One", leaving their Primary Area(s) of Responsibility uncovered, New York State Department of Health came up with a new plan, which I will attempt to recreate or paraphrase here. If a Multiple Casualty Incident happens in one ambulance service provider's area, a neighboring service may not respond in, unless requested in by either the first area's agency, under pre-existing Mutual Aid agreements, or by the State Office of Emergency Management (OEM). Before the second agency can respond, they must secure sufficient coverage for their own area, to handle their usual call volume, before they can respond to the out of area MCI. Here's the teeth of the enforcement: Any agency that self-dispatches a unit, uninvited, to an out of area call, or fail to provide proper coverage in their home area, BOTH the agency, AND the individual crew members, are getting a $10,000.00 Fine!

I would say there is no such thing as a "Routine" call, either for EMS, Fire, or PD, as there are always going to be variables that can change the direction of a call, implementing themselves into that call, with no warning. You'll never see it coming.

Someone correct me if I am wrong, but I thought programs for tracking down IP addresses were restricted to the LEOs, and National Security/Homeland Security?

I must have seen the same ad.

"Resident's committee says we gotta keep that door closed. I don't care that there's an 'EMS crew' in there, keep that door closed and locked to keep out the riff raff. Besides, there's a ambulance out front so they'll take care of whatever an EMS is".

Stuff can always be taken out of context. Years ago, a TV host took children's rhymes, and "edited" them with a coo-coo clock sound. Try hearing this! Jack and Jill went up the hill to (sound effect of coo-coo clock) Jack (sound effect of coo-coo clock), and (sound effect of coo-coo clock) and Jill (sound effect of coo-coo clock). Sure sounds filthy to me, with the sound used as a sensor!

Children's "game", re the 1918 Influenza Pandemic: As for the other one, must be the (allegedly) prim and proper upbringing I had, but that "747ed" me (It went right over my head).

This in from AOL and FEMA, and a followup to my last posting on this string... Emergency Management and Response Information Sharing and Analysis Center (EMR-ISAC) INFOGRAM 26-08 July 10, 2008 NOTE: This INFOGRAM will be distributed weekly to provide members of the Emergency Services Sector with information concerning the protection of their critical infrastructures. For further information, contact the Emergency Management and Response- Information Sharing and Analysis Center (EMR-ISAC) at (301) 447-1325 or by e-mail at emr-isac@dhs.gov. Physical Security Planning Recently, a security firm tested the physical security of numerous public and private organizations at several U.S. locations. Sometimes using uniform components from surplus stores and forged identification badges, the researchers were able to gain access to facilities 98 percent of the time. Access was granted without an escort on many occasions even when the test team members had very obvious errors to the clothing they were wearing, the identification they were carrying, and the explanations they were giving. The Emergency Management and Response—Information Sharing and Analysis Center (EMR-ISAC) acknowledges that Emergency Services Sector (ESS) personnel are typically very helpful and accommodating. Outstanding service to the community and its citizens is abundantly prevalent among first responders. Unfortunately, current realities make these positive mannerisms a potential vulnerability that provides significant advantages to those planning thefts or terrorist attacks. Recognizing the interdependent relationship between critical infrastructure protection (CIP) and physical security, the EMR-ISAC examined the basic measures of a time-efficient, cost-effective, and common sense approach to physical security by ESS departments and agencies. The following is a summary of preventive actions from various sources for the consideration of ESS leaders responsible for any type of physical location: · Acquire the assistance of a physical security specialist (usually from a law enforcement agency) to conduct annual physical security vulnerability assessments to determine where improvements are needed. · Randomly inspect the security and condition of all facilities, storage areas, and HVAC systems. · Increase observation and scrutiny of all facilities, storage, and surrounding areas. · Keep all doors (including apparatus bay doors) and windows closed and locked unless these access points are continuously monitored so intruders can be immediately intercepted. · Use appropriate locking systems for all access points (e.g., single cylinder locks for solid core doors and double cylinder locks for doors with glass). · Obtain a monitored security alert system for buildings, storage areas, etc., that are not always occupied and in regular use. · Guarantee that all apparatus, vehicles, and equipment maintained in exterior parking or storage areas are always locked when unattended. · Periodically test security systems, back-up power sources, and emergency communications. · Initiate and enforce a reliable identification system for department personnel and property. · Develop inspection practices for incoming deliveries including postal packages and mail. · Screen all visitors (including vendors) and deny entry to anyone who refuses inspection. · Implement a dependable visitor/vendor identification and accountability system that includes escorting non-department personnel as much as practicable. · Restrict access to communication centers and equipment including computer systems and networks to the few essential department personnel and authorized technicians. · Prepare an SOP containing the organization's physical security policy and practices. · Train department personnel regarding the application and enforcement of all physical security measures. Threat Advisory System Response Guideline The American Society for Industrial Security (ASIS) recently released the second edition of the “Threat Advisory System Response Guideline.” ASIS developed the Guideline to provide organizations with security measures they might implement during elevated alert levels announced by the Department of Homeland Security (DHS). The Guideline is divided into four major sections that correspond to threat levels of the DHS Homeland Security Advisory System. Each section includes three subcategories: emergency response, personnel protection, and physical protection. When reviewing the Guideline, the Emergency Management and Response—Information Sharing and Analysis Center (EMR-ISAC) learned that the document is a quality tool for Emergency Services Sector (ESS) departments and agencies. The document will enable ESS organizations to decide upon and provide a security architecture characterized by appropriate awareness, prevention, preparedness, and response to changes in threat conditions. Its detailed worksheet format will help decision makers determine those steps that apply to specific security environments. ASIS developed the Guideline as an initiative to provide private business and industry a methodology for prompt consideration of possible actions that could be implemented based upon changes in the Homeland Security Advisory System. The document’s overarching objective is to balance the need for a process both applicable and understandable to a large portion of the private sector, while also providing sufficient detail to be of practical use to the organization. The EMR-ISAC suggests that this Guideline has planning and operating value for emergency services organizations. Therefore, it can be seen and downloaded at the following link: http://www.asisonline.org/guidelines/guidelinesthreat.pdf (856 KB, 36 pp.).

For many years, I have been taught how to do the "Combi-Tube", but the state (New York) is waiting for a "Pilot" program. As for the nasal intubation, I have been trained in them for so many refreshers, I forget when I first heard of them, but have never actually inserted one, in over 35 years, now.

Not known for tall tails? Even here in New York City, we've heard of the most famous Texan who ever lived, Pecos Bill. Per his own story, he roped, saddled, and rode a tornado across the Texas Panhandle, and had a real one-rider horse, that when Bill's wife tried riding it, it bucked her so high, she went higher than the orbit of the moon. My nephew, by the way, was born at Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, so I have nothing against Texans.

I quickly mention, per the FDNY EMS protocols, which might be dissimilar from your local protocols, we don't put M95 masks on the patients, as, while they can breath through them, they are supposed to provide protection for inhaled air through them, and the moisture from the sputum will quickly cause them to start to dissolve. Then, also, you cannot watch their lips for change in color due to a change in the patient's condition.

All I know is, when Superman shows up, Clark Kent disappears. Likewise Batman and Bruce Wayne, Spiderman and that kid Peter Parker, or the Hulk and Bruce Banner. I also note that when the Underdog shows up, I never can find my Beagle, "Shoeshine". Then, again, nobody seems to be missing when Mighty Mouse, or Minute Mouse and Courageous Cat show up.

This is coincidence, but the first posting on this other string has relevance to this string here. You'll know it when you read it! http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

This string reminds me of a story I used to tell, on having complaints from the ER Doctor that the folded triangle bandage ends were not tucked in. Doc don't realize that the patient was immobilized and removed from an overturned car, hanging 30 feet up a tree, when the car skidded and flipped off the elevated highway, during the blizzard that caused the power blackout around midnight! Never happened, just fun in the telling!

Here in NYC/NY State, I have never heard of IN meds administration. I have seen my Paramedics administer meds down an ET (now reconnect the BVM, and keep pumping). However, I can not speak about the rest of the state. I have located what might answer some of your questions, at the New York State Department of Health's site. Link to... http://w2.health.state.ny.us/query.html?co...p;search=Search

Letmesleep, I have no knowledge of what your experience in the field is. I will try to stay away from anything negative, but, have you never had a patient who is squirming so violently, even when restrained, that you either cannot slip a BP Cuff around their arm, or they keep banging against your equipment so that you cannot make out the sounds? I agree that vitals should be taken on all patient contacts for which a call report is filed (not nessesarily just those transported, but the Refused Medical Assistance/Against Medical Advice, and even those who are not taken as they are "pronounced" on scene), but sometimes you cannot do what you know you should do. All I can suggest, and with your local protocols as your guide, follow the triple "D" of "document, Document, DOCUMENT" as to why you were unable to attain the vital signs, with notation of witnesses, usually the LEOs, to back you up if the document should be questioned.

Hey! And you don't divulge the secret identity of the EMT City Administrator!

I trust everyone remembers I am in a big city, and (usually) have LEO resources readily available to back me up. The LEOs are there, just by the call type, in case the patient exibits as a danger to themselves or others. If they have to restrain the patient, it is not an "Arrest'" it is "Protective Custody", although the tactics and materials they use in restraining, don't look different, because they are not different.

Where I come from, that's ALS terminology, and I am but a (not so) humble BLS provider.

With going home in more or less the same condition I started the shift as priority one, if I feel threatened by the patient, I unapologetically will back out, and await the restraining of the patient by the LEOs. If the LEOs (reference here is the NYPD) cannot handle it, under their policies, they call in the Emergency Services Unit. Using their training and specialized equipment, they eventually will put the patient into a restraining body sized "bag", which then goes onto our (FDNY EMS) stretcher, and we all go to the Psych ER. After the facility doctors get the patient on tranquilizers, "chemical restraints", or whatever, we take the patient out of the bag, leaving them in the "rubber room", for the hospital's further evaluation and whatever treatment decided on. I have been on only 2 of those calls from 1973, and was frightened by the patient's violence, or exhibited potential violence, on both of them.

While I always remind everyone to follow local protocols, I think it is internationally across the boards that one never places a patient face down on the stretcher! Also, no "Bellevue Sandwiches", placing the patient between a long backboard and a "Scoop" stretcher. I catch anyone doing this, after restraining with every belt, tape, and the LEO's cuffs to the stretcher, whoever it is that I caught is walking back to the base, as well as being brought up on departmental, state, and whatever-else-I-can-find-on-them charges! In all cases, remember that someone hopped up on various recreational pharmaceuticals, individually or in combination, can exhibit feats of strength to put fear into even the Hulk, himself. Joking aside, it was perhaps 25 to 30 years ago, a druggie was shot over 10 times by the FBI, all "Kill" shots (should have instantly died from each bullet wound), but still, due to the drugs, was able to come after the FBI agents and kill at least 3 of them. So the guy broke his arm in 2 places? Where? The waiting room and the ER? (LOL)