Richard B the EMT

I mentioned the FDNY EMS EMD is staffed by EMTs and Paramedics. The dispatchers can and do call back to verify information, sometimes independently of requests by the field crews. Someone quoted Dr House, that "People lie". True. I have heard a tape from the EMD, where a CRO gave information on assisting an in home birth, complete to the newborn crying. Crew arrives, the location is a vacant lot, and the cellphone callback number is no good. That CRO is now a lieutenant, but he was a good CRO and then a dispatcher, but even the best might not catch a caller in a lie. Then, there are those who know how to work the system. For getting the LEOs sooner, say "Shots Fired". For getting an ambulance, say "I think he's having a heart attack." We used to call these callers "professional callers", as they know our key phrases that get a quick response. How much can a call taker, a dispatcher, or the field crew do, when the caller says, and unfortunately, correctly so, "You have the address, and the nature of the problem. It's your job and responsibility to get here and treat, so give me no 'until the ambulance gets here' instructions, and get here!" Of course, they didn't give a callback number, and hang up at that point. There will always be the situation where the caller does that, but gave the address incorrectly, like saying "21st Street", as they would say it locally, when meaning "121st Street". Hey, I refer to my local numbered streets like that, too, so it's human nature. However, if and when they call back, they get upset with us, because we're supposed to be mind readers and have gotten it correctly the first time. These are also the same people who have ambulances sitting across the street from where the ambulance is needed, the crew gets the call, and instead of saying "on the way," say "we're here" to the dispatcher, and still gets yelled at by the bystanders/friends/family/patient for taking so long to arrive. There have been many improvements, like the E-9-1-1, which is a caller ID at the Public Safety Answering Point. However, nobody's system is perfect, and there will always be room for improvement. The calling public will still be those professional callers, and figure ways around the newer, perfect, system, too.

Now, let's do a medical call. CRO- "EMS 8643." ACD- "8643, this is 1234, and we're going to Queens. Caller is on". CRO- "Hello, Caller. This is EMS. Is the person you're calling about breathing?" Caller- "I don't think so" CRO- "Is the caller awake?" Caller- "No" ACD- "Sending" (as mentioned in previous posting) CRO- "This is at the train station at Beach 116 Street?" Caller- "Yeah." CRO- "The phone there is 718-555-9999?" Caller- "Yes" ACD- "I have some first aid instructions for you to do until the ambulance gets there" The caller hangs up. The CRO routes the call into the CAD system as a call type "ARREST", which will place it as a priority one on the dispatcher's screen for dual ALS/BLS response. The CRO then sends the job through the CAD to the Screening Nurse, asking for a callback. The Screening nurse, an RN, calls the number back, tries to get more information, and give instructions. If the responding crew(s) cannot locate the patient, they will ask the dispatcher to call back the number, making sure they are at the correct location, or get an apartment number in a multiple dwelling. Sometimes, if a CRO felt the caller was hiding something, or holding information back, they would have the Nurse call back, again, for more information. CROs had no authority to cancel calls, except when a subsequent call stated the patient had left the scene by alternate means, but the RNs did. We usually operated with 18 CROs on the phone lines, another one on the "Relay position" for jobs sent by the NYPD without callers on line, like a Cop putting "over the air", a request for "a bus" to respond, or one where the caller told the ACD the basic information and hung up before the ACD could connect with the CROs. After the merger, the FDNY did away with the positions of "Screening Nurses". Sometimes, some of us long-timers miss that. In my posting, I used the CRO number of 8643. Yes, that was my number, and has been reassigned a couple of times after I was reassigned street-side in the fall of 1996.

I was a call-taker for the pre-merger NYC EMS from 1985 to 1996, so let me take you through a call to the 9-1-1 system in NYC from back then. The caller calls 9-1-1, and is connected to an "Automatic Call Distribution" operator at 1 Police Plaza's communications office. On recognizing that it is a request for EMS, the ACD puts the call down a trunk line to the EMS Communications Bureau, Maspeth, where the next available operator gets the call. (This is 1985 to 1996 for me, the information style and protocols used probably had changed by now in 2007. The ACD is an NYPD civilian communications technician, and the Call Receiving Operator at EMS is either a Uniformed Member of the EMS EMT or Paramedic) CRO- "EMS 8643" ACD- "ACD 1234, going to Queens, 8643. Caller on" CRO- "This is EMS, caller, is the patient breathing?" Caller- "Uh, donno." CRO- "Is the patient awake?" Caller- "No idea" CRO-" What is going on needs an ambulance?" Caller- "I was asked to call. There's a car accident on the Eastbound LIE (Long Island Expressway) at the 108th Street Exit." ACD- "Sending." At this time, the ACD sends a "linking" to CRO 8643s computer screen, 8643 taps the keyboard key to put the ACDs information into the mask, clicks another to have the computer verify the address as existing, while still talking with the caller. CRO- "Please confirm, that's LIE at 108th, for the car accident?" Caller- "Yes." CRO- "If you can, let somebody at the scene know not to move anybody out of the vehicles, unless they are in imminent danger. We'll be there as soon as possible." While talking, 8643 entered the call type into the Computer Assisted Dispatch (CAD) system, as an MVAInj, and the CAD sends the call to the Queens West dispatcher. The dispatcher might have already alerted the nearest ambulance, which would be on the way to the LIE at 108, before the caller, CRO, and ACD hang up the phones. For space, continued next posting.

It has been a while, but I have been host to US Army student Medics, and US Navy student Corpsmen (can they come up with a non gender specific name sometime before the end of this decade?) on my FDNY BLS ambulance. This was authorized by FDNY Headquarters, 9 Metrotech Plaza, Brooklyn, NY 11201. I don't know if they allow any ride-alongs, nowadays, for military or civilian personnel, other than new EMTs in the FDNY, but with the address here, feel free to write and ask.

I have no superstitions, knock wood! Lol! Sorry, John, you just activated my punster hair-trigger.

Brentoli said I just did some major housecleaning, and just threw that copy out last week!

Bushy, as to the Scoop for that purpose, welcome to the party! We all know some tricks, and feel ...perhaps vindicated is the wrong word, but you feel good when someone else finds out about your old procedure, and claims it as new. Perhaps next week, I'll find out a "new for me, old for someone else" procedure, and we'll all love it!

I skimmed the string, so I must have missed that point. I apologize.

Incognitogirl, never underestimate the power of the printed word, especially when swatting someone with section one of the Sunday New York Times!

Hey, I used that line here somewhere within the last month!

OK, subject of "Hazing?" DO NOT DO IT! See this old string on the topic and take heed! http://www.emtcity.com/phpBB2/viewtopic.ph...ht=hazing#23103

In which case... Salt, Pepper, Mustard and Ketchup to you all! What? Youse guyz never had Seasoned Greetings before?

There is more in this world than can be dreamt of in your philosophy (Shakespeare, but probably not the exact quote). I have had at least one episode of Deja vu, covered somewhere on a different string, and I'll raise you a close encounter of the first kind, from when I was somewhere 8 to 10 years old! (Reminder: close encounter 1st kind= UFO sighting, 2nd kind= physical evidence, 3rd kind= met the crew of the UFO, 4th kind= abduction. After the movie "Close Encounters of the Third Kind" came out, someone did a "Skin flick" alleging to a 5th kind...Sex with the aliens!) My only encounter with a ghost was probably a setup by the camp councilors, and I was 4 at the time. On request only, I'll send the file I created on the former girlfriend who taught me how to do seances. It is not due to the seances that she is my "former!"

Seeing it was Spenac thought I was the EDP, I have to borrow someone else's signoff, "Why am I not surprised?" Anyway, when you hear what sounds like shooting close at hand, and your partner is yelling in your ear to get down to the next lower floor, and is leading the way so fast, the equipment he's carrying is still falling from being unattended in midair...get the idea?

While I lack documentation, I have heard many reports, as in the previous posting by itku2er, that patients who normally are "not with it", become very alert within hours of dying, including reporting to onlookers that a deceased relative was waiting for them. Yes, this even when the patient had no way of knowing the relative had pre-deceased them.

This seems to be a mention of an error done on the part of the facility staff, not really anything funny.

When Rudy Guiliani was still mayor of NYC, on his orders, a midnight "evacuation" of the senior citizen residence buildings known as the Neponsit Home For Adults was conducted, as the place was "in imminent danger of collapse". I know several of the residents were concentration camp survivors, so I can only guess how they responded to that midnight knock on the door, and the uniformed persons telling them they had to leave immediately. Some of these people were early alzheimers patients, so health law was violated, as there is a specific 30 day "break in period" (my wording, not official) to get them ready for a move. At least 150 persons, all ambulatory, by the way, were relocated between midnight and the following sunrise, to other facilities and hospitals around the city. The buildings, in "imminent danger of collapse", now at least 10 years later, still stand, but are unoccupied, and are not sealed off!

As I see it, it doesn't matter the age or size of the EDP (Emotionally Disturbed Person) or the drug abuser. When the patient's adrenalin, or the "Recreational Pharmaceutical" starts kicking in, they can successfully hold off 4 or more football linebacker-sized cops, and sometimes not even feel 2 taser shots fired into them (witnessed while I was fleeing the scene). The third taser shot did the trick in bringing the EDP down, but not until after at least 1 cop got a broken nose..

On review, I just remembered a story from years ago, might relate to the animals. Seems an off duty coal miner, in a movie theater, suddenly jumped up, and while running for the doors, yelled for everybody to get out before the roof collapsed. 10 minutes later, the roof did collapse. The miner was initially charged with causing the collapse, but other miners advised that he had probably heard groaning sounds from the roof similar to the mine's roof, just before it had collapsed. So...How is the house structure?

I keep mentioning that the building that my defunct Peninsula Volunteer Ambulance Corps was in for 10 of our years of existence, had been a funeral parlor, but I don't recall any ghosts there, despite many hours in quarters on standby, alone. As for your son and his guitars, Happiness, did the instruments keep their tune when he didn't have them in your building? Perhaps your ghost(s) or polterghist(s) appreciate not your son's choice in music played on that guitar?

A mention: A "Shot" type call in the street that I was on, a traumatic arrest secondary to several handgun bullets entering the head and torso, bleeding heavily from the mouth, with my BLS on scene, and ALS moments out. Bubbles in the blood, and my partner started CPR, as I radioed the ALS to enter the scene from a different direction due to my ambulance and the NYPD blocking the other, before joining in the CPR. ALS arrives on scene, and one of the medics is demanding to know why CPR was started. My partner, even though he realized it was a hopeless case, told him it was because the patient was still breathing, if agonal. General question: In your jurisdiction, if there is even agonal breathing, does not YOUR ops guide state BLS is to start CPR?

Thank you, DustDevil and AnthonyM83, for your responses to my question. Dust, my mom, reading over my shoulder, considers you to be political. Really? Anthony, I am unsure of this information, but I think the Dublin type response you described was also done, either in the late 1960s or early 1970s, just before I started in the field, with a unit out of St. Vincent's Hospital, Manhattan, NY, but they also transported. Mom was still reading over my shoulder and commented, on reading about Harbor General, but not reading to the end, and commented that it sounded like "Ramparts General", the On Line Medical Control for LACoFD's "Squad 51". Also, early on, wasn't that about the time Seattle, Washington's Medic One program got started?

I worked at least one cardiac arrest where, with consultation with the on line medical control doctor, the paramedics pronounced the patient as DOA. The last item to be disconnected from the man was the EKG. Wait one! The EKG now showed a shockable rhythm, which got him one. The Paramedics running the call re-contacted OLMC, and told the doctor, "Miracle workers here", and explained the pronounced patient was "back". We transported, and, an hour and a half later, when we brought in the next patient, the man was still beating with assisted breaths. Unknown if quality of life save, and I didn't get further information as to if the patient survived at all.

Dust, would you agree with my assessment that what the civilian Paramedic does nowadays, is originally based on procedures developed by in-the-battlefield Army Medics and Navy Corpsmen, from at least the First World War, to today? If I asked this of you before, I apologize for repeating myself.

Quick mention of a procedure now outlawed here in NY State: We no longer are allowed to use a rolled blanket "horseshoe" for stabilizing the head and neck of trauma patients.