Richard B the EMT

Most people, I thought, know the only way to defeat a "child-proof" container, is to have a child open the container!

Back to Hortons? I have no clue, actually. FYI, Type ones are pickup truck style fronts with modular box backs, type twos are high top vans, and type threes are van style front with "cutaway" to a modular box.

One idiot I had the displeasure to be in discussion with, tried to tell me that ambulances didn't need either sirens or lights! His theory was, ambulances were a "demand" service, you called and requested a unit respond! OK, this was back in 1973, but really!!? By that line of thought, there are NO emergency services! MY sarcastic take on that is, if my house is burning, I DEMAND a fire engine respond to put the wet stuff on the red stuff, and assist my family and myself in exiting the building if we cannot do it on our own! If I am being robbed at gunpoint, I DEMAND that a LEO respond immediately, to stop the thief, recover my money and/or "stuff", and take the miscreant to an incarceration center! By that line of reasoning, the only "emergency services" will be the 24 hour on-call plumber: after all, he has "Emergency Service" painted on the truck hood, doesn't he?

Perhaps that is a local set of initials, but, what is/are the "JP"? By the way, for anyone I may have confused, I use "Coroner's Office" and "Medical Examiner's Office" interchangeably.

Old story being retold. Loved that story for the over 20 years I have heard it. I thank you for reminding me of it. (Mom was reading over my shoulder, and she remembers it, too!)

Not if you want to remain a friend!

When EMS in NYC was still part of the New York City Health and Hospitals Corporation, we were lobbying to become an independent "Mayoral Emergency" agency, like the NYPD and the FDNY. This would have meant we would have had our own commissioner who would report to the Mayor, instead of reporting to a third VP of NYC-HHC, who might refer our vital information to the mayor. We wanted "Third Service" status. When we were "merged" into the FDNY, the EMS Chief of Operations then started reporting to the FDNY Deputy Chief of Operations, and through channels to the Fire Commissioner. At least it is one less step to the Mayor. After many years of legal infighting through the NY State Court of Appeals, The EMTs and Paramedics union, and the Supervisor's union, got what is called "Uniform" status. This means we are now allowed, when in contract negotiations, to negotiate alongside the UFA, UFOA, and the PBA, and to be separated from other locals in the District Council, who might be either "paper-pushers" or floor cleaners (no insult intended to either of these needed professions), within DC 37, of the American Federation of State County and Municipal Employees (AFSCME). FYI, the city considers the Sanitation Department as the Third Mayoral Emergency Agency. Could this be because they plow the streets clear during and after snowfalls?

If FDNY EMS responds to an obvious death, say, with rigor and dependant lividity, cold to touch and negative respiration and pulse, we have the authority to pronounce "Assumption of Death," and the Medical Examiner's office usually uses our time of pronouncement for legal records. If not already on the scene, we request the NYPD respond to "protect" the deceased, leave a copy (multi page ambulance call report) with them, provide some emotional support, to best of ability, to the bereaved family, and go available for our next assignment. Official wording is, "DOA, left with PD, not removed. We used to have a policy, if the patient was not in public view, we would leave the deceased as just described. If the patient was in public view, we would either make attempt to treat, while removing to the nearest appropriate ED, or, with PD authorization, remove to the morgue. Now, all DOA removals are done by the Office of the Chief Medical Examiner, or, if the patient's doctor states willingness to sign a death certificate, the body will be released to a funeral home. There are specifics I am not fully aware of regarding this.

Did this supervisor think he was Murdoch, from Mother, Jugs and Speed?

While I don't recall what ambulance manufacture the FDNY is moving to, we are almost completely type one modulars on diesel fueled Ford F350 chassis/drivetrains. I think we have 5 type 3 modulars on diesel fueled Ford E350 chassis/drivetrains, but they are "special purpose" usage. Suffice to say, when these type 3s are trotted out, the Secret Service is praying they won't be needed.

JPINFV asks: Crazy system I work for, the answer, unfortunately, is YES. There might need to be LEO involvement, so an EMS supervisor might have to be requested, too.

The CFR Engine, BLS and ALS ambulance crews follow a simple credo: If someone starts CPR, CPR will be continued until physically unable to continue, higher medical authority (Medical control) tells you to stop, or Spontaneous Return Of Pulse/Circulation. Why the staff starts? No clue.

Speaking of the red light cameras, there's one 2 blocks from me. I wouldn't say the strobe light is bright, but the ISS (International Space Station) crew reportedly saw the flash.

On the "big city" side, perhaps there is some truth here: Call comes in as a cardiac arrest, the CFR engine, BLS ambulance, and ALS ambulance respond. On arrival, find the patient's room is at the far end of the corridor. Staff member flags us from the door and enters the room. Crews arrive in room to find staff members doing CPR, not sweated up, looking neat. As crews take over CPR, states that the patient was talking with them "5 minutes ago". Crews not looking neat less than 2 minutes into CPR, on a patient that has rigor mortis and dependant lividity. Crews now extremely sweated out. CPR and meds continues for 10 minutes as senior Paramedic calls Medical Control for authorization to discontinue CPR, approved. Leave body with PD. 1) Is the person flagging the crew from the room door the lookout to tell the staff members already in the room to "start CPR, the crews are here"? 2) If the patient was talking 5 minutes ago, was it a 2 person conversation, or the staffer talking and not getting an answer? 2A) Never ask staff if the patient was talking back to them. If you ask, you know the chief nurse will be calling in a complaint before you get the ambulances out of the facility driveway. 3) Just as the crews are leaving, someone will always find the DNR paperwork. I'll say every service has some facility in their area where some, if not all of this, goes on.

What I remember about opticon is, it is a strobe light flashing at about 10 flashes per second, or something like that. Red light cameras flash twice, at roughly 1 second intervals. With that in mind, a red light camera shouldn't have any effect on the Opticon system. (Emphasis, SHOULDN'T, but what do I know to specifics on this one?)

Not for nothing, but the only place I've heard of a "WaWa" is here on EMT City. Try, at 5 minutes to tour change, and watching your relief crew pull their POVs into the parking lot, get a call at the most distant end of the service district, for an "Unknown" patient condition. On arrival, a long wait to get the elevator to the 25th floor, and when you get let into the apartment, it turns out to be someone elderly fell down, and the likewise elderly spouse just wants us to put the person back into the bed. Other than being on the floor not being able to get up, the person has no medical or trauma complaints. Due to the "patient's" age, policy is to clear authorization for RMA (Refused Medical Attention) with Medical Control, which at that hour is still going to take 20 minutes to complete. It will take the same 20 minutes, following packaging the person down on the floor, to remove to the ED. Patient and spouse insist that "The cops just help him back into bed, no muss, no fuss." Judgement call, and I have had partners gone both of these ways on different times: 1) Run the call through Medical Control, risking having to get the cops and supervisor to the scene if MedCom says the patient has to go, but the patient doesn't want to go, 2) Put the patient into bed, and tell Dispatch the condition is "corrected, no EMS needed".

All one has to do, is oPUN their minds!

When fishing, do you know how to communicate with a fish? Drop him a line. I said that on porpose. ...and for the halibut. I usually don't flounder. Come on, don't you know that fish are actually very smart? They always travel in schools. If you need to borrow money, go to a fish. They are usually good for a fin. Don't you know the difference between a radio and a fish? You can tune a radio, and you can tuna fish. Oops, I think I'm gonna get canned here!

If I could find the original "Reilly's Rules Of EMS", I'd give the exact number of this response: "When offered the choice of arrest or hospitalization via your ambulance, the drunk will be in the ambulance before you are. Corollary one: If the drunk chooses arrest, he's rode with your driver on a prior occasion!"

Depending on geographic area, due to obstructions, both stationary and other vehicles, an EV driver might not be able to see cross traffic until too late to stop. As per my mantras, below, balance the need for the speed with a ride that's a glide!

As I understand it, dashcams, other than on a LEO department vehicle, cannot be even viewed until duly authorized personnel can take the recording medium out of the vehicle. I have seen dashcams from an assortment of EVs, mostly either sales demos, or in EVOC classes, and have to admit that the videos can either hang or exonerate the EV driver, and always give EVOC students something to think about during training.

A boycot? Not a girlcot, you sexist??!? LOL

I have seen the Paramedics put stuff down the tube in cardiac arrest situations, but am unsure if it is either protocol or even effective with albuterol. Back later with an answer after talking to some Paramedics. (See mantra below re protocols!)

The number of responses a crew does on a given tour of duty, be it 8, 12, or 24, can be dependant on area activities (street county or town fairs), weather (snow or ice, heat) , traffic, holiday, time of the 24 hour day, geologic upheavals (think California style earthquake, or a simple <?> landslide), some of the above, all of the above, or none of the above. I have done, including calls not needing patient transport (numerous reasons), up to 9 calls on a given 8 hour tour of duty, and on the same day a year later, done no calls at all. There can be excessive reason for a large call volume, and have it happen for no observable rhyme or reason. I also feel that those working a 24 hour tour of duty can have similar experiences. Let us not forget I am usually no more than 15 minutes ground travel from an "appropriate ED", so I can usually make a fast turnaround and be available for a next assignment. Someone else on the string can be at least an hour and a half by Medevac flight, and some really urban crews can be even longer than that, due to circumstances I couldn't guess at, due to being with my head set to "urban/suburban" responses. I'd probably be lost in areas where either domestic or wild animals outnumber people by 10 to my one, where others would feel right at home there, and be uncomfortable surrounded by skyscrapers, whereas I am not. It's just what one is used to.

New FYI, from the least populated borough/county of NYC: Staten Island, AKA Richmond County. Seems instead of giving opticon or similar equipment to any of the emergency services, the buses running on Victory Blvd. will get this stuff! Link: http://www.newsday.com/news/local/newyork/...815,print.story Story as from Newsday Newspaper web site: Newsday.com Buses will get power to turn traffic lights green THE ASSOCIATED PRESS August 29, 2007 A pilot program starting next month will give buses the power to change red lights to green. The technology, to be used on Staten Island, will link emitters on 300 buses to receivers atop 14 traffic lights along 2.3 miles of Victory Boulevard. It's designed to speed up service. The devices will turn lights from red to green 7 seconds earlier if a bus is within about 120 feet of an intersection, city Department of Transportation spokesman Craig Chin said yesterday. The program will begin at the end of September, Chin said. The technology will be incorporated into the city's planned Bus Rapid Transit project, a speeded-up bus service that will be introduced over the next two years in each borough. Copyright © 2007, Newsday Inc. Richard B, again. I still want one for my private vehicle, as per a long closed out string.