Richard B the EMT

I just spoke to one of the paramedics working as a "telemitrist" (in-house title) at FDNY EMS Telemetry Control, which is our On-Line Medical Control office. In the scenario of carrying a patient, but coming up on a vehicle accident, as per both FDNY and New York State DoH rules, regulations, and protocols (specific passages not noted), an FDNY EMS ambulance WOULD be obligated to stop and investigate, as well as advising the Emergency Medical Dispatch office by radio that they were doing so, and request another ambulance be started out for the MVA (MVC in some areas). 1/2 the crew could initiate care on the scene, the other could continue care of the original patient, while awaiting the second ambulance. Admittedly, I didn't mention the other stuff from the string, that of the person in the car waving a gun around at the crew, or the shootout that followed, to the telemitrist.

Due to an injury, I am now on light duty at FDNY HQ, 9 MetroTech Center, in Brooklyn. When I was field-side, I most recently (7 years) covered Far Rockaway in Queens County, and from 1973 to 1996, covered the entire Rockaways Peninsula, from Beach 2 to Beach 169 Street, Jamaica Bay to the Atlantic Ocean, with the unfortunately defunct Peninsula Volunteer Ambulance Corps. Area hospitals are Peninsula Hospital Center (H37), Saint Johns Episcopal Hospital (H40, AKA Saint Johns of "the Rock" to differentiate with Saint Johns of "the Boulevard", which is central Queens county), Trauma Centers at Jamaica Hospital (H34), Mary "inaccurate," oops, Mary Immaculate, and Brookdale Hospitals. Burn Centers are either New York/Cornell, in Manhattan, or, surprisingly, Nassau University Medical Center (still referred to as Nassau County Medical Center, or (pronounced) NicMic, for the initials of NCMC), which is also a Trauma Center, in Uniondale, Nassau County. For the uninformed, FDNY EMS serves Manhattan, Bronx, Brooklyn (Kings), Queens, and Staten Island (Richmond) Counties, also referred to as "Boroughs".

Marital, spousal, and even the dating scene, as affected by one of the couple being in an ambulance service. for example, link to http://www.emtcity.com/phpBB2/viewtopic.ph...t=marital#54811 Or, an entire listing of EMS stressors, at http://www.emtcity.com/phpBB2/viewforum.ph...=0&start=50

Just an observation: Every time I see a brand new service (non 9-1-1 provider) on the streets of my area, they always seem to be travelling at full emergency status, meaning L&S, and at breakneck speeds. Also, they seem to have teams (2 person crews) of fresh out of the box EMTs. At the various EDs, I ask what type of call they were on. Most times, due to my experiences, they meet no rapid transit criteria I am aware of, but the seemingly universal answer given is, "We are being paid to get to them fast, and get them to the ED fast." I also note, with almost predictable regularity, within 6 months to a year, some team and vehicle of the new-jack service will be involved in a major ambulance-involved collision, or worse, a pedestrian struck incident, usually with a death. Also, due to press coverage, all ambulance services get a lot of grief at the hands of the press, and thru them, the public. "You work an ambulance? You're a potential vehicular homicide waiting to happen. I don't care that you work for their competitor, you're all the same!" There's at least 3 new services working in my neighborhood, and I am hoping I will not see my prediction happen yet again.

Whatever poisonous reptiles we have on display at the Bronx Zoological Park. Due to location, closest ED is Bronx Municipal Hospital/Jacobi Medical Center, which is also the snakebite center. One never knows what an individual might have in their home, brought in illegally from somewhere else. Remember, a few years ago, we had some guy in the Harlem section of Manhattan, had both a Lion and an alligator in his apartment, and the city only found out after the lion took a bite out of the guy! So, who is to say what types of exotic snakes are here? Certainly, not this reporter, your humble (?) servant.

Check the search function, we had a long posting on this, months ago, possibly a few years.

need two postings to describe it!

Is that an ambulance, a rescue company, a portable emergency room, or a Major Incident Response Vehicle? I've seen a few of that size out in Suffolk County, New York, but that's too big for the streets of NYC! It is so huge that I

At higher level of medical authority, doctors are not allowed to take care of their own family members. I have no knowledge how this affects those of us at BLS and ALS levels. If a crew member recognizes a family member's address as the pickup point, I would think the dispatch center should be notified of this, and dispatch a secondary unit, so the crew who's family member is injured or killed can be taken off service, and the member can attend to their own family. Within the FDNY EMS EMD center, it is possible to request "location histories" be programmed into the computer assisted dispatch (CAD) system, like notification of persons hostile to EMS thereat, or family member of member of service. This might give dispatch a heads up of possible MOS family at a location, complete to some medical history, if the MOS feels it needed. I have my own address so noted for household of MOS and family of MOS (my mother). I do realize this is not available within all systems, but most supervisors, on being advised that a MOS family member might be involved, will bend over backwards to get a second unit to this type situation, as well as responding themselves.

Both my local hospitals are now "stroke centers", and one is getting a cath lab within the next few months. Perhaps all hospitals will be going the direction of being both stroke and cath centers, while there will still be Trauma, Burn, and the one Snakebite, centers, due to the expected expenditures.

In years gone by, sometime between 1978 and 1980, working a non-911 provider ambulance service, I had a dialysis patient on board, enroute for scheduled dialysis treatment. I was with another EMT who was the "wheelman" on that ambulance. We were flagged down (OK, already a different situation from the one described) by an NYPD cop, who pointed out a patient collapsed in the middle of the street. My patient told me to see if I could do anything for the person down in the middle of 5th Avenue (again, a different action from the described one), and when I did, also having been told by the cop that EMS/911 was supposed to have been on the way, discovered the street job to be a cardiac arrest. I commenced CPR with a Bag Valve Mask (BVM). Roughly 5 minutes later, the "Muni" ambulance pulled up, and the crew took over patient care. My partner, who had stayed with our dialysis patient, resumed driving to the dialysis center. We had kept our dispatcher appraised of the situation, and arrived at the dialysis center roughly 10 minutes late. On arrival back at my base, the owner told me, while it was possibly, and probably, good publicity, he had no way to bill for services rendered on the street job, and mentioned that, under NYS DoH rules, on which I have still not seen documentation, due to me having a patient already on board, I could have told the cop that I had one already aboard and couldn't stop. Now, today, as I understand the FDNY EMS/NYS DoH rules and regulations, I could be going to a Priority One Cardiac Arrest, but if someone at the door to the building stops us, requesting medical aid, we are to either take care of the new patient while radioing for an additional unit to take care of the original Pri 1 patient, or split the team with one going up to start care on the original pri 1 patient until the arrival of the backup unit, again while radioing in for that backup unit. I will be calling up the FDNY EMS Academy tomorrow, Monday, and ask for a clear cut answer, at least under the FDNY EMS/NYS DoH rules, regulations, and protocols, and should have an answer posted within 48 hours of this posting.

I don't think I'll play this one, anymore. I got renamed "Not-So-Courageous Argus"!

Go to the "Sporty's Pilot Shop", to the link provided, for a different model kneeboard notepad. For someone like a pilot, who is usually in a seated position, it sounds good, but for someone who more likely will be standing, like us in EMS, perhaps not so good an idea, but then, my needs might not be the same as yours. http://www.sportys.com/acb/showdetl.cfm?&a...amp;DID=19#desc

While I have not transported either to or from a dialysis center in over 25 years, one thing was beaten into me by the staffs at the various centers: NOBODY but the patients are to sit in those chairs, due to understandable concerns of Blood Borne Pathogen contaminations, either from or to the dialysis patients. We usually were allowed, begrudgingly, to use a corner of the receptionist's desk. Maybe that is just the way things were done in the NYC area, the centers by you might be less stringent in this type enforcement, or times have changed in that aforementioned 25 years.

Ruffems, you stated you had an "almost repeat" episode, within a 3 month period? With that in mind, I'd like to expand the question to ask: Can one can be susceptible to second or more episodes of heat related diseases at, for a time frame within this question, over one year's time from the initial episode?

Hope you're feeling better. That is a lot worse than when the cleaning lady started asking me why I was putting window cleaner on my hair. She had been mistaking my hairspray for Windex (both blue liquids, you know), could have been worse, and the reverse. Still, there's the home care attendant (usually not medically trained in my area, more likely paid companions) thought the nitro paste was for use in body massages, she had a severe headache, and her charge, fully covered by the paste, was dead.

Remember, drive with due regard for all other motorists on the road. The only reason I could see for 90 MPH with L&S is prior knowledge that the Nuclear Emergency Search Team (NEST) found a device, and is NOT going to prevent Hiroshima happening again, too close to your back bumper! Otherwise, balance your need for the speed, with the ride that's a glide!

Speaking of dumb criminals, does anyone have any information, aside from a movie plot line in a Chuck Norris movie, if what I now describe really happened... A man walks into a bank, pulls a WW2 model Luger, announces a robbery, and suddenly is faced by 30 armed, with weapons drawn, persons, all from either the Police precinct, Trooper barracks, Sheriff's department office, or FBI field office, across the street from the bank. The LEOs were in the process of cashing their paychecks (checques in some countries), when the guy attempted the robbery.

Well, then, there will always be 1) those who try to follow the book, no matter what, 2) those who follow the book, but reach out if something seems "off" with any particular patient to their medical control, 3) those under directive to experiment within specified limits, and 4) under their protocols, carte blanque for experimentation, with suggested guidelines but no direct medical control, like areas where the trip to a hospital is measured in days, unless a medevac. Put me in the second category.

Licences? "Badges? We don' need no stinkin' badges!"

My interpretation of the thread was questioning "yes" or "no" to blindly following "cookie cutter" standing orders and/or protocols, allowing for national, state/provence, county, or departmental protocols and medical control interpretations, regarding oxygen flow rates for chest pain. I also thought the question was asked if less flow was possibly less hazardous to the patient, who might have additional problems that could be aggravated on the high flow. That, I believe, is what the questions of the string were. What were your interpretations of questions found within this string, if different from mine??

When you read the article, note the last line that "Lane could not immediately be located for comment." We do know his location: somewhere in LEO custody!

From the Queens Tribune, a free county newspaper from Queens County, New York City, New York, dated June 22, 2007: http://www.queenstribune.com/news/1182538754.html Ambulance Vol Packing Up His Gear FHVAC President Dave Solomon is headed for Oregon following retirement. -------------------------------------------------------------------------------- By JULIET WERNER Dave Solomon, 55, has spent the past 18 years moving up the ladder at the Forest Hills Volunteer Ambulance Corps. The active President, Solomon came to the Corps in 1989 as a Vietnam War veteran with experience in First Aid and CPR. He successfully completed the EMT course and now teaches a similar course to those residents of Forest Hills and Rego Park who would like to follow in his footsteps. “You have to have the stomach for it,” Solomon said, adding that he can normally tell right away if a student is cut out for the work, but will allow them three months to ease into the challenging tasks. He says his students are ready for the ambulance or “bus” when he can turn his back on a situation, confident that they will take the initiative to help the person in need. Solomon has this type of trust with Mike Rizzo, his partner of 15 years. Rizzo, or “Pops,” met Solomon in Queens through their work with the Boy and Cub Scouts. They attend career days at high schools together, delivering joint speeches and showing students around their shared ambulance. “It’s gotta have to be a marriage,” Rizzo said. “Each one of us has to learn to think like the other person thinks, without asking questions, knowing exactly where the equipment is, what you need on the scene. And that takes time.” But with Solomon, the partnership formed easily. “Couple months,” Rizzo said. “It was excessively short.” Rizzo is especially sentimental these days because his longtime partner will retire this month from the FHVAC. On the evening of June 27 the American Legion Post 1424 of Forest Hills will swear in new officers and make a presentation in Solomon’s honor. Solomon’s dedication to the FHVAC is unmatched, his bravery remarkable. He played a role in 13 separate “life saves,” meaning that he brought 13 people back from the dead. Solomon’s efforts were tireless. He worked night shifts, frequently going straight to his paid day-job following ten hours in the ambulance. This exhausting schedule will be drawing to a close this summer when Solomon retires from his Con Edison job of 36 years. “Time is moving slow now,” Solomon confessed. “I’ve got 49 days left, but who’s counting?” Once the 49 days are over, Solomon and his wife Linda will drive across the country with their pit bull and move into a new house in Albany, Ore. that they purchased sight unseen. Linda, a native Oregonian, met Solomon in New York and also works as an EMT at the FHVAC. Accustomed to living in Queens and working under tight time constraints Solomon is preparing to adjust to a new lifestyle. “It’s going to be laid back out there,” he said. “They do not have volunteers out there and I refuse to take money to help somebody.” Rizzo has no doubt that the West Coast will welcome his former partner with open arms. “I’m sure with all his knowledge and experience he’ll work himself into something,” Rizzo said, adding that he plans to continue on as an EMT for “as long as god keeps giving [him] the strength to do what [he’s] doing.” Although he’ll miss his partner, he knows he doesn’t have much say in the matter. At this point their separation is inevitable. “I’m not gonna go to Oregon,” Rizzo quipped.

Cruel! Funny, but Cruel.

I thought same conversation, but instead of a sheep, was a duck?