Richard B the EMT

Any "Standby" call, where during a seeming lull in the activity, where you have your back to the incident, and suddenly everyone looking past you at the incident suddenly make the assortment of comments, of "WTF?", "Oh Sh*t!', Oh, NOOOO!", and/or "OMG!", inclusive of your EMS, FD, and LEO Chiefs on the scene. If they turn and start running away from the incident, keep up with them (!), and turn to find out what happened after they stop running. This is especially true if the runners include the Bomb Squad/Ordnance Disposal team members! PS: In the event of a nuclear explosion, the current laws against prayer in public schools in the United States will be temporarily declared to be null and void.

Perhaps I should mention, in Spaceballs, the group of good guys was in a shootout with a group of the bad guys, with a seemingly disinterested princess hiding behind the heros. They shot her hair, cutting off a small lock, which so incensed the princess, she picked up two blasters, and shot dead at least 10 of the baddies, with one shot each, but in quick order. Also, you DO know that "Spaceballs" was a Mel Brooks spoof of the original "Star Wars", don't you? Complete to the "Princess Leah" hairdo being a disguised headphone set?

1) Looking to join up with woman with small boat and boating trailer. Send picture of boat and trailer. 2) The woman who had been the Business VP of my vollie ambulance refused to pump her own fuel, either her own vehicle, or the ambulance. She actually declined my offer of instruction! Yes, there are men who don't know how to pump their own fuel, and woman vehicle engine mechanics, and I know a few in both categories.

As I understand it, the tank, no matter who the manufacturer, or steel, aluminum, composite, or some new one I haven't yet heard of, shouldn't be a problem. Regulators, however, go with the manufacturer's recommendation. As for the "O" rings, recently, the FDNY removed the plastic ones from service, in favor of a semi-metallic one. Seems when the plastic ones were reused, they would be cut by the tightening of the T-post, would lose pressure as a not so slow leak, or rupture entirely, causing the tank to spin from the pressure release. On a personal note, I carry a tank in my POV, and the temperature over a year ranges from the rare minus 5 during a winter's overnight (wind chill doesn't affect this), to 105 on a midsummer's day, has not affected the tank or my regulator. (Note to self: You still have a plastic "O" ring on that tank in your POV, change it out!) Finally, if you must put the tank on the patient carrying device, with the patient, put some kind of insulation between the patient and the tank, as that tank can be really cold next to the skin!

Perhaps she's related to the 9 year old who set his genitals on fire with the lighter fluid?

Kind of sounded like Yiddish, till the last segment. Youse gots me good!

Like the Princess in "Spaceballs" when they shot her hair?

Someone mentioned, except for the "Bang Brothers" vehicle shown, that it looks like an American small town, that it could be a small city stateside? Do not the Bang Brothers leave the military reserves occasionally, driving down the local town streets? This is not, of course, referring to the nut case who actually stole a tank, and drove a path of crushing destruction around California some years ago, until the thief got stuck on a raised highway medium, and the LEOs shot and killed him. Leno made a joke about it, showing a Tank model antitheft "Club".

I mention that I have, and will again, stop at street scenes. I probably did not state, but thought I implied, stop in as safe a manner as possible. I mentioned that my ol' Olds was hit in the rear twice, despite having all those emergency lights activated, what I called my "E" lights. Remember, nothing is a sure bet. A little more than 10 years ago, a driver decided to ignore a lane closure on a local main roadway, full of Fire units, Police cars, and an ambulance attending to a 2 car accident, and ran into the crew and patient being loaded. The patient was backboarded, so obviously he couldn't jump clear, and the 2 EMTs were actually loading him into the ambulance. The EMTs were pinned between the speeding car's bumper, and the step-bumper of the type one ambulance. I never knew the final status of the patient, but one of the EMTs has, now, limited usage of her legs, and the other one died at the Trauma Center on the surgical table. That EMT, Christopher Prescott, was the first EMT of the New York City EMS to die in the line of duty. In this and other incidences, even when on duty, things can and do happen. Just make sure that you use all possible precautions when on a scene, on or off duty.

I replaced that brown 1984 Olds wagon with a red 1989 Toyota Corolla AllTrak wagon in 1989. That was replaced in turn by a loden green 1998 Chevy Venture minivan, which is still in use. For continuation on that, try and find an old string on "What Do You Drive?"

Oops, forgot two specific calls: I saw a car stopped on the Long Island Expressway, with the hood up, and lit up all the "E" lights on my stationwagon as I pulled in behind him. Somebody swerved around me, but the person behind him hydroplaned and slammed into my car with such force, it hit the stalled out car, causing the stalled out driver to be injured. No other injuries, by the way. $4700.00 worth of damage repair to me, which, surprisingly, the insurance paid, instead of declaring my car a total loss. Same vehicle, a year later. My Vollie Ambulance is parked parallel to the curb in front of quarters, and won't start. I pull alongside, in a traffic lane, on a local business street. 4 way flashers on, "E' lights on, cables hooked to the ambulance from my battery, and some damn fool peels out of the public parking lot about 50 feet to the south, and slams into my rear. One injury...ME. I don't remember how much the insurance company paid out for my vehicle repair this time. The fool driving the car that hit me jumped out and started screaming at me as to how I cut him off (in a parked vehicle?) until he realised he was surrounded by Vollie Ambulance people in uniform, firefighters from Engine 268 and Ladder 137 of the FDNY, and 2 beat cops from the NYPD, all of which advised that idiot they had seen him hit my parked vehicle, with me in it, and a junior member almost hit by my car, driven forward by the impact. The only thing going good for that guy was his insurance policy, while still in effect, was due to expire the next day, and he hadn't renewed! My Vollies immobilized me, and transport to the hospital was done by a municipal ambulance.

A quick comment on the male bovine excrement stuff: I once worked overtime as part of the medical coverage at the New York City Marathon. I was there for 7 hours, and handled...ABSOLUTELY NO PATIENTS WHATSOEVER! But... On my way home, I actually saw a car turn turtle (flip over onto it's roof), only a hundred feet ahead of me. I treated onscene until the locals arrived, they treated, packaged, and transported, thanking me for stopping.

Another point I think I should mention: I had always been taught that when the EMS crew arrives onscene, technically, the emergency is over. Ask yourself if the patient is stable or not, following your initial evaluation and treatment. I'd suggest the CUPS protocols, that of Cardiac, Unconcious, Potentially unstable, and Stable If you and your partner(s) feel that the patient is stable, turn off the beacons, strobes and other assorted flashers, and proceed at normal traffic speed, stopping appropriately at red traffic signals, to the hospital. If the patient meets yours or local protocols for anything other than stable, run under emergency lights and siren status as per your agency, county or state vehicle protocols and/or laws.

As I write this, it is the first anniversary of 2 Jersey City, New Jersey, police officers accidently driving off a bridge into the river. Ironically, they had been posting flares because the bridge warning lights were not functioning, and while doing so, the bridge was opened for a boat, and nobody told the cops. They found the second body almost a week later. Can anyone find an article I seem to remember, that strobe lights, no matter what the color, seemed to almost draw vehicles driven by impaired drivers into the rears of the vehicles displaying those strobe lights?

I carry my department issued "Jump Kit" with me, off duty, for when I stop at street scenes to render aid. I also have set up a personally owned kit with the same stuff as required by the job for the issued kit, so I am actually carrying 2 kits. I also have licence plates that identify me as an EMT. I am willing to stop at something streetside to render help till the on duty crews arrive. I have a scanner radio and I monitor sometimes. I will not go to a scene where the call is inside a residential location, then I have no way of saying I "saw something happening and decided to help". Can we all agree to disagree that some of us will stop at something in the streets that we see from our POVs, others will not stop? On a side note, if something happens in front of you, and you do decide to stop and help, make sure that SOMEBODY has called the emergency number for the area? I have heard urban legend horror stories for years, where someone stopped to render help, but all the bystanders thought that the individual was responding to someone else's call to 911. I call it "Elevator Syndrome". Everyone stands in front of the elevator doors, complaining how slow the elevator is, but everyone thinks somebody else pushed the call button, and the elevator never comes.

This seems to be de-evolving into an old discussion somewhere else on the EMT City forums, that of "Legal" and "Moral" "Duty To Act." I'm going to go by memory, and infer Local Protocols Rule philosophies here...again. I'm an EMT of 33 years experience, under New York State's DoH rules. I will paraphrase, as I don't want to look up specific numbered quotes at this time. An EMT or Paramedic who is on duty, in uniform, and/or being paid for their services has a legal duty to act, to the best of their abilities, to the level of their training, acting as their protection under New York State Public Health Law Article 30. An EMT or Paramedic who is off duty, in or out of uniform, and acts to the best of their abilities, to the level of their training, without expectation of receiving monetary or other compensation (that free drink someone mentioned disqualifies the individual in this instance), is covered under "Good Sam" rules. We all know, here in New York State, even with the protection of either Article 30, or under the Good Sam laws (Is there actually a law? I'm not sure on the specific), in the overly litigatious United States "society", where anyone can sue anyone else, for almost anything, at any time, you can be sued. I always refer to the urban legend of the patient who got brought back from a Cardiac Arrest, who sued the Paramedics and their service for ripping his $300.00 imported Italian silk shirt while applying the electrodes from the Defibrillator. Can someone check for me, as to if a medical person who is NOT NAEMT responds aboard an aircraft where they are a passenger, if they are operating under the rules of the state from where the aircraft departed, or the state of the destination, or whatever state the aircraft is flying over? I admit confusion on that specific.

Much as I am a proponent of the Louisville Slugger tranquilizer, never use these on a vehicle operator until the vehicle is at a complete halt, and is in Neutral, with the parking brake set.

Chicagoambo: The department was supposed to open a new "combined" house, but due to UFA and UFOA (firefighters and fire officers unions, respectively) opposition, didn't initially happen. Instead, they built a second building in a different county (first one supposed to be in Staten Island, second, my "home house" in Queens). The original first house has now opened, but took a year to become combined. The second house that became first, captains and chiefs prior to the combining, approached all affected personnel (the firefighter's house building was settling and as of this writing is for sale, the EMS building was being held up by the termites holding hands) if they had a gripe, they could, without any prejudice, request transfers. Some did. Now, EMS Station 47 (BLS units 47Adam, Boy, Charlie, and 64Adam, ALS unit 47Willie, and "Haz-Tec" ALS unit 47Zebra), Fire Battalion 47, Engine 266, and Ladder 121 are all under the one roof. We seem to be getting along.

Some systems, like the FDNY, have separate categories, as "Firefighting" and "EMS". EMS is mission specific, and Fire Fighting has a small Certified First Responder-Defibrillator aspect. Nobody is crosstrained, at least officially, within the FDNY. I am an EMT in the FDNY. I have never been trained in using an SCBA, using a "2-and-a-half-line", or setting up a ladder, nor do I expect to get such training. Unless the firefighters keep a real tight escort on me, I don't expect to even enter a burning building, and my "bunker gear" is strictly Blood-Borne Pathogen resistant, stating on it that it's not for structure firefighting.

As with always, following your local protocols, I am aware of a "Code" as being, in my geographic area, meaning a Cardiac Arrest. For announcing it over the public address system at the hospitals, it varies from "Code Blue", to "CAC (Cardiac Arrest Call)", to "Code 99", "Code 66", to simply saying "Code". I also note that for a fire situation in the hospital, at least locally, they seem to use "Code Red". In the days when the New York City Health and Hospitals Corporation ran EMS (prior to the "merger" of EMS into the FDNY on March 17, 1996), when the Bellevue Hospital-based Mobile Emergency Room Vehicle, commonly known as MERV-1, was activated, they'd page "Dr, Day, Dr. May Day" to notify the predesignated Doctors and Nurses to get to the ER Ambulance dock to board the MERV. As for on the ambulances themselves, it can and will vary by service. I always operated under the assumption that "Code 1" was "No lights and sirens", as for an Emotionally Disturbed Person call (let's argue if that should be an EMS or PD call in another forum, huh, folks?), "Code 2" for "lights on and siren as conditions warrant it's use". "Code 3" is always a "Lights and siren engaged at all times while enroute" deal. Code 3 is also an EMS related products dealer, that I know about, but have never used. Some Ambulances have colored lights to silently communicate from the patient compartment to the cab. I operated with Green to "Go", Yellow for "easy ride due to patient's condition", and Red for "stop." Many runs were under combined green and yellow. However, we had one driver didn't get the plan explained to him, we wanted to stop, and he went at higher speed to the hospital. His explanation was that he thought the Red meant something like the so-called "Diesel IV" due to the patient's condition we should get to the hospital as quickly as possible. At least he was quickly retrained in what the little lights meant! (Sidenote- The MERVs are now being replaced by newer vehicles called MIRVs, for Major Incident Response Vehicles, which can carry 5 or 6 patients at the same time, as opposed to the 2 streacher carry capability of the usual ambulances)

Yipes! That sucks, big time!

4 questions: 1) Dustdevil: Is this not a string on handling bariatric patients? (Yes, I saw the smiley face) 2) JPINFP: A 24 hour car? Is this simply a full time unit, not one runs, say, day and evening tours, but not overnight, or something similar? 3) Strippel: Is an ECF an "Extended Care Facility"? 4) Everyone who writes additions to the strings: Could you please remember that the initials you use commonly to state a condition, situation or location might not be used outside your jurisdiction? Remember that to some, "WNL" might not mean "within normal limits" re a blood pressure, to them it means "we never looked"!

Recently, the New York City Council was asking about specialty ambulances for the bariatric patients, basically, a larger ambulance with bariatric streacher, ramp, and possibly an onboard winch to assist in loading/unloading. They felt that there should be at least 2 in each borough (New York City consists of 5 boroughs or counties, for our 8 million residents and 2 million daily transients). A high level FDNY EMS person stated that there's no need, if we had a large patient, we'd transport in a fire Rescue vehicle. We have one rescue in each borough. When attempting to move bariatric patients, primarily from skilled care or nursing homes, what I've seen is, we use the crews of 2 ambulances (4 persons), and an Engine crew (5 persons including the apparatus officer) with an EMS supervisor (one, usually). One ambulance puts it's streacher into the second, everyone grabs as best they can on the patient's mattress, and move the patient on the mattress to the floor of the transporting ambulance, then with a "notification" to the receiving ED to have a bariatric bed standing by, we transfer the patient, mattress and all, to the bariatric bed in the ambulance loading dock at the ED. Transport by Rescue? The units used by the FDNY have an isle down the middle of the back that is only a little bit wider than most conventional "lift-in" or "roll-in" streachers, and the doors are nowhere near as wide as our type one ambulances, big as those vehicles usually are; we'd be all over each other trying to get the patient/mattress "package" into or out of the truck, and the mattress wouldn't be able to fit the isle. I am aware that several non 9-1-1 ambulance services in New York City have the specialized equipment for bariatric patients, but, as I just said, they are not a part of NYC 9-1-1. Aside from the obvious of the patient having to wait for either a bariatric ambulance, or an FDNY Rescue, I'm sure that you can come up with other disadvantages. Now the questions: How do you handle the morbidly obese patients in your area's jurisdiction, and under your local protocols? What would you do differently if you felt you could or should change the rules/vehicles currently in use?

I'm glad you sent a link along, as I've heard of these things for years, but never seen one. Now that I have, I can say that I wouldn't want to work in one. As for the patient, I can only wonder what they'd feel like riding at 90 degrees to direction of travel, especially when the vehicle hits potholes, or has to do a sudden slowdown due to traffic, pedestrians, or animals.

I just read this to my mom, and she is almost ROFL.