Sad state of affairs

[JakeEMTP]

I read this article with disbelief. How is it possible that this could happen?

I realise it was New Years eve, but still. Good thing the first responding Engine co. showed up. :roll: Another to add to the list of places not to visit.

http://www.ems1.com/products/vehicles/articles/331538/

[paramedicmike]

Firefighters' union president Brian McBride said that Payne's death shows the tragic consequences of failing to fund the city's emergency medical system.

"We have to adequately budget for public safety," McBride said. "We've been fighting this battle for years. It's a public-safety emergency."

Interesting. I wonder where this argument was two years ago when the IAFF sued the City of Philadlephia to prevent the closing of some houses (which would have only resulted in a redistribution of both equipment and staffing...no loss of jobs at all) which would have allowed the City to fund up to 12 new medic units.

At the peak of the day, the City of Philadelphia has only 40 medic units available for the *entire* city (of more than 1.5 million people). One of those medic units is dedicated to the international airport. That leaves 39 for the whole city. Some of these medic units are only 12 hour units.

This does not count the BLS units (as referenced in this article) the City is trying to scrape together staffed with FFs who view it as punishment to be put on an ambulance. These guys do not want to be on the ambulance. They're unhappy that they're not on an engine. While certified to the EMT-B level, they don't provide any care because a) they're not happy, despite being "certified" they don't know what to do and c) they're too scared to know what to do so they just load and go (this won't be accurate to each and every person involved...but it is certainly the rule and not the exception).

Now, couple this with a City administration that just doesn't care (aside from the corruption). Add into it a city population that abuses the system worse than *any* place I've seen, and the IAFF which sues whenever the city makes even the most half hearted effort to improve things and you've got something that is so far gone that calling it broken is to grossly understate how bad things are.

As Jake mentioned, Philadelphia is NOT a place where you want to be if you need an ambulance. It is a filthy, dirty, run down dump of a $hithole. I would argue it's a place you don't want to be period!

To be fair, there are good, dedicated providers who work for Philly Fire. One of my best friends, and my old partner, is a Philly medic. He's one of the best medics with whom I've ever worked. He told me recently he's just tired of beating his head against the wall. While the system may be broken...not all of the providers are. I just want to make that clear.

Oh..and last thing...while this isn't an excuse at all, the patient in question was 600+ pounds. It's still unclear if a more timely response would have prevented her death. What we know for sure though, is that such a broken and delayed response certainly did absolutely nothing to try and save her.

-be safe

[JakeEMTP]

Thanks for the insight Mike.

I'm sure most Philly medics are more than capable and no slam was intended to the providers. That was not why I posted the article. More to show a system flawed. I am trying to understand why a system was allowed to progress to such a state of disrepair and your info is appreciated.

Perhaps, if EMS was separate from the FD the situation could improve. Maybe I'm a optimist. I know IAFF would never let it happen.

[Cookie]

They shut the freaking engine off! :evil: If it will ever pick a time not to start is when you need it most. We always leave our engine running.

Remind me never to visit Philley.

[JPINFV]

A few points.

1. Umm, does Philly not have mutual aid? I'm sure that there are private ambulance companies in/around Philly and a ride to the hospital with most IFT crews is better than waiting on scene for an hour with the fire department.

2. At what time should the fire department just say "fuck it" and transport themselves. "Not supposed to" and "can't" are two different words. My car isn't supposed to go past 65 on the freeway, that doesn't, thankfully, mean it can't. I imagine that the liability is a bit less transporting a SOB in a fire truck than waiting on scene for over an hour for an ambulance.

[CBEMT]

A few points.

2. At what time should the fire department just say "fuck it" and transport themselves.

With a six-hundred pound SOB patient? Never, I would think. Even if she codes when the ambulance shows up, I'd rather run the code in an ambulance than the jump seat of an engine.

[JPINFV]

Well, I imagine that it doesn't take an hour to get to a hospital in Philly.

[paramedicmike]

1. Umm, does Philly not have mutual aid? I'm sure that there are private ambulance companies in/around Philly and a ride to the hospital with most IFT crews is better than waiting on scene for an hour with the fire department.

No. Philadelphia does not use mutual aid. What's more, while you have little else to go on, you're just going to have to trust me when I tell you that the IFT organizations in the City are worse that the FD's EMS.

2. At what time should the fire department just say "fuck it" and transport themselves. "Not supposed to" and "can't" are two different words. My car isn't supposed to go past 65 on the freeway, that doesn't, thankfully, mean it can't. I imagine that the liability is a bit less transporting a SOB in a fire truck than waiting on scene for over an hour for an ambulance.

An even different set of words is, "Not my job". You'll hear that utterance more often than "not supposed to" and "can't".

Attitudes not withstanding, the question here is, "Would this woman have fit into an engine for a mad dash to the ER?" I don't know the answer. I know she was a big lady. I don't know if the engine crew thought about this. I don't know if they could have even put her in there. That may come out with time. I think we can all agree, however, that in most cases this would be the most common sense way to handle this situation. But facts unknown to all but those on scene may have prevented this solution from taking place.

-be safe

[strippel]

Mike's got it right.

Although he is closer to the city than I am, I have heard and seen what he says.

One of our "newer" medics left PFD, and moved up here to the country. He has told stories. Also, we have had medics go down there to work for experience. They returned fast.

It is sad. Such a beautiful city, with so much to offer.

[Richard B the EMT]

We always refer to "would have, should have, could have."

This is a tragedy, but not necessarily an avoidable one.

I had an ambulance stall out on me. Got back downstairs to the ambulance, which I had left running with a "Key-less run-on system" activated, and found the locked up ambulance sitting "dead," beacon lights still turning, but really slowly. Not enough juice to restart, but luckily, we had the supervisor in the area with jumper cables. The patient was a non life threatening injury case, who was unable to walk. Our delay on the scene was only 5 minutes.

Had this been, per CUPS status, anything above "potentially unstable", yes, this call would have been a problem.

I also remember on the old show, "Emergency!" only 2 times they transported without an ambulance. One time on top of "Squad 51" with a woman in labor, as a wildfire bore down on them, and the other, a CPR call where the ambulance got into a "T-bone" accident, and they transported on top of "Engine 51" in the hose bed, instead of waiting 15 minutes for a backup ambulance. However, that was the fiction of TV, not reality.