FDNY EMTs do not let Private Medics help with choking child

[JPINFV]

I can't think of a single ER in Orange County, CA that doesn't have some sort of "lock" on it. Of course the quality ranges from a simple button near a door that is unlocked half the time to an intercom with video cam that requires you to be buzzed in by staff. Most of the locks are key pads, but over half of those use one of 2 combinations that are fairly obvious if you've spend longer than 5 minutes in California EMS.

[tskstorm]

I have a question, why did the paramedic crew not open the door and get in? It makes no since to bang on the door unless it was locked. If the door was

locked then that would rise to another question, why was the door locked?

As stated before FDNY has auto-locking doors, and any crew who works the north bronx knows you lock everything, every time. Ambulances are broken into weekly if not more often with door locks, leaving them open is just asking for trouble ..

Well, here's a question. Were the medics responding with lights and sirens, and if so, did the ambulance crew miss it?

Standard practice on lights and sirens calls, is all lights on, sirens as necessary, approaching intersections or to make people move again as necessary. Its not policy, its not even good practice, but it is what is done regularly. Probability is, they pulled up with lights on, no siren. I work with a few paramedics from our lady of mercy regularly and I haven't asked what happened with this but I will next chance I get. See if they can shed some light on it.

EDITED for punctuation.

[JPINFV]

Standard practice on lights and sirens calls, is all lights on, sirens as necessary, approaching intersections or to make people move again as necessary. Its not policy, its not even good practice, but it is what is done regularly. Probability is, they pulled up with lights on, no siren. I work with a few paramedics from our lady of mercy regularly and I haven't asked what happened with this but I will next chance I get. See if they can shed some light on it.

EDITED for punctuation.

But that's the point. I want to say that it'll be extremely hard to miss a big diesel truck or van pulling up with a bunch of shiny lights on it. It would almost be like the paramedics had to sneak up in a blind spot to the back of the ambulance. Damn you, you sneaky stalking paramedics.

[tskstorm]

But that's the point. I want to say that it'll be extremely hard to miss a big diesel truck or van pulling up with a bunch of shiny lights on it. It would almost be like the paramedics had to sneak up in a blind spot to the back of the ambulance. Damn you, you sneaky stalking paramedics.

2 persons in back are doing cpr on a 4 year old, and the driver is trying to get the ambulance going calling in the notification, putting in the signals. who's looking behind the ambulance? This is all speculation, and wont get us far.

[Richard B the EMT]

1) As already mentioned, the doors on all FDNY EMS ambulances (except to the cab) remain locked at all times. Close the door, it is locked, against theft of contents, against all except those authorized to be aboard, regulated by the crew with the keys. That way, one can keep out interfering family members and bystanders.

Another reason is, if the patient is an "evil-doer", or was perceived as one, who is now a patient because the bystanders issued "street justice", and want to issue a reinforcement lesson, they cannot get in. I have been in that situation, and it ain't pretty.

2) I have mentioned that the New York City 9-1-1 system is, in addition to Engine company Certified First Responder-Defibrillator, EMT BLS, and Paramedic ALS, we have a mixed bag of providers at both BLS and ALS level. "Primary", and here I go with the department and Union "line", is units of the FDNY EMS Command.

Then, there are hospital based "Voluntaries", so called, as 30+ years ago, then NYC Mayor Abraham Beame cut back on all municipal services, including the NYC Health and Hospitals Corporation EMS, as a part of a budget cutback, and some "private", non HHC hospitals "Volunteered" to put their own ambulances into the 9-1-1 system. The crews are usually union members (local 1199) paid by their base hospitals.

Still as a part of the 9-1-1 system, a few years ago, several other private hospitals managed to get contracts with the city, to provide ambulances to the 9-1-1 system, but did something without advising the city until after the contracts were signed. These hospitals then turned around, and sub-contracted with private ambulance services that until this time, had never provided 9-1-1 service within NYC. Like the "Voluntaries", they have the name of the hospital on the side, but also have the name of the private service provider, using Saint Barnabas Hospital/Metro-Care Ambulance Service, who were the first to do this, as an example. AMR also has some units in the system in this way.

To the best of my knowledge, none of the private ambulance services thus "back-doored" into the 9-1-1 system, are union shops, nor do they have any medical "Bennies" if their crews should get hurt, unlike the FDNY EMS and "Voluntaries" crews.

Now, on a tangent, if an FDNY EMS crew makes a mistake, they will have a supervisor on their back within 24 hours, so any mistakes will still be fresh in their minds as they get correction or punishment, as witnessed by the crew mentioned in the newspaper article that sparked this string. As a part of the contract with the "Voluntaries" an FDNY EMS supervisor can approach a hospital based crew and give correction for errors they made in the field, or address the appropriate hospital supervisor to do it. However, these "private contractor" service ambulance crews can ignore the FDNY EMS, or hospital supervisors with impunity. It can be over a month before the State DoH can contact the crew, and advise them of whatever errors they made in the field, by which time, the crew probably has forgotten the errors they were accused of doing.

Kind of at the bottom of the list, are the community-based "Volunteer" ambulance services. I make distinction here between "Voluntaries" and "Volunteer", as the former are paid, the latter are unpaid "charity workers" but all personnel mentioned here are DoH certified. Volunteers either self dispatch, respond to direct phone calls, or are dispatched by the FDNY EMS EMD, as units of the "MARS", or Mutual Aid Radio System.

What I witness, for the most part, is respect between the FDNY EMS and hospital employed "Voluntaries", but it also seems to be a lack of respect towards any and all of the "private contractor" ambulance crews.

A mention: Most of the "private contractor" ambulance crews just do Inter-Facility Transfers, with the occasional emergency call. They also have specific crews that are dedicated to doing the 9-1-1 calls, with their own FDNY EMS EMD radio designations and assigned territories, as do the FDNY and hospital based units.

[catie]

Ok..Let me get this straight....Two EMT's are preforming CPR on a airway obstructed child...Does this sound a little strange to anyone but me? One is doing chest compressions I guess.. and the other is doing what? Please tell me they are not attempting to bag this kid!If they are only doing compressions,are they taking turns or is one just there for moral support?I just have a hard time picturing what this second person is doing.

As an EMT myself I cannot understand at all what these guys are thinking!I have been to several calls for an unresponsive children and it certainly freaks everyone involved out. But as a person who is trained to handle these calls and who the public looks to, you have to remain calm and professional.

These guys just freaked out and did what our supervisors always tell us as Basics to do -" haul arse and get there as fast as you can". When a minute seems like an eternity these guys made a spur of the moment decision to go.Maybe they felt like at least if they were moving they were doing something to save the child. Who knows?

I am certainly not trying to judge these guys, I just hate the way this ended. The loss of an innocent child because of the ignorance of "trained professionals",if this kid was alive when they aos.

[tskstorm]

Ok..Let me get this straight....Two EMT's are preforming CPR on a airway obstructed child...Does this sound a little strange to anyone but me? One is doing chest compressions I guess.. and the other is doing what? Please tell me they are not attempting to bag this kid!If they are only doing compressions,are they taking turns or is one just there for moral support?I just have a hard time picturing what this second person is doing.

As an EMT myself I cannot understand at all what these guys are thinking!I have been to several calls for an unresponsive children and it certainly freaks everyone involved out. But as a person who is trained to handle these calls and who the public looks to, you have to remain calm and professional.

These guys just freaked out and did what our supervisors always tell us as Basics to do -" haul arse and get there as fast as you can". When a minute seems like an eternity these guys made a spur of the moment decision to go.Maybe they felt like at least if they were moving they were doing something to save the child. Who knows?

I am certainly not trying to judge these guys, I just hate the way this ended. The loss of an innocent child because of the ignorance of "trained professionals",if this kid was alive when they aos.

Do you have an AHA CPR card? Are you required to have one to maintain your EMT certification? If you answered yes to either of these questions, you need to re-read the standards for FBAO in an unresponsive pt.

No one freaked out, and there was a supervisor on scene, and the supervisor probably did tell them to haul ass! Not hearing a bang on the back of the bus, not seeing lights, misunderstanding the radio, this is freaking out?

Oh, and for the record, the standard is CPR this is a combination of compressions and ventilations, better to push the ball into a lung lobe and have the lobe removed then for the alternative, death.

[Richard B the EMT]

better to push the ball into a lung lobe and have the lobe removed then for the alternative, death.

The way I was taught, similarly, if you can clear the airway by forcing the Foreign Body Obstruction into the opening for one lung, at least you will be getting air into the other one. One blocked is better than both blocked.

[Don1977]

The ED's here have codes to get in, or if they see you on cam and know you are coming, they open the doors for you.

[Kiwiology]

Weird, not sure why the BLS crew legged it but maybe they though this was a movie and the double slap was to go. But, then surely they can look out the window and see paramedics with thier gear wanting to get in or do you not have windows?

Autolocking doors eh, we don't have that but our ER does require a key code to get in thru the ambulance entrance. Really annoying when you don't have one and you just went back to get a ryhthm strip and get locked out in the cold in short sleeves!