SUFFOLK COUNTY EMS

[Ronnie]

Here is why Suffolk EMS is in the stone age....

1. response by the closest ambulance is not guaranteed because the vast majority of ambulances are not manned at the station...the dispatcher doesn't know if the ambulance is going to respond until well into the course of the call.

2. stations are not manned which means the 911 callers have to wait for the EMTs to hear the call, get dressed, drive to the station and then respond to the call...and that's assuming any of the volunteers are available to go

3. too many separate agencies...they all buy ambulances, drugs and medical supplies separately...but they all need the same things...it's common knowledge that buying in bulk is cheaper, so why isn't it done here???

4. it's an unwritten rule that all ambulances must be the most expensive possible, with all the bells and wistles that nobody needs...buy in bulk, buy SMART and save money!

5. three paid supervisors and one SUV could accomplish the job of 20 volunteer chiefs each with their own Chevy Tahoe within their own little district.

6. ambulances are only located at the stations and don't leave unless there is a job...most heavily populated places implemented something called "system status management" many years ago, this means that ambulances relocate to the optimum locations given the number of trucks available and the frequency of calls in certain areas...so let's say a certain area happens to be busy and many of the local trucks are out on jobs, the remaining ambulances would relocate so as to still provide good coverage to the whole region. This doesn't happen in Suffolk.

7. Fire Departments DO NOT first respond on EMS jobs at all...this is basically an expected service in high population areas in the USA...the gold standard is the paramedic engine company and that's definitly not happening in Suffolk anytime soon

8. availability of paramedics is random at best...one department may pay someone to first respond, but the agency down the road may not...so it comes down to luck whether or not someone has a heart attack in an ambulance district that has nitro, aspirin, morphine, lidocaine, 12 lead EKG and enough members that know how to use it, OR they're in for a fast ride to the hospital while more cardiac tissue dies.

9. even if the department has paramedics, the majority don't carry narcotics...there's no good excuse for this...morphine can save the life of someone with acute pulmonary edema, valium can save the life of someone with continuous seizures, both can be used to reduce pain and anxiety, yet most departments don't carry them

10. not enough training...in the city, it is beaten into you that no medic is fully competent for the job until their 2nd refresher...that's 6 years of full time EMS and unfortunately it's not possible in a volunteer system

11. dispatchers play telephone tag trying to get resourses where they need to be...caller dials 911, tells story to police, police send officer and forward caller to county fire/rescue, tells same story to county fire/rescue, county fire/rescue calls local fire department and tells story to their dispatcher, their dispatcher activates member's radios, members respond to station, then finally respond to call. And here's how the same call would have gone in the county I used to work in...caller dials 911, tells story to police/fire/EMS calltaker, message entered into MDT and sent simultaneously to dispatchers who notified specific police, fire and EMS units, they all responded.

12. volunteers have no real motivation to engage in time-consuming and expensive training...there is no pay increase for volunteers when they go from EMT to paramedic

13. the protocols are ancient and extremely restrictive...this is because the doctors in charge of writing them do not trust the level of care being provided by the volunteers.

14. in order to perform most of the procedures the vollies are trained to do, they must get permission from medical control...this is required for just about everything, yet even for the simplest transports, the tech must call medical control afterwards to make sure they didn't screw something up


Now I'm sure I will get flamed by vollies saying that I should be grateful that they are there for my sorry ass when I run off the road and they are forced to leave their family in the middle of Thanksgiving dinner, blah, blah, blah...but I don't buy their silly argument. The system is totally broken out here in Suffolk and those in denial are perpetuating it.

While other ambulance services in the US are looking for new and better ways to serve the public, ambulance services in Suffolk are blaming the media for making them look bad.

[ltjag]

A refreshingly honest assessment of the system, but don't think it does'nt apply here in Nassau too. True we have the County PD's EAB as a backup to many FD's, but because of FD turf claims they may not be called until two or three other FD's are requested and are found to be unable to get a crew out. All of this is to the detriment of the patient who does'nt care about the agency status of those responding. All they want is the quickest and most competent response in their time of need. The world is broken up into two groups when it comes to fire and EMS povision here on the Island. Those who know the truly sad state of affairs and those in denial. That people who call themselves unpaid professionals are willing to hold hostage the safety of their communities for the sake of being able to continue to pursue their hobby is a travesty.

[LI800]

The bigger issue with Nassau PD'd EAB is -not- turf (While it may be true in many areas, we actually welcome EAB coming into our district and backing us up, simply because we're so damn busy).

There's simply not enough EAB ambulances. Most precincts have 2 buses (while a few have 3 or more). I belong to an agency that actually mutual aids TO NCPD becuase they simply don't have enough ambulances in the precinct, and the surrounding precinct is busier than they are.

The best thing for Nassau County EMS is this; the FDs throw in the towel and finally admit that we can't do this anymore. The handful of VACs in Nassau aren't doing it any better, and they should do the same.

Nassau County should create a Nassau County EMS Agency:

1. Invest in a county EMS Manager that KNOWS how to run a professional 9-1-1 ambulance service. This position is separate from FSA, VEEB, REMSCO, the Fire Comishion, everything. They direct-line into Suozzi's office (At least initially) for accountability and control.

2. Invest in a billing manager that knows how to actually collect on the billing they're already doing. This person direct lines into the EMS Manager, and dotted lines into the comptroller's office for financial accountability. As billing revenues warrant, hire an assistant, then another, then another. 95% of medical billing can be done electronically. Require the field personnel to input the key data needed for billing into a computer at the end of their tour (you're already paying them), you just eliminated the need for the billing manager to do data entry.

3. ALL ambulance dispatch is transferred over to FireCom, where it belongs. Ambulances moved onto their own frequency, separate from the precinct frequencies. FireCom's doing the bulk of EMS dispatching as it is, EXCEPT for the NCPD EAB ambulances. The additional load may require additional headcount at FireCom over time.

4. An executive order is issued by the County Executive, with legislation by NYS and endorsement by the governor that the Certificates of Operation be revoked to the FDs on a district by district basis, allowing Nassau to take over EMS gradually while not doing a "shock" to the system. (And before many people start crying about how this can't be done, it can be done, check the NYS Laws, and I'm not talking about Part 800 or Article 30).

5. The NCPD EAB vehicles and personnel are shifted over to this new Nassau County EMS agency.

6. This new agency starts on the western border of Nassau and gradually goes east, taking over EMS services, gradually over time, as the funds collected from patient billing allow the expansion process. (I know of 3 agencies covering 30sq miles that between them run about 3500 EMS runs alone. 3500x$400 per call on average = 1.4 million just for consolidating 3 agencies. Factor out monies you may not be able to collect (welfare, etc.,) and you still have $1 million. More than enough to staff those 3 agencies alone.

7. Apply the same principles on each agency you take over.

8. Assume Nassau County does 85,000 EMS runs a year (which I think is a VERY low number based on data I've seen), you've got a $34 million budget from revenues to run this agency with to start.

..And that's just a start.. Edited by: LI800 at: 3/27/04 5:39 pm

[wow]

did you say firecom dispatches most of the ambulances already....you gotta be kidding ....listen to 3 and 6 ...or any channel for that matter ...they cops are asking where the fd is...and can we find a county bus....all day long....the county system is busy ...but it all gets done...the 911 ops do a great job of dispatching calls...and can switch a baby not breathing to the closest bus and hold the back pain for 5 minutes longer!!!

[Ronnie]

I'll preface this by saying all I know about Nassau ems has come from this board. But I really find it hard to believe that Nassau ems is even close to being as crappy as Suffolk.

Nassau at least has a second layer of EMS capabilities, namely the police ambulances. The volunteers probably hold calls for too long, or have preference for other volunteers, but the police ambulances are available if all else fails. Whereas in Suffolk, if all else fails, they just have to keep bouncing the call among vollies and hope someone picks it up. There is absolutely no backup that is DEFINITELY there.


Add these to my list....

15. Suffolk county dispatch uses EMD coding for no reason!!! the whole point of EMD coding is to triage the medical problems and send APPROPRIATE resources. they categorize calls into A,B,C,D and E. A is non-emergency no lights/siren, B is BLS only, C-E are increasing degrees of seriousness and require paramedics....the problem is that the decision to sent medics rests with the individual ambulance companies and more often than not, no medics are dispatched...I find that amazingly stupid given the fact that the dispatchers already determined what the problem was and assessed the need for medics.

the way we did it upstate where I used to live, was the central county dispatcher would automatically send paramedics...if the ambulance district where the call was located didn't have medics, the county dispatcher would find the closest one and send them, no questions asked.

16.this ties in to 15, but if one of the commercial ambulances happened to be driving near the location of the call, they were going. Can you imagine how much the boneheads in Suffolk would complain if FRES started sending AMR, Hunter or EAS as mutual aid or as ALS intercepts to volunteer jobs!!! The fact that it would improve the health of the sick and injured is not important to these vollies and for the life of me, I can't understand why.

16. vollies have no real emergency vehicle operators training (or at least don't use it)....speeding, blowing through major intersections without making sure every lane is clear, blatantly running red lights, driving recklessly, responding with lights and sirens to non-emergency jobs, transporting extremely stable patients while speeding with lights and sirens...the last one makes me so mad because it's so irresponsible...I have actually had more than one moron tell me that the state law says all ambulances must use lights and sirens when there is a patient on board...the truth is that any government agency that mentions the subject ALWAYS says the lights and sirens are to be used for life threatening emergencies only...this is clearly not happening on every call as evidenced by the incessant complaing by vollies that patients use ambulances as taxi services.

[I couldn't have said it b]

Is what I am. That some insist upon steering these discussions into personal attacks upon those with divergent views. Ronnie has eloquently and factually put forth a description of the problems plaguing the Suffolk EMS system as well as some proposals to right them. He seems to know of what he speaks. I don't see anyone offering anything to suggest that conditions in the system are anything other than what he represents them to be. That being said, Ronnie better watch his back. Whistle-blowing is fraught with peril. You may find yourself the subject of a campaign such as that against Newsday for your blasphemous railing against the volunteers. Ahh, but they've probably already labeled you some sort of union agitator or disgruntled malcontent. Hey, if you can't attack the message, attack the messenger. Carry on Ronnie.

[Carries Dad]

Ronnie while you have many good points three seem to be out of place here. Numbers 9, 13, and 14 would fall squarely on the back of the medical director who could have all three changed at any point he wants. I know some of the more progressive people in the system who would like all these things to change and the only thing stopping them is the medical director.

As for number 16 the NYS DOH Bureau of Emergency Medical Services POLICY STATEMENT No. 00-13 from Nov of 2000 defines what and what not is permitted and what training is required it the agency serving you is not abiding by that call them and I’m sure they would be more than glad to come and explain it to them. If they are doing what your saying (and sadly I have seen it myself) they are doing a disservice to the patient and the public. As for the taxi comment it’s not restricted to the vollies I hear just as many paid guys complaining about it also. Of course they usually send the person off and report the call as unfounded. Remember when your on one of those taxi runs somebody who really needs an ambulance may get denied one.

one last thought for LI800
DO you really think th NCPD would ever give up control of the ambulances?

[Biased]

1. "responding with lights and sirens to non-emergency jobs"

If its not an emergency why are people calling an ambulance ? They need a sector car not an ambulance.

2. "transporting extremely stable patients while speeding with lights and sirens...the last one makes me so mad because it's so irresponsible...I have actually had more than one moron tell me that the state law says all ambulances must use lights and sirens when there is a patient on board...the truth is that any government agency that mentions the subject ALWAYS says the lights and sirens are to be used for life threatening emergencies only..."

NOT state laws......Insurance companies.(we all know THEY controll the state) If an ambulance transporting a patient,stable or not, was to have an accident,regardless of whos fault, the insurance companies first question is "were you in the process of transporting a patient?"
The next question is "were your audible and visual warnings working?"
You figure it out.


and this one really gave me the laughs....


3. "16.this ties in to 15, but if one of the commercial ambulances happened to be driving near the location of the call, they were going. Can you imagine how much the boneheads in Suffolk would complain if FRES started sending AMR, Hunter or EAS as mutual aid or as ALS intercepts to volunteer jobs!!!"

Yeah ok the paid ambulance companys will drop a job they KNOW they will be paid for to handle a vollie call...
would never happen. They are FOR profit companies without guarantee of pay the would tell "county" to go scratch or maybe we could handle it in say 2 hours ?


"The fact that it would improve the health of the sick and injured is not important to these vollies and for the life of me, I can't understand why."

How would sending a crew from Hunter, AMR, Lifestar or any other PAID provider IMPROVE the level of care ?
Please explain this one.......

or did we not think that when most EMS vollies are not VOLUNTEERING they are WORKING at one of the privates??

That would mean same level of care, now your just paying for it.

[ltjag]

As for why people call ambulances, it is well settled that as much as 80% of "emergency" ambulance calls are not emergencies that require ambulance transports. People have this notion that if they go by ambulance, they'll be seen quicker. Of course that is nonsense, but they don't know that. Still others don't want to inconvenience their families. I cant count how many times I've rolled up to find two cars in the driveway and a capable driver at the call, but, after all, the insurance company pays for the ambulance ride, so what the hell. As you point out, most paid buses are staffed by people who also volunteer. This just increases the likelihood that these buffs will be unable to resist the impulse to insert themselves into a call if they were to "stumble" onto it. It would also increase the likelihood of getting a higher certified responder as most commercials staff with an AEMT or an AEMT/P in addition to an all but useless EMT. On the lights and sirens issue, if you get into an accident, you're damned if you did have them on, and damned if you did'nt. If your patient is stable and you're crossing an intersection against the light, the lawyer for the other guy is going to have a field day no matter whether you're lights were on or not. Turning on your lights is not a defense to negligence, just as not having them on does not necessarily impart liability. The critical question is why were you crossing against the light? Your patients status is the key issue.

[Vengeful Medic]

ltjag, you took my thunder......but that's okay because you pointed out something that I spoke on in another posting.

I have been reading about how some people are advocating lights and sirens to everything. Now lets think about it. Lights and sirens to everything. So......say there's a job for a toothache, I'm going to go lights and sirens to pick up this taxi riding imbecile who thought that if they called an ambulance they'd get a free ride to the dentist (via the ER)? No..I will not travel lights and sirens to that kind of nonsense. I will point out the EMD practices of a nearby jurisdiction: FDNY EMS.

Here are some call types that do not get lights and sirens: EDP's (Why do you want to rush there just so you can wait for PD??? You're just going to sit there and stare at the house. And I'd love to hear someone say something about intervening with that EDP..I have a story or two about messing around with these people.
Injury Minor: Like lacerations, bumps, scratches, sprains, strains...you know...the minor crap that does not really require emergent response or emergent transport.

Now keeping this in mind, let's go to the actual patient transport. Why would you go lights and sirens to the hospital for someone that had a laceration or an EDP? Or someone that sprained his ankle? Why add that risk to your crew, the patient, and most importantly yourself....?

That's gross irresponsibility as far as my concern goes. But that is simply my own thought on the matter. Thank you for your time folks..

Omar-Fara Norgaisse, EMT-P

[EMT For Free]

As a person involved in the System, I find it hard to believe that the people who are writing and commenting are part of the same system.

I am a volunteer. I attend any and all required training deemed necessary to get the job done. I don't need a pay check in order for me to vested in the service that needs to be provided.

It is not the system that is completely at fault. It is a good system. It is the boneheads that are coming in the system and try to change it because their life is all about the mighty dollar.

As far as training, I completed my EVOC course and remember being taught that If I am running HOT, I am to use due caution/regard when entering an intersection (meaning...If my light is red, then I am to come to a COMPLETE STOP at the light, check the intersection and if it is clear, then I may proceed).

The courses are offered within the county. If the department do not mandate for their member to take the course, then shame on them. If the person has completed the course and still blows through an intersection as if they were the only one on the road, then definitely shame on them too. (And I am making a call to the D.A.'s office if someone gets hurt because of a bonehead's stupidity).

Ultimately, the responsibility falls on the people who "make the system", which includes my self not just the people who develped the system. I can take all the training that I and is offered to me. Whether I do what I am trained is another story and I am and should be prepared to accept whatever recourse is taken based on my actions.

Ready to accept the good and the bad!!!
Take responsibility!

[Ronnie]

I posted seventeen cases for why I think Suffolk EMS is horrible, so far the only one that has generated any discussion is the use of lights and sirens. Give me a break, while it is somewhat important, the MAJOR problems (i.e. lack of in-house crews, lack of paramedics, lack of narcotics, too many districts, no group purchasing, no centralized communication, etc...) were totally ignored. But I'm glad we've determined that blowing through stop lights is bad.

[EMT For Free]

I think I commented on each of your topics. Hope this helps.
Feel better.
1.
Nothing is ever guaranteed. I called police for an accident that happened approximately 3 blocks from a police station. YOu know that after 1 hour, no sector car ever arrived.
I agree that dispatcher should be aware if there are crews on call for each area.

2.
This varies in each department. Besides, if you are on duty, you should be dressed already.
3.
Yes, Bulk purchasing would be ideal, but isn't that the concept of NYS bid purchasing (OGS), which these would departments qualify.

4.
That's what makes this country great.... Variety! Should money could be spent in other ways, but maybe some of these dept. are getting the best for the lowest prices. So with that, maybe they should share their info.

5.
Who cares/ More important things!

6. Actually there are some dept. that do this. Especially during the summer seasons. Depending on the size of the district, it may not matter if the ambulance is stationed in the bay. Headquarters could be the most central location in the town.

7. Obviously you are not familiar with every department in the county.

8.
Paramedics/ EMT CC's not much difference as far as I am concerned. By the time we get the hospital, they both would have done pretty much the same thing. Some dept may not need to pay someone because they have the necessary vollies doing the job. In the end, the cardiac patient's ultimate goal is to get to the hosp and be seen by the "Pro" himself. Mr. Cardiologist.

9.
Depending on ETA to hosp. within the district, it may not be necessary to have narcotics. That's up to each dept and their medial director to make that decision. Let's do more recruiting. Let's train these people (hopefully to the paramedic level) and then re-evaluate the issue.

10. Maybe for some! CME and continuous internal QAQI and training would definitely help in this area. Also.... Losing that Paragod mentality.

11. I don't know what you are talking about in the first half of this comment, but Hey, as far as the second section.. (And here's how the same call would have gone in the county I used to work in...caller dials 911, tells story to police/fire/EMS calltaker, message entered into MDT and sent simultaneously to dispatchers who notified specific police, fire and EMS units, they all responded.)
that's how our dispatchers work! I've seen them in action.

12. To many pessimistic view like this. Lack of motivation by leaders and to many skeptics. Many people who currently work in the paid service received all their initial training from a volunteer ems/fire service. The few others were good ole rookies with no experience trained by the one and only NYC EMS (yes the green and orange crew). The other slim pickings came from out of state. So why are now picking on our master, our teacher, our mentor or our Sensei? Other than that its not because they don't want to, but years ago mortgage rates were ridiculous, we had and still have gang problems, so we need to move and find "nicer" communities and pay more to protect our children and families. It's lack of time. I really want to help, but I need to pay mortgage and rent, so I get another job. So dept. kick you out or force you to leave. So I now get a job as paid ems with the training obtained through the volley system and I am now anti-vollies. THAT'S HOW THAT WORKS!!!

13. I definitely beg to differ on this point. Heck things are changing, maybe not as fast as you might like, but it's changing. Changing enough that I am teaching lay person on how to use the epi pens in emergency situations.

14.
Checks and balances! That's all! Like I said, change maybe slow, but not absent. Those post calls are part of the process of how they determine to upgrade the standing orders.


SOOOO, WHEN ARE YOU PUTTING IN AN APPLICATION TO JOIN YOUR LOCAL DEPARTMENT (if you haven't already) TO HELP IMPROVE THIS SYSTEM. YOU SOUND PASSIONATE. NOW TAKE THAT ENERGY AND PUT IT INTO ACTION BY HELPING THE SYSTEM AND NOT JUST TRASHING IT ON THIS INCOGNITO WEBSITE.

P.S. no one likes to look bad!

[Ronnie]

A typical response from the vollie sheep of Long Island...if you can't beat 'em, join 'em. NO THANKS...as soon as I finish school, I'm outta here. In fact, I wish I had never come to this suburban hell-hole. It's surprising that anyone would want to live here in the first place, but to each his own eh?

[grab the cash]

GOOD Now get the F out !!!

[EMT For Free]

I agree with Grab the Cash.

Good bye. Don't complain about something that you really don't care about. At this point, you are just talking to be talking. Why "waste" your time on this issue if you want to be away from it.

Use your time more constructively.

Once again... GOOD BYE!

[Vengeful Medic]

I agree with most of your points, however my view about the response system is one of safety only. That's the point I was trying to make. The tone of some postings I read was perceived by me to be one of "Run HOT. PERIOD". That's all I really wanted to say on that subject.

[EMT For Free]

That's the great thing about this site. Our ability to voice our opinions, whether they are shared or not.

Safety is on my priority list too!

Thanks

[to LI800]

Whilst observing some of the problems in the EMS system of Suffolk, I would like to offer some changes. First, Suffolk EMS may want to find a better Medical Director than what they current have now. I have never met Ms. ALicandro, never been introduced to her, and I dont believe she ever came to my department to offer an omnipotent words of wisdom. I think all Suffolk EMS hides, no matter what they do, behind the cover of bureacracy until some major incident occurs, where they can appear as if they are in control. Yet, I never see or hear of any proactivity. It's as if the Medical Director and the supposed EMS coordinators do not exist. I imagine a day when these folks activate the numerous resources I believe that they posses instead of merely issuing out statements that those in EMS should already know in the first place.

[Vengeful Medic]

Suffolk County EMS operates the way that they do for reasons that do baffle me sometimes. I bear no malice or ill will towards it's staff, however I think as far as ALS is concerned,they need to be a little more proactive, improve on the current Protocols (There is absolutely no reason why EMT-P Protocols should be so damned close to the EMT-CC protocols). I have always thought that way as an EMT-CC and again now as a Paramedic. Being that I work in another system that is much more aggressive in its patient care, I find it very limiting and frustrating to have to make a phone call to do what I know will help the patient improve. Again, nothing personal against SCEMS or Medical Control (although the latter has tried my patience once or twice), but I think a few moves forward with reinforced training on the department level (audited by the county to ensure compliance) will improve advanced life support throughout the county. And this is no secret...as far as my belief in this goes. Thank you for your time, folks...

Omar-Fara B. Norgaisse, EMT-P

[ltjag]

Both EMS and firefighting here on the Island will always be subpar. All of the equipment and protocols in the world are only as good as the people at the point of administration. EMS protocols on the Island will never exceed idiot level until such time as the practitioners in the field themselves do. To be sure there are a good many knowledgeable and competent providers running around out there. They, however, are but a small fraction of the overall force. It is unavoidable that protocols must be oriented toward the level of ability of those who will ultimately be implementing them. My anti-volunteer beliefs are well known. You can slam me as biased or you may ascribe to me any motivations you wish for going on about this topic the way I have. The feelings I hold about the low quality of care here on the Island are validated by the bodies who set the protocols. Of course there are going to be some out there who don't need MedCom to hold their hand on a call, but there are vastly more who need to be walked through each and every step, no matter how trivial. Listen in on MedCom sometime. Some of the exchanges are frightening.

[Vengeful Medic]

ltjag, I agree....And I have listened in on MedCom more times than I wanted to. And yes, some of the exchanges are scary. But that's why I'm suggesting a training system whee Continuing medical education is not an option, but a mandate for all ALS providers in Suffolk, that way you can ensure that training is all on the same level, and you have documentation (on both th County level and local department level) that such training towards a standard of competency has been provided and done. In my department , I have implemented a continuing education program for all ALS providers...to this point only a few have taken advantage of it. I have even extended an invitation to all the ALS providers to make arrangements for a one-on-one training session that would involve whatever topic is covered for that month (this month and next month is cardiology). I think with time this program will become much more popular within my department as providers will realize that the information provided is to their benefit, and taught from different points of view, WHILE maintaining the same standard. Something like this is what I would like to see throughout the county..I believe some departments have something akin to what we're doing here.

[BC Jack]

My Brother in Iraq sent me this game check it out...................


Subject: Squish a terrorist



This held my attention for only 30 minutes.

I feel better now.

thecrowshow.com/swf/squoosh.htm


Devin Pratt Former EMT-CC AKA Billy the IV kid

[my2cents]

just a point of clarification: Suffolk EMS has no jurisdiction whatsover on the formulation, promulgation of protocols. That comes from the REMAC...physicians from the very hospitals you transport your patient to. The system Medical Director is but one small cog in the wheel...

[ltjag]

whatever the composition of the agency that establishes protocols, the fact is that they are inclined to set very minimally demanding ones. Why? They are aware of the paucity of technicians who are capable of carrying them out. Remember that part of the oath that went "first, do no harm", the people who promulgate protocols have that first and foremost in their minds and accordingly will only give the "stay and play" crowd a limited number of options so as not to unduly delay transport of the patient. Again, just another example of how the public has to sacrifice for the sake of the hobbyists. What a shame.

[Funny LT]

Oh, go get a job and stop being so disgruntled because a vollie in your department ratted your sorry behind out for doing side work.

You reap what you sow.

[Another Voice]

You really should stop trashing the fire service. You are giving your former colleagues from Long Beach, both paid and volunteer, a bad reputation. If you were from my department you would have received a blanket party some time ago.

You are a disgrace.

Stick to a subject that you think you know about...politics in long beach.

But, wait, if you knew as much about long beach politics as you claim to know about everything else maybe you wouldn't be out of a job.

You're a loser.

And no matter how many SAT words you use to bash the volunteer fire service...you're still a loser.

And even if you get your job back...you'll still be a loser.

A wannabe loser with a real crummy attitude.

Stop trying to fix Nassau's problems and worry about your own.

Loser.

[ltjag]

You guys are like a broken record. Oops, I'm sorry. You guys are'nt old enough to remember records are you? Listen, I've got a job and my "problems" are being handled rather nicely thank you. How about we contain the Ltjag bashing to just that thread that was created for that purpose. That way if people want to check out your childish sniping they know where to go to do so.

[FFMEDIC]

Here is the thing. I do agree with Omar about the fact that medics and CC's protocols should not be the same. Medics are trained at a higher level than CC's are. That is not to say that there aren't good CC's out there or bad medics for that matter. What I am saying is that a lot of us who do this for a living have a very good idea as to what it is we are doing as opposed to those who don't, do not have any idea. There is no money to be made doing this. It is most certainly a labor of love. Anyone who says otherwise has no idea. If one brother works between 50 and 80 hours a week fixing cars and your other brother works as an accountant, fixes cars on the weekend, who are you going to bring your car to? I would be willing to bet you the guy who works the crazy hours because he probably knows his stuff. This is an example, not true all the time. But I know that if I had to choose what medic was going to help my mother it would be someone who put in 60 hours a week being a medic than a guy who does a duty shift once a week.I also vollie so I am not bashing the vollies or trying to get rid of them. What I am saying is that the more you are exposed to calls the better you are going to be. Thats cold hard truth. Why can't we have Paid guys supplementing vollies. This way you can still show up on calls when you feel like it and when you don't we got it covered also. Best way to learn is to go out and do it. If you do 12 hours of duty crew at your VAC weekly you might get a few good calls in, but what about all the ones you missed. The medics and CC's that are not so good get weeded out of the paid jobs because no one will eventually hire them. Whereas if your a vollie most no one is going to throw out an ALS provider even if he/she does suck. It does happen, don't get me wrong, but for the most part there are some really scary techs out there. I think that we should be much more aggressive with our protocols out here. Separate the medics and CC's. Make it mandatory that if you don't get a certain number of calls and intubation's in a year that you re-mediate. Keep on top of these guys and gals. The only way to get better protocols is to prove to the Doc's that we are better. Dr. Goodman is an awesome Doc and an even better friend. The man is dedicated to getting us better protocols and better meds. Alicandro is not with him b/c she sees what some of these nitwits are doing out there. So in closing, I BEG YOU, if don't know what you are doing or don't feel comfortable, CALL FOR HELP!! Do not screw the rest of us that want to have better protocols and better care. Ronnie while I agree with most of your posting, if your not willing to fix it then don't criticize it. Hope you get an application and help us......

[Vengeful Medic]

...FFMEDIC. It is about time the providers at the advanced levels stopped the tomfoolery, and got serious about their craft (be it volunteer or paid). The sooner we get on the money and screw up less in the field, the sooner our efforts will be recognized and respected, and the sooner we will have bestowed upon us protocols that make better use of our skills and knowledge to provide better care in the field for our paitents. Now this is not to say behave so we can get more toys. Those with that mindset need not subscribe to this posting, as I do not want any responsibility for those who do not take EMS and the mission of EMS seriously. No, the people I am reaching out to are those who seek to promote better patient care, not better patient drugging/sticking/whatever else you can dream up. Think about it. And if you can't get the training in house, be like the wandering grasshopper, and seek the master in the mountain. Your diligence will be rewarded with knowledge and wisdom.


Omar-Fara B. Norgaisse, EMT-P

[Ham]

The land of the little people.

[ofd]

whatever

[Stimey]

Yeah you hike it to the city to make no money. Labor of love my...

[Hereyougo]

None because the world revolves around them

[Vengeful Medic]

I don't know which Paramedic you've been talking to..but it most certainly was not me....and no the world doesn't revolve around me, just for the record.

[HOW MANY]

HOW MANY EMT-CC'S DOES IT TAKE TO SCREW IN A LIGHTBULB............ONLY ONE BUT THEY HAVE TO CALL IN FOR ORDERS TO DO IT!!!!!!!!!!!

[Hereyougo]

Omar took it serious. Its called a joke. Heres another one I found on the net.

What do you call an EMT with no sense of humor?
Give up...... A PARAMEDIC

[Vengeful Medic]

No...I think you misunderstand....

I NEVER HAD A SENSE OF HUMOR.

Make a note of that........

[ProEMT]

Well this discussion has gotten to the level of kindergarten again. As far as the protocols go, REMAC makes the decisions based on what others do, what the docs report about the patients brought in, and their own feelings. How many of you ALS providers take the time to explain to the ER docs what you did and why. Talk to them once in a while and see who understands what a paramedic can accually do, not what we are allowed to do by REMAC. As with much in this field it comes down to education, and a paramedics first responsibility is to EDUCATE. If a volly can keep up his skills and contuning education, great. If they can't we still need EMT's remember BLS before ALS, and for many departmebts so close to hospitals You may never get to the als if you are loading and going so how important is ALS in 95% of the calls

[Mikecp421]

33!!

:P

:P

:roll:

:D

[Guesst]

:lol:

:oops:

:(

:shock:

[guest8]

:lol:

[newguest]

:shock:

[Lets Go Paid]

Lets Go Paid :lol:

[hello8888]

hi

[Unregistered6666]

HI

[Unregistered(((]

3Thou shalt have no other gods before me.
4Thou shalt not make unto thee any graven image, or any likeness of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth. 5Thou shalt not bow down thyself to them, nor serve them: for I the LORD thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me; 6And shewing mercy unto thousands of them that love me, and keep my commandments.
7Thou shalt not take the name of the LORD thy God in vain; for the LORD will not hold him guiltless that taketh his name in vain.
8Remember the sabbath day, to keep it holy. 9Six days shalt thou labour, and do all thy work: 10But the seventh day is the sabbath of the LORD thy God: in it thou shalt not do any work, thou, nor thy son, nor thy daughter, thy manservant, nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates: 11For in six days the LORD made heaven and earth, the sea, and all that in them is, and rested the seventh day: wherefore the LORD blessed the sabbath day, and hallowed it.
12Honour thy father and thy mother: that thy days may be long upon the land which the LORD thy God giveth thee.
13Thou shalt not kill.
14Thou shalt not commit adultery.
15Thou shalt not steal.
16Thou shalt not bear false witness against thy neighbour.
17Thou shalt not covet thy neighbour's house, thou shalt not covet thy neighbour's wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbour's