Response-time rules for Suffolk ambulances OKd

[islipian]

FYI


Response-time rules for ambulances OKd
Protocol calls for dispatch to seek help from other agencies after two minutes if a full crew doesn't call in to confirm they're on the way NEWSDAY

BY ELIZABETH MOORE
STAFF WRITER

May 12, 2004

After 18 years of efforts to persuade Suffolk's volunteer ambulance crews to get out faster, the county's emergency medical services council yesterday voted for the first time to add teeth to its response-time goals.

The new protocol is limited: It instructs all emergency dispatchers to follow the same procedures.

And it directs that when the most serious calls come in, dispatchers are to seek help from another agency after two minutes if a full crew of volunteers hasn't called in to confirm they are on their way.

But it's a protocol, this time, not a goal or guideline, and no one yesterday seemed to doubt it would have an impact.

"This is a public health crisis," said David Brenner, chairman of the Suffolk County Regional Emergency Medical Services Council, after a contentious meeting and vote. "I don't think the public is aware of it. The volunteers are wonderful ... but the system doesn't work."

The new protocol was opposed by fire and ambulance volunteers, who said having to call in to their agency was an "unfunded mandate" and argued that the shift from a guideline to a standard opens the door to a mountain of potential liability litigation. They asked for more time to meet the goals.

"The cooperation of the volunteers is necessary to make something like this work, and you don't have that committed cooperation," said Norman Reilly, chairman of the Suffolk Fire, Rescue and Emergency Services Commission.

The rule was also opposed by Suffolk's own fire rescue and emergency services commissioner, David Fischler, who contended that state law leaves decisions such as this in the hands of the local volunteers.

Most Suffolk fire and ambulance agencies don't meet the time goal in the protocol of getting an ambulance to the scene of a medical emergency within 9 minutes, 90 percent of the time, Brenner said. Indeed, a Newsday analysis of dispatch data from 2001 did not find a single agency that met that time standard for the most serious calls, such as heart attacks, strokes and choking episodes. And in more than 240 cases out of about 100,000 calls, people had to wait more than 40 minutes for help. Some of those people died. In that year, emergency medical volunteers also failed to respond to about 6 percent of calls to their agencies, forcing dispatchers to find someone else to answer it.

Those types of delays continue to occur regularly, speakers yesterday confirmed.

"People are dying," said Christine Larkin, a critical-care EMT from Holbrook Fire Department, who said she had been called just the night before to a neighboring community to help a patient having a heart attack whose own department did not turn out. "Five more minutes and he would have been dead," she said.

Two years ago, a new, non-binding response time goal was approved after bitter debate by the council, which is chartered under the state's public health law to coordinate emergency medical services in the region. But emergency medical officials said they were disappointed at the limited efforts made by volunteer agencies to meet the new goals.
Emergency medical officials yesterday rejected volunteers' request for more time to find ways to meet the new standard.

In 1986, a county task force set a goal of getting to calls within 10 minutes, amid alarm about Suffolk's slow ambulance service. Volunteers then argued against making it mandatory, saying their agencies needed time to make it work, said council member Robert Delagi, chief of operations for the county's emergency medical services division.

"I'd say our system has already had 20 years to adjust to response-time goals," Delagi said. "Why hasn't the emergency response leadership done anything about it?"
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[ABOUT TIME]

It's about time hopefully this will put the nail in the coffin of the antiquated voluteer ambulance system. With the growing size of every community on LI it only makes sense to have a paid ems system that can handle the volume of the calls.
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[FF]

Oh MY!!!!! SC REMSCO came out with response time protocols that they have NO AUTHORITY WHATSOEVER to enforce!!!!!!


"The rule was also opposed by Suffolk's own fire rescue and emergency services commissioner, David Fischler, who contended that state law leaves decisions such as this in the hands of the local volunteers."



"state law leaves decisions such as this in the hands of the local volunteers."

Each Fire Department/ambulance corp. is its own AUTHORITY.
________
California Dispensary (http://california.dispensaries.org/)

[ltjag]

a department's inability to meet this protocol is excused by virtue of it's only having to answer to itself? Hmmm.

[ems2]

hey ever notice that the people passing these rules AREN'T the ones answering the calls???? Try it and you might just see where we're all coming from!!!!!!

[FF]

Thats EX Lt. right ?
Still waiting to hear when youll get your job back ?
When would you know by again June 2003 ?
Hope your not holding your breath.
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SweetNhorny (http://camslivesexy.com/cam/SweetNhorny)

[volems]

a fully paid system....yeah that's what i need more money to go towards my taxes....has anybody ever seen paid ems responding to emergency calls? they are not much faster, especially in li traffic.
if they had to do all of li then the wait would be just as long....nothing like calling metrocare or lifestar to get a 2 hour eta!

[brookhavenguy]

What Dave Fischler says may not hold a grain of salt..The County is currently interviewing for his replacement..which will be in the next few months.

[ltjag]

Boy, you really put me in my place with that last posting. The way you artfully defeated my point of view was most impressive. Unfortunately yours is a tactic that is all too common on these threads: If you cant attack the message, attack the messenger. I think a better approach would be to think about what you're going to post before you do it. You guys just make it too easy for me to pick you apart.

[volems]

and how soon can we get rid of alicandro?

[volems]

take it somewhere else guys.....don't turn this into something that has nothing to do with ems. duke it out on your own board.

[FF]

Your "point of view" is not valid here EX.
You have been proven to be a LYING HAS BEEN EX.
Crawl back to your non-union side job, hope its payin the bills, and leave the dangerous stuff to us PROFFESIONALS EX.

That is all.
________
COLORADO MARIJUANA DISPENSARIES (http://colorado.dispensaries.org/)

[ltjag]

but I'm not the one who took this thread on a detour into personal attack. I invite FF, and anyone else who wishes to blast me personally, to please do so on the thread that exists for that purpose.

My first posting here was on point. I feel that a department thumbing its nose at a well reasoned protocol just because the agency that promulgated it is unable to enforce it is just plain foolish. How do you justify that to the public you serve? I think most volunteer departments would just as well not have a quantifiable response time standard against which their capabilities can be compared. It is not likely to reflect well upon them. I say, too bad. In the world of emergency services, time is everything. The most talented crew outfitted with state of the art equipment are'nt doing any good if they don't get there in time. Apologizing to the family of a patient who lay wanting for care for an excessive amount of time is among the most unpleasant duties we confront. That you are volunteering and "doing the best we can" is just not an acceptable excuse. "Doing the best we can" is not cutting it anymore. Bring on the paid.

[Vengeful Medic]

As the article says back in 1986, the local agencies needed "time" to get things together in regards to a response time "standard"......that was never done.....so what has changed now in 2004, that you still need time?? It seems pretty simple to me. Unless there's something I'm missing here?



Omar-Fara B. Norgaisse, EMT-P
________
College Girls live (http://www.girlcamfriend.com/webcam/college-girls/)

[Remsco Times]

"Bring on the paid."
Why ? You still will not get a job............

Nobody was thumbing their nose at the protocol. Just pointing out the agency THINKS it has some kind of authority over individual depts. It does not!
Again EX Lt. stay out of things you KNOW NOTHING about. Suffolk Co. and its needs are far from those of Long Beach.(your former employer). Stop saying going to paid is the answer, you still will not have a job and if we got rid of vollies you would have NO chance at all to be a fireman, NOBODY is going to hire you.
Decrepit has been. Make that decrepit never was!!
10-4 K ?

[already paid]

A study was done on Long Island if the system goes paid the property taxes are expected to increase to about 10% But I don't think people realize how much money is wasted on BS crap toys departments really don't need. So maybe it wouldn't be as bad as 10% minus all the stupid toys. Anyway most corps have paid people at least 12 hrs a day.Go paid!!!

[GCFDVolly]

Improving response time saves lives in the EMS and Fire Service.

NFPA 1720 -- Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Volunteer Fire Departments and 1710 -- Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments all address standards for improving the fire service and emergency medical operations.

Counties and departments across the nation or considering ways of moving toward "Response Standards" to provide a base line for evaluating the ability to respond within a predetermined norm for providing emergency services.

I individually believe it is healthy for all emergency service organizations to continuously re-evaluate and improve the approach to providing emergency services.

In evaluating EMS response time, I believe the most important performance measurement should clearly be the time from call to arrival of qualified and experienced advanced emergency medical techs, with the ability to expedite transport as soon as the patient is stabilized / ready for transport.

In achieving that goal, clearly, the time from notification of the call to the time the techs/units are responding is key.

In this instance, it appears Suffolk county is focusing on whether members notify the dispatcher they are on the way to the firehouse / ems station to initiate response, which frankly, is along way from response, and arrival on scene.

The most proactive of Suffolk and Nassau county volunteer fire /ems departments are looking at ways of improving 24 x 7 response through the implementation of duty crews, fly cars with techs, and through hiring on duty personnel to ensure response. Melville FD has made many positive strides as I have had the opportunity to witness at work when co-workers have needed EMS.

I think the energy of the Suffolk and Nassau fire service should be focused on improving care and response time in innovative ways, as many departments are.

While I hold the volunteer fire and ems service and members in the highest regard, if the volunteer ems and fire service puts its energy to maintaining the status quo without adapting to the changing demographics in using all of our volunteer talent, equipment, and tax payer resources in the most effective and efficient way, our own collective inaction could be the strongest case for forced change.

We should be challenging ourselves on how we can best improve response time, service, and qualifications, with the most judicious use of our time, energy, talent, and taxpayer funds.

With all due respect to the posters on this thread, I have to agree with LT Jag's challenge to us all, as I cannot in good consensus say nothing when I hear resistance in improving response time to take care of our families and neighbors in the time when they need emergency care the most. LT Jag?s reasoning is compelling. On another note, I would personnel appreciate if he would not continue the organized effort with the UFA against our FDNY brothers that volunteer in Long Beach and Garden City, but I can not refute the goal of improving EMS and the Fire Service because he is not currently employed. I think we all need to look past that when taking positions about the emergency services that affect lives, although I may be in the minority.

Obviously there are better ways for improving response time than what might of come out from Suffolk County currently. I ask are we collectively challenging our selves to develop a better approach than that Suffolk County is recommending, or are we focusing on fighting change to maintain local autonomy?

With volunteer duty crews, volunteer designated response personnel, or career personnel ready to respond 24 x 7, couldn't we guarantee better response with the units notifying the dispatcher they are responding right away vs waiting for two minutes for members to notify the dispatcher by phone, radio, or two way pager that we are on the way with an undetermined responce time?

When I was much younger in Nassau County, I was with my family when my Uncle had a heart attack, and passed away in front of us while waiting for a county ambulance with a very extended delay from the most remote area in Nassau County (there is no dedicated volunteer or career ems in GC to this day).

Earlier response Volunteer or Career responce, would have likely made the difference. In this day and age, I think there is no excuse not to move to an innovative approach, which improves response time. No family should have to have an extended wait for assistance for a loved one while a dispatcher or chief is not sure that there will be an adequate response.

All the preparation for ensuring response has to be before the call comes in!

It cannot be left to chance or good intentions.

Ask not what the EMS/Fire Service can do for you; ask what you can do for improving emergency services for your family and neighbors.

Just a few thoughts.

Let us all know what you think, as the fire service can only benefit from your knowledge and insight used in a positive direction!!!!

Respectfully Submitted,

GCFDVolly

(Verbose Aging Squid from GCFD who has a lot to learn about Suffolk and Nassau County EMS/Fire Service wishing the Best for our Brothers and Sisters in Suffolk County for creating a positive dialogue for continuous improvement.)


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R27 (http://www.bmw-tech.org/wiki/BMW_R27)

[854]

<<<Most Suffolk fire and ambulance agencies don't meet the time goal in the protocol of getting an ambulance to the scene of a medical emergency within 9 minutes, 90 percent of the time, Brenner said. Indeed, a Newsday analysis of dispatch data from 2001 did not find a single agency that met that time standard for the most serious calls, such as heart attacks, strokes and choking episodes.>>>

"Not a single agency" Over 9 minutes to a choke/stroke/heart????

DO you people need a building to fall on you? The public is NOT being served. The system is broken. It doesn't work!!!!!

Now a protocol calls for an additional resource being called after two minutes and you don't like that either???

ems2 states: "hey ever notice that the people passing these rules AREN'T the ones answering the calls???? "

Maybe their the ones waiting for a bus to arrive for their family.

Long Island Resident:
"I guess you don't feel that the volunteers on Long Island provide the necessary care when they are called to duty.
Try and sell that to all of the people who are still alive to rebut that nonsense.
Helping people is not about a paycheck, it's about helping people.
Oh and by the way, for the growing Long Island communities, I hope they can afford the taxes if people like you get their way!"

1. I feel the volunteers do the best they can.
2. The people who aren't alive can't complain about the long wait, can they?
3. Helping people is NOT about a paycheck.
4. Helping people is ALSO not about the cost...is it?

Again, 9 minutes to a level 1 is a disgraceful time and the system can't even make that time. The people deserve better than that.


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Motorcycle tires (http://www.motorcycle-tech.com/tires/motorcycle-tires)

[ffnextdoor]

My agency is using a system that you have a minute and half to get out if there is no response you get a 3 and 2 minutes to confirm a crew responding a total of 4 minutes....

As for the nine minutes there are points in almost every district in my town that you could not get to in 9 minutes even with lights and sirens....

I do understand that these people are waiting for the BUS but maybe the county should spend some of the money and hot air they are using to educate people on what is an emergency. I know the past years stats are not what they are making them out to be, also NEWSDAY(who loves the volunteers) forgot to mention aboout the alpha system and the amount of those calls that were 2nd 3rd 4th alarms....


jimmy

[LIZ MOORE]

ELIZABETH MOORE IS HOT

[FireMedic096998]

I think that the protocol is a necessary step in the right direction. There is always going to be second and third alarms that hinder our ability to get there in a timely manner, but for the most part that is not the case. We should be getting out in 2-4 minutes no matter what. I agree with what was said about there being places in your district that you just cant get to within 9 minutes and as volunteer or paid we can understand that. I am both and i do it because I love it and i figured that i liked it so much why not get paid to do it too. I dont see the problem with that, and i cant see why anyone else should??? I serve my home community and get paid to serve others b/c they do not have the resources in some departments to offer the proper level of care. Most people i work with get paid and go home and volunteer just like I do. That doesn't make us bad people, it makes us people who love what we do. It is a slow and steady progression to a combination system of career and volunteer. 2/3's of EMS agencies have some kind of paid employee, responder or crews, and almost every firehouse in Suffolk has atleast one houseman, if not more. I dont see why that is such a big deal. I am a 4th generation fireman and proud of it, but I do see that we are not recruiting like we used to and it is only a matter of time before we dont have the participation anymore because we are all going to be working 2 or 3 jobs to afford to live here. If you dont agree with me thats fine, this is just one guys opinion.

Bryan Kelly
FF/Medic
________
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[Vengeful Medic]

And I would also like this to get thrown into the mix (I had this conversation today with a few friends of mine who are like minded on this issue....for the most part..):

The volunteer has done its best to serve the various and diverse communities of BOTH Nassau and Suffolk. However, in regards to suffolk, there is no Police Ambulance to guarantee a response within an acceptable time frame for alarms. Meanwhile, several departments have already gone paid in many respects (be it day coverage, fly car coverage, or 24 hours). I personally know a lot of Volunteers who are very upset with the Paid Crew situation in some departments or even in general. But I also believe that crying about it will not solve anything....action had to be taken to avert possibly a disaster in terms of Pre-hospital Care in Suffolk County. You really have three groups as I see it based on my conversations with several people:

1) People who only volunteer and like it that way (and also think the system should stay that way).

2) People who work in the EMS field for a living and come home to Volunteer and like it that way because they eat, drink and dream EMS (I fall into this group).

3) People who want a fully paid system because they feel that it is the only way to guarantee Pre-hospital coverage within an "acceptable time frame".

Now, further on the issue of "going paid", here's what would happen (again, opinion based on conversations with several people who are in this field):

A paid EMS system would initially have to work off of the Taxes for at least the first 2-3 years.....
Then at around the three year mark, for revenue recovery, the taxes will gradually be decreased while the system fully integrates a third party billing system.

Okay, nothing earth shattering, but as far as most of these posts were concerned, no one really brought this angle up (unless I missed something). However that's my sermon for today. Thanks for your time.....

Omar-Fara B. Norgaisse, EMT-P

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[GCFDVolly]

Good Ideas
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[System Provider]

To all who have Comments;

I have been in the system for over 26 years, both as a volunteer and as part of a paid service. My experience also includes management in both services and on a national and International level.

First let remember we are here to provide a service to the tax payer, community and who ever is in the need of medical (or traumatic) assistance, there should be no restriction to the service that is provided, all services should be providing Advance Life Support, a first responder (ALS or BLS preferably ALS) should be on scene within in 6 minutes and an ambulance with in 12 minuets, this is a national excepted standard for response time.
As for the REMSCO Standard, well REMSCO is part of New York State Health Law Article 30 which covers EMS and is responsible for local Policy and Procedures and Medical Control Policy and Procedures. The Law gives REMSCO the authority to implement this policy, Fire Companies, Districts, Departments and Community Ambulance Companies are required by law to meet what ever standard the local REMSCO establishes.

REMSCO not Suffolk County EMS came up with this document and they (REMSCO) has the power and authority both implement this standard and to go to the state and pull any Certificate of Service given to any EMS Provider in the County. What is interesting is that if you call in within two minutes and have a crew that dose not effect response time, you still have to respond to the building gather your crew and respond to the incident. Where is the saving of time? There are 109 fire departments and 47 Ambulance companies in Suffolk County, if you look at just the fire service and consider there budgets some are at or about 1 million dollars and some are as high as 4 million dollars, if each had a budget of 1 million dollars that is 109 million dollars that could be used county wide for a paid fire and EMS system with the added billing to insurance companies. Wow what a system we would have with response time meeting or exceeding the national standard.

I am a volunteer and proud of it, but I know that we are a Public Service Provider and must provide the service, anyone including the organizations I belong to can not meet this standard, it is being met in other systems in the country, just look.

Commissioner of Fire Rescue and Emergency Services seems to be under the impression that “home Rule” means you do not have to meet any laws set by government bodies let me remind you that we are governed by OSHA, PESH, NIOSH and any Federal, State, Corporation, and Town Laws depending on the organization and its structure.

If you would like to educate yourself I suggest you visit the New York State Health Department web site and look for Article 30 and read it for your self.

[serviceprovider]

To all who have Comments;

I have been in the system for over 26 years, both as a volunteer and as part of a paid service. My experience also includes management in both services and on a national and International level.

First let remember we are here to provide a service to the tax payer, community and who ever is in the need of medical (or traumatic) assistance, there should be no restriction to the service that is provided, all services should be providing Advance Life Support, a first responder (ALS or BLS preferably ALS) should be on scene within in 6 minutes and an ambulance with in 12 minuets, this is a national excepted standard for response time.
As for the REMSCO Standard, well REMSCO is part of New York State Health Law Article 30 which covers EMS and is responsible for local Policy and Procedures and Medical Control Policy and Procedures. The Law gives REMSCO the authority to implement this policy, Fire Companies, Districts, Departments and Community Ambulance Companies are required by law to meet what ever standard the local REMSCO establishes.

REMSCO not Suffolk County EMS came up with this document and they (REMSCO) has the power and authority both implement this standard and to go to the state and pull any Certificate of Service given to any EMS Provider in the County. What is interesting is that if you call in within two minutes and have a crew that dose not effect response time, you still have to respond to the building gather your crew and respond to the incident. Where is the saving of time? There are 109 fire departments and 47 Ambulance companies in Suffolk County, if you look at just the fire service and consider there budgets some are at or about 1 million dollars and some are as high as 4 million dollars, if each had a budget of 1 million dollars that is 109 million dollars that could be used county wide for a paid fire and EMS system with the added billing to insurance companies. Wow what a system we would have with response time meeting or exceeding the national standard.

I am a volunteer and proud of it, but I know that we are a Public Service Provider and must provide the service, anyone including the organizations I belong to can not meet this standard, it is being met in other systems in the country, just look.

Commissioner of Fire Rescue and Emergency Services seems to be under the impression that “home Rule” means you do not have to meet any laws set by government bodies let me remind you that we are governed by OSHA, PESH, NIOSH and any Federal, State, Corporation, and Town Laws depending on the organization and its structure.

If you would like to educate yourself I suggest you visit the New York State Health Department web site and look for Article 30 and read it for your self.

[Vengeful Medic]

Interesting point, and I'm glad you cleared up/pointed out that REMSCO supercedes the rules of the local departments/agencies. The statement by Fischler is akin to what FDNY EMS likes to think: That they supercede what the state says.


Omar-Fara B. Norgaisse, EMT-P
________
Avandia lawyer (http://classactionsettlements.org/)

[ltjag]

How about all of those departments that can't/won't meet this response protocol band together and set up a fly car full of white sheets. If you're unable to put a crew at the scene within this timeframe than all that can be done for that patient is to throw a sheet over them.

[Service Provider]

To all who have Comments;

I have been in the system for over 26 years, both as a volunteer and as part of a paid service. My experience also includes management in both services and on a national and International level.

First let remember we are here to provide a service to the tax payer, community and who ever is in the need of medical (or traumatic) assistance, there should be no restriction to the service that is provided, all services should be providing Advance Life Support, a first responder (ALS or BLS preferably ALS) should be on scene within in 6 minutes and an ambulance with in 12 minuets, this is a national excepted standard for response time.
As for the REMSCO Standard, well REMSCO is part of New York State Health Law Article 30 which covers EMS and is responsible for local Policy and Procedures and Medical Control Policy and Procedures. The Law gives REMSCO the authority to implement this policy, Fire Companies, Districts, Departments and Community Ambulance Companies are required by law to meet what ever standard the local REMSCO establishes.

REMSCO not Suffolk County EMS came up with this document and they (REMSCO) has the power and authority both implement this standard and to go to the state and pull any Certificate of Service given to any EMS Provider in the County. What is interesting is that if you call in within two minutes and have a crew that dose not effect response time, you still have to respond to the building gather your crew and respond to the incident. Where is the saving of time? There are 109 fire departments and 47 Ambulance companies in Suffolk County, if you look at just the fire service and consider there budgets some are at or about 1 million dollars and some are as high as 4 million dollars, if each had a budget of 1 million dollars that is 109 million dollars that could be used county wide for a paid fire and EMS system with the added billing to insurance companies. Wow what a system we would have with response time meeting or exceeding the national standard.

I am a volunteer and proud of it, but I know that we are a Public Service Provider and must provide the service, anyone including the organizations I belong to can not meet this standard, it is being met in other systems in the country, just look.

Commissioner of Fire Rescue and Emergency Services seems to be under the impression that “home Rule” means you do not have to meet any laws set by government bodies let me remind you that we are governed by OSHA, PESH, NIOSH and any Federal, State, Corporation, and Town Laws depending on the organization and its structure.

If you would like to educate yourself I suggest you visit the New York State Health Department web site and look for Article 30 and read it for your self.

[duh]

echo cho cho cho cho cho....................


I believe you said that already.
________
RENT GUARANTEE FORUM (http://www.insurance-forums.org/rent-guarantee/)

[FireFighter]

I don't know what the problem figureing this out is.

In Nassau there are volunteers and a county bus. That way taxes aren't unbarable with all paid and the community is best served. When a call comes out the volleys go for it and the county bus takes it in, if the volleys have it the county turns around if not they have it. The volleys aren't mad b/c the life is saved.

Not all paid ! But combo !

[MMPBK]

I have some comments regarding your post that I think you may want to research.

1) Remsco may have the authority to implement policies and procedures regarding patient care. But that arguement is tenious at best regarding operational autonomy of the Fire Districts and the Fire Chiefs operating their districts under General Municipal and Town Law. These districts are run and administered by "public elected" officials, not appointed or nominated members of a council. "Home Rule" will win every time in the courts, and Commissioner Fischler knows this. In addition, Fire Chiefs have sole operational authority of their fire departments while they are on duty by Town Law. Article 30 and Remsco do not trump these laws and they may only implement policies and procedures within their purview. There may be more of an argument for enforcement of Remsco Policies regarding ambulance districts.

2) This policy that was adopted by Remsco was neither field tested nor researched prior to its implementation. I have yet to see the results of a study of such a policy that definitively shows a reduction in response times to EMS calls. What is the anticipated result of contacting another agency after 2 minutes and then having them travel an additional 4 minutes to an alarm after they have arranged to get a crew to call in 2 minutes and get to their quarters in 5 minutes. This policy is BS and will not do anything to reduce response times below the 9 minute threshold they want. They should be looking elsewhere.

3) What is the end goal that Remsco is looking for and what other "irons" do they have in the fire? If it is a career ALS First Response System, then lets get off our butts and start pushing for it. This policy will not assist us in getting there. We should be consulting with our elected officials and the individual districts to come up with an accommodation that provides a consistent level of standard of care throughout Suffolk County.

As for other ideas.

4) First, we should be looking into the reduction or elimination of the Alpha Call type by other means of transportation so that the true emergencies can be handled appropriately. When used correctly, the EMD dispatch system is a powerful tool that can assist this county immensely. Is it perfect, no. But it can help us.

5) Second, we should be contacting every hospital in Suffolk County and working with them to develop a non-emergency transport system. Other EMS systems throughout the country have used this idea quite successfully and to the hospitals and clinics delight.

6) Third, we must have properly educated people meet with the individual fire districts and ambulance corps to find out what is needed to get them on board with the 9 minute response goal. They must "buy" in to the program or your dead in the water to start. If you can get them to agree, it will save you time in the long run by not having to run the gamut through the courts. Unfortunately, I do not think the members of the Remsco Board are capable of spearheading this initiative because of their actions regarding the recent policy adoption.

There are many bright people out there with ideas to get the system better. I am planning, as well as others I suspect, of attending the next Remsco meeting to see what is discussed. I will support any policy or procedure that will move us in the right direction of providing prompt and adequate patient care. However, I will not support an unenforceable, possibly illegal, and ineffectual policy such as the one that has just been adopted. This will only be part of the problem. I'm coming with other ideas and trying to be part of the solution. I wish that I came a little earlier. How about the rest of you with the mouths, do you have the ideas?


Edited by: MMPBK at: 5/18/04 12:10 am

________
Lovely Wendie (http://www.lovelywendie99.com/)

[FireMedic096998]

I agree with you that this protocol is no perfect it is a step in the right direction. I don't think this procedure that they put into effect is about volunteers, i think it is their way of pushing for more paid agencies with volunteers. If thats the case, I am OK with that b/c when my family member is having chest pain wherever they live and the ambulance is waiting 8-15 minutes to crew up, we are wasting time. There are a million studies that prove that response times do save lives. Think about your basic EMT protocols when using an AED, they want you there with 4-6 minutes to deliver the first shock. If you don't have that, they might as well get a priest instead of an ambulance. That is just one example. The point of the 2 minute response is that we all have large districts if they are not getting a crew in 2 minutes, maybe someone else will be. I know where i work, we are on the road with a full ALS crew within 30 seconds, even on 24's. Is that the reality all over Suffolk or Nassau, no probably not, but where i am it is, and it is a little more comforting for the community to know that. Now you can argue, what about 2nd and 3rd hits??? My answer is that no matter how paid or volunteer we are there will always be multiple calls, adn there always will be a delayed response to them b/c our priority is to the first. Look at NYC with all the ambulances, and they still get hammered every now and then in areas and have trouble, there is no way around that. I am not saying that you have to put on full ALS crews or any paid at all. If your VAC is getting the job done with just volunteers, then thats great. But to have some foolish pride that will only end up hurting the people we are supposed to be helping, thats stupid. Another thing that really amazes me is that SCPD gets the calls 3-6 minutes before our agencies do, thats a fact. Why is that??? I am not sure, but it is a problem, because that is time wasted by FRES, not the volunteers, that could be used crewing up our trucks. There are a lot of issues and we all know what they are. Whether your districts solution is responders, crews, or whatever thats fine, as long as your getting to your patients. I think that there are way too many people on this board bitching without a solution, that is just ignorance. This board should be used for the sort of thing that we are doing, not the BS that is going on. We all have some good opinions and maybe we can use this board to get some positive things accomplished.
Bryan Kelly
FF/Medic
________
Toyota Sequoia Specifications (http://www.toyota-wiki.com/wiki/Toyota_Sequoia)

[ExCaptEMS]

Any EMS agency that does not comply with the REMSCO protocol risks losing their 1 million dollar indemnification policy provided by Suffolk County. Depts that comply will see their coverage increased by another million. The legislature is going to vote to support REMSCOs efforts. People have been waiting for improvement of the response times since the 1986 Newsday series. The mgmt of our EMS agencies have done very little to improve for 18 years. This issue has been researched ad nauseum by REMSCO and is legally sound. Agencies that don't comply risk litigation by patients who do not receive service. The standard is set. This protocol is more lenient then NFPA standards. All the agencies should embrace this as it increases their professionalization.
________
LovelyWendie (http://www.lovelywendie99.com/)

[MMPBK]

It may be true that an agency may lose their million dollar county indemnification policy but it is a very little relevance. Most districts have supplemental policies that are equal or greater than the existing county policy. Sometimes 10 times greater. The expected benefit of enticing agencies to adopt the policy or risk losing the policy is flawed. It is far cheaper to pay for additional coverage than to finance a paid system, a simple fact. As for the legislature supporting REMSCO's efforts, I am sure that may be true. But the political and legal reality may be that any decision by the county legislature to support this idea is window dressing at best. The county legislature would have to some major legal manipulation to pass any legislation that would be binding on the fire districts and supersede "home rule". None of which could be completed in the near future and and without potential political fallout from the tremendous voting power that the Volunteer Fire Service on Long Island has. In addition, with all the outcry regarding school budget votes and increasing taxes, I do not think that the public support for this initiative is quite there yet. Soon maybe, but not yet. And as for REMSCO researching this issue "ad nauseum" and the legal soundness of a policy that is tenuous supported, at best, by Article 30, I refer you to my previous post. This policy and/or protocol has not been field tested in anyway nor any information provided supporting that this protocol will achieve the goal of getting us to the patients in under 9 minutes. No supporting documentation has been provided to my fire department, nor my neighboring departments, to any effect. Article 30 gives REMSCO authority over triage, treatment and transport. The extension of this protocol to cover the operational purview of response has not been established (this battle was fought in NYC years ago to no avail) and shall be for a court to decide if it ever gets that far. As I said before, I do not feel that this protocol is even close to answering the problem. We must seek an alternative method of incorporating the fire and EMS districts with the country legislature and adopting a county wide first response ALS system that has a continuity and standard level of care. This protocol does nothing to reduce response times or reach that goal.
________
Michigan medical marijuana (http://michigan.dispensaries.org/)

[ExCaptEMS]

I am really sick of hearing how agencies can't meet the standard. Comments like "our taxes will go up, if we have a paid system" are BS. Nassau PD EAB runs over 50% of the EMS runs in their county on appx 18-19 million dollar budget and gets back 13-14 million from third party billing. If we started a system in Suffolk with third party billing we would see similar results. Or...Using a public utility model would enable the system to run on billing independently without using the tax rolls. Check out Pinellas County, Florida. The population demographics are very similar. Suffolk County should put a referendum on the ballot and let the public decide. All the wining and crying by the vollies has to stop. Either do the job or get out of the business. REMSCO absolutely has the authority to promulgate protocols. They have the backing of the State Health commissioner and SEMAC as well. The home rule issues are a smokescreen, just another attempt to skirt the issue.
________
Lovely Wendie (http://www.lovelywendie99.com/)

[FF]

......would also probably help eliminate all the BS calls too.
________
Web shows (http://livesexwebshows.com/)

[MMPBK]

You state "REMSCO absolutely has the authority to promulgate protocols. They have the backing of the State Health commissioner and SEMAC as well. The home rule issues are a smokescreen, just another attempt to skirt the issue."

I agree the REMSCO has the authority to promulgate protocols, but only to the extent of their authority listed in Article 30 of the Public Health Law that restricts that jurisdiction to Triage, Treatment and Transport. Once again the stretching of their authority to operations as stipulated in other areas of state law are by no means absolute or even confirmed.


"They have the backing of the State Health commissioner and SEMAC as well."

That may also be true. But whether that is translated to autonomous authority over "elected" officials and other sections of state law will yet to be seen.

"The home rule issues are a smokescreen, just another attempt to skirt the issue."

I hate to say this, but, this issue is at the core of our state and federal government and legislative process as a whole. For you to say that it is "a smokescreen to skirt the issue" indicates a willingness to violate what our federal and state laws and constitutions were written to restrict. And that is the unchecked and over reaching of government agencies or branches of government infringing on the rights of the citizens to rule themselves. This is a process issue in addition to an inadequacy issue.

I once again state my position that yes the system has to be changed and for the better. There are a lot of ideas out there to address the issue and you mention a few. However, I will not support expediency at the cost of the process and I will not support a policy that does not address the overall issue.
________
Ford Vh Platform (http://www.ford-wiki.com/wiki/Ford_VH_platform)

[SCPD]

Elected officals ALWAYS have jurisdiction over appointed people. Why do you think people like the SC Sheriff is the highest law enforcement officer in the county, because he is ELECTED not APPOINTED like the Police Commisioner.

[SuffolkCC]

As some here may know I'm a paid/volly EMTCC in Suffolk. Reading this story from L.M. enrages me! She says that "dispatch data from 2001 did not find a single agency that met that time standard for the most serious calls" This is just false. I am Chief of Stony Brook Ambulance and I work at Wyandanch Ambulance. While I'm not gonna bash WWHAC here all I will say is that when my partner and I are working 90% of the time we are ON SCENE with 3-4 minutes of the call being dispatched many many many calls we're on scene within 1-2 min. As for SBVAC I think I am qualified to say that we are blessed with a small district and MANY DEDICATED VOLLIES and meet the 9 min almost always. Sure there are a few times that the second ambulance doesn't get out but with a 1/2 of 1% 24 rate I'm comfortable that we are providing QUALITY CARE in a timely fashion to the public. THERE ARE COMPANIES HERE THAT DO WELL AND TAKE THEIR JOBS SERIOUSLY THERE ARE COMPANIES THAT NEED HELP..... HELL THERE ARE COMPANIES THAT NEED TO GO PAID - PERIOD - BUT LIZ MOORE NEEDS TO GET HER FACTS STRAIGHT.
Philip Aubrey - SBVAC
________
Teen Movies (http://www.fucktube.com/categories/39/teen/videos/1)

[Vengeful Medic]

Actually Phil, I don't know why you even gave Liz Moore's piece the time of day in regards to her story pointing to 2001 stats finding no one meeting the standard. Liz Moore hates the Vollies. Plain and simple. We all know this. I'm not saying you are wrong, hell you are absolutely correct. But dude....let her words fall on deaf ears and blind eyes. Have a good weekend.

Omar-Fara B. Norgaisse, EMT-P
________
Honda cd175 (http://www.cyclechaos.com/wiki/Honda_CD175)

[Vengeful Medic]

It would seem you are promoting that local departments are Fiefdoms that should be left to their own devices. Pre-hospital care in the State of New York is directed by protocols set by the Department of Health, and enforceable by the same. In other words, you want to dance in this hall? Okay. You play by our rules when you come in here, or you are out of here. IF an agency does not want to or is unable to meet the standards, then by all means the DOH should and MUST take action that should include removal of CON (Ambulance Service Certification). If a department cannot meet the standard, then I'm sure Suffolk REMSCO will try to work with those agencies further (although I don't know how much more you can beat a dead horse). But if a department DOES NOT WANT to meet the standard, then they need to close up shop and divvy up their district (EMS-wise) between the surrounding jurisdictions....but then we run into the problem of increasing the workload on your neighbors. So here's the deal. Get with the program. There are solutions to the problem. You know what they are. Get to it. Otherwise, get off the damned porch.
________
BODY SCIENCE (http://bodyscience.ws/)

[TOPDOGEMT]

The only way we can get times down throughout the county is to have full time paid crews in house 24/7. Having crews respond from their home to a another location to pick up a ambulance is time wasted. Having a crew in ready mode at all times with the ambulance is the only way to do the right thing by the people of Suffolk.

[MMPBK]

"It would seem you are promoting that local departments are Fiefdoms that should be left to their own devices."


You are missing the point. But fine. I recommend that everyone read a little history of law, particularly the constitutions of both the US and New York State. It is interesting reading and will give you insight into how laws are written and the concept of "home rule".

"Pre-hospital care in the State of New York is directed by protocols set by the Department of Health, and enforceable by the same. In other words, you want to dance in this hall? Okay. You play by our rules when you come in here, or you are out of here."

I agree with you. But heres the catch. Your "dance hall" is the area of Triage, Treatment and Transport as stipulated in Article 30 of the Public Health Law. This response protocol falls within the confines of someone else's "dance hall", General Municipal and Town Law. So who is dancing in who's hall. Think about it.

"IF an agency does not want to or is unable to meet the standards, then by all means the DOH should and MUST take action that should include removal of CON (Ambulance Service Certification)."

Interesting proposal. What standard are you talking about? I assume it is the desire to reduce response times and get resources to the scene in under 9 minutes 90% of the time. Excellent goal to say the least.

Therefore, I propose the following:

Before you go and try instituting a protocol that in no way will ever meet that standard and in doing so infringes on numerous sections of law and the autonomy granted to other agencies underneath the law, may be you should be petitioning the state and county to pass a law that requires all ambulance agencies within their jurisdiction to meet a minimum universal standard and allow the individual agencies to determine what method they are to institute the program. This sets a standard and allows an agency their own autonomy to function. A "regulatory standard" as opposed to an arguably illegal protocol.

And before you start wielding around the argument that SEMSCO, and the Department of Health have this and that authority and they should pull a CON. I have yet to see a universal minimum response standard put forth, or adopted by, any of these agencies for use state-wide. I wonder why that is? Basically, because they do not want the headache of legal battles with agencies throughout NYS. This is a state-level law change people, pure and simple, not a REMSCO BS Protocol.

"There are solutions to the problem. You know what they are. Get to it. Otherwise, get off the damned porch."

Unfortunately, my porch is in the state of New York and I will not allow an ill-advised and ineffectual protocol to circumvent or violate what is clearly written in state law. My agency is doing everything it can to meet the standard, but it will do so on its' own terms and within the confines of the law in which it authority resides.
________
INFANTS WELLBUTRIN (http://www.classactionsettlements.org/lawsuit/wellbutrin/)

[ltjag]

I must say that the exchange on this thread is very refreshing. The posters are armed with a thorough knowledge of the realities of the system as well as the legal and political landscape within which it operates. I hope my chiming in does'nt draw my detractors into their usual off point harangues on this thread.

The argument here is a rather technical one. I see the point about the states inability to legislate the minutiae of a given departments operations. The state is vast and the public safety needs of one part may be completely different from those in another. The state could'nt reasonably create a "one size fits all" response time "standard", but rather should yield that responsibility to the regional agencies overseeing a given region. These agencies are familiar with the peculiar needs of their region and thus are far better suited to set the protocols that will work in that area. As far as the issue of compliance is concerned, that should also be within the ambit of the regional agency. It may be technically correct that the regional agency cannot impose this response protocol on those departments in their region. They should, however, have the ability to hold some sort of sword over those departments that cant or wont meet a legitimate standard that is formulated with the specific circumstances of the region taken into consideration. For a department to simply rely on the fact that no agency can make them comply as justification for their not complying is just absurd.

[Go Away]

You are not a member of ANY fire department or ambulance corp. PLEASE stop being the Jennie of Nassau.
X.

[MMPBK]

" It may be technically correct that the regional agency cannot impose this response protocol on those departments in their region. They should, however, have the ability to hold some sort of sword over those departments that cant or wont meet a legitimate standard that is formulated with the specific circumstances of the region taken into consideration. For a department to simply rely on the fact that no agency can make them comply as justification for their not complying is just absurd."

Unfortunately, REMSCO was never given that particular sword of which you speak. An argument can be made that what makes this particular standard appropriate for one region and not another violates equal protection and causes disparaging patient care standards statewide. If this standard is not adopted in, let's say Putnam County, what compelling argument can be used to say Suffolk is right and has the authority. An extraordinarily technical argument at best.

Hence the reason I propose the state take up this issue and resolve it by setting the standard statewide and let the individual agencies comply in their own methods, whether by volunteers or career staff. We must comply with agencies or authorities having jurisdiction and the state could easily address this issue if they wanted to. Unfortunately, this is a "political third rail" that could easily become a nightmare if not handle properly and I do not think Suffolk REMSCO has the necessary wherewithal to handle this argument, as proven by the recent poor judgment with this protocol.
________
Wellbutrin Settlement (http://www.classactionsettlements.org/lawsuit/wellbutrin/)

[Vengeful Medic]

MMPBK, you are alright in my book...instead of coming at me with rhetoiric, you replied with intellect and a sound base. I'll debate you anytime, brother!!!!!!




Omar-Fara B. Norgaisse, EMT-P


(in case people wonder why I put hats up, that's a rating system I use for a subject matter. The more hats, the better the subject and the discussions therein. Silly, yes. But I like it!!)
________
LovelyWendie (http://www.lovelywendie99.com/)

[Asking]

I understand home rule, but how about imminent domain. I thought imminent domain could be used in cases like these?? The township has the right to supersede the municipality and the county the township and the state the county and so on. If that is true, which i am not sure about, then we do have to abide by the protocols set forth by these agencies. These municipalities are just, for lack of a better word "gifts", until the a higher agency takes them back. Also the problem i see with allowing agencies to accept these protocols at their own pace is that some adapt better than others. I mean i can guarantee you that there are still places that tail board and ride without 4 fireman on a fire truck because they just can't. (Only example i could come up with) To allow these agencies to take their time could be detrimental to the system and more importantly the patients. I think this will solve a lot of our staffing problems by forcing agencies to fix the problem immediately instead of 5 years from now or whenever they get around to it. Is it the protocol that is going to save the county, no probably not, but i think it is a step in the right direction. Just some food for thought.

[Vengeful Medic]

However in response, you said it right: There are too many technicalities that are in play here. But that's why the state leaves many policy decisions and regional protocols to the REMSCO's, so that decisions that may work in one part of the state and not another would be left to the affected region. As for "Home Rule", I will endeavor to read the NYS Constitution to make my own interpretation in regards to who actually benefits from the "Home Rule". I still say that regardless of a department's S.O.P.'s/Chief's Rules/By-Laws, they cannot deviate from the dictates of the DOH. I understand that you are saying that DOH 's realm of responsibility is in Triage, Treatment and Transport. Well, I am of the belief that Triage begins when the 911 call for EMS is picked up by the EMD (Emergency Medical Dispatch). The dispatcher right off the bat is triaging the patient into a category for response and care. That alone makes it a DOH issue just what you said-Triage (Alpha, Bravo, Charlie, etc.); -Treatment and Transport (ALS vs. BLS). Maybe I'm way off base here, but that 's my take on this in terms of interpretation. What do you think?

Omar-Fara B. Norgaisse, EMT-P

________
Nevada marijuana dispensaries (http://nevada.dispensaries.org/)

[Vengeful Medic]

In general I agree with you, Asking. Again, I have stated this on other threads (and I know I'll get roasted for it by those who know me, but facts are facts at this point): We need a combinations system. But not a Nassau PD type situation. A county wide EMS system run by Suffolk Division of EMS to supplement the Volunteer system. Even if it's just a fly car system so that you don't try to "push out" the volunteers. But at least you have a closer to guaranteed provider response to a greater percentage of alarms. And on top of that, agencies that are suffering in terms of having problems getting a crew can benefit from this. I am by no means calling for an end to the Volunteer system (as that's where I got my start in EMS here in NY), not by a long shot. But I do recognize a need for a supplement to correct a glaring issue that's close to all our hearts: getting the care to the patient as soon as possible.

Omar-Fara B. Norgaisse, EMT-P

________
Bmw m47 history (http://www.bmw-tech.org/wiki/BMW_M47)

[Asking]

I agree 100%. I think that the triage does start with EMD, because that is exactly what they are doing, prioritizing our calls. Now there is no perfect solution and we all know that EMD has given us the Alpha sick that becomes the viable Echo cardiac arrest. I do have to say that i agree with you Omar and I think that it would be silly of any Suffolk agency to snub their nose at this. I think that this business is all about patient care and you can't talk about patient care if you do not speak about reasonable response times. I think that a lot of these agencies are thinking they are doing good, but they aren't. Omar you just got hired somewhere, i know im FT there, and we are out the door in 1 minute with a CC and a Medic on every first hit. And most second hits they get a BLS crew out in 3-4 during the day (houseman). They were doing this before pretty much anyone (Nov 2002). I think that is serving your community!!! They were able to realize that they were not getting the job done and it was time to pay some help. So now 18 hours a day and 7 days a week there is at least a CC and Medic on. From 1800-2400 is Volunteer coverage and that is much more acceptable for the public and the vollies. Also, the vollies love us, we releaved a huge stress from their shoulders. They still get to ride calls too. If they wanna ride with us they can and if they do not, they still have the 6 hour tour to do so. This department gets plenty of good calls, trauma and medical alike. There are 4 full time crews and 3 of the 4 has a preceptor as well. It is a good system. But getting back to the original conversation, i am unsure about imminent domain?? I guess we will have to wait for MMPBK to read and let us know. Whoever it is knows a helluva a lot more than me. LOL

[MMPBK]

Thank you very much. I appreciate a good debate also. Now back to the show.
________
Justin Bieber (http://justinbieberfan.info/)

[MMPBK]

I think you mean "eminent domain". This is usually used by governments when dealing with individual property rights. I don't know how it applies here, but I will look into it.

"The township has the right to supersede the municipality and the county the township and the state the county and so on."

This is a tough subject that usually takes quite a few years of law school to understand sufficiently. But maybe I can explain it like this.

Local governments (i.e. village, town, county) may govern themselves under the specific laws of New York State that allow them to. They may legislate areas not specifically addressed under State Law and may make local ordinances stricter than what the state allows only if it does not conflict with existing laws and the constitution. This does not mean that the town can pass a law that violates state law (i.e.-It is OK to steal). It does mean that a village can pass zoning laws that, let's say, restrict flag poles to 30' where no such law exists in state law.

The difficulty arises when the municipal fire districts are formed under State Law and given certain rights and authority that the town or county does not have. The town or county can not just pass a law or regulation binding the municipality when they do not have the authority and the authority of the fire districts resides in law higher than the town or county.

Also, any regulations or ordinances affecting the autonomy and authority of a municipality or local government is done so through the legislative process by elected officials. Not through an appointed committee formed under a section of Article 30 of the Public Health Law. To do so infringes upon home rule and how people govern themselves.

These are not "gifts" in any sense of the word. They are the basis of government in the state of New York.

________
Amatuer Tube (http://www.fucktube.com/)

[MMPBK]

"I still say that regardless of a department's S.O.P.'s/Chief's Rules/By-Laws, they cannot deviate from the dictates of the DOH."

Good argument. But this is not the dictate of the State DOH, it is an arbitrary decision by a regional committee to adopt a position that is not accepted statewide, nor mandated by any law to be accepted. However, the operational prerogative of the Chief and the administrative and governance prerogative of commissioners exists in state Municipal and Town Law. You might have any argument for compliance if this came directly from our elected officials at the state. But it did not.

"Well, I am of the belief that Triage begins when the 911 call for EMS is picked up by the EMD (Emergency Medical Dispatch). The dispatcher right off the bat is triaging the patient into a category for response and care. That alone makes it a DOH issue just what you said-Triage (Alpha, Bravo, Charlie, etc)"

Another excellent argument. But here's the wrench. The EMD Dispatch system was designed for efficient categorization of emergency calls to assist in the dispatch of the appropriate resources to the assignment (i.e. ALS units to ALS calls. BLS to BLS calls). It also provides appropriate basic layperson medical care for the patient in the advance of the ambulance or responder. It does have recommendations for response times, however, nothing is written in stone and left to the individual agencies operations. However, and this is the big one, the state BEMS has informed EMS agencies that once a call is dispatched and a unit responding, that unit may not divert to a higher priority assignment, regardless of call type. Therefore, the argument that this is true "triage" has been corrupted by our own state BEMS. In addition, there is no state mandate to adopt the EMD dispatch system therefore there really is no uniform initiation of "triage" even if BEMS did not make the interpretation it had.

________
LEATHER BOOTS (http://www.fucktube.com/video/351/blonde-milf-in-leather-boots)

[ltjag]

You guys are good. I have a great appreciation for the caliber of the dialog that is taking place on this thread. I must admit that you seem to have a far deeper knowledge of the field than I ever had, or will have.

In my earlier post I suggested that the regional agencies should be empowered to both enact and enforce a response time protocol. It's been stated here that the at-issue protocol that just came out is "arbitrary". I don't know about that, but I would speculate that the agency that promulgated it did its due diligence in arriving at it. As far as whether the agency is comprised of appointed or elected members, it is really of no moment. To me, the question is what is their authority, where does their authority flow from, and, is it clearly enumerated? I don't know the answers to the questions I pose. I do know that these regional agencies are, or should be, familiar with the needs of the area they represent. They should possess knowledge of the resources available in that area and the logistics of deploying them. As you know from an earlier post of mine, I think the at-issue protocol is lenient to the point of being a joke. I think it was arrived at almost as a concession to the predominant volunteer status of the affected departments. These departments have had a carrot dangled in front of them for years with no substantial improvement to show for it. Now its time for the stick. Again, I cant speak knowledgeably about the enforceability of this protocol, but it does'nt seem to me that if a department cant meet it that they should just get a pass. Someone, somewhere needs to be able to hold their feet to the fire.

[DM]

By a FORMER fireman.

Right X ?

[MMPBK]

"It's been stated here that the at-issue protocol that just came out is "arbitrary". I don't know about that, but I would speculate that the agency that promulgated it did its due diligence in arriving at it."

Arbitrary is the best term to use in this particular case. The "protocol" was written and not field tested with any agency prior to its' implementation. No research has been conducted, no literature search conducted, nor any findings presented to support this protocol. Therefore, it is arbitrary by it's own nature.

As for the agency that promulgated it did its' due diligence in arriving at it is contradictory by the evidence above. If they did not research it or test it, they in no way arrived at the protocol with due diligence.

Also, last time I checked, protocols are properly researched and tested prior to their implementation to ensure effectiveness and safety. Why should this protocol be any different if your using that argument.
________
SHIP SALE (http://ship-sale.com/)

[Asking]

I agree that this should have been tested at a smaller level first to see its effectiveness or non for that matter. But again this is just a protocol, if it doesn't work out, we bring it back to the drawing board and re-write it until it fits. Can anyone remember when it was standing order to give 2 amps of Bicarb at every arrest??? I can't but I have heard stories, talk about alkolotic, wow. Or isuprel, when that first came out, it was the wonder drug, then we found out it would give a hamburger a heartbeat. My point is, I think REMSCO went about this in a trial and error fashion. I don't know if its the best method of testing, but maybe it will wake up some of those districts that need to get their acts together. I understand the concerns with it, but the same time I think of it as a scare tactic more than something they are going to force down our throats. I think they will eventually realize that in its current state it is very rough around the edges, but with some cleaning up we might have something good here. I just think that at least it is something. I was at one of my per diem gigs today and heard a department 24 a call to 4 other places before someone finally got out. That is ridiculous, but these neighboring districts have had enough of helping, they are called all the time. While I understand that, it is a real shame that they have worn the surrounding departments down so bad that no one comes out anymore. It was their only hit too, not a second or third. So I think that maybe it will make us go out an recruit more or put some paid staff on during the day or whatever. Something needs to be done, because we are a proud group of volunteers, that is hurting the people we are supposed to be serving. Pride can kill just as quick as a mudslinging message board, LOL!!!!! Well on that note, its bedtime. Goodnight and Be Safe!!!!

[Vengeful Medic]

Goodnight, Asking, ltjag, MMPBK, et al.

Time for me to work...

The City, the City, she calls me..............
________
Juicepop22 (http://www.girlcamfriend.com/cam/juicepop22/)

[EM]

Seeking quicker ambulance times




BY ELIZABETH MOORE
Staff Writer

Saying more than 2,000 Suffolk residents were forced to wait more than 20 minutes for an ambulance after making a call last year, a county legislator plans to file unprecedented legislation that would compel agencies to take concrete steps to bring their response times in line with national standards.

"The current system needs to adjust because the status quo is too dangerous," wrote Legis. David Bishop, the West Babylon Democrat who wrote the proposal, in his letter to Babylon Town chiefs.

The county's ambulance agencies are generally providing more skilled service, faster, than 15 years ago, records show. But few, if any, manage to answer calls within 9 minutes, 90 percent of the time, a goal adopted by the National Institutes of Health and the county's regional emergency medical services council. Precise information about Suffolk response times isn't being collected, another problem that would be addressed by the bill, co-sponsored by West Hills Republican Legis. Paul Tonna.

Departments that took steps called for in the legislation would get $2 million in increased county liability coverage. Those that defied the requirements would be referred to the state to have their credentials reviewed and would lose their county-sponsored liability insurance.

The bill's sponsors say they expect opposition from the volunteer community. David Fischler, the county's commissioner of fire, rescue and emergency services, said recent initiatives, such as requiring volunteers to call in to say whether they are on their way to an emergency, should be given time to work. "I do not support penalizing the volunteers," he said.

Richard Vella, president of the Suffolk County Volunteer Firemen's Association, said that while he was unfamiliar with the details, he didn't like the measure's mandatory sound.

"We really don't know if they have the authority to make a protocol like that," he said. "If it was going to be a guideline, we could probably live with it."

If the bill is filed, it would be the first measure seeking to compel Suffolk volunteers to improve performance, said Chief Deputy County Executive Paul Sabatino. Bishop and Tonna are term-limited and won't be running for office.

"It's time to take this issue on," Tonna said. "We pay enough taxes. You can have all the best equipment and best-trained people, but if they don't get there in time, what good is it?"

Marian Myra, 66, experienced how frightening ambulance delays can be the morning of June 6 of last year when she suddenly felt her cheeks go numb and found she couldn't speak. She was having a stroke.

Her husband dialed 911 and a police officer arrived promptly. But Copiague couldn't find any volunteers, nor could Lindenhurst. More than 39 minutes later, a crew from Amityville arrived.

Fortunately, Myra's attack was a ministroke, one that gradually subsided in a few hours.

"Every time we called back, they kept saying, 'It's on its way, it's on its way,' but we'd never hear the sirens or anything, so obviously nothing was on its way," she said. "I understand that they are volunteers, and thank God for them, but by the same token, when you need them, where are they? This is all we have to fall back on."

In a letter to Bishop about Myra's case, Copiague Chief Peter Sayevich said the delay was the first of such length in the department. But he said the case "demonstrates a clear difficulty ... throughout Suffolk County during those hours where volunteers are typically at work."

Emergency medical volunteers practice under Suffolk County's license, and the county also provides ambulance services with dispatching, equipment and $1 million in liability insurance.

But Bishop emphasized that his legislation does not mandate a paid service to replace the volunteers.

"Volunteers, paid, Martians -- I don't care who they send as long as the call gets answered," Bishop said. "They want the responsibility? Solve the problem."
Copyright © 2004, Newsday, Inc.

[ltjag]

Finally, a couple of term limited pols have sprouted balls and decided to confront this problem. Better late than never I suppose. To comment on a couple of gems in the article:

"Richard Vella, president of the Suffolk County Volunteer Firefighters Association, said that he was unfamiliar with the details, but did'nt like the measures mandatory sound."

Really. So it would be the position of the Association that because its members serve for free that they should not be held to any consistently measurable standard of performance? How about if a company in the business of making widgets was staffed by volunteers who produced three widgets an hour. One day one of the volunteers gets the idea of asking for money in return for his services with the promise that if you pay him/her, then he/she will produce twenty five widgets an hour. What do you think that manufacturer is going to do? I'll tell you what hes going to do, hes going to go all paid and see his productivity skyrocket. This may not be the perfect analogy, but I think you can see my point. Moving on:

"We really don't know if they have the authority to make a protocol like that", he said. "If it was going to be a guideline, we could probably live with it". Once again we see that "You cant make us" attitude. The translation of we could probably live with it is: we would ignore it.

[MMPBK]

"Really. So it would be the position of the Association that because its members serve for free that they should not be held to any consistently measurable standard of performance?"

No, you miss the point. This is not a standard that they are currently pushing and a standard has yet to be put forward. It is easy for a politician to jump in front of the parade and say I am leading. These guys are becoming a worse problem than the protocol. (maybe thats a better idea,comparatively). Hopefully, the politicians will pass legislation based on research, not emotion.

""We really don't know if they have the authority to make a protocol like that", he said. "If it was going to be a guideline, we could probably live with it". Once again we see that "You cant make us" attitude. The translation of we could probably live with it is: we would ignore it. "

This guy knows the laws. You can not jump to conclusions based on this quote. You know how the press, and Liz Moore especially, puts their spin on these things. It will work out in the end because even the leaders of the volunteer service know that this is a public relations nightmare.

________
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[FF]

If you only spent as much energy looking for a JOB.


Again, while yes something needs to be done, the COUNTY is not really in a postition to make laws governing fire and ems agencies. THEY FALL UNDER STATE LAW, NOT COUNTY.

Perhaps the STATE legislature should be working on this, not the county.

Again X please BUTT OUT!!
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[notalent losers]

No matter what is said, it comes down to this. The people representing the volunteers will criticize anything that anyone does to improve service in Suffolk county. Has there ever been a representative of these groups or departments that has EVER suggested something positive????????


Here's my quick fix of the response time problem...

have the vollies sign up for shifts at the station, and during their shift, make sure they are in quarters or around town in the ambulance with a full crew. No more responding to the station to pick up the ambulance.

I assure you the response times would drop below 9 minutes 90% of the time.

[Vengeful Medic]

Actually, the "County" as it is implied here did not make that protocol (the county being Suffolk County EMS or even REMAC), although there are a few people from the "County" that sit on REMSCO (the actual agency that made this protocol, and incidentally REMSCO is actually a STATE mandated agency that covers the Suffolk Region). And the State legislature had already worked on it, when they approved Article 30 of the Public Health Law, which gives REMSCO the authority to act in this capacity. REMSCO is simply an extension of the State to the various regions (I forget how many) in NYS.


Omar-Fara B. Norgaisse, EMT-P

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[ExCaptEMS]

Just to further clarify the situation: The REMAC put together the protocol. REMSCO merely endorsed it by a vote of the council. Article 30 empowers REMAC:

Emergency Medical Services (EMS)
ARTICLE 30
and
ARTICLE 30A
of the
STATE OF NEW YORK
PUBLIC HEALTH LAW
Emergency Medical Services

REVISIONS AS PROVIDED FOR BY:

CHAPTER 190 OF THE LAWS OF 2001
CHAPTER 349 OF THE LAWS OF 2001
CHAPTER 463 OF THE LAWS OF 2001
NEW YORK STATE DEPARTMENT OF HEALTH
Emergency Medical Services Program
433 River Street
Hedley Building, Suite 303
Troy, New York 12180-2299
518-402-0996
FAX: 518-402-0985


SECTION 3004-A. REGIONAL EMERGENCY MEDICAL ADVISORY COMMITTEES.

1. Regional emergency medical advisory committees shall develop policies, procedures, and triage, treatment, and transportation protocols which are consistent with the standards of the state emergency medical advisory committee and which address specific local conditions. Regional emergency medical advisory committees may also approve physicians to provide on line medical control, coordinate the development of regional medical control systems, and participate in quality improvement activities addressing system-wide concerns. Hospitals and prehospitalmedical care services shall be authorized to release patient outcome information to regional emergency medical advisory committees for purposes of assessing prehospital care concerns. Regional quality improvement programs shall be presumed to be an extension of the quality improvement program set forth in section three thousand six of this article, and the provisions of subdivisions two and three of such section three thousand six shall apply to such programs.

****The first sentence states develop policies and procedures. And TRANSPORTATION PROTOCOLS
***** it ALSO says participate in quality improvement activities addressing system-wide concerns. I hope this clarifies the situation. REMSCO was also provided with two legal opinions and numerous advisories from the DOH, NYS state and SEMAC. REMSCO is the regional council...therefore they are a local participating agency at the county level. If changes can't be made at that level to insure prompt response, who is going to do it!! Not the EMS agencies. They've done very little so far. The days of the hobbiest EMS system are numbered. We've been waiting 18 years for change. It's about time.
________
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[Ocrainaugh]

I've been sitting by the sidelines watching this discussion develop, and with a few execeptions, I'm impressed by the reasoned discussion.
A couple of points tho' do need to be made.

1. Get an egg timer. Hold your breath while you turn it over three times after it empties. Lemme know how you make out. Impossible, isn't it? Nine minutes is too long for anybody to go without air. It's too long to pump blood out of a ruptured cerebral artery. How would you like to wait nine minutes with your anterior descending coronary artery occluded? We used to think that for every minute that passes, a heart in V-Fib will lose 10 % of it's chance to return to a normal rhythm. Guess what? We've since found that's not true. Instead of survival decreasing arithmetically, it decreases geometrically, falling off rapidly after the first couple of minutes. We don't have the time we thought we had, do we?
2. Seems to me that anyone with a scanner tuned to 46.46 knows that the whole of the town of Smithtown has been following this plan (a call-in system with a quick sig 3 followed by a quick mutual aid request). On the calls that couldn't be handled by the originating agency, it shortened the time to get a bus to the scene. Period.
3. We all agree that REMSCO has authority to establish protocols in re: triage/treatment/transport. Hello? Transport? Getting an ambulance to the patient to take him/her to the hospital in an appropriate amount of time? Sounds like transport to me.
4.NFPA1710. Do we really want to look at the standard set by the FPA? Two BLS providers on scene in four minutes and two ALS providers on scene in eight minutes? When the NFPA came out and said we had to replace the back steps, we engaged in an orgy of fire apparatus buying without batting an eye. Every FD has a fleet with cabs large enough that, left in many foriegn lands would have a family of six living in 'em. NFPA's standard is even more stringent than REMSCO's protocol, isn't it? Why no move to embrace it with the same enthusiasm that we bought new toys?
5. This problem has been left uncorrected by us vollies for over a quarter of a century. I was quoted in the original Newsday article explaining why things were so bad in the 'danch, and what we intended to do about it, We put our money where our mouths were, and got the mail delivered. Would that it could have stayed that way, but...JUst a thought, but the problem didn't start the day before the original article had come out. It was our dirty little secret for a long time before then. Start to finish, we put men on the moon in far less time. Why? Will. There doesn't exist the will culturally to improve the system. There are dozens of bright spots throughout the county as individuals and individual squads step up to the plate, but as a system, we don't want to change. Phil, it's good that you and your partner make it to a patient in 3-4 minutes, and I hope that you're on when I or mine need the help, but as you're well aware, that's a candle glowing in the darkness that is WWHAC.
Dinosaurs were unwilling or unable to embrace change. Now they heat our homes and power our cars. Some squads only make 80% of their calls. Would Macy's be in business if they didn't meet the needs of 20% of their customers? Why should we expect not to be replaced.

BTW, the misinformed who said that those of us who created and passed the protocol weren't highly experienced street medics like themselves, funny, I seem to remember being in an ambulance or two once or twice these past 30 years, and I was a youngster on the response subcommittee. Jeannie? the one you called the Wicked Witch? Did her ER residency at Adams-Cowley. She knows a thing or two about how an EMS system needs to be run. The FD where she lives? Wouldn't accept her when she applied. She has to talk directly to the loved ones of the dead, the ones we couldn't get to. You want that job?
Peace,
Obewan (Tom Cronogue, J.S.G.)

[SuffolkEMT]

First and foremost. I repect Tom Cronogue, I took one of his EMT courses..and actually enjoyed it.
Everybody agrees there IS a problem, and while a chosen few departments continue to laugh the problems off, many have made moves to improve their response.
Today, more than ever there are "flycars" and First responders paid by FDs and EMS companies all over the place. But as posted before on another thread, the First responder cannot treat the patient and and drive at the same time.
The Fire Chiefs (mostly) need to step up to the plate and do something to get people out to respond to calls.
Its amazing how a FD cannot get two people to ride an ambulance, but five minutes later can field a stump jumper, pumper and Tanker to ride around the RCA property for 4 hours at a clip.
Daytime response sucks bigtime, we all know that, but instead of Politicians (on their way out) threatening the Volunteers, ask us "what can we do to help you guys?"
Form a sub-committee. They have them for dumber reasons, and get input from The Cronogues , the Miglinos, The EMTs and the Drivers, see whats broke and put their heads together to fix it.
It used to be that an EMT was respected, Today with medics and A-EMT's a basic EMT is just a "wannabe" classified by those with higher training..do I smell bridges being burned.. ??
As for me I volunteer EMT in my FD and I am a paid part time First Responder in another..as a 1st Res. I get to the scene and begin initial care in under three minutes (small district).
In some towns, it takes three minutes to get out of your side street.
In house crews, would be great, my department tried it, it worked for a week, people got bored, had too many other things to do.
Whatever happened to the idea of college kids spending time at firehouses, housewives with babysitting available in case there is a call. grooming High School students to become members by offering EMT classes in H.S.? (remember all these ideas?)
I was among those who called for the County to enact the 10% real property tax for volunteers, that only took three resolutions and as many years to get thru the "language."
Maybe the County could pressure the school districts to jump on board, because I know working two jobs and volunteering is not only difficult but a strain on family life.
There is a State resolution being tossed around for local businesses to be given tax credits for letting employees leave work for an hour or two for serious fires, training and other emergencies. Why not include ambulance calls?
Of course LtJag will say I just made the case for Paid EMS..well maybe I did, maybe the Fire Districts and EMS Districts need to look ast it more corefully, but guess what when and if they decide that is the way to go, tyhe same people complaining about response time, will be crying because their taxes just shot up by 10%.
How many of those people complaining we "cannot" do the job, has come to their local EMS agency and asked What can i do to help get this ambulance out faster?"
How many Politicians who sit and make idle threats have ever jioned their local FD...as i scan the current Suffolk legislautre i see none. And I scan the current Brookhaven Town Board ..I see none (don't know about the other Towns but am guessing just about the same), but Wow they love it when we invite them to our dinners every year and they praise us and pat us on the back, with the steak knife in their hand!
Why do outgoing politicians need to grandstand,,and why oh why let Liz moore write the damn story..she would love to see us all fall off the face of the earth.
I just think that before making idle threats, that I honestly doubt will even pass thru the whole legislature, that more discussioin betweent hose involved and not Newsday should tke place.
Just my opinion, for whatever its worth


________
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[rep]

Tom , thats precisely the point.... your points as eloquent as they are boil down to one basic fact.. How long do you want your family waiting for a bus ??

When the time and response issue began to rear its ugly head again initially ,I was like why are they beating up the volly's ? . I was one and took great offense.

Then on a Tuesday morning around 8 am I answered a call from my house and went straight to the scene....a flash A.P.E. It had to be twenty minutes before an ambulance from the district arrived.The terrified look on this guys face and the look of helplessness (circling the drain) really hit me hard. No longer do i have the arrogant Im a volly leave me alone attitude. We as EMS providers have an enormous responsibility to the people we serve, literally we are the difference in some cases between life and death.. we need to remember this.The organization i belong to recognized this several years ago . With Newly elected younger chief we hired two full time EMTs during the critical times, and even before REMSCO and Legisl. David Bishop sponsored this pending legislation, we also hired a full time fly car medic. With the latter being said what has Suffolk County EMS done to assist the EMS organizations in the County.The available classes have dwindled and now there seems to be a partnership with North Shore LIJ to conduct classes thats good , however i DON'T LIVE IN Syosset.

Ultimately ,its up to the Chiefs of the departments to ensure that operationally all that is being done to have the manpower to do the job efficiently and within acceptable guidelines. As time progresses in the volly EMS system, i think your going to find it more difficult to find a person willing to run for chief and accept such an un mitigated risk filled position. Thats why i do see the system going to a primarily paid system with smattering of volunteers, (EMS not FIRE).

Tom as a side bar; i think as an incentive for expedient response times to the individual EMS departments that rely on town checks, They SHOULD NOT be allowed to purchase any new vehicles Ie. responder cars, chiefs cars ,vans etc.unless there stats have been reviewed and they show a consistent improvement on response times. That is of course unless the its a new ambulance or the response vehicle has been retired for mechanical or MVA reasons. Not simply because the new chief doesn't like the light bar.

thanks hope it makes some sense

[Ocrainaugh]

Thanx for the props, guys, We try to make it fun...

Paid providers isn't the solution...it's a solution. There are many more out there that need to be tried.

Everybunny's screaming about the lack of available housing for youngsters on LI, How about building or buying a house or dorm on or next to the grounds to provide housing in trade for time? 20 hours a week in return for a studio sounds like a deal to me.

How about tuition for hours?

How about a tank of gas once a week?

Can't get to a call out on your borders in 9 minutes? maybe you shouldn't have built a central palace and now you need to do what you should have in the first place and build a sub or two. Manorville did, and it works like a charm.

Jimmy Harrington next door ran a program where it was calls for points, and those points could be traded in for mechandise. Seemed to work for him for two years that I saw.

How about putting some folk out in the community doing well checks of your high volume sites...Senior housing etc. Getting them to fill a script instead of having it run out and now they call you for a bus can save you a trip.

Look to non traditional sources for members. the aforementioned seniors, the juniors, folk like that.

Do you do exit interviews? Do you know why your people are leaving? You think you do, but in many cases, you're gonna be surprised.

While we're there, do you do entrance interviews? There's not a whole lotta Mother Theresa'a out there. Thats' why the few that are become saints. Just about everybody in your house came in there looking to fill a void in their lives, not to give you a hand. If you're a boss, and you don't know what your troops need, you're gonna lose them to somebody who takes the time to find out and address their needs. In the danch, we have members who literally need a roof over their heads. We're at the bottom of Mr. Maslow's pyramid here, and yet we talk about high minded idaels like public service and saving lives. If you're ignoring them and their needs, they're gonna move on, trust me. As soon as the 'danch switched from a member's needs based supervisory structure to an officer's privledge based one, we went right in the toilet, in seconds.

Call volume isn't the only reason vollie systems fail. If it is, then explain Va. Beach EMS, or Chevy Chase/Bethesda to me. Anybody ask them what they do to make it right?

Even though I make my coin on the career side, this can still be a volunteer world. It's up to us what we want to do.
Peace,
Obewan

[rep]

Tom One More question if i may, Has the Suffolk County Chiefs Association either Fire or EMS sent folks to Chevy Chase or Va. Beach EMS to see how they do it with the volume ??

That would be an expenditure as a tax payer and a volley i would whole heartedly endorse.

thanks

[Ocrainaugh]

Don't know that FRES or the Fire or Ambulance Chiefs have, but i did a bit of research on my own. One thing I found was that these jobs have leadership who engender respect, for their members, their customers, their system and themselves. They accept responsibility for their actions or inactions, identify problems and move to correct 'em. They don't kill the messenger, they read the message. This gives them a depth that is lacking up here, culturally. The infantry respects the bosses and vice versa. See a pattern developing? Switch down a few threads to the one about good chiefs and see if you can find ANYBODY respecting anybody there. That common thread seems to run thru all the successful squads.career, combination or vollie. By and large that was the big difference I noted in talking to the folk down there. Maybe we could give that a try?
Peace,
Obewan

[Asking]

I have grown up here on Long Island my whole life. I then moved down to PA/MD and joined my local FD there. The system down there is the one that you all are speaking of. It works great. The call volume is approx the same as it is here and most of the BLS and all of the ALS is paid in the county, but with vollie BLS supplement also. The FD's some are paid with vollie supplement and some are vollie all together. It is similar to the Islip model, where there are strategically placed 2 medic squad units and the 2 man BLS ambulance crews in the buildings (fire or vac). The county works under a similar EMD coding, but not the same. They know the capability of each company and its membership. They know that if you have your paid crew out on a job and they aren't at the hospital yet, they bang it out for vollies. You have 2 minutes to come up on a 9 for ALS calls and 4 minutes for BLS. If nothing is heard they 24 it, unless the crew on the other call advises they can handle, the catch is they have to give an ETA. The ETA must be accurate, if you under bid it, it is caught in the QA process and action is taken. Rarely ever was there a problem with that. The FD's were the same way, but that is not part of this discussion. The point to this is that I worked in that system for 5 years and moved back here to LI and went to USB and got my medic. I am telling you that that system would work great in Suffolk. Nassau is a whole other animal with the PD and everything. That is nothing to take from the vollies, I am one of those as well in my very limited spare time. But I can say that from my experience at work and volunteer, there are some serious problems with our system. I think that we have a lot of outstanding minds in EMS in this county, we need to pool them with people like Tom and whomever else to make this work. I would love to share my knowledge of that system with the powers that be and see what they think. Or even take part in a group that is dedicated to brainstorming some ideas on how to fix some of our problems. We have a great system with great people, vollie and career alike, I think we can work through this to find the better solution. Just a thought......

[ExCaptEMS]

Golly, am I hearing the voice of reason on this board? Thank you to everyone who contributed to the conversation here. There are certainly some great ideas lurking about. Fact of the matter is that we need to take care of our patients, not the volunteers. The system may change somewhat from what it was..IE..combination paid/volunteer, but the bottom line must be met..get the ambulance to the patient! If it works in Maryland and other places..it can work here.
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[SuffolkEMT]

Lets send a copy of this thread to the Leg Bishop and Tonna, Let them know that we do care and want they system, any system to work.
Contact the members of the Public Safety committee which oversees Fire and EMS.
Angie Carpenter chairs it and members are Peter O'Leary, Dave Bishop, Andrew Crecca, Bill Lindsay, Dan LosQuadro and Lynn Nowick. The committee meets next June 1st. 1 PM at Happaugue
The full legislature meets June 8th 9:30 a.m. at Happaugue.
There are a lot of ideas out there, lets work to get them implemented before Liz Moore and company do a real hack job on is, trust me it is coming.

________
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[Ocrainaugh]

If you wanna go, I wanna go. let's show up and talk to the boss and see what he/she says.

[SuffolkCC]

First - Thanks for the check Omar - greatly appreciated - I actually hadn't even given her story one read through until that night - I guess it just pissed me off that millions of readers hear that crap and here we are all working our asses off to read something like that.... regardless -

Second- this is the PSA - don't think I'm bragging or judging here what I'm advertising is for the benefit of ALL. As prev. mentioned I am Chief out at Stony Brook Ambulance. We are privileged in many ways but one of our top resources is that we receive nearly 400-600 applications each year for 25-40 spots available. This past year with some success the 375-540 people who didn't make it in were given a flier with contact info for other departments. These are college kids with a knack for learning and are eager to help and make a difference. The downside is many districts (most) won't let or can't let people who live outside the district volly there so we were limited. This is something that I would like to continue but I need contact info for departments who are able to take these kids in. Please feel free to email me at office@sbvac.org with any info regarding this. Hope we can help - Tommy it's always great to hear your graceful remarks to such a touchy subject. Please keep up the great work one and all and remember we are a brotherhood - of public servants.
Phil Aubrey
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[ExCaptEMS]

An interesting concept could be put forth here in Suffolk County. EMS agencies utilizing college students to ride shifts in exchange for room and board or a stipend. I know it is done in Maryland, (for VFDs) just outside of D.C. Anyone know anything about the way they do it down there?
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[Asking]

I was one, and so were friends. It depends on what you are looking for. They provide you with a place to live, rent free, in return for some services in the firehouse or vac. They will work around your schedule sometimes too. Some places even help with your tuition or your books. You have to sign a contract with the stipulations of said agreement in it. I will ride 24 hours of duty hours on the ambulance a week and some light housekeeping or whatever it is. The point is that it works in many places with great success, why not here. Some places even have a program now that you get a card, and every point you make gets you a free gallon of gas that can be redeemed on that card. Some places offer stipend programs that allow you to get paid for doing your duty time. In college it was something like $1 and hour and $7 a call, you had to do a minimum of 60 hours in a month to be considered, if you didn't, no stipend, it was vollie time. If you did, whatever your hours added up to was your stipend. I don't know how that would work with retirement programs in the firehouse, but I am certain there is something that can be done. Plenty of good ideas out there. PLENTY!!!! Oh yeah and to answer the SBVAC chief, they could be associates out in the Mastic/Shirley area probably, but I would check with the chiefs out there first. Be Safe

[SuffolkCC]

Thx for the post. Like I was saying in my last message. Just to clear any liabilities we don't go to other companies for this potential service, we do however encourage them to come to us and give us fliers. Bayshore and Brentwood did it. I believe WWHAC did it as well.....I can't vouch for the results at the other companies but we try. As for a quid pro quo volly system at Stony Brook...yea good luck... USB gives 20 of my members housing during the SUMMER only in order to help us cover the intersession like we are required to do. THAT IS ALL. No books, tuition, credit, or any form of school year assistance. We are fortunate to have the members we do and to be able to select the best from a large pool; however in this day and age (I myself am not a student) working folks need some help if we're gonna keep this thing alive. When someone's not receiving a paycheck some form of repayment would go a great distance. I understand that there are certain measures out there but come on! SBVAC has an ANNUAL budget of $78,000 (thats right- and no I didn't forget any zeros). If SBVAC can stretch that dollar so can everyone else - let some of that multi-million dollar budget go to the vollies in the department that are actually responsible for gettin the truck out the door on time! Again keep it up - be safe.

PA
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[SuffolkEMT]

I'll be there
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[BallBreaker]

You have to give credit to the Southampton Town Board for listening to the people that answer the calls out there and telling REMSCO to pound salt.

[Respond]

June 5, 2004
'The Ambulance Is on Its Way' Can Be Empty Pledge in Suffolk
By PATRICK HEALY

ummer was waning, and Bob and Phran Ginsberg were driving to their Suffolk County home after enjoying a dinner with their two teenagers, savoring their company before school resumed and everyone shot off in disparate directions.

Then, in a split-second crash of metal and glass, everything changed. The black Mazda driven by 19-year-old Jonathan Ginsberg skidded on a dark, slick curve in Lloyd Harbor and plowed into a sport utility vehicle. When Mr. and Mrs. Ginsberg came upon the scene in their own car seconds later, they found Jonathan and his sister Bailey, 15, unconscious. Mr. Ginsberg said someone nearby had heard the crash and called 911, but 20 minutes later there was still no sign of an ambulance.

That night in 2002, the Ginsbergs discovered what is often the stark reality of ambulance service in Suffolk County: a patchwork of autonomous and sometimes feuding ambulance companies whose ranks of volunteers are declining, routine failures to record crucial emergency data and waiting times of 30 minutes or more for an ambulance.

State data shows that the average response time of emergency services in Suffolk is slower than in Nassau and Westchester Counties.

"The system is failing," said Mitchell Savino, a former chairman of the county's Regional Emergency Medical Services Council, a state-chartered oversight group, which monitors ambulance service"Are people dying? Sure. People are dying because of this. Just listen to your scanner."

Again and again in interviews, paramedics, police officers, rescue officials and patients' families voiced feelings similar to Mr. Savino's, many sharing accounts of a system that imperils people when they are at their most vulnerable.

As New York City prepares to spend millions of dollars to overhaul its 911 system, critics say it is time to re-examine Suffolk's emergency response network, which relies solely on dozens of independent volunteer companies. The council that monitors the county's companies is pushing for major improvements and greater oversight to raise Suffolk's performance to the level of neighboring Nassau and Westchester Counties.

The county's Department of Fire, Rescue and Emergency Services says it is trying to recruit more volunteers and to improve its response times, but the department chairman, David H. Fischler, said responders did an "excellent job most of the time" and referred to county data showing that a majority of ambulance calls are answered within nine minutes, the ceiling for an acceptable response time set by the county's oversight council for ambulance service..

But a report prepared in March 2003 by the council and based on state data found that Suffolk's average response time was about 12 minutes per call, compared with 8 minutes in Nassau County and 9 in Westchester. County officials say those figures have changed little in the past year. The quality of emergency response data in Suffolk is one of the main impediments to determining accurate response times. In a digital age, county dispatchers still record 911 callers' information with pencil and paper and walk the forms to other dispatchers who radio local ambulance companies. If an emergency call requires both fire and ambulance services, dispatchers must fill out the same form twice.

Suffolk County was recently awarded a long sought state grant to overhaul and automate its computer dispatch system.

An examination of hundreds of thousands of records for the last two years found that tens of thousands of entries were missing the location of a call, the time an ambulance left the station, or the time it arrived at the scene of an emergency.

Without good data, paramedics and officials with the county's ambulance council say, Suffolk's ambulance companies cannot properly analyze their performance and detect weak points in the system.

An examination of the county's data showed that the county received 110,000 emergency medical calls last year, and in more than 7,000 cases, callers waited 15 minutes or more for an ambulance. In at least 202 cases, that wait stretched on for 40 minutes or longer.

In emergencies like heart attacks or strokes, seconds can mean the difference between living and dying, experts in emergency medicine say. The brain begins to die four to six minutes after the heart stops, and the chances of surviving a heart attack drop to 10 percent if emergency care does not arrive within 10 minutes.

Some response delays are caused by Long Island's notoriously clogged roads and highways, and the sheer physical size of Suffolk County, which covers 912 square miles, but critics say the majority can be traced to dispatch problems and the structure of the ambulance network.

Suffolk's system is rooted in volunteerism and local control, two principles that long defined early suburban life in New York State. Today, 98 local agencies — some fire departments, some individual ambulance corps — operate the 236 ambulances that respond to 911 calls, said David Brenner, the chairman of Suffolk's oversight council for ambulance service.

The county and the council monitor all the agencies, but the ambulance companies are not part of any broader government agency.

Many are nonprofit corporations financed by local taxes. They set their own rules for how many hours a station is occupied, and how soon a dispatcher can radio another ambulance agency for backup if a company fails to respond to a first call. Some companies wait four minutes before putting out a broader call while others wait 10, said Dr. Jeanne Alicandro, the director of the county's Division of Emergency Medical Services.

Some ambulance corps respond to calls in other districts every day, thanks largely to a mutual-aid dispatch system, but Dr. Alicandro said many companies were still quite territorial. Some go out of their way to avoid crossing into a neighboring district when on a call, emergency officials said. Some companies hire paid responders but do not allow them to take calls from adjoining districts, Mr. Savino said. Some ambulance services have merged in recent years or hired paramedics to handle calls when few volunteers are available. But most of the services are still part-time, all-volunteer companies that handle a few hundred calls every year.

Next door, in Nassau County, service is more reliable because paid police ambulances answer about three out of every five calls for help, Suffolk county officials said.

Even the harshest critics of the Suffolk system have few complaints about the people racing to calls. In one night spent with volunteers at the Huntington ambulance corps, eight volunteers sat poised to answer calls, and a dispatcher monitored the phones and radio. When emergency tones blared, the crews ran to their trucks and reached homes in a few minutes.

But often, at many stations, no one is around to handle calls. More people are calling 911, but emergency medical technicians said the blue-collar and middle-class residents who have long made up the bulk of volunteers now work two or three jobs to afford the cost of living on Long Island.

"People don't have as much time to put into it," said Rich Becker, a volunteer emergency medical technician in Holbrook. Last year, there were 17,845 calls in Suffolk where departments described the result of the call. In those cases, 4,681 calls were passed on to a different agency after the first failed to respond.

Last month , the regional Emergency Medical Service council imposed new, stricter dispatch standards over the objections of some fire and rescue associations. They call for dispatchers to seek help from a second ambulance company if the first crew fails to respond to an alarm within two minutes.

But some emergency medical technicians questioned whether top-down directives like this can work in a system in which agencies have long been islands unto themselves.

"They can make protocols, but who's going to enforce the changes?" said Mr. Becker, the Holbrook emergency medical technician. "There's very little control with the volunteer departments. They do their own things."

For the people left waiting in living rooms and by the sides of roads, the minutes tick by as emotions go from worry to rage to disbelief. Some call 911 again and again to ask about the delays. Still others grow so frantic that they drive a loved one to the hospital themselves. When Bob Ginsberg found himself in that position in September 2002, he said, he sprinted down a dark stretch of road in Lloyd Harbor in a futile search for a doctor for his two teenage children. Mr. Ginsberg said an ambulance did not arrive for 25 minutes, and county records do not provide a clear picture of what happened that night, including the exact time between the crash and the arrival of the ambulance.

Jonathan Ginsberg survived the crash, but Bailey died at the hospital. Mr. Ginsberg said he did not know whether anything could have saved Bailey that night, but the lost minutes plague him.

"It makes me sick to my stomach," he said.

[SuffolkEMT]

What paper did this article come from? Healy's writing makes Elizabeth Moore seem like our best friend.
Mr Ginsburgs story is a tragedy, but I wonder, if he
"sprinted" down the dark road, how much time was there between the accident and the crash? Do people reaaly look at their watch during times like these or did it seems like 20 minutes? How many telephone operators did it go thru before activation, and was a precise exact location of the accident given?
And The district is at fault as his the EMS call takers for not being able to supply activation and respomse times..Not the responders.

Also Yes Districts hire First Responders to cover "their" districts.
The First responders are being paid from that toens tax money to protect those citizens.
How would you like it if you need an ambulance and your First responder who you are paying gor, cannot respond because he is two towns away assisting a districts who doesnt care enough to hire their own 1st responders to coever their town.
You would be screaming even louder.

________
Live sex webshows (http://livesexwebshows.com/)

[Respond]

NYTimes.com > New York Region

TIMES NEWS TRACKER

Topics Alerts

Emergency Medical Service

'The Ambulance Is on Its Way' Can Be Empty Pledge in Suffolk
By PATRICK HEALY

June 5, 2004

[paid only]

This was on the front page of yesterday's New York Times...I think it's fantastic!!!! Maybe one of these days the killer volunteers will give up and let the pros take over.


Hey moron, both examples were used to make a point of how backwards the system is out here. The problem with districts being selfish about their resources is EXACTLY why every district should be combined. Also, if nobody even recorded the times for the call, Mr. Ginsberg can say whatever he wants, all he knows is that his daughter died in a wreck and he had to wait forever for an ambulance.

[Ocrainaugh]

Mr Healy makes Liz look like our best friend? How about we're our own worst enemies? What's going on out here cannot be defended. This guy waits 25 minutes for the bus at a fatal MVA. BTW, who covers Lloyd Harbour? Isn't that the same one Healey was lauding for having 8 members doing a standby when he did a ridealong? I know they have a dispatcher sitting in quarters behind a very impressive array of expensve recorders and radios. How could the data from that call be missing? Do they have a Mrs Lincoln on staff? Please tell me, do we think the people are THAT stupid? If we put half of the effort we're putting into building moats around our castles to keep that evil witch Jeannie (after all, this is all OBVIOUSLY her fault...) and her minions outside our walls into making the system work, all this would evaporate.

THIS IS OUR MESS AND WE HAVE TO CLEAN IT UP!

if we don't, and somebody else has to come in and do it for us, you won't like the way it looks when they're done. Thank God Mr Healey wasn't interviewing the lady from "Ballsy Southhampton" who waited TWENTYFIVE MINUTES for a bus with her dead baby in her arms. Go ahead and explain that one away as an abberation. Wanna talk to her?
peace,
Obewan

[SuffolkEMT]

OK answer me this and I'll forever be silent.
In a recent letter to Newsday, it was mentioned by a REMSCO member, that when people are injured or die because the responsible Ambulance Agency did not respond in a reasonable time, that they can be sued or at least are in line for litigation.
My question is lets say my FD is sued for failing to respond on time or at all...I am the EMT on the ambulance, so of course everyone on the rig will be subject to the lawsuit..Now as an an EMT I have a duty to act..So by me not responding in a timely fashion on an ambulance, I failed my duty to act.(Depending on how the lawyer interprets the law)
Does that mean I am now possibly in danger of losing my certification..beacause my agency could not get an ambulance out even tho I answered the alarm and was stuck sitting on the apron.
If thats true..I have answered my last ambulance call.
Why? Because I need my EMT for my REAL PAYING JOB..
I am not going to risk that because my volunteer agency cannot get a rig out in time, and I am not going to be sued for their ignorance and stupidity.
________
Live Sex Webshows (http://livesexwebshows.com/)

[Medic]

I do not think that you personally would have a problem. The reason being because your department sets OPG's. Those OPG's should state what you need at a bare minimum to respond to an alarm in an EMS or Fire fashion. Therefore if you are at your firehouse and you do not have a driver with you and your OPG's state that you have to have a driver and an EMT before roling, you are following the OPG's set forth by your department. Your Chief's will probably have a few questions to answer, but you should be good. Now I don't know that I would just sit there helpless. If you have an 80 unit there is always proceeding to the alarm by yourself and telling firecom to 24 to the nearest, you'll be going solo. That is just what I would do. At least this way if all they get is a driver, now you have a combi crew. What do you guys think????? I am pretty sure that you would be protected though. Also NY state mandates at least an EMT and a driver, so if your department OPG's vary from that then that is something you need to take up with your Chief's. Basically, your fine.

[ltjag]

Thats the only way to describe this whole discussion. That anyone is willing to defend a departments "right" to disregard an exceedingly liberal response time standard is unbelievable. That they would do so in a public forum is an indication of gross stupidity. We who are participating in this dialog are, or should be, aware of the consequences of waiting over 9 minutes for an ambulance. If the patient could wait the 9 minutes, than they probably don't need an ambulance at all. On the other hand, if someone has a legitimate emergency than even 9 minutes is an eternity to that patient. To the more serious calls, this amount of time can be a death sentence. I just don't see how anyone can advocate for either a more liberal standard, or, for none at all. You want to talk about liability, the folks out in Southhampton have really set themselves up for some. Better they should have buried their heads in the sand on this one. By listening to those who provide the service they are allowing themselves to be bamboozled into thinking all is well. It seems that the volunteers as a whole subscribe to the belief that if we keep on saying everything's OK, than it will be. Are there really departments out there whose time recording practices are as lax as this article says they are? Unbelievable. What about departments that "cook" their numbers to make their response time appear better than they really are? Rather than vilifying the press for criticizing the volunteers, how about we just accept that they are reporting accurately on the sad state of the system? Give the press something praiseworthy and I'm sure they'll run it.

[Vengeful Medic]

The Press has had plenty of opportunities to print or portray something good about the Vollies. EMS week...where are they?
At the scene of a major incident, instead of looping footage of the new Heavy Rescue, why not show an EMT consoling the child in her arms?
Instead of printing page after page of vollie bashing media frenzied articles, why not do a spotlight on some local events that have EMS agencies participating?
Why? Because that's not what sells newspapers. That's not what makes the Liz Moore's and Jeff Healy or whatever his name is look good to their respective Media outlets.
But then, a lot of departments do not get involved in community relations beyond the basic EMS Week propaganda. How about having regularly scheduled wellness checks (okay, here's where the people who are interested in patient care and not politics should take notice)? Blood Pressure Screenings, blood glucose screenings (this is a layperson skill, no medics needed, so calm down), discuss the good of having a personal doctor and undergoing annual checkups, when the ambulance should REALLY be called (as opposed to being used as a taxi ride to refill your meds). How about discussing common disease states that are preventable at home with medication compliance and good personal hygiene...
Ok, this turned into more of a rant, but I think somewhere in there I made my point. The media NEVER reports accurately on ANYTHING. Especially when it's one sided enough to give the level of sensationalism to boost ratings. You see, ltjag, you are making a statement here based on the presumption that the media still practices "Responsible Journalism". Those days are long...since...gone.


Omar-Fara B. Norgaisse, EMT-P

________
Weed Vaporizers (http://weedvaporizer.info/)

[chief no more]

Believe me, the young lady referred to in the MVA didn't stand a chance even if the ambulance was parked around the corner.

I know that's not the point of this discussion but, it should be known.

On the subject of response to that alarm I seriously doubt that it was twenty minutes to get an ambulance to the scene. Even though the area in which the accident occurred is a very long haul from where the ambulance and crew responded from (I think it is the furthest point in their district away from their quarters) I am pretty sure that it was far less than "20" minutes. The only thing that would have hastened the arrival of an ambulance and crew that night would have been if there was a substation closer to scene that a crew could have responded from.

If my memory serves me correctly (and I believe it does because this was one of those cases that I will remember for a long time), the family was actually thanking the EMS crew that night for all of their efforts.

I have a great deal of empathy for her family and I am saddened whenever I think of that night. I Know those that responded that night did everything they could have to save a life. Unfortunately, it was out of their hands on that horrible evening.

Be safe everybody............

________
Art On The Hill Condo Prathumnak (http://pattayaluxurycondos.com)

[BuffMedic]

Omar is 100% right in his whole statement. I have been saying the same things. The age of responsible journalism IS over, has been since before Vietnam. They just learned how to take a group of hard working, middle class citizens, fighting for something and make us all look bad. Meanwhile they claim the 1st amendment and all they care about is selling another paper or winning some useless award. There are extraordinary things going on in this county every day, but you will never see that in any Newsday or on News 12. They do a 20 minute section congratulating McDonalds on serving a low fat value meal, but 40 departments show up to battle brush fires in Rocky Point and we get 10 seconds, if that. You know what makes it even worse, is that I don't want the credit and most of the good fireman, EMT's and Medics out there don't. But we need it!!!!! So who gets it? Me? You? I don't want it!!!!! But we need some good journalism about all the great things going on out there not all the negative. I am also preaching. If you are like me then you have been thinking and saying this stuff for a long time. You know what the problem with Liz Moore and all the other jerks is, they don't know what it is like to be us. When I say us, I mean the group of us who love hanging out with each other, love helping people, love going out in the middle of Christmas dinner for some BS auto alarm or BS hang nail. No matter what we love what we do, whether it be for volunteer or pay check or both. Those are the guys and gals I hang around with and train with. So I guess some of you are hanging out with the wrong people. And as for these writers and newscasters, hope some day you get to meet some of the fine people I was just talking about, I think you'll see what I mean. Take Care.............

[give me a break]

The reason the "evil" media doesn't cover all the good stuff we do is because we're SUPPOSED to do it. Whether you're a vollie or paid, when the tones go off, it is you job to respond, treat the patient and take them to the hospital!!! Any discrepancies in those three things brings with it bad press (ie...slow responses).


You cannot expect the press to automatically know about the good things happening in EMS if nobody tells them!!!!! Why do you think every major company in the world has a public relations department? They employ people to write up press releases and send these press releases to the press. Duh!!!! That's how the press finds out!!!!

The suppression side of FDNY has excellent relations with the media (well, until their members started selling drugs and driving drunk). I remember an article in the NY Post a few months ago that basically credited the firefighters with delivering a baby in someone's house. At the end of the article, it quickly mentioned that the paramedics arrived just before the engine company...who do you think REALLY delivered that child? I'll bet you ten million bucks it wasn't the firefighters. So, how did the NY Post find out?? I'd say one of the firefighters rang their PR people who turned around and gave a tip to the newspaper.

You moan about the lack of coverage of the wildfires a few weeks ago, but did anyone think to call up Newsday and say "hey there, this is the Rocky Point FD, we've got a humongous wildfire, why don't you send a reporter over to take some pictures and interview some of our firefighters, they've been busting their asses all day out here"


Finally, does anyone else find it ironic that Suffolk County, one of the most affluent places in the USA, has just about the most piss-poor EMS system in the country?? I could really go on and on about the things wrong here that could be EASILY fixed, but I'm sure denial will fix them too don't you?
________
OUTDOOR HARDCORE (http://www.fucktube.com/categories/802/hardcore/videos/1)

[Ocrainaugh]

Omar, you're right. The media very rarely has anything good to say about anything, and you're right, it's cause good news doesn't sell. Wellness checks are a great idea. A better idea however, is getting the bus out. That's the problem...we don't get the bus out. If we got the bus out, the Moores and the Healeys of the world would move on to fry other fish and we could go back to doing what we do best. After all, we all know what EMS actually stands for don't we?

If I was a taxpayer in Southampton, I'd be starting a recall petition for the idiots who decided that the not inconviencing the providers is more important than the public safety. Great lobby effort out there guys, but that's gonna come back to bite your butt, especially when the idiots who went out on a limb for ya actually see the position you put them in, trust me.

SuffolkEMT, could you be named in a lawsuit? Absolutely. Anybody could be sued for anything. E. Farm got sued a couple of years back for having "Advanced Cardiac Life Support" printed on the side of their buses without ACLS providers inside. They got over. The question is can you be successfully sued? If you're playing by the rules, providing care to the best of your ability within the scope of your training and pedaling as fast as you can, nobody can touch you. The chiefs and board members who know there's a problem and choose not to address it or cook the books to hide it, they probably shouldn't sleep so peacefully. At a meeting last week between a County Legislator and our local fire chiefs they actually told him there is no problem, and 99% of the time the bus is there in under nine minutes. I dunno what color the sky is on the planet where these guys are chief, but it sure ain't blue.

BTW, all this hoopla is about making a phone call to let dispatch know you're comin'. Imagine the yellin' and smellin' that would be going on had someone said ya hadda be there in nine minutes (which is 5 minutes longer than the NFPA standard)?
Peace,
Obewan

[Factfinder]

Get your facts straight before you post responses on a public domain such as this. It is one thing to spew this kind of puke over a truck room floor, but to be speaking as an insider to such information is appauling. The accusation of cooking the books to make things appear better than they are also has no basis. While there are issues to be addressed I dont see anything in the current recommendations or proposed legislation that has the potential to address a single one of those issues. How about someone coming up with a plan that actually improves the response time instead of smoke and mirrors. Bottom line is Remsco wants to see paid EMS in Suffolk County...you are well aware of that one, aren't you. You are entitled to be a good little suck up that is your choice, but do so with some kind of integrity.
and by the way the sky sure is blue here!
________
CATASTROPHE BOND FORUM (http://www.insurance-forums.org/catastrophe-bond/)

[DavisDem]

"someone said ya hadda be there in nine minutes (which is 5 minutes longer than the NFPA standard)?"

You tell me one town in Suffolk County, that even if you had a crew sitting in the rig on the apron during the day where you could get to a scene in 4 minutes (NAFPA standard)
With traffic congestion and all the other BS We're lucky to get to the scene in REMSCOs time, again even with a paid crew in house waiting.
First responders are getting to the scene and giving patient care in sufficient time. Its high time REMSCO members.. and you know who I mean, rode with some of us to see what we are up against.
If we got an ambulance to the scene in 30 seconds REMSCO would still find fault in how we handle calls.

I was second guessed by a Ambulance officer because I took a patient with a partial amputation of a finger to Stony Brook..hell we got the ambulance there in 9 minutes but thats not good enough being it was just me the First responder and one driver..and I asked for a third person on the rig..wow slap my hand for that.

No matter what any of us do we will be faulted..and everyone wonders why we stop doing what we are doing.
Too bad I need my certification because I would give it up in a heart beat, its not worth the aggravation.

________
LovelyWendie (http://www.lovelywendie99.com/)

[ExCaptEMS]

You guys make me sick! OCrainaugh is right. Make all the excuses in the world, but it ain't gonna work. The buses are not getting out. If any of you took the time to actually read the REMSCO/REMAC..that's right REMAC PROTOCOL.(the doctors put together the protocol, REMSCO endorsed it), you would see it's all about mutual aid. Have a crew confirmation system, confirm your crew in four minutes, and try to reach a GOAL of nine minutes 90 percent of the time! If you cant get a crew, mutual aid the call. Get ALS to the scene when needed. THAT'S IT!!!!! All this BS about unfunded mandates and cookie cutter plans is just what it is..BS. If your department can't cut it, then surrender your CON and get out of the business!!! REMSCO has no ax to grind with the vollies, most council members of REMSCO are present or former vollies themselves. There is no intent to "go paid". The Newsday and Times reporters are right on the money. They did extensive research on the subject before going to the presses. As for the townships voting resolutions to oppose it..well guess what...liability abounds in those places. If I lived in Southampton, I'd be calling the town board on this one. They're putting the whole town govt and EMS agencies in line for a lawsuit --and it's all on paper. What a bonanza for a civil attorney!
________
Outdoor Public (http://www.fucktube.com/categories/810/public/videos/1)

[Enough Already]

Have a crew confirmation system, confirm your crew in four minutes, and try to reach a GOAL of nine minutes 90 percent of the time! If you cant get a crew, mutual aid the call. Get ALS to the scene when needed.

Its not up to the poor bastards riding the ambulance or sitting on the apron!! Its Chiefs Policies we have to follow who get their rulings from Commissioners. The Chiefs tell the dispatchers or County Dispatch when to 24 a call....But who gets the brunt of the attacks..Its the VOLUNTEERS who ride the rigs, respond when they can and care about patient care..Thats who the media is attacking You and I who have no say over The Administrative policies..

[Enough Already]

I have called Suffolk County Dispatch on a bad call asking for early mutual aid just to get a rig on the road..(and before you say anything I was the only person in the rig). ..you know what i was told?
"Your 24 time is not up yet!!!!"
And before you say anything..I was the only person who responded..but Of course I have training so should be able to drive and treat at the same time and its my fault I did not get to the person in the grand 9 minutes.
But hey thats ok..blame it all on the EMT or driver who is sitting waiting counting the minutes like everyone else out there...

[SuffolkCC]

Davis you want one agency.....again I bring in the evil fact that I am a paid CC in Suffolk.... but when I work at Wyandanch Ambulance due to the NASTY conditions in the building (which is their own fault) my partner and I sit in the bus (gladly). From activation to 21 time I would say were on scene...ON SCENE...on average of 2.5 minutes. Yes we do have a small district...but it's one that's packed with cars and packed with drug abusing/drunk residents wandering the roads....also the agency where I'm a volly at has IN HOUSE CREWS.....24 hours a day....and I would say were on scene within 5 min 75% of the time.

PEOPLE ITS NOT ABOUT POLITICS. IT'S NOT ABOUT PAID VS. VOLLIE. IT'S ABOUT PATIENT CARE STUPID.

Regardless of paid or vollie were all in this together, were all here to help (usually thanklessly), so lets all try to make this work. Stay safe and get the bus out.
Peace,
Phil Aubrey
________
SHEMALE CUMSHOT (http://www.fucktube.com/categories/955/cumshot/videos/1)

[Vengeful Medic]

Wow....hot like a smoking gun, eh, fact finder?.....Well take a look at this and let me know what you think, ok?

"How about someone coming up with a plan that actually improves the response time instead of smoke and mirrors."

Ok...do you have any ideas or plans?...Because Everyone had since 1986 to do what was needed and didn't. That's the bottom line. REMSCO is now doing what needs to be done to start fixing the problem. If that means setting a protocol to ensure as much as a rapid EMS response as possible, then so be it.

"Bottom line is REMSCO wants to see paid EMS in Suffolk County..."

Really? Have you seen any documentation on this? Have you an insider in County EMS or REMSCO that actually made this statement to you? Or are you being a hypocrite yourself and "spewing puke" that is without basis?

You sound a little angry...maybe you require some anger management?......


Omar-Fara B. Norgaisse, EMT-P
________
Asian Petite (http://www.fucktube.com/categories/134/petite/videos/1)

[Ocrainaugh]

Touched a nerve with that one, didn't we, Vengeful? Dude, when ya got Omar telling you you need anger management help, you got issues.

Yeah, Factfinder, you caught us. REMSCO has 100 red, white and blue ambulances, each one with three medics in it all covered in naval jelly hidden in a bunker in Westhampton just waiting for the dawn of that glorious day when we can replace the vollies with the paid ems.

What do you think, Jeannie invented all this just to make you look bad? She's just the messenger. It's the message you have a problem with.

This system is all we got and we gotta make it work. End of story. There's no calvary comin' It's just us. Omar's right when he says this is a problem we created back in the last third of the twentieth century and have been studiously ignoring.

Factfinder, you want some facts? It's two minutes and I got a crew on the way. That's a fact. It's four minutes, I don't have a crew. I gotta give it away. That's another fact. That's what this protocol does...it forces us to face these facts, some of which is unpleasant. There are those who want to find facts like these and stomp them down so that they never see the light of day. you think the people are stupid?

The "smoke and mirrors" you mention are absolutely in use, and have been for the past 30 years. Unfortunately, the mirrors are now cracked, and the smoke has blown away. There are those who don't like the bright light.

Truth be told, the 1710 thing is just a scam by the NFPA to do for the bus manufacturers, unions and architects what they did for the firetruck companies with the back step thing.

Truth be told, the culture that got us here, the one that wrote the mantra " Give us 22 minutes and we'll give you an ambulance (maybe)" is being dragged kicking and screaming into the 1980's and they hate it. Tough.

Peace,
Obewan

BTW, Phil, on behalf of us drug besotted mind altered denizens of Straight Path, we thank you for your circumspection in response.
T

[Ocrainaugh]

So anyhow, where were we? Oh yeah, Factfinder wants a plan that reduces response times. Otay, lets do the math...

Time of alarm Protocol No Protocol
0000 0000
No Response
sig 3 0002 0005

No response
2nd sig 3 n/a 0010

1st Sig 24 0004 0015

No Response
sig 3/24 0006 0020

No response
2nd sig 3/24 n/a 0025

2nd sig 24 0008 0030

Sig 21, 2nd
sig24 (add 9 min)0017 0039

Sorry, Carolyn Dawn Johnson was doin' "Simple Life " on CMT...everything stops here when that happens...
anyhow, it seems to me that anagency compliant with the REMSCO protocol that has to go thru two mutual aid agencies to get a bus to the patient does it in 17 minutes, while one that follows the average of the common practice today gets the same bus there in 39 minutes...Gimme a minute here...carry the six, take away 12, divide by two...under the new protocol, the bus gets there TWENTY-TWO MINUTES SOONER! That would be MIckey's big hand on the 12, little hand on the two tick marks past the four, hmmm, that's better than A THIRD OF AN HOUR SOONER!

Does that work for ya, Factfinder? No mirrors, no smoke, just cold, hard numbers.
Peace,
Obewan

[ExCaptEMS]

Man you amaze me! Following Chief's protocols. Where were our beloved Chiefs since 1987. Not an ounce of effort from them or anyone else (except Newsday) has gone into making EMS any better in Suffolk. So now REMSCO AND NEW YORK STATE DOH will make it happen. Dust off your certificates and get ready to turn em in! You'll lose your indemnification insurance from the county, open yourselves up to a lawsuit, and disgrace the communities you serve. Oh but wait, we're only volunteers!!!!
________
Paxil attorneys (http://www.classactionsettlements.org/lawsuit/paxil/)

[SuffolkEMT]

"open yourselves up to a lawsuit"

Well you hit it on the head...I am NOT going to be sued because my Chief isn't following the rules and will not follow the protocols..and because of that I be sued because Mr. X found out that EMT#****** failed to respond in the alloted time although he was on the ambulance...waiting...
I need my EMT for my job where, by the way we get a three man ambulance out and to the scene in 3 to 5 minutes every call!!
My vollie days as an EMT is over..Give me the hoseline anyday


________
WEB SHOWS (http://livesexwebshows.com/)

[ExCaptEMS]

There is more than one lawsuit in progress regarding response times. One is in a western town, the other is in an eastern town. Once the legal community gets wind of this, and the negative publicity gets out the public, people will be clamoring to sue EMS agencies for delayed response. Call it the deep-pockets syndrome or whatever you want. The more the wagons circle, the more negative stories about our inablility to improve our response times, the more causes of action will appear. All because the people in charge of our EMS system are ignorant to the problem. They spend more time fighting it, instead of improving it. It's so simple..the protocol tells us how to do it. Pick up a phone and tell someone you're coming...REMSCO is available to assist any agency that comes forward with a legitimate request. And wow , they have more than a year to comply!
________
HEALTHY LIVING ADVICE (http://www.health-forums.org/healthy-living/)

[Ocrainaugh]

Not to worry. The individual provider, sitting in the bus waiting for a driver has no liability. He/she is doing the best he can at the moment with what the job has provided. Stay within your protocols, level of training, act in good faith and write in black ink & you're doing your job. If you're a boss, yeah, you got a problem...but nobody's gonna hurt the infantry.
Peace,
Obewan

[Factfinder]

You all miss the point. I don't hear anyone denying there needs to be improvement in response times. I don't see anyone hiding from this and many agencies have taken steps over the years to improve their response times. Some successful and some not.
If you have any comprehension of the English Language and you go back to read my first entry...I agree that there needs to be a plan, but I don't agree with Remsco for several reasons. First and foremost is to dispatch using the coded system is to actually delay the dispatch of alarms in some cases several minutes. Now whatever time you think you have saved...you just lost...Then to have a responder call in to say they are responding slows their response down...it does not speed it up. It does not guarantee they will arrive and it does not guarantee a more expedient response. Why are you so blinded by this agency that you cannot see right through this for what it is.
You want a plan...How about combining resources during problematic response hours. Maybe duty crews with members from all of the agencies strategically located throughout a Township. You know similar to evening.overnight crews.
I never thought I would respond to this site because I have always felt that many of you are cowards and have plenty of dung to spew here but take no real action or have no real thoughts of your own.
The mentality of stooping to name calling...case in point.
There are many solutions or combinations of solutions that can work to improve the system. No matter what those solutions may be they all begin with communication. Until you improve the communication and mutual respect between the agencies you will struggle to make any strides in improvement.
As for Jeannie coming up with this...No I never indicated she came up with anything. I do believe she is being hand fed what her support team is serving up. They see she is very emotional and use that emotion to fuel their desires for a paid system. Those that have been pushing for a paid system to provide themselves with nice Chiefs positions. Of course this would be a transition and not happen overnight. I believe this is the beginning of that transition.
You numbers are theory and a nice one at that. You may know you have a crew responding in half the time; but they aren't on the road yet... and let us not forget that depending on the call the mutual aid is called in 2 minutes.
The REMSCO protocol will only fuel the burnout of an already overburdened system. We will be calling in mutual aid and canceling them more times than not. Count on that.
________
Cb200 (http://www.honda-wiki.org/wiki/Honda_CB200)

[SuffolkCC]

Tom! While I don't want to offend Mr EMT please don't confuse us. I have a firm grasp of EMS legal issues (as I should) and don't worry about his position. Also I always sign my posts.

Factfinder.....don't know what to say about u. I personally agree with the REMSCO decision. My agency will have no problem conforming to the guidelines. I think that any agency that doesn't at least have duty crews really needs to rethink their EMS program. I don't understand how you can tell the public that you accept the responsibility of ensuring their safety, but you cant reliably ensure that you have a crew...around. IN HOUSE crews are a much more reliable solution. You don't like paid, then eliminate the difference in paid vs. volly. With paid you have an in house crew....you're just paying them. I agree that agencies should work together. COMBINE resources! However; aside from a few areas to the best of my knowledge, the leadership is just too proud to allow that to happen. As for Dr. A. I think she's doing a great job. She always makes herself available to my agency and my members. She has volunteered to teach classes for my members and is always willing to meet with me in person regardless of how small the issue is. She cares - thats more than I can say for a lot of the EMS vollies in Suffolk. "We do what we can with what we have." is no longer an excuse. This is our problem and we need to fix it. Since we seem to refuse to even acknowledge the problem REMSCO has for us. We should learn a valuable lesson from this. If we don't get our act together....someone else will for us-and i guarantee you won't like that outcome. For those many vollies who do still care and want to make a difference-not for the glory, but to help their communities-please keep up the great work and stay safe.
Phil Aubrey
________
Handjob Sex (http://www.fucktube.com/categories/24/handjob/videos/1)

[ExCaptEMS]

As far as "calling in" goes, many depts. already use that system and its proven to work. How long does it take to make a 15 second phone call!!! 15 secs!! Use you cell phone! FRES uses the call in system for many of its dispatched depts, as well as the Town of Smithtown
(4-2-0) IT WORKS! Sounds like you have an axe to grind with REMSCO. Why don't you call the medical director and speak with her personally. She welcomes calls from providers. She will give you the facts. A combination paid system is evolving slowly as we speak. It is not being pushed by the council. REMSCO will accept any solution to the problem and it doesnt necessarily mean hiring people. Mr Bishop summed it up accurately, volunteer, paid, or martians, just get the bus to the patient!!! Why dont you come to the next REMSCO meeting and get the real facts. The next one is on July 19 at the east campus of SCCC.
________
Jailbroken (http://jailbroken.org/)

[ExCaptEMS]

Sorry..I posted the wrong date for the next REMSCO MEETING..it is TUESDAY, JULY 13, 2004 2 PM AT THE SCCC EAST CAMPUS...
________
Extreme Q Vaporizer (http://extremevaporizer.net/)

[ExCaptEMS]

There are many solutions or combinations of solutions that can work to improve the system.

Forgot to mention..most of the things you bring up as possible solutions have all been hashed and rehashed, some have been tryed and scuttled...or territorial or political reasons have stifled them. 18 years and nothing has significantly improved things. I have been around EMS in both counties since 1975, and have seen the ideas come and go. Just wondering, how long have you been a provider? Take the way back machine to 1986-1987. Read the 1986 Suffolk County EMS Task Force report. You'd be amazed at how the same problems still exist. Proof positive of this systems inability to improve itself under the current management system!
________
Ship sale (http://ship-sale.com/)

[Ocrainaugh]

Factfinder, what the heck are you talking about? Do you read or just start typing from a prepared script? Do you own a radio? Do you own a watch? Try using the two at the same time. you say a program that gets a bus to a patient 20 minutes sooner as in the above example, is going to delay a response? Yeah, I think you're right. We missed the point. Must be our cowardice. What was that about namecalling? You funny man, I like you.

Phil sorry about the confusion. You know I'm an old man and I wasn't working with a whole buncha tools before they started to slip away.
Peace,
Obewan

[SuffolkEMT]

Hey I'm not a bad guy..feel like I have the plague..nop one wants to be associated with me..lol
________
MisticqueDenise (http://www.girlcamfriend.com/cam/MisticqueDenise/)

[ExCaptEMS]

Hey Factfinder...are you one of those guys that jumps off a C truck at like 60 mph? Just wonderin!!..Seriously though....don't take it personally, we're here to discuss the issues. We're not here to bash one another. Chill out with us here..let's not disrespect one another. Everyone's entitled to an opinion, and we should respect that.
________
STARCRAFT 2 ZERG REPLAYS (http://screplays.com/replays)

[SuffolkCC]

Sorry to stray from the topic at hand but I have to clear something up.

It would seem that my "to DavisDem" post has kicked up the dirt. Here is my response.

Some of you may have no idea what I'm talking about or wonder what on Earth anyone could be upset about for my previous post. (Considering there are two WWHAC members posting in this thread and they haven't said a thing). So I will explain. It is being spread throughout WWHAC that I am a bigoted racist (try to stop laughing so you can finish this post). The evidence is of course my reply to DavisDem above mentioned. Now, I have read through that post about....five times now and I don't see any reference to race at all whatsoever (Correct me if I'm wrong and my New Mexico education has failed me).

Everything I said there was the truth. I choose not to elaborate any further on the condition of the building at WWHAC because I'm not here to bash WWHAC, it's members or employees. Nor do I think that that type of dirty laundry (excuse the pun) should be aired here. However - if anyone thinks that Wyandanch as a town doesn't have issues with substance abuse they're kidding themselves. Now, I'm not saying that every person in Wyandanch has a problem - that would be creating a stereotype - but due to the number of people living under the poverty limit, the homelessness, and whatever other factors one chooses to enter into the equation Wyandanch has a higher "per capita" substance abuse problem than many other places (not all). Heck - SBVAC's district has a tremendous drinking/drug use problem, but they all have homes and stay out of the roads (for the most part).

To everyone who actually CAME TO ME with any issues they had with my post - thank you for being adult enough to address the issue and talk through it. To everyone who was not mature enough to speak to me like and adult - I'm sorry for you. I think it's sad that you must revert to calling me a racist and saying that I have a problem; when the real problem is that you don't want to see that what I said is the truth.

Please people let's grow up. If I have the integrity to sign my name to everything I write, it would be nice to get the same in return.

Again, stay safe and keep gettin' the busses out.

Phil Aubrey
________
UPSKIRT PANTYHOSE (http://www.fucktube.com/categories/1126/pantyhose/videos/1)

[toocuteemt]

Can't we all think about this from the patients prospective????

Do you want to wait for an ambulance for 20 minutes while your loved one is sick??

[Ocrainaugh]

Phil, don't bother. A guy who spends his days caring for the sick and injured in a town where when somebody doesn't get their way is branded a racist...It's the way of the world. After riding there since 1980, I can't tell you the number of times I've been called a racist, sometimes by people I was currently sticking a needle in. It's a term that's been a bit overused, to put it mildly. If you're going to be there, and you are, people aren't going to bother to confuse the issue with facts when they have an axe to grind. You may not have noticed but our corps ( and this isn't just confined to the 'Danch,) is drama powered. You just gave 'em some drama. Red herrings like that take the focus off the tthings that are actually wrong, and in many cases that is exactly the objective. Do yourself a favor, thicken up the skin, let your deeds do your talking for you. To all involved, let me issue some advice, in the words of that great western philosopher, Sgt Hulka of the movie classic "Stripes", Lighten up, Francis.

Aside to Toocute, over 7000 people in Suffolk last year would have been happy to only have waited 20 minutes for an ambulance. For them, it took longer.
Peace,
Obewan

[SUFFOLKFFEMT]

when and where is it??
DOES ANYONE GET TO SPEAK???

[Ocrainaugh]

1300 at the legislative building by the 4th pct. If you fill out a recognition card you can address the gathering

[SUFFOLKFFEMT]

Volunteers criticize emergency-response bill

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BY SUMATHI REDDY
STAFF WRITER

June 16, 2004


A proposed law that would penalize Suffolk County ambulance companies if they do not meet a minimum response time standard drew opposition yesterday from volunteer firefighters and emergency medical technicians, who called it unfair and unrealistic.

The county legislature's Public Safety & Public Information committee tabled the bill, which would require ambulance agencies to answer calls within nine minutes 90 percent of the time, a goal adopted by the National Institutes of Health and the county's Regional Emergency Medical Services Council.

Under the proposal, departments that fail to meet such a standard would lose their $1-million county-sponsored liability insurance and would be referred to the state for a credential review.

A majority of Suffolk's ambulance companies exceed the nine-minute standard, officials have said.

The bill, co-sponsored by Legis. David Bishop (D-West Babylon) and Legis. Paul Tonna (R-West Hills), would also require the ambulance agencies to report their response times to the county.

Most of those who spoke in opposition to the bill were from the East End, highlighting the differences between their area and western Suffolk - districts that take up to 30 minutes to cross, congested traffic during tourist season and hard-to-get- to areas such as barrier beaches.

"What's gonna work for Montauk is not gonna work for Huntington," said Ronald Hintze, chief of the Flanders Fire Department. " ... So we can't take a cookie cutter approach to this."

Firefighters and emergency medical technicians also expressed liability fears and said such a mandate could result in higher property taxes or having to hire personnel.

But Regional EMS Council representatives defended the bill. "Human physiology does not vary by geography or time of day," said Carl Goodman, chair of the council's medical advisory committee.

Bishop said he now intends to work with the volunteer community to shape the bill. "But what I will not do is allow this status quo to continue," he said.
Copyright © 2004, Newsday, Inc. | Article licensing and reprint options




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Volunteers criticize emergency-response bill

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BY SUMATHI REDDY
STAFF WRITER

June 16, 2004


A proposed law that would penalize Suffolk County ambulance companies if they do not meet a minimum response time standard drew opposition yesterday from volunteer firefighters and emergency medical technicians, who called it unfair and unrealistic.

The county legislature's Public Safety & Public Information committee tabled the bill, which would require ambulance agencies to answer calls within nine minutes 90 percent of the time, a goal adopted by the National Institutes of Health and the county's Regional Emergency Medical Services Council.

Under the proposal, departments that fail to meet such a standard would lose their $1-million county-sponsored liability insurance and would be referred to the state for a credential review.

A majority of Suffolk's ambulance companies exceed the nine-minute standard, officials have said.

The bill, co-sponsored by Legis. David Bishop (D-West Babylon) and Legis. Paul Tonna (R-West Hills), would also require the ambulance agencies to report their response times to the county.

Most of those who spoke in opposition to the bill were from the East End, highlighting the differences between their area and western Suffolk - districts that take up to 30 minutes to cross, congested traffic during tourist season and hard-to-get- to areas such as barrier beaches.

"What's gonna work for Montauk is not gonna work for Huntington," said Ronald Hintze, chief of the Flanders Fire Department. " ... So we can't take a cookie cutter approach to this."

Firefighters and emergency medical technicians also expressed liability fears and said such a mandate could result in higher property taxes or having to hire personnel.

But Regional EMS Council representatives defended the bill. "Human physiology does not vary by geography or time of day," said Carl Goodman, chair of the council's medical advisory committee.

Bishop said he now intends to work with the volunteer community to shape the bill. "But what I will not do is allow this status quo to continue," he said.
Copyright © 2004, Newsday, Inc. | Article licensing and reprint options

[EMT]

This is a great plan to know if a crew is responding but..........

My question is, does REMSCO want us wasting travel time while we try and call dispatch, or is REMSCO asking us to break the law and call while driving to the station ? And on the same thought wouldnt this be a dangerous act ? Cell phone, light flashing, driving a little faster than normal..............

[FF]

"Volunteers criticize emergency-response bill"

Wrong.

Volunteers criticized the AUTHORITY of the agency that created the bill, NOT the bill itself.

Oh and yeah dumb ass Bishop has to stick his nose into anything he can......
Hey Davey heres an idea, since you dont want a new jail either, why dont you sponsor a bill that requires criminals to perform ems functions.......you dummy.
________
Washington dispensaries (http://washington.dispensaries.org/)

[TOB FF]

What's he care. He and Tonna have reached the term limit.
________
Birth Control Forums (http://www.health-forums.org/birth-control/)

[ExCaptEMS]

or is REMSCO asking us to break the law and call while driving to the station ?

Once again ridiculous statements are the order of the day. If you can't get to the station without breaking the VTL, then you should find another place to volunteer. How about a nursing home? Then you can drive normally, and have no problem getting there safely, without risking the lives of yourself and the public.
I can tell you that calling in before you respond takes about 10 secs. Smithtown dispatched depts and many dispatched by FRES have used the system for years with much success. The crew confirmation system doesn't have to be a phone call. Many depts issue radios to members. That would work. Or, having in house crews, with notification to the dispatch entity that people are in house. Writing names on a blackboard so your dispatcher knows people are available. And then there is the cell phone, which everyone has..and of course by using your hands free headset. Whatever works..The idea is to get the crew confirmed by whatever means, and get the ambulance out, with ALS if needed. Instead of making people wait until their heart stops.
________
ARIZONA DISPENSARY (http://arizona.dispensaries.org/)

[Ocrainaugh]

So lemme see, you already agree that you're speeding, and now you're gonna worry about making a 15 sec. phone call...any thing else you wanna admit to here where anybody can read it? Or do the guys in Smithtown, or any of the other dozens of corps or dept's who have a call in system in progress just have absolutely no concern for the safety of the motoring public? If they can make it work, why can't you? Betcha if you got a radio outta the deal, you'd go SCHWING!
Peace,
Obewan

[excaphfd]

How about instead of buying brand new cars and responders , buy two way radios for your responding members to call into medcom with or even better pay an in house dispatcher that responding members can call on the radio and then the dispatcher can call medcom . simplistic i know , but it might work.

[A BYSTANDER]

OK.......CANT HIRE EXTRA DISPATCHERS FOR CALL-INS.....
OK SUPPLY PORTABLE RADIOS FOR MEMBERS TO CALL...MMMM. TOO MUCH RADIO TRAFFIC??..MMMM(FOR A 16)....BUT TO A FIRE ,A FALSE ALARM NO LESS ,4 CHIEFS ,3 PUMPERS, A LADDER, A REHAB TRUCK, AN AMBULANCE ,,(AT LEAST 1) AND A HEAVY RESCUECAN USE THE RADIO..MMMMMTHE DISPATCHER CAN HANDLE THAT ...BUT NOT THREE FOR A 16...MAKES SENSE TO ME??????????

AND CELL PHONES?...MOST OF YA'LL TALK ON THEM NOW WHEN RESPONDING TO CALLS......
IM JUST NOT GETTIN THE PROBLEM? MAYBE WE HAVE THE WRONG LEADERSHIP...CAUSE I JUST DONT SEE THERE SOLUTION YET.....OR AT LEAST HAVENT HEARD OF ONE THAT THEY CAN IMPLEMENT.

[toocuteemt]

Is there really an answer to this problem???

[excaphfd]

im sorry, its early whats your point ??

Thanks

[Ocrainaugh]

Of course there's an answer, Toocute...but it's going to revolve around people becoming willing to embrace change. People are dragging their feet because they don't want their little worlds rocked. We wnet thru this in the 60's when them newfangled EMT's came around and wuffo we need them around for anyhow. We's doin' jus' fine without this CPR stuff anwhows, then in the 70's when caddilac stopped producing the limo chassis..that was to be the end of life as we knew it. Then in the 80's when the Big Brother State had the NERVE to insist we hadda get the buses certified, it was really over...AND THEN, when we hadda actually have an EMT, ahhh, you know the rest...The players have to realize that we need to get better, or we'll get replaced. All the whining about I gotta make a 5 sec phone call or my district's too big or we only got two roads or how can I make a cell call when I'm drivin' is just smoke and mirrors to hide the real truth...I like things the way they are, I don't wanna change and if this negatively impacts on the patient, maybe he should not call and bother us. This would be a real good hobby if it wuzzn't for all those annoying sick and hurt people.
The president of the SCACA and chairman of FRES got up at the hearing and said everything is fine, and EMS is in the best shape it's ever been. Wow.

The answer lies in us doing what's right for the public we serve. It's as simple as that.
Peace,
Obewan

[toocuteemt]

what should be an allowed time fro an ambulance to be signal 2 after a call comes out?

[Vengeful Medic]

And here is when I come back from my lurk in the shadows..watching and waiting...hey everyone.....

To answer your question, Toocute, An allowed time for an ambulance to be signal 2 after a job comes over should be immediately. However we do not live in such a world (that world is 40 miles west of me.........)

Realistically, A unit should be signal 2 by the two minute mark if you take into account actually getting up from the chair, using bathroom really quick and washing hands (I hope). Then you gotta get the location of the job, open the bay doors, turn the truck on...make sure everyone is on the truck, and pull out and give your sig 2. Yeah, that could be done in about 2 minutes......Unless your crew is not in house.....and for that we go to the call in system.....Ocrainaugh? Take it away.....

Omar-Fara B. Norgaisse, EMT-P
________
Montana dispensary (http://montana.dispensaries.org/)

[Vengeful Medic]

"The players have to realize that we need to get better, or we'll get replaced."

Yes, Tommy......like big friggin' cogs in a wheel. We are ALL easily and sometimes efficiently replaced. No one in EMS holds a firm grasp on "Forever", although there are some that seem to hold on to the past and just can't let go. Medicine is evolution, people. As medicine changes, everything around it must change, most importantly prehospital care. If we continue to do things the way we did 5, 10, 15 Years ago, we will begin to kill many more people as a result of our inability to look past the nostalgic haze and suck it up and press on (<---yeah....big run on sentence...sue me) to the future.

And to do that is (man how many times must I say this???) to go back to basics:

Training
Response Approach
Proper Equipment
etc...

If that means that everyone must supplement their EMS response with Paid Personnel, then so be it. It's not about you or your department being "Hard Core Vollie".....yeah, there's pride but you still can't get out the god-damned door.

If that means that the county may have to step in and introduce a fully paid EMS (be it simply first responder or actual units sitting at CSL's throughout the county) then so be it. Hell I don't care if an FDNY unit shows up to my Wheatley Heights home as long as they get there fast and have a competent crew on. I don't care if it's Sag Harbor...same rule....I don't care if it was SCEMS at my front door and Delagi and Lateulere were the crew. I want competent Prehospital care personnel at my home to take care of my family within a reasonable time. 20 minutes? Not reasonable. 30 minutes? I will not be a happy camper. 40 minutes? I'll be on my phone with the lawyer.'

That's what people are thinking. So Tommy, if the people in these departments that don't want to get their act together and basically blow off the protocol....what do you truly believe will happen to them?

Omar-Fara B. Norgaisse, EMT-P

________
Alegrya (http://www.girlcamfriend.com/cam/Alegrya/)

[Vengeful Medic]

Let us see if I can dissect what you are saying here.....:

"Volunteers criticized the AUTHORITY of the agency that created the bill, NOT the bill itself"

Well, here's my problem with that statement...REMSCO DOES have the authority to do it.....please read Article 30 & 31 of the NYS Public Health law. It may enlighten you as to who actually calls the shots in regards to response, triage, treatment, and transport....as well as certifications...for departments as well as individuals.....I'd keep that in mind...

"why don't you sponsor a bill that requires criminals to perform ems functions.......you dummy."

Heh-heh.....There already are criminals performing EMS functions......you don't need a bill for that, lol.


Omar-Fara B. Norgaisse, EMT-P Edited by: Vengeful Medic at: 6/17/04 12:57 pm

________
RHODE ISLAND MEDICAL MARIJUANA DISPENSARIES (http://rhodeisland.dispensaries.org/)

[nyit95]

tommy, maybe phil really needs to tell ALL on why the members and some of his co workers disagree with some of his ways of treatment of patients. See i also am a CC and an employee of wwhvac and i HAVE confronted and questioned mr aubrey on a few of his protocol ways, and maybe he should follow the ones set fourth by scems and maybe he wont have the problems he does right now with the vollies and some of his co workers. The whoe truth he should tell you instead of him feeling "picked on."!!

[EMS All The Way]

Organize and Set Standards

Plan

Train

Staff (Volunteer or Paid)

Respond

Monitor Performance

Critique

Continuously Improve

Enjoy the Pride/Satisfaction of Saving Lives, Serving the Community, and Working with the Very Best

[Ocrainaugh]

Go, Omar,Go, Omar...Go, go, g-go, Omar!...Yeah, What he says!

Toocute...like he says, it should only be the actual mechanics of getting in the truck and getting the bus out the door that use time. Omar, I dunno about the FDNY showing up in da 'Danch...think they're varsity enuff to make it in the big leagues? (there...that should set off a few of the less balanced...)anywayhow, just a couple of points...
about the authority of the agency to establish a bill...yeah, the Suffolk co legislature has the authority to pass a bill. This bill wasn't REMSCO's idea, it came from Dave Bishop. REMSCO duzzn't write bills.
It doesn't take a scientiste' de la rockette' to get this accomplished, we just gotta go ahead and do it. when we realize this fact, and we step up to the plate, this will all just go away.
EMS, if we could just get that song sung countywide, life would be good.
NYIT, what Phil is doing or not doing is one thing. That all comes down to a lack of supervision by those who should be watching what's going on over there. If an issue pops up over here, I fix it. If it wa sover here and a guy was writing his own procedures, he wouldn't be the first to be dispatched to see Tommy Lat for review and repair. If a vacuum is left those who are left standing in it are going to expand into it. But to hang a tag like that on a guy unwarranted just aint right. There'sa distinct lack of love over there, that's for sure.
Peace,
Obewan

[Vengeful Medic]

You bring tears to my eyes.......

You actually get it <sniff>

Thank you for brightening my day and proving that there ARE people with a clue out there....


Omar-Fara B. Norgaisse, EMT-P
________
Herbal Health (http://herbalhealthshop.com)

[Vengeful Medic]

I will not answer on the FDNY issue as I have to drive through a lot of their territory to get to work.......wouldn't want me mysteriously run off the road now would we......?


Omar-Fara B. Norgaisse, EMT-P
________
Kitchen Measures (http://kitchenmeasures.com/)

[emt35yrs]

I have been answering calls for over 35 years as an EMT, 32 years as a Paramedic. Volunteers are a good thing. There isn't a single system in this country that doe not use them if they are available, but the Systems set the standards for the system and the volunteers work within those standards...as professional as the paid personnel they work beside.

[ExCaptEMS]

Volunteers will always be the backbone of the EMS system, as long as we have the people. That IS a good thing. The providers are not the problem here. The problem is when people who are in charge fail to do their jobs. Objecting to response standards is a failure to do their job. They are an embarrassment to the communities they serve. We have a contingent of chiefs out here who feel they shouldn't have to abide by ANY standard and that is wrong. The Southampton Town board was bamboozled by these fools. I can see the lawsuits coming. Bottom line, the patient suffers. I could not believe my ears when a EMS chief from out east said on News12, " I can't get across my district in 17 minutes" as an excuse to not follow response protocol. There has to be a way to fix the problem. Put crews in house, relocate the buses in a substation to properly serve the community. There has to be a way to reallocate some recources to get the job done. Fire Depts are always building substations to suit their needs, why not the EMS substations?
________
Essential vaaapp vaporizer (http://essentialvaaappvaporizer.com)

[sigh]

instead of wasting time writing here why not go out and respond to some jobs in your district?

[Paid EMS]

everyone thinks that the solution to the response problem is a paid system. Our Police Department is all paid and it takes them over 9 minutes to get to certain calls. Like the ones they arent intrested in. Newsday isn't intrested in making that an issue. That isn't important right. Someone in a previous post said that if PD ran EMS they wouldnt pick calls; yet when a sector car is out at Donkin Donuts or 7-11 doing "paperwork" in the parking lot and an audible alarm comes in they arent intrested. Yet if a good call comes in that is in their sector they all of a sudden become availible with like 5 or 6 other units that were previously unavailible.

[Firecop]

This is a really good thread, except no one seems to have any real answers. I'll do my best to see if I can help out. As a vollie in a Nassau dept for 15 years and a police officer for almost as long here it goes. I have the pleasure of seeing both Nassau and Suffolk county EMS systems work and not work everyday. I'll start with the most recent post of a sector car sitting around and not answering a BS call in their sector but a hot call their the first ones their. Does it happen sure it does just like the EMS system. I can't tell you how many times a PAID NCPD Ambulance is not available for the 75 year old female who fell but a minute later the CAR INTO A HOUSE with people trapped come out and the PD BUS answers right up to respond. It happens the same in the volunteer service with Depts that do not run squad crews at nights or call ins. How people are perfectly capable at any given time day or night to respond to a call in their district ? If it is Mr Jones calls he feels ill and these capable responders sit at home because it sounds like a BS call. These same responders jump up and race to the barn to get the bus out if it came over a child not breathing etc...

Speaking of the town of Smithtown, they have an excellent system that works great at night. The call in system works because right after the call is toned out the phones are ringing with the crew calling in, and if that crew member dosen't call in the Dispatcher calls their house and no answer? Well then right away within 1 minute of the alarm you know if you need an EMT or a Driver and they tone it out again for the missing crew member if that is what is needed.
Unless you have a paid crew during the day everyone has problems getting a crew out. But what about banging out 2 depts for a bus at the same time? Williston Park and Albertson have been doing this for the past 2 years. Any Signal 9's both dept get toned out. So why not try it in Suffolk? Why wait the so called 4 minutes to automatically 24 the call? And if a certain dept always has problems getting out at night. 24 the call right away.
Another topic that came up here is it's a Chiefs Problem.. Well how many Chiefs in Suffolk even get up at night and go to the Signal 16s? Why not make it a requirement in these department That to be elected chief you have to be an EMT-D or at least a CFR-d? My department has 4 chiefs all their trucks have O2, Defib, Medic bags, etc.... They respond to most of our rescue calls both day and nighttime. How many Chief cars also have this vital equipment that just sits there when a chief is home at night and hears Signal 16 and he reaches over and hits the reset button on his pager? I heard a Suffolk Chief say the other night at a call " I wish it was a 16 i could have hit the button" That is the same Chief that will bitch and moan at a Rescue Company Captain about getting the bus out...

More to come later... We all need to help each other out and come up with a good game plan. Who knows ? maybe something said here will be used to formulate a plan ....

[Firemt]

We are all on the same page..we are responding and doing our job, but we cant drive and treat at the same time.
The bottom line is the FDs and Corps need to recruit and when they get the people make it so they want to stay.
let the first responders ride the rigs, let them go on 24s and lets stop the bullsh*t.
Departments that have no dispatchers, well guess you have to call medcom on your cellphones to let them know you are responding..Volunteer Dispatchers get your act together and do not take the phone off the hook because people calling you during an alarm is bothersome.
pay one or two housepeople/EMTs and when you get the job Dont have an attitude because EMTs don't clean toiliets."
Fds having trouble..maybe look into more community ambulances..they seem to work on the south shore.
If we want this to stay volunteer we need to push our chiefs and commissioners to get on the ball and talk to our members tog et them to understand what is going on.
The County..instead of threatening us should step up and revamp their Recruitment program and have discussion with their Amb Corps and EMTS in their districts..town meeetings wouldnt be a bad idea

[Ocrainaugh]

The conventonal wisdom is that "WE NEED MORE PEOPLE! " Fact is, we got people. Add em uop and you find out that the Suffolk Co system has more people involved in EMS and fire than the Suffolk, Nassau and Troop L have put together in cops! We're just not using them right. Please don't get me started on buses ramping calls, aid or vollie. I was a cop in EAB for 20 years and I duno haw many times Id have to pick up a cal on somebody elses post cuz they were hitting on a nurse and wouldn't go 10-1. Vollies? can you say HIP center? Everybodys trying to justify their own position here while the patient has just one..."Would SOMEBODY please take me to the hospital?!"
Peace,
Obewan

[Firemt]

Tom
I know we have the people but they have to be motivated and we have to find out why no one is answering the ambulance calls..Every department has their reason, but its up to hatbands to motivate their people to get the rigs out in a timely matter and i f they cant its up to the Commissioners to put a fire under their Chiefs butts.
I'm not arguing with you..I agree!!

With that I close my case and may you all carry on

[FFMEDIC]

I agree, we do have the people, I think that the call load has become too much for those overworked volunteers. Most departments have the same scenario, 100 vollies and the same 30 people doing 90% of the work. The problem is that we do not live in 1970 anymore, when the busiest dept out here was doing 300 calls a year and no one needed to be an EMT. We can fix a lot of the problems. Corps are doing 3000 calls now. It is becoming too much for JUST vollies to handle, they NEED supplementation. I know some people start to cringe when they hear that, but it is the cold, hard truth. You can try recruitment if you really think it will work, but I don't think it will matter.The answer is staring us in the face, we are just too afraid to open our eyes. The other thing people don't realize is that the county or the town are completely able to yank your funding and/or insurance. They are threatening it right now, I am sure they are not playing games either. Most depts realize that this is not the epitome of guidelines, but it is a start. The people who are mad are the people who realize that they do not have the capabilities to do this, they should, they have had at least 8-10 years to prep their corps. We were warned back in 1986 to get ready for changes. Guess What????? THERE HERE!!!! Time to get off your bums and find the solution to your particular problem at your particular corp. I know all the places I work, did it years ago, and the places I vollie also fixed the problem. Some systems just need a little revamp, others need to start something and park the pride. It is nice to know some of us stepped up to the plate, while the rest of you out there are screwing all of us with the fact that you can't get out. Then What Happens???Eventually we are all going to do what Mr. Miglino does, and say NO I AM NOT SENDING A CREW!!!!!!!! I have to applaud him for that. Some people don't like it, I think it takes balls, big balls, and he is tired of covering all the other districts. I don't always agree with what he does, but that I agree with. Maybe you'll fix the problem when no one will come in for 24's and your taxpayers start making complaints. Or will you still finger point at the people trying to fix the problem, instead of going to the drawing board and working out the solution with your board. All in all, a lot of us are working to fix the problem, the ones who don't get on board are going to be left behind. That would be sad!! Can always use help in Suffolk County. Good Volunteers are hard to find, use all the help we can get. Be Safe out there......LATER

[FF]

Yeah we have alot of membership on the books.....

Alot of experienced people who have put in 5,10,15,20 years after awhile the same BS after BS gets old people stop responding unless it sounds good.

"..."Would SOMEBODY please take me to the hospital?!""
That statement says alot. In my time i'd say maybe 70% of the calls i was on were, for example, I have a tooth ache, it started 3 days ago but now its 3 am and i dont want to wake anyone(family member) to take me to the hospital.(That would explain the 2 new cars in the driveway.)
How about this one: I dont like the housing social services put me in now that im out of the riverhead inn so i want to go to the hospital. She got a ride in the white taxi alright, but it also had blue striping.

What im trying to say is educating the public as to when is an appropriate time to call an ambulance would go along way to cutting back on BS.
Yeah yeah i know what seems like an emergency to one person may not be to another, now delaying appropriate care, but something needs to be done.
Perhaps PD, they are usually the first on the scene. PO if it is a BS call how bout canceling the bus and giving them this number to call 732-TAXI.
________
AmelieLove (http://www.girlcamfriend.com/cam/AmelieLove/)

[sammy]

Your close........

"The other thing people don't realize is that the county or the town are completely able to yank your funding and/or insurance"

Yes the COUNTY(not town) could cancel our SUPPLIMENTAL insurance. Most depts. have their own and really dont need the counties anyway.
NO the COUNTY nor the TOWN can take away ANY funding.
Funding comes from the state and federal governments and the taxpayers directly.
Im not saying the defiance is right or wrong just pointing out a missconception.

[Vengeful Medic]

Three words for that:

Cross Street Location.

Strategic placement of units at cross streets that would make their response times lower and also would be conducive to optimal patient care. You put 2 crews (if you can get them) equidistant from each other, maybe by primary access roads, and each crew handles the jobs that come over in their area....hmmmmm....what a novel concept......

Omar-Fara B. Norgaisse, EMT-P
________
LovelyWendie99 (http://www.lovelywendie99.com/)

[Vengeful Medic]

In any PD or EMS jurisdiction you will find that units skell their way out of the BS jobs and practically kill themselves (often times literally) to get to the "hot jobs" you are preaching to the choir....we hear what you are saying....but it is an issue everywhere...vollie or paid....band aid or gun........


Omar-Fara B. Norgaisse, EMT-P
________
UHWH WAREHOUSE (http://uhwh.com/)

[Vengeful Medic]

If I could run with the torch in regards to the title of your post for a moment....

I just wanted to state a few things that may actually help us out in terms of educating the public.

All throughout Paramedic School, we were told day in and day out about how Paramedics should take on the responsibility to educate their communities in terms of wellness and health. In fact, I had spent many days actually formulating an outline to begin a series of lectures to the public on wellness and health, and also give insight into EMS (also a nice recruiting tool, I figured). Now today (or rather earlier yesterday at work) my co-workers and I were discussing how EMS is the only service in NY that does not do any advertising. If you go to Louisiana, you will see advertisements, calling for people to become a Paramedic, etc, etc, etc. And I got to thinking that our bosses, the "EMS Professionals" are lacking in one major area that doesn't seem to get any major effort put into it: Public Relations. I'm not talking about the backpedaling and spin doctoring that's done when one of us gets into trouble and we want the public to believe that we are not all irresponsible murdering drug addicted drunken bastards. No, I'm talking about arranging such events as regular open houses, wellness checks, etc. And here's where the recruiting tool comes into play-The Volunteers can get involved very heavily into this. YES!! Just think of it-instead of just sitting around their headquarters and waiting for something to happen or thinking they only take people to the hospital and that's it, they can become (here it comes): INTERACTIVE with their community. They can acutally go out and target the elderly and underserved in their communities for wellness checks. Those who have the gift of gab (and actually know what they are talking about) can give regular lectures to the concerned public about asthma, diabetes, high blood pressure, what EMS is about, etc. Why should we only do this on open house during EMS week? Look at our brother services (Fire, Law Enforecment). They always have regualr events where they interact with the public. if EMS put just an inkling of that type of interaction into play, you may jus see a turn around in your membership, amount of calls given away (as in a decrease), hey, maybe even better response times.
Yes, it will cost some money. Yes, it will not be easy. But hey, nothing good comes cheap, and no good job comes without effort. The resources are already there in each and every single department that handles EMS (be it Fire Department or Ambulance Corps). Put them to good use.
CHIEFS: Get over whatever is stuck up your rear ends and instead of alienating those who have something to offer, look into this (what I think is a) great plan. And maybe you can be part of the turn around we need. A part of the SOLUTION. Now there's another novel idea....be a part of the solution. Work with your people instead of against them. You people know who you are. And you are out there. Let's start cleaning up this mess that we are in before they call in the clean up team for us. And at that point, we will already have been up that mythical river in a leaky boat without a paddle, life vest and the ability to swim....and the river is actually the Hudson (ever find anything that gets lost down there...I don't think so...........).
Think about this. Please. Thank you.

Omar-Fara B. Norgaisse, EMT-P

(PS: IF there are typos in this posting, I apologize, but it is very late, and I'm too tired and impatient to do the spell check this early morning. Thank you.... )
________
Ffm Latina (http://www.fucktube.com/categories/548/latina/videos/1)

[wwhpc]

as a coworker of nyit95 I can say that no matter what Phil (a competant CC) has done, or what hornets nest she's tried to stir, nyit has NO right to say anything. Little (or giant) MoMo as the case would be....be quiet.... look in the mirror before you say anything about anyone...at least Phil knows what he's doing...even if he does more than he should at least he knows how to do it... you on the other hand....I wish my last name wasn't on the PCR's you've (loosely) written..... get a life....learn how to be an emt...

[Ocrainaugh]

Otay, I dunno what I just did there, but somehow I sent that blank screen. If only I knew how to use this thing...
Anyhow, In a perfect, or semiperfect world, we could educate the public about system abuse calls. Guess what...the morons who call with the toothache ( and I CAN TOP THAT ONE, hAD A CALL FOR A TOOTHACHE AT the dentist's office {hmmm. dunno why it did that either...sorry} and the caller was yup...the dentist. He said this guy's tooth really hurts.) they know exactly what they're doing. Educating them isn't going to stop them from taking advantage of us, just like they do in all aspects of their lives. We're gonna be stuck with them and their dramatic little tales of woe for as long as we stay involved. These people live in a unicentric universe and nothing gona fix that. Fact is, the majority of our patients, and by the majoprty I mean around 95%, do need us. They may not need all the excitment we bring, with the flashing lites and noisy whoop-whoops, but they absolutely need a medical paraprofessional to get them into the system The dwarf does it with crown vic's staffed by PFD EMT's maybe he's on to something...he usually is.
I have to vehemently disagree with the concept of not responding to a mutual aid when you have the ability to do so. I know it's frustrating to go to the same squad time and time again, but remember, when you receive a call that someone else has been unable to handle, you now hold the liability to handle it. If you can't get out for it,, that's one thing, but to be able to, and refuse to, that's gona cost you. Remember the elements of negligence before you act, or choose not to. Possibly the solution is to bill the requesting agency for your crew's time and trouble?

In many cases, the town ABSOLUTELY can remove a squad's funding. 4 example, WWHAC is a private corporation contracted to the ambulance improvement dist run by the TOB. The town board is actually the board of commissioners. As such, they have a fiduciary responsibility to hold the squad to it's contract. If the squad is in breach, they can absolutely do what is needed to enforce the contract. Almost all the ambulance corps and a large number of the FD's are set up that way.

NYIT partner, let me ask you a favor ( I don't ask for much, do I?) could we please keep our rather large volume of dirty laundry to ourselves? Yeah, WWHAC is a sinking ship. We know it. Most of our problems go back to what several of the posters here have alluded to, a lack of leadership. The paids do what they do because there's no one to tell them any different. Let's keep what we have going on behind our admittedly dirty windows. While you're here, wave to the media reporters. I had a very good friend who became a Sgt in my unit. She told me she never had to hunt for anybody. all she had to do was sit in MEDCOM with the door open, and everybody would come in to tell her what the other guys were doing wrong. If you're concerned that the Healey's of the world are out to crucify us, let them work for it, please? Thanx. pS Omar, I ain't sitting my fat butt in a bus on a street corner for nobody. While I realize Third Watch is Science Fiction, out here, we get our nice comfy stations that I just luv.
Peace,
Obewan

[Vengeful Medic]

1- Who the hell is the Dwarf??

2- If we don't try to educate the public, how will we know if it will work...that's somewhat of a defeatist attitude there, Tommy....I'm surprised at you...

3- Think of all the fresh air you can get on a street corner....thankfully the Hamlets of Wyandanch-Wheatley Heights and Deer Park do not need to have CSL situations because most of each respective district (if not all of it) is reachable within 9 minutes. However when you get districts the size of Brentwood, Huntington, CI-Hauppauge, etc., It becomes a bigger consideration (no pun intended). So instead of building a costly building, why not post for 3 or 4 hours at a time.....you don't actually have to sit in the truck..you can stand outside.....but seriously...you have sat your fat tail in a bus for 12 hours, and I do it for 16's and 12's on almost a daily basis. IT's not the greatest thing, but it's not that bad of a choice/solution.

Omar-Fara B. Norgaisse, EMT-P
________
MFLB REVIEWS (http://vaporizer.org/reviews)

[Ocrainaugh]

Yeah, have sat in the bus for twelve at at time, sometinmes longer, but at least I got to ride around and harrass the motoring public. The 'wood does that with their responder, they make the guy go sit in a parking lot all night. sheesh.

The reason I feel that way is cuz been there, done that. It's not defeatist, it's futile. We tried social outreach for years and all we got out of it was more calls.

The Dwarf? Make that a homework assignment.
Luvya!
Tommy

[Vengeful Medic]

Sits in a parking lot all night, eh?.....At least he doesn't have to worry about some crackhead coming to the window and trying to choke him for some alcohol preps to suck on....or some bleach solution to take off the edge....But seriously, okay, I can see what you are saying (now that we have clarified the whole social outreach thing, but I'm not giving up on it), so I won't say that I was thinking that you lost your edge, have gone soft...etc, etc, etc...

But there still has to be some kind of means of interaction with the public other than seeing them in the back of our buses. I still believe that prevention is key. You and I both know nothing works overnight, however given time something like this could have some effect that would be mutually beneficial. I dunno, call me idealistic.

Omar-Fara B. Norgaisse, EMT-P Edited by: Vengeful Medic at: 6/22/04 6:23 pm

________
The girls next door forum (http://www.tv-gossip.com/girls-next-door/)

[islipian]

The medic in the "wood" is not relegated to a parking lot. The medic is free to roam all 22.5 square miles of the busiest ambulance district in all of New York. The medic usually parks in that lot because its the safest part of town on tour one. Omar , don't laugh we have had crews harassed for the kind of crap you were talking about. Man thats scary.

Besides "O" although "the wood" isn't totally void of manpower problems and response issues they have been at least been attempting to address these issues for the past 3 OR 4 years by supplementing the vollies with paid personnel. All of this without the veil of outside intervention or funding cut threats. talk about insight.
thanks for doing what you do
________
Love quotes advice (http://www.love-help.org/love-quotes/)

[Dust in the Wind]

All i Have to say is that being there and seeing it for fact Ms. MoMo needs to listen to herself. Wanna Talk about following protocols!!! At least Phil has the brains and common sense to take his BSI precautions!!! I mean lets get real here Not wearing Gloves while starting a Line!!! Come on now if not for your own protection how about your family and your coworkers. Never once did i see you wash your hands!!!! Just a quick wipe with a 4x4 Maybe you need to go over your state protocols.

You all know me Im the most hated person in all the Danch!!!!!
Peace Cooter

[Ocrainaugh]

Ladies and gentlemen, once again I beseech you to keep in house stuff in house. All you have to do is look at some of the other boards here to se what comes of going down this road. Think about it.
Peace,
Obewan

[Vengeful Medic]

Yes, it's very scary...not as scary as the EDP that tried to kick my gut back into being flat again.......but scary.....lol...


Omar-Fara B. Norgaisse, EMT-P
________
Dragonball Z Dicussion (http://www.tv-gossip.com/dragonball-z/)

[Just a thought]

First we don't want to hire full time anybody, we HAVE to its the most responsible thing to do for our community.

As far as coram goes thats extremely commendable and in this day age a truly great feat.How ever this is a question not a dig , can coram get out all the time every time. If they can thank god !! and also do they supplement their Fire/EMS staff with houseman during the day ?

And as to how many paid personnel is enough well I really cant exactly answer that i guess if all the calls are answered with Vollies and paid then thats enough !

And "waiting on the apron" it doesn't matter if you have a fleet of ambulances if some moron wants to sue there is a lawyer out there who will take the case.

Thanks and just a thought
________
Kaiser Jeep Specifications (http://www.dodge-wiki.com/wiki/Kaiser_Jeep)

[Ocrainaugh]

Waiting, the test of an act or omission in New York civil law is what would a reasonable person expect in such a situation. A good rule of thumb is to keep enuff buses on line to handle the maximum # of calls you usually get, plus 1. If you regularly get three at once maybe 4 would be a good idea. Crewing them should follow a similar rule. Recently the town of Islip told B'wood they should have 3 paid crews on. Listening to them, it sounds reasonable, doesn't it? I routinely reinforce the platoon with additional personnel when the winds shake the trees and the aideds fall out. Bottom line, you gotta get the bus out, be it paid or vollie. I think your screen name says it all, Waiting on the Apron. While your waiting there, the aided is waiting laying in the street.
Peace,
Obewan

[emsgoddess]

The fact of the matter is every department is looking for people.... yes they are getting new members but a good % of these members as much as I hate to say it are joining for the wrong reasons.... just to say "yes I'm proud of the fact that I'm a Vollie" but then when it comes time to get a bus out they are nowhere to be found... blowing 3's numerous times is not called for.... why should a headache be any different then a 4th width... yes it may be a BS call but you know what people die and their only presenting symptom was a headache... i disagree with having 24 hr paid crews when you have a vollie list of 20-25 people long, tell these people answer calls or resign its that simple.....

[re:emsgoddess]

"i disagree with having 24 hr paid crews when you have a vollie list of 20-25 people long,"

Oh, do you? But I'll answer that after I go to....:

"tell these people answer calls or resign its that simple....."

And then what? Oh, we didn't think of that little detail did we?? And you yourself said that you "...disagree with having 24 hour paid crews...". But yet you are advocating to "tell these people to answer calls or resign...". Here's the thing-it's not that simple. Because then you will have to hire the 24 hr paid crew when the 20-25 members that used to ride in your hypothetical department says "take-off" and you are left with an escalating 24 rate and NO ONE to answer the calls, because your recruiting efforts are not yielding any long term prospects.

Look, I can understand that a lot of people are against paid, super pro vollie and all that jazz. Really. I do. But here's the thing. As it has been said countless times by myself and others here on this board and other boards, the people OUT THERE still need a BUS to roll up 10-84/sig 21/sig 22 on scene to take care of them and/or their loved ones. And honestly they are not going to care if it is paid, vollie, Cornell or Cabrini that shows up..as long as someone does in a timely manner and does the job right. I just don't understand why this concept is so hard to grasp. I mean really.....

Omar-Fara B. Norgaisse, EMT-P Edited by: Vengeful Medic at: 6/25/04 4:06 am

[Response Times]

You know what 24 hr paid crews are a last ditch effort...yeah I'll admit I'm new to the whole EMS situation before that all I knew where fire dept's...as far as recruiting efforts go what recruiting efforts where I'm a vollie there are no so called recruiting efforts...or minimal ones at most..to vollie system is going down hill I agree but I think it's up to the active members to say "hey wait this isn't right" we're suffering based on comparison but we're doing our part, sit down make a phone call or something tell the other members that aren't doing their part that we do need them and that they are important to our dept's/corps... I love where I am and if it went 24 hr paid I would be really upset

Omar your right in alot of what you said but so am I...I'm not against 24 hr paid I just feel that like I said it's a last ditch effort...I know people that are paid EMTs/paramedics and some day you never know I may join them but I will never stop being a vollie...paid is a job, vollie is from the heart

[my2cents]

Just to set the record straight: the reason your EMT-B/CC/P First Responder arrival time doesn't count is because the national STANDARD clearly states that an AMBULANCE is the vehicle that will provide transport to a MEDICAL FACILITY that can provide DEFINITIVE care. A first responder cannot provide that. I'm not arguing the point that the patient isn't receiving quality, competent emergency medical care (or at least should be if you allow personnel to respond to the scene, whether it's an official EASV or someone with a jump bag in their trunk).


________
buy vapor tower (http://www.vaporshop.com/vapor-tower-vaporizer.html)

[my2cents]

So, let's assume for a minute you're the Chief of the "a-b-c" fire department, who is enroute to a local hospital with a patient that your agency was called in for a mutual aid. Enroute to the hospital, your ambulance wraps up in an intersection in the fire district from which you were mutual-aided, and now you need another ambulance to help the aided in the accident. The very department that couldn't answer the call you're transporting now responds to the MVA that your ambulance was invloved in, but couldn't get out 15 minutes earlier.

How do you 'splain that Lucy?

It happened today in Copiague. North Lindy wrapped up while on an 18 and well, as they say...the rest is history.


________
Harley-Davidson XLH (http://www.cyclechaos.com/wiki/Harley-Davidson_XLH)

[Lucy]

15 minutes ago when the call went out I had my daughter (5)/son (6) waiting for the school bus was I to leave them by themselves. Bus comes wave bye-bye off to school they go now i can respond.

My husband ricky would have responded but he was just leaving work 15 minutes away.

[Vengeful Medic]

I just caught what you were responding to....you should have just left it alone and not even bothered to perpetuate that. Besides, it's so much better to confront or discuss the issue with the person (or persons) that there is a problem with...not slander them here...yes, I know I have been guilty of a certain outburst here on the d6d6d6d6d6d6d6d6 report on another thread (which I have since deleted), but I felt better talking to the person that I had the problem with.

Cooter, leave that nonsense off of here...that's not what this thread is about anyways...Thank you.

Omar-Fara B. Norgaisse, EMT-P
________
Medical marijuana card (http://medicalmarijuanacard.info)

[iplyf]

seems that some paid emtcc is being investigated at the danch for something that has finally caught up with him

[SuffolkCC]

I don't even know why I'm responding to this, but oh well. Iplyf you speak of that which you know nothing of. I am the person you are talking about, however your "facts" are wrong. Wish you would mature and sign your name so I could talk to about this outside this venue, but I doubt you are willing to do that. Shame. Again I try not to air out laundry here, but since it's my own do so with I'll keep it to a minimum. An issue came up - it was addressed - and it's past. I'm sorry those who tried to "hang" me instead screwed it up for themselves, but that's karma. Please grow up and mind your own business. For those who live in glass houses should be careful throwing stones. Peace -
Phil Aubrey
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Rolls-Royce Twenty (http://www.bmw-tech.org/wiki/Rolls-Royce_Twenty)

[unbelievable]

these threads can never stay on the point can they? some idiot always has to throw in someone's name or corps to drag them down. GROW UP!!! :">
________
Honda OSM specifications (http://www.honda-wiki.org/wiki/Honda_OSM)

[BUSYBODY]

A BUS CARRIES PASSENGERS UP TO MAYBE 45 TO 60 AT ONE TIME. A TAXI CARRIES PASSENGERS TO AIRPORTS, HOTELS, DINNER, RAIL ROAD STATIONS, ETC. FOR A PRICE ESTABLISHED BY THE NYS TAXI COMMISSION OR A FLAT RATE DEPENDING ON DISTANCE.
WHAT WE HAVE DISCUSSED HERE IS TRANSPORTATION OF AN ILL OR INJURED PERSON TO AN EMERGENCY DEPARTMENT OF AN APPROPRIATE HOSPITAL. PLEASE GIVE IT THE RESPECT DUE AND STOP CALLING IT A BUS. AND THE PUBLIC SHOULD STOP USING IT FOR A TAXI RIDE TO THE HOSPITAL.

[EMT For Free]

Let's Be Honest

July 14, 2004

Democrat David Bishop, a Suffolk County Legislator from Babylon, has proposed a nine-minute rule that ambulance companies must adhere to.

Ninety percent of ambulance company responses must be made in nine minutes or less or the companies will lose their $1 million county-sponsored liability insurance. The measure was co-sponsored by Republican Legislator Paul Tonna.
This bill is not what it seems to be. On its face, it would appear Bishop and Tonna are concerned with the public's health and safety. A nine-minute rule could be implemented in some areas of the county, but in other areas, like the rural East End, it is impossible because of the massive summer traffic jams.
We believe Bishop and Tonna are carrying the unions' water. Both men have strong ties to organized labor. If ambulance companies, particularly volunteer ambulance companies, cannot meet this arbitrary standard, their representatives can call for paid ambulance departments. You can bet the paid ambulance departments would instantly become unionized and this would create more dues-paying members for the union. It would also create a big jump in taxes and would create a hazardous condition for volunteers as they would be forced to race to emergencies, trying to beat the nine-minute rule.
This legislation is ill-advised and suspect. Bishop and Tonna should reveal to their colleagues where the idea for this nonsense came from. It's time to be honest.
And why not?

[Free here too]

Boy they really got this 9 minute thing stuck in their heads don't they? Let me guess, trying to show their concern for public health because maybe it might be an election year for them???

[Wow, a whole $1 million d]

For the bemillionth time, nothing in the protocol, or the legislation that mirrors the protocol, requires a 9 minute response time...altho' why anybunny would be against having a bus on the ground in nine minutes I dinna understand...They require that we establish a crew confirmation system, so that we don't wait 15 minutes to determine the same information that we could have determined at the four minute mark, that either a crew is coming or a crew isn't coming. Would somebody, including the editorial staff of Suffolk Life, please READ THE DAMN THING BEFORE CONDEMNING IT!? Feel free to now resume whining about "cookie cutter approaches", "unfunded mandates", "my district is to big for me to get anywhere in". oh and don't forget the one about this is designed to get everybody in Suffolk EMS jobs". Don't they already have jobs?
peace,
Obewan

[my2cents]

I used to think this paper presented a fair and unbiased view - and why not? They've always supported the fire and EMS community. But to imply that the only reason Bishop and Tonna want this legislation passed is to feather the beds of the Unions that might see a windfall of membership if districts start paying people borders on the ludicrous and inane.

People are dying in this county waiting for ambulances while myopic Neanderthalistic fire chiefs, fire commissioners and even some EMS leaders are fighting the concept of providing quality and efficient emergency medical care.

Suffolk Life should issue a retraction immediately, and focus on the real issue, not something that that is politically motivated.

AND WHY NOT???
________
Christian Lautenschlager (http://www.mercedes-wiki.com/wiki/Christian_Lautenschlager)

[unregistered]

for us "non" fire department personell could you explain edp?



________
Asian Vid (http://www.fucktube.com/categories/4/asian/videos/1)

[unregistered]

you know what you said really hit home i know of a neighbor whose father died in her arms while waiting for an ambulance to arrive. I hear of plenty of calls of people who are having strokes and as you know every minute counts.. should these people become vegetables simply because the "volunteer" personnel cannot respond in a timely manner... yes people work in the daytime hours and are unable to respond so there is the number one reason to support the "paid" system i know i would not like it if it was my family member suffering for the "ego' of the volunteer if you really care let's do what is right for the community and get them the best available means to be transported to the hospital.. Time is critical in most instances and I am sorry it if would interfere with the "volunteers" and their egos and "perks" I say let's get paid so i can rest easy that someone will answer my call when and if it becomes necessary and by the way i am not slamming volunteers, i appreciate what they do for the community, but they are limited and emergencies are nothing to play around with.
________
Shemale Ebony (http://www.fucktube.com/categories/959/ebony/videos/1)

[One more time]

"For the bemillionth time, nothing in the protocol, or the legislation that mirrors the protocol, requires a 9 minute response time...altho' why anybunny would be against having a bus on the ground in nine minutes I dinna understand...They require that we establish a crew confirmation system, so that we don't wait 15 minutes to determine the same information that we could have determined at the four minute mark, that either a crew is coming or a crew isn't coming. Would somebody, including the editorial staff of Suffolk Life, please READ THE DAMN THING BEFORE CONDEMNING IT!? Feel free to now resume whining about "cookie cutter approaches", "unfunded mandates", "my district is to big for me to get anywhere in". oh and don't forget the one about this is designed to get everybody in Suffolk EMS jobs". Don't they already have jobs?"

Ok, first lets agree to disagree because obviously you have not a single clue regarding the principles and legal issues at issue here and I do not have the time nor the inclination to explain it to you.

First, the protocol of which you speak specifically states that is an effort to achieve that goal of 9 minutes. The argument is that it will not significantly reduce the response times to get anywhere near that goal. So therefore, why are the politicians making it manadatory to follow the protocol in order to maintain the county insurance?

Now you may ask how do I know it won't work? Because if you knew anything about response area matrix and timing issues, as well as staffing and response issues, you would undestand that the notification and response of outlying mutual districts would not signifcantly reduce the overall response to the majority of the calls. And,..... wait for it....., THIS PROTOCOL HAS IN NO WAY BEEN FIELD TESTED FOR ACCURACY AND RESPONSE TIME REDUCTION. WHY HASN'T BEEN? BECAUSE I THINK SOME PEOPLE MAY NOT LIKE WHAT THEY WILL FIND OUT.

The concern is that these people(REMSCO and Politicians) are trying to solve the problem of the outlier responses at the expense of the entire system and I don't agree with that approach. And holding a gun to the heads of fire and ambulance districts, in a possibly untenable legal situation, is foolish.

[Ocrainaugh]

Yeah, as a new guy in this system, I probably should wait 'til I have some experience under my belt before I say anything here...
Lemme see...You wait 15 minutes to request your first mutual aid or you wait four minutes. Yeah, I can see where that doesn't save 11 minutes. The first mutual aid dept doesn't make it, so you wait another 15 minutes before requesting a second mutual aid instead of requesting a second dept. Yeah, That doesn't save another 11 minutes...as to field testing it, yeah, it's not being field tested. THAT'S 'CAUSE THE FOURTH DIVISION HAS BEEN DOING IT FOR YEARS AND HAS PROVEN THAT IT GET'S A BUS THERE FASTER! Yeah, you're not gonna make it in nine minutes if you're coming from two districts over and you didn't get toned out until it's been in the system for eight already, but you'll still get a TWENTY-TWO minute head start over the way things are now. If it was you or yours, would you rather wait the extra 22 minutes just so we don't inconvenience the responders?

The goal remains nine minutes. that's what it's been since 1987, 13 years into the last century. The protocol REQUIRES the two minute sig. 3 if no crew confirmed and the four minute mutual aid if no crew still confirmed. That's it.
Yeah, we are trying to solve the problem "at the expense of the system." That's because last year for more than 7,000 citizens, that "system" didn't work and that "system" has had 17 years to fix itself and has refused. As to the principle here, the principle is that because of the way this "system" is not working, people are DYING. Sorry if you're being inconvenienced. If you want all this to go away, make the "System" work.

I think after 35 years in this system, 17 of 'em as a boss, yeah, I think I might have a single clue or two. Don't worry, I really don't need you to explain it to me. I'll be okay. BTW, look up the word matrix. Read article 30 of the public health law. While your at it, look up the word system. We don't have one.
Peace,
Obewan

[One more time]

"I think after 35 years in this system, 17 of 'em as a boss, yeah, I think I might have a single clue or two. Don't worry, I really don't need you to explain it to me. I'll be OK. BTW, look up the word matrix. Read article 30 of the public health law. While your at it, look up the word system. We don't have one."

Based on your last response you have spent 35 years to long in the system. And if your a boss, lord help us, because you have not a single clue. Look up the GAO report that the federal government completed and begin educating yourself on QI/PI and performance indicators. After your done with that, begin reading up on statistical analysis and begin setting up a response model for your volunteer system and then compete the time calculations for response. After you done with that, maybe you might understand that this protocol will in no way, and I repeat it louder since you didn't understand it the first time, IN NO WAY reduce the vast majority of the responses near the 9 minute threshold.

Why, you may ask? BECAUSE THE PROTOCOL WAS DESIGNED, WHETHER INTENTIONALLY OR OTHERWISE, TO ADDRESS THE CALLS THAT FALL OUTSIDE THE NORMAL RESPONSES. AN OUTLIER AS IT IS CALLED.

Therefore the argument is as follows: If that is the case and you are trying to reduce the response times for the outliers by implementing a mutual aid policy to address it, then this protocol may work to address that. DO NOT COUCH THIS AS ANYTHING OTHER THAN THAT. TO SAY THAT THIS WILL HELP ACHIEVE THE 9 MINUTE GOAL AND TO PLACE A REQUIREMENT THAT A DISTRICT MUST COMPLY WITH THIS PROTOCOL TO MAINTAIN INSURANCE IS ASININE.

"That's because last year for more than 7,000 citizens, that "system" didn't work"

Really, and out of how many calls was the number derived? What was the mean response time of these outliers, if that is what they were, and where in the county were they clustered? Did it also include the delayed dispatch of the EMS system secondary to the current 911 call receiving policies or secondary dispatch delays?

Make the system work? Interesting concept. Let me first tell you that I am all for changing the system so that it will work. For instance, a career implemented county-wide ALS first response system. I am, however, not for a group of people who are attempting to change things in a way that will make it more difficult for things to change for the better in the future.

If you, and the glorious fourth division, believe this system does not have to be field tested for accuracy, show me, or tell me where, the statistics are to support your case. Since I am quite current with the statistics from your division, please explain to me how it has proven to get the bus there faster. Because, my friend, it has not.

Stop the emotional debate, and begin an educated and rational development of a plan to get the job done. This protocol is useless in achieving that goal. As you would say,

Peace

[Ocrainaugh]

"Never try to teach a pig to sing. It just wastes your time and annoys the pig."

Yeah, you're absolutely right. I have spent 35 years too long here...shoulda gone into private industry and made some money. Maybe I shoulda been an accountant so I could unnerstand what you're trying to say, but I'm just a simple groundpounder, not an Ivy Tower dweller. in the words of my hero Popeye, "I yam what I Yam.
Anyhow, I submit my friend, that it is you oh nine minute obsessed wunderkind, that doesn't get it...It's not going to get the "outliers" (gawd I luv that word...) a nine minute response time, but it IS going to get a bus there faster. That's what the objective is here, get a bus there faster. It's not addressed to the "outlier " calls. It's addressed to all of 'em. The objective of the protocol is to get a crew confirmation system up and running for all alarms, not just the outliers. If a corps/squad/dept duzzn't have a crew, they can get one somewhere else in a much shorter time. Why is that such an anathema to you? You like sitting on the ramp wondering if someone is gonna show up?
As to a countywide ALS FR system, paid is not the solution, it's A solution. Sounds like you want a job.
Leadership and management, training of officer candidates in same, no longer electing officers based on personality and instead on capability, wise marshaling and application of existing resources will address our needs. Eliminating the countless separate administrations that make getting anything accomplished here like trying to reverse direction in a supertanker will get it fixed. Changing the focus of the "system" from us and our toys to our customers needs will enable us to survive and prosper.
There's no emotion here, Jackson, just three and a half decades of takin' people to the hospital. If that doesn't matter to you, well gee whiz, I guess I'll just have to live with your scorn, won't I. At least my therapist'll be happy. If only you were around in the '60's to tell me I was an idiot, maybe I wouldn't have wasted my life this way. Since you educated me in my shortcomings, I hadda tell the guys who work for me that I'm a bad boss. Boy, were they surprised, but they all wanted to thank you for pointing it out to 'em. Fourth? Who said I was from the Fourth? Do I look rich? You really have no idea, do you?
Peace,
Obewan

[One more time]

I will quote many an American and say'

"Get a grip!"

"Anyhow, I submit my friend, that it is you oh nine minute obsessed wunderkind, that doesn't get it...It's not going to get the "outliers" (gawd I luv that word...) a nine minute response time, but it IS going to get a bus there faster. That's what the objective is here, get a bus there faster. It's not addressed to the "outlier " calls. It's addressed to all of 'em. The objective of the protocol is to get a crew confirmation system up and running for all alarms, not just the outliers. If a corps/squad/dept duzzn't have a crew, they can get one somewhere else in a much shorter time. Why is that such an anathema to you? You like sitting on the ramp wondering if someone is gonna show up?"

Ok, to use something that you might understand try this. You don't put a bandaid on an arterial bleed. This protocol will not address the overall problems that the system has. And if you can not figure that out for yourself, well, I will just have to live with it. As for your assertion that this protocol is to set up a crew confirmation system, who the hell have you been listening to? If that is the case, and there are alternative systems in place that do work for different systems, then why cookie-cutter approach this problem and force all systems to comply, incldung the one's that do not have a problem. Oh, that's right, this is the only idea that will work. Wonderful.

"As to a countywide ALS FR system, paid is not the solution, it's A solution. Sounds like you want a job."

Really? Thanks, I've got one that pays really well and I do not need to go and create one for myself.

"Leadership and management, training of officer candidates in same, no longer electing officers based on personality and instead on capability, wise marshaling and application of existing resources will address our needs. Eliminating the countless separate administrations that make getting anything accomplished here like trying to reverse direction in a supertanker will get it fixed. Changing the focus of the "system" from us and our toys to our customers needs will enable us to survive and prosper."

Wow, something I can agree with. So forget the protocol and push for this. Oh' that's right, let's use the bandaid first.

"Since you educated me in my shortcomings, I hadda tell the guys who work for me that I'm a bad boss. Boy, were they surprised, but they all wanted to thank you for pointing it out to 'em. Fourth? Who said I was from the Fourth? Do I look rich? You really have no idea, do you?"

Your the one who brought up the fourth. It still does not matter. As for not having an idea, well, I beg to differ. I don't believe in starting something that has not been researched. Proper development and research into the needs of the community and the resources available are the FIRST things that need to be conducted before initiating protocols, programs, or policies. If you have not figure that out, then anything you do will be compromised by the unforeseen. This must be done long before a protocol is developed, and a lot longer before legislatures starting making law. As an example, I leave you with the following:

"There can be no doubt that Iraq has an active and advanced weapons of mass destruction program."

Sound familiar. And these people were a lot smarter and better staffed and funded than we will ever be.

Peace

[Ocrainaugh]

You're absolutely right. It is a bandage. Stopping bleeding is the first thing you do when someone is bleeding to death. This system is choking on it's own blood, despite what Drew says. Probably not the best idea to wait for the blood tests to come back from the lab until you start to plug the holes it's squirting from.

These horrible response times aren't the problem, they're a symptom of the problem. As a result of this symptom, people are dying. This has to be fixed first. Period.
We agree that leadership in the field is an absolute disaster in many places. We can all cite chiefs across the county who are absolute jerks. You wanna talk about clueless, look in a lot of the white cars. That's what has to be fixed. Places with good leadership don't seem to be having a problem for the most part. The boats with Capt Binghamton at the wheel are rapidly taking on water.

I brought up the Fourth Div because you said this hadn't been tried. It has. There. It works. The bus gets there quicker. We have the numbers to prove it. Y'know how we got 'em? Research. Whadda you think, you're the only person in the universe who knows how to gather and interpret data? Some of us went to school and everything. You seem to think we just sat around until sumbunny said "Hey! I got an idea!". This was developed after exhaustive research. Reams of data were gathered, analyzed, interpreted and discussed. Do you think the people who did this are stupid? Doctors, lawyers businessmen and women, gov't officials, teachers, jurists and people just like you and me did this. over the course of almost two years. I was invited to participate as someone who did just what we're trying to do in Suffolk, fix something that was broken and make it a star. We took Wyandanch from the poster child for everything that was wrong with the system in the 1987 Newsday study and worked our butts off until it was the NYS EMS Agency of the Year ten years later. Every element of this system was represented in the process, despite the denials you're hearing from some of the players. This plan was not developed one evening over some firehouse bar after a parade.

Dave got involved because people in his district, those annoying patients, were complaining the bus wasn't coming and some of them had died. You have a problem with the man doing his job, representing his constituents?

Your quote was cute. There's some Kurdish tribesmen in Northern Iraq who'd like to disagree with you but they can't. They're dead. Murdered by Iraq's weapons of mass destruction that aren't there. The clown had ten years to hide 'em in a very big desert and we've only had a year to look for 'em. Even the antichrist herself, Hillary agrees they're there. Sometime, kid, a duck is a duck is a duck, no matter how many times you wanna call it a goose.
Peace,
Obewan

[One more time]

"I brought up the Fourth Div because you said this hadn't been tried. It has. There. It works. The bus gets there quicker. We have the numbers to prove it. Y'know how we got 'em? Research. Whadda you think, you're the only person in the universe who knows how to gather and interpret data? Some of us went to school and everything. You seem to think we just sat around until sumbunny said "Hey! I got an idea!". This was developed after exhaustive research. Reams of data were gathered, analyzed, interpreted and discussed. Do you think the people who did this are stupid? Doctors, lawyers businessmen and women, gov't officials, teachers, jurists and people just like you and me did this. over the course of almost two years."

"REALLY? WHERES THE DATA? I HAVE ASKED FOR IT NUMEROUS TIMES FROM BOTH REMSCO, REMAC, AND FRES. I HAVE YET TO RECEIVE IT.

Why? Because everyone that I have consulted states the same thing. It has not been gathered or we were not looking at that. So if you can tell me exactly where this supposed data exists, you are the only one in the county that does. And do not even begin to believe that the data that was used for the Newsday article is even remotely accurate or what is necessary. If this was the same supposed data that REMSCO used then it is basically skewed and inappropriate from the get go.

As for your assertion about the fourth division, I will once again ask you "WHERE'S THE DATA TO PROVE YOU ASSERTION?". Obviously, in the same place as the other data. Tell me where I can find it or get it. I love your answer "The bus gets there quicker". You sound like an oil heat commercial, because "its just better".

"Dave got involved because people in his district, those annoying patients, were complaining the bus wasn't coming and some of them had died. You have a problem with the man doing his job, representing his constituents?"

Good for him. He's trying to do the right thing. Fantastic. Now let him do it right.

"There's some Kurdish tribesmen in Northern Iraq who'd like to disagree with you but they can't. They're dead. Murdered by Iraq's weapons of mass destruction that aren't there. The clown had ten years to hide 'em in a very big desert and we've only had a year to look for 'em. Even the antichrist herself, Hillary agrees they're there. Sometime, kid, a duck is a duck is a duck, no matter how many times you wanna call it a goose."

You my friend are living in a world, well, I don't know what world your living in. Read the newspaper or watch CNN once in a while and you might understand what is going on. You know that little report that congress just released on the CIA? You know the one. Read it, great information.

Let me just say this. Do not be surprised by what is going to come to pass. The forces that are gathering and the money that will be amassed to fight are going to be staggering. Unfortunately, that money could be better spent. You may continue to sit here and espouse how great this plan is and how it will save all these lives.

In the end, I am going to be sitting at the other end of the table and I am going to do whatever I can to put an end to this ridiculous plan, legally. At the same time, I am going to assist whatever people I can to get a true alternative plan in place as soon as possible.

Your right. This is a great plan. It is going to save thousands of lives. Its not going to cost a dime. Its not forcing anything down anybody's throats. Fine, you win.

See you in court.


Peace

[go paid now]

this poor schmuck in Central Islip sunday morning is might die because even on a delta stabbing Central Islip, east brentwood , brentwood , exchange ,lakeland and bayshore from southside hospital and so much time has elapsed PD is cancelling rescue and doing a self transport !! NO ONE COULD GET TO THE CALL.

thats 5 departments...500 members approximately

Glad its not my mom having a heart attack


Volunteers no offense but
GO PAID NOW PEOPLES LIVES DEPEND ON IT

[Ocrainaugh]

You're absolutely right. The data is skewed, as a result of the numerous agencies that REFUSED to provide their response times so that they wouldn't look bad. It's also skewed because the statisticians disregarded numerous calls in which the response times exceeded an hour or more, figuring those couldn't possibly have been accurate. We know better, don't we? So, in fact, you and I both know that things are even worse than the data shows. In spite of that, you stand against anybody and anything that might fix it. Great. The data? You know its in the EMS office. If you think you're being stonewalled, FOIL it. Court? You actually wanna get up in open court and argue this? Cool. That should be funny to watch. Whadda you gonna say, everything's fine in Oz and pay no attention to the man behind the curtain? Better get a judicial trial, I'd hate to take your side of it to a jury. There's some anecdotal evidence that'd kinda skew a jury away from your One True Path.
I'm just a simple man. Probably not as well educated nor as smart as you are. I look at simple things and draw my view of the world from them. I look around me at corps, squads and dept's that have adopted the protocol, and see that the bus is getting there quicker. Granted, It may not be theirs, but it's a bus. The aided is getting to the hospital quicker. That's the bottom line. The places where it's not in effect, I see business as usual. I don't deal with spreadsheets. Not my job. Im not real good with them anyway. The world I work in, it's called the real world. It's where the people are. It's not some theoretical one wherein people's suffering s reduced to an entry in a ledger. A few years ago, where I am now was a horror show. It's not anymore. The bus goes out, the bus comes back. No drama. No weeping and gnashing of teeth. We do what we're there to do, and the people are happy. This protocol is part of it. whether you like it or not.
See me in court? Probably not. I'm not a big enuff fish to be involved in that. But in my first career, I got that all the time. That's only a threat to someone if they haven't done the right thing. If they have, It's a chance to have someone say for the record "'Dude, Ya done good."
The Clinton News Network? Rather read Newsday. At least Newsday's got comics. CIA a mess? Yup. Hard to sell nuclear secrets to the Chinese for donations to the DNC with an effective intelligence apparatus up and running, so gotta gut that. They succeeded. But we're off topic here.
Oh, well...back to skewing data.
Peace,
Obewan

[Enough Already]

enough with this bullsh** PLEASE.....why don't you two just take each other out back and fight it out already!! People will continue to complain about response times and continue to die whether paid or vollie. Paying people in SC is not the wonder solution (or even A wonder solution). The 2 of you going back and forth is doing nothing for this thread. And not for nothing but if we are held to mandates, advisories, laws, whatever they are calling this crap nowadays, don't you think we should be ENTITLED to the info to review for ourselves instead of having to foil it from fres? They should have given it out so we can all see exactly where the problems lie.

Oh and to "Go Paid Now, 27 delta 3 stabbing"....why not offer up for the job instead of bashing the dept's that couldn't get out for one reason or another? Does your dept have a 0% mutual rate or are you just as IMPERFECT as the rest of us? get a life

[go paid now]

how the hell do you know i wasnt there asking were the hell the rescue was ??

[neanderthal]

or did you send those comments telepathicly to the website ? OBVIOUSLY you were sitting around listening to the scanner, radio etc while that call hit 5 departments.

[Ocrainaugh]

Yeah, I let this run on...I apologize. I let it get a l'i personal. Usually I let crap like that run off my back. We obviously both are passionate about it. It still comes down to getting the bus to the aided, and we gotta fix that. The protocol is the protocol, and it's a very minor thing. If you're looking for the data, it was distributed at REMSCO, at REMAC, was given to FRES, and was made a part of the record at the county leg hearings. There's copies of it all over the place. I got a copy laying around here someplace in this mess.
Once again, guys and girls, sorry 'bout that.
Peace,
Obewan

[Vengeful Medic]

Emotionally Disturbed Person...and it's not a Fire Department Term...it's an EMS one......Any other questions?

Omar-Fara B. Norgaisse, EMT-P
________
FIRESTONE AND FORD TIRE CONTROVERSY (http://www.ford-wiki.com/wiki/Firestone_and_Ford_tire_controversy)

[my2cents]

And what my friend, makes you think the term EDP is strictly reserved for use in EMS? Look up a few replies ago and re-read the thread about white cars...

Many EDPs there...
________
R5 (http://www.ford-wiki.com/wiki/Jaguar_R5)

[854]

I thought the EDP was replaced with AMS
________
HEARING DISORDERS FORUMS (http://www.health-forums.org/hearing-disorders/)

[yaya]

PLease tell me ur not an emt or a paramedic please, Saying the "i thought edp got replaced with ams". Dam Jolly Volliies

[emt cc]

THERE IS ALOT OF EDPS ON THIS WEBSITE

[bfd]

bfd

//

[Mikecp421]

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UNprofessionals SUCK MOOSE CCK!!!!!













UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!













UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!













UNprofessionals SUCK MOOSE CCK!!!!!

















vollies suck




















UNprofessionals SUCK MOOSE CCK!!!!!






UNprofessionals SUCK MOOSE CCK!!!!!








UNprofessionals SUCK MOOSE CCK!!!!!








UNprofessionals SUCK MOOSE CCK!!!!!








UNprofessionals SUCK MOOSE CCK!!!!!









UNprofessionals SUCK MOOSE CCK!!!!!
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UNprofessionals SUCK MOOSE CCK!!!!!













UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!













UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!













UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!

















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UNprofessionals SUCK MOOSE CCK!!!!!

















vollies suck




















UNprofessionals SUCK MOOSE CCK!!!!!






UNprofessionals SUCK MOOSE CCK!!!!!








UNprofessionals SUCK MOOSE CCK!!!!!








UNprofessionals SUCK MOOSE CCK!!!!!








UNprofessionals SUCK MOOSE CCK!!!!!









UNprofessionals SUCK MOOSE CCK!!!!!





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UNprofessionals SUCK MOOSE CCK!!!!!

















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[guest5]

:lol:

[bye2]

:lol:

[Fire Medic]

I just wanted to say to I think SC volunteers are great. The knowledge and skill of many of ya'll possess is a powerful statement in its own right. However, I am a man of conviction. The EMS office has finally taken a path to a higher service. Whether the system is paid or volunteer, should not be the judgement of of response time. If it is a Alpha call or an Echo call the alarm needs to be tended to with the highest priority and level of care. Now gone from LI, I have to a fully paid system, the response time is six minutes. After that we have to explain in a CAD system why we were late whether it was a train delay an act of god, or I was on the crapper. Remember ACLS implies that death rate grows rampid after 5-6 minutes. When I was a vollie ( an I loved being one ) I know we did not leave that front ramp under six minutes. So, please dont bash REMSCO, EMS, FRES, your chiefs, or your friends cause they want a more productive and fullfilling system that will respond in a timely fashion.

I may have moved but I shall NEVER FORGET.

FYI


Response-time rules for ambulances OKd
Protocol calls for dispatch to seek help from other agencies after two minutes if a full crew doesn't call in to confirm they're on the way NEWSDAY

BY ELIZABETH MOORE
STAFF WRITER

May 12, 2004

After 18 years of efforts to persuade Suffolk's volunteer ambulance crews to get out faster, the county's emergency medical services council yesterday voted for the first time to add teeth to its response-time goals.

The new protocol is limited: It instructs all emergency dispatchers to follow the same procedures.

And it directs that when the most serious calls come in, dispatchers are to seek help from another agency after two minutes if a full crew of volunteers hasn't called in to confirm they are on their way.

But it's a protocol, this time, not a goal or guideline, and no one yesterday seemed to doubt it would have an impact.

"This is a public health crisis," said David Brenner, chairman of the Suffolk County Regional Emergency Medical Services Council, after a contentious meeting and vote. "I don't think the public is aware of it. The volunteers are wonderful ... but the system doesn't work."

The new protocol was opposed by fire and ambulance volunteers, who said having to call in to their agency was an "unfunded mandate" and argued that the shift from a guideline to a standard opens the door to a mountain of potential liability litigation. They asked for more time to meet the goals.

"The cooperation of the volunteers is necessary to make something like this work, and you don't have that committed cooperation," said Norman Reilly, chairman of the Suffolk Fire, Rescue and Emergency Services Commission.

The rule was also opposed by Suffolk's own fire rescue and emergency services commissioner, David Fischler, who contended that state law leaves decisions such as this in the hands of the local volunteers.

Most Suffolk fire and ambulance agencies don't meet the time goal in the protocol of getting an ambulance to the scene of a medical emergency within 9 minutes, 90 percent of the time, Brenner said. Indeed, a Newsday analysis of dispatch data from 2001 did not find a single agency that met that time standard for the most serious calls, such as heart attacks, strokes and choking episodes. And in more than 240 cases out of about 100,000 calls, people had to wait more than 40 minutes for help. Some of those people died. In that year, emergency medical volunteers also failed to respond to about 6 percent of calls to their agencies, forcing dispatchers to find someone else to answer it.

Those types of delays continue to occur regularly, speakers yesterday confirmed.

"People are dying," said Christine Larkin, a critical-care EMT from Holbrook Fire Department, who said she had been called just the night before to a neighboring community to help a patient having a heart attack whose own department did not turn out. "Five more minutes and he would have been dead," she said.

Two years ago, a new, non-binding response time goal was approved after bitter debate by the council, which is chartered under the state's public health law to coordinate emergency medical services in the region. But emergency medical officials said they were disappointed at the limited efforts made by volunteer agencies to meet the new goals.
Emergency medical officials yesterday rejected volunteers' request for more time to find ways to meet the new standard.

In 1986, a county task force set a goal of getting to calls within 10 minutes, amid alarm about Suffolk's slow ambulance service. Volunteers then argued against making it mandatory, saying their agencies needed time to make it work, said council member Robert Delagi, chief of operations for the county's emergency medical services division.

"I'd say our system has already had 20 years to adjust to response-time goals," Delagi said. "Why hasn't the emergency response leadership done anything about it?"


About time.

[him too]

got to go