Bullets

Yeah i thought RoC PRIMED had to cut the study on ITD short because it was doing so bad. So an unproven and a toilet plunger are supposed to improve outcomes?

I am a member of the LGBT (lesbian, gay, bisexual, transgender) community. Two questions:

1) How are LGBT people received/treated in EMS (in EMT or medic positions or in management positions)

2) How are LGBT people received/treated in the fire service (in any position you can speak to)?

Thanks for the time.

Cad, out.

Unless you make it an issue, its not an issue

We use flightsuits for our special operations crews. Since they respond off duty, its easier to have everyone issued a jumpsuit and we look professional. If we have time then we can change into our regular uniform we carry in our deployment bag

I understand that the theory is LLR reduced pressure on the IVC, but would that shift all the weight onto the aortic arch and descending aorta? or are they assuming the pressure of the heart pumping is enough to overcome this?

Good point but for me it wasn't worth it. The only escape routes were to New Jersey. I'd rather die in the flames on the water.

Dont flatter yourself, if you are that close to NJ and have to cross water, you arent in a garden spot of NY State

2 pens

Notepad

ID

Cell phone

Glove pouch

SOG Powerlock with bit kit

Benchmade 8Med Rescue hook

2 Sharpies

Radio in a radio strap

Really ????? You don't work dead bodies ?? How many dead infants have you left at home ?

2

in 10 years of working EMS, I find it comes down to how you handle the situation. Not to sound like a cold hearted bastard, but i see no advantage to a compassion code. Old or young… if there are the signs that it is an obvious death, the best thing to do is to make the situation as it is. You have a dead body, and you have new patients to take care of… the Family. Remember the Phases of Death you learned in your EMT class, or should have, you will have to adjust to that to the surviving family. I usually call my dispatch to have a social worker be sent to the location to help the family deal as well.

I have worked with many partners who believe a compassion code will make their job easier just to get it done with and not have to deal with a grieving family. A compassion code, in my opinion would be the worst thing to do. In most cases, the family realizes that there is nothing more we can do as Providers, but still have the phases to go through; and yes, that means they will go through a phase of anger… "Why wont you do anything! Do something…"

To better enable you to deal with these situations, enroll in a class/Seminar that covers dealing with surviving family members of the deceased. If you talk to a social worker, they can probably put you in contact with someone they feel may be knowledgable in the sociology and psychology of such matters.

Im with this guy, compassion codes are crap, i feel this may be unethical to work that code if they are obviously dead

Actually I do understand the laws concerning firearms sale transactions.

there are many times that firearms are sold through ads in shopper news or uncle henry's or whatever they call it in your neck of the woods without the transaction going through a FFL.

We were out at the range last evening with a state police firearms instructor and a county sheriifs' deputy who is a FFL. We were trying out some new pistols and qualifying with some of them. We were talking about how easy it is to skirt the laws regarding firearm sales.

I was up country last week and saw a sign" Sporting goods" show. Being in the market for another magazine for my 1908 colt , i figured it was worth a stop. There were half a dozen sellers set up in a hall and not one of them was a licensed dealer. I saw several transactions . all cash or check and no paperwork was done on any of them.

Didn't find what I was looking for & left.

The law requires legally operating firearms dealers to follow it , not the private sellers who do sell at small shows and over the web.

Yes it is supposed to be followed in intrastate transactions , but the reality is many don't, and there is no one checking to see if they are doing those transactions legally.

Back in the mid 80's we worked a section of a major Northeast city where anything you wanted could be bought within 15 minutes of putting out a feeler through the hood network. since we often took care of the gang members we got to know the who, what & where of the underworld of illegal gun sales. All cash and no questions asked.

Last I heard things haven't changed much according to the state troopers we know that still work there.

Go ahead and pretend the laws are getting the job done.

talk about sticking your head in the sand and pretending all is good.

My argument isnt for carte blanche sale and trade of firearms. That is unreasonable and irresponsible. My argument is that the laws that currently exist are sufficient but require enforcement and require mandatory reporting of psych records as we have with criminal records

If by your admission, the current laws arent being enforced, how will passing new laws change that? Without having a cop in every bedroom, parking lot, bathroom and rest stop?

How do you regulate sales between private individuals without registering every single firearm? Which is logistically and practically impossible

Bullets tell me this then

My brother has police officer friends who own quite a few weapons, not sure how they got them but they sell those guns from time to time. My father is actually going to meet with one or two of them in the next month or two and they are going to sell my father a AR15 and another couple of guns. There will be no background check of my father, no reporting to the FBI or the ATF on the sale of these guns.

They in fact will be travelling across state lines to sell these guns.

These are cops selling these guns and they are saying that this is legal.

Your thoughts to this?

Blatantly illegal

ATF Title 27

No nonlicensee shall transfer, sell, trade, give, transport, or deliver any firearm to any other nonlicensee, who the transferor knows or has reasonable cause to believe does not reside in (or if the person is a corporation or other business entity, does not maintain a place of business in) the State in which the transferor resides

Only way it can be done is through an FFL, which would require a NICS check

Bullets, maybe you can correct me if I am wrong, but the Firearm Owners Protection Act of 1986 allows FFLs to sell weapons at a show as long as they do a background check. However, the ATF states that only 50-75% of all vendors at shows are FFLs. The FOPA (1986) also allows those individuals who are "not engaged in the business" of selling firearms or those who only make "occasional" sales to sell any weapons without a background check. This would mean that 25-50% of all gun show sales are conducted without a background check. That's a pretty big loophole if you ask me.

An FFL must complete a NICS check if they are selling a firearm. The gunshows i go to, eastern PA, require vendors to have a FFL or they wont give them space and this in the norm in this area. There are guys who are selling one gun, but these guys are not renting table space to sell a single rifle, unless its a Class 3 item. The guys who a renting tables are either in the business of selling guns or ammo, military surplus, reloading supplies, and beef jerky.

I was at Oaks, PA a few weeks back and it is the largest gun show in the area, 1000 tables. Every one of them required an NICS check and advertised this clearly.

Let us also not forget that the very nature of doing a transaction without a background check will typically mean that said transaction is probably going to be difficult to document when it comes to publishing statistics. Therefore, it is reasonable to ask how accurate the sale without background check statistics really are? It is probably reasonable to suspect the number may be much higher.

How do you enforce background checks between private individuals? How do you regulate any commerce between two private individuals? Sales of cars, guns, potatoes ect. Its physically impossible to regulate that unless you require registration of every firearm also logistically impossible. If it occurs intrastate some would say its unconstitutional for the federal government to attempt to regulate intrastate commerce.

And i will say, even when background checks occur, only a tiny fraction of states report mental health records to NICS. NJ does an internal check, so if you have been in the NJ mental health system it would come up, but otherwise there is no record. Either states dont keep this info or they dont report it, both of which are unacceptable but would thin out the applicant pool.

And as previously noted, face to face transactions can only occur between residents of the same state

Steve: Like you , I am a gun owner and firm believer of the right for us to legally own them.

However I do believe that a background check should be mandatory and over the counter gun shows sales & internet sales should all be required to have it done before the sale goes through.

This is not gun registration, it is an attempt at keeping guns out of the hands of people that can't legally possess them. A poor attempt granted, but an attempt all the same.

We all know that criminals can always get their hands on guns as there are millions of them in circulation, but eventually they will go away as they malfunction and are harder to get in the underworld.

Here in Maine it is illegal for convicted felons to possess them and those who have been convicted of domestic violence can't have them either.

Domestic violence deaths are on the rise , with the majority of them being caused by firearms.

Do we not do anything to try and slow this trend??

When I worked in Hartford Ct it was a regular occurrence to have gang shootings and the majority of those weapons were in the hands of folks that would not pass a background check. a slow Friday night was only responding to 3 or 4 shootings.

despite you owning firearms, you clearly have no knowledge of firearms law

Any sale of firearms that occurs across state line must go through an FFL, a persons with a license from the ATF to sell firearms. Before the FFL can release the fireamr to the buy they must conduct a background check

The gun show loophole is a lie. 99.99999% of sellers at a gunshow are businesses. These people must conduct a background check before they can sell their inventory to a buyer. They also must record who they sold it to and keep a log of all their inventory that can be reviewed by the ATF at any time.

Can a private individual sell a firearm to another in a face to face transaction? Yes, but this is rare at a gunshow. Hundreds of people, some get thousands attending, and maybe 1 or 2 will have a private sale.

SCOTUS has established that the militia is any able-bodied male aged 18-45

SCOTUS has established that individuals have the right to own a firearm "in common use"

Someone mentioned suppressors being easily availible...patently false. The ATF regulates the possesion of suppressors. You must apply to own one which involves an extensive background check and a $200 stamp of approval. They are regulated items under the National Firearms Act, the same that regulates ownership of automatic weapons and other destructive devices

This is why i find it difficult to have reasonable debates with liberals and Democrats and other anti-gun owners. If you do not have a knowledge of the law as it currently exists, how can you speak authoritatively about the topic? Many have no idea about what the NFA says. Many have no idead what the AWB did (ban cosmetic features, no impact on functionality). This makes it difficult to have a discussion when you are operating on different levels of knowledge

Depending on how you view the history of EMS, combat medics were administering reconstituted human plasma and whole blood units in the field during WWII

This is the website for the US Army's Office of Medical History, and has a section on both WBU and Plasma administration in a combat setting

http://history.amedd.army.mil/booksdocs/wwii/blood/DEFAULT.htm

Ummm...move

I work in nice stations, showers beds couches flat screen tv's Xbox computers

I make $18hrs as a basic and most companies around me pay 11-15

Medics are paid 20-40 depending on where they are. More in the city

Sounds like an Arizona problem. But our fire dept only does fire suppression, EMS does everything else

Penetrating trauma to Head, Neck, Torso

"SMR should be CONSIDERED when the patient displays such fidnings as numbness, tingling, and loss of motor or sensory function or actual LOC. However, if the patient with penetrating injury have no neurological complaints, seconday mechanism of injury, or findings, the spine does not need to be immobilized (although the backboard may still be used for lifting and transport purposes)"

Basically taken verbatim from the PHTLS book, natch

Bamboozle just came through NJ, a three day concert event on the shore. this was their apparatus for the weekend

May 18, 2012:

One BLS Unit

1 Staging Unit

4 Medical ATVs

One ALS Unit

1 Logistical Support truck to establish field hosptial

NIMS Type 1 MCRU (suppies for 100 patints each)

1 Physicians

Medical Ambulance Bus (Can transport up to 30 patients)

May 19, 2012:

4 BLS Unit

1 Staging Unit

4 Medical ATVs

One ALS Unit

1 Logistical Support truck to establish field hosptial

NIMS Type 1 MCRU (suppies for 100 patints each)

1 Physicians

Medical Ambulance Bus (Can transport up to 30 patients)

May 20, 2012:

3 BLS Unit

1 Staging Unit

4 Medical ATVs

One ALS Unit

1 Logistical Support truck to establish field hosptial

NIMS Type 1 MCRU (suppies for 100 patints each)

1 Physicians

Medical Ambulance Bus (Can transport up to 30 patients)

As well as approx 30-40 EMTs, a dozen Medics staffing a 20 bed field hospital and three 6 bed foreward medical tents

Honestly, if you need something double sided then you should go with dogtags. If they are stamped you can have two tags, or if they are engraved you can do both sides

Every call gets the jump bag, a Meret Omni Pro, which has:

O2 cylinder, opa, npa, nrb, nc, and wound care supplies, some oral glucose, shears, penlights, bp cuff and steth.

Arrests we bring in the AED and Suction, CPR in progress gets a LSB.

I think our bag is too big for what we bring, but i dont have final say in the bag we use. As long as the current one works, we will continue to use it. But im trying to get us to go to a smaller Meret bag

Once you start targeting certain people for engaging in otherwise legal action you're going to run into problems if it can be shown. What's different between targeting someone only because they are using a constitutional right and targeting someone because they're black? This is the sort of "discretion" that leads to lawsuits.

It is a fine line, which is why your local friendly law enforcement agent has been trained to use his discretion

Your superiors is going to be happy that you're taking an hour to process a camera that you took because you didn't like what the photographer was taking pictures of? Don't police officers generally carry cameras for processing crime scenes?

To ensure that i do a proper report involving an accident with serious injuries? Your damn straight he is. But you might not know that an average accident report takes about 30-45 minutes to write if its a simple fender bender. Once you start having patients who would require full trauma naked assessments and transports to a trauma hospital, im most likely shutting the road down as it is.

While we do carry cameras, we only can capture what happened after we arrive. If there is a bystander with a camera they may have caught something before PD shows up, which could influence our decisions

At least in California it's only trespassing if it's marked "no trespassing" or once the owner requests the person to leave. It's not a prima facie violation to just stand in someone's front yard.

Depends on the situation in NJ but there are a few factors that determine if the person is trespassing. However it is not required that there be an actual sign.

Better be issuing everyone a citation that's watching. Furthermore, what if the person isn't blocking the flow of pedestrian traffic? If I'm standing on a bench, then I'm not blocking anyone's traffic. Furthermore, there's generally going to be a clause about lawful activity, which 1st amendment protected activity definitely is

Why? I can issue anyone i want, its called officer discretion, i just didnt have enough time to write everyone, sorry. I do it every day, issue someone a ticket and not the next guy. I specifically stated that the person was standing in the street and could be blocking traffic, vehicular traffic. And obstructing the flow of traffic is not a lawful activity. Also, in NJ the beach is not always owned by the municipality, so then laws regarding use and access are a little different. In my town the beach is owned by a private organization who can close the beach and make everyone leave whenever they want. WHich is what we do when we have bad water rescues, we have them close the beach and throw everyone off

.

Only for a reasonable amount of time necessary to copy the pictures. Deleting them is destruction of property.

Yes, but that means i have to go back to Headquarters and download the photos, which could take at least an hour to do the paperwork

Hey, look, we finally have a legal response. It's always amazing that people want to respond to douche bags by acting like douche bags.

Just expanding on all the legal, non-violent repsonibilities. If i saw an EMT strike a photographer, you better believe that EMT is in cuffs

"Am I being detained? No? Bye

Ok have a nice day, be safe

Really simple... as a cop, i would deal with this in two possible ways, maybe three....have the photographer arrested for either

A.) Trespassing

While the accident may have taken place in the "public" there is a decent shot that in order to get the photos or videos the photographer has to be on private property, and may be charged with tresspassing

B.) Issue a Summons

If the shutterbug is not on private property, say he is standing on the street, then you can pull him aside and issue him a summons for obstructing the flow of traffic or some similar statute. Should take enough time to write the summons and check the guy for wants/warrants for EMS to finish

C.)Seize

If the guy is taking pictures of an accident scene with injuries, then he may capture something that might reveal how the accident occured, perhaps he was on scene before me! If there are injuries then it become a serious accident and gets a investigatory report. Those photos are now my evidence, thank you sir

D.)Stand (by me)

If all else fails, nothing says i can stand in front of the guy and obstruct his view

Dont be a jerk, dont snatch the camera, i know his rights, but an officer who thinks can be a little creative can diffuse the situation. Every bystander is a potential witness, and as such it is my inverstigatory duty to interview them. Lets start with the camera guy and waste time. Nothin illegal about occupying someone attention for 5-10 minutes

I cut when the injury warrants, or if i need to visualize. I used to be hesitant to cut, but once you take a patient to a trauma center or a decent ER, and traumatic injury the hospital staff is just going to cut it all off anyway, might as well save them some time

What part of Jersey? Im in Monmouth County.

And whats wrong with Jersey?

The "national protocol"? What's that? Can you please explain?

NREMT? the medics are NREMT-Ps in that they at least share a more common standard of care with other medics from other states, as opposed to NJ basics who vary videly compaored to other states BLS

Is NJ really that bass ackwards?

All of the things you listed have been the "standard of care for many years.

I knew NJ was screwed up in how they provided care , but WOW.

Unfortunately yes. BLS care in NJ has been O2 via 15l NRB, wound care, splinting, oral glucose and assisting a patient with THEIR prescribed SL nitro, MDA, and thats about it. They recently allowed EMTs to carry Epipens

The BLS system, and EMS as a whole is controlled by the First Aid Council, a group of Volunteer agencies that number in the hundreds. What began as an organization that advocated for volunteers and promoted interoperability and intersquad relations has morphed into the single largest obstruction of EMS advancement in the state.They cling to old practices and standards, and most of the FAC leadership hasnt been inside an ambulance in 30 years. The EMS legislation recently passed in NJ only requires 1 EMT per truck, while the law originally required 2, but the FAC fought hard to get it changed to 1 because it would "be a hardship" on volunteers to get members to show for calls. They also dont feel that background checks should be required for EMTs to ride calls

Here is the Bill

http://www.njleg.sta...1000/818_I1.HTM

Here is the NJSFAC position on the EMS legistlation

http://www.njsfac.org/s818.shtml

ALS is equally screwed up. while they use the national protocol, the way its managed is kinda screwy. Each MICU unit is based out of a hospital. Some are employees of that hospital and the Hospital itself runs a EMS service, others are private corporations that contract with hospitals to provide ALS service out of the Hospital. So in Monmouth and Ocean counties, MONOC is the ALS provider and runs a truck out of every hospital. this is good in some ways because it allows a smoother operation between BLS and ALS since your always working with the same handful of medics from the same company. Its bad because if the ALS company is bad, the service is bad. In other counties, like Middlesex each hospital has its own medic service. So JFKMC and Muhlenberg Hospital are one service, Perth Amboy and Old Bridge run two other trucks, Robert Wood (level I) runs their own ALS service, and then Rahway, which is on the border but in Union county is a totally different company. So a BLS squad in Middlesex could get any combination of 4 different ALS companies depending on location

Does anyone know any real details regarind the new EMT-B course that will be coming to NJ?

The course is supposed to double.

ANy details on what new skills/ scope of practice will be?

What type of bridge course will be available to existing emts?

Thanks

So this is the deal, Each eduactional project is being allowed to set their cirriculum from a menu of topics. There is a standard all must teach, and then any additional information at the projects direction. It means expansion beyond the old 120 hrs course. Some places may choose to add more A&P, pharmacology, trauma teatment, ect. based on area and type of calls. Some places where they have trialed this new course (Bergen) are running as basic course at around 300hrs with expanded clinical time, which is a monumental step in the right direction and hopefully will weed out idiots and bad providers and develop some better EMTs, while others (Monmouth) are barely changing anything to 160hrs, which is ridiculous

It will also so the addition of Aspirin administration. EMTs (no more "B") can assist with aspirin, if it is prescribed or available, to patients complaining of non-traumatic chest pain up to 325mg

Oxygen administration via NC, allowing for titration. In the past NRB was the only "allowed" route per protocol, though most EMT-B would use the NC, now its officially ok

Tourniquets get moved up in the bleeding control protocol. Before it was Direct pressure>Elevation>Pressure points>Tourniquets now its Direct pressue>tourniquets. The old fear of losing a limb is out, as it has no real medical science to advocate for in NJ, no squad has extended transports time that come anywhere close to the 4-6 hrs before Muscle, bone and tissue death

Trendelenburg Position is out, no science to support it, supine is fine, body self regulates BP, the only difference in BP sabilization is standing vs lying.

"Golden Hour" is out, its crap, now its golden period based on injury.

On Jan 1st. OEMSCERT becomes ELECTIVES ONLY and a new LMS platform will handle Initial and refresher courses on March 1st. The core 13 class that used to be required will now be broken up into three segements, one to be taken each year of your certification and known as the Core Refresher. After June 30th, CORE 13 goes away. The Core refresher will become your bridge, unless your squad or department runs an in-service course on aspirin and tourniquets.

Basically the State is adopting the national standard, along with the PHTLS guidlines regarding trauma treatment, which means less backboarding (hopefully) unless the pateint complains of neck/back pain or has clear neurological defecits and less emphasis on MOI (good), but no hope for any kind of C-spine Clearance a la NEXUS or Canadian (boo) It is also why many are hopeful for the AEMT cert to be back in NJ

When you rely on the gang members to provide scene security at shootings cause the cops have too many calls stacked up to respond

When you see an OG beat the ever-lovin ______ out of a new member for messing with the "docs" on shootings

When the "spots" have pictures of Cop uniforms and EMT uniforms so they dont get confused and blast the EMTs

You know the new gang members, and the gang Lt. stop by the station to tell you when they are doing initiations and you stock extra

You learned to eat a whole new world of food

Ive always had a good relationship with the gangs, and i always had an understanding with most of the Lts and officers. We would eat in the same Church's and Red Tower's. We told them we dont care if they have drugs on them or in them, we dont care about affiliation, were just here to treat and help. We have one rule, and thats no weapons on the truck, and ive been on shootings when some of the senior members would clear their boys before we transported. we got along great, and we usually got a discount at the local spots

Actually I transport all dead people in arrest(and who that is dead isn't in arrest) because I look like I really tried to save their families loved one. I look the hero and even though I know what the outcome is, I still have a little bit of hero wannabe in my blood.

If the protocols haven't kept up with the times and the medical director/base station physician are still stuck in the dark ages of transport all codes, then are you sure that your service is really progressive?

This and this, sort of.

I think there is a misunderstanding in the public that there is more that can be done at a hospital then in the field, and services think that transporting the dead decreases the possibility of a suit because "EMS didn't help my dad/mom/sister/dog, the let him die"

Or for concerns of provider safety...I've had more then a few codes where the living get physical with EMS because they think we are giving up

Also, I'm in NJ, ain't to much progressive EMS 'round these parts, squads still backboard off MOI. one service requires c-spine in all GSW