Richard B the EMT

NY State EMS Council Delegate’s Report
May 24-25, 2016
By: Thomas Lateulere
SEMAC is reviewing literature documenting promising news about nebulized magnesium sulfate for the
treatment of adult patients with asthma. Note that there is more literature review necessary before considering
protocol revisions.
The “Alternate Formulary TAG” will issue its revised recommendations at the September 13-14, 2016
meetings.
SEMAC Advisory 02-02 regarding AEDs for pediatric patients is now outdated and can be rescinded. Pediatric
defibrillation with an AED is covered in the appropriate clinical protocol. SEMAC Advisory 97-03 regarding
hyperventilation in severe brain trauma is under review and STAC has been asked to provide guidance. BLS
Protocols T-5 and SC2 will be modified to remove references to MAST.
MAST has been removed from the NY State BLS Protocols. A protocol revision is forthcoming that will state
that for unstable pelvic fractures, a pelvic immobilization device should be used. SEMAC Advisory 97-04
regarding MAST is rescinded.
An update to the Syringe Epinephrine Kit (SEK) Program was provided. All 18 regions have endorsed this
program; 382 agencies statewide have registered thus far; 4,000 BLS providers have been trained; and 1,974
SEK have been distributed. To date, there have been 11 uses so far with 0 protocol violations. SEMAC, the
Bureau of EMS and the pilot demonstration project administrator and medical director will be meeting with the
NY State Health Commissioner to discuss changes in scope of practice. Ms. Burns revised the State DOH
position released after the March meetings, now stating the DOH’s position that there is no need for
participating agencies to purchase/replace epinephrine auto-injectors, however, un-expired kits should remain
on ambulances as a safeguard against technical failure of drawing up medicine, or in cases where there may be
multiple patients.
The Bureau of EMS reported that they have begun printing EMT cards in house, significantly reducing the time
frame between the NY State written exam and receiving the certification card. It is expected that EMT cards
will be received within 12-14 days after taking the exam.
The Test Item Committee, including Suffolk County’s Matt Zukosky, has completed their work, culminating in
the adoption of 250 new questions that will be added to the test bank over the next 6 months.
The Bureau of EMS reported the following written exam results for newly certified providers from this past
year: 1419 people taking the CFR exam; 92.8 % pass rate; 3569 people taking the EMT-B exam; 89.41% pass
rate; 37 people taking the AEMT exam; 79.1% pass rate; 54 people taking the EMT-CC exam; 95.1% pass rate;
and 558 people taking the EMT-P exam; 88.6% pass rate.
Continued.
NY State EMS Council Delegate’s Report – Page 2.
May 24-25, 2016
By: Thomas Lateulere
Congratulations go out to Tom Lateulere for his appointment as Chair of the SEMSCO’s Education & Training
Committee.
New National Registry psychomotor skills testing process is under review for adoption in NY State.
CIC Renewal Requirement that candidates are actively providing patient care has been amended as follows: For
CIC whose CIC certification is expired for more than 2 years seeks recertification; he/she must document active
participation providing patient care on an ambulance. This effectively removes the actively riding requirement
for CICs that continue teaching but are no longer riding members of an ambulance service.
A TAG has been established to review the NY State EMT-CC curriculum as compared to the National AEMT
curriculum.
The recently revised instructor renewal process is underway, with a small contingent of instructors statewide
completing the process. Several issues have been identified and additional guidance forthcoming.
Ms. Burns reported that the Bureau has filled 3 supervisor positions across the state. Congratulations to long
time EMS Representative Rich Robinson, who takes over leadership of the MARO Office, which includes
Suffolk County. It was also reported that Ms. Linda Tripoli, the Trauma Program Manager, has accepted
another position within the DOH, and a replacement is expected soon.
Regarding modifications to NY State Regulation Parts 800 and 80, progress has been made, modified language
currently under review by the Bureau of Legal Affairs.
Ms. Burns reflected on this year’s EMS Memorial Ceremony (May 17th) thanking all those that participated,
stating that there was a record number of ambulances on the plaza, EMS providers present, and elected state
officials present.
The MOLST form and process is undergoing a transformation into the electronic world. EMS providers need to
be prepared for the release of eMOLST, with further information released as it becomes available.
The Bureau is working with other key stakeholders and putting together a focus group from fire service,
ambulance service, hazmat, public health and law enforcement to enhance NY State Department of Homeland
Security and Emergency Services Training Center in Oriskiny, NY.
An EMS Systems Safety TAG has completed its work on recommendations for ambulance construction, which
will lead ultimately to revisions to Part 800 and the CON/TOA TAG completed its work on revising Policy
Statement 06-06. The TAG is now working on revising the policy statement on use of red lights/sirens when
patients are on board.
Continued.
NY State EMS Council Delegate’s Report – Page 3.
May 24-25, 2016
By: Thomas Lateulere
NY State EMS Award Winners have been chosen from regional submissions. Congratulations to the following
nominees from the Suffolk Region that received the NY State Award: Dr. Scott Coyne (Physician of
Excellence); Connie Kraft, RN (Registered Professional Nurse of Excellence); Bay Shore-Brightwaters Rescue
Ambulance (EMS Agency of the Year); Joshua Lebenns (ALS Provider of the Year); and Tom Lateulere (EMS
Educator of the Year).
The Legislative Committee recommended, and SEMSCO approved a motion to oppose A 3241, which if passed
eliminates the requirement that motorcycle riders and passengers wear helmets.
The next SEMAC/SEMSCO meeting dates are September 13-14, 2016 at the Hilton Garden Inn.
END OF REPORT

As mentioned in a different string, I am going to run for President, but first, gotta change my name to "None Of The Above"!

As for the national election, I'm now running for president. Before I do, however, I'm changing my name to "None of the Above"!

Beware THIS dog, if provoked, he DOES bite!

Welcome aboard.

June 3, 1985 is the day I entered municipal employment, reporting to the New York City Health and Hospitals Corporation Emergency Medical Services Academy, then in the Nurse's Residence Building of Queens General Hospital. I spent 11 years in the Communications Bureau, and after the "merger" into the FDNY on March 17, 1996, finished my time "in the field" out of Station 47, Rockaway (Queens County, NYC), mostly on unit 47Adam3, covering Far Rockaway.

Happy Anniversary to all my brother and sister EMT classmates in NEOP (New Employee Orientation Program) 85-02. Special shout out to Carlos Lillo, one of my classmates, and one of the 2 Paramedics included in the 343 FDNY Line Of Duty Deaths of September 11, 2001.

I'm now medically retired 5 years, and due to accrued injuries, allowed my NY State EMT "certs" to expire the end of last summer.

"Pigs Is Pigs"? Wow, I read that story back when I was still a pre-teen!

I'm in a geographic bind for Hockey. Stuck between the Rangers and Islanders.

Condolences to all her family, and all that knew her.

As for me, I like the New York Mets, as they're my hometown team (Queens, NY). I also like the New York Yankees (sometimes called the "Bronx Bombers") as I like Tradition. My third "like" is ANY team beating the Dodgers, because my parents came from BROOKLYN!!!

The baseball team?

Rat115 has a good idea.

Welcome aboard, little Grasshopper! Let the EMT City teams help get you established as an EMT first, with a bit of experience before going tactical.

Having said that, I was an EMT, EMT-D(efibrillator), and EMT-B(asic) for 41 years, now retired for 5 with my NY State EMT "certs" expired from last summer. I never was asked to go tactical, although I did think of going for USAR Team NYC 1, before medical issues made me reconsider.

We may be gruff, easy, and hard on you, all at the same time,  Tactical EMT, but we all mean well, even when we seem to be attacking you, politely, of course. Let us help you get your act together, before you do any "oopsies".

Some time back, an individual basically came here looking for information on starting a medevac helicopter service. We ended up "shooting him down", as the person knew nothing about city/county/state/province/country requirements for even what should go into an ambulance, let alone the costs that would be incurred just running a helicopter as an aircraft. Little things, like fuel, insurance, the $3/4 million for the aircraft purchase...

The current Hawaii Five 0 TV show has an interesting character, an ex felon shrimp food stand truck operator, who took and passed a helicopter pilot's license test, purchased a used helicopter, and opened a sideline business  as a tourist ride with himself as the pilot. Nice fiction, but improbable outside of Oahu...er...Hollywood. Note I'm saying improbable, not saying "ain't gonna happen". Someone with a good amount of money invested in hardware, software, the proper personnel, and a couple of tons of luck could start up a business.

I have to be a realist. Several companies I used to work for were later purchased by other companies, then the purchasing companies were themselves folded into other companies. A few of them survived, many folded. In today's market, does anybody know if a startup ambulance company could or would survive?

All I can suggest, if you still want to open an ambulance company, first research the hell out of what all the costs involved would be, extrapolate what the costs might go in the next year, decade, supply availability, and probably a bunch of stuff I, as an individual retired EMT, have no clue what they are, just that they are there. As indicated, perhaps you'll be a lucky one.

On a bit of a side note, a dose of Narcan went for a few dollars only a few years ago. Now, both the original company and manufacturers of generic Narcan are charging almost $100.00 a dose, That's a new expense some companies may not want to spend, as Nasal spray Narcan is still in "Pilot Program" status, here in New York State. Not everyone can get a medical director to sign off on using it. You and your crews going to have it on your ambulances? BLS or ALS levels, or both?

Good luck with your endeavor of a new ambulance company, none the less!

As noted, some of us lurk.

as for me, I've been a jerk

all the time using Facebook,

(knowing that won't get me off of the hook)

with the "Dinosaurs of EMS"

Hoping that won't cause a mess

Most of them live so far from me

that they can't afford to come for tea

but know I am not in a jam

became an EMT 'cause I gave a Damn

42 years a-riding the truck

helping those injured by a streak of bad luck

saying "hold my beer and watch me do this"

and then to the Trauma rooms 'cause they're now in distress

or cardiac arrest, if the family knew

notify the ER, coming in "Code Blue"

Some people think EMS folks don't care,

were that the case, we just wouldn't be there

Now the next generation must carry the fight, thus

because I can't lift now, goddam my arthritis

the newjacks know me from my former station

watching them work, a degree of elation

when what they do brings out my smile

as they do what I used to, and do it in style!

What you say, Sonny?

Sorry, what?

Even if a pain detector would be developed, as also mentioned, pain is subjective. Anyone heard of TEMS therapy, where a low level electric current is passed through an injury site? Different patients tolerate different voltages. I, for one, tolerate a fairly high one, whereas my girlfriend, on trying my device, turned it off on the second lowest setting due to the discomfort she felt (she was in control of the device, not me, so dismiss thoughts I was tortduring her). 

On a different angle, when providing medical coverage at a "Rugby Sevens" event, several players wanted me to simply tape up obvious finger dislocations, so they could get back into the game!

I don't have documentation, but I think local protocols have been changed to, as ERDoc stated, treat to effect, not "slamming".

This, if it was changed, happened after I came off the streets, and retired.

Mazz and ERdoc, each of us have had different experiences with "awakening" overdose patients. Like noses and opinions, everyone has one.

Perhaps it's my NYC cynicism, but most I've witnessed woke up angry and combative. Obviously, between us 3, we seem to run to opposite ends of the spectrum.

You're not a Yellow Submarine, hence you're not a pigment of the imagination, ITKU2ER.

I probably will word this incorrectly, but per the Paramedics I worked with, just give enough narcan to get the desired state of the patient breathing, rammerjamming the narcan beyond that will wake them up, and they come up swinging. BTW, that's my wording, obviously not the textbook wording. 

Observation over my long career (yeah, I know some here have more, and at ALS level above my BLS), they awaken in an aggressive mood.

As both a retiree, and one who has allowed my EMT cert to expire, I, for one, don't have as much to say as I used to.

...And all for a quarter!

Getting?

Puts in coin, and gets a Tablet computer. Spends the next month trying to figure out the device's operations.

Speaking as BLS, I've seen my Paramedics have both good and bad days starting IVs, so presume the same for both your classmates and yourself,