Richard B the EMT

How many times have we heard the dispatcher putting an alert tone over the air, following it with "Unit ****, you're transmitting a signal", when somebody is accidentally transmitting. If they're transmitting, they can't hear the "stop transmitting" request.

Just mentioning that there's malpractice insurance available through membership in the National Association of Emergency Medical Technicians. It is a separate payment made to the insuring agency, at reduced cost to NAEMT members. As I say this, I also say I am a member of the NAEMT, but have not purchased the malpractice insurance for myself. I further mention it's kind of like my family's thoughts on getting the burglar alarm, that it would invite burglary attempts from thieves wondering what it was we were hiding behind the alarm (we now have an alarm). Following on the thought, "why would you have insurance, what are you trying to hide?" I mention this only to play devil's advocate, if you feel more comfortable with or without the insurance, that will always be a decision to be made by each individual. In all cases, I KNOW we all will be doing our best regarding patient care.

Responding to several posts in this string, but in no particular order... 1) In "Patton," the General ordered a MASH Doctor to wear a helmet for his own safety, when the doc tried explaining he would be unable to use his stethoscope, Patton told him to cut holes to accommodate the steth. Design will always follow needs, although I would have tried to get that doc a British "Tommy" "pie tin" style helmet. 2) Fugetaboudit! Annibuddy who tawks differently from me and my posse has an accent. I don't got no accent! Youse guys got dat? Or does youse wanna make sumpin' of it? 3) I'm on my 4th vehicle (see the string on "what do you drive') and I live in NYC! 4) I am all for designing in safety to my ambulance vehicle, but don't forget the training of your Motor Vehicle Operator. 5) Don't forget the skills, or lack of them, of other drivers on the road with you. 6) Did you take into account the road conditions, with or without weather, and/or available light on the roadway, as a part of the equation? 7) A "bus" is something driven by drivers for the Metropolitan Transportation Authority (MTA), I work in, and drive, an Ambulance!

A simple reminder: EMS Week is always the 3rd week of May. Now you can mark your calenders for upcoming years.

CSR, are you saying your agency could not handle a 60 patient tour bus crash, even with some kind of mutual aid with neighboring EMS agencies? Either I am reading something completely incorrect into your posting (which I hope is the case), or something ain't right with your agency (which I completely hope is not the case).

A little over a decade ago, we had the "Golden Venture" incident, where about 300+ would be illegal Fugian Chinese immigrants landed in the Fort Tilden/Roxbury area of the Rockaway Peninsula section of Queens County, NY, from a small freighter ship (the "Golden Venture"), hauling the Chinese AS the cargo, deliberately ran aground. We had multiple "alphabet soup" agency responses, at city, state, and federal levels, and ambulances from all over the tri-state area and beyond (NY, NJ, Connecticut, Pennsylvania). We lost 6 of the Chinese to drowning, and one to a cardiac arrest, and surprisingly, we only had one injured rescuer (a paramedic twisted her ankle on the beachfront sand). The assorted rescuers treated them for hypothermia, and guarded them until the Immigrations and Naturalizations Service (INS) took them into custody. We seemed to have some kind of real cooperative effort of all agencies in the incident command structure. If a common mistake of moving all the victims to the nearest hospital is followed, we've simply moved the MCI from one location to another. At the bombing of the World Trade Center (the first time), EMS told all the hospitals within the NYC area that they would have to remain open, and categorical diversions would not be accepted, even the hospitals furthest from the incident. That way, no one hospital would be overwhelmed by sudden patient influx, and all could share some of the workload generated. I can presume in the areas where it's over an hour travel time to a "next nearest hospital," that there would be some kind of multi-agency Mutual Aid agreements made, with some idea of "Who's in Charge" in place prior to the incident. Can you say "Pre-Plan"? Multiple Incident Command areas only work if they are coordinated, like a north, south, east, and West Command under an uber-command that is fully in charge. If each command ends up claiming to be the boss, each command potentially can undermine another command, and put personnel at risk. I'll use a fantasy event of a train derailment, causing a multi-block big fire fueled by torn up Gasoline tank cars, some of which have already gone BLEVE (Boiling Liquid Expansion Vapor Explosion). North Command authorizes a fire break to be created by use of explosives, but east command orders the troops in with hand lines, and neither knows the other's agenda. How many firefighters just got needlessly killed? There needs to be some kind of coordination in the responses, too. After the 9-11 Attack, so many EMS agencies responded to the WTC, and a lot of them left their home communities unprotected. I theorize they felt that their predesignated mutual aid departments would cover their home territories. The problem with that was, If company A thinks company B is going to cover their area as they respond to company C's area, even as company B is also responding into company C's area, who is left to cover both company A and B's area? New York State DoH came up with a general plan to answer that. No EMS agency can "self assign" themselves to another EMS agency's "turf," they have to be "invited." Then, they can only leave their own "turf" after making sure that they have minimal staffing to cover the home turf. If your agency has one ambulance, you cannot strip your community of it, but if you have 2, both have to be staffed before one of them can go help the next town. In the event of something big, like that scenario I previously mentioned, the State Office of Emergency Management (OEM) is the only agency that can call up for additional units, with the proviso that the department called still can maintain their own area's coverage prior to responding to the staging area. Violation of these rules will result in big-time financial fines, both for the department, and the individual crewpersons. Note: I am not saying this is the best way to do things, but it is the way I am told they are going to be for the time being, until a better system can be "thunk up."

Accidental duplication, see my next posting, with corrected spelling.

In the final years prior to it's demise, my Peninsula Volunteer Ambulance Corps was starting to put Junior Members on the ambulance. We minimally ran with a "Crew Chief," who was an EMT, an MVO (Motor Vehicle Operator), who could also be an EMT, and under an in-house "third man" rule, whoever the personnel came thru the door next would dispatch (ALL PVAC Personnel who rode, or wanted to ride, were trained as dispatchers). The "Juniors" who rode, were selected on an individual, case by case, basis, and were always supposed to be under the direct supervision of the Crew Chief. They had been trained by our American Red Cross certified First Aid instructors to the level of "advanced first aiders", and all were also trained to ARC or American Heart Association standards for CPR, to what nowadays probably could be considered "First Responder" training level (don't hold me to that). The First Aid and CPR training was our minimum standard for anyone who would ride, or drive, for both junior or senior members. As New York State DoH didn't (and still doesn't) allow for EMTs under the age of 18, that became the minimum age for "Senior" members, and 21 was the minimum age for drivers ("insurance regs?"). There was one junior who everyone felt should be allowed to ride, but she felt she wasn't mature enough to do so, which the majority of the seniors felt was a very mature thing to have her admit to. What an irony! Jump 11 or 12 years to the present: In February of 2006, I had an episode while working, which caused me need of the Paramedics, with me as the patient. This former PVAC "junior" is now an FDNY EMS Paramedic, in the title for only a short time, and was working on the Paramedic ambulance that responded for me. Her care for me was excellent. Must have been that time with the old "first responder" training from back then. (Side-note: Her partner had been a PVAC member years before she joined the Vollies. Talk about "Old Home Week!) As noted, the FDNY Firefighters have all been trained as NYS Certified First Responders, to take some basic life-savings skills to use prior to the FDNY EMS arrival onscene. Per department "stats" they seem to be doing some good.

Once again, the web page for the New York State Department of Health, Bureau of EMS is

If I remember the NYS DoH rules, when the EMT card expires at midnight of the expiration date, the holder can not refer to themselves as an EMT. If they can get into a refresher class before one calendar year from that expiration date (and pass, of course!), then, they don't need to take the full initial class again. However, at one year and one day, if not already in a class, the individual needs to take the initial basic class.

1980 to 1985, I worked for Nassau Ambulance/Ambulette Service (Freeport, Nassau county, NY). "Night call", we worked with pagers. There was a month I tried to eat with my family at a local restaurant, every Saturday night, and got paged out just as we sat down, each time. The servers all wondered if I ever got to eat (sometimes, it seemed to be "never"). My mom got a laugh, when sneaking a look into a JEMS article on how pagers gave EMS and VFD people "freedom", felt that when I strapped on the pager, I went into a kind of slavery.

I must mention that, at public hangings in the 1870s American West, it may not have been too much of a deterrent, as, at the hanging of a pickpocket, several other pickpockets were arrested for doing the thievery thing, in the crowd of onlookers.

OK, mom was reading over my shoulder again. She commented that if taking a killer out of circulation, permanently, is in the service of humanity, than so be it.

Does anyone from Utah care to contribute with how the firing squad gets selected, following the comment about the gun barrel temperature, firing a bullet versus blank?

If some "proper authority" like an EMS crew-person, or a LEO, feels that a suspected or confirmed EDP is a potential threat to either the patient's own self, their family or bystanders at the location, or to the Emergency Responders, have the LEOs restrain (handcuff, at the minimum) the patient. The patient is not under arrest, but placed into "Protective Custody" for everyone's protection. (Semantics! Use them, learn them, love them!)

One of the guys from my "house" (we're an FD-based service) was hurt last night, while transporting an EDP. Apparently, while picking the patient up from the floor, the patient moved, my guy tried to compensate, and threw his back out. Thank goodness for Worker's Compensation. Per my lieutenant, who I asked about the incident just before I went off shift, while EDPs are actually a LEO problem, we just supply the vehicle for transport. If he had his "druthers," PD would do the transportation, also. Until the rules get changed, however, he suggests we always have a LEO ride the ambulance with the patient and crew, that way, if the patient has to be restrained, any onus will be on the LEOs, not the EMSers.

"When the forecast calls for an inch of snow, you run out with all the other crazies to stand in line for three hours to buy a month's worth of groceries. " Donno about that being strictly from Arkansas, as milk and bread disappear from the supermarket shelves as soon as a weather reporter reports that there's going to be snow, no matter what the accumulation, here in NYC.

Serial killer Gary Gilmore was executed by the state of Utah, by firing squad. As mentioned, there were seven rifles, six loaded with bullets, the seventh with a blank. If I recall the reason for that, it was so no one of the seven could claim with any certainty that he actually killed Gilmore, as the weapons were randomly assigned, and any of the seven could have fired either a fatal shot, or the blank. FYI.

Sir Hunter Royal Medic, perchance you are a Chiurgen (spelling?) in the Society of Creative Anachronisms?

I just saw a Roberts catalog, selling a T-shirt with reversed lettering, that says "Ambulance Driver."

Anonymous, from poster and T-shirt

Just to throw another log into this fire, what about a personal radio for Marine Band, especially when your agency doesn't run boats, and have to depend on local Coast Guard, LEO or FD run boats, to coordinate between in-the-water and land-based services?

20 years ago, my EMS Academy instructors referred to us as "Technician," as in "Technician B, what is the answer to question 5?" Unless you're a rude person, I don't think you'd refer to a Doctor as "Mac", unless that was his/her name.

As someone who carries their "company" kit when off duty, I ask the crews I assist if they can give me back fresh stock of what I used, using the "you would have used that yourself had you treated them" argument. Even when they don't know me personally, most give me the stuff. Otherwise, I restock when next I get to my station, and into the supply lockers.

Ace, a small suggestion? When you reproduce these admittedly advanced missives into the EMT City strings, click to disable the smileys, otherwise there's distracting smileys where they don't belong.