Richard B the EMT

I am now transmitting an update on usage in New York State of Emergency Red Lights and Sirens on POVs, just received moments prior to posting here:

Bureau of EMS Policy Statement

Policy Statement #

05-02

Date

03/10/05

Subject

Re: Amendment to 10NYCRR Part 800.26 Emergency Ambulance Service Vehicles

Supercedes/Updates

New

Pages

1 of 2

10NYCRR Part 800.26 — Emergency Ambulance Service Vehicles

In November of 2004, amendments to the Part 800.26, which address Emergency Ambulance Service Vehicles (EASV) went into effect. The proposed amendments are intended to allow local EMS systems and agencies an increased flexibility in determining the best and most appropriate configuration for assigning vehicles to emergency response in order to meet system, local EMS personnel, deployment and patient needs.

The new sections of the regulation are as follows:

The governing authority of any ambulance service, which, as a part of its response system, utilizes emergency ambulance service vehicles, other than an ambulance to bring personnel and equipment to the scene, must have policies in effect for equipment, staffing, individual authorization, dispatch and response criteria and appropriate insurance.

(a) A waiver of the equipment for emergency ambulance service vehicles may be considered when the service provides an acceptable plan to the Department demonstrating how appropriate staff, equipment and vehicles will respond to a call for emergency medical assistance. The Regional EMS Councils will be solicited for comment.…

Policy

The purpose of an EASV, which remains unchanged by this amendment and policy, is to deliver personnel and/or equipment to the scene of a medical emergency. Ambulance services must still address and document how this purpose is met whenever an EASV equipment waiver is requested.

Part 800.26( is the list of equipment required for all EASVs. This list represents the minimum amount of equipment and suppliesnecessary for an EMS provider to respond to a scene to care for a sick or injured patient. The amendment to the regulation specifically allows for an ambulance service to request that the Department of Health, Bureau of EMS (BEMS), in consultation with the Regional EMS Council (REMSCO), waive some, or all of the equipment requirements listed in Part 800.26(. In order for a waiver to be considered, the following criteria must be met.

A request for an equipment waiver must be made in writing to BEMS.

The letter must be on the EMS agency's official letterhead.

The letter must detail what specific equipment and/or supplies are to be waived .

The letter must include the reason the waiver is being requested.

The letter must include the agency's EASV policies and procedures addressing equipment, staffing, individual authorizations, dispatch, response criteria and appropriate insurance.

The letter must be signed by the agency's chief executive officer (CEO), or the head of the governing body (i.e. Chairman of the board of commissioners, president or mayor)

The ambulance service must submit a complete and executed Affirmation of Compliance (DOH-1881) identifying each EASV.

A copy must be provided to the REMSCO(s).

The complete regulation, including the equipment list is available on the Department's web site at www.health.state.ny.us/nysdoh/ems/part800.htm#800.26

Important Notes

In addition to the Part 800 requirements, the operation of any EASV must be in compliance with all applicable New York State Vehicle and Traffic Laws. Additionally, when equipped with red lights and siren, the EASV must be insured with the appropriate coverage as an emergency vehicle. No waivers for appropriate policies and procedures or vehicle insurance will be granted.

This policy statement DOES NOT SUPERCEDE DOH EMS Policy Statement 01-01. Policy Statement 01-01 is intended to clarify the requirements and procedures for authorization of Emergency Ambulance Service Vehicles (EASV).

Authorization as an EASV involves more than just the use of red lights and a siren on a vehicle. It is expected that every EASV be in compliance with all of the provisions of 10 NYCRR Part 800.21 & .26. This includes proper agency identification; vehicle marking and patient care equipment. All vehicles authorized by the service as EASVs may be subject to inspection. In the event violations to the code are found, the violations will be charged against the service authorizing the vehicle.

Issued and Authorized by:

Edward Wronski, Director

Someone said helicopters are so ugly the ground repels them? What about the A10 "Warthog"? That tank-buster jet is so ugly, it's actually distinguished looking!

I just remembered something: For those agencies still using MAST, if doing a Medivac, the pressure in the MAST will be changing due to good old barometric pressure, with the helo's changing altitude!

There is a type system that can hear an approaching siren, determine the direction of approach, and turn that direction green for the emergency vehicle, but I forget the name of it.

Opticon is one type system that uses a special strobe light to activate, but, as before, I don't recall any of the competitors names. Likewise systems that use activation devices similar to garage door remote control openers.

The only drawback of any of these systems used on the avenue, is, if 2 Emergency vehicles are approaching from different directions, whichever the system "gets" first will get the priority of the green light.

I would suggest, with these systems, or without, that everyone operate their Emergency vehicle following New York State Vehicle and Traffic Law #1102, paraphrased here: Operate your vehicle with due regard for others on the road.

Re the EMS imposter:

Did he hurt, kill, or allow anyone to die before he was busted?

Also, reports keep coming in of people with "middle eastern" accents, wanting to buy used ambulances, and pay for them in cash.

Also, folks walking up to crews and asking questions about operations have been reported.

If either happens to you, remember what they look like, and report them to the local LEOs, State Police, local FBI office, or local Office of Homeland Security (those with camera cellphones, take a picture!). I'd rather be thought crying wolf, than allow someone to use a retired ambulance vehicle as a WMD delivery system.

On similar note, keep your apparatus yards locked when nobody is around, which can slow down anyone planning to steal an emergency vehicle for nefarious purposes (always wanted to use that word, "nefarious").

While overweight, I'm in shape.

Round is a shape, isn't it?

(Rim shot!)

I'm an EMT in the FDNY EMS. We have Engine Company Certified First Responders-Defib, but don't have cross-trained Firefighter EMTs or Firefighter Paramedics, or EMTs or Paramedics who fight fires. Just the way it seems to be working.

PS: If a firefighter is an EMT or Paramedic outside of the FDNY, they don't utilize the skills on the job for the FDNY. At the same time, if an EMT or Paramedic is trained as a Firefighter outside of FDNY, they also can not use their skills as a firefighter on the job for FDNY.

The area my "house" covers is about 11 miles long, by a mile wide at it's widest, but the patch on my arm says the "City of New York," which is a much larger area. Either BKone or FDNYEMT will take this one if I can't find out the geographic size of NYC.

The reason that only the Engine and Ladder companies get the Opticon systems is, most likely, because they are way heavier vehicles than a cop car, or an ambulance, therefore, they're harder to stop when at any real speed above 5 MPH.

In NYC, a lot of Emergency Vehicle Bases (Firehouses and VAC) have a traffic light that's controlled by the house watch crew-person, changing to red for the traffic crossing in front of the house to allow a fast egress, or backing back into the house. Such was just installed at my "house".

BKone, which VAC were (or are) you with?

As always, NYC is a small town of only 8 million people.

Actually, NYC is a collection of small towns. The Rockaway Peninsula is a small group of communities roughly the population of Grand Forks, North Dakota, within the county of Queens, population roughly the same as the state of North Dakota, as per my brother, born here in Belle Harbor, Rockaway Peninsula, Queens County NY, who now lives and works in Grand Forks, ND

There are areas where English is spoken, where "certified" usually refers to a psychiatrist officially declaring someone an Emotionally Disturbed Person. Food for thought?

Up. Down. Up. Down. Up. Down.

OK.

Now, the other eyelid!

(lol)

I have at least 2 extended care facilities in my service area that are Bariatric "ghettos" as there are no residents on that floor under 500 LBS. We don't have bariatric specialty trucks, we usually ask "suppression" to send an engine, load the patient, still on their bed mattress, onto the floor of the ambulance (stretcher transported in another ambulance, or on the hose bed), and unload onto a hospital bed brought out to the ambulance bays. It ain't pretty, it ain't fast, but it works.

Restart the survey, with the addition of "Used to smoke/chew" and "Never smoked/chewed." I'm sure that there's enough people fit those categories also.

Also, I mentioned the current vehicle has a siren? It is totally for Parade Details, and not for Emergency useage (too many cops know me).

Kind of. Red to the rear, Amber to the front, Green (VAC) or Blue (VFD) dash lights allowed under NYS Vehicle and Traffic Law.

Then, there's NYS VTL #115-C, which allows a department to authorize a member's POV as a first response vehicle, as long as it's carrying a specified minimum requirements list of equipment, and the operator has the appropriate identification as member of the department, with letter of authorization from the department (just being a member of that department doesn't cut it). Then, the POV can have forward facing Red Lights, and a siren. The vehicle will be referred to, officially, as an "Ambulance Emergency Service Vehicle," and is probably known as a "Fly-Car," or a "Scout Car" locally.

Such L&S are ONLY to be used when the agency dispatches the POV's owner to a scene, as the POV will be then operating as a regular Emergency Vehicle, with such special privileges and responsibilities as a marked departmental Emergency Vehicle would have in Emergency mode.

I'm checking to see if NYC has it's own laws countering such use within the city.

That was a dark day (pun unintended) for the FDNY EMS, but we had additional units on, at least those tour 2 units that got mandated to stay. Most of them went home at the usual time before the orders were cut at 9 Metrotech, the FDNY HQ, but a lot of crew persons returned on their own. Also, I think every one of the VACs and VFDs within the city had crews on, and were doing calls.

One unit out of my "house," a summer seasonal supplemental one, did a full double tour. Also, even though not 9-1-1 responders, all of the proprietary, Private services also held crews for extended times, checking in on the extended care facilities that use them under contract.

Does your EMS agency have the budget for an ambulance with either a lift, or portable ramps with a winch under the "Captain's Chair"? Don't forget maintenance for this stuff, after purchase.

In order of appearance:

1974 Ford Mustang (4 cylinder) (1980-1986)

1984 Oldsmobile Firenza Wagon (4 cylinder) (1986-1989)

1989 Toyota Corolla Altrac Wagon (4 cylinder) (1989-1998)

1998 Chevrolet Venture Minivan (6 cylinder) (1998-?)

All had/have emergency lights, the Olds and Toyota had an electronic siren. The Chevy has a manual control switch to a "motor driven" alarm type siren (not satisfactory but not enough space under the hood).

I'm sure that all the rest of us "Big City" people are joining in with the rural ones in laughter here. LMAO.

From website http://nyshca.org/NYProxyLaw.html

New York Society Healthcare Consumer Advocacy

HomeContact NYSHCAMembersEventsLinksNY State's Proxy LawPatients' Bill of RightsLetter from the PresidentJob Openings

New York State's Healthcare Proxy Law

A New Law Gives Patients the Power

A new law called the New York Healthcare Proxy law allows you to appoint someone you trust---for example, a family member or close friend--to decide about treatment if you lose the ability to decide for yourself. You can do this by using a form called a Healthcare Proxy (for a printable version, click here).

This law gives you the power to make sure that healthcare professionals follow your wishes. Your agent can also decide how your wishes apply as your medical condition changes. Hospitals, doctors and other healthcare providers must follow your agent's decisions as if they were your own.

You can give the person you select, your healthcare agent, as little or as much authority as you want. You can allow your agent to decide about all healthcare or only certain treatments. You may also give your agent instructions that he or she has to follow.

Why Should I Choose a Healthcare Agent?

If you become unable, even temporarily, to make health care decisions, someone else must decide for you. Health care providers often look to family members for guidance. Family members may express what they think your wishes are related to a particular treatment. However, in New York State, only a health care agent you appoint has the legal authority to make treatment decisions if you are unable to decide for yourself. Appointing an agent lets you control your medical treatment by:

allowing your agent to make health care decisions on your behalf as you would want them decided;

choosing one person to make health care decisions because you think that person would make the best decisions;

choosing one person to avoid conflict or confusion among family members and/or significant others. You may also appoint an alternate agent to take over if your first choice cannot make decisions for you.

Who can be a health care agent?

Anyone 18 years of age or older can be a health care agent. The person you are appointing as your agent or your alternate agent cannot sign as a witness on your Health Care Proxy form.

How Can I Appoint a Health Care Agent?

All competent adults, 18 years of age or older, can appoint a health care agent by signing a form called a Health Care Proxy. You don’t need a lawyer or a notary, just two adult witnesses. Your agent cannot sign as a witness. You can use the form here, but you don't have to.

When would my health care agent begin to make health care decisions for me?

Your health care agent would begin to make health care decisions after your doctor decides that you are not able to make your own health care decisions. As long as you are able to make health care decisions for yourself, you will have the right to do so.

What decisions can my healthcare agent make?

Unless you limit your health care agent’s authority, your agent will be able to make any health care decision that you could have made if you were able to decide for yourself. Your agent can agree that you should receive treatment, choose among different treatments and decide that treatments should not be provided, in accordance with your wishes and interests. However, your agent can only make decisions about artificial nutrition and hydration (nourishment and water provided by feeding tube or intravenous line) if he or she knows your wishes from what you have said or what you have written. The Health Care Proxy form does not give your agent the power to make non-health care decisions for you, such as financial decisions.

Why do I need to appoint a health care agent if I’m young and healthy?

Appointing a health care agent is a good idea even though you are not elderly or terminally ill. A health care agent can act on your behalf if you become even temporarily unable to make your own health care decisions (such as might occur if you are under general anesthesia or have become comatose because of an accident). When you again become able to make your own health care decisions, your health care agent will no longer be authorized to act.

How will my healthcare agent make decisions?

You can write instructions on the proxy form. Your agent must follow your oral and written instructions. As well as your moral and religious beliefs. If your agent does not know your wishes or beliefs, your agent is legally required to act in your best interests.

How will my health care agent know my wishes?

Having an open and frank discussion about your wishes with your health care agent will put him or her in a better position to serve your interests. If your agent does not know your wishes or beliefs, your agent is legally required to act in your best interest. Because this is a major responsibility for the person you appoint as your health care agent, you should have a discussion with the person about what types of treatments you would or would not want under different types of circumstances, such as:

whether you would want life support initiated/continued/removed if you are in a permanent coma;

whether you would want treatments initiated/continued/removed if you have a terminal illness;

whether you would want artificial nutrition and hydration initiated/withheld or continued or withdrawn and under what types of circumstances.

Can my health care agent overrule my wishes or prior treatment instructions?

No. Your agent is obligated to make decisions based on your wishes. If you clearly expressed particular wishes, or gave particular treatment instructions, your agent has a duty to follow those wishes or instructions unless he or she has a good faith basis for believing that your wishes changed or do not apply to the circumstances.

Who will pay attention to my agent?

All hospitals, nursing homes, doctors and other health care providers are legally required to provide your health care agent with the same information that would be provided to you and to honor the decisions by your agent as if they were made by you. If a hospital or nursing home objects to some treatment options (such as removing certain treatment) they must tell you or your agent BEFORE or upon admission, if reasonably possible.

What if my healthcare agent is not available when decisions must be made?

You may appoint an alternate agent to decide for you if your health care agent is unavailable, unable or unwilling to act when decisions must be made. Otherwise, health care providers will make health care decisions for you that follow instructions you gave while you were still able to do so. Any instructions that you write on your Health Care Proxy form will guide health care providers under these circumstances.

What if I change my mind?

It is easy to cancel your Health Care Proxy, to change the person you have chosen as your health care agent or to change any instructions or limitations you have included on the form. Simply fill out a new form. In addition, you may indicate that your Health Care Proxy expires on a specified date or if certain events occur. Otherwise, the Health Care Proxy will be valid indefinitely. If you choose your spouse as your health care agent or as your alternate, and you get divorced or legally separated, the appointment is automatically cancelled. However, if you would like your former spouse to remain your agent, you may note this on your current form and date it or complete a new form naming your former spouse.

Can my healthcare agent be legally liable for decisions made on my behalf?

No. Your health care agent will not be liable for health care decisions made in good faith on your behalf. Also, he or she cannot be held liable for costs of your care, just because he or she is your agent.

Is a healthcare proxy the same as a living will?

No. A living will is a document that provides specific instructions about health care decisions. You may put such instructions on your Health Care Proxy form. The Health Care Proxy allows you to choose someone you trust to make health care decisions on your behalf. Unlike a living will, a Health Care Proxy does not require that you know in advance all the decisions that may arise. Instead, your health care agent can interpret your wishes as medical circumstances change and can make decisions you could not have known would have to be made.

In contrast, the healthcare proxy allows you to choose someone you trust to make treatment decisions on your behalf. Unlike a living will, a healthcare proxy does not require that you know in advance all the decisions that may arise. Instead, your healthcare agent can interpret your wishes as medical circumstances change and can make decisions you could not have know would have to be made. The healthcare proxy is just as useful for decisions to receive treatment as it is for decisions to stop treatment. If you complete a healthcare proxy form, but also have a living will, the living will provides instructions for your healthcare agent, and will guide his or her decisions.

Where should I keep the proxy form after it is signed?

Give a copy to your agent, your doctor, your attorney and any other family members or close friends you want. Keep a copy in your wallet or purse or with other important papers, but not in a location where no one can access it, like a safe deposit box. Bring a copy if you are admitted to the hospital, even for minor surgery, or if you undergo outpatient surgery.

May I use the Health Care Proxy form to express my wishes about organ and/or tissue donation?

Yes. Use the optional organ and tissue donation section on the Health Care Proxy form and be sure to have the section witnessed by two people. You may specify that your organs and/or tissues be used for transplantation, research or educational purposes. Any limitation( s) associated with your wishes should be noted in this section of the proxy.

Failure to include your wishes and instructions on your Health Care Proxy form will not be taken to mean that you do not want to be an organ and/or tissue donor.

Can my health care agent make decisions for me about organ and/or tissue donation?

No. The power of a health care agent to make health care decisions on your behalf ends upon your death. Noting your wishes on your Health Care Proxy form allows you to clearly state your wishes about organ and tissue donation

Who can consent to a donation if I choose not to state my wishes at this time?

It is important to note your wishes about organ and/or tissue donation so that family members who will be approached about donation are aware of your wishes. However, New York Law provides a list of individuals who are authorized to consent to organ and/or tissue donation on your behalf. They are listed in order of priority: your spouse, a son or daughter 18 years of age or older, either of your parents, a brother or sister 18 years of age or older, a guardian appointed by a court prior to the donor’s death, or any other legally authorized person.

Appointing a healthcare agent is a serious decision. Make sure you talk about it with your family, close friends, and your doctor. Do it in advance, not just when you are planning to enter the hospital.

About the Healthcare Proxy Form

This is an important legal document. Before signing, you should understand the following facts:

This form gives the person you choose as your agent the authority to make all health care decisions for you, including the decision to remove or provide life-sustaining treatment, unless you say otherwise in this form. “Health care” means any treatment, service or procedure to diagnose or treat your physical or mental condition.

Unless your agent reasonably knows your wishes about artificial nutrition and hydration (nourishment and water provided by a feeding tube or intravenous line), he or she will not be allowed to refuse or consent to those measures for you.

Your agent will start making decisions for you when your doctor determines that you are not able to make health care decisions for yourself.

You may write on this form examples of the types of treatments that you would not desire and/or those treatments that you want to make sure you receive. The instructions may be used to limit the decision-making power of the agent. Your agent must follow your instructions when making decisions for you.

You do not need a lawyer to fill out this form.

You may choose any adult (18 years of age or older), including a family member or close friend, to be your agent. If you select a doctor as your agent, he or she will have to choose between acting as your agent or as your attending doctor because a doctor cannot do both at the same time. Also, if you are a patient or resident of a hospital, nursing home or mental hygiene facility, there are special restrictions about naming someone who works for that facility as your agent. Ask staff at the facility to explain those restrictions.

Before appointing someone as your health care agent, discuss it with him or her to make sure that he or she is willing to act as your agent. Tell the person you choose that he or she will be your health care agent. Discuss your health care wishes and this form with your agent. Be sure to give him or her a signed copy. Your agent cannot be sued for health care decisions made in good faith.

If you have named your spouse as your health care agent and you later become divorced or legally separated, your former spouse can no longer be your agent by law, unless you state otherwise. If you would like your former spouse to remain your agent, you may note this on your current form and date it or complete a new form naming your former spouse.

Even though you have signed this form, you have the right to make health care decisions for yourself as long as you are able to do so, and treatment cannot be given to you or stopped if you object, nor will your agent have any power to object.

You may cancel the authority given to your agent by telling him or her or your health care provider orally or in writing.

Appointing a health care agent is voluntary. No one can require you to appoint one.

You may express your wishes or instructions regarding organ and/or tissue donation on this form.

You may write on this form any information about treatment that you do not desire and/or those treatments that you want to make sure you receive. Your agent must follow your instructions (oral and written) when making decisions for you. If you want to give your agent written instructions, do so right on the form. For example, you could say:

If I become terminally ill, I do/don't want to receive the following treatments:...

If I am in a coma or unconscious, with no hope of recovery, then I do/don't want...

If I have brain damage or a brain disease that makes me unable to recognize people or speak and there is no hope that my condition will improve, I do/don't want...

I have discussed with my agent my wishes about _________________________ and I want my agent to make all decisions about these measures.

Examples of medical treatments about which you may wish to give your agent special instructions are listed below. This is not a complete list of the treatments about which you may leave instructions.

artificial respiration

artificial nutrition and hydration (nourishment and water provided by feeding tubes

cardiopulmonary resuscitation (CPR)

antipsychotic medication

electric shock therapy

antibiotics

psychosurgery

dialysis

transplantation

blood transfusions

abortion

sterilization

Talk about choosing an agent with your family and/or close friends. You should discuss this form with a doctor or another healthcare professional, such as a nurse or social worker, before you sign it to make sure that you understand the types of decisions that may be made for you. You may also wish to give your doctor a signed copy. You do not need a lawyer to fill out this form.

You can choose any adult (over Eighteen), including a family member, or close friend, to be your agent. If you select a doctor as your agent, he or she may have to choose between acting as your agent or as your attending doctor; a physician cannot do both at the same time. Also, if you are a patient or resident of a hospital, nursing home or mental hygiene facility, there are special restrictions bout naming someone who works for that facility as your agent. You should ask staff at the facility to explain those restrictions.

You should tell the person you choose that he or she will be your healthcare agent. You should discuss your healthcare wishes and this form with your agent. Be sure to give him or her a signed copy. Your agent cannot be sued for healthcare decisions made in good faith.

Even after you have signed this form, you have the right to make healthcare decisions for yourself as long as you are able to do so, and treatment cannot be given to you or stopped if you object. You can cancel the control given to your agent by telling him or her or your healthcare provider orally or in writing.

Filling Out the Proxy Form

Item(1)

Write your name and the name, home address and telephone number of the person you are selecting as your agent.

Item(2) If you have special instructions for your agent, you should write them here. Also, if you wish to limit your agent's authority in any way, you should say so here. If you do not state any limitations, your agent will be allowed to make all healthcare decisions that you could have made, including the decision to consent to or refuse life-sustaining treatment

Item(3) You may write the name, home address and telephone number of an alternate agent.

Item(4) This form will remain valid indefinitely unless you set an expiration date or condition for its expiration. This section is optional and should be filled in only if you want the health care proxy to expire.

Item(5) You must date and sign the proxy.* If you are unable to sign yourself, you may direct someone else to sign in your presence. Be sure to include your address.

Item(6) You may state wishes or instructions about organ and/or tissue donation on this form. A health care agent cannot make a decision about organ and/or tissue donation because the agent’s authority ends upon your death. The law does provide for certain individuals in order of priority to consent to an organ and/or tissue donation on your behalf: your spouse, a son or daughter 18 years of age or older, either of your parents, a brother or sister 18 years of age or older, a guardian appointed by a court prior to the donor’s death, or any other legally authorized person.

Item(7) Two witnesses 18 years of age or older must sign this Health Care Proxy form. The person who is appointed your agent or alternate agent cannot sign as a witness.

*The Healthcare Proxy Law takes effect January 1991; forms signed before that date are valid.

Two witnesses at least 18 years of age must sign your proxy. The person who is appointed agent or alternate agent cannot sign as a witness.

Healthcare Proxy Form

Item 1 (1) __________________________________________________________________________

hereby appoint

_______________________________________________________________________

(name, home address and telephone number)

________________________________________________________________________

________________________________________________________________________

as my health care agent to make any and all health care decisions for me, except to the extent

that I state otherwise. This proxy shall take effect only when and if I become unable to make my

own health care decisions.

Item 2

Optional: Alternate Agent

If the person I appoint is unable, unwilling or unavailable to act as my health care agent,

I hereby appoint

________________________________________________________________________

(name, home address and telephone number)

________________________________________________________________________

________________________________________________________________________

as my health care agent to make any and all health care decisions for me, except to the extent that I state otherwise.

(Unless your agent knows your wishes about artificial nutrition and hydration (feeding tubes), your agent will not be allowed to make decisions about artificial nutrition and hydration. See above samples of language you could use.)

Item 3

Unless I revoke it or state an expiration date or circumstances under which it will expire, this

proxy shall remain in effect indefinitely. (Optional: If you want this proxy to expire, state

the date or conditions here.) This proxy shall expire (specify date or conditions):

__________________________________________________________________________

__________________________________________________________________________

Item 4

Optional: I direct my health care agent to make health care decisions according to my wishes and limitations, as he or she knows or as stated below. (If you want to limit your agent’s authority to make health care decisions for you or to give specific instructions, you may state your wishes or limitations here.) I direct my health care agent to make health care decisions in accordance with the following limitations and/or instructions (attach additional pages as necessary):

_____________________________________________________________________________

_____________________________________________________________________________

Item 5

Your Identification (please print)

Your Name __________________________________________________________________________

Your Signature ___________________________________________ Date _______________

Your Address _________________________________________________________________________

Item 6

Optional: Organ and/or Tissue Donation

I hereby make an anatomical gift, to be effective upon my death, of: (check any that apply)

Any needed organs and/or tissues

The following organs and/or tissues _____________________________________________________

________________________________________________________________________________

__

Limitations ________________________________________________________________________

If you do not state your wishes or instructions about organ and/or tissue donation on this form, it will not be taken to mean that you do not wish to make a donation or prevent a person, who is otherwise authorized by law, to consent to a donation on your behalf.

Your Signature __________________________ Date_______________________________________

Item 7

Statement by Witnesses (Witnesses must be 18 years of age or older and cannot be the health care agent or alternate.)

I declare that the person who signed this document is personally known to me and appears to be of sound mind and acting of his or her own free will. He or she signed (or asked another to sign for him or her) this document in my presence.

Date _______________________________________

Name of Witness 1

(print) _________________________________

Signature ______________________________

Address ________________________________

______________________________________

Date _______________________________________

Name of Witness 2

(print) _________________________________

Signature ______________________________

Address ________________________________

______________________________________

Copyright 2003 NYSHCA.

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All rights reserved

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I'm going to get a good wording for a posting on the subjects of Advanced Directives, which clearly defines, in advance, what a person would want, should they become like Terri, and "Power of Attorney," which is designating someone to speak for a person who becomes similar to her, again, designated in advance. My mother is a big proponent of these, so I'll basically be quoting her.

BKohn Henry and FDNYEMT5330, what are we running, including the voluntaries and Metroscare? 250 plus ambulances a tour, for those 3,000 calls a day?

With 3000 calls a day, the FDNY EMS is perhaps the most busy EMS in the world, definitely in the US

So far, no problems.

I work in a predominantly black neighborhood, have a Haitian partner, and have problems with communicating with the new immigrant Russian population, who don't speak much if any English. Most of the Hispanic population are from Nicaragua, but my partner from Haiti speaks a bunch of languages, and that lessens the language barrier.

By my ethnic and religious background, I should be able to speak, in alphabetical order, German, Hebrew, Polish, Russian, and Yiddish. I don't. I just don't have an aptitude for foreign languages; witness that after 5 school terms of first year Spanish, all I can really do, is ask and understand the question of "what time is it?"

I do have the nasty co-workers saying I don't really speak English (my native tongue, American variety). To them, I joke that I'm speaking "Brooklyneese," even though I'm actually not from Brooklyn.

Most of the bigotry I witness is directed at me, an admittedly overweight white guy, by those who are either incarcerated, or restrained EDPs.