Richard B the EMT

You kind of illustrated what I said about the GPS unit(s) used by Access_A-Ride. Thanks.

I was just advised by a new associate of mine, the Paramedic Coordinator at Presbyterian-New York Cornell Weill Hospital (formerly Cornell Medical Center), of new information concerning the alleged falsification of EMT documentation, by an EMT instructor, who submitted course attendance sheets with the names of people who didn't attend the classes he supposedly taught. Not to violate the copyright rules, but hopefully the Boston Globe won't pull down the link, at The Boston Globe As to this EMT Instructor-Coordinator, and those who faked the class under his, and his associates, I give an understatement of

We're supposed to only get one notification when a string we are following has gotten an update, but for some reason, I get multiples on the Moment of Silence disruption in London per day, even though nobody has added to the string. No fault of EMTAnnie, I am sure, but they show under her name.

It HAS been moved. Now it is "on the personal side".

Dyna-Med Trauma 2 box??? WOW, that takes me back to 1977, when I purchased the Trauma ONE model, had it survive an ambulance crash in better shape than I did, only to be stolen a few months later.

Try thinking of it like this: We all know some "professional" callers to 9-1-1 know the buzzwords to get both a "faster" response, and/or an ALS response. The other side of the coin is the caller that doesn't have a clue, and the call-taker gets an incorrect idea of what's going on, and starts out a BLS response where an ALS response was actually needed. This is not the fault of the call taker. On arrival, most BLS crews can recognize when ALS is needed, and request them for on-scene meet-up, or intercept. Hopefully, that can help you make sense of it.

1) Local protocol in NYC seems to use the Ladder/Truck company more than an engine company, for the portable blockade. 2) I think the FDNY EMS may be overusing the KEDs and IDEAs, but that is when, not only due to the MOI, the crew "has a high level of suspicion". 3) Some times, at least in my response area, we'll be in agreement with the ER doctors that the immobilization actually was unnecessary, except for protocols, level of suspicion, or the MOI. However, as mentioned in this string, nobody wants to be sued for Malpractice in denying a patient a form of "accepted" treatment.

Most times, I know the way, or have looked it up on the map, previously to the travel day. There's also turn by turn printouts from Google Map/Google World, or others like them. Someone mentioned factory/dealer prep GPS units. When I bought my Nissan Quest in July 2009, the GPS would have added $1,500.00 to the vehicle's price. I bought a decent GPS from Costco for a bit less than $200.00, with discount for purchasing it on line. Basically, I use it for destinations I am uncertain about, or for my annual pilgrimage to the "Pulse Check" convention, running from NYC to Albany, NY. A sidenote, here. When the Pulse Check was held in Lake George, NY, I found I didn't have an actual street address for the Roaring Brook Ranch and Spa, as their address is a number on "Driveway". If the convention returns to this venue, I'm asking for Latatude/Longditude coordinates, which my GPS can handle. On a second sidenote, Momma B uses "Access-A-Ride", and they use GPS units. What she tells me, sometimes, the GPS is insistant that the driver, while travelling westbound on Beach Channel Drive, and west of Beach 116th Street, make a northbound right. The issue is, where the GPS insists the driver turn, is a 4 foot high bulkhead wall between the roadway and Jamaica Bay. I can assure you, the vans and sedans Access-A-Ride uses, don't have pontoons for use on water deeper than the vans are high.

I don't know if the story is urban legend or not. Please note I prefaced my comment by saying

Does anybody look for a Medical Alert device necklace, wristband, or ankle bracelet anymore?

When I was a call taker in the EMD, I gotr a call from a woman complaining that her husband was having a toothache. But when she said that the toothache pain was radiating down her husband's left arm, my internal alarm bells went off, and I entered it as call-type "Card", for a possible cardiac, instead of call type "Sick." BLS and ALS were assigned, and arrived just as the gentleman went into arrest! Sorry, no followup as to disposition. Then, there was a classic call: The call taker gets a man on line, who says his wife is delivering the baby right that moment. The call taker gives the appropriate pre-arrival instructions, and just as the CAD (Computer Assisted Dispatch) system updates to showing the ambulance as on the scene, the caller, with the sounds of a newborn crying in the background, thanks the call taker for all the help, and hangs up. Seconds later, the BLS crew reports the address is an empty lot. The call back # turns out to be a phony. Hearing the playback, my call taker did nothing wrong, and the department is still using the tape for training, even though the actual call turned out to be bogus.

The classic anecdotal story is the high school football linebacker who took a hard hit. He exhibits no deficit in any way without c-spine immobilization during evaluation, then takes a cup of Gatorade, tilts his head back to sip the beverage... and collapses, full cardiac arrest with no ROSC (Return Of Spontaneous Circulation). The autopsy indicates he had a partially severed spine, with the head tilt fully severing the spinal column and cord. Food for thought.

I humbly decline the honor of educating you on this!

1) While I am Jewish, I will continue to say "Merry Christmas" to anyone who has not specifically asked me not to say that to them, as it is against their religion. 1-A) No one has ever made that request of me. 2) It was told to me, a child from a Jewish household went to a Catholic friend's house, and, in deference to his yeshiva's teachings, when telling his parents about it, commented on the beautiful "Winter Vacation" tree his friend had. 3) I, and others of other religions, have joked about me putting up a "Hanuka Bush" for the season. So far, I have not done so. 4) As for the Sikhs in the RCMP, it is my understanding that both sides made concessions on that, the RCMP allowing the turbans in the first place, and the Sikhs using colors corresponding to the uniform colors, with the "Cap Device", normally worn on the front of the uniform hat, being on the front of the turban. 5) Rock Shoes quoted Evelyn Beatrice Hall (Thanks, never knew the origin prior to seeing it here) as saying : "I disapprove of what you say, but I will defend to the death your right to say it". I had always thought it was "I will defend to YOUR death your right to say it". 6) Numerous times now, as a spectator, I have attended, in late May or early June, a cultural "Pow-Wow" and crafts show at the Gateway National Recreation Area-Floyd Bennett Field division, where a religious leader from one of the tribes (bands, for the Canadian's reference) offers up an event opening prayer. I have already stated I am Jewish, and now say I cannot understand anything but the (American style) English language (a personal failing, as I've tried learning Spanish and Hebrew, both unsuccessfully), but I stand quietly out of deference to the "Native Americans" and "First Nation" members whom I am standing next to. Call it simple respect for another culture and /or religion. 6-A) When they do their "Grand Entrance" Parade, they also welcome Veterans, LEOs, Fire Fighters, and EMS providers to join them, so I have also been, if only within that limitation, accepted by them. 6- A girlfriend of mine, from many years prior to Lady J, found out she was Deneh Navajo, and raised separately from her birth family (she had been adopted on the "black market", and had only found the birth family in 1996). I am somewhat friendly with a concessionary operator at this Pow-Wow (love the Buffalo meat stew on fry bread), who knows her birth family, as both are from the same "reservation" in Arizona.

I admit to not knowing why the policy exists, but I will follow policy until I am told it's been changed. Then I'll follow the new policy. I am in a position that I follow, but don't assist in the creation or, policies. I should mention that sometimes the Paramedics will have one, instead of both members of the team, ride with the patient, with the "shotgun" EMT, no matter if the transport is being done in the ALS or BLS unit. In this instance, the Paramedic assigned as "wheelman" stays driving the ALS rig.

These are all good questions and answers, young grasshoppers! LOL

FDNY EMS uses dual Paramedic teams, and dual EMT teams, for, respectively, ALS and BLS. The union prefers having 2 Paramedics, as having them provides a built in backup of knowledge, and skill. I have witnessed this many times, where one Paramedic is having a bad day and is unable to establish a line, and the partner gets it on try #1. If the Paramedics go with the patient in the back of the BLS ambulance, at least in my system, the EMTs assist to the best of ability, and scope of practice. In the cases where both Paramedics need to ride in with the patient, the EMT assigned as "shotgun" becomes the driver of the Paramedic's ambulance, as the assigned driver/EMT in the BLS ambulance maintains such status, as both go to the appropriate ER. We, in our union local, joke that it's a Pair-A-Medics. On a side note, sometimes due to personnel having to leave in the middle of a tour for personal illness or family emergency, they will team up an EMT with a Paramedic, to keep a unit in service. The unit is considered a BLS unit, even if the EMT is then aboard the vehicle usually equipped for ALS, and the Paramedic assumes an EMT role. If the combined team has a dual training level call, as in both a BLS and ALS unit responding, the Paramedic is then allowed to use their ALS skills while with the full ALS team and equipment. There have come times that the department agrees with 2 Paramedic teams, and times they bring up single Parqamedic units, or so-called "Mensa Medics" in contract negotiation times. So far, dual Paramedic teams have won out. That's how the FDNY EMS Command does it, but this may not be the procedures and/or protocols of other agencies around the country, or the world. I'd check with your supervisors and medical director to find out what is expected of you in these circumstances.

They might live at the accident location, had gotten into the car from inside the house, but hadn't yet opened the garage door, or started the engine.

On the other hand, I recall the problems from the one time they sold, and billed as such, "Anatomically Correct" Barbie and Ken dolls.

Somebody just stop me if I start calling new members of the EMT City as "young whippersnappers!" (LOL) It is a 2 way street, here. Long-timers like me can sometimes show the older, tried and true ways to the newjacks, while they might be able to show us the newest change in a protocol, or even protocols never experienced by us, as both BLS and ALS skill sets and requirements are increased.

I have also been the practice dummy, although some say I need no practice being a dummy (LOL). As the practice dummy, I find the KED, or the Iron Duck equivalent, the IDEA (Iron Duck Extrication Appliance), to both be easier to apply than the "short back board", and more comfortable for the "patient". I give the comfort rating, as, until most agencies in my area started using them, I always found my neck being uncomfortably stretched upwards and to my left in the drills using the short back board. FYI, the FDNY EMS primarily uses the IDEA for the extrication, then move the patient to the long back board.

That 2 vehicle stack looks unstable. I'd try to establish voice and visual contact with anyone in the vehicles, while awaiting that Heavy Rescue to place cribbing blocks to brace the upper vehicle for scene safety. Is there a light fixture possibly in contact with the blue vehicle, causing both to be electrified, thus an electrocution hazard to rescuers? Did the blue vehicle enter the garage, and end up on top, or did the red vehicle force the blue one up top when it entered the garage? Debris sandwiched between the vehicles indicates a high speed impact through the garage door. Definitely don your hardhats as well as your usual protective gear, as that suspended ceiling might also come down. More to come (from everybody!) Also, how steady is the floor? Just thought there might be a basement underneath, and the floor is not intended to support the weight of both vehicles. Cribbing to the basement, also, if needed.

Condolences to you, and your family, from both myself, and my mother, Past Commander Sara Berger, of the Queens County Council (New York) of the Jewish War Veterans of the United States. Richard Berger, Sara Berger.

Don't hold me to this, but I think FDNY, and the FDNY EMS, use Iron Duck brand bags.