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"First Responders" on Ambulances


Dustdevil

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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.

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It's not the best situation, of course, but you've gotta make do!

Skip, that is the first thing you have ever said here that I even partially disagreed with.

Why should anybody "make do?" Why shouldn't they make the responsible government officials do the right thing and provide service in line with the the 21st century standards of care? I know you are too smart to believe that they can't afford paramedics or training. It is all these people who are inclined to just accept the $hitty state of things as they are that perpetuate poor standards.

As for dual-medic units being a dream, put down the crack pipe, Buddah. It has been the standard in North Texas for over two decades.

Ever notice there are three qualified pilots on board every airliner? How about we get rid of two of them? After all, it only takes one, right? Just replace the first officer and flight engineer with more stewardesses. I can't see that being a problem, can you?

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This ain't north Texas, Toto. Good for you if you can get agencies to put 2 medics and 1 emt on every ambulance, but this is definitely not the case everywhere else. Many agencies apparently can't afford to pay 1 medic decent wages - let alone 2 in the same bus. Not everyone has a bottomless well of municipal money to work with, and in case you hadn't noticed, Medicaid doesn't pay very well. I've worked a lot of calls over a lot of years with just myself and a driver, and occasionally a firefighter/first respondere or 2 - we've done quite well for our community, and our records reflect that.

Now, to bring this thread back to the original question - ambulances ran for a lot of years in NY with Certified First Responders in charge. Was it ideal? No. Would it be better to send no ambulance at all than to send one staffed with a CFR, if that is the highest level you have available? No.

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Through the roof state and local taxes AND a lottery and places like NY can't afford ALS? Puhleeze.

I would say that ninety percent of all jurisdictions that whine about a lack of money have plenty. It's not a lack of money. It is a lack of competent leadership.

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Through the roof state and local taxes AND a lottery and places like NY can't afford ALS? Puhleeze.

I would say that ninety percent of all jurisdictions that whine about a lack of money have plenty. It's not a lack of money. It is a lack of competent leadership.

Amen, brother!

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Through the roof state and local taxes AND a lottery and places like NY can't afford ALS? Puhleeze.

I would say that ninety percent of all jurisdictions that whine about a lack of money have plenty. It's not a lack of money. It is a lack of competent leadership.

I agree...but you know the upper members of the local/reginal government aren't about to take a pay cut.

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Through the roof state and local taxes AND a lottery and places like NY can't afford ALS? Puhleeze.

I would say that ninety percent of all jurisdictions that whine about a lack of money have plenty. It's not a lack of money. It is a lack of competent leadership.

They probably just don't care. Despite what our industry would like to think, I imagine less than 50% of tax payers utilize an ambulance sometime in their lifetime. If you're a wealthy politician you probably will never utilize an ambulance. The majority of the middle and upper class of our nation are educated enough to determine if their "emergency" truly needs an ambulance and call 911 accordingly. Their sense of self is developed enough to determine if something is seriously wrong. Since critical patients probably constitute less than 25% of the EMS call volume in this nation, most people will feel that they will never use the system. So why "pay" for it? I know plenty of people who look at ambulances as a type of "welfare van" for the poor. To these people paramedics take out the proverbial "trash" of America.

Is this wrong? Absolutely, but the perception is easy to mix with reality, especially in urban systems with large amounts of poverty. Granted I'm making very large estimates in my above statements, but if I as someone involved in the field am making these assumptions, imagine how bad it is among the general public? Put this image together with poor educational standards and ignorant rednecks populating the ranks of the profession and you'll see what I mean.

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All hail the mighty PARAMEDIC!!!!!

Lest we forget where we came from... ?

If your jurisdiction is fortunate enough to have an intake Paragod (oooops!) program than lucky not to have climbed the ladder to the top! EMT-B, EMT-A, EMT-P

Most of us were not as fortunate.... one day a FR may just save your ass...

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As a First Responder in NY, I feel that we (meaning FR's) are qualified to staff a bus. NYS Law requires at least an EMT, so we always have an EMT with us, and we have the same training as EMT's, with only one or two minor differences. I have run full codes and major traumas on my own, and I resent the notion that we need to be "babyed" to do our jobs. Furthermore, let's not forget that many first responder's are exactly that...the first one's on the scene, responsible for caring for the pt. until the bus arrives (I've been on calls where I'm the only FR on scene and the bus doesnt show up for ten or 20 minutes) and yes, I have been first on scene for full arrests, major traumas and the like. (and of course the normal share of BS calls.) So I think it is unfair to bash FR's. Besides, I've seen plenty of EMT's and "Para-gods" who should have there certification cards ripped up!

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