NYPD ESU have Tac Medics (one did ride alongs on my bus while they went through medic school), they perform SWAT type functions as well. I've done many standbys for barricaded EDP's, and have seen ESU do their thing. Extrication is just another of their functions.
NYPD vs FDNY
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NYPD ESU have Tac Medics (one did ride alongs on my bus while they went through medic school), they perform SWAT type functions as well. I've done many standbys for barricaded EDP's, and have seen ESU do their thing. Extrication is just another of their functions.
Apples and oranges, career and volunteer. besides, with volunteer, those individuals only certify in what they want to be certified in. Many don't want anything to do with an ambulance. Othere only want to be on an ambulance. Others yet will only respond to certain calls, and not others. When you're career, you don't have near that amount of discretion.
Also, if you lie own whenever your employer expands you job description without some incentive, then they will continue to do so until you're inundated with more tasks than you can handle. I belive that one jurisdiction had their FF's cutting grass or something during their downtime.
Bullets
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why do i need to bring an engine to a MVC just block MORE lanes of traffic on a highway? traffic control is PDs job. more apparatus, more people=more chance for injury.
46Young said:
Unless you live in NJ, then private independent volunteer EMS organizations existed as early as 1927 and realistically existed prior to that
adamjh3
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If that BRT is placed correctly it has more of a chance of deflecting the vehicle of an inattentive motorist. Car not going through scene = less chance of injury. Besides, an MVC with entrapment is already likely taking up a couple lanes of traffic, better to put a barrier there than a cop with a vest and flashlight.
dixie_flatline
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I agree! Anything that has to do with a patient's care is totally tied to patient extrication and rescue. Let's follow this concept!
So, an accident that needs patients extricated is DEF tied to patient care. This will require hydraulics which need a generator. We'll need a pump and water tank for the charged handline as required by NFPA, as well as proper extrication PPE, and possibly struts/jacks/rams/airbags/cribbing. This may also require set of irons, and cutter for the batteries. Also, a saw or two couldn't hurt, with extra blades and batteries/fuel. Also, tarps. If the vehicle is engulfed when we arrive, we would need airpacks to extinguish it, as required by both NFPA and OSHA. I would want to extinguish it myself to ensure I don't cause steam burns to my patient. If it's dark out, we'll need a light tower.... or four.
BUT WAIT! Little Timmy just fell down the well and is injured! Well now we'll need properly trained people, and at a minimum a few hundred feet of life-safety rope, a tripod, harnesses, rack, and other proper tech-rescue equipment and training. If this well is far from a roadway or down a ravine, we could also use a stokes basket and more rope and manpower, all rescue- and medical-related, of course.
But now, a tank is leaking some fertilizer and people are sick! Clearly only rescue-trained Paramedics can save they day, and we need to get to our patients. I now require Level A suits to go with my SCBAs, along with proper decontamination equipment and that watertank/pump/hose combination again. I'll retrieve and decon these people myself to ENSURE proper patient care.
What's that, a person swept away from a ditch during a storm? Well good thing we have our RIB and lifejacks (floaties?) along with cold-water-immersion suits, because when they patient gets onboard I'll need to monitor them for hypothermia, initiate rewarming, and possibly even perform CPR or intubation immediately.
And then I got to thinking, what if there's a workplace shooting and people are wounded inside? There's been multiple instances of workplace or school violence where deaths occur because rapid care wasn't given to victims. And I need to save them, so my rescue team will need ballistic helmets and protective vests, possibly shields. But now to protect ourselves and our patients, we'll all need to be armed. No sense going about this half-arsed.
....On second thought, maybe a tank, so we can just DRIVE ON IN THERE TO EXTRACT THEM OURSELVES.h34r:
tl;dr - I get it, EMS is still the redheaded step-child that is trying to make a name for itself. Fire is the bratty older brother who always gets the cool stuff and gets what it wants. The fact remains, we are three pillars of public service that cannot stand alone without the other two. We should each stick to what we do best. There's no denying, our common goal is proper service to our patient. My job is patient care, and if I feel there's an issue with my patient or extrication, I'll speak to the person doing it. Otherwise, I don't care who cuts the damn car, as long as my patient gets out. I am VERY EMS-oriented, and stress proper patient care at all times. But turning over anything related to patient treatment to us? It's a bit much.
This is in the running for my favorite comment of the year. How can anyone expect EMS to do extrication (unless you just give all of the heavy rescue pieces to the EMS squads)? With the Glidescope and CPAP and Autopulse and whatever new toy comes out next year, we can barely fit all of the medical crap on the ambulance. There certainly isn't room for cribbing, air bags, saws, and the million other things that you need for an entrapment rescue. Even so, then you get too much overlap because a lot of the equipment on the rescue pieces can also be used in a myriad of fire-type calls, so the fire department would still need rescue-type apparatus, and then the municipality would be paying twice for similar units (not that government ever operates rationally).
As for you - sorry, but no. Even though the cops in our area actually have a great relationship with the Fire Department, they still operate under their own ABC's mentality - Ambulances Before Cops. Namely, they will park in front of the ambo if at all possible, and use cones and flares to try and divert traffic. They try, but cannot always guarantee a closed-off, safe operating area. It's not like we can technically even give orders that the cops have to follow - and we certainly can't pull up and wait 10 minutes for all of the cruisers to get there and finish pushing traffic away from the scene before we start our operations.
Using a heavy piece to provide a shadow to work in is the only way I've seen to rapidly establish a relatively safe work environment. An 18-wheeler going at speed would probably still ruin everyone's night, but the squad or engine give you the best coverage/protection.
DrParasite
The fire extinguisher is not just for show
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other Rescue units from your state:
http://www.carsrescue.org/ which has eight advanced life ambulances (medic units), three advanced life support quick response cars (zone cars), two heavy rescue trucks (squads), a water rescue truck with two boats, a technical rescue truck, a collapse rescue trailer, a command car, a mass causality incident truck and a special events bicycle response team with support trailer
http://www.rescue14.com/ 6 ALS certified ambulances 1 BLS certified ambulance1 heavy rescue/squad truck (ALS certified - non-transport) 1 support/utility vehicle (ALS certified - non-transport) 2 medically equipped response cart
I'm sure there are more but I'm too lazy to find ever non-fire based Rescue Squad in your state. The only reason I bring this up is because many EMS agencies do rescue too, or have expanded their operations to fill a need. and many do it without the tax funding that is provided to fire departments (and yes, I think CARS even operates as a Truck Company at working fires, despite being an EMS organization). So that all hazards idea isn't limited to just the fire service.
agree 100%, wish more people followed this way of thinking in their operations.
lifting the vehicle using the spreaders isn't the problem. i wouldn't do it, but I was told that it is an approved way to lifte the car, especially in an life saving situation.
the biggest problem with this operation was when they lifted an inch, they didn't crib an inch. so when the tool failed, instead of having the car come down and inch on the cribbing, it came down hard on the victim's head.
I find that very hard to believe that any ESU cop has never done a cut job in their career. I have seen and heard multiple ESU units respond cross borough for a pin job (and sometimes cross borough lines), they can jump calls anytime they want, and often race to calls. plus with the call volume of NYC, I find it very hard to believe that they have never in their entire crew done a cut, unless they were a pair of newbie ESU officers.
One other thing to remember, every Truck company in FDNY has a cutter, spreader, ram, and set of airbags. In this case, it was the truck company that was extricating, not the Heavy Rescue. Not only that, but on more and more extrication jobs, the BC is returning the Rescue and Squad, since the truck company has the patient extricated before they even get on scene.
Bullets
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I expect EMS to do extrication by doing EXACTLY what you propose, giving all the equipment to the EMS Agency. I know engines carry basic extrication equipment, but any Fire Co ive seen that does heavy work has a separate vehicle that contains all the equipment needed for Tech rescue, confined space, collapse, rope, ect. So if your going to have a separate vehicle, why cant EMS have that vehicle? You wouldnt have two vehicles, you would have one, and it would be EMS's
We rarely have fire on MVC's in either of the jurisdictions i work in. They are used for entrapment and they just pull a line for possible fire suppression. otherwise they just sit there and i will explain why.
This applies for two towns about 40miles apart that i work for, its the same situation in both town. At any time there are 2-3 ambulances staffed in each town. one of these crews is a rescue crew. IF a call requires rescue equipment, that crew rolls the Heavy and another rolls an ambulance. At the same time, the volly FF are paged, respond from home, get a engine and then respond to the scene. By the time FF get to the MVC, EMS is in the car, cutting and extricating. So unless im cutting, we dont bring fire because its a hazard to have volleys bluelight it from their home then run code 1 all the way to the call.
EMS has and will continue to be the sole operator of heavy/tech rescues in both areas in which i work. i like it because it streamlines operation, we dont have pissing contests with fire
Also, LEOs dont like FF because they generally cause problems and interfere
dixie_flatline
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I guess we are kind of talking past each other. Our experience is with two vastly different systems - I work in a combined career/vollie department, in which Fire handles Suppression and EMS both. I don't have enough experience with how your type of system actually works to carry on an intelligent debate with so many variables changed.
I'll acknowledge that in your area, with the constraints of volunteers responding (no such thing as blue lighters in MD, no POV responses period) and such, you may very well be correct in your assessment. If the fire department in unstaffed during the day and cannot guarantee any kind of timely response (equal or better than the EMS units), then they probably shouldn't have the keys for the primary extrication pieces. I stand by my department in this area though, as having that fire apparatus blocking traffic has undoubtedly saved my bacon before.
Bullets
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I guess i wasnt clear. In my system, when fire does respond to stuff on major highways, they usually block lanes that do not need to be closed, obstruct scenes and get in arguments with LEO and EMS over command and scene control. Many times when EMS is operating in the shoulder or a high way, fire will arrive and block the right lane or two. This results in FD and PD arguing, PD telling fire to get off the scene or move the apparatus, FD saying they are involved in the scene somehow and refusing to move. Ive seen engines towed off the highway and Fire chiefs handcuffed and booked by PD.
Thats why EMS or PD tries to determine if FD is needed quickly and if not, cx them as fast as possible. FD is generally found to be a nuisance
LondonMedic
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What the :censored::censored::censored::censored: is wrong with you people?
dixie_flatline
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Uh.... what?
The list is long and distinguished, but you'll have to be a little more specific.
There's a reason why you need a suppression unit to block the scene - there are numerous instances of near misses, responders actually getting hit, and even LODD's from lack of protection. If you give frustrated drivers even the smallest amount of space, they'll try and squeeze through the scene. I've almost been hit myself. People feel they are self important, and only care about getting past the scene, in any way possible, to get where they're going without regard to anyone else. We have pictures from a few of our engines that have been struck from behind, sometimes at highway speed!
You're placing a lot of trust in other drivers if you're willing to leave yourself exposed like that when working an MVA. Besides there being drunks on the road, you also have a scourge of distracted driving - drivers eating, playing with the radio, dialing through their ipod, texting, nodding off at the wheel, fixating and trying to follow their GPS, etc. We didn't get any engine coverage in NYC unless it was a cut job, and I almost got run over more than a few times.
The FD resources are absolutely correct in taking extra lanes. We're taught to take any lanes involved in the incident, plus one extra lane. There have been too many documented collisions and near misses to not have this policy. You can blame all the poor drivers out there for this line of thinking. The engine will be positioned at an angle in such a way that if it gets hit (which it does, on occasion, good thing it's there!), it will roll away from the scene, not into it.
What's going to do a better job of protecting you, a police cruiser, or a 40+ ft. engine?
If lack of resources precludes your area from having this type of coverage, then this is moot. Otherwise, this is standard practice for many other places.
I work the I495/95/395 "mixing bowl" in Northern Virginia. You wouldn't believe the amount of stupidity and carnage I've seen here. So many loops and turns, the directions change without changing direction (example, 495 outer loop south becomes 495 north after going through the bowl), the GPS has people cutting across four or five lanes, etc.
What I meant is that there are many EMS organizations that came into existence in the 40's, 50's, 60's, and 70's. It's difficult to say that one type of system should replace all others when the one you work came into existence much later than other, differently structured systems.
My point is that no one delivery model can claim that they have "rights" to EMS, and can say that other types of systems should not be in place.
That remindes me, the engine is supposed to park behind the scene, and the ambulance is supposed to park in front of the scene. A police cruiser, or even two, simply cannot effectively protect a highway scene, or a busy intersection for that matter, especially if they're in front of the scene instead of behind it, where the suppression unit would be.
Not that my opinion is important in anyway, But I figure I'd chime in just because I'm in the middle on this.
In our area, we work extremely well with our Fire and Law. We have both "County" and "City" Fire and Law. Fire is mixed, some stations Voly, some Paid.
Depending on the call, everyone may respond. Law for just about any situation that may become dangerous. Fire one "major" calls, which really is our higher priority Breathers, and Chest Pains. Everyone responds to things like Cardiac Arrests, MVA's, and anything else we request them for. Such as Man Power, Crowd Control, and so on.
Law handles combative patients (Aside from ones that are medical issues, such as Hypoglycemics), large crowds, traffic control, and bystander that may be or become dangerous. And even can assist us with basic medical stuff. Some are great about holding pressure on wounds, even doing compressions and so on.
Fire handles (or is in charge of) the more "Physical things" such as Extrication, pulling people out of holes, moving cars from the road, fuel spills from MVA's., and so on They also a great assistance to Patient care, (some are EMT's or Medics) Fire Fighters help us a lot on Cardiac Arrests and other major calls depending on their scope of practice, back boarding, oxygen applications, and other stuff.
EMS is absolutely in charge of anything Medical, even in the presence of a fire Medic, once we are on scene.
Some Pros and Cons:
Fire sometimes do some pretty crazy things with Medical Patients. Mostly just because they aren't around them that often or it's just their training. Such as Every Breather we get is always on a NRB (hopefully) at 12LPM, even if they really don't need it.
I like Fire doing extrication, and they do it well (Which there are only a couple FD's here that can do complex extrication). The reason being is that we (EMS) can Focus all of our attention on Patient Care.
Fire is a little overstaffed, and EMS a little understaffed. And Average day for an EMS crew is about 7-13 calls in a 12-hour shift. Each FD average is about 2-5. But on the same token, there are about +5 FD's in our area for a day shift, and about +9 FD's on any night shift (Due to the lack of EMS Units).
Law is great. They help us directly if they can. If Not, they always find something useful to do.
Aside from a few bad apples, everyone once they get on scene asks "Where are we at? Let me start my job. And After that, What can I help you with?"
The Biggest thing I think, is that EVERYONE communicates with each other. No stone is left unturned by at least two people. If anyone is just standing around because they are out of things they can do, they help someone else with their tasks at hand until everything is taken care of.
In my personal opinion, Law has their place and job, Fire has their place and job, EMS has there place and job. And We all have our Primary functions, but when it boils down to it, everyone is multipurpose.
Law, Fire, and EMS, all have one thing in common. We are all public servants. Sometimes we have to step out of our norm to do the most good. If that means I'm running emergency just to teach a new mother how to give her baby Tylenol, then let it be so. At least I helped.
Lastly, Everyone Has The Same Goals: Make sure we are safe. Make sure our partners are safe. Make sure the public is safe. Make sure we do everything that we can. And Go Home Alive.
In our area, we work extremely well with our Fire and Law. We have both "County" and "City" Fire and Law. Fire is mixed, some stations Voly, some Paid.
Depending on the call, everyone may respond. Law for just about any situation that may become dangerous. Fire one "major" calls, which really is our higher priority Breathers, and Chest Pains. Everyone responds to things like Cardiac Arrests, MVA's, and anything else we request them for. Such as Man Power, Crowd Control, and so on.
Law handles combative patients (Aside from ones that are medical issues, such as Hypoglycemics), large crowds, traffic control, and bystander that may be or become dangerous. And even can assist us with basic medical stuff. Some are great about holding pressure on wounds, even doing compressions and so on.
Fire handles (or is in charge of) the more "Physical things" such as Extrication, pulling people out of holes, moving cars from the road, fuel spills from MVA's., and so on They also a great assistance to Patient care, (some are EMT's or Medics) Fire Fighters help us a lot on Cardiac Arrests and other major calls depending on their scope of practice, back boarding, oxygen applications, and other stuff.
EMS is absolutely in charge of anything Medical, even in the presence of a fire Medic, once we are on scene.
Some Pros and Cons:
Fire sometimes do some pretty crazy things with Medical Patients. Mostly just because they aren't around them that often or it's just their training. Such as Every Breather we get is always on a NRB (hopefully) at 12LPM, even if they really don't need it.
I like Fire doing extrication, and they do it well (Which there are only a couple FD's here that can do complex extrication). The reason being is that we (EMS) can Focus all of our attention on Patient Care.
Fire is a little overstaffed, and EMS a little understaffed. And Average day for an EMS crew is about 7-13 calls in a 12-hour shift. Each FD average is about 2-5. But on the same token, there are about +5 FD's in our area for a day shift, and about +9 FD's on any night shift (Due to the lack of EMS Units).
Law is great. They help us directly if they can. If Not, they always find something useful to do.
Aside from a few bad apples, everyone once they get on scene asks "Where are we at? Let me start my job. And After that, What can I help you with?"
The Biggest thing I think, is that EVERYONE communicates with each other. No stone is left unturned by at least two people. If anyone is just standing around because they are out of things they can do, they help someone else with their tasks at hand until everything is taken care of.
In my personal opinion, Law has their place and job, Fire has their place and job, EMS has there place and job. And We all have our Primary functions, but when it boils down to it, everyone is multipurpose.
Law, Fire, and EMS, all have one thing in common. We are all public servants. Sometimes we have to step out of our norm to do the most good. If that means I'm running emergency just to teach a new mother how to give her baby Tylenol, then let it be so. At least I helped.
Lastly, Everyone Has The Same Goals: Make sure we are safe. Make sure our partners are safe. Make sure the public is safe. Make sure we do everything that we can. And Go Home Alive.
Bullets
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I guess i see what you mean, and i am all to familar with how people respond to traffic diversion, i make my living dealing with traffic, EMS is just my supplemental job. However, i work on the New Jersey Turnpike, Garden State Parkway, I287/440, US 1/9, SH 35, 18, so i work on plenty of limited access highways and multilane state highways and we just dont have FD rsources on 99% of the emergent activity i deal with, be it EMS or PD and we i think we have had a handful of close calls. NJSP does a great job protecting EMS, and the local LEOs have enough units to cover us
Saturday night i had the opportunity to work with UMDNJ Rescue 1, and they were an excellent rescue squad and a perfect example of how EMS can operate extrication effectively. also, here is a whole bunch of EMS operated rescue vehicles
http://njfirepictures.smugmug.com/F...47760_nNHyC/4/130318449_nzzVH#614945789_P9BQD
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