My Little Story About FD vs EMS

[mycrofft]

Many firefighters are nurses, PAs, RTs, EMT/medics.

The trouble is that those who are, often keep it to themselves. They don't want it to be known that they may have a clue what is going on and how to help the patient. Mind you, they are under no circumstance permitted to act past the level of a CFR. Their purpose on scene is to help life and carry and to assist with CPR.

As far as keeping skills sharp, they usually work elsewhere on the side. Like I said they just keep that to themselves on jobs.

As far as applicants, there are plenty of good applicants. 41,000 of them this year to be exact. Unfortunately with a job so desirable, if you want to get it you are going to have to serve your time in EMS. If you aren't willing to put in that extra minimum 2 years in EMS effort, then you must not want it THAT badly.

Medical people who voluntarily join the FD to be a firefighter? Well, they're the sort who run INTO burning buildings, so it figures.

Since it is axiomatic that the majority of calls are medically related in one way or another, it makes sense, although I cannot believe that no one's cousin or nephew hasn't/might not get "a little help until they get onto an engine".

 

[Aidey]

I think part of the story is fires utter lack of action. When Linuss talked about it before, all they did was stand around. Even in an open space PPV is an option to reduce risk around the car. Or even a fog nozzle over everything while doing a rapid extrication.

I can also believe agonal /ineffective breathing lasted for 40 minutes. Think about how long some terminal pts last with abnormal breathing.

 

[abckidsmom]

Who said anything about unstabilized?

You carry struts and cribbing on your ambulance? You said you got their first, and they stopped you when they got on scene. Who stabilized the vehicle?

As safe as it could be, considering. You've been in EMS long enough to know it's never 100% safe and there are risks that are taken, and it's up to each individual provider to decide on their own what level of risk they will accept.

However, it's my decision and not some FFs that not in anyway in charge of me.



I'm going to go with the fact that the ambulance medic is the higher credentialed provider, and that their name is attached to the patient in the end.

You didn't hear me though. What if they are wrong?? I want people to call me on stuff if I'm doing something that's wrong, and I do my best to hear them and understand what they're saying in that moment, and sometimes I don't.

Did you read about Crew Resource Management in that other thread the other day? It was very interesting.

Thing is, it generally (99% of the time) is not that way. A perfect storm, perhaps?

The Big One typically brings this on. A van and a semi into a house will tend to bring out the big emotions.

Agreed, but in the end it's my decision, not someone elses.





Like I said, couldn't include too much without divulging the actual incident, the agencies involved, etc. However, at 4 years doing this, I'd like to think I would not be compared to an ignorant kid running around a dangerous scene playing with matches...

Even approaching a vehicle on an angle in a gas leak expecting to work is the same thing. If you smell something when you get out of your ambulance, the first and only thing you should do when at that point is stay back and get the people back.

The guy who goes to turn the valve off should have on full PPE with SCBA, and no one should be in the densest area of gas before that's done.

Doing anything else is equivalent to playing with matches. It's just not the smartest thing.

 

[NYMedic828]

Medical people who voluntarily join the FD to be a firefighter? Well, they're the sort who run INTO burning buildings, so it figures.

Since it is axiomatic that the majority of calls are medically related in one way or another, it makes sense, although I cannot believe that no one's cousin or nephew hasn't/might not get "a little help until they get onto an engine".

The system that revolves around the NYC hiring process is has substantial checks and balanced. It is competitive civil service and there is no other way to be hired whatsoever other than the legitimate routes.

Many chief's sons actually work as EMTs because they knew a long time ago it was the only way to get made.

Unless of course you would like to defraud the city and be arrested on felony charges.

Whenever someone tells me "o yea my uncle is a chief I'm gonna be in the next academy" I shut them down pretty quickly. They usually walk away with their head hanging.

 

[Bullets]

Even approaching a vehicle on an angle in a gas leak expecting to work is the same thing. If you smell something when you get out of your ambulance, the first and only thing you should do when at that point is stay back and get the people back.

The guy who goes to turn the valve off should have on full PPE with SCBA, and no one should be in the densest area of gas before that's done.

Doing anything else is equivalent to playing with matches. It's just not the smartest thing.

Once the gas is shut off, there is no huge cloud of gas that lingers in an open air environment. Natural gas is lighter than air, and will disperse immediately. The additive that smells like rotten eggs is heavier and sinks. In an open leak the gas and the additive separate. I was operating at a leak two days ago. at 5ft the LEL was 100%, We closed the valve and had a 0% LEL reading less than 60 seconds later at the same distance

 

[abckidsmom]

Once the gas is shut off, there is no huge cloud of gas that lingers in an open air environment. Natural gas is lighter than air, and will disperse immediately. The additive that smells like rotten eggs is heavier and sinks. In an open leak the gas and the additive separate. I was operating at a leak two days ago. at 5ft the LEL was 100%, We closed the valve and had a 0% LEL reading less than 60 seconds later at the same distance

But until the gas is shut off, you have to behave as if the gas is on. Right?

 

[NYMedic828]

Once the gas is shut off, there is no huge cloud of gas that lingers in an open air environment. Natural gas is lighter than air, and will disperse immediately. The additive that smells like rotten eggs is heavier and sinks. In an open leak the gas and the additive separate. I was operating at a leak two days ago. at 5ft the LEL was 100%, We closed the valve and had a 0% LEL reading less than 60 seconds later at the same distance

Actually you are incorrect. Ethyl-mercaptan, the substance added to "natural gasses" which are otherwise odorless, is in fact lighter than air the same as the gas itself is.

The density of air is aprox 1.25. The density of natural gasses is usually 0.6-0.8. Ethyl-mercaptan is at a density of aprox. 0.8. If you still smell it, there is still gas in your presence.

Granted if your meter is not picking it up, the amount is not substantial enough to pose immediate threat.

Olfactory sensors are HIGHLY receptive to exceptionally minimal amounts of Ethyl-mercaptan. Just because your meter isn't as sensitive as your olfactory senses doesn't mean the gas is gone.

 

[VFlutter]

But until the gas is shut off, you have to behave as if the gas is on. Right?

But in this situation the gas was shut off and the accident scene was in an open air environment. I would think the risk is minimal

 

[WTEngel]

I worked a gas leak about 8 years ago and the guy from the gas company was in a trench, with gas leaking around him, hammering away with a pick at this pipe, leaking natural gas. The only thing that could have made it more of a caricature of UNsafety was if he had a pipe lit up while he was doing it!

When I went to HazMat tech school, we learned that sometimes the safest area is actually in the densest area of gas. It is too rich to ignite, like when a vehicle's carb gets flooded. I am by no means advocating that anyone run and seek refuge within the vapor cloud...it is just food for thought.

I guess this guy working on that pipe was either extremely smart, extremely stupid, had balls the size of cantaloupes, or some combination of two out of those 3. I didn't hang around too close to ask...

At any rate, this isn't in any way really related to the incident Linuss is talking about. Just thought I would throw it out there.

Linuss, you're going to have to move on brother. Perhaps the firefighter was a bit too high strung and authoritative, and perhaps you were a bit too cavalier. Saying that no one is going to tell you what to do is a losing argument though. And I say this as a friend (whom you've never actually met...)

CRM and team work talk aside, this is one of those situations where admin from both sides should have stepped in, and both crews should have been debriefed about the incident. There probably was no truly "right" party to this matter, but that doesn't mean both organizations should let it fester. Ultimately patient care and safety is always effected when crews working relationships fall apart.

 

[mycrofft]

Maybe he had a nonsparking pick?

Once one's nose has had a shot of mercaptan, some folks' noses will keep registering it, others report they stop smelling it even if still in it, sort of like hydrogen sulphide.

Explosimeter anyone?

 

[WTEngel]

I had considered he was working with non sparking tools, however, it was still a pit of fumes! lol

The gas got fixed anyway and no mushroom clouds were seen. It makes for a good little war story from time to time...

 

[mycrofft]

No such things as:

Non sparking tools
Firearm safeties
Friendly fire
Non-skid brakes
Foolproof.

 

[Veneficus]

Maybe the guy just really understood UEL and LEL.

Quiz: how many of you fire guys know the material that has the highest range of UEL-LEL?

(hint, 97% and 3% respectively)

Oh and hazmat uses nonsparking beryllium tools, they cost a fortune.

 

[WTEngel]

That's my point. He either really understood it, or had no clue...

 

[DrParasite]

You carry struts and cribbing on your ambulance? You said you got their first, and they stopped you when they got on scene. Who stabilized the vehicle?

struts? no. cribbing/step chocks/wheel chocks? absolutely. not enough to deal with a rollover, but enough to get started until the rescue arrives.

 

[Chief Complaint]

No such things as:

Non sparking tools
Firearm safeties
Friendly fire
Non-skid brakes
Foolproof.

We have non sparking tools.

 

[Bullets]

No such things as:

Non sparking tools
Firearm safeties
Friendly fire
Non-skid brakes
Foolproof.

and intrinsically safe radios

And to Vene, Ethylene Oxide has the range you state, but i remember it being 3.6-100

And Acetylene has a larger range, 2.5-100

 

[Veneficus]

and intrinsically safe radios

And to Vene, Ethylene Oxide has the range you state, but i remember it being 3.6-100

And Acetylene has a larger range, 2.5-100

the numbers I have above for acetylene are from Kirk's Fire Investigation textbook.

I would wager without a much hotter burning material like magnesium, a UEL of 100% is impossible on earth. That whole fire tetrahedron thing.

 

[Bullets]

the numbers I have above for acetylene are from Kirk's Fire Investigation textbook.

I would wager without a much hotter burning material like magnesium, a UEL of 100% is impossible on earth. That whole fire tetrahedron thing.

Ive got the Mathesons gas reference

Yeah I believe these substances only reach 100% in a vacuum