# smoking in the ambulance:



## emt seeking first job (Sep 3, 2010)

One of the issues I have where I vollie is all the people who ride in the buses chain smoke.

There is no ventilation in the back, A/C on one bus is busted.

They don't just smoke, they chain smoke, while driving, or sitting parked.

They only stop to treat a patient.

I noticed in a private once, in the cabin, there were a dozen no smoking stickers...

Is this going to be an issue anywhere I go? 

Rather then speak up, I am just going to leave, its that, one guy who drives weaving lights and sirens for no reason, the personal trips and errands in the buses, and the overly vulgar discussions (as there are no females in the service).

So on the smoking issue, what do people think?

I have seen people smoke outside a bus before, but never in it. Is it that coomon?


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## EMT11KDL (Sep 3, 2010)

with one of my departments, there is a no smoking policy, meaning when you step onto the property no smoking.... most of our guys chew though so that truly isnt a problem with that department.  

the other department i work for, the only rule they have is you cannot smoke inside the bus or in the station.  we actually have a picnic table outside the station just for people to sit and smoke at


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## Sassafras (Sep 3, 2010)

As one of the few females many times I am the only girl on shift...the vulgar talk is there, the smoking is there.  The chain smokers can and do smoke in the rigs between patients.  I've come to the conclusion that until it hinders patient care it's just not a fight I'm ready to fight.  Perhaps in years to come as I gain confidence, but until then I'm not ready to burn bridges.


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## Shishkabob (Sep 3, 2010)

No smoking in or near an ambulance, ever.  It has O2 tanks and signs that claim as such.


If my partner starts smoking, they get kicked out, not only for the O2 tanks, but because smoke makes me light headed, and I don't want my health f'ed up for their vice.


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## akflightmedic (Sep 3, 2010)

First, NO ONE will ever smoke in an ambulance I am riding in or one that I am affiliated with, period. I would even say something to people I am NOT affiliated with.

You have every right to speak up and you should. To say until it hinders patient care...What the heck does that mean?? When you load the severe allergy patient in the truck and they react to lingering smoke, then you will worry about it?? Does that make any sense?

If the stupidity of doing this is not enough, then rest assured you have the Federal and state laws on your side. OSHA has mandates about this and there are only a few states which are not OSHA states but they can be Non OSHA states because their own policies/laws meet or exceed the federal ones, so essentially it is all the same.

Here is a reference for you:

OSHA regulations state that there shall be no smoking within 20 feet of any compressed cylinder including oxygen (29 CFR 1910.101b). This rules out smoking in any ambulance or EMS response vehicle as well as within most garages or apparatus bays where EMS vehicles are housed. This sentiment is echoed by the National Fire Protection Association (NFPA) in their standards.

Also in regards to a PR perspective:

In addition to all of the known health and safety related aspects of smoking, the public relations perspective must also be examined. The health care community has repeatedly indicated the hazards of smoking. As a professional representative of the healthcare community, EMS providers must support the public health warnings and not permit smoking in the health care environment. Disregarding this may lessen the public confidence and understanding of EMS professionals as health care providers.


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## medic417 (Sep 3, 2010)

Very unprofessional.  Patients with severe respiratory problems are suffering because of exposure to the smoke that is in the ambulance and even on the clothes of those treating them.  Any service that allows smoking in the ambulance should be shut down.


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## emt seeking first job (Sep 3, 2010)

Sassafrass, I hear you, better not make waves.

Is the policy not to smoke in the bus? Is it constant.

I could handle aone cigarette every two hours, but literally, they chain smoke.

I have not seen such a large group of chain smokers in the USA, ever, reminds me of Russia 20 years ago.

The vulgar talk is out of hand. They circle the block to follow girls walking. One guy will say "hi", over the PA system.

Its beyond vulgar, beyond saying, "oooo, she is nice..."

AND they mess around on the radio constantly....even though they all have a "blackberry group..."

The sads thing is the President is a straight up guy, he puts up with them because otherwise he there would NEVER be any buses on the road....ever.

I pray another vollie takes me.....


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## emt seeking first job (Sep 3, 2010)

The one time I did do something was when I was with one guy in the basement, we were assigned to clear a path to the meters.

It was dusty, full of debris, O2 tanks, who knows what else, some gas cans even...

I just said, dude, this aint the best place to smoke, the guy shrugged, I just walked away.


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## emt seeking first job (Sep 3, 2010)

akflightmedic said:


> First, NO ONE will ever smoke in an ambulance I am riding in or one that I am affiliated with, period. I would even say something to people I am NOT affiliated with.
> 
> You have every right to speak up and you should. To say until it hinders patient care...What the heck does that mean?? When you load the severe allergy patient in the truck and they react to lingering smoke, then you will worry about it?? Does that make any sense?
> 
> ...



As one of dozens of EMT-b card holders with no experience in NYC, it serves me better to quietly move on.


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## akflightmedic (Sep 3, 2010)

Sassafras said:


> As one of the few females many times I am the only girl on shift...the vulgar talk is there, the smoking is there.  The chain smokers can and do smoke in the rigs between patients.  I've come to the conclusion that until it hinders patient care it's just not a fight I'm ready to fight.  Perhaps in years to come as I gain confidence, but until then I'm not ready to burn bridges.



And when that time comes, your argument will be weak and lack credibility as you tolerated it and enabled it during this "confidence gaining phase". If something bothers you now, you have every right to speak up now. Waiting to do so, it will then be assumed you are doing it for other reasons...


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## akflightmedic (Sep 3, 2010)

Here is the NY State policy:

No Smoking Policy
Bureau of EMS Policy Statement
Policy Statement #	00-07
Date	08/16/00
Subject	Re: No Smoking Policy
Supercedes/Updates	89-10

Policy:

It is the policy of the Bureau of EMS that there should be no smoking in or around any ambulance or EMS response vehicle at any time. This includes vehicle garages and apparatus bays, as well as during an EMS response in which patients are being treated. Smoking should be restricted to defined areas. It is recommended that smoking and/or loitering be prohibited in stairwells, vestibules, entrances and exits.

All provider agencies need to develop and institute policies consistent with this Policy Statement

Authorized by: Edward G. Wronski, Director


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## emt seeking first job (Sep 3, 2010)

AK, there is a big gap, between what is said and what is done.

IMHO, people should choose his or her battles wisely.


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## Shishkabob (Sep 3, 2010)

Hey, if you don't care about your safety and health, that's up to you, but that's where I put my foot down and force my way with people.  They can smoke if they want, but not in the truck, and not near me.

If they continue to smoke in the truck, I make a phone call to the supervisor.  We'll see who wins that one.


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## akflightmedic (Sep 3, 2010)

Not only for yourself, but you must be a patient advocate. If you are not strong enough to defend yourself, then obviously you can not defend your patients health.


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## emt seeking first job (Sep 3, 2010)

Linuss said:


> Hey, if you don't care about your safety and health, that's up to you, but that's where I put my foot down and force my way with people.  They can smoke if they want, but not in the truck, and not near me.
> 
> If they continue to smoke in the truck, I make a phone call to the supervisor.  We'll see who wins that one.



Linuss, probably if it were a paid service. However, it is a vollie, and one that has really only two people willing and able to crew chief on a weekly basis.

One guy is mostly cool but he is influenced heavily by the other guy, a competent EMT but very arrogant. If it were not for him, they would really have nobody that can really handle "it all".....

I care about health and safety. But lets say I see that going on, as a bystander, what would or could I do ?


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## 94H (Sep 3, 2010)

No way is smoking allowed in an Ambulance

Vollie or not, its unprofessional, dangerous and illegal

Just leave this place already


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## emt seeking first job (Sep 3, 2010)

94H said:


> No way is smoking allowed in an Ambulance
> 
> Vollie or not, its unprofessional, dangerous and illegal
> 
> Just leave this place already



I am.

I am just concerned I will find the same problem somewhere else, 94H.


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## MasterIntubator (Sep 3, 2010)

Dude,  it is not your battle, it is not your rule.  Its an enforceable rule set-forth by governing agencies bigger then your agency and there is nothing they can do to you for making it known.  Verbalize it.  If nothing happens, make a phone call.  There are no exceptions, and if you fail at reporting it, then you can be held just as responsible.
It is kinda like being a state mandated reporter for elderly/child abuse.  You have no choice about reporting it, or be prepared for consequenses.   This IS our job.  Safety.


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## medic417 (Sep 3, 2010)

As we now see it is illegal it is your responsibility to report it.  Failure to report makes you as guilty as they are.


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## 94H (Sep 3, 2010)

emt seeking first job said:


> I am.
> 
> I am just concerned I will find the same problem somewhere else, 94H.



I dont think your gonna see that problem at most places. Thats a pretty solidly followed rule


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## EMT11KDL (Sep 3, 2010)

94H said:


> I dont think your gonna see that problem at most places. Thats a pretty solidly followed rule



I have worked with multiple agencies and all of them have NON smoking policy when in the rigs and stations.. most of the agencies allow there personal to smoke outside in a certain area.  I am extremely shocked that the agency you are currently with allow them to smoke.


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## ZVNEMT (Sep 3, 2010)

all of my partners smoke, I do not. If they need a smoke, I make them do it outside. My lungs don't have to tolerate their carcinogenic inhalation habits...


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## fortsmithman (Sep 3, 2010)

Here in the Northwest Territories it is an offence to smoke cigarettes in any workplace.  I think the fine is 5000.00.  I believe in the province of British Columbia it's an offence to smoke in any vehicle if there is a person under the age of 16.  I don't know what the fine is but it's my understanding that demerit points are added to the DL.


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## medicman90 (Sep 3, 2010)

Used to smoke.

I quit for my health...but with my vollie service I was allowed to smoke.

On the property, not in any buildings and without a doubt NOT in the apparatus.

Occasionally in the bay, but...not really, and I only did when all the garage doors were opened up. We have *huge* bay doors.


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## Outbac1 (Sep 3, 2010)

Here no one is allowed to smoke in the vehicles or bases. Provincially no one is allowed to smoke in a public place. This includes stores, restaurants, government bldgs. etc.

  I would not let anyone smoke in a vehicle I was in.


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## LucidResq (Sep 4, 2010)

There are no good excuses for failing to confront or report illegal activity that puts patient health, safety and comfort in jeopardy. 

Sorry, it may be uncomfortable, but even if you're leaving I think the most ethical thing to do would be to at least bring it to the attention of someone who can take action on it after you're gone.


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## reaper (Sep 4, 2010)

I am a smoker and never smoke in the unit. Not because of the oxygen myth that is projected, but because it is very bad for asthma Pt's and anyone who is allergic to smoke. The ambulance is there for the Pt's, not for our leisure!


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## Phlipper (Sep 4, 2010)

emt seeking first job said:


> Sassafrass, I hear you, better not make waves.
> 
> Is the policy not to smoke in the bus? Is it constant.
> 
> ...



In the short time I have been involved with EMS I have already heard a ton of jokes, jabs, and comments from fire, LE, and civilians about EMTs/Paras being overweight, goofy, and generally unprofessional.  And I have to be honest ... many were right on the money.

If we want to be treated (and payed) like educated professionals we have to act like professionals.  It starts with us.  Being 50 pounds overweight, chain smoking on a call (much less in the truck!), and making crude comments around other public service and medical staff is NOT the way to remedy this.


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## Leonidas1 (Sep 4, 2010)

I finished a 24 earlier today, and my partner smoked at least 4 times (total) in the rig. I smoked for 20 years (quit 07/2005 with nicoderm CQ, it works), so personally the smell doesn`t bother me. But, if a Paramedic choses to give the public a negative perception of himself (by smoking while driving an ambulance), that`s up to him. In addition, the company that I work for has a great number of employees who just don`t give a _ _ _ _. And if you ask them, they will tell you such. It`s sad to say, but a lot of EMT-B`s and EMT-P`s who work for the private ambulance companies in Chicago, have no sense of pride. It wasn`t like this when I started (2002).

Said the patient sluggishly...."I spent 25 dollas fo dis groove I`m on. I know you ain`t about kill it wit dat narkin?"


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## reaper (Sep 4, 2010)

Phlipper said:


> In the short time I have been involved with EMS I have already heard a ton of jokes, jabs, and comments from fire, LE, and civilians about EMTs/Paras being overweight, goofy, and generally unprofessional.  And I have to be honest ... many were right on the money.
> 
> If we want to be treated (and payed) like educated professionals we have to act like professionals.  It starts with us.  Being 50 pounds overweight, chain smoking on a call (much less in the truck!), and making crude comments around other public service and medical staff is NOT the way to remedy this.



How does this differ from the LEO/FD/Nurses that are the same way?


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## Rob123 (Sep 4, 2010)

94H said:


> No way is smoking allowed in an Ambulance
> 
> Vollie or not, its unprofessional, dangerous and illegal
> 
> Just leave this place already


 

Agreed. Pick any other NYC volunteer corp. I'll bet anything that they don't allow smoking, vulgarity and playing with the radio or PA.

Although I don't know which corps you belong to. I can also bet that your neighboring volunteer corps know about the problems at your corp. You probably won't even have to explain why you leaving if you apply elsewhere.


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## Dominion (Sep 5, 2010)

emt seeking first job said:


> One of the issues I have where I vollie is all the people who ride in the buses chain smoke.
> 
> There is no ventilation in the back, A/C on one bus is busted.
> 
> ...



Our policy on smoking is the first time you're caught you and your partner get a write up (unless your partner turned you in).   Second time it's a one week suspension for you and a write up for the partner.  Third time you're gone and your partner gets a write up.  The partner write up thing is more a "you didn't report it, you're just as guilty" type thing.

As far as errands, what's wrong with moving around in your ambulance?  I get the point of running a TON of errands in the truck but if you have to pick up a couple things or run to the post office I don't see the issue.  We are encouraged to ride around our districts and talk to people and learn our areas, part of that is doing an errand if we need to.  As long as we don't leave our response area it's not an issue for us.

Vulgarity, it's ok unless you are being vulgar around a patient or their family members.  As far as around other health professionals, fire, leo, etc. Most of the people around here are just as vulgar if not more so than EMS.


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## emt seeking first job (Sep 5, 2010)

Dominion said:


> Our policy on smoking is the first time you're caught you and your partner get a write up (unless your partner turned you in).   Second time it's a one week suspension for you and a write up for the partner.  Third time you're gone and your partner gets a write up.  The partner write up thing is more a "you didn't report it, you're just as guilty" type thing.
> 
> As far as errands, what's wrong with moving around in your ambulance?  I get the point of running a TON of errands in the truck but if you have to pick up a couple things or run to the post office I don't see the issue.  We are encouraged to ride around our districts and talk to people and learn our areas, part of that is doing an errand if we need to.  As long as we don't leave our response area it's not an issue for us.
> 
> Vulgarity, it's ok unless you are being vulgar around a patient or their family members.  As far as around other health professionals, fire, leo, etc. Most of the people around here are just as vulgar if not more so than EMS.





REGARDING ERRANDS:

The service rarely has buses on the street. IMHO, if we are there for 4-16 hours a week, it is not necessary to do ones errands, hair cuts, shopping, etc during THOSE HOURS.

Besides, in a NYC vollie buffing/jumping calls, seconds count. In fact, any 911 service, seconds count. So aside from a break to get something to nosh on or use the facilities, going into a store, shopping around, waiting online, is just not appropriate.

Buffing requires you be ready to roll, on the street. Another issue is the horrendous driving, not stopping to check at red lights, weaving, following too close, taking turn to quick, often to make up for effing around in some store....

(tounge in cheek) Would you want the service responding to YOUR FAMILY MEMBER's EMERGENCY effing around the smart phone displays in the back of Best Buy when they need help...?

REGARDING VULGARITIES:

The problem with humor is it can get out of hand. Sometimes is extends to following women walking down the street and using the PA for comments. Part of the problem is their are no females in the service to keep things getting too out of hand, without citing examples, it gets WAAAAAY out of hand. Females have come by, and I can see they get creeped out by the vibe of the group. Some of the memebers are so bizarre. Like they have no people skills. Their mannerisms and gestures are wierd.

As always, I say NOTHING, EVER.

One guy even gave a little lecture, telling the other guys how they scare females away...and how it would be nice to have mixed company.

I have been in mixed company, and people joke around, even the women, yet, what goes on here is way out of hand.


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## emt seeking first job (Sep 5, 2010)

Rob123 said:


> Agreed. Pick any other NYC volunteer corp. I'll bet anything that they don't allow smoking, vulgarity and playing with the radio or PA.
> 
> Although I don't know which corps you belong to. I can also bet that your neighboring volunteer corps know about the problems at your corp. You probably won't even have to explain why you leaving if you apply elsewhere.




ROB123, that is what I am hoping for, to bow out gracefully, and quietly, and move on if another service will have me.


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## Aidey (Sep 5, 2010)

emt seeking first job said:


> REGARDING ERRANDS:
> 
> The service rarely has buses on the street. IMHO, if we are there for 4-16 hours a week, it is not necessary to do ones errands, hair cuts, shopping, etc during THOSE HOURS.
> 
> ...



I agree with your statement that people who are only at the ambulance for a few hours at a time don't have a lot of justification for errands aside from the occasional emergency. 

However, as someone who lives in an ambulance 12 hours a day, 3-4 or more days a week, I don't care about people running errands at my job. As long as you can make it into the ambulance in the regulated 2 minutes, where you are or what you were doing isn't a big deal to me. 

Have I run errands? Yup. So has every single person I've ever worked with. As I said, we've got 2 minutes to get in the ambulance and go en route to a call. We have GPS trackers on our ambulances, so they know if you are moving within 2 minutes or not. 

If I have a family member with an emergency I care a heck of a lot more about their training and education and skills as an EMT/Medic than what store they were in when they were dispatched.


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## Aidey (Sep 5, 2010)

Oh, and I can not BELIEVE that in this day and age in a city like NYC buffing/jumping calls is legal. What the heck is the NYC EMS council thinking allowing BS like that to happen? It is stupid on so many levels it makes my head hurt.


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## emt seeking first job (Sep 5, 2010)

Aidey said:


> I agree with your statement that people who are only at the ambulance for a few hours at a time don't have a lot of justification for errands aside from the occasional emergency.
> 
> However, as someone who lives in an ambulance 12 hours a day, 3-4 or more days a week, I don't care about people running errands at my job. As long as you can make it into the ambulance in the regulated 2 minutes, where you are or what you were doing isn't a big deal to me.
> 
> ...




I agree, within reason to errands, so long as it does not put the person in a position where they can not get to the vehicle in two minutes, as you said. So long as they stop what they are doing when they get the call.

That would rule out hair cuts, medical appointments.

When I was an LEO, I did it all the time, I also would coop, however, I never took my belt or boots off.

I did have problems w/ partners disappearing where there was no radio coverage, or taking to long to get to the vehicle.


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## emt seeking first job (Sep 5, 2010)

Aidey said:


> Oh, and I can not BELIEVE that in this day and age in a city like NYC buffing/jumping calls is legal. What the heck is the NYC EMS council thinking allowing BS like that to happen? It is stupid on so many levels it makes my head hurt.




It is an open secret. It is tolerated, sometimes even welcome.

As was posted, years ago when 911 had long waits, people called the vollies, but since the vollies are not staffed round the clock, and culture has changed, almost NOBODY calls directly.

When I first was told about it, my heart sank, however, sometimes in multiple car crashes we are actually welcomed. On critical calls, sometimes ALS asks to go in our bus so they can have four hands to work the patient.

We also respond and standby at a distance during police matters which may result in an EMS request. We are never turned away...

So long as we stand down when asked, let FDNY or hospital EMS call the shots, we are actually welcomed most times. Many of the FDNY and hospital providers either where or even are still in a buffing vollie....


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## emt seeking first job (Sep 5, 2010)

Aidey said:


> Oh, and I can not BELIEVE that in this day and age in a city like NYC buffing/jumping calls is legal. What the heck is the NYC EMS council thinking allowing BS like that to happen? It is stupid on so many levels it makes my head hurt.




All vollies log in with FDNY and are available but according to what I was told they rarely contact vollies, last time being 2009 flu epdiemic.


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## Shishkabob (Sep 5, 2010)

emt seeking first job said:


> Besides, in a NYC vollie buffing/jumping calls, seconds count. In fact, any 911 service, seconds count.




Trust me, if it ever comes to the point where seconds count, it's too late.


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## emt seeking first job (Sep 5, 2010)

Linuss said:


> Trust me, if it ever comes to the point where seconds count, it's too late.



What about minutes ?

What about the difference between four versus eight minutes ?

At the very least, they waste time and gas and if their second loose the potential revenue for the organization....


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## Shishkabob (Sep 5, 2010)

I thought you were speaking clinically, not financially.


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## emt seeking first job (Sep 5, 2010)

Both.

Both the outcome of the patient and the potential revenue.

Is there a difference between bagging or shocking someone in four minutes or in eight ?


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## Dominion (Sep 5, 2010)

We have 1 minute from receiving the dispatch to going enroute.  In the worst case scenario we canm ake that easily.  I've been in the far back of a store and made it from my position to my ambulance in 1 minute 30 something seconds.  Essentially you hear your sector/squad get toned out and you immediately start moving towards where you parked.  Would I ever go to get my hair cut, go to the doctor, etc.  No, hell no.  But I'll certainly get some shopping done or something like that.  Last week I needed to pick up breaks for my car, we got a lull in the day and ran up to Autozone, I picked up my car parts and put them in the truck and we went back.  No biggie.  

I'm also on duty 12-36 hours a day and that makes a huge difference.  Me personally, I don't take my boots off unless I'm on an overnight shift.  Some of my co-workers though take off their boots, socks, undo their belt, and take off their uniform shirt to lay down.  It's a 5 minute ordeal for them to get up and make a call.


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## medicman90 (Sep 7, 2010)

Dominion said:


> We have 1 minute from receiving the dispatch to going enroute.  In the worst case scenario we canm ake that easily.  I've been in the far back of a store and made it from my position to my ambulance in 1 minute 30 something seconds.  Essentially you hear your sector/squad get toned out and you immediately start moving towards where you parked.  Would I ever go to get my hair cut, go to the doctor, etc.  No, hell no.  But I'll certainly get some shopping done or something like that.  Last week I needed to pick up breaks for my car, we got a lull in the day and ran up to Autozone, I picked up my car parts and put them in the truck and we went back.  No biggie.
> 
> I'm also on duty 12-36 hours a day and that makes a huge difference.  Me personally, I don't take my boots off unless I'm on an overnight shift.  Some of my co-workers though take off their boots, socks, undo their belt, and take off their uniform shirt to lay down.  It's a 5 minute ordeal for them to get up and make a call.



After 2200 some of the guys get into pajamas...but we allow jumpsuits/coveralls with our logo/name and fire written on it.

so..all they have to do is jump into their suits wearing gym shorts/t-shirts and zip their boots on.

Also...where is 2 minutes "regulation?" I don't _run_ to the rig anymore...too klutzy to run.

you know what the difference is between a 2 minute response and a 5 minute response?

including that 10 minute drive to the location? 12 vs 15 minutes.

Walk quickly to the rig, don't run, don't kill yourself getting to someone else's emergency. Hurry, don't dawdle...but don't rush. When you start rushing for the sake of rushing you do stupid things.


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## Shishkabob (Sep 7, 2010)

Dominion said:


> I'm also on duty 12-36 hours a day and that makes a huge difference.



Wow, 36 hours *A DAY*?!  And I thought a 24 hour days were long h34r:


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## MasterIntubator (Sep 7, 2010)

5 minutes?  It should not be that difficult.  Heck I sleep in shorts only on 24s and still can get out the door ( that is rig moving ) in 2 minutes or less, without running... at 3 am.  If your agency is accredited, those stats do count, or you can loose that.  We keep ours.


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