NYPD vs FDNY

[usalsfyre]

In your situation that makes tons of sense considering that you are the only full time emergency service around besides a sheriffs department or something. I'm sure they too are stretched very thin, and have no interest in rescue services. But for areas that have 24/7 FD coverage with good staffing and equipment, wouldn't it make sense to save more ambulances for EMS calls?

Yep, if the FD is performing the job well then why not. My point all along has been you can't apply the "FD should do it" model everywhere, and that extrication at its core is a patient focused medical activity and just because someone has rank doesn't mean they should be making the decisions.

 

[usalsfyre]

In my opinion: EMS should be all about the patient. Fire should be responsible for extrication of the patient.

These are not separate activities. They are intertwined.

 

[Cup of Joe]

These are not separate activities. They are intertwined.

Couldn't agree more. And in the idea of having them focus on a particular job on scene doesn't mean they all aren't working together or towards different goals.

 

[DesertMedic66]

How many extrications have you worked?



Let's just assume it's a single car MVC with a single patient:

Most ambulances are medic/basic. Show me a medic who hasn't worked a train wreck critical patient by themselves, and I'll show you a medic with minimal field experience (or in a multi-medic response agency). If a patient needs more than 1 provider due to being critical / "something going wrong", you better have a second ambulance there anyhow, as honestly, in a situation such as that, an EMT isn't going to cut it.

If you get the patient out and start transporting, you still only have the Paramedic in the back with the patient as the EMT will be driving... so that really didn't help much, did it?

If the situation warrants a provider in a car, you're really only ever going to fit one provider in there, and as far as my experience goes, it's always been the medic for extended extrication. (Though I have my partner crawl through the car on non-critical... air bags scare me!)



I have, and will, take a second ambulance out of service to back me up (or me back up another crew), if it is believed that the second Paramedic will be a benefit.




Just being honest here.

I don't keep track of how many calls I run.

We have fire respond to every call so we don't need to take a second ambulance out of service. We will just have 1 or 2 firefighters ride with us if we think the patient is going to go south on us.

If there is only one patient then we only get one ambulance even if it's a full arrest because we also have fire on scene. I've even had medic transport 4 stable patients at once.

We have roughly 8 medic units for 2,400 square miles so we have to have a good reason and be able to justify having a second unit dispatched and put out of service. So at least in my area EMS doing extrication is not going to happen for a long long time.

Now we could probably handle medical calls if fire didn't respond but it's still good to have them there for many reasons (IMO). I don't see anything changing with how we operate.

 

[usalsfyre]

So what your saying is fire is massively overstaffed and EMS is massively understaffed...

 

[DesertMedic66]

So what your saying is fire is massively overstaffed and EMS is massively understaffed...

Understaffed yes but not by choice. If we need more ambulances we have about a 30-45 min wait time.

And someone (forgot who) said something I agree with. Police should be scene safety, EMS should be patient care, fire should be extrication. Each can focus on their job but they need to communicate. If fire is on scene first they are incharge of both patient care and extrication. Once EMS arrives we take over all patient care. Communication seems to be the major issue

 

[frdude1000]

Our department is combined fire/ems. Our fire apparatus responds as first responders and as manpower on ems calls. Most of our engines are ALS and we use them to upgrade BLS units to ALS and to upstaff medic units on ALS-2 responses (unconscious, code, etc.).

We call MVA's PIC's in my area (personal injury collision). For a smaller road collision, you get 1 BLS ambulance and 1 fire apparatus. For a highway collision, you get 1 engine, 1 bls unit, and 1 rescue squad. For a PIC with reported entrapment, roll over, etc, you get the engine, a tower, an ambulance and a squad. To be a firefighter in my county, you must be an EMT also.

 

[MrBrown]

Brown will never understand the justification for sending a ladder or aerial appliance, which is a gargantioun monstrosity weighing thousands of pounds and used for extricating people from high places, to a road traffic accident, which is usually something occuring at ground level.

 

[boingo]

So what your saying is fire is massively overstaffed and EMS is massively understaffed...

That is EXACTLY what he is saying.

 

[silver]

Brown will never understand the justification for sending a ladder or aerial appliance, which is a gargantioun monstrosity weighing thousands of pounds and used for extricating people from high places, to a road traffic accident, which is usually something occuring at ground level.

Technically FDNY only has 5 rescue companies (they also have squad companies that run in rescue pumpers).

NYPD ESU has 10 heavy rescue trucks.

 

[akflightmedic]

I agree, there was NOT enough quality footage of the brunette FDNY EMT to determine her accurate level of hotness, but initial impression was satisfactory.

 

[JOHNFORCENYC]

Fdny & nypd should work hand in hand & not against each other. The prime reason of appearing to a call is to rescue both critical & non critical patients. In my case, since i work in nyc, they are my priority.

It is sad to say that fdny & nypd dont get along. I hope in the near future that both realize, its not about whos better than who, but the obligation of helping a patient is a priority!

 

[firecoins]

Both they NYPD ESU units and FDNY units should have extrication capabilities.
I have little interest in how it may be done in your local but this is necessary in NYC. Both units particpate in many rescues and are well trained. Just wish they could work together better.

 

[DrParasite]

Technically FDNY only has 5 rescue companies (they also have squad companies that run in rescue pumpers).

technically you are right. however, every truck company has a full set of rescue tools, cribbing, and airbags. There are also 7 Rescue Engine Companies (called Squads in NYC). that are equipped and trained to operate as engine, truck or rescue companies, depending on what the situation calls for and how they are dispatched.

NYPD ESU has 10 heavy rescue trucks.

they have 10 big heavy rescues (3 in Brooklyn, 1 in Staten Island, and 2 in every other borough), but they also have 40 REPs (ESU patrol trucks), which carry scba gear, medical kits and rescue equipment including heavy hydraulics.

so as you can tell it's isn't as simple as 5 FD vs 10 PD.

I still think there is a huge duplication of services, and a recipe for problems esp when both agencies rush the scene, to see who can rescue the person first or make the first cut in the car. and the video shows what can happen.

 

[Tigger]

Brown will never understand the justification for sending a ladder or aerial appliance, which is a gargantioun monstrosity weighing thousands of pounds and used for extricating people from high places, to a road traffic accident, which is usually something occuring at ground level.

Lots of compartment space on North American aerials, perfect for filling with shiny things that lift and cut things. That and they make excellent blocking apparatus for highway MVAs, though it sure does suck to lose an 850k ladder to semi truck. Better than losing a person though right?

 

[NYBLS]

No one has yet to the multiple individuals saying that a charged line is needed on an extrication. Anyone have a plan for that?

 

[clibb]

How many extrications have you worked?



Let's just assume it's a single car MVC with a single patient:

Most ambulances are medic/basic. Show me a medic who hasn't worked a train wreck critical patient by themselves, and I'll show you a medic with minimal field experience (or in a multi-medic response agency). If a patient needs more than 1 provider due to being critical / "something going wrong", you better have a second ambulance there anyhow, as honestly, in a situation such as that, an EMT isn't going to cut it.

If you get the patient out and start transporting, you still only have the Paramedic in the back with the patient as the EMT will be driving... so that really didn't help much, did it?

If the situation warrants a provider in a car, you're really only ever going to fit one provider in there, and as far as my experience goes, it's always been the medic for extended extrication. (Though I have my partner crawl through the car on non-critical... air bags scare me!)



I have, and will, take a second ambulance out of service to back me up (or me back up another crew), if it is believed that the second Paramedic will be a benefit.




Just being honest here.

Linus,

What do you do with a Trauma patient that an EMT cannot do? Pain meds? I would really love to know. We run EMT/Medic ambulances here and fire do respond to our calls. We have a very good relationship with fire and sure we'll take a firefighter with us if we need it, but a second medic? Barely.
I don't know the protocols you have with AMR. Here as a Basic, I can start an IV, give 250 ml of fluid. I can intubate patients with a Kingtube after the medic has missed 2 times.
I would rather have a firefighter cut out a person out of a vehicle because they have been TRAINED doing that.

I COMPLETELY agree with you when it comes to dissolving all Fire Departments. People need to concentrate more on EMS and not fire. Most calls that Fire Departments respond to are medical calls, well maybe not in NYC.
My insurance guy told me that it costs them MORE if a Fire Department puts out the fire at my house than it does to just let it burn down and rebuild it.
Firefighters are people who haven't realized that 95% of their job is medical calls

 

[MusicMedic]

i dunno about you guys, but a Van Ambulances really dont have alot of space..
i can barley stuff a bariatric patient in the back.. on top of the Medic and his drug box and Me.. it can get quite stuffy.. on top of that add heavy extracation gear? yeah im not gonna have room to move my feet..

even in the Mods (box ambulances) it can get stuffy when you have more than two people working on a patient... i really dont know where the extracation gear is gonna go? Maybe strapped on top of the rig?

 

[MusicMedic]

Another point or two or three I want to make:

say for example a 300 lb male gets trapped in a car and needs to be extricated.. i sure as hell wouldn't want to break my back with just me and my partner extricate them.. I would want a few more bodies at least. which leads me to another point: I call for back up and another ambulance responds: out comes two 105 lbs 5'3 EMT's (male or female).. im not that big either but I would want more help than that..

which also leads me to a another point: Extrication gear can be heavy and requires strength to manipulate properly. FF's go through rigorous Physical Ability Testing to get hired and even more rigorous PT in the academy..

if EMS/Private Ambulance companies wanted to do Extrication, it would require the EMT's/Medics on board to also be held to a certain physical standard which then would certainly eliminate people from EMS..

 

[FrostbiteMedic]

Who should be doing extrication?

Neither Fire, nor police, nor ems. 3rd service rescue, like is common here in Tennessee. Let Fire do fire, let EMS do EMS, let LE do LE. I believe Rescue should do rescue. To me, combining these services is like saying Fire-based EMS is the greatest thing since sliced bread (no offense to the Fire EMTS and Medics on this board). Separate job=Separate agencies
*holds up umbrella for the crap storm that is about to rain down on him*