Click Click 27
Forum Crew Member
If You Don't Know Me By Now..U Better Google My Name!
Posts: 39
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Post by Click Click 27 on Jan 10, 2008 3:02:48 GMT -5
look it all comes down to this question now.
what is an BLS or ALS call on the fireground?
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Post by citywidepfdsq11 on Jan 10, 2008 11:58:48 GMT -5
ALRIGHT... I have sat back and read everything. If you are overly concerned about not having enough resources then what is mutual aid for? There are 5 ALS units in Burlington Co. and 6 in Camden. Now I know that after 1am you only have 4. But its the fact that what would be the issue with having one standby for any situation? Working Fire, Haz-Mat, or whatever the IC feels is warranted. Last time I checked the M in MICU did stand for Mobile right? If there was a remote chance that you cant have a medic or they are still responding because out in GODS country of the outter limits in BURLCO.. WHY ARE YOU GOING TO PITCH A TENT?? You have 2 EMT's on the bus right? Do what you can and leave. this goes for any call, fire or EMS.... Now getting back to what the org topic started. I feel as though that if the IC or Ops command wants a Medic to standby then GET IT FOR THEM.. I don't care if the medics want to sit in there buggy.... As long as they are there ready to go if they are needed. If something happens to one of our guys at a scene and the BAMBULANCE crew wants to WAIT FOR THE MEDICS!! There is gonna be a brawl at the fire scene. Look at Camden, they get shootings and everything under the sun, they hardly wait for the medics, granted they could spit to a hospital. Its the fact of the matter that if you get someone from the service that needs help, GET EVERYTHING YOU CAN TO THAT PERSON. What would it take for a ALS unit to standby? Or even with the higher ups that are on this board to bring this to the county level??? all companies or at the least 2nd alarm of greater. I always say that its better safe then sorry. BLS units have to stay within the scope of practice. And don't get me wrong, I am sure that alot of people here have some good experience. But when you need an IV or you are tossing some NASTY heart rhythms, its nice to get on ops and say ALS TO THE FRONT WITH THE BUS FOR A ALS TREAT. And I don't care if your from Dist 36 or 16 or 43 or who cares. DO YOU WANT TO SIT BACK AND WATCH ONE OF YOUR OWN PERISH CAUSE YOU DIDN'T THINK IT WAS A GOOD IDEA TO HAVE ALS THERE........ I'm not here to offend anyone but think of the WHAT IF factor for one second... ITS GONNA MAKE YOU FEEL LIKE CRAP.........
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Post by opsoverkill on Jan 10, 2008 12:46:32 GMT -5
Citywide you have good points but I want you to sit back and place yourself in the Place of the person in charge of the ALS units that are covering over 1049 square miles with a population of over 959,000 people with 11 units. As a good manager would you like having a unit standing-by? You have to remove your heart for the brotherhood and tell me what would be the best use for this resource.
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riverlinetk
Division Supervisor
Training Aide
Posts: 49
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Post by riverlinetk on Jan 10, 2008 12:55:35 GMT -5
Yea, lets stick with the CHAIN of BROTHERHOOD!!!
ME
YOU
US
THEM
Isn't that how we work on crews, incidents, firegrounds, etc?
Putting the them before us all isn't doing any CYA for what we do!
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Post by opsoverkill on Jan 10, 2008 13:04:59 GMT -5
I understand that!!. But remove yourself from that as a manger that has a legal responsibility to the whole not to the few and get called on to the carpet having ALS units on standby at fire calls. When there have been calls where ALS would have made a difference in saving someones life. And now the public is outraged and it is voting time for budget or for Town Council and they want answers. How are you going to explain the brotherhood to them and say the ALS was need to standby as your love one was dying. And remember they have no idea the concept that is held between Firefighters. All at the same time ensuring that your budget will be passed and the councilman that has been for the fire department gets reelected. Because if he does not and the budget fails they are going to close down stations and lay off fireman
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riverlinetk
Division Supervisor
Training Aide
Posts: 49
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Post by riverlinetk on Jan 10, 2008 13:11:50 GMT -5
I don't think that what the town wants for answers can be considered versus protecting our own. Your own guys will want answers when there is a medic crew miles away sleeping when they were needed. And lets NOT get started again on the what can als do over bls. I could care less who is available, when, and where. The resources at your fireground are your responsibility, and how the rest of the area is covered is not up to you nor matter to you. right? I still find it hard to believe that we can't get away from the resource availability and allocation points, and now we have added towship/supervisor politics as well. Shut down whatever needs to be shut down, but our lives are more important than politics. It's that simple. Any rebuttal involved resources or money means we are putting extraneous circumstances ahead of US.
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Post by citywidepfdsq11 on Jan 10, 2008 13:22:47 GMT -5
Well I think as a manager as long as my unit is either handling a call or AWAITING the what if. I wouldn't have an issue. If there is such a HUUUGGGEEE concern then send the supervisor from burlco and have the cam sup notified. Supervisor or medic unit, when it all comes down they all do the same job. If you as a medic sup then feel that the need is present to commit a ALS unit to the scene then DO SO. What I am saying is that the medic sup is dispatched on all companies. They would contact central for info on the fire. Get some info as, what type construction, status on occupants, and conditions of the fire. I understand that you may have issues that if there is another need for the unit. But think this way, if its documented that units are tied up and none close. THEY WILL PUT EXTRA TRUCKS ON.. Now I know some of you might not believe that but when the state allows BLS agencies to handle ALS calls with paramagics, then what will happen? LAY OFFS OF MEDICS, or them leaving the hospital based to go to the agencies that provide both BLS and ALS. And as far as budget time. They are hospital based, there is no way they would lay them off, with the amount of cash the medics, ground-star and the hospitals make. This topic will GO ON AND ON AND ON.. But when it comes down to it, riverline has it best. The Chain of Brotherhood is something that many people wont understand, but WHO CARES. Yourself is the most important then your partner, then the crew, then others. You think a civi is gonna risk there life to go and get someone. NO, so take care of our own first and all other follow behind. And I am sure that there are plenty of ALS units between, Camden, Burlington, Mercer and Ocean Counties.
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Post by opsoverkill on Jan 10, 2008 13:31:01 GMT -5
Unfortunately it comes down to money and resource availability. And what the public and politicians want.
I commend your passion on the brotherhood. You continue to answer as a firefighter. Now, remove yourself from the firefighter ranks and place those gold five bugles on your shirt collar. Where you have to answer these difficult question and make these difficult decision.
Trust me the first thing that is usually cut at of a township budget is fire/police budgets. You say close down what needs to be closed down. How does that help the brotherhood and the area we are protecting. Are you willing to lose your job as a Career FF due to a town that voted everything down because of the previously mentioned situation?
It sucks having those gold bugles on at times. You have to make a educated decision and do what is best for the many while protect the few that are doing the job!!!!
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Post by voyager9 on Jan 10, 2008 15:38:46 GMT -5
You have to remember that in most cases the people who are responsible for whether ALS can stay on a fire ground are not firefighters, but usually administrators. I think this thread has shown that most firefighters/emts would have ALS on the AllCos. The Administrators have the responsibility and the liability to use their units effectively and to the benefit of the people.
The reason this thread keeps talking about resources and money is not because we, as firefighters, think that is a reason but because we know that the people who are responsible for that decision do.
I still think having ALS available on scene is a viable workaround. You don't get complete coverage but its better then nothing.
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riverlinetk
Division Supervisor
Training Aide
Posts: 49
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Post by riverlinetk on Jan 10, 2008 15:40:48 GMT -5
You're going in a whole different direction. Bottom line is what we need we have the ability to call for. No politician, financial planner/advisor, citizen or anyone else is going to have a problem with protecting ff's or any other emergency response personnel on an incident. On the whole the community comes to use with open arms at an incident with stuff for us, but now all of the sudden we want a medic unit for our guys its going to change? I'm not here to argue about this in any way, but I do think it's impossible to make political and financial statements. Next time the pinelands burn should we all just not go because we can't commit the resources? B/c without a doubt there is a giant staffing and apparatus coverage problem in this county when that happens.
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Post by thelurker on Jan 10, 2008 17:56:59 GMT -5
I haven't really been keeping up with this post, but I was just asked for my 2 cents, so I gave it a read. I see a fight developing between Sean and Cone. I see what Sean is saying and I see what Cone is saying.
The line is plain to me. If as the IC, you feel that you would like to supply ALS for your fire ground, then put it on the grids. Otherwise, don't. You can justify it like anything else we do, "our jobs are very dangerous, and we need to worry about protecting our own." Remember, we have RIT teams. They are nothing more than a group of FF's standing near the building just incase something happens. When people ask why the FF's are standing around doing nothing, we explain that they are there incase a FF gets trapped or lost. The same can be done with the presence of ALS.
Don't fear the public, if you can justify your actions, and educate them, they are often not that unreasonable. In fact, they really give the Emergency Services field a good bit of leeway because they dont want to have to do it.
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1900
Forum Captain
Posts: 103
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Post by 1900 on Jan 11, 2008 13:58:31 GMT -5
I have to say I like this idea and this is not a bad idea... First, I am well aware of the limited numbers of ALS in this County, however like everyone else has said thats not our problem, theres a ton of shortages in this County but that hasnt stopped us...If we or someone determines this is a good idea then we make if happen...maybe if there werent so many Medic dependant squads we wouldnt have this shortage! As for the Medics "STANDING BY" or "STANDING AROUND" at a fire scene how is this any different then the Medics waiting on scene for a BLS to show up in those towns that refuse to address the volunteer short comings or for those managers in charge that refuse to use "paid" ambulances the next town over because they dont like them... Second, as for the ME, YOU, US, THEM..I understand this and agree with it, but seriously I dont give a shit whos hurt, if your hurt and need atttention you will get it, based on the need not who you are. I would not use this as your selling point. The ALS could be on scene for us or them..we had a shed fire one night and Medic 31 just happend to show up, while at the same time the neighbor who was standing outside watching had a major bleed, with the Medics already there the Pt. the bleed was recognized and the outcome was positive. So to me a better selling point could would be us or them. Third, as for BLS and ALS abilities come on now, yes Sean I believe in your skills and mine, but there have been many of times I have seen BLS do things that make me pray to god they are not around if and when I need an Ambulance. Fourth, I am not saying you need them on every job, but just like anything else you release them or turn them around if there is not a need for them...Its all about the "What Ifs" ecspecially now-a-days...if not then why have RIT, why have Covers...If we were thinking like managers then we would only send one truck or less to every call. How many working fires do we really have in this county? With that said why not just send an Engine to check it out or verify...With the number of fire truck accidents we are only adding to the problem with the number of apparatus we put on the street...And with the cost of gas and diesel fuel how much are we spending or wasting for an average of less then 50 working fires a year...So if we want to think lilke managers then there you go...And on that same hand with the limited numbers of working fires in this County would it really be taxing the Medics? If so then add on another Medic Unit. My point is everything we do is PRO-ACTIVE, or what if, or CYA...so why is this any different? Truthfully, if only true working fires were put in-service this would limit dispatching and the need for resources. As for the BLS for RIT...I routinely have a dedicated BLS for US...even on MVCs.
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RngrVnc33
Forum Captain
Keepin' It Moist
Posts: 131
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Post by RngrVnc33 on Jan 11, 2008 19:53:42 GMT -5
1 BLS for rehab, 1 BLS for transport, and a 3rd BLS for RIT as I did today......
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Post by papacheese on Jan 13, 2008 18:54:53 GMT -5
Great thread...good point and counterpoint action without one slur or moronic statement.
Ladies and gentlemen...we have a Kodak moment going on! LOL
Seriously, I mentioned this on the other thread: what Ops is telling us is the practical aspects of the situation, all of which are 1000% true.
Here's my point: if that's the case, then it's up to us to lobby for the funding and resources needed to ensure that an ALS unit is available for working jobs....cause anything less (to me) is unacceptable.
How do we convince the policy makers?
Tell them that 50% of the firefighter LODDs were cardiac related...
Tell them that as a valuable part of the emergency response community that keeps the citizens and community safe, as a dedicated group that regularly goes in harm's way and donates thousands upon thousands of hours to staying ready to fight, we deserve the extra measure of medical support in the event we suffer an injury.
Tell them that there are few events in life more dangerous than an active fireground..and that ALS is an integral part of our insurance policy, along with training and RIT.
I acknowledge the reality of zero-sum budgeting, politics, and administrative conundrums, but this only makes sense...I even have a catchy phrase to tell them:
[glow=red,2,300]"Protect US so we can protect YOU"[/glow]
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riverlinetk
Division Supervisor
Training Aide
Posts: 49
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Post by riverlinetk on Jan 14, 2008 11:52:55 GMT -5
Well stated! Simply put this topic in which we are worried about taking care of our own has brought out an even larger problem that we face in this county. There is a definite lack of units and coverage on the als side of things here. I might be wrong but we are the largest county in the state? We have how many medic units (5) to cover how large of an area? The response times of als services to some of the more remote points here is unacceptable. To go along with the fact that the response times of some of our bls units is unacceptable. However, this is a paid service that the citizens should have at their use as needed when they need it. We do need to lobby for more funding and more resources so that we can be better served by the things that should matter to use more. OUR LIVES!
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Post by woody401 on Jan 15, 2008 9:31:35 GMT -5
I would have to respectfully disagree!! Having ALS on all companies in services would be a waste of money and a waste of a limited resource. Face it, when you break it down to the simplest form what does ALS more then BLS during the first few minutes of an injury or medical issue. Remember it is all about the ABC Airway, Breathing, and Circulation BLS can handle them also; the only difference is that ALS has more tools in the toolbox. Let us take the worse case scenario with the Mount Holly Fire. Instead of getting g pinched by the rungs of the ladder, it amputates his leg. They only thing ALS will do different would be. Start IVs and maybe give pain meds. All that the delay being dispatched would not make the difference with the overall outcome. Yes there are of things the ALS can do like tube him and defib etc. but BLS keep the airway open and breath for him and all have AEDs. I guess you have to have the belief that you will be getting competent EMTs from the local EMS to respond. This county has to get away from the Medic Dependency and do what you are certified to do. Now going off topic a little, would you fly him?? I would not!!!! Reason-Flying him would almost guarantee him going to Cooper due the Cooper rules etc. I will transport to ground to Jefferson who specialize with this type of injury. Is there a delay yes with the initial transport but that is nothing compared to the delay getting him the proper treatment after he gets to Cooper. Just some thing to keep in the back of your head. So, if you think ALS still needs to be dispatched on all companies for the “just in case” I will finish with this. I submit that we should all change are grids to reflect that the All Companies in Service Box be dispatched for any received call “JUST IN CASE.” I have to agree with opsoverkill meidics are not needed in all company in service because you should be expecting when a bls ambulance is dispatched to you location is that you get competent emts and they dont raly on medics for patient care and if a medic is need you can meet a medic in route because you should never wait for a medic
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Post by WebBoss on Jan 16, 2008 17:03:34 GMT -5
I would have to respectfully disagree!! Having ALS on all companies in services would be a waste of money and a waste of a limited resource. Face it, when you break it down to the simplest form what does ALS more then BLS during the first few minutes of an injury or medical issue. Remember it is all about the ABC Airway, Breathing, and Circulation BLS can handle them also; the only difference is that ALS has more tools in the toolbox. Let us take the worse case scenario with the Mount Holly Fire. Instead of getting g pinched by the rungs of the ladder, it amputates his leg. They only thing ALS will do different would be. Start IVs and maybe give pain meds. All that the delay being dispatched would not make the difference with the overall outcome. Yes there are of things the ALS can do like tube him and defib etc. but BLS keep the airway open and breath for him and all have AEDs. I guess you have to have the belief that you will be getting competent EMTs from the local EMS to respond. This county has to get away from the Medic Dependency and do what you are certified to do. Now going off topic a little, would you fly him?? I would not!!!! Reason-Flying him would almost guarantee him going to Cooper due the Cooper rules etc. I will transport to ground to Jefferson who specialize with this type of injury. Is there a delay yes with the initial transport but that is nothing compared to the delay getting him the proper treatment after he gets to Cooper. Just some thing to keep in the back of your head. So, if you think ALS still needs to be dispatched on all companies for the “just in case” I will finish with this. I submit that we should all change are grids to reflect that the All Companies in Service Box be dispatched for any received call “JUST IN CASE.” I have to agree with opsoverkill meidics are not needed in all company in service because you should be expecting when a bls ambulance is dispatched to you location is that you get competent emts and they dont raly on medics for patient care and if a medic is need you can meet a medic in route because you should never wait for a medic Brother, respectfully, Competent EMT's are hard to come by in this county. WHY? I have no idea but apparently there's something in the water that causes them to be medic dependant. Now, for the purposes of this argument, EMT's competent or not, are probably not going to posses the skills or carry the equipment and supplies for what I or any other fireman is going to need when shit goes south in a fire and we have to get dragged out and medically attended too. <period>
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Post by opsoverkill on Jan 16, 2008 17:36:26 GMT -5
I have been there. I was the treating EMT on the FF Jackson injury then 10 years later he succumbed to his injuries in Camden Engine 10. I was with very competent Medics. He was fighting all the way to Trauma due to the pain and what ended up getting done---- BLS skills keep airway open(he was screaming so that was fine) hiflow O2 he kept pulling off. Tried to get IV access for ALS by removing gear. Was very difficult due to needing to be cut opened due to degloving burns to hands. Als never got a chance for IV attempt done at Trauma and given Morphine which relieved him and then they tubed him for airway protection.
So the skills are almost basic stuff. Just have to get away of being wrapped into the moment. Als get met us enroute which when you think about gets us away from the scene and moving towards trauma and away from a highly charged atmosphere. Fireman would not understand even a 30 second delay waiting for ALS to even get in the truck. Believe me!!!
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tootall
Special Operations Command
BurlCoFire EMS Moderator
Posts: 98
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Post by tootall on Jan 16, 2008 18:16:39 GMT -5
I have been there. I was the treating EMT on the FF Jackson injury then 10 years later he succumbed to his injuries in Camden Engine 10. I was with very competent Medics. He was fighting all the way to Trauma due to the pain and what ended up getting done---- BLS skills keep airway open(he was screaming so that was fine) hiflow O2 he kept pulling off. Tried to get IV access for ALS by removing gear. Was very difficult due to needing to be cut opened due to degloving burns to hands. Als never got a chance for IV attempt done at Trauma and given Morphine which relieved him and then they tubed him for airway protection. So the skills are almost basic stuff. Just have to get away of being wrapped into the moment. Als get met us en route which when you think about gets us away from the scene and moving towards trauma and away from a highly charged atmosphere. Fireman would not understand even a 30 second delay waiting for ALS to even get in the truck. Believe me!!! That is only one instance when ALS couldn't do much. That would be like saying since the Medic couldnt start a line that one time we won't use them anymore. Sh%t happens!!! What if there was something else they could have done that could have changed the outcome? There are instances when ALS DOES NOT need to be on location for our BS working fires. You argue that there are not enough recourses to go around in the area. But think about this....In Camden or Burlington County's when there is a stand off or high risk search warrant completed are medics involved in them? YES..so why once again does the fire service take the back seat to the Police?
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Post by opsoverkill on Jan 17, 2008 10:13:05 GMT -5
High Risk warrent are done with extra truck with a trained ERT medic. If it is State warrant. Underwood Medics supply their team for The State Police.
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