EDITOR–AND LISA GOT THE LAST WORD! This thread is closed.

Defib is a BLS skill, not a paramedic skill. You dont need to ALS engines to Defib. Period. Educate yourself.

NOONE does Intracardiac anything (except pericardial centisis and if your doing that in the first 5 minutes of a call your WRONG) anything in the field. Educate yourself

If in your scenario, there was 2-3 minute gap, then the fire department should be doing BLS. Thats according to nationally recognized ACLS and CPR guidelines..and also of note: BLS care (CPR, Defib) is the only thing that hse been proven to save lives, not paramedic drugs, not paramedic ETT.

So once again, educate yourself to the medical facts, the standard of proactice, the current guidelines….not what you read on the bathroom stall wall at the union house.

Lisa, if you ever want to learn the medical/clinical reality of EMS, not the IAFF agenda, let me know. If you want to know what actually saves lives, let me know.

Now back on track..how does this relate to the rural metro debate…well…
Rural Metro is a means to the end for BFD, the end is job security by deveoping a big red curtain over EMS in Boise, adding more medics to every engine, and ensuring their expansion goes unopposed and unsupervised.

Now I had written a specific and detailed reply, but I realized that anything that comes out of my mouth you wont belive.
Nemo: “Lisa the sky is blue!”

Lisa: “No its not, its IAFF Red!” (Ok, maybe in her world it is…)

Anyway, here is an excellent summery that is written far better than I could…. Remember the corner stone of this argument is more paramedic equal poor outcomes. MY contention, and shared by this gentleman I suspect , that any system that does not triage and manage the paramedic to patient ratio, and the patient acuity of the patients the paramedic sees (Like the King County Medic One system does, a system with out ALS engines)contributes to this problem. The LEADING CAUSE OF PARAMEDIC Oversaturation…the topic of the article I posted below, is the ALS First response concept. See the connection to ALS first response now? Say it with me…More Paramedics..Bad. ALS engines equal an about 150% increase in paramedics per shift in Boise alone. How much “BAD” is that??? (too much)

So here is the post, with the citations…the science so to speak…
http://www.emsnetwork.org/artman2/publish/article_28849.shtml

I would also point out the extensive research by Wang et al on intubation success rates and their relatioship to paramedic clinical exposure…which follows the same thoughts and would generally lead someone to the same conclusions. READ: ALS Engine deployment equal less high acuity clinical exposure.

Also while not clinical evidence, this is an excellent news series in USA today that discusses many of the same issues. It has some excellent view of EMS in the fire service, and what bodes for Boise if BFD has its way (read a system like Washington DC or LAFD), instead of a unified system like ACP wants, like the Seattle system…something the union will never let happen. Too much non union influence fo for the union to be happy…

http://www.usatoday.com/news/nation/ems-day1-cover.htm

http://www.usatoday.com/news/nation/ems-day1-seattle.htm

http://www.usatoday.com/news/nation/ems-day1-dc.htm

and this Q/A session:
http://cgi1.usatoday.com/mchat/20030730004/tscript.htm

I really like the statement from Stafford VA.

As you can see this is hardly Nemo’s twisted lil mind working overtime.
Nor is it a vendetta against the Fire Service. It is a crusade against crappy medical care, crappy paramedics, and the crappy politics that cause it.

So Lisa, you will see my nuts are quite intact. Thank you.

How did you get that lame name anyways…Nemo? To scared to use your real name….we know it anyways!I’m afraid I would feel like kind of a sissy living in a Disneyland frame of mind….Cause your really in Fantasyland saying that having a Paramedic/Firefighter on and Engine decreases the survivabilty! Show us that Data Mr. cartoon fish!

Even though your comment was made to be ironic, here is a thought provioking issue. In several studies, critical trauma patients did better with both BLS transport and TAXI service in both time to the ER and overall survival, than did those attended by Both ALS engine medics and ALS transport.

Now this was in system(s) that have many issues, including PARAMEDIC OVERSATURATION (see a recurring theme???), but the point remains, the BS about needing a paramedic in the first 10 minutes for 90% of calls is just that..BS. BS and a waste of tax dollars.

We DONT need paramedics on every fire engine. We dont need as many ALS Ambulances in this Valley as we have.

We need a few select highly trained medics for ALS ambulances and a whole slew of BLS engines and BLS ambulances…and a SYSTEM (nto a single agency, a system) for them all to work under….

…and even a whole slew of Taxis too…. 🙂

Putting Medics on Engines is not just Overkill..it actually contributes to DECREASES in survival.

So your comment was closer than you thought.

Nemo

Hmm, I am not aware of any of those who tried for BFD who failed the medical portion, in fact, is there really a medical portion? Last hiring I saw there wasnt. Not a real one. I am however aware of how some of our medics who went over there were treated because of their past affiliation with us….., including one medic who later went on to Lifeflight…so no debate as to that medics medical qualifications there……could’nt stand the anti-EMS mentality prevalant in your own agency.

And if I wanted to drag actual names through the gutter, I could mention names with specific incidents…not that it would do any good. At least when our medics have issues we do what an agency should , review the problems, look for the root cause, and retrain..or boot. Not turn a blind eye. Not cover up.

As I said, no program is perfect, and ours certainly isnt, but it is better medically than the farce BFD calls an FTO program. It serves the greater good not a union agenda. It has the practice of quality medicine as its prime directive, not advancement of the Union Job Retention. And when we have an issue, we address it honestly, and we do our best to fix it.

I know of at least one medic on your side with NUMEROUS medical (not personality…not operational…MEDICAL CARE) complaints from our side to yours…your union protects him from anything that might “damage his job” , including reprimand, retraining, or de-authorization. Maybe thats why so many crappy medics want to be firefighters?

BTW, BFD was offered assistance with the training of medics with FTO time, etc. They of course declined. Rumor was the Union didnt want union members to be “under” non union members such as what happens in an FTO-preceptee relationship.

Yeah, thats the organization that we want running medical care in this county. Right.

BTW Lisa, why are you standing up for them, its not likely your a FF and its not like the Fire service has an outstanding record on womans rights….. 🙂