[slathrum]

Originally Posted by Gallium

I see you've completely missed my point. Additionally, there are instances where standing orders and new protocols have superseded "medical direction". In my state things flow down from the state level, and in many instances (fire in particular) the state and the rest of the nation takes cues from NY City.

I asked a question about ALS<>IV lines.

- G

It just doesn't work like that. Who do you think orders those "standing orders." Legislators? No. Like I've tried to explain, it's a physician acting as a medical director. The state gives EMS it's scope of practice. Local physicians allow EMS to work within that scope of practice as an extension of their medical license. It's quite simple, but I just can't seem to get this through.

[ignantmike]

Originally Posted by slathrum

It just doesn't work like that. Who do you think orders those "standing orders." Legislators? No. Like I've tried to explain, it's a physician acting as a medical director. The state gives EMS it's scope of practice. Local physicians allow EMS to work within that scope of practice as an extension of their medical license. It's quite simple, but I just can't seem to get this through.

this is the way it works in ohio.....atleast in northeast....former emt-b ff here......

[podwich]

Originally Posted by Gallium

No, they are not the same by any stretch, but are more similar than they are dissimilar....just like me, you, Tantrix and TBO collectively have more in common than any of us and Pelosi, Bloomberg and Obama.


Physician Assistant school
Doctor of Osteopathy


One (here, and in many instances in other places) requires a minimum # of patient contact hours (500-1500, depending on where, what school, etc).

The other...does not generally have a teaching hospital, and sometimes applicants need a referral from another DO and prior demonstrated experience with patient care.

I'm not at all sure what you're talking about. MD and DO are similar. PA is a different level. Admission requirements for MD and DO are virtually identical, as is course work, testing, residency, practice, etc. DO programs associate with teaching hospitals, just as do MDs.

PA is quite dissimilar.

So what in the world are you talking about?

[certifiedfunds]

Only took 3 days for them to announce the layoffs and station closures.

Closures. I wonder why they can just staff them with volunteers like they were 4 years ago before the union got involved?

Progress being made toward board appointment. Current term up next year. This union has to go.

[hotpig]

Originally Posted by certifiedfunds

Only took 3 days for them to announce the layoffs and station closures.

Closures. I wonder why they can just staff them with volunteers like they were 4 years ago before the union got involved?

Progress being made toward board appointment. Current term up next year. This union has to go.

Why are you blaming the Union because there is not enough tax money to pay fire fighters? Unions do not tax Government Agencies do.When the Grant money is gone so are the paid (union or not) help.

Yes stations close when no one is there. You won and a volunteer fire department will have to be formed or the District will have to pay some one Else's department to provide service. It is happening all over the country.

[DaleGribble]

Originally Posted by Gallium

I hate to appear as if I am splitting hairs, but I think I'm about to learn something...


Not all ALS protocols require med direction. SOME of them do, but certainly not all, not even for your state.

Question: Is running a IV ALS or BLS ?

Answer: ALS.

Question: Do EMT-P need medical control /direction for running an IV?

Answer: No.

Actually, yes.

As a paramedic I work under my med controls license, with that being the case I can only perform the procedures my med control allows. I'm very fortunate that my med control allows, via standing orders, everything the state regulatory board allows paramedics to do. IV's, RSI, Pleural decompression, all the drugs and drips, the whole shabangabang. I can perform damn near every state approved procedure without direct medical orders. Basically the only time I have to call a doctor is if I want to give Morphine or I run into something I don't know anything about and need advice.

We also have the ability to deal with Physicians that show up on scene and try to take control. Our med control has issued and signed documentation that states all our pt's are under care of her license and gives us the authority to disregard their orders. Basically it works like this, if a Proctologist shows up on a scene and tries to take over we can tell him "Thanks, but no thanks." Now if an ER doc, Anesthesiologist or Trauma surgeon shows up and is willing to continue his treatments in transit, I won't get in his/her way.

[certifiedfunds]

Originally Posted by hotpig

Why are you blaming the Union because there is not enough tax money to pay fire fighters? Unions do not tax Government Agencies do.When the Grant money is gone so are the paid (union or not) help.

Yes stations close when no one is there. You won and a volunteer fire department will have to be formed or the District will have to pay some one Else's department to provide service. It is happening all over the country.

We had a volunteer dept.

Will the firefighters union allow volunteers under the same roof?


That station was staffed with volunteers. Then they hired employees. Then they unionized. Then they became unaffordable.

[bmoore]

Originally Posted by hotpig

Why are you blaming the Union because there is not enough tax money to pay fire fighters? Unions do not tax Government Agencies do.When the Grant money is gone so are the paid (union or not) help.

Yes stations close when no one is there. You won and a volunteer fire department will have to be formed or the District will have to pay some one Else's department to provide service. It is happening all over the country.

Hotpig I should have jumped in earlier to help you out. You are not dealing with logic or any facts here my friend. Its the unions fault no matter what. You can't engage these people man, its like arguing with a drunk on a medical aide. Local 4488 out.

[certifiedfunds]

Originally Posted by bmoore

Hotpig I should have jumped in earlier to help you out. You are not dealing with logic or any facts here my friend. Its the unions fault no matter what. You can't engage these people man, its like arguing with a drunk on a medical aide. Local 4488 out.

Perhaps you can help then. Will your union allow volunteers in the same shop? Educate me. I honestly don't know.

[hotpig]

Originally Posted by certifiedfunds

Perhaps you can help then. Will your union allow volunteers in the same shop? Educate me. I honestly don't know.

My last shift we had two of us union guys on duty. In addition to us the non Union Chief during the day shift. A volunteer worked a eight hour shift with the Union guy at station one.

Unless the Department agreed by collective bargaining to get rid of volunteers they are welcome any time.

[certifiedfunds]

Originally Posted by hotpig

My last shift we had two of us union guys on duty. In addition to us the non Union Chief during the day shift. A volunteer worked a eight hour shift with the Union guy at station one.

Unless the Department agreed by collective bargaining to get rid of volunteers they are welcome any time.

Ok. So then that's what we need to determine. Thanks.

Ultimately we need to bring the department back to all volunteer again except for the paid chief but in the interim we need to get the stations manned with volunteers again.

[Sam Spade]

Originally Posted by certifiedfunds

Only took 3 days for them to announce the layoffs and station closures.

Closures. I wonder why they can just staff them with volunteers like they were 4 years ago before the union got involved?

Progress being made toward board appointment. Current term up next year. This union has to go.

Chips are falling, you should be happy.

I can give you the probable reason for closures: your vollys from four years ago haven't maintained their certs and there's no one qualified to work the stations. You can't expect the full time guys to continue on for free. They're too busy looking for work.

I hope that things work out for y'all. I mean that sincerely. I also hope you continue to post on the matter; I think it's fascinating and instructive and much easier to understand than the same issue on a state or national scale.

[certifiedfunds]

Originally Posted by Sam Spade

Chips are falling, you should be happy.

I can give you the probable reason for closures: your vollys from four years ago haven't maintained their certs and there's no one qualified to work the stations. You can't expect the full time guys to continue on for free. They're too busy looking for work.

I hope that things work out for y'all. I mean that sincerely. I also hope you continue to post on the matter; I think it's fascinating and instructive and much easier to understand than the same issue on a state or national scale.

I am. I said upthread I'd rather pay Allstate than be held hostage.

There are no more vollys. It used to be I'd see them all over town. They had decals on their windows. It just occurred to me that I don't see them any more.

Its not going to be easy, however, we had the department we wanted and were willing to pay for. The renewal tax passed 50-40 ish. The new money failed 60-30. Clearly I'm not alone.

up until the last 4 years we were just fine with what we had. Now we can't afford what we've been given. Previous tax was sufficient to fund expansion, equipment, training etc. It wasn't until they switched to paid and then unionized that the budget got busted.

[Tvov]

Originally Posted by Sam Spade

I can give you the probable reason for closures: your vollys from four years ago haven't maintained their certs and there's no one qualified to work the stations.

This is assuming the FD did medical response. Most states the basic Fire Fighter I course is one time only, no need for "maintaining".

As long as the paid Chief did not alienate the volunteers, they will probably return. Heck, they'll probably start responding tonight if they are needed.

[hotpig]

Less and less people have the time that it takes to be a Certified or Licensed volunteer firefighter or EMT. Every year both the State and the Feds add additional requirements.

Hiring people is not a option in this economy. As bad as it is right now in many parts of the country I can not image what it will be like in ten years.

As a thirty veteran both volunteer and paid and certified Instructor I can believe I would actually say this. In order to save lives and property the standards need to be lowered at some point.

We are better trained then thirty years ago. Because of this we are doing a lot more work with a lot less people than thirty years ago. Every year we do more than the year before with even less people.

[certifiedfunds]

Originally Posted by Tvov

This is assuming the FD did medical response. Most states the basic Fire Fighter I course is one time only, no need for "maintaining".

As long as the paid Chief did not alienate the volunteers, they will probably return. Heck, they'll probably start responding tonight if they are needed.

They did med response too.

Was talking with my councilman this morning about it and we laughed about how it used to be if you called 911 with a hangnail 12 of them would descend on your house.

They were a proud and enthusiastic bunch for sure.