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Los Angeles FD Tries Out Motorcycle Response Team

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Strategic Placement or Response Time Gimmick?

THE LOS ANGELES CITY FIRE DEPARTMENT IS trying out an experimental motorcycle response team, a five-man unit that can speed to the side of an injured victim, provide information to dispatchers and skirt traffic to scout fires and other problems.

LAFD photo via Wildfire Today

The Los Angeles Times tells us:

Fire departments serving traffic-snarled cities around the nation have adopted similar motorcycle teams to improve response times, staff special events and, in some cases, save lives and resources. As the L.A. department faces budget cuts and intense scrutiny over response times that lag behind national standards, some believe that a roving motorcycle unit could help the department.

The pilot unit features five off-road-capable motorcycles on loan from the Kawasaki Motor Corp. Each bike retails for about $6,300 and is outfitted with a defibrillator, a small fire extinguisher, various medical supplies and a handlebar-mounted GPS system. A dozen firefighters have undergone the necessary training, and a permanent unit could have up to 10 motorcycles and 28 riders, said Capt. Craig White, who first proposed the unit to the department.

During the early part of the trial period the team was used to scout a major wildfire by scampering around the fire with their GPS units recording their locations before the fire helicopters reached the scene.  The  LA Times continues:

In addition to scouting fires, advocates say the motorcycle response team could also help save lives. When a heart attack occurs, the American Heart and Lung Assn. says, irreversible brain damage can begin after four minutes. Motorcycle-borne medics equipped with defibrillators in Miami cut response times from an average of seven minutes to less than three in some places, said Capt. Roman Bas of Miami-Dade Fire Rescue.

"Absolutely it saved lives," Bas said. "And it saved money too."

Bas said deploying motorcycles instead of ambulances and trucks reduced fuel consumption and extended the working life of more valuable emergency response vehicles, which were used less. He had planned to expand the program to 12 battalions, with a roving motorcycle response unit to cover multiple areas of the city. But Miami's motorcycle medic unit was dismantled in 2008 after departmentwide budget cuts.

The officers involved with the program hope that they can obtain state and/or federal grants to make the motorcycle unit permanent.  LAFD Chief Brian Cummings said motorcycles could be "one of the solutions" the department considers for improving response times.  (Firegeezer notes that the fire chief has been strongly criticized since March when it was disclosed that the department was usuing false figures to coverup rising response times after shutting down several fire stations.  See the Firegeezer report from March 18 HERE, and March 11 HERE.)

LAFD

Read the FULL STORY.

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LAFD Response Times Dip After Station Shutdowns …. (No! Really?)

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Anybody Besides the Fire Chief and Mayor Surprised at This?

THE LOS ANGELES, CALIFORNIA, CONTROLLER Wendy Greul released the report yesterday of an audit her department conducted into the Fire Department's response times.  Using a 2-year baseline from June 2007 to July 2009, the auditors found that after the fire station closings and rotating brownouts took place in July of last year, the response times for ambulance calls increased an average 12 seconds citywide and as much as 20 seconds in certain areas including the San Fernando Valley.  The Daily News reports:

The report found response times for emergency medical calls increased an average of 12 seconds to four minutes, 57 seconds. However, the response time to fires and non-medical emergencies dropped about 21 seconds — also to four minutes, 57 seconds.

Pat McOsker, president of the United Firefighters of Los Angeles City, said the audit confirms his warnings over the past several years.

"You cannot cut the department by the 15 percent it has been cut and not have an impact," McOsker said. "In emergencies, seconds count and we have a system that delays the response."

Not to be overlooked in the report is this observation by the Controller:

She also expressed concern about the quality of the department's response time data, noting that about one-third of the incidents reviewed were not coded properly and it was unclear whether they were emergency or non-emergency calls.

"It's unacceptable that the LAFD has not been able to accurately track its emergency response times," Greuel said, adding she hoped the audit would lay the groundwork for city officials to make improvements.

In her report Greuel also pointed out that 650,000 of the 1.9 million incident reports they reviewed were coded "unclearly" rendering their study unable to be compared with the NFPA response standards.

KNBC-TV Ch. 4 tells more in this video report:

 

View more videos at: http://nbclosangeles.com.

Los Angeles Mayor Antonio Villaraigosa, left, and Fire Chief Brian Cummings
discuss response times and deployment at a March 13 news conference.
(Barbara Davidson, Los Angeles Times / March 13, 2012)

It has been pointed out that part of the problem is created at the dispatch center where calls are taking longer to be processed before the alarm is dispatched. Again from the Daily News:

(Local President) McOsker said part of the problem is dispatchers are required to go through a list of more than 20 questions before an emergency call is placed with paramedics. The protocol was developed to try to reduce the number of calls made for nonemergencies.

"There was a time that once they determined the nature of the emergency, they could send a unit out," McOsker said. "Now, they have to go through the entire list of questions before they send anyone to the call."

Using their own resources to analyze the raw data, the Los Angeles Times has concluded:

(Times staff writer Ben) Welsh crunched data from more than 1 million dispatches from the department's database and found that the Fire Department falls far short of the standard that rescue units be alerted within one minute on 90% of 911 calls. And average call-processing time has increased, most notably for medical calls, which account for the overwhelming majority of responses.

Five years ago firefighters were dispatched to medical calls within a minute 38% of time, the analysis found. By 2011, that number dropped to 15%.

The Times also found that in the more than 250,000 medical dispatches last year, the department took 75% longer, on average, than the national standard.

You can read the entire 46-page Controller's report (.pdf file) HERE.

On March 18 Firegeezer reported on the surprising announcement that LAFD had been using phony numbers to calculate their response times.  Read that posting HERE where we also addressed the vehicle maintenance problems that are affecting the response times as well.

It was also last March when McOsker opined:  "This department is being held together with bubble gum, baling wire and duct tape."

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Ann Arbor, Michigan, Fire Chief Wants to Restructure

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Fewer Stations Without Layoffs

ANN ARBOR, MICHIGAN, FIRE CHIEF CHUCK HUBBARD is expected to meet with the city council tonight (Monday) and present a plan to improve the fire department's response times and coverage of the service area.

Ann Arbor has seen its fire protection shrink in the past ten years with the closing of one of their six fire stations and a 30%  reduction in the number of firefighters on duty.  A recent study by the ICMA knocked the city for not meeting the minimum standards for responses and 2-in-2-out practice.

Chief Hubbard's plan which will be presented at an open meeting calls for the closing of two more stations and rearranging the apparatus to better utilize the staffing.  AnnArbor.com, the city's digital newspaper, reports:

Hubbard's restructuring proposal is aimed at making sure the fire department is better suited toward meeting national standards, including the NFPA rule that says four firefighters should arrive at a fire within four minutes 90 percent of the time, and 13 firefighters should arrive within eight minutes 90 percent of the time.

The proposed restructuring plan calls for positioning two engines, one tower, one mini pumper and one battalion chief at Station 1 downtown. Another two engines and one mini pumper would be positioned at Station 2, and one ladder truck would be positioned at Station 5 off Plymouth Road near the University of Michigan's North Campus.

Hubbard claims the staffing proposal enables four firefighters to be dispatched to most scenes within the recommended industry response times.

The chief's 15-page plan can be viewed HERE (.pdf file).

The full article in AnnArbor.com is HERE.
See related editorial on public safety cuts in Ann Arbor HERE.
Ann Arbor Fire Department WEBSITE.

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LAFD Admits Inflating Response Time Results Favorably

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Hadn't Switched to New Criteria Standards

THE LOS ANGELES (CITY) FIRE DEPARTMENT ISSUED a mea culpa Friday afternoon admitting that for several years they had been claiming better-than-actual response times for their fire and ambulance emergencies.  The disclosure was made after the Los Angeles Times questioned the results being claimed and looked into the stats more closely.

photo by ELKI

The Times reports:

Federal guidelines call for (firefighters) to arrive on scene in under five minutes 90% of the time. But a former department statistician counted all responses within six minutes, officials explained, which improved the record. Retired Capt. Billy Wells, who crunched the data with a hand calculator, said he followed the department's long tradition of using a six-minute response standard.

Wells' successor, Capt. Mark Woolf, said he reluctantly continued using the flawed formula for a time because he didn't want to be blamed for a sudden drop in department performance. "I didn't want to touch that [extra] minute because I knew the data would take a dump," he said.

Corrected data generated by a new computer system shows that in 2008, the department actually hit the five-minute goal only 64% of the time, officials said. By last year, that number had fallen to about 60%.

Fire Chief Brian Cummings said his department's performance is pretty good, given the 16% reduction to its budget in recent years, which has led to the elimination of firetrucks or ambulances at about one-fourth of the city's 106 fire stations.

The problem first came to light when a candidate for the upcoming mayoral election, Austin Beutner criticized the city controller for failing to scrutinize the effects of recent budget cuts that had shown a precipitous drop in response times after 2008.

Read the complete Los Angeles Times story HERE.

Job Openings

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Edmonton EMS Expanding Rapidly

THE EDMONTON, ALBERTA, EMS HAS IMMEDIATE openings for several paramedics and EMT's with still more coming online in the near future.  The need for additional resources including ambulances, stations, and medics to operate them, has come about for several reasons.  The Calgary Herald describes a few of them:

The median response time in the past two years for so-called "lights and sirens" ambulance calls increased to eight minutes and 13 seconds from seven minutes.

EMTLife.com photo

Health Minister Fred Horne announced Tuesday that five additional paramedics and 12 emergency medical technicians have been hired this month, and that 14 more vacancies will be fast-tracked to get to full staffing levels as soon as possible.

He also said Alberta Health Services opened a new EMS station in northeast Edmonton on Jan. 17, and that five more are slated to open across the province between now and 2014, including one in the city's west end.

Horne said response times are longer because the population is growing and aging, with the result being EMS workers are responding to more calls than ever.  (The Herald adds:)  City ambulances responded to nearly 48,000 lights and sirens calls in 2010-11, a number expected to increase to more than 65,000 in 2011-12.

In addition, Alberta is continuing to suffer with overrun hospital emergency rooms creating situations where ambulances are forced to "store" their patients for long periods of time, as much as 45 minutes or longer, before they can take them from the ambulance into the hospital itself, thus keeping ambulances out of service for longer times.

In April 2009 all provincial EMS responsibilities were transferred from the localities to the province-wide Alberta Health Services which also oversees all hospital operations.  And as always happens when local activities are transferred to a giant, centralized government-run agency, the entire EMS network fell apart.  This has had a direct bearing on the ability of local EMS departments to function as well as they did previous to the consolidation.  This has also created the situation where paramedics are fleeing the Edmonton EMS to escape the stress and frustration that has crept into the organization.  A survey taken of Edmonton EMS employees in November showed that 2/3 of them are actively looking for employment elsewhere.

 The Edmonton Journal recently reported:

The Health Sciences Association of Alberta conducted a survey which was completed by 146 out of 304 eligible members of the union (in Edmonton).

It found that in the last four shifts completed by those workers:

— 86 per cent experienced a lack of resources, including no ambulances available for emergency calls, otherwise called a red alert.

— 72 per cent said they could not meet their response-time targets three or more times.

— 72 per cent had pending calls of more than one hour, sometimes up to four times.

"According to our survey respondents, the emergency ambulance service in the Edmonton metro zone is completely inadequate as it is and the vast majority of our respondents have raised their concerns to the attention of Alberta Health Services’ management but to no avail," reads the executive summary of the online survey, done between last Nov. 4 and 11. "We shouldn’t be surprised then that two-thirds of our respondents are seriously considering seeking employment elsewhere."

After seeing those results – that were taken by somebody else instead of them – Alberta Health Services sprung into action and announced that they are going to form (another) committee and start having meetings in February.

Read the entire Calgary Herald article HERE.
The Globe & Mail has MORE.
Read the damning report from the Edmonton Journal HERE.

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Do You Trust Your Firetruck? How Much?

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The Signs Say to Not Drive Into Flood Waters

CHRISTMAS DAY IN MELBOURNE, AUSTRALIA, THIS YEAR will be remembered mainly by the widespread flooding through the area.  And the people in the northeast suburb of Eltham will remember it as the day the firetruck drove into the flood waters.  Despite the signs and the S.O.P.'s to the contrary, this tanker driver for the Victoria Country Fire Authority misjudged the depth of the water.

 

The CFA officers were not amused and have opened an investigation into the performance of the driver who is one of the most experienced operators in the department.  The Herald Sun is reporting:

Research Fire Brigade Capt Neville Stewart, who was not driving the truck, said the incident happened so quickly. "We weren't expecting it and then we just had to keep going, we couldn't stop it," he said.

The CFA's northwest metropolitan region acting operations manager, Tony O'Day, said the driver was one of the most experienced in the brigade. "It's an error of judgment," Mr O'Day said. "Once they started driving through the water, they were committed and made a decision to keep driving rather than stop. It's certainly not standard behaviour. We don't encourage it."

The crew got itself in deep trouble when it misjudged a signpost and sized up the water incorrectly.

Mr O'Day said people were always told not to drive through floodwaters because of the dangers, and the firefighters should have known better. He said the crew regretted the decision. "They are fairly shaken," Mr O'Day said.

Firegeezer got a kick out of the windshield wipers continuing to operate while under water.  And as the tanker comes up out of the water, watch the captain open the cab door and let the water run out.
Thanks to the Gnome Handler for finding this gem.

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Morning Lineup – December 27

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Tuesday Morning  (I think)

Just how important is an ambulance, anyway?  Naturally we have our own ideas about that, and in most places the citizens agree with us because they buy and staff enough of them to take care of the community's needs. 

But in some places there are bureaucratic and managerial bunglers who are so intent on their own interests that the sick and injured are being left to suffer.  While these impeders are well-meaning, their actions filter through the system and degrade the EMS more than they help it.  We have documented here on several occasions how local medical directors in a few areas are so intent on upgrading patient care at the entry level (i.e. ambulance) that they drive away many potential first-aiders who could do good work in getting effective care to the emergency victim.  Those areas end up with scant ambulance service and even in some cases, untrained drivers who only do that … drive.

You may recall, if you're a long-time reader, that about 3 years ago I calculated that on a regular weekday the London (England) Ambulance Service has more desks in service at HQ than they have ambulances on the street.  Nationwide, many of the 12 National Health Trusts that operate the hospitals, ambulances, etc.,  have begun using more and more so-called Emergency Care Assistants (ECA's) who have nothing more than basic first-aid training and are supposed to be ambulance drivers and assist in loading and unloading the patients.  But the cash-strapped ambulance trusts have been using these lesser-paid workers more and more in place of paramedics.  The Telegraph reported last month  that half of the 12 Trusts have been at times sending out ambulances with nothing other than ECA's on board - no paramedics (even though the taxpayers are paying for them).  This is the end result of the intertwined actions of the bunglers in all levels of the organizations.

Some areas of Canada and Australia have been suffering from hospital mismanagement where the emergency rooms are literally unable to accept patients as the ambulances bring them (called "ramping").  Then you get this ridiculous situation where the hospital parking lot is filled with ambulances where the medics are maintaining patient care for 45 minutes and up to 2 hours while waiting for the disfunctioning hospital to make room for their patients.  During all that time there are no ambulances available to respond to fresh emergencies.  The Canadian provinces have apparently gotten their acts together and have largely eliminated the loading dock backups, but in some areas of Australia the situation has not improved at all.

"Ramping" at PA Hospital, Queensland, Australia

What brought this up today was the news from Down Under about a locally famous TV cooking show chef whose family home burned down Monday morning killing the mother and their three children and leaving Chef Matt Golinski in critical condition with 40% burn coverage.  Also making the headlines was that the ambulance dispatched on this most urgent call did not arrive until a half-hour after one was called for, and there was only one – one! – person on the unit, a paramedic / driver.  The Sydney Morning Herald reported yesterday:

The spokeswoman said an intensive care paramedic was dispatched from Maroochydore but confirmed only one person was in the ambulance, so a police officer then drove the vehicle from the scene to hospital while the paramedic tended to Mr Golinski.

She said there was nothing unusual about sending the first available ambulance, even if only one paramedic was able to attend, given other emergency response agencies were able to assist.

"If they're the closest vehicle then yes, it is standard operating procedure that other agencies would assist with driving the vehicle [to hospital]," she told this website.

You got that?  In the minds of the bunglers, there is "nothing unusual" about an ambulance showing up with only a driver.  They also further say that the delay and failure to send more than one ambulance was because all units were busy on other calls.  This was at 3:30 am.  The ambulance supervisor, by the way, didn't arrive until 45 minutes after dispatch.

I'm not deliberately picking on the Queensland Ambulance Service, but merely using this most recent example to point out just what is going on in the civilized world as the governmental bureaucracies grow and starve out the basic functions they are charged with.  And don't think it isn't happening in the U. S., too.  Just this past Saturday, on Christmas Eve the city manager of Pontiac, Michigan, handed out layoff notices to the entire fire department.  Every single FD employee.

Ok, watch your back and let's get started on this equipment check.  I'll head for the Bunn-O-Matic and get another pot started.

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Morning Lineup – December 24

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Saturday Morning – Let's Go Watch the Fire

There is no lack of towns that have incompetent politicians that run the treasury dry and then try to blame the city employees for their failures.  How they propose to bail out of their crises can become innovative and sometimes even comical.  Danbury, Connecticut, is the latest city council to don clown hats and big red noses while they toy with the citizens' public safety.

Earlier this month the fire chief announced that the department will be shutting down one of the city's busiest engine companies (Engine 21) during the day as "a crucial cost-saving measure."  In its stead, the firefighters will not be used to fill in vacant positions, oh no.  They are being kept in quarters and given an SUV to drive to fire calls in.  No water, no pump, no tools…. just a big uh-oh squad to comfort the taxpayer as they all gather to watch the house burn while waiting for the 2nd- and 3rd-due companies to arrive.  "Listen… do you hear the sirens?  They're coming!"

"Observer 21 responding…."  (Danbury Patch photo)

It seems that nobody but the fire chief understands how this will save money or maintain protection.  Local 801's president recently talked to the Danbury Patch:

"It's all smoke and mirrors," said Louis DeMici, president of Local 801. "We've asked them for documentation. We've yet to be provided it."

Both Mayor Mark Boughton and Fire Chief Geoff Herald have said the city is saving money on the SUV for many reasons. It is smaller, uses less gasoline, its maintenance costs are a fraction of that of a fire engine. They argue a fire engine isn't required on most calls, because most calls to the fire department are not fires.

DeMici said the city is claiming replacing Engine 21 with a smaller, red SUV is saving money, but really, when the SUV arrives at a fire, other fire departments in the city have to send an engine, so they're sending them farther, adding extra wear and tear. In those cases, the SUV is more expensive than if the SUV was still Engine 21.

"The union is opposed to this," DeMici said. "When Engine 21 is closed, another company has to respond. It's a longer distance."

According to the Local's WEBSITE, the unit serves the downtown area south of West Street to the Bethel Town line and the Long Ridge Road area, where the reduction in resources could be a big problem. The coverage area has several pockets of densely-populated neighborhoods, apartment buildings and schools.

Does this clown council qualify for listing in the "silly season" file?  I sure hope that you don't have bosses that think that way.

Let's get started on the equipment check now while I get the Bunn-O-Matic into high gear.  Watch out for all those last-minute shoppers and traffic jams today.  See you back in the day room in a little while.

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This Really Messes Up the Response Time Averages

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This Explains That Big Blip on the Graph

A WOMAN IN NOTTINGHAMSHIRE, ENGLAND, WAS SURPRISED, then upset, and now is disgusted after an ambulance arrived at her house for a scheduled transport to take her husband to a medical facility.  The problem was that the man has died nearly four years ago.

The Press Association reports:

Doris Keeley, 65, said: "My husband had never been for any such appointments. I took his death badly at the time and, you know, you just get on with life, and then this comes and brings it all back. I'm very upset. If it had happened six months after his death I'd have been finished.

"I saw George's name on the pick-up list along with our address and postcode and was told the ambulance had been requested by Barnby Gate Surgery in Newark. We had never used that surgery."

A spokeswoman from the surgery confirmed that they had booked an ambulance two weeks in advance, but for a different patient at a different address.

The East Midlands Ambulance Service has started an investigation into what caused the snafu.

East Midlands Ambulance photo

The Press Association has the STORY.

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Shock … followed by purposeful action

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A brilliant and terrible Tuesday morning

Fourteen months into retirement I am teaching a Fire Officer II class at the Reagan National Airport fire station. The classroom is also their kitchen. The kitchen has a television.

The acting battalion chief steps in, apologizes for the interruption, and turns the television on. 

Good Morning America (ABC) is covering the breaking news of a plane that has hit the World Trade Center.

As the news camera focuses on the entry hole, many of the experienced air-crash-rescue guys are speculating on what type of plane hit the tower and the issues facing FDNY.

After a dozen minutes I try to restart the class. Agree to leave the television on with the sound turned down. I get one or two sentences out when we see the second plane hitting the tower.

Class over!

You do not need a Formal Announcement to Mobilize

As FDNY Firefighter James Hanlon (Ladder 1) points out in the opening of the Naudet Brothers documentary 9|11:

… there were days we would go to the Trade Center five times in a single shift. My point is, we knew those towers as well as anybody. But nobody, nobody, expected September 11th.

When the civilian editors of Fire-Rescue Magazine and Journal of EMS were vetting my article, Attack on the Pentagon: The Initial Fire and EMS Response (April 2002 issue), they struggled with the concept that hundreds of emergency responders initiated action without receiving a formal notification.

The Metropolitan Washington Airports Authority Fire Department never expected a 757 to be used as an assault weapon against the Pentagon. When the second plane struck in New York, the dozen off-duty members attending the Fire Officer class joined the 16 on-duty members preparing for the unknown.

They were not alone.

Most of the senior staff and urban search and rescue commanders in my department started purposeful action when they heard of the second plane in New York City. The information came through radio and television, informal digital networks and word-of-mouth.

Rapidly deploying 72 USAR members and 75 tons of equipment

It takes dedicated action by dozens of staff, support and non-USAR firefighters to make a deployment happen.

A point of pride is the ability to assemble the team well within the response deadline for domestic and international response. A deployment represents an administrative five alarm event.

A small role I had while assigned as a company officer at the Fire and Rescue Academy was to respond from home to get the facility unlocked on evenings, weekends and holidays. The Academy, with six classrooms and a large training bay, is the point of staging and assembly for the team.

Far from high tech. The tasks included moving apparatus out of the bay, properly configuring the "quad" – a large space with movable walls to create smaller class spaces, and powering up the facility.

Have to do Something

Ten years ago I also had a part-time job as a civilian Fire Instructor III at the Fire and Rescue Academy.

American Airlines Flight 77 struck the Pentagon shortly after I left the airport.

I was stunned. What could I do? No fire gear in the car, not in uniform, my "retired" fire department ID card did not provide KardKey access to headquarters or communications.

Headed for the Academy. Maybe they are assembling a fire crew with Engine 407.  I was at the Academy in 1982 when we loaded up a Suburban with EMS gear and responded in near-blizzard conditions to the Air Florida 90 crash at the 14th Street bridge.

Not this time. All of the on-duty uniformed staff are away, either responding to the Pentagon or the anticipated USAR deployment. None of the remaining staff experienced a USAR deployment. 

I looked up in time to see the South Tower collapse on live TV. 

Purposeful Action – Setting the Academy for USAR deployment

No more wondering what to do.

Without asking for authorization, started moving academy apparatus out of the high bay building and up the hill. Configured the quad. Tried to set up the communications equipment, but no one had the key to the cabinet.

Before the 11 am official federal mobilization notice, the academy was ready …

… and I was on my way home, satisfied that I did something worthwhile in reaction to the unthinkable.

An Inherent Orientation to Action

Emergency service folks are hard-wired to take action.

To validate the impact of our Citizen CPR program we tried to identify the background of every person who performed CPR prior to the arrival of the department. More than half of the citizen responders were off-duty or former police, fire, ems and health care staff. 

The same orientation that motivated Jeff Simpson, a Dumfries-Triangle Rescue Squad volunteer EMT who was near the World Trade Center. 

From the National EMS Memorial:

"I have no doubt whatsoever that, while I was stricken with disbelief and inaction, Jeff was figuring how he could help.

It was clear in the few minutes we were in the plaza that thousands of people had and would continue to be injured. There were many police, fire and EMS squads arriving at the scene and it was toward these and the injured that Jeff was headed the last time I saw him.

Frankly, there was no other reason for him to go towards the World Trade Center. His hotel, work site and safety were in the opposite direction.

With the second plane hitting the tower, Jeff would have been thinking about the increased number of casualties. I believe Jeff was caught in the collapse of the towers.

I do not know if he was inside the towers or working at one of the triage stations that had been set up close to the towers. In either case, he was doing what he was trained to do and spent his final hours helping the victims," stated Joseph T. Finnegan.

Mike "FossilMedic" Ward

Earlier 9/11 essays:

2011: Remembering 41 EMS responders who died at WTC, including a hero from Prince William County, Virginia

2010: A Terrible and Brilliant Blue Sky Morning

2008: Reprint "The Anger Never Dies"

Kansas City fails to meet ambulance response times

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After Fire Department takeover of MAST, a year of poor ambulance response times

An April 23 editorial in the Kansas City Star:

The Fire Department has failed in every three-month period since the takeover to meet the council’s response requirement citywide.

In fact, the department hasn’t yet reached the mandated response time citywide in any single month. The times have been slowest north of the river, and often not much better in the city’s southern parts.

(ambulance picture from Mike Ransdell @ Kansas City Star )

Read more here: The Star’s editorial | KC’s ambulance response times are unacceptably slow

Issues with the work hours and compensation of the former MAST paramedics. 

Accusations that the fire department is forcing single-role ems providers to work a 52 hour work week for the pay they were getting while working a 40 hour work week.

A proposal to place single role providers on a 24 hour shift was reversed last month after consulting with the city attorney. 

While the discussion remains a "private lawyer-client" matter, pretty confident it may relate to the experience from other fire-based ems services that struggled with application of the Fair Labor Standards Act to "uniformed civilians."  (article HERE)

Firefighters receiving cross-over training and taking ems overtime shifts instead of the single role civilians.

Single-role former MAST employees not confortable with fire union representation.

Another hostile takeover of an ems service with a messy and unfinished merger one year later.

Mike "FossilMedic" Ward

related articles:

November 22, 2009 (KCFD takeover of MAST):  The Neon Red Elephant of EMS   

November 05, 2010 (why firefighters would want ems):  The F-word in EMS .  

 

Ohhhhh…. It’s the Geography!

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THE WALES AMBULANCE SERVICE IN UK HAS been under constant criticism for more than two years for its extraordinarily-long response times that are consistantly the worst in the UK.   Ambulance service executives have come and gone in a constant attempt to bring in somebody who can solve the problem.

Today BBC News is reporting that Catherine O’Sullivan, of Aneurin Bevan Community Health Council – the health watchdog which covers the former Gwent area – said the “difficult geography” of Wales should be taken into account when calculating ambulance response times.  Apparently more hills and dales add minutes to the time it takes to travel a few miles to the emergency.  Listen to the audio interview HERE.

Ambulance Penalized for Poor Response Time

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LATE SATURDAY AFTERNOON A 20-YR.-OLD WOMAN fell off a 5th-floor balcony in Fatehgunj, India.  Immediately neighbors started calling the emergency number for help but the town’s only ambulance was on another call at the time.  When it failed to show up promptly, the locals put the woman in a private vehicle and drove her to a hospital.

The Indian Express relates what happened next:

When the 108 emergency van arrived 30 minutes later, the angry crowd attacked it.   The van left, but returned with a staffer flashing a cricket bat at the crowd. This made matters worse. “The locals must have made around 25 to 30 calls in the period, but the ambulance arrived half an hour late. By then, the crowd had completely lost patience and started pelting stones at the van. At this, someone from inside the vehicle pulled out a cricket bat,” said Firoz Sheikh, an eyewitness.

Apparently the brandishing of the cricket bat was the tipping point because the crowd then set upon the three ambulance workers and beat them up while they trashed the ambulance.

Meanwhile, the woman for whose aid the ambulance was called, Somaiya Memon is in serious condition. “The woman’s mother informed us that she has a medical problem that makes her feel dizzy and faint at times. She was on the balcony of her apartment on the fifth floor when she had a similar attack. She was rushed to a private hospital and is in a serious condition,” said Head Constable Jayanti Vallabhi.

   

 

4 Infants Perish as Baby Sitter Bails Out

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FOUR CHILDREN UNDER THE AGE OF 5 perished Saturday night when a fire swept unchecked and unreported through a townhouse in Flint, Michigan.  One of the children lived there and the others were being watched by the child’s father, a 28-yr.-old man who was cooking something and fell asleep.

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Flint Journal / Hollyn Johnson

When he woke up, the fire was well advanced and he dove out a first-floor window to escape.  The children ages 4, 3, 2, and 1 were all upstairs and trapped in the fire.  At about that time, shortly after 11 pm, a neighbor saw the fire breaking out the windows and called the fire department.

Battalion Chief Andy Graves told the Flint Journal that the home was fully involved when the units arrived, but they made an attempt anyway, advancing a hose line up the stairs while knocking down the fire.  However, all the children were already dead by that time.  Chief Graves added that the prolonged response time of seven minutes was created by the closure of a nearby fire station.  He also said that none of the smoke detectors in the public housing unit were working and that contributed greatly to a delayed alarm.

The fire got up into the common attic and spread throughout the building, damaging the other five units in the structure.

The Associated Press has MORE.

“Where’s That &%*$@* Ambulance?”

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PERHAPS AMBULANCE RESPONSE TIMES NEED TO be taken a little more seriously in Macon, Georgia.

On Monday afternoon a 55-yr.-old man was taken into custody the police for discharging firearms in the city limits.  The Macon Telelgraph reports on why he was doing it:

Isaiah Morgan, of Swan Drive, told officers he is a diabetic and called 911 for help. He said he was shooting guns because the ambulance didn’t come fast enough, according to the report.

A woman living in the 1700 block of Wren Avenue told officers her apartment was hit by a stray bullet, but it wasn’t damaged. She said she didn’t want to press charges, according to the report.

Police say they took a 22-caliber revolver and a shotgun from Morgan.  The report didn’t state how long Morgan had been waiting for the ambulance.

Ambulance Delays by Design

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THE CENTRAL AND WEST WALES AMBULANCE SERVICE already has one of the UK’s worst response time averages, arriving at the scene of an incident within eight minutes only 47.8% of the time.  Now the Regional Director of the ambulance service has taken firm and positive steps to …… make their response times even worse.

The director, Richard Lee has instructed the dispatchers that they will not dispatch any ambulance while the crew is on their “meal break,” even if the medics want to be available.  A health trust spokesman said, “Ambulance crews are entitled to an uninterrupted break during their shift in line with the UK-wide NHS terms and conditions of service for non-medical staff.”

The County Times reports from the medics interviewed:

“Can you imagine a road accident or a cardiac arrest happening in Welshpool and control having to ring a crew to attend from Llanfyllin or Newtown because the ones two minutes down the road are having lunch? It is ludicrous,” explained one crew member.  “We have no idea why they have decided to enforce this ruling but one that’s for sure is we’d all rather be made available. What they are doing is putting lives at risk when at the same time we’re all volunteering to be made available during our meal breaks.  People will die as a result of the absurd new rule.”
They also fear response times to life threatening calls will be further delayed despite already being the lowest in Wales.  “Response times in Powys are already pretty poor as it and this will just make things worse,” added the worried crew member.

Firegeezer has been reporting occasionally from several areas around the UK where this absurd rule has been in place.  Many times there have since been people who have been critically ill, sometimes dying as a nearby ambulance is off the air for the mandatory meal break.  The medics and their union have been very vocal in their opposition to this nutty reasoning.  Whenever one of these tragedies occur, the medics are both angry and emabarrassed about the whole thing.

See one of our previous reports on this scheme HERE,

One Plane Looks Like Any Other

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AN AUSTRIAN AIRLINES (AUA) BOEING 777 was enroute from Tokyo to Vienna Wednesday when a 90-yr.-old woman took seriously ill.  The pilot radioed to Helsinki-Vantaa Airport in Finland requesting an emergency landing and calling for an ambulance to meet the aircraft.

However, when the plane landed and stopped on the taxiway, there was no ambulance.  The pilot radioed again, but still no ambulance.  Finally, 45 minutes later the ambulance showed up.  But by then the woman had passed away.  The ambulance had been standing by at another aircraft a kilometer away, a Finnair plane that had just arrived from Tokyo.

It’s early in the investigation, but it has already been determined that the airport ground control had passed on accurate information to the emergency dispatch center.  Now they are trying to determine why the ambulance went to the wrong airplane.

Sourced from:
Helsinki News
Austrian Times
YLE News

"Bridge-Breaker" Ambulances Required to Detour

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THE LATEST ADDITIONS TO THE GREAT WESTERN AMBULANCE SERVICE fleet in Great Britain are too heavy for Bristol’s most famous bridge.  The historic suspension bridge was designed and built by famous engineer Isambard Brunel 150 years ago.  While it remains structurally sound, it has a weight limit of 4 tons.

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Clifton Suspension Bridge (Getty image)

As ambulances everywhere are getting larger and larger, the GWAS has recently taken possession of some units that weigh nearly 5 tons.  So the word has been issued:  All GWAS ambulances are required to use alternate routes to get from one side of the river chasm to the other.  Rapid Response vehicles can continue to use the bridge, however.

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Bristol Ambulance photo by 999Josh

The added response time of the 2-mile detour is partly offset by the higher speed limits on the revised route.  Fire engines are also prohibited from using the bridge.

The Daily Telegraph has the full STORY.
Great Western Ambulance Service WEBSITE.

The Bristol area of the GWAS already holds the distinction of having the worst response times of any ambulance service in the UK.  Just last month the Bristol News reported:

The ambulance service in the Bristol area remains the worst in the country for reaching the sickest patients, according to new figures.

Great Western Ambulance Service (GWAS) failed to meet national targets for attending life-threatening emergencies every year since it was formed in 2006.

It has also continuously been the worst performing trust in England for the same period.

You can read the entire article HERE.

Pre-Planning the Desert

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BERNALILLO COUNTY, NEW MEXICO, FIREFIGHTERS ARE TAKING ADVANTAGE of recent refinements of modern technology to improve response capabilities in the desert.  Anybody who has driven through the wild west knows that you can travel for miles on end on unimproved roads that go nowhere.  Except to the occasional isolated homestead or makeshift dwelling.

Whenever the FD gets a call for a fire or medical emergency, it is common to struggle to find the location where the dirt roads have no names and the old trailer homes have no numbers.  And traveling down the wrong road will lead to a dead-end while you can see the smoke rising from just a couple of miles away. 

Now the county fire department is using their advanced GPS equipment to map out these outreaches and document the locations where people are living.  Taking a one-time blitz attack on the project to map out the vast Pajarito Mesa, a team of 20 firefighters is spending an entire week mapping out the roadways and identifying the locations where living souls are to be found.  Many, if not most of them, are the time-honored squatters who live their lives anonymously.

KRQE-TV Ch. 13 Albuquerque explains:

The concept of the project is simple; map every road, home and structure in the Pajarito Mesa, including land owners and squatters.  Bernalillo County Firefighters have already mapped more than 200 miles of road in only four days. They said they don’t know how many more miles they will have to do.

In addition to the roads, they’ve also documented each home.  Whether it’s a tent, a trailer or a house, each one will be placed on the map.  “There’s a bunch of houses out here, homes I should say,” Firefighter William Walker said.

Bernalillo County Battalion Commander John Nash said too often homes burn to the ground while fire crews desperately try to find their location. He said once the mapping is done, response time will be reduced.

Here is their video report from the field on this unique challenge:

Still On Hold For Meal Breaks in UK

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THE PRACTICE OF PUTTING EMERGENCY CALLS ON HOLD WHILE the ambulance crews take their full allotted time for meals is still vigorously practiced in the UK.  The latest chapter in this sorry saga comes to us from Portsmouth, England, via The News:

Emergency calls are being held back from ambulance crews so they can have tea breaks, The News can reveal today.

The revelations come a month after The News reported how an injured 96-year-old woman from Gosport was left shivering on the pavement for over an hour, while an ambulance crew tucked into their meal just a few hundred yards away.

The ambulance service has confirmed that its investigation found that the only crew available in the area were on a break at the time, and the crew were not alerted until their break had finished.

A paramedic, who wished to remain anonymous, said: ‘The control room have been told not to send people out when they are on their meal break.

‘But as soon as the break is over very, very often you get called to a job which came through to the control room earlier.

‘Over the last 10 shifts I’ve done, on nine of them as soon as the break is over, five seconds later, you are called to an incident that came in 20 or 30 minutes before.

‘If the crew is on a break, then the control room will just sit on it – this is putting lives at risk and it’s bordering on criminal.

You can read the full article in today’s edition of The News HERE.

Longtime readers of Firegeezer know that this is not the first time we’ve brought such articles to you attention.  Going back over two years, we’ve been passing along horror stories such as the man who had a fatal heart attack on a London sidewalk just around the corner from an ambulance station.

This is not a creature of the medics’ union, but instead it has been promulgated by an entrenched bureaucracy that has lost sight of just what the mission of an emergency ambulance service is.  The paramedics are always both embarrassed and infuriated when this happens.  They are flat out against it and are constantly telling the public that they want to be dispatched to emergencies.  But the pencil-pushers are insistent on keeping the crews on a full, scheduled break instead of allowing them to eat during their slack times.

Have we mentioned that the UK ambulance services are a part of their nationalized, government-run health care system?

"Yeah, We're Saving Money….Maybe"

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ATLANTA, GEORGIA, HAS EARNED FOR ITSELF the reputation of being one of the most ineptly-run city governments in the country.  One of their dubious methods of providing for the citizens’ health and well-being is to play “firehouse roulette.” 

That’s the practice of shutting down firehouses on a rotating schedule and hoping that the day goes by without something serious happening nearby.  That didn’t work so well the other day for an Atlanta police officer who was having a heart attack in his cruiser.  Here he tells WAGA-TV what happened:

It Doesn't Help the Response Time Average, Either

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A 79-YR.-OLD MAN IN HAMPSHIRE, ENGLAND, RECEIVED A DOUBLE-DOSE of National Health Service incompetency earlier this month.  The resident of Bishop’s Waltham was downed by an infection on June 3 and needed emergency transport to the nearest hospital in Winchester which was 11 miles away from his home.  So his wife called the South Central Ambulance Service NHS Trust and they responded.

Mr. Leslie Palmer was packaged up and put in the ambulance, ready for the 20 minute trip when things started to not go just right.  His wife tells Andrew Napier of This is Hampshire:

Mrs Palmer explained that the first time she knew something was wrong was when the driver said they were in Charles Watts Way, Hedge End – the opposite direction – and 19 miles away from the hospital.

“I heard the man inside tell the driver ‘get on the motorway’ but it was much longer than it should have been,” she explained.

They eventually reached the hospital 45 minutes after setting out on the 11-mile journey.  Nothing has been reported on just what the NHS hospital did for Mr. Palmer, but it didn’t seem to work.  He was sent back home where just two days later he required emergency transport back to the same hospital.

This time he got a different ambulance crew, but like the first one they have been forcefully instructed to always follow the guidance of the SatNav system on all of their travels.  (Street knowledge is apparently discouraged at South Central.)  She tells the PA how this journey went:

After leaving their home at 6:50 pm, “We were soon going through lanes I had never seen before,” said Mrs Palmer, a retired nanny.

“We were on little roads no bigger than the ambulance and my husband’s head was shaking around and we thought we were going to end up in a farm yard at any minute.”

Mrs Palmer said that the ambulance eventually got off the lanes at a village called Fishers Pond at 7.30pm but still five miles from the hospital in Winchester.

Another 45-minute scenic cruise for the Palmers.

Mrs. Palmer later stated the obvious,  ”It’s an utter nonsense. Taxi drivers have to know the roads, why can’t the ambulance driver know the roads – I cannot believe it.”

South Central Ambulance Service WEBSITE.

Response Times Still Slow in Wales

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THE WELSH AMBULANCE SERVICE, MAINTAINING ITS REPUTATION as the worst segment of Britain’s National Health Service ambulance divisions,  took an agonizingly-long three hours to respond to an elderly woman who was laying on the floor in pain after a fall.

Hilda Davis, 75, fractured her hip when she fell in her home Tuesday afternoon at 2:15.  Mrs. Davis resides in a “sheltered accomodation” facility and when the home wardens found her 30 minutes later, they called 9-9-9 immediately.  But the ambulance did not arrive until 6 pm.  WalesOnline continues:

(Her son Mark) Davis, 50, who is a chiropodist, said: “I had a call saying that mum had a fall and as I had another couple of appointments to do, I assumed that the ambulance was en route and that I would meet mum in A&E.

“I called the warden as I was heading for A&E only to be told that mum was still there waiting for an ambulance.

“I headed straight for her home and the medics finally arrived at about 6pm – they were embarrassed that mum had been on the floor there for three hours.

“They did their best for her and got her to A&E.”

He added: “We’ve been let down by the ambulance service – not by the staff who are doing the best they can but by the service itself.

“This is not a service. For someone to be waiting three hours-plus, that’s not a service, especially for the elderly.”

The officials at the Welsh Ambulance Service are taking the same action that they do for all the other significant delayed calls, they issued a statement.  “We would like to apologise for any distress caused by the delayed response of the service.”

This follows on the heels of another remarkable event this past Saturday when a 79-yr.-old man was left laying and bleeding from a severe head injury for 2-½ hours before an ambulance arrived.  The ambulance was called at 4 pm and major head injuries are supposed to be moved up to a priority 1 level of dispatch.  The ambulance eventually arrived at 6:30.

Miss Harvey, 49, from Whitchurch, said: “We didn’t know what to do for the best – we thought about driving him because none of us had been drinking.

“But because he had hit his head so hard we were worried that something would happen on the way to hospital if it was just me and him in the car.

“We felt that calling an ambulance was the best thing to do – I now wish I’d taken him to hospital myself.”

Being delivered to the University Hospital of Wales wasn’t the end of his woes, however.  He was left waiting there for nearly six hours before he was seen and then a doctor finally got to him at 2 am.  The Welsh Ambulance Service jumped into action by issuing their standard statement,  “We apologise for any delay which may have occurred in this incident. We are unable to comment on individual cases but clearly this is an issue we are taking seriously and an investigation will be conducted.”

Ahhhh….nationalized health service.

A-Crash-A-Day for Scottish Ambulances

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SCOTTISH AMBULANCE SERVICE UNITS were involved in 334 collisions in 2008, with 67 of them occurring during emergency responses.  Patient transporters, designed for non-emergency transport of infirm patients to medical facilities, accounted for nearly one-third of the accidents.

However, one member of the Scottish Parliament is blaming the accident rate on pressures placed on the service to meet designated response-time averages.  The Daily Record reports:

Scottish Tory health spokeswoman Mary Scanlon blamed time targets for the number of accidents.

She said: “The target of reaching 75 per cent of 999 calls in eight minutes was achieved last year but it puts tremendous pressure on drivers.”

The Highlands and Islands MSP added: “More emphasis should be placed on the treatment given to the patient, rather than simply counting the minutes.

“Obviously, the time taken is important but it is only one of several elements.”

Read the entire article HERE.

A Different View of "Progress"

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CUMBERLAND COUNTY, NORTH CAROLINA, HAS THE SLOWEST AMBULANCE response times of any large county in the state.  Last year the ambulances were taking 18 minutes to arrive at an emergency location.

A committee of mostly fire and EMS officials have just reported to the county commissioners on their suggestions for improving the response times.

One of them calls for a centralized 9-1-1 and dispatching office which would shave a couple of minutes off the response time.  Another suggestion was to replace the current ambulance provider with another one that would be created by the county.  They didn’t say how that would make things better.

The current head of the county ambulance service said that the county is implementing new procedures that should shave up to 90 seconds off response times in the short term.  Those new procedures were not spelled out for the newspaper reporter.

They stated that their goal is to reduce the response times to 12 minutes by 2013.  And their overall goal is to have the response times down to national standards, nine minutes,  by 2015.  “That’s right, folks.  If you can just hang on for another six years or so, we’ll start getting to you before you die”.

Read the complete story in the Fayetteville Observer HERE and you will see that nowhere do they say anything about perhaps adding more ambulances and medics to key areas.  Maybe that’s one of the “new procedures” that they didn’t specify.

This select committee hopes to have a final report on their recommendations to the commissioners by Christmas of this year.