FDNY Training Tips 2024-51: MAYDAY for a Member - Cyanide in Smoke
- Thread starter Capttomo
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This speaks to my post of a few weeks ago. In addition to the F.A.S.T. Truck, a C.F.R.D. Engine AND A Dedicate Firefighter ONLY, Advanced Life Support Ambulance should be included in the assignment of ALL "All Hands or Above" Incidents. Chicago F.D., L.A.F.D. have a Dedicate A.L.S. Ambulance responds along with a "F.A.S.T./R.I.T. Chief" to all working fires. F.DN.Y. at one time had, "And Not that long ago" department Ambulances that responded to all multiple alarms, these ambulances were manned by train Firefighters who operated under the direction of a FDNY Medical Officer M.D. when the Dr. arrived, at the incident. The need for treatment for Cyanide poisoning for smoke inhalation victims has been strongly shown in recent research and that includes firefighters. A Rapid Intervention Company Engine = "R.I.C.E." is also needed, as a dedicated unit/s to stretch a hoseline/s to protect members tapped from spread fire. F.D.N.Y. let's UP OUR GAME.
Captain Bob Rainey FDNY Engine 26 retired
Captain Bob Rainey FDNY Engine 26 retired
Certain EMS Branch directors will dedicate a FAST bus
Now if we only had more of those “certain” individuals.
Cap, All good stuff and I agree we can always do better. With regard to dedicated ALS for Firefighters only, In theory it sounds easy but in practice it's a little more involved. When resources permit you can, and I have dedicated an FDNY ALS to the FAST team. Usually the FDNY Rescue Paramedics as they have additional training. If not available then a regular ALS unit till I get a Rescue or assign a BLS till additional units get into the box. Not perfect but it will work.
With rapidly changing conditions such as rescue of a 10-45 code 2 we would need to have the ALS address the 10-45 if they were in fact the only ALS on the scene. Similar to putting the FAST Truck to work for fire duty. Additional ALS & BLS resources would also be requested under these conditions. **Note to EMS Officers** don't forget about the members who just got the victim out of the IDLH as they likely need a once over to be sure they are uninjured ** . Like all requests for additional units you have to think about reflex time. Where are they responding from ? To address this dilemma I frequently tried to stack the deck in my favor by requesting additional units early even if the alarm level hadn't yet escalated and yes, I have been scolded for it in the past. In Medical Branch Director class I was told to listen to the handle talkie and let the information drive my decision making and it has served me well. Have I been caught short ? absolutely ! But, I tried really hard to not let that happen again.
In my view EMS officers should not be concerned about requesting additional resources as they see fit for rapidly escalating incidents (reports of water problems, trapped occupants or actual 10-45's just to name a few) regardless of the alarm level. When the higher up's form EMS arrive they can release what they don't need. EMS officers should also convey un met needs to the incident commander. It's a big department with a deep deep bench that can transmit additional alarms or special call fire resources for EMS work. So much to discuss but know that the solutions exist.
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The idea of a dedicate ALS unit for Firefighters as I said is done in Chicago, L.A. and I think Boston. When I started filling in as an FDNY Acting Battalion Chief the Division Commander in FDNY Division 3 and truly a great one Vincent Dunn, said if you are the I.C. Commander and the fire or incident is not under control you should never be standing there with no one to put to work if needed. Call help early and keep in mind the "Reflex Time" = the time from when you call for help, until the help is on the scene and ready to go to work. In short if no one is standing next to you have already screwed up. That applies to EMS both B.L.S. & A.L.S, Units. Don't play catch up, have all the help standing near BEFORE you need it. At times I called for a 10-75 or a 10-76 and all the units were not needed. I just said thanks and we let them go home. NEVER put the FAST/RIT Team to work for anything but FAST Work, until the new FAST/RIT team is on the scene and ready to go to work. I say it again if you call enough help, early there is no reason you put the FAST/RIT team to work unless there is a Mayday! Captain Bob Rainey FDNY Engine 26 retired,
Also on larger jobs i.e. 10-77s, etc a rescue medics will be assigned to the FAST and may stage the floor below.
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The Rescue Medics and all Medics and EMTs are great people and yes, at big jobs they're assigned to the FAST Team/s but once again they are not dedicated to Firefighter only. One or more serious civilian injury put them to work on the effected civilians and the Rescue or other Medics are not available when the firefighter/s, who may haves rescued or removed those civilians need advance life support. We have firefighters who are fully trained R.N. and Paramedics, some on light duty from injuries. Let us use them to treat our own firefighters in a dedicated "Firefighter Only" medical unit. Captain Bob Rainey FDNY Engine 26 retired
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Brother it is possible, and the dedication of an ALS Unit is done in Chicago, L.A., Philadelphia, and as I said I think Boston. Also, as I have said it was also done in FDNY years ago in a somewhat different form. The FDNY Department Ambulance responded with somewhat trained firemen and the FDNY Medical Officer/M.D. and the Medical Officer supervised the treatment of any injured members. I once had glass blown into my eye, at a 2nd alarm in the Bronx. The department ambulance responded, and the Medical Officer, placed a patch over my eye and had me transported to NY Eye & Ear Hospital on Manhattans Lower East Side. Many young FDNY Firefighters were EMT or Paramedics before becoming FDNY Firefighters, so it is just a matter of recertification and reopening Department Ambulances for use by members only. Or as the cities above, MORE Dedicated ALS units assigned on serious fire and emergencies. How do I justify a dedicated Ff. ONLY ALS Unit? I would add more ALS units to the assignment at every serious fire or/& add a Department Ambulance to the All hands or Greater Alarm assignments. Captain Bob Rainey FDNY Engine 26 retired.
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In my opinion I think the Ambulance should go automatically on a 10-66 or on a Third Alarm.
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That is what formally happen in FDNY in the 1970s when I came on the job. Often, I would work at Satellite 1 that was quartered in the old firehouse of Engine 30 on Spring St. now the location of the FDNY Museum. Also, in E-30s old quarters, was the old Medical Office and the large apparatus floor quartered 3 Department Ambulances. Only one normally responded on any 3rd Alarm or greater. But Thay could be special called when ever need for any line of duty injury, or by order of the Incident Commander. The firemen driving the ambulances were somewhat trained but knew their equipment and would work under the direction of the duty Medical Officer M.D. Captain Bob Rainey FDNY Engine 26 retired
I think we are all in agreement that additional dedicated EMS resources are needed at the scene. The current response matrix has BLS/ALS & EMS Officers on all alarm levels. They are assigned on the transmission of the 10-75 or special call and in circumstances where the box is loaded up they are sent at the same time as the additional companies on the box. It's an automated system. Keep in mind that EMS availability to respond appropriately is based on what is going on in the city at that specific moment in time. The same EMS units that service the city for every other medical situation are the same units that will be responding to the 10-75. There is no special pool of individuals waiting for fire specific responses.
It has been previously brought up that a system of Department Ambulances staffed by trained FDNY Firefighters supervised by FD Doctors has had a positive impact on the departments ability to care for its members. And, while that worked then I don't think it would be feasible today, It has to do with indemnification, compensation, job description, contracts, training , supervision, scope of practice and a whole host of other things that normally weigh initiatives down including who is paying for it. If its not funded or has no influential stake holders with access to funding sources its dead on arrival.
The city has an existing functional (overtaxed and underpaid) EMS system. The answer in my mind is to take the existing system and improve it so that it functions in a manner that serves the needs of the members and the public. Admittedly, the pervious statement is easier said than done. Because, unless you have an administration (outside of the FDNY) that thinks this is a priority the idea will sit on the back burner indefinitely with an occasional dust off when we have a close call or a tragedy only to be back burnered again as time passes.
It has been previously brought up that a system of Department Ambulances staffed by trained FDNY Firefighters supervised by FD Doctors has had a positive impact on the departments ability to care for its members. And, while that worked then I don't think it would be feasible today, It has to do with indemnification, compensation, job description, contracts, training , supervision, scope of practice and a whole host of other things that normally weigh initiatives down including who is paying for it. If its not funded or has no influential stake holders with access to funding sources its dead on arrival.
The city has an existing functional (overtaxed and underpaid) EMS system. The answer in my mind is to take the existing system and improve it so that it functions in a manner that serves the needs of the members and the public. Admittedly, the pervious statement is easier said than done. Because, unless you have an administration (outside of the FDNY) that thinks this is a priority the idea will sit on the back burner indefinitely with an occasional dust off when we have a close call or a tragedy only to be back burnered again as time passes.