DAVE STATTER’S FIRE BLOG STATter911 is running a tape of a roadside childbirth from yesterday that carries an excellent example of a professional dispatcher/firefighter talking the process through with a very excitable father.

Click on his webpage HERE and then click on the link labeled “hear entire 911 call.”  It runs for just over 8 minutes, but it’s precious.

DON’T WHINE IF YOU DID NOT REVIEW AND COMMENT

The very last chance to review and comment on the EMS Scope of Practice Educational standards will close May 30. This is the third and final draft before the standards are submitted to NHTSA. The scope replaces the National EMS Curriculum in 2011.

Go here to access the draft documents:

http://www.nemses.org/draft_standards/index.cfm

Two-thirds of the existing paramedic instructor-coordinators will be unable to run or supervise paramedic training programs when the states adopt the scope.

I would tell you why, but you need to read the standard yourself … or re-read this blog entry from last year:

http://firegeezer.com/2007/09/25/nursing-is-a-profession-firefighting-is-a-hobby-and-paramedics-are-caught-in-the-middle/

It’s not Pizza AND Beer….. It’s
Pizza Beer

Tom Seefurth, a Chicago-area home brewer,  saw the possibilities of blending two great favorites and developed what he calls the World’s First Culinary Beer. 

After spending a year refining the recipe, he is now offering Mama Mia’s Pizza Beer.  Using a flavoring packet containing a secret combination of basil, oregano, tomatoes and garlic during the brewing process, he has introduced his Pizza Beer to the mid-western market.

By holding a series of flavor tests in various Chicago taverns, he found that he had a hit on his hands.  So Seefurth went to the Sprecher Brewing Co. in Milwaukee and contracted to have them produce the dark brown ale with the unmistakable pizza aftertaste.

“We started brewing in February and lined up distributors in the Chicago area. Then we got calls from people in the Milwaukee market asking if they could sell our beer,” he said.

Making the rounds of television and radio stations, Tom and his wife Athena (Mama Mia) have been actively promoting the brew and demonstrating how it can be used in dozens of food recipes as well as just drinking it.

Available in its over-sized 16.9 oz. bottle, it retails for $2.49 each.  The distribution area now covers most of Illinois, southern Wisconsin and is spreading into Indiana.  You can go to their website HERE and learn the story behind the unique brew.  Click the “On the Big Screen” tab on the left sidebar and you can view some of their videos showing the various recipes.  And tell them Firegeezer sent you.

CLARKSTOWN, NEW YORK, POLICE HAVE ISSUED THEIR REPORT on the tragic ambulance crash of April 14 where a paramedic lost her arm.  (Firegeezer story HERE.)

Journal News/Kathy Gardner photo

The Regional EMS ambulance was proceding non-emergency when it swerved into a delivery truck that was parked on the road’s shoulder.  The crash ripped the right side off the ambulance and tore off the medic’s right arm.  She also suffered a fractured vertebra in her neck.  The driver suffered a head injury and fractures to his lower back and neck.  Both of them are in rehabilitation hospitals.

The police say that the driver Scott Millar, 19, took his eyes off the road and thought another vehicle was entering his lane, causing him to veer to his right into a flatbed truck parked on the shoulder of Route 59.

The Lower Hudson Journal News reports:

The Clarkstown Accident Investigation Unit found that “driver inattention” led to the accident on April 14, Sgt. Harry Baumann said yesterday.

“The driver was looking at his GPS and through his peripheral vision thought another car was coming into his lane,” Baumann said. “He swerved sharply to the right and hit the truck.”

The ambulance was on a non-emergency trip and was operating within the speed limit.  While the police have laid the blame with the driver, they have declined to place charges against him.

Read the full story HERE.

FossilMedic tells us that maybe they don’t really matter after all:

ALS RESPONSE TIMES: EMS PHYSICIANS SAY “NEVER MIND”

Twenty-five years ago semi-automatic cardiac defibrillators (AEDs) could only be operated by paramedics. Applying electricity was considered as invasive as starting an intravenous line, administering drugs or pushing a tube down the throat of a non-breathing patient.

Miami, 1966 - the first defibrillator

In order for my department to place AEDs on a fire company we had to make sure that there was an ALS credentialed firefighter on the rig. As we were starting the trial period in 1986, the updated national standard curricula allowed use of AEDs by EMT-Basics. The department did not stop the effort to staff engine companies with a paramedic/firefighter, because it increased the minimum staffing from three to four.

The chiefs were following the drama within the NFPA 1500 committee and believed that Department of Labor or NFPA would recommend four-person staffing of fire companies. Fellow fossils may recall the mass withdrawal of the IAFF representatives from the code consensus process in protest of how the internal workflow was progressing on the Standard on Fire Department Occupational Safety Programs. The final result of this battle was the NIOSH “two-in-two out” ruling for work performed in immediate danger to life and health (IDLH) environments.

EIGHT MINUTES FOR ALS MEANS MANY PARAMEDICS SEEING FEW PATIENTS

There is scant evidence justifying the ems response times that we have treated as gospel. We spent the past decade using the same threadbare data to build large, complex and expensive fire-based ems delivery systems. In many systems, there are so many paramedics that there is almost no opportunity to treat enough seriously ill patients to assure competency in the few out-of-hospital clinical interventions that MAY make a difference in long-term patient outcome.

Dr. Paul Pepe assists on the scene

While fire-based systems were building resource rich systems, private/public agencies were finding the limits of high performance ems systems by overloading transport unit workload. Somewhere in the middle is probably the best system.

A WORD FROM EMS MEDICAL DIRECTORS FROM THE LARGEST CITIES

The Consortium of U. S. Metropolitan Municipalities’ EMS Medical Directors developed a statement that was published in the April/June 2008 issue of Prehospital Emergency Care. PEC is a peer reviewed professional journal. I explained how medicine develops and shares knowledge earlier this year: http://firegeezer.com/2008/02/05/secret-handshakes-and-decoder-rings/

This group has a State of the Science professional meeting in February. From their website http://gatheringofeagles.us/ : The U.S. Metropolitan Municipalities EMS Medical Directors Consortium (The “Eagles” Coalition) is comprised of most of the jurisdictional EMS Medical Directors for the nation’s largest cities 9-1-1 systems as well as the FBI and the U. S. Secret Service. In essence, this small cadre of leading emergency specialists not only oversee the medical aspects of day-to-day 9-1-1 calls and early resuscitative care in the nations most populous cities, but most of them are also responsible for much of the medical aspects of homeland security in these high-risk venues in which nearly 50 million Americans dwell and make their livelihood.

Some of these medical directors worked as a paramedic before they started medical school. They share our perspective of street emergency medicine.

WHAT URBAN EMS SYSTEMS SHOULD BE DOING

The physicians outlined recommendations for six areas of clinical treatment. ST-Elevation Myocardial Infarction (STEMI), pulmonary edema, asthma, seizure, trauma and cardiac arrest. Their recommendations for cardiac arrest are surprising:

Response interval of less than 5 minutes for basic CPR and automatic external defibrillators (AEDs). No response interval was specified for ALS arrival.

In justifying its cardiac arrest recommendation, the group noted that much of the clinical research used to establish acceptable ALS response time intervals was conducted prior to the widespread dissemination of AEDs and at a time in which the compression component of CPR was not emphasized as it is now. As a result, the consensus group proposed that EMS systems not focus response time measurement on ALS ambulances, but rather pay greater attention to first response/BLS response time to measure what it called the “most important predictive elements for optimal outcome: time elapsed until initiation of basic chest compressions and time elapsed until defibrillation attempts.”This is a powerful recommendation from emergency medicine physicians with EMS experience and operational authority. It is going to be difficult to promote blanketing a city with paramedic staffed first responder fire companies if all you need is an AED and chest compressions to make a difference in cardiac arrest survival. Maybe fewer paramedics is a good idea.

Dr. Copass helps unload a Seattle cardiac arrest patient
in the 1990’s

Go here to download the rest of the Best Practices in Emergency Services summary and the Prehospital Emergency Care article.  14 pages, 137 KB Adobe Acrobat file
http://home.gwu.edu/~mikeward/0804_EMSMedicalDirectorsConsensus.pdf

THE RELELNTLESS STORM THAT BATTERED the Mid-Atlantic states over the weekend caused a house collapse that trapped two people in their home Sunday night.

A house under construction in Chesapeake Beach, Maryland, withered under the winds and fell over onto the occupied house next door, trapping the two residents inside.  The Washington, D. C., Fire and EMS Dept. dispatched a collapse team to assist with the rescue of the two people who were slightly injured.

Baltimore tv station WBFF filed this video report Monday night:

North Beach VFD WEBSITE.

MORE THAN A DOZEN BRUSH FIRES ARE burning in Brevard and Volusia Counties, Florida, today and weather conditions continue to be unfavorable.

AP / Matay photo

With some of the fires still advancing, in one case jumping Rte. 1, and most of the state under Red Flag warnings, Governor Charlie Crist has declared a state of emergency.  The declaration will allow the fire departments to accept help from out of state as well as Federal emergency disaster funds.

Many areas of the central portion of the state have not had any rain in over 50 days.  The extremely dry conditions coupled with continued high winds of more than 25 mph are keeping the fire services on full alert.

The largest fire going this morning is in Brevard County where 5½ sq. miles have been burned including about 70 homes.  In Daytona Beach, about 80 miles north, 500 people were evacuated overnight but have since been allowed to return home.

A Brevard County home burns on Monday.
(AP/Matay photo)

In St. Lucie County, the home of a firefighter who was on duty burned down.  The Treasure Coast Palm REPORTS:

Alan Civita was notified Monday afternoon while on duty that a fire was threatening his family’s home. Then he found out flames engulfed his residence.

“When Civita finally made it to his home he found that his home had completely burned to the ground, absolutely nothing remains,” a release from Fire District Deputy Chief Tom Whitley states.

The Professional Firefighters and Paramedics of St. Lucie County established a fund for Civita and his family.

Anyone who wishes to send assistance can mail it to Local 1377 Benevolent Fund, 3214 S. U.S. 1, Suite 1, Fort Pierce, FL 34982.

WTEV Ch. 47 filed this video report Tuesday morning:

During this Spring budgeting season, many muncipalities have been faced with upcoming shortfalls.  These are largely caused from instituting ambitious and popular, but often unnecessary, spending programs without sufficient resources to pay for them.

When the economic cycle takes a downturn, as they always do, some cities and counties institute a policy of slashing spending.  One of the things that we have been lamenting about here is the tendency of many governments to call for across-the-board cuts for every agency.  Looking for the easy way out, they pretend that cutting back on “nice” programs is just as damaging as cutting back on public safety, so the order goes out for everyone to cut X% next year.

One place where the city council takes public safety more seriously is Vancouver, Washington.  This city of 150,000 has decided to put Fire and Police at the head of the line for budgetary protection.  After hearing from the police and fire chiefs what services would have to be eliminated, the council has decided to do whatever is necessary to keep both departments fully functioning.

The fire chief told that he would have to cancel the building of a new fire station that had already been budgeted, along with the 13 FF’s to staff it.  He would also have to eliminate a medical response vehicle and its six paramedics.

“I think the basic reason for having a city is public safety.” Councilwoman Pat Jollota said.

While they are trying hard to keep from raising taxes, they are also cutting other agencies such as parks in order to shield the police and fire from any budget cuts.

This is the kind of elected official that we should be supporting come election time.  That and a constant reminder to our citizens that public safety really is more vital than handing out booklets on how to shop for groceries.

And we still have to get this equipment checked out.  So while you get started on that, I’ll run some fresh coffee.

Vancouver Fire Dept. WEBSITE.

A CHALLENGING EXTRICATION FACED CHARLESTON COUNTY, South Carolina, fire and rescue workers Monday afternoon.

A Honda automobile made an improper lane change causing a collision with a cement truck.  The truck rolled over onto the car, crushing it and then the fresh concrete started pouring into passenger compartment of the car.

The 15-yr.-old driver and her mother in the passenger seat were killed and the driver’s twin sister who was in the rear seat is in critical condition.

SConFire is carrying the story and links to the photos HERE.

IF YOU’RE LOOKING FOR SUN ‘N’ SAND, and you prefer your beach to be quiet and private (most of the time, anyway), here’s a list of 15 of the longest beaches in the world.

Starting with a couple that are 150 miles long, the list includes a few in North America, too.  The beach in the photo above is a mere 12 miles long.

You can start dreaming and planning HERE.