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Mandatory minimum training for fire and rescue

On Aug. 28, County Administrator Doug Barnes will lead a meeting with fire and rescue officials about developing mandatory minimum training requirements for the combined fire and rescue system of volunteers and paid personnel.

Fire and Rescue Chief Chris Eudailey has asked the three volunteer agencies to create a spreadsheet of all volunteers and their training certifications—a task some volunteer leaders have said is not an easy one to do.

The county does not have a central location for training records of all people within the combined system.

I requested last month the training levels of all officers in the volunteer agencies and to date only one has returned to me a spreadsheet of the information. Spotsylvania Volunteer Rescue Squad has not responded to the request yet and Chancellor Volunteer Fire and Rescue is still creating the list.

Spotsylvania Volunteer Fire Department President Mark Kuechler and I met this morning and he went over the list with me. He said the list is based on certifications he saw in the files, which means the list may not be 100 percent correct if someone recertified or obtained additional training but did not provide the agency with the certifications.

But the list he provided me this morning shows that at least six officers for that agency do not have the basic fire fighting certifications. Several have expired CPR certifications.

Such lapses in certifications or having officers in charge who do not have fire fighting 1 or fire fighting 2 certifications does not happen for career personnel because Eudailey created minimum standards for career officers. I recently obtained the job descriptions and certifications a person needs to be a career officer and I will post them later.

This apparently is why Mr. Barnes called for the training meeting on Aug. 28 at Germanna Community College.

Permalink: http://news.fredericksburg.com/spotsygovt/2010/08/04/mandatory-minimum-training-for-fire-and-rescue/

  • LarryG

    well.. call me dumb… or whatever.. but I was a rube thinking that we already did this but just specific to each separate VOL group.

    The more we find out – the worse it sounds.

    And it’s very unfortunate because the heritage of the Vols is family and community – for members of the community to safeguard and protect the community.

    I just don’t know how we could have an effective training program – without knowing the status of the individuals.

    Simple things like knowing what training to schedule and how often would seem to be driven by – knowledge of who had training and who did not.

    And I’ll accept Monday morning quarterbacking criticism from those in the trenches trying to do the right thing.

    Easier said that done …

    We appear to have some strong leadership now at the county level and perhaps that was the missing ingredient…

    I have an opinion that each of us – no matter who we are or what we do as a career or as a volunteer ….likes to feel good about what we do – i.e. likes to know that we are doing a good job….

    I realize this is sort of a Boy Scoutish idealism but I still believe that most folks want to do a good job and I believe this is true of the Vols.

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    Sounds a litle like the feedback Spotsylvania County government and elected officials gets back on its collection of “Balanced Scorecard” statistics. How does the County plan on getting anything done based on PART of a story, only a third of the numbers necessary to make an informed decision and people in charge who can’t be sure who’s showing up at the next emergency, how accounatable they MIGHT BE, and can only confirm THEY are the greatest bunch of people you could ever come to know.

    Just how systemic are the problems we are having with safety and management of County business affairs and conduct?

    What in Spotsylvania County passes for “acceptable”? We’re 10 years, 7 months down the road from “MINIMUM requirements” in Fire and Rescue and still don’t have a clue what minimum requirements even means, except as defined by established rules on paper no one still appears capable of bringing to Spotsylvania County.

    My best guess? Mediocrity like molasses is about the only business you’ll find in Spotsylvania County, working off 4 cylinders, sitting idle and in neutral.

    QUESTION: How much longer must this issue be brought to our attention without the slightest bit of progress being made by those who claim to be in charge but don’t have the necessary information to make change in citizen safety, much less local government’s version of accountability and transparency?

    LAST QUESTION: How many more EXCUSES do the citizens of Spotsylvania County have to receive before asking for a count on confidence in their local elected officials, special interest GROUPS and those who claim to know what’s best for the CITIZENS of Spotsylvania County, but are not saying?

  • GIVEMEABREAK2M

    I just have three (3) very simple questions. (1) Why isn’t there a certain place for the storage of these training records (central depository). The lack of such a depository is yet another prime example of very poor management. (2) Why does the county have people on our fire and rescue units that fail to meet the basic training requirements including expired certifications. (3) Such basic failures wouldn’t be allowed “anywhere” else, why is it allowed in Spotsylvania?

    As a “TAXPAYER” I expect more from County Administration and the Chief of Fire and Rescue.Get your act together or look for employment elsewhere. This taxpayer is tired of reading about managers who fail to manage in Spotsylvania County.

  • ramshead89

    Give me a break i will try to answer your questions.
    1) there is a central place for the storage of certifications, i even know of a spreadsheet CFVRD uses, however the problem comes trying to maintain this. This (last i knew) was maintained by the wife of Hap Connors, Sue. With full time jobs and 300 members in the department it is hard to keep up with the certifications that are soon to expire, and with certain people only coming around the station one or two times a month catching up with them to get these certifications from them is a challenge. Also I am guilty of not turning in certain specialty training certifications i receive. These are not essential to my duty, and i do not get fired as long as i keep other certifications up to date. The other problem is you have 4 separate agencies accountable for themselves with no central one, imagine each as it’s own little independent city. While one may have great public records the other city may have a different way to manage it. different computer systems or software. Eventually this will change to have these volunteer agencies accountable to the county and there will be one database for certifications of people on an ambulance or fire truck in spotsylvania county. Its a time and budget problem.

    2) It’s pretty simple, sort of “take what you can get” and show your appreciation by promoting them. These people that are officers showed a lot of dedication to the service and as a way of thank you they were given a leadership role. They may not be the most certified but they are the best available. It’s not an option more of a necessity. It shouldn’t have to be a necessity, however it is to maintain the levels we are at now. One day this will change and we will be able to uphold the level we set for ourselves.

    on a side note to part 2, it is actually in chancellors protocol that a EMS captain must be a certified medic (EMT-P or EMT-I) a year ago NONE of the captains were those levels, only station 6 had a EMT-E which is ALS. At the begining of this year there was only 1 station whos captain was not an ALS provider which was an improvement (until the whole scandal with 6 recently) but i do not run there so i am unsure how that has been handled

    and
    3) You need to visit Orange County, or Culpeper, or King William. or any where in west virginia. volunteers make up around 70 (it might be more) of the fire service. if you think it’s bad in spotsylvania you should try a more rural area. now i am not saying it’s acceptable but you do have to realize not long ago spotsylvania was rural. This is the transition phase we are going through. in about 15 years orange may have this issue. It wont be allowed in spotsylvania after very long. I would say be patient, but i do advise against that. Fight for it because we need the push, just inside be patient while you act for the change that comes with these growing pains

    Marty, sorry I don’t know if there is an acceptable answer to your questions

  • bhaas

    Folks…what we are finally seeing, thanks in no small part, to DT’s reporting and Mr. Barnes taking the “bit” in his teeth, is that things were no where near what we thought they were. The “chaos” was infinitely worse. In short, it wasn’t WHAT you knew, it was WHO you knew.

    Hopefully, the new changes being implemented will eliminate this kind of mentality forever here in Spotsylvania.

  • Sam

    Growing pains possibly.
    I am a huge current-volunteer organization skeptic. Look folks, you gotta give this time to work. The county is currently in the discovery phase of how bad the problem is with the organization as a whole. I applaud the Volunteer organization who have complied and desire to be a part of the future face of this county.
    You don’t go out and buy a new car because the one you’re in is out of gas… Give it time and support both career and Volunteer firefighters in these difficult times.

  • dtelvock

    RAmshead, you misunderstood me.

    All training records are not in one central location. Each agency has their own records, but the combined system does not have all training records in a central spot, like in fire admin,

    It’s a combined system. The training records are not combined. I had to FOIA four different agencies: County Fire and Rescue, Chancellor, SVFD, and SVRS.

    That’s what I meant. Sorry for the misunderstanding

  • ramshead89

    Sorry i should have put
    “The other problem is you have 4 separate agencies accountable for themselves with no central one, imagine each as it’s own little independent city.”

    first followed up with

    “Eventually this will change to have these volunteer agencies accountable to the county and there will be one database for certifications of people on an ambulance or fire truck in spotsylvania county”

    because there is no central one for everyone at spotsy, but each agency has there own

    The training person used to be Greg Leitz, apparently now its Jeff Bailey (i’ve never dealt with him) and Greg is the assistant, (it may have always been like that, I don’t know) I wouldn’t be surprised if you see that devision taking on the certifications and records unless they devote a new devision to record keeping for this…

  • ramshead89

    poor writing skills… thank god I study science.

  • Fredtastic

    Bill Haas said it right a few blogs ago and Sam said it here – GIVE IT TIME PEOPLE. Did Mr. Barnes know the system was this screwed up? No. Should he have? Maybe. But thank goodness he has taken this issue and made it his priority to fix. And it looks to me like he’s taking it one step at a time. This won’t be fixed in a week or a month. Give it time. Give them time. If Mr. Barnes is mediocrity, then I’m fine with mediocrity because I believe that he is doing exactly what he’s paid to do.

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    If the “acceptable answers” to my questions can’t rise above “even more excuses” and a “business as usual” willingness to accept 2nd best, then WE have the answers to my questions. How about yours?

    Just because “others” don’t do it any better than Spotsy, is NOT an acceptable REASON why Spotsy and its citizen population should expect less of its safety management, County Administration or it governing body of elected officials.

    Doug Barnes was around 10 years ago, and 20 years beyond that. The same can be said of members on the Spotsylvania County BOS. What is it about NOW that is so much different from THEN (10 years ago) or has the price of a life been depreciated and marginalized to “we’ll try to do better next time and hope to be qualified to do so, but only after “another committee meeting is held.”

    Where and with whom you wish to invest your trust with your life is an individual decision that rest squarely on your shoulders, but not the publics right to chose how they wish safety management to be conducted for ALL its county/local citizens.

    We waited 10 years, so what is another 10 years to get it right, or is tomorrow to soon to do anything about public safety or someone elses last breath?

    Why is Doug Barnes having to show up at a meeting with Fire and Rescue to address BASIC business principles with 4 different Fire and Rescue PRINCIPLES who can’t even manage a calendar of public proficiency or accreditation in fire and rescue staffing? Has Doug Barnes been placed in charge of change, or is that the shared responsibility of 4 different agencies that can’t respond as one to the safety needs of its county population?

    Who’s really in charge, or better still, who can bring 10 years of “business as usual” out of the muck and mire of mediocrity and put it ahead of a single lost life? If he or she has a name, it’s not Doug Barnes, but IT is the citizens of Spotsylvania County.

    If members of this blogging community want to sit and WAIT for change, maybe WE should invest in something more than just 10 more years of wishful thinking.

  • bhaas

    Well said, Fredtastic.

    I seriously doubt that Mr. Barnes is mediocrity. When this whole F&EMS issue “broke” last winter, I had serious doubts that the CA could achieve what he has to date. My hat is off to his achievements to date. BTW, I have communicated that message to Mr. Barnes.

  • getitstraight

    Ramshead,
    EMT-E and ST are not considered, and should not be considered ALS in the eyes of the county. We don’t call a Nurse a Doctor just because they have more training than a Medical Assistant.
    Fredtastic,
    These problems were neither hidden nor unknown. Those in leadership have chosen to ignore these problems in order to play favorites, politics, and keep the status quo. These problems are not suddenly appearing because they’re just now being discovered; it just took this long for the public to finally care about the delivery of service and professionalism they werre receiving. The management of the Department of Fire, Rescue, and Emergency Management, a combined system of career and volunteer agencies (as per county code) has failed to deliver the best possible service to the citizens; there is no reason to begin a blame game because everyone is responsible: the Tax payers, the County Administrator, the Board of Supervisors, and the Chiefs of the agencies; people have put personal agendas far ahead of the true needs of the County and its Citizens. This is echoed in the fact that the most important recommendations from this 1999 Fire/EMS study were never implemented, simply ignored out of convenience.
    There was a goal of 24/7 staffing in every fire anc EMS station set TO BE MET last year; was it met? Of course not did anything get changed to fix the problem? Of course not, they delayed the accomplishment another year just like they’ve delayed or ignored every other change.

  • LarryG

    I’m thinking back to those who posted here that because the Vols were C3(501)c .. that they were not accountable to the county.

    I think hearing that statement is what did it for me.

    I think if the goal is 24/7 ALS county-wide that it is a goal that needs to be made clear to county taxpayers in terms of how many more personnel will be needed and the cost.

    I very much value the contributions and the traditions of the Vols and back when this was a county of 15,000 people, many people owes their lives and their homes to that dedicated group of community volunteers.

    but as they say ” that was then, this is now”.

    I don’t know how the VOLs fit into a 24/7 ALS county-wide but would be interested in knowing what percentage of that staffing would be Vol verses career.

    My impression is that it would not be a high percentage and that we’re talking about full-time people but I’ll admit I don’t know.

    Just out of curiosity – does anyone here know the rough percentages of Vols to Career for fire service and EMS as separate services?

  • ramshead89

    the county doesn’t recognize trauma units anymore except the old school dispatchers, but thats if they remember when a unit marks up if it marks up as trauma. now it’s only rescue or medic.

    So I have a question now….

    Whens the protest? or the demonstration? I’ll be in town the 14th- 27th if anyone wants to do a sit in or a rally.

  • DYOFFT

    Getitstraight,

    You need to get it straight that there is no longer anybody in the Commonwealth of Virginia practicing as an EMT-ST, that certification has finally been done away with. Either everybody expired or upgraded to EMT-E.

    Furthermore, the Department of Health’s Office of EMS considers EMT-E ALS, so why shouldn’t the county? Are you familiar with what an EMT-E can do? Do you know that if the career staff started hiring EMT-E’s, they could staff ambulances with a mix of E’s and I/P’s and save a lot of burnout from the medics? OR how about save some money? Maybe the county should start using the EMD system that dispatch has but does not use appropriately so that we can classify calls coming into dispatch as BLS or ALS and send the appropriate unit from initial dispatch. Why are we sending two paramedics on one ambulance to an old folks’ home for a stubbed toe? That is a BLS call and there is NO NEED for ALS to respond.

  • MedicVA

    Getitstraight ~~

    First off, There are no such thing as an EMT-ST. If you mean, CT, then you are correct. The EMT-CT level got merged into the EMT-I(Intermediate) level. CT level EMTs do not exist anymore.

    Secondly, if you knew anything about EMS, you would know that the EMT-E(Enhanced) is an ALS level certification. EMT-E personnel can dispense medications, start IV whether its via the venous system, or via IO – intraosseous (into the bone). The ONLY thing they can not do cardiac related care, such as EKG/12-leads and they can not dispense cardiac related medication(s).

    So, if you think what they can do is not considered ALS, you obviously don’t know what your talking about.

  • LarryG

    is there a website that explains the different certification levels?

    What is considered the minimum standard for places like Stafford, Henrico, Chesterfield, etc?

  • MedicVA

    “the county doesn’t recognize trauma units anymore except the old school dispatchers, but thats if they remember when a unit marks up if it marks up as trauma. now it’s only rescue or medic.”

    huh? You obviouisly..nevermind..I will keep my mouth shut. Do you have any clue as to what your talking about?

    “Whens the protest? or the demonstration? I’ll be in town the 14th- 27th if anyone wants to do a sit in or a rally. ”

    If your not a full time resident, then why are you commenting on something that doesn’t concern you?

  • MedicVA

    LarryG,

    Yes. Check out the VA OEMS website..

    http://www.vdh.state.va.us/oems/

    Also, there are state requirements on how a crew (AIC and Driver) marks up when staffing. For example, if the AIC is a paramedic, and the driver has no other EMT cert other than CPR, that unit is only a “Rescue” unit, with ALS capability. To be staffed as a “Medic” unit, the AIC muse be an EMT-I/P and the driver must be atleast an EMT-B.

    Conversely, if the driver is an EMT-I/P and the AIC is an EMT-B (but doesn’t have the EVOC training), that ambulance is a Rescue unit with NO ALS capablity, even though there is a medic on the ambulance.

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    While Larryg shares with us his sentimental recall of days gone by in the service of Fire and Rescue, what else is being added to this current issue on F&R staff proficiency and accreditation, when he admits “I don’t really know” and then invites US to go looking for a percentage number, not otherwise or easily found in official F&R documents and has absolutely nothing to do with accountability of staff proficiency; whether Voluntary or Career.

    Following this trail to nowhere, we are joined by DYOFT and MedicVA with all the latest TECHNO babble/jargon that’s meant to baffle US for want of a PUBLIC translation of what they just said and what relevance it has with the issue at hand.

    When someone comes to your home and beats down your front door, CLAIMING he or she is there to save you, do you ask them for their credentials first, or is that something your COUNTY F&R agencies AND local government have already taken into ACCOUNT BEFORE sending their safty personnel out on emergency assignment?

    Bill, you and Fredtastic missed the point by a mile. I too have a long history with Doug Barnes and nothing about him is mediocre. However, Doug will never be any better or accomplish anything more than mediocrity, when he is surrounded by assigned leadership that could’nt cut there way out of a wet paper bag in a tropical rain storm.

    I want Spotsylvania County to become business proficient, without all the EXCUSES from those holding on to the rudder. These may be uncharted waters, but if its a little more wind in your sails you need, I think you’re going to need more than just another Commission, a few more politicians or an abundance of more lip service.

    Just remember, Doug Barnes will never be any better than the people who report to him OR the local leaders he reports to. The same goes for the people who report to Doug. They will never be any better than what they are allowed to be, by their leaders. We can’t keep saying “I didn’t know”…when they should have known. “That’s their business, not ours”….when it’s about everyone in the county being put at risk because no one wants to be held accounatable in those worst case senarios.

    Rather than denying there is a problem, when there is, try acknowledging and encouraging those, even if its a swift kick in the pants, to get the job done using best practice policies instead of second best.

  • Sam

    MedicVa
    Are you sure an EMT-B can be In Charge of a unit with a certified Paramedic driving?.
    I think I would actually call the state and ask them about who is actually in charge in that scenario.

    Marty I’m not having any problems following what they typed, pretty straightforward. Just gotta calm down and educate yourself sir.

  • bhaas

    Marty, I am not sure what point I missed.

    I have never met Barnes in my life. I have had a couple of email contacts since last February.

    When all this F&EMS business broke last winter with the death of Ms. Hill, I was very, very skeptical that the management in this county would succeed in the reorganization effort that I felt was needed. However, as I see it, Barnes took the “bit” in his mouth and forged ahead. I suspect that there is still resistance from some corners, but Barnes seems to to be determined.

    Now, I realize that you would like to “cluster bomb” the whole management team in the county and start over. Well, I admit that there are times when my frustration borders on that level too, but I think we ought to sit back, take a deep breath, and let this whole reorganization sort itself out.

  • LarryG

    I’m pretty much on the same wagon. I think the average non-FEMS person in Spotsylvania is pretty clueless in terms of what kind of certifications , staffing, and coverage we OUGHT to have or how we might want to compare to counties like Stafford, Prince William, Hanover, Henrico and Chesterfield.

    and while some might want to focus on who to blame – I don’t think that will accomplish much and if you blame everyone from the vols to the BOS to the CA – not sure how you’d expect them to be the ones to fix it…

    at some point, you have to acknowledge the mistakes, and move on and work to improve the system.

    I would love to see some metrics for our system and to be able to compare our system with some equivalent peer systems.

    The least we should shoot for in my mind is to favorably compare with peer systems our size.

    I wouldn’t mind having the state weigh in and tell us what a reasonable standard is for us to shoot for.

    and then to have those recommendations codified and allocate to individuals for responsibility – and to hold those individuals responsible for accomplishing the documented objectives.

    And if they don’t accomplish the goals and have made no progress towards them – then let’s change people and redouble the efforts.

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    Have to ask myself and maybe you guys why I would want to “cluster bomb” anything that moves in Spotsylvania County government or its special interest GROUPS? The only reason I’m showing up is because Dan Telvock is enamored with the TRUTH about F&R and what’s really been going on behind closed for 10 years and doesn’t appear to be getting any better.

    So, when I’m asked/invited to “sit back, take a deep breath, and let this whole reorganization sort itself out, why don’t we ask Dan Telvock/ FLS to freeze a couple frames of his reporting, like he did when a Chief came up AGAIN on charges and DAN closed his blog down for any comment from the public. Why? Because he was told to.

    Sam invites me to “calm down and educate myself.”

    What part of long standing poor business practices in County F&R does Sam think I didn’t get? What part of not knowing whether F&R personnel are certified or not, did I miss?

    What does it matter to me or any other member of the public whether an EMT-B can or cannot be in charge of a unit with a certified Paramedic driving.?

    What does it matter to me or any other citizen whether an AIC is a paramedic, or not, and the driver has no other EMT certification other than CPR, that unit is only a “Rescue Unit” with ALS capability? What’s with, “to be staffed as a ‘Medic’ Unit, the AIC must be an EMT-I/P and the driver must be at least an EMT-B.

    So what part of this “techno-babble” serves me, or any other citizen in better understanding whether Volunteer or Carrier firefighters and emergency medical personnel assigned to any of the 4 DIFFERENT agencies is certified to perform their job or any assigned job, OR do we WAIT for our rescue team to work that out at the emergency scene?

    Poor business practices I understand. How you wish to disguise, cover-up and obfuscate whether something is working or not, is a price someone is going to pay sooner or later.

    My mind is made up, and would encourage others to take a second look at what could otherwise be another ten years for a COUNTY to make up its mind AGAIN, and AGAIN, and better still….AGAIN.

  • MedicVA

    Sam,

    I am positive. I have been doing this for approximately 3 years or so now. As a new EMT-B, I had other medics drive for me, since I did not the training to drive the ambulance at that point. They were there to offer assistance and help me if the situation dictated. But otherwise, as the AIC, that patient was mine until we reached the hospital and transferred care. And thats the way it stands, no matter who is the driver and AIC.

    Now, the situation has reversied itself. I sometimes drive for other EMT-Bs. As a matter of fact, my regular partner is only an EMT-B. And sometimes I will act as a driver for other EMT-Bs as well.

    In cases of the the most serious patients, for example in those in cardiac arrest, I am there to provide the ALS care. The EMT-B at that point, would be following the direction of me, and doing whatever BLS skill I needed done that point while providing the ALS care.

  • Sam

    Well Marty you’re right ignorance is bliss. The fact that the citizens are only interested in screw-ups, criminal charges and death they can point to is simply amazing to me. You could careless as long as no one else says something is wrong with this picture. Gotcha.

  • spotsyundergrnd

    MedicVa, please make sure your liability insurance is paid up. If you are telling me that you the medic are not fully responsible for the care that happens on the ambulance you are assigned to, you need a lot more than 3 years experience. If you are on the scene of a call you must asses the patient and determine if they are ALS or BLS. If you do not then its failure to act, if you do asses them and allow them to be treated BLS when ALS could have improved their care, that’s abandonment. Don’t get me wrong a stubbed toe does not need ALS nor does a majority of the calls we run, just be careful that the patient with pain who could have benefited from morphine for his/her stubbed toe is not an attorney. Until tort reform happens, career and volunteer staff will over-treat their patients turning a stubbed toe from a BLS to an ALS call with IV’s and pain medicine because remember pain is relative.

    With that said that type of scenario plays into the whole debate of whether ALS or BLS is needed to staff stations and is why IMHO career staff sends ALS to everything, they are avoiding a lawsuit. This works for them but makes a currently unrealistic goal for the volunteers. I think the next step for the volunteers would be to strategically place ALS response vehicles in the county to insure ALS coverage. Staff those 24/7 and you will cut the argument greatly.

  • bhaas

    Marty….Have you never heard of a “rhetorical” statement, i.e. “cluster bomb.”

    I was led to make that statement because I am very hard pressed to find any statement you have ever made about Spotsy county BOS, CA, or senior staff and/or their actions that was not totally negative.

    Surely, you are not blaming Dan T. for your negative attitudes?

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    There’s just nothing, zero, zilch, nada that could give SAM’s “GOTCHA” and BILL’s “Negative Attitude” any relevant bearing to this discussion, other than desperation and a little too much sugar in their diet. Have a good weekend.

  • ramshead89

    Medic VA. I know of 4 people that run as trauma units. Tell me where in our computers it has “trauma” as a designation for an ambulance. You can call a E a medic all you want, and they are better than nothing, but if you’re having a cardiac problem, I didn’t see in our protocols that an E can follow ACLS.
    Spotsy just hired their first EMT-E he graduates with this new class, great guy, should have just been an I since he has ACLS and PALS, but they don’t have a plan for him as a medic.

    I do no longer live in spotsy, however I do still pay my car tax there (even though i should take advantage of the credit i get volunteering) and i have family that lives there. I spent 18 years growing up in that town and I saw the problems in the volunteer system. Sorry but when my dad who has cardiac issues goes down, i want ALS there. and by ALS i mean I or P. i will be on an ambulance some time that week i am home, i just really like a good protest.

    And i love our dispatchers, a lot of them are volunteers, or have volunteered at some point. (6 is how many i recall, i know there is more though) and they do a great job making our life easy. You know its a good night when they give you the lay out of the scene for firefighting along with pre alerting additional resources. Thats just the same as us using the term sergeant in the volunteer sector.

    All I want are some QRC’s staffed with ALS in the county during volunteer hours. Volunteers cannot fill that demand, nor should they be asked to with trying to staff 10 stations already. The county needs to step in to ensure that ALS is there for your family.

    And that whole debate about a basic in the back while a medic drive, After looking at a patient and saying “this is bs” i would love to drive and let the bls person take it over, but I really hate driving an ambulance and will only do it if the other person is not EVOC and if the patient is critical thank god for firefighters because then one of them is usually evoc 2, or unstaff them to pull their driver because if he drove the fire truck he has to be certified. And yes, i would unstaff a fire truck in a heart beat if it meant providing ALS to a critical patient. But putting a BLS provider in the back still falls under the highest level of certification, so if they kill someone it will probably get a little sticky…

  • DYOFFT

    Ramshead,

    “Trauma” is in the Firehouse Software incident reporting system that we are required to use after every single call. It is not in the CAD system because there isn’t enough memory on the server to fit another x-number of units in there. This is per BC4 when we switched over to the new CAD/Firehouse Software.

    Ramshead, I know of 7 people that currently run as a Trauma unit, and another 3 that have in recent years past (within the last 2).

    As for the debate of whether a Paramedic can drive for a BLS provider, I say absolutely. The ALS provider is only able to act as a driver/EMT-B if the other EMT-B on the truck does not have EVOC. If the ALS provider assessed the patient, and then was unable to continue care because the EMT-B does not have EVOC, there’s abandonment issues. If the ALS provider does not act outside his scope of care (i.e. assessing/providing at the ALS level without an available driver), then there is no violation.

    The “good answer” is to just get everybody through a 2-day EVOC course; of course some people are afraid of driving the big scary ambulances, and probably have no business volunteering anyway.

  • getitstraight

    DYOFFT
    Are you serious?! Are you and the rest of your leadership so disillusioned to believe that you don’t have to provide service to someone? Even someone with an elementary understanding of the law would be able to argue that! The concept you are describing is loosely based on the Good Samaritan laws which prevent someone from being liable because they are unable to provide care to a higher level based on circumstance. These do not apply to a crew that responds to a 911 call; you aren’t a layperson or a bystander, you are a health care provider and are fully expected to provide to the highest level possible; and since every ambulance in the county has ALS equipment on it, you are fully capable of providing ALS care. I challenge anyone to come back to me with caselaw or a written opinion from the State which states that an ALS provider does not need to provide care to an ALS patient because they’re “just the driver.” Please, show me.

  • David

    getitstraight:
    I believe you may have misunderstood the previous commenter’s point. If the patient does not require ALS interventions, then it is perfectly acceptable for the EMT-B to function as attendant in charge while the ALS provider drives.

  • getitstraight

    David,
    I don’t think so…he clearly states the fact that the ALS provider is only acting as a “driver/EMT-B” and that it is only abandonment if he assesses the patient.
    If the “ALS provider does not act outside his [role as a 'driver/EMT-B'...], then there is no violation.”

    They might be able to win the abandonment argument, but they sure as heck wouldn’t win the one on neglect.

  • David

    getitstraight:
    The key variable in the equation is the patient’s need. If, in fact, the patient requires ALS interventions, and the ALS driver were to start them, he or she is then committed to the patient until transferred to an equal or higher level of care. If, however, the patient does not need ALS care, and the ALS provider did not begin procedures outside the scope of the BLS protocol, then there is no neglect or abandonment.

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    Why don’t we all get out our Fire and Rescue dictionary and syllabus to see what these gentlemen are talking about and how this knowledge translates to best practices in the field of Fire Fighting and Emergency Medical Services.

    Let’s all pay close attention to what the manual calls for when being attended by rescue personnel who are neither accredited, nor wish to drive an ambulance to the emergency scene.

    How many F&R personnel, career or volunteer, does it take to screw in a light bulb, or at the very least, the light of day?

  • ramshead89

    marty it only takes 1 firefighter. He holds the lightbulb while the world revolves around him

  • getitstraight

    David,
    You’re correct, but I’m talking about patients that need ALS. My discussion has nothing to do with a BLS patient. Your presumption is fundamentally flawed. Both providers have a duty to act because they respond to an emergency call for service. If the patient requires ALS and the ALS driver does not provide for them then there is failure to act. If harm is caused to the patient because of the failure to act and the injury was directly caused by that deviation, then there is negligence; simplified of course, but present nonetheless. You can’t ignore the fact that the driver is ALS just because he’s the driver.

    One might argue that a nurse cannot provide ALS just because they’re a volunteer EMT and that is correct; because they are not licensed to do so. But the ALS driver is licensed to do so and is fully capable of providing the needed care to the patient.

    I don’t think the public will accept (I know I won’t) any answers without proof of case-law to the contrary, or a written opinion from the Virginia Office of EMS.

    And either way, it is COMPLETELY unethical to even try to argue the fact that an ALS patient shouldn’t receive ALS care when an ALS provider is present on the scene.

    Marty,
    ALS is Advanced Life Support. Meaning if the patient requires more than basic first aid or palliative care, they likely need ALS (chest pain, stroke, pain management, allergic reaction, difficulty breathing, etc). To give you an idea of best practices, or at least practices local to our region, Spotsylvania County is the only county on the I-95 corridor (and surrounding), border to border, that does not have 24-hour guaranteed ALS care; most have 1 per 12,000 residents or better. Now I may be wrong, but I thought Spotsylvania County was a little further along than Louisa and Caroline.

  • David

    Mr. Work,
    I was attempting to clear up a misunderstanding between the previous comments. If the vocabulary is too esoteric for you, I would be happy to answer any relevant question you might have. Sarcasm is unnecessary and counterproductive to intelligent discourse.

  • MedicVa

    getitstraight ~

    Let me try to clear up ANY confusion. You are correct, for the most part.

    For calls that are deemed emergent, ie. chest pain/cardiac arrest, stroke, possible stroke, diabetec emergency, etc.. Not only is the ambulance dispatched, but also the FD. However, for a Stroke(CVA), there is nothing a paramedic or any other EMT can d other than haul ass to MWH.

    If the patient is assessed, and ALS is then deemed necessary by the ALS provider, a firefighter who also has the EMT-B certification can drive. By doing that, the ambulance is then UPGRADED to a medic unit, and ALS care can then be administered.

    But also, be advised, not ALL chest pain calls need ALS care. If I am with an EMT-B, and he/she doesnt feel comfortable with call, yes..by all means, I will take over patient care, and do whatever is necessary. I have held the FD on scene until I know the pt is stable and that their assistance is no longer needed. Other times, I have asked the FD or another ambulance to meet us somewhere so I can get another driver, since the patients condition had deteriorated.

    We dont make the rules, and like you, I find it frustrating and at times, quite ridiculous. But, thats the way it is and we have to abide by them, until OEMS changes it.

    Did that clear ANYTHING up?

  • captainobvious

    Here is my concern with the level of ALS coverage. If me or my family calls 911 and actually need ALS, I would prefer an ALS ambulance to be dispatched and arrive in a timely manner. When ALS is needed, is this the time to jump through hoops and meet another ambulance that could be coming from the other end of the county? I know it may cost a little more in the long run, but I am sure if your family was in the same situation, would you like an ambulance to respond just to see if your family member needs ALS? And then HOPE there is an ALS provider available to assist?

  • poppy

    When are we gonna see the minimum qualifications for the career staff, you promised us dan

  • http://MAVRICKinc7@msn.com Martin (Marty) Work

    How many 911 calls have been recorded where the person at risk, within ALS standards and protocols, has checked the patient out, declared them to be OK, left the scene of the 911 call, only to be followed in emergency circustances, by the patient, for what ALS personnel, within reasonable parameters of medical emergency and common diagnosis protocols missed the call because they were not accredited or certified to make a diagnosis that was later found to have put the patient at further risk and danger of losing his or her life?

    How much does it really cost the patient and the county for having to rescue the patient, not on the first try, but the second, and closer to the margins of life and death?

    GETITSTRAIGHT: thanks for the assist. Now that we’ve covered “A”, maybe we can work our way to “B” and the rest of the alphabet used in F&R Standard Operating Procedure (Career or Voluntary)

    MEDICVA’s August 12 post, while very informative, leaves me with my worst nightmare when he/she is able to conclude these are the “rules” which are at times “frustrating” and even “ridiculous”, and “that’s the way it is and we have to abide by these RULES.

    How much comfort does anyone in Spotsylvania County get, knowing that they could be declared another footnote in the lost colume because the attending emergency personnel didn’t have the appropriate training or accreditation?

    And DAVID, you can call me Marty, although I do respond to just about any name I’m called. The vocabulary being used by F& R is not “esoteric.” It’s just that you’re communication with your BLOG audience represents less than 1/100th of a single percentage point of the population that inhabits Spotsylvania County. Simply said, you’re communicating with yourself and a few others listening in, while declaring you have the answers, but will only answer questions you deem relevant. You continue this same line of thought by concluding my sarcasm, and not my message, are unnecessary and counterproduvtive to “intelligent discourse.”

    It occurs to me, if you are the one teaching the class in F&R that you might consider speaking to the entire class instead of those sitting in the front row. Those of us in the back of the room speak and understand English almost as well as yourself. If any of us should raise our hand and ask that you speak up and use the same language as we do, on a daily basis, would that be considered irrelevant or just plain unintelligent in our need to understand what the teacher is talking about and which page we should turn to in case he/she can’t make the message better understood by at least 75% of the class?

    Too much sarcasm? Should we expect to know less about the issue because the teacher speaks another language? Maybe you should rethink your postured position on what intelligent discourse is and what it’s not allowed to be, because of RULES no one appears interested in following. But, what do I know, I’m just another dummy hanging out on the sidelines waiting for someone to make a decision. It doesn’t even have to be an intelligent decision.

  • David

    Mr. Work,
    As we do not know each other personally, the familiarity implied by addressing you with your first name goes against my upbringing.

    Since my initial remarks were addressed to a single contributor, I saw no reason to define for general readers the acronyms that contributor used in the first place.

    Regarding the unnecessary sarcasm on this topic, I stand by my previous statement. It is possible to discuss, even disagree, without resorting to insults and acerbic remarks. I have no interest in participating in a debate that doesn’t have courtesy and mutual respect for another’s opinion as it’s basis. Good day.