What Happened With Ezras Nashim In Boro Park On Monday Night?

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  • #1503748

    bk613
    Participant

    My point wasn’t to knock or minimize the selflessness of the members. Rather it was that someone who works in EMS full time will have a lot more exposure to patients and that’s why they are more knowledgeable. For example, on a 12 hr tour in NYC a crew can easily do 8-12 jobs. Multiply that by 4 days a week, 32-48 jobs, which can easily total 2000 (if not more) jobs a year. Contrast this to Hatzalah members, I really doubt there are many members who see even 1/4 of that in a given year.
    Again I’m not bashing Hatzalah for this fact. I feel the same way about rural volunteer ems agencies as well.

    #1503743

    klugeryid
    Participant

    Health
    What is Jems article?
    BTW my post was supposed to say ”money does not make one more knowledgeable nor more experienced”
    The word money, was auto-corrected to the word one

    #1503766

    klugeryid
    Participant

    Bk613
    You are conflating two points and confusing the issue.
    The numbers you give have to do with the fact that nyc ems covers millions of citizens vs hatzolah who is basically only servicing the Jewish population.
    Paying them would not change the numbers at all.
    You actually made my point.
    It’s numbers treated that gives the possibility of experience.
    Hatzolah members actually are full time. They just do worthwhile pursuits while not on calls.
    As opposed to NYC ems workers who sit around and do nothing because they are getting paid anyway.
    When a call comes in they have no incentive to get there nor to get the job done. They are being paid either way. As long as you can’t prove negligence they are fine
    Hatzolah members on the other hand
    Are motivated by a desire to save a life
    Want to take care of the issue properly and quickly. Remember they are giving us their job, voluntarily to do so. That shows dedication, gives motivation and demands proficiency. None of which exists in the NYC ems system.
    Just listen with your eyes closed next time you hear a siren.
    If it takes more than 3-5 seconds to go down your block it’s not hatzolah.
    And let’s not forget the difference between brains and brawn.
    Experience may be the greatest teacher, but with brains, your experience can be my teacher

    #1503775

    Ctrl Alt Del
    Participant

    So many comments to address…can’t quote them all. But suffice it to say the following:

    1) Health, your experience with Hatzolah was terribly unfortunate. None of us know the circumstances so in truth we can’t ever REALLY know what happened. What we DO know is that many thousands of people have been helped selflessly by competent friends/neighbors/strangers who dropped what they were doing to help us/our families out. Unfortunate circumstances and cases does not undo that. Consider the famous case of the unfortunate FF so many years ago who had an undetected, Hatzolah performed,
    esophageal intubation (I think that’s what it was) who ended up dying. Terrible, yes. Still doesn’t undo the years worth of help they’ve provided pre and post incident.

    2) Given the admittedly fraction of calls that you’re privy to, in which there was a bad outcome, does not reflect on the general competency of an organization that’s many hundreds strong. Even if we feel that bad outcome was the result of what we perceive as negligence or carelessness. The statistical numbers simply don’t allow for that.

    3) There is a percieved notion that somehow volunteers are “less” than their paid cohorts. As you well know, the initial educational requirements are the same for both camps, as are the recert requirements. And don’t think for even a second that paid servicemembers spend even an iota of time more than the minimum required on CME activities. They don’t. As of now, I am unaware of any studies regarding the competence of paid vs volunteer.

    4) In my experience, no one will ever care for you as much as your friends, neighbors, and “landsman”. I’m not putting down the muni’s, but some guy from some town, 150 miles away, riding a truck in the city….simply doesn’t have the same urgency in his step as your neighbor does. This is not a “Jewish” thing, I’ve seen this repeated over and over in paid services around the country. Local volunteers always seem to have a sense of urgency (sorry for the double use of the word) when they are caring for people of their locality. It’s a natural instinct. I want to make clear though, I do believe that many many EMS pros are caring and competent techs, I just think it comes more naturally when you do it for your own locale.

    5) As I’ve stated before, the rate of incompetence (IMHO and agreed to by you) is pretty stable throughout all EMS agencies. And whether you’ve witnessed it or not, Hatzolah has pretty much the same remediation scheme and disciplinary processes as other agencies. Do bad eggs get through….yeah, same as EMS. Do some folks pull “protektzia” …..maybe. I’m not particularly ware of any cases, despite having been around way too long for my own good. And if it is happening…..once again, same as in EMS. I know the Chief, the borough commander…..the lieutenant……its exactly the same.

    6) The age of the internet has made knowledge extremely accessible. One can have information immediately available, that previously took years of study and understanding. So just a small piece of advice, no matter what type of practitioner you are, or claim to be, Cutting and pasting chunks of medical info from websites is a poor way to bolster your point in an argument because even at the very best, it still undermines your perceived authenticity. At worst, it makes you seem a common liar.

    As an aside, I am curious. If paid services, or muni’s should be trusted more because of their call volume and/or experience, and options for recourse…..why go to bat for EN? [Mind you, my PERSONAL feeling is that they should’ve been incorporated into Hatzolah (for logistical reasons), and if not, I have no problem with them being an independent agency either.] EN doesn’t (or wont) have the same percieved problems as Hatzolah?

    #1503783

    bk613
    Participant

    I don’t understand your point. A city emt sees at least 2000 patients a year. The average Hatzola emt sees (I’m assuming, I don’t have real numbers) between 200-400. Regardless of one’s motivation to help others, which granted Hatzola has more of, how does that translate into proficiency at a job. There is a limit as to what you can learn from books and from others.
    Next, regarding your 3-5 second claim, you need to keep in mind that Hatzola members are responding in private cars which are a lot easier to maneuver and drive than city ambulances. Even Hatzola ambulances, with the exception of Queens, are smaller than the FDNY ambulances.
    As an aside the number of emergencies where seconds truly count can be counted on 1 hand.

    #1503794

    bk613
    Participant

    Just to clarify one point in my previous post. I don’t think that the majority of FDNY ambulances would be going as fast as Hatzola does if they had smaller vehicles, however, I do think they would be quicker. The notion that all city ems workers don’t care at all isn’t true. They picked a high stress, low paying job for a reason. Most, if not all, genuinely want to help people in their time of need.

    #1503840

    klugeryid
    Participant

    B613
    I do not know where you got your figures from.
    I went to Wikipedia which lists the following stats for NYC ems in 2016
    275723 medical emergencies called in
    4414 emergency medical professionals
    That works out to an average of
    275723÷4414=62.***
    So at a 40week work year it’s about 1.5 calls a week per person.
    I think most hatzolah members are in that range.

    As to the speed of the ambulances
    the city’s average response time also incrementally ticked up — from eight minutes 27 seconds in 2012 to nine minutes and 23 seconds in 2014. But at peak times and for calls deemed less urgent, response times can frequently be significantly longer, records show.

    The city responds much more quickly — six minutes or less, on average — to the most critical calls, which include cardiac arrest and choking.

    So let’s say their response time is six min.
    Long enough to cause death my heart attack or permanent damage by stroke.
    Now I don’t have stats for hatzolah but based on personal experience it ranges from 30seconds to 3 min

    Nobody is asking the ambulances to drive like race cars.
    But those engines should be able to hit 35mph on ocean parkway.
    They often don’t.

    And finally
    You truly did miss my point.
    I was just stating that to hinge any fault on the fact that hatzolah utilizes unpaid members, is complete foolishness.
    If you think there are issues in competency, by all means address them. But to base anything on the lack of pay is nonsense.

    #1503852

    Health
    Participant

    ky -“What is Jems article?
    BTW my post was supposed to say ”money does not make one more knowledgeable nor more experienced”

    Journal of Emergency Medical Services.
    Of course money doesn’t.
    Do you want to know the research brought down in Jems?

    #1503853

    Health
    Participant

    CAD -“Mind you, my PERSONAL feeling is that they should’ve been incorporated into Hatzolah”

    I agree.

    “EN doesn’t (or wont) have the same percieved problems as Hatzolah?”

    I addressed this previously – page 6:
    “The biggest problem with these orgs. like Hatzola & EN, are the fact that they are volunteer.”

    #1503890

    klugeryid
    Participant

    Health
    Of course I would like to know it
    Again I think caring any issues on volunteerism is incorrect

    #1503891

    2scents
    Participant

    bk613 – I think that you are mixing up two different concepts, Hatzolah is by no means a DIY agency, they have the very same requirements that any other agency has. Their EMTs and Medics go to the same schools and colleges that any other EMT or Medic goes to. they have the same certification and license as well as the exact same continues education requirements that anyone else has.

    Regarding the exposure argument, the average EMT and Medic in the 911 system does not do this full time, most 12 hour shifts see an average of 2 calls. Furthermore, a lot of 911 systems are not multi-tiered which means that if the caller gives a nature that would require paramedics, the medics will be dispatched and stuck with the transport, this is a waste of time and resources, this also means that some medics might have lower acuity calls their entire shift. This does not happen with most hatzolah systems.

    Furthermore, most hatzolah systems are very busy and have high call volumes. divide these calls among the number of active members, this gives them a fair share of exposure.

    #1503893

    ubiquitin
    Participant

    KY
    A few points

    “Long enough to cause death my heart attack or permanent damage by stroke.”

    that is slightly exagerated
    Top put in in context the max time it is expected for a blocked artery to be opened in heart attack is 90 minutes from when patient hits the ED (“door to baloon time”)
    for stroke the window to administer TPA is 3 hours (with data suggesting and it often being administered at longer time than that)
    While by no means impossible, it is unlikely that 6 minutes would make a big difference

    It is hard to deny that an EMT who does it full time and obvuiosuly has more experience, and has a more rigorous ongoing education is “better” than a volunteer generally speaking.
    That said there are cases where seconds count (cardiac arrest being classic example, as well as choking) and obviously hatzolah being emeshed in our communites and racidg over in private cars can boast a better response time.

    There is also an advantage to having a friendly/caring face at a moment of need, particulary as there may be angst involved in going to hospital particulary on Shabbos./Y”T.

    that said I’ve always dreamed of doing a study taking a hospital say maiomonidoes and comaring if say Heart attacks brought in by Hatzolah do better than by EMS. Granted it would be hard to control for confounding factors, but would still be interesting .

    #1503894

    klugeryid
    Participant

    Basing any issues on volunteerism is incorrect.
    A volunteer organization can have any standards and checks that they want
    So if there is an issue that’s where you would need to go
    People are asking to join hatzolah.
    They don’t need to lower standards to fill ranks
    Oftentimes organizations are staffed by volunteers because they have no money or not enough interest so they get haphazard help as they are able
    IN hatzolah case that is not the idea
    I assume they keep it volunteer to ascertain that only truly devoted people become members.
    But either way,
    Changing to a paid corps will not fix anything.

    #1503896

    2scents
    Participant

    Health – if you have the article point to it. I highly doubt that there is such an article that discusses the dynamics of Hatzoloh for many reasons.

    1) there are no other volunteer ALS agencies.

    2) most volunteer agencies have 18 year olds or 70 year olds on the active roster. Hatzolah has middle aged people, many of them having a lot of years of experience.

    3) Unlike the majority of volunteer BLS agencies, Hatzolah has a robust system with many of its members that are otherwise involved in the medical industry, including working for other EMS agencies as paid personnel, nurses, PAs and even doctors.

    #1503899

    2scents
    Participant

    bk613, Just saw your post about the number of ‘jobs’ a paid EMT or Medic will see on a shift. It is not true, they will normally see 2 or 3 patients on a regular shift.

    EMS has a lot of downtime and no one is rushing to leave the hospital to make themselves available for the next job.

    EMS is a very low paying job, very few have this as their primary job or stay at this for a long time.

    #1503900

    2scents
    Participant

    Why would someone say that compassion and dedication is inferior to a small paycheck? in fact, if compassion and dedication are lacking the care is probably watered down.

    A lot of healthcare facilities in the areas that Hatzolah covers use Hatzolah as their primary EMS agency in an emergency, they do this by choice.

    #1503944

    Health
    Participant

    ky -“Again I think caring any issues on volunteerism is incorrect”

    What do you mean by this?!?
    I have a feeling that you’re not capable to discuss EMS, which includes Hatzola!

    #1503983

    👑RebYidd23
    Participant

    A city EMT sees more patients, but if someone standing next to the patient orders a pizza, the pizza might already be there when the EMT arrives. That’s bad news for the patient.

    #1503975

    Health
    Participant

    2scents -“Health – if you have the article point to it. I highly doubt that there is such an article that discusses the dynamics of Hatzoloh for many reasons.”

    Stop with your lying!
    I said the article discusses volunteering in EMS, NOT Hatzola.

    “Regarding the exposure argument, the average EMT and Medic in the 911 system does not do this full time, most 12 hour shifts see an average of 2 calls.”

    Another lie; which 911 system are you talking about?
    In NJ most 911 handles many calls.
    In NYC, only the outer boroughs, might have less, but I doubt only 2 calls.

    “Furthermore, a lot of 911 systems are not multi-tiered which means that if the caller gives a nature that would require paramedics, the medics will be dispatched and stuck with the transport, this is a waste of time and resources,”

    Another misconception, it’s actually better to not have a tiered system.
    The best systems send only Medics to calls. So they do a lot of BLS – So what?!?

    #1503991

    2scents
    Participant

    ubiquitin – I responded to your post earlier not sure why it disappeared, I will respond once again.

    You mentioned two examples, strokes and heart attacks. The time windows you posted are correct, yet the context is incorrect.

    Heart attacks, true hospitals have door to balloon or door to cath time, yet this by no means represents patient outcome. Time is muscle and minutes matter. If there is an occlusion in one of the blood vessels supplying the heart, the heart is getting injured and dying. the earlier that is taken care of and reperfused means fewer chances of the patient going into cardiac arrest or having permanent chronic heart failure (basically means less dead muscle or less dead meat in their chest).

    Hospitals have ‘heart stats’ and ‘MI teams’ that are activated by EMS on the field, these patients are of the highest priority in the emergency room, they bypass all the normal procedures and are usually immediately are taken to the cardiac cath lab, no one sits around waiting even just one minute. Everyone knows that every wasted minute means more dead cells.

    Paramedics can diagnose some heart attacks, they can activate the cath lab from the patients home so that the team in the hospital can begin prepping for the procedure. they can also initiate first-line treatment all the while the ambulance is pushing traffic to get to the patients home. which is why a grass routes EMS response makes a lot of sense. All of this reduces the overall time from onset until treatment and without doubt results in better patient outcomes.

    Strokes, true there is a 3 hour window (or 4+ hour window that some comprehensive stroke centers have adopted) yet this is just for the cut off time, basically it means that once the patient is out of the time window the risks of administering tPA overweigh and is withheld. By no means does this mean that time is not of the essence.

    Time is brain, every minute that elapses more cells die, EMS will usually make a stroke notification, neurology will await them at the door, the CT scanner will be cleared upon EMS’s notification, these patients are immediately taken to the scanner and treated. Everyone knows that minutes matter, minutes are what make a difference between no or minor neurological deficits versus major irreversible deficits. Minutes are what make the difference between a favorable and unfavorable outcome.

    Besides, the time window is just for ischemic strokes, with hemorrhagic strokes, these patients are bleeding out and can have increased intracranial pressure, all in a matter of minutes, these are very high priority patients that usually require immediate airway management and neurosurgery.

    Please do not state publicly that minutes do not matter when it comes to heart attacks and strokes, they do! If anyone is experiencing any symptoms of a heart attack or stroke they should immediately without delay call whichever EMS they prefer.

    #1503992

    klugeryid
    Participant

    health
    ky -“Again I think caring any issues on volunteerism is incorrect”

    What do you mean by this?!?
    I have a feeling that you’re not capable to discuss EMS, which includes Hatzola!

    i already fixed it
    it was an auto correct supposed to say
    “Basing any issues on volunteerism is incorrect.”

    why cant i discuss?
    as to stats, i posted from wikipedia
    averages out to maximum 1.6 per week per person in nyc ems
    look it up

    #1503994

    2scents
    Participant

    Health,

    No one is lying, you said such an article exists, (you have not yet produced the article), I pointed out that the dynamics are different. Comprehension my friend.

    With the call volume, you call me a liar, but then say you doubt.. you either know or you do not.

    Regarding the multi-tiered system, Is that your opinion or is that the consensus? Does it make sense to tie up an ALS only crew for a BLS call when a different ALS crew has to cover the next call in the area?

    The progressive systems have two-tiered systems, such as Kings county medic one, it makes sure that there are adequate resources available at all times, it also makes sure that the medics treat patients that require ALS care instead of being tied up with patients that can adequately be managed by BLS, they can also downgrade the patient to BLS after appropriately assessing the patient, so they are exposed to more higher acuity patients and retain their skills and knowledge.

    To put it in context, even on a busy shift, a single tiered ALS truck can respond to BLS only calls, vs a tiered response system would have these medics respond to ALS only calls. Which means more experience and more exposure to sicker patients. As Hatzolah does.

    #1504081

    Health
    Participant

    ky -“it was an auto correct supposed to say
    “Basing any issues on volunteerism is incorrect.”

    With what medical basis would you post this?
    You think that the article in jEMS is incorrect?
    Do you even read the article?

    “why cant i discuss?
    as to stats, i posted from wikipedia
    averages out to maximum 1.6 per week per person in nyc ems
    look it up”

    Let me explain you something about your aquiring info about NYC EMS – the Stats aren’t accurate.
    The stats don’t differentiate between outer boroughs & night calls.
    They are all inclusive. When I did my Medic training – they were plenty busy. As a matter fact, they did all sort of Shtick to avoid responding. Most days they had more calls than units able to respond to them!

    #1504107

    Health
    Participant

    2scents -“The progressive systems have two-tiered systems, such as Kings county medic one, it makes sure that there are adequate resources available at all times,”

    Your posts are disjointed. If you try to condense them – I’ll try to answer them.
    Are you talking about the State of Washington?

    #1504113

    ubiquitin
    Participant

    2scents
    “You mentioned two examples, strokes and heart attacks.”

    no Ky did ” So let’s say their response time is six min.Long enough to cause death my heart attack or permanent damage by stroke.”

    I was replying to a minor inaccuracy .

    “Everyone knows that every wasted minute means more dead cells.”
    Not to mention financial penalties. (I’ve sat in administrative meetings trying to improve door to ballon time)

    “Please do not state publicly that minutes do not matter when it comes to heart attacks and strokes, they do! If anyone is experiencing any symptoms of a heart attack or stroke they should immediately without delay call whichever EMS they prefer.”
    Agreed, my word choice was poor and I did not mean to imply that any time should be wasted in seeking emergency medical care

    Though my question is simply do you think patients of a similar acuity brought in by Hatzolah have a better outcome than those brought in by say FDNY?
    There is proabbly no available hard dtata that can possibly actualy address this question , and I fully understand and respect a prefrence not to answer. Its just something Ive worried about since anecdotaly I havent seen such a discrepency in outcome and it is hard to imagine there is one

    #1504114

    ubiquitin
    Participant

    As a f/u to my recent post (#1504113 not sure if these numbers change if order it goes up changes)

    I am by no means criticsing hatzolah they offer a vital service and dedicate themselves to saving their brothers and sisters all for free.
    There are many advantagous to having hatzolah and if I had to call for help ch”v I would without question call hatzolah.

    This doesnt change my question

    #1504134

    ubiquitin
    Participant

    “Its just something Ive worried about since anecdotaly I havent seen such a discrepency in outcome and it is hard to imagine there is one”

    should read “something I’ve wondered about since anecdotally”
    I’m not worried about this, just wondering

    #1504164

    GAON
    Participant

    KY,

    “As to the speed of the ambulances”

    All those “speed” stats I think is unnecessary, as one of the main factors seem to be that the Hatzolo’s range is much closer than any EMT stationed within the neighborhood. There are numerous members spread out within the Jewish community, hence chance is you will have a member seconds away from the call.

    #1504170

    klugeryid
    Participant

    health
    ky -“it was an auto correct supposed to say
    “Basing any issues on volunteerism is incorrect.”

    With what medical basis would you post this?
    You think that the article in jEMS is incorrect?
    Do you even read the article?

    what does medical knowledge have to do with this?
    i am stating that a claim that volunteer services are worse simply because they are not paid is foolish as money/pay does not create competence.
    if there are issues with hatzolah
    they do not stem from it being volunteer!!!

    as to the article?
    no i did not read it
    you said you would post it
    i am waiting

    #1504172

    2scents
    Participant

    ubiquitin – Sorry that I attributed those comments to you, this is not a debate and not trying to win anyone over nor am I trying to put anyone down, sorry if it was taken that way.

    Regarding the outcome of patients, I do not think that such data exists and why would any hospital even try to gather this data?

    Yet anecdotally people have situations in which time was of essence or where the dedication and caring had a difference in patient outcome.

    For example, someone I know that had a widowmaker heart attack (LAD) with massive global ST elevations. This patient had a 17 minute dispatch to cath time (!). This means 17 minutes from when the first ring to hatzolah was made until this patient was on the table. These patients have a very high mortality rate.

    Another example, Hatzolah brought in a patient which the attending ER physician refused to activate the cath lab, the paramedics contacted the cardiologist on call and were able to get the patient to the cath lab, I doubt that FDNY medics or any other EMS would have done that. This pt would have been diagnosed as an NSTEMI and had a scheduled cath during regular business hours, if he would have survived. (this patient had a 100% occlusion).

    By no means am I mocking EMS, nor am I saying that there is data to suggest that outcome might be different depending on the agency that manages the patient. But given the choice most people would chose speed, dedication and resources vs a municipal agency.

    #1504265

    apushatayid
    Participant

    “If it takes more than 3-5 seconds to go down your block it’s not hatzolah.”

    This is probably true, however, I believe a contributing factor is that “our community”, for the most part, moves out of the way when hatzalah comes their way, sadly this is not true when it is “of of their” ambulances. Dont take my word for it. stick your fingers in your ears and open your eyes and watch what happens.

    #1504218

    ubiquitin
    Participant

    2scents
    “Regarding the outcome of patients, I do not think that such data exists and why would any hospital even try to gather this data?”

    Yes that is what I said,

    I am not accusing you of mocking EMS. And I am by no means in any way criticiisng hatzolah. As I said, IF needed I would call them
    I am just wondering if you think there is a difference in patient outcome. that is all.

    “Yet anecdotally people have situations…” totally! Though sadly there are a few anecdotes in the reverse (admitedly far less) I am asking if you think these anecdotes add up to improved patient outcomes. Kudos for all involved in saving the pateitn w/ the LAD obstruction,. This may or may not surpirse you but Ive met patients brought in by EMS who survived.

    Again if you dont want to answer, that is obviously fine, and I fully undertsand why that would be.
    My question is simply do you think patients brought in by Hatzolah have better outcomes than similar patients brought in by another agency.
    1 )Yes
    2) No
    3) prefer not to answer

    Again I understand there is no data to back it up, and you cant know with certaintly, but you seem to have some anaecdotal experience and it must point you in one direction or another,
    (and again worth noting even if outcomes are the same it is reassuring t ohave a familair face, I am not critisicng there holy work at all.)
    I hope you dont mind obliging me , its just soemthing Ive wondered about

    #1504213

    Health
    Participant

    ky -“i am stating that a claim that volunteer services are worse simply because they are not paid is foolish as money/pay does not create competence.”

    I agree. I don’t think even Bk613 meant that.

    “if there are issues with hatzolah
    they do not stem from it being volunteer!!!”

    They do have probs by the fact that they are vollys, but they have other problems as well.

    “as to the article?
    no i did not read it
    you said you would post it
    i am waiting”

    No, I did not say that I would post it. I don’t remember where it is.
    But I remember the reason why they wrote Paid services are better in most cases.
    Do you want what I remember?

    #1504301

    2scents
    Participant

    ubiquitin, You asked what I think, I cannot prove this, yet my answer would be as following.

    Most patients, probably no difference in outcome, mainly because the majority of patients are not that sick that outcome is even a factor.
    From the very sick patients, Yes some have a better outcome due to the resources of hatzolah.

    Again, this is my personal opinion, not sure why you would want my opinion.

    For instance, I am familiar with a particular skilled nursing facility that for some reason decided on not calling Hatzolah when they have a sick patient. The nursing staff (completely non jewish) protested and requested that hatzolah be the primary EMS agency for the facility.

    #1504305

    2scents
    Participant

    ubiquitin – For now I will try to refrain from responding, I do not want to get caught up with this back and forth, seems like you were trying to score some points. not sure what the agenda is.

    “Though sadly there are a few anecdotes in the reverse (admitedly far less)”
    I guess its an alternative way of saying that they are not a perfect agency, They are just a bunch of humans after all.

    “This may or may not surpirse you but Ive met patients brought in by EMS who survived”
    Thanks for the awareness.

    #1504310

    2scents
    Participant

    Now, just reread your post once again.

    “My question is simply do you think patients brought in by Hatzolah have better outcomes than similar patients brought in by another agency”

    Simple, what does simply mean? No, not simply because the same people that work during the day in EMS and at off hours volunteer for their local Hatzoloh, no. not simply because the wording on the sides of the ambulance are written in hebrew. no.

    Maybe due to the fact that they had a quicker on scene response.
    Maybe due to the fact that they had resources and able to deploy them rapidly.
    Maybe due to the fact that they cared, therefore, went the distance and were not simply doing their job.
    Maybe due to the fact that they went to a different facility that was not the nearest, which had better resources that contributed to the favourable outcome.

    So no, not simply because they came in with Hatzolah.

    #1504330

    ubiquitin
    Participant

    2scents
    thank you for your reply they seem to have gone up in some funny order since you first respond then say you wont then ask a question

    “Most patients, probably no difference in outcome, mainly because the majority of patients are not that sick that outcome is even a factor.
    From the very sick patients, Yes some have a better outcome due to the resources of hatzolah.
    Again, this is my personal opinion, not sure why you would want my opinion.”

    Thank you. I know this is your personal opinion, I want it because you seem knowledgeable, and as I mentioned (and you did too) real data isnt available.

    “I do not want to get caught up with this back and forth, seems like you were trying to score some points. not sure what the agenda is”
    No need for any back and forth, I’m not sure what you mean by “score some points” There is no agenda. Its something I wondered about, I asked, you answered thats it. Thank you, now back to your regularly scheduled programming.

    your last post confused me a bit “Maybe due to the fact….So no, not simply because they came in with Hatzolah.” Doesnt “because they came in with Hatzolah.” include those facts?
    that is my question if given the fact that : they had a quicker on scene response, and the fact that they had resources and able to deploy them rapidly. and therefore, went the distance and were not simply doing their job ” given those facts, do those facts transplate to better patient outcomes. (not just survival, if the fellow who was in the cathlab walked out with better heart function than the guy brought in by FDNY that too is a better outcome although both lived.
    (note not the and the fact to the fact that they went to a different facility that was not the nearest, which had better resources that contributed to the favorable outcome.” since that seems harder to gauge though it is a critical point)

    Earlier you said “Most patients, probably no difference in outcome, ”

    Are you now saying there is a difference in outcome?

    #1504337

    klugeryid
    Participant

    Health
    The stats don’t differentiate between outer boroughs & night calls.
    They are all inclusive. When I did my Medic training – they were plenty busy. As a matter fact, they did all sort of Shtick to avoid responding. Most days they had more calls than units able to respond to them!

    You give me quite an interesting logic toy here. But your argument is actually self-defeating let’s make a simple if than
    flowchart if the resources of EMS are structured to reflect the calls the volume of calls coming in based on where they’re coming from then the averages would equal out to the total average for total call if they are not spreading their resources then think for a moment what we have in congested interboroughs you have an overwhelming amount of goals which leads to longer if no response times as you ended your post that sometimes there were too many calls to respond to not a very comforting nor positive result for somebody in Anaheim graduation if you’re in an Outer Borough then according to your logic your EMS workers far fewer cases than the average of 1.6 per week leaving him wolf Ali in adequately prepared your emergency the only way around the unpreparedness would be to say that they are rotating the staff and their positions in that case you would probably end up with the same average being as part-time there in my volume area and part-time there in low-volume area to sum it all up there is no way to have EMS workers getting higher exexperience and sufficient coverage if you accept the total number of calls and the total number of workers as stated in the Wikipedia article unless and I don’t think you were you are claiming that they are either overstating the call volume or on this thing you workers by shifting calls in to high and low zones you are only making the outcome worse for the patient not better

    as to the article from Jem yes I would like to know what you recall from that article however just realize that if you saw the article and read the article and are unable to find the article how do you expect somebody who never heard of this publication to go and find one specific article that I never heard of before

    #1504320

    Health
    Participant

    2scents -“For instance, I am familiar with a particular skilled nursing facility that for some reason decided on not calling Hatzolah when they have a sick patient. The nursing staff (completely non jewish) protested and requested that hatzolah be the primary EMS agency for the facility.”

    Now I have another proof – that I’m not a nurse in my 2 other degrees – I would never call Hatzola to transport from a nursing home. Either it’s an emergency where I’d call EMS or not and I’d call a transport service!

    #1504353

    klugeryid
    Participant

    Sorry
    My post came out garbled
    I will try to fix it later

    #1504358

    Health
    Participant

    ky -“sufficient coverage if you accept the total number of calls and the total number of workers as stated in the Wikipedia article unless”
    “4414 emergency medical professionals”

    The number of workers are off. Because it doesn’t include vacation, administrators, people on sick leave, & those on disabilty. Like I said before -“The stats don’t differentiate between outer boroughs & night calls.
    They are all inclusive. When I did my Medic training – they were plenty busy. Most days they had more calls than units able to respond to them!”

    “how do you expect somebody who never heard of this publication to go and find one specific article that I never heard of before”

    Ok. When I have time I’ll post what I remember.

    #1504364

    2scents
    Participant

    Ubiquitin,

    I gave my opinion. Not the facts. The real truth is that i do not know. The rest of what i have written, just disregard.

    #1504365

    klugeryid
    Participant

    Health
    The stats don’t differentiate between outer boroughs & night calls.
    They are all inclusive. When I did my Medic training – they were plenty busy. As a matter fact, they did all sort of Shtick to avoid responding. Most days they had more calls than units able to respond to them!

    You give me quite an interesting logic toy here. But your argument is actually self-defeating .
    let’s make a simple if then flowchart .
    if the resources of EMS are structured to reflect the volume of calls coming in based on where they’re coming from then the averages would equal out to the -total , average worker to call ratio.
    if they are not spreading their resources according to need, then think for a moment .
    what we have is, in the congested inner boroughs (whichever that may be )you have an overwhelming amount of calls , meaning ,longer to no response times .as you ended yourself in your post “that sometimes there were too many calls to respond to ”
    not a very comforting nor positive result for somebody in An emergency situation.
    if you’re in an Outer Borough then according to your logic, your EMS workers get far fewer cases than the average of 1.6 per week. leaving him woefully inadequately prepared for emergencies.
    the only way around the unpreparedness would be to say that they are rotating the staff and their positions .
    But in that case you would probably end up with the same average , being as part-time they are in high volume areas and part-time in low-volume areas.
    to sum it all up there is no way to have all EMS workers getting higher exexperience and sufficient coverage if you accept the total number of calls and the total number of workers as stated in the Wikipedia article.( unless, and I don’t think you were, you are claiming that they are either overstating the call volume or, Understating worker counts. )
    And if you will say they are constantly shifting workers from high to low zones you are only making the outcome worse for the patient not better as you can and will end up having low experienced workers operating in high call zones, and when they finally get experience you shift them out to the outer boroughs, where they sit and wait for calls.
    Talk about playing Russian roulette!!

    #1504366

    klugeryid
    Participant

    Health
    Now I have another proof – that I’m not a nurse in my 2 other degrees – I would never call Hatzola to transport from a nursing home. Either it’s an emergency where I’d call EMS or not and I’d call a transport service!
    Not exactly proof
    Just proof that you are not part of a particularly skilled facility

    #1504499

    Health
    Participant

    ky -“to sum it all up there is no way to have all EMS workers getting higher exexperience”

    Did you read my last post to you?
    I forgot training – first time & refreshers. And instructors.
    I should have wrote this:
    “overstating the worker counts”

    And I agree, some of the night shift in certain areas and both the night & day shifts in some outer boroughs are not getting a lot of experience.

    #1504430

    Uncle Ben
    Participant

    Can we officially declare an end to this pointless “discussion”?

    #1504517

    ubiquitin
    Participant

    2scents

    “I gave my opinion. Not the facts. The real truth is that i do not know. ”

    Yes I know this is your opinion, that is waht I was asking for.

    thank you. all the best

    Uncle BEN
    “Can we officially declare an end to this pointless “discussion”?”
    why do you care? They are obviously enjoying it. I get why the mods might be frustrated by why cant you fargin their fun

    #1504535

    lesschumras
    Participant

    just a few points,

    A. not all paid EMT’s spend off time eating donuts
    B. not all Hazolah members are selfless
    C. there was a major accident the other night in
    Nassau County where a charter bus with 38 students
    and 5 adults slammed into an overpass which
    sheared off the entire roof. Nassau EMTs and local
    volunteer units responded so quickly that within 30
    minutes all the injured had been triaged and on their
    way via ambulance to hospitals
    D. the speed of the ambulance and use of
    the siren are not indicative of how caring
    The EMTs are, at least in Nassau.
    years ago I passed out in shul.and the Nassau
    EMTs came immediately. During transport I asked
    why no siren and why they were. observing speed limits and traffic laws. They said that when its
    determined, as in my case, that the patient was
    not in danger, they can’t use the siren or ignore
    traffic laws as that would create needless accidents

    #1504589

    Health
    Participant

    Ubiq -“had to call for help ch”v I would without question call hatzolah.”

    One question – WHY???

    #1504600

    Health
    Participant

    KY – “as to the article from Jem yes I would like to know what you recall from that article”

    The research found that the only Volly systems that worked was like in Balto. County, MD.
    When a 911 EMS call came in, they dispatched the nearest fire station. A lot of EMS in this country is fire based. They gave the Vollys a few minutes to respond; and if they didn’t respond within the allotted time – they dispatched the nearest paid fire station.

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