Thursday, January 11, 2018

The Local Dangers We Don't See......

We all view things through our life experiences and training. Recently my fire training has me looking at things from a firefighters view.

As I went through BLEVE or Boiling Liquid Expanding Vapor Explosion training a few weeks ago I realized the danger posed by the numerous accidents and the huge propane tank at US-93 and Pierce Ferry Rd.

If there was a fire threatening that huge propane tank the evacuation area is suggested to be one mile in all directions. If you think something like this can't happen here, it can, and it has.

It was almost 45 years ago on July 5, 1973 that a propane tank car being off-loaded in Kingman, AZ, caught fire, resulting in a BLEVE or boiling liquid expanding vapor explosion. On that day 11 Kingman firefighters and one civilian were killed. This was the worst firefighter tragedy in Arizona until 2013 when 19 Granite Mountain Hotshots firefighters were killed in the Yarnell Hill Fire.

In case something like this happens local people need to know how to react. Evacuate do not become a spectator and causality, run....

The propane tank in this example is like people have at home, it's nothing like the huge propane tank at US-93 and Pierce Ferry Rd.

EVERYONE needs to see this video for your safety and that of friends and family Example of a BLEVE  The really scary part of the video is at the beginning of the video, and again eight minute and 30 seconds in, it's a propane tank like everyone has at home.... and it's devastating...

Another video Only known video of the 1973 Kingman BLEVE

Be Safe.....

Wednesday, January 3, 2018

Better Survivability in Heart Attacks in the LMRFD

The fire chief has applied for a grant for a mechanical CPR unit. This will improve the survivability for patients in cardiac arrest. It will allows a two man ambulance crew to run a effective cardiac call by allowing the paramedic to monitor the patient and push medications as the CPR unit does CPR at the correct depth and rate without getting tired like an EMT.

We need more people trained in CPR and AED use and have any business with an AED well marked on the building.

Friday, December 8, 2017

Seems Director Kiffer Wants to be Fire Chief Too

The job of the LMRFD Board of Directors is to oversee the finances of the fire district and hire a chief to run day to day operations. The Board of Directors has no power to interfere with day to day operations and this type of interference can cause the Arizona Attorney General to become involved.

Director Kiffer wants to run the day to day operations and it's not her job. What's her problem with someone working from home as long as they get the work done? Half the businesses today have people working from home. With call forwarding and computers there's little someone can't do from home.

Excerpt from November 20th LMRFD Board Meeting,,,, Sorry I had to take a screen shot as apposed to copying the entire document because they have the page locked to prevent people from easy access to public information.

I find it funny when friends of Director Kiffer complain to her about problems with the fire district she takes them to the chief rather than tell them to take their complaint to the chief's office. When I complain the chief isn't returning my calls Director Kiffer tells me if I have a complaint it needs to go to the chief's office...

I found it funny with all the problems Director Kiffer has with the fire chief, somehow the problem I see with the fire district was her reason I shouldn't be on the fire board.

Excerpt from November 20th LMRFD Board Meeting

It seems the chief knows what his job is, too bad Director Kiffer doesn't know hers.

I was also disappointed that Director Kiffer wants to put a credit card machine on the ambulance. I guess she wants paramedics to ask for your Visa card before they transport. Not only is this against the law, it shows a disregard for the lives of the people she is supposed to be protecting. 

Thursday, December 7, 2017

LMRFD Board Member Kiffer People Don't Complain to the Chief "because they feel your unavailable, they feel that you're rude to them"

At the November 20th  board meeting of the LMRFD they needed to appoint a new board member because someone had quit. when I was being considered for the vacant position Director Kiffer asked if I had problems with the LMRFD. My answer was yes that when paramedics put very sick patients in private vehicles it could cost the district millions.

Needless to say who runs the LMRFD board, but I wasn't chosen for the board. Director Kiffer nominated someone else and everyone fell in line...

Kiffer then made a motion to choose someone else for the empty LMRFD board vacancy because I see problems in the LMRFD.

I filed a complaint against the fire chief when I should have complained to him. Yet when people complain directly to Director Kiffer about the fire chief she takes the complaint directly to the chief rather than tell them what I was told, that complaints should go to the fire chief's office.

Later in executive session when Director Kiffer was asked by the chief "why aren't these complains coming to my office" Kiffer said "because they feel your unavailable, they feel that you're rude to them, they feel you're not hearing them, these are the things people are telling me"

Funny, that's what I had told the board earlier in the same board meeting. That I had left several calls for the chief when he took over and never received a return call. I had spent days filling out a volunteer application for the LMRFD and never even received a thanks, but no thanks call.

So on this one point I agree with Director Kiffer, that the chief is unavailable and rude. He should at least return calls from people and if someone goes to all the trouble to fill out a volunteer application, have the courtesy to say thank you. My complaint was about the chief, so I had little faith the complaint would have been taken seriously.

From November 20th 2017 LMRFD Board Meeting minutes.....

Tuesday, November 21, 2017

UPDATE Two Rollovers One Fatal One Not

UPDATE: This is the call that board member Charlotte was referring to at the November 20th board meeting when she asked me if complaints should be directed to the chief. I saw no point in reporting a bad decision by the fire chief to the fire chief...

December 22nd was a cold day with fog and rain in the Dolan Springs area. As usual I was listening to scanner traffic on DPS, MCSO and fire dispatch channels.

A little after 9:00 AM DPS put out two rollover accidents about four miles apart on Highway 93 North of Rosie’s.

Several DPS units a Mohave County sheriff’s deputy and the Lake Mohave Ranchos ambulance were dispatched to the first accident, an SUV at mile post 22. DPS dispatch advised responding units that the driver at mile post 22 was hanging out the window of an SUV.

The MCSO deputy was the closest unit and was first on scene at both accidents. The deputy checked the second accident first as it was closest to Dolan Springs at mile post 24. Checking for injuries the deputy advised dispatch that the driver had self extricated and was walking around the vehicle.

The deputy then proceeded to the first accident at mile post 22 about four miles away. Upon arriving at the accident, he advised dispatch that the driver was pinned in the vehicle in critical condition and he needed EMS.

It was a foggy day and they had a hard time finding a medical helicopter willing to fly. When the helicopter did arrive they couldn't land. Law enforcement at mile post 22 kept saying the driver was pinned in the vehicle and in critical condition and kept asking for EMS.

At some point the LMRFD chief asked the ambulance to call him by cell phone. What he didn't want to say over the radio, we’ll never know.

When the LMRFD ambulance arrived at the accident at mile post 24, the one where the driver was walking around, fire dispatch said no, and wanted them to respond to the other accident.
The ambulance R415 said this “negative alarm Per-chief 401 we were advised to stop at the accident at mp24 we’ll be out investigating”.  Basically telling dispatch no, and hanging up on them. Law enforcement continued to ask for EMS that never arrived.

I literally listened to patient at mile post 22 die over the radio as reports from law enforcement got worse and worse until around 10:00 AM DPS advised troopers it was now a fatality accident.

Nobody has the right to triage a patient from 40 miles away and decide who lives and who dies. EMS should always use first hand reports from those on the scene and respond to most critical patient first, especially when it’s known that the other patient is walking around.

We all know about the Golden Hour and in this case it was wasted on a stable patient rather than the critical patient who needed paramedics.

To me the fact that the driver was breathing on his own and lived for almost an hour tells me he didn’t have a spinal injury that caused paralysis and would cause his breathing to stop. The fact that he lived for around an hour laying on the cold wet ground, tells me internal bleeding wasn't bad enough to cause him to bleed out rapidly.

None of this information can tell us if the driver would have survived the accident. What it does tell us is that LMRFD paramedics should have responded to the most critical patient and done everything possible to give him a chance to survive.

NOTE: The accident at MP 22 ended up being at MP 20.5

If it was your family member pinned in a vehicle in critical condition what do you think was the right thing to do? 

There's what may meet the requirements of the LMRFD's CON Certificate of Need and then there's what's the right thing to do.

CON says ambulance must respond to 50% of calls in 20 minutes, 70% of calls in 30 minutes, 85% of calls in 45 minutes, and 98% of calls in 60 minutes.

The patient at MP 22 was an 18 year old kid who had just graduated high school and was in Vegas looking into a job and visiting his sister.

It was raining on December 22nd, it was cold and only 40 degrees. Someone can die from hypothermia in 1-2 hours at 40 degrees. He could have been suffering from hypothermia. My paramedic training was that any patient with hypothermia is not dead until they are warm and dead. 

The EMS Board looked into this and said LMRFD did respond to both calls. Thats is True 

The LMRFD ambulance was dispatched at 09:11 hrs and arrived at the accident where the driver was walking around at 09:37 hrs. Other EMS did not arrive for 20 minutes after they had transported the stable patient.

In the report the medical director said it was reasonable to respond to the first patients they encounter. MY PROBLEM is that the LMRFD ambulance was dispatched to the critical patient at MP 22 not the MP 24 accident. Yet at the chiefs direction the ambulance stopped at a stable patient 4 miles short and picked up a stable patient.

Engine 431 from Meadview was dispatched for extrication at 09:11 hrs but didn't arrive at the critical patient until 10:35 hrs He was already dead.

Monday, November 20, 2017

Questions I Would Have Asked if Appointed to the Fire Board

If I had been appointed to the fire board I would have first asked why they didn't have a Facebook page to keep citizens informed on what's going on like most fire districts today. The LMRFD web page makes it difficult to read things like the board minutes and public notices.

Then I would have asked why the Fire Chief drives a fire truck home to Golden Valley? Why is he putting between 2200 and 3500 miles on an expensive Type 6 Brush truck that will need replaced soon.  (7 trips 4 days & 3 calls or 11 trips 4 days & 7 calls)

At 6 MPG if he drives 2200 miles thats 366 gallons of diesel at $3.32 a gallon thats $1200 a month.
At 6 MPG if he drives 3500 miles thats 583 gallons of diesel at $3.32 a gallon thats almost $2000 a month.

At 3500 miles a month he putting 42,000 miles a year on a vehicle that normally would run a couple calls a month maybe 200 miles or 2400 miles a year. At that rate the chief is putting 17 years on the truck ever year.. And a Type 6 Brush Truck is not cheap to replace. It's a very expensive piece of equipment with new Type 6 Brush Truck's running between between $80,000 to $100,000.

I would have asked why we didn't have volunteers running a BLS ambulance as a second out. That we ambulance revenue is down because we lose about $2500 in ambulance revenue every time we have to call River Medical because the LMRFD ambulance is on a call.

I would have asked why paramedic's call a helicopter for patients that KRMC can handle? The LMRFD loses over $500 in millage, and if a helicopter isn't called until the ambulance is loading the patient, many times it's a 30 minute flight time to Dolan. Thats 30 minutes to get to Dolan, load time, and 30 minutes back, or over an hour to get the patient to the hospital. It's 37 miles from my house on 9th and the ER doors at KRMC, about 30 minutes lights and siren.

So the LMRFD looses $500 and KRMC looses thousands of dollars in treatment billing, and the patient get's a bill for $25,000..... Everybody looses.... LMRFD, KRMC, and especially the patient who we hope made the hour trip to Vegas, gets there in over an hour rather than 30 minutes, and get's billed ten times as much as the ambulance ride they also get billed for.

Thursday, November 9, 2017

Good Samaritans Laws in Arizona

Good Samaritans are those who run toward someone who needs help, and helps before professional help arrives. 

I always tell people law is like a game, who ever knows the rules best wins. There are a lot of rules in law and they change often, so know the law..... 

There are two life saving medications a layperson can give in an emergency. With long response times both can truly save a life. 

If you know someone who has allergies to nuts, seafood, or bee stings PLEASE take the Anaphylaxis course below and learn the sign and symptoms of anaphylactic shock. Arizona ARS 36-2226 allows someone to give the life saving drug Epinephrine in an emergency. 

First Aid for Free online Anaphylaxis Awareness Course

First Aid for Free Everybody Needs to Take This Trainin

Epinephrine for Severe Allergic Reaction 
36-2226 Emergency administration of epinephrine by Good Samaritans; exemption from civil liability
A. Notwithstanding any other law, a person may administer epinephrine to another person who is suffering from a severe allergic reaction if the person acts in good faith and without compensation for the act of administering the epinephrine and a health professional who is qualified to administer epinephrine is not immediately available.

B. A person who administers epinephrine pursuant to subsection A is not subject to civil liability for any injury that results from that act unless the person acts with gross negligence, wilful misconduct or intentional wrongdoing.

36-2267 Administration of opioid antagonist; exemption from civil liability; definition
A. A person may administer an opioid antagonist that is prescribed or dispensed pursuant to section 32-1979 or 36-2266 in accordance with the protocol specified by the physician, nurse practitioner, pharmacist or other health professional to a person who is experiencing an opioid-related overdose.
B. A person who in good faith and without compensation administers an opioid antagonist to a person who is experiencing an opioid-related overdose is not liable for any civil or other damages as the result of any act or omission by the person rendering the care or as the result of any act or failure to act to arrange for further medical treatment or care for the person experiencing the overdose, unless the person while rendering the care acts with gross negligence, wilful misconduct or intentional wrongdoing.

C. For the purposes of this section, "person" includes an employee of a school district or charter school who is acting in the person's official capacity.

General Good Samaritan Protection
32-1471. Health care provider and any other person; emergency aid; nonliability
Any health care provider licensed or certified to practice as such in this state or elsewhere, or a licensed ambulance attendant, driver or pilot as defined in section 41-1831, or any other person who renders emergency care at a public gathering or at the scene of an emergency occurrence gratuitously and in good faith shall not be liable for any civil or other damages as the result of any act or omission by such person rendering the emergency care, or as the result of any act or failure to act to provide or arrange for further medical treatment or care for the injured persons, unless such person, while rendering such emergency care, is guilty of gross negligence.

Wednesday, November 8, 2017

Tuesday, November 7, 2017

Customer Service Survey - If You Don't Ask, How Do You Know?

The LMRFD ambulance revenue is down from previous years and the board is wondering why. 

Why not do a customer service survey like KRMC and many other health care providers who want to know where they do well and where they could do better..

At the September LMRFD board meeting the minutes say there was 17 EMS calls and 10 patient refusals in August..

At the October LMRFD board meeting the minutes say there was 29 transports and 17 patient refusals in September..

Over half the EMS calls were refusals, over half? It doesn't say if any went by private owned vehicle (POV), if so how many and how much revenue was lost by the LMRFD? 

With their history of offering to put patients in someones car so they can drive them to KRMC rather than be transported by ambulance, if eight went by private owned vehicle the LMRFD lost around $20,000.

If We Don't Ask, How Do We Know? 
The only way to know what works and where problems exist is to ask the customers.....

Monday, October 30, 2017

For someone to belittle those of us who volunteer to help others should tell you something about that person

A LMRFD firefighter brought up the fact I complain that the majority of the LMRFD firefighters live in other towns, and only one LMRFD firefighter lives in the fire district. That's TRUE....

I complain about not having firefighters living here because like the major rain storm we had about a year ago that closed Pierce Ferry Road, firefighters from Meadview were unable to make it to a call near Dolan Springs we are left unprotected and alone.

If a major disaster closed US-93 we would be left with the two firefighters on duty to cover the 144 square mile fire district as well as the 2200 square miles the ambulance covers.

The term "volunteer" contrasts with career firefighters who are fully compensated for their services. In fact the majority of fire departments in the United States are volunteer. Of the total 29,727 fire departments in the country, 19,762 are all volunteer; 5,421 are mostly volunteer; 1,893 are mostly career; and 2,651 are all career

LMRFD firefighters paramedics are paid around $700.00 per shift.(plus the cost of benefits).. I donate my time to help the town of Chloride. So I'm sorry, I suppose the LMRFD firefighter who complained that I volunteer for Chloride would also like me to stop volunteering for the Red Cross. I guess he thinks all of us who GIVE out time and energy should just stop helping our neighbors. 

I'm SORRY but helping neighbors helping neighbors is what makes living in a small town all about, and what makes America great.

I guess he thinks all the volunteer firefighters and Red Cross volunteers who selflessly leave their homes and families at personal risk to help others in neighboring communities and states should just stop. Sorry but it's what I've always done and will continue to do. 

For someone who comes to our community for profit to belittle anyone who volunteers hours of their time and energy to obtain the required training to help others should tell you something about that person.... 

How Many People Are Interested in the LMRFD's Problems and Potential Liability

Apparently 2,602 People this month alone.... almost 15,000 in the last two years

Sunday, October 29, 2017

I Was Asked How Many Fires I Had Responded To For NACFD?

The answer is NONE. Why? Because I respond to fires and EMS calls in Chloride and it's been well over three years since Chloride has had a structure fire.

Why? Because NACFD teaches Chloride residents fire safety and has installed 48 smoke alarms for free. NACFD has given Chloride an AED (Automatic External Defibrillator) and trained 5% of Chloride residents in CPR AED use and first aid and giving another CPR AED training November 4th. (Sorry it's Full)

NACFD is proactive rather than reactive by training their residents in fire safety. Knowing Chloride is remote like most of the LMRFD, NACFD's fire safety, smoke alarms, CPR/AED and first aid training help residents help each other prior to the arrival of professional EMS or fire services. 

Saturday, October 28, 2017

I'll No Longer Post information on Chatter Box. The administrator Told Me My Posts Were a "Drama Magnet"

UPDATE October 29th 2017
It appears my new post simply saying "New Post on My Blog, Please Read" I put on Chatter Box this afternoon was also deleted by Chatter Box Administration. 

So Please Check Here Often. I'll TRY to advise people of new posts to my blog on Chatter Box, but they may get deleted....

Even thought only two or three people most of who don't even live in the fire district post negative comments and far more people like my posts and support the things I try to educate tax payers of the 144 square mile fire district and those in the 2200 square miles covered by the LMRFD ambulance, I was told by an administrator that my posts were a "Drama Magnet".

I was called an idiot and other names over and over, and that wasn't considered a "personal attack" Yet when I mentioned that an administrator had told me that my educational posts about the fire district were a Drama Magnet my post was deleted as a personal attack. Apparently you are not allowed to criticize the people who run Chatter Box without having your post removed. So much for free speech....

If I'm allowed to post links to my blog on Chatter Box in the future I will. Other wise please check back often for education about problems in the LMRFD that will one day cost the district millions of dollars in a lawsuit....