Thursday, January 30, 2020

Why So Many Half Truths? Yes we Can Require the Chief to Live in the Fire District

Half of what we're told is BS. We're told we can't have a residency requirement for our firefighters. 

Half true, we can't require a firefighter to live in Dolan or Meadview. We can require the chief to live here since the law does not apply to executive-level firefighters. 


Section 48-824 - Firefighter; residency requirement; prohibition; exemption; definition
A.    A fire district shall not impose any residency requirement on any firefighter as a condition of employment.

B. This section does not apply to executive-level firefighters.

C. For the purposes of this section, "firefighter" means a professional firefighter who is a member of a city, town, county or fire district fire department.
A.R.S. § 48-824

EMS use of red lights and sirens is a dangerous sacred cow

EMS use of red lights and sirens is a dangerous sacred cow

The evidence tells us that not using red lights and sirens should be the rule – and using them should be an infrequent exception

Don't get me wrong I like running code, lights on and my 100 watt whooper going it's fun and very dangerous...

It's a little after 6:30 in the morning and the LMRFD just got a call to check out a person in a DPS car at the Chevron. This is not a serious medical emergency, even if it was the crew is 4 miles away and the chief is running code from his home on the far side of Kingman, why?

He's 45 minutes away, if needed the crew would or should have loaded the patient and been in route long before he ever gets here. Guess it means more time off when he wants....

LINK






Taxpayers in the LMRFD Should Receive Something for their $1,000,000

In the Lake Mohave Ranchos Fire District your property taxes pay for the firefighter paramedics, but if they do so much as take your blood pressure outside the fire station, you're going to get a bill for around $2500... Why

LMRFD Firefighter Paramedics Respond: Cost $2445.11

NACFD Firefighter Paramedics Respond: Cost ZERO
You are billed if private ambulance transports you...

In NACFD the Northern Arizona Consolidated Fire District your property taxes pay for the firefighter's, EMT's, and paramedics who respond on fire and EMS calls. You never get a bill for their services. Your Cost When NACFD Firefighter Paramedic Respond to your home is ZERO.

If the NACFD paramedics give you a breathing treatment, it costs you nothing. When AMR Ambulance arrives you can tell them you're feeling better and don't want to go to the hospital, and pay nothing.

It's not the best idea and you will have to sign a release known as an AMA Against Medical Advice.Your total bill is ZERO, nothing. 

Your property taxes pay for those firefighter paramedics so you don't get a bill. 

Cost When LMRFD Firefighter Paramedic Respond and just take your blood pressure is $2500

Let's say you live in the LMRFD and you get short of breath. You call 911 and they send an engine with firefighter paramedics on the LMRFD ambulance. with paramedics. 


They know you from other calls and tell you they can give you a breathing treatment, but you have to get transported to the hospital. The cost is $1845.11 and $15.01 a mile or $600 from Dolan for a total of $2445.11 

From LMRFD Page
Ambulance Information

If you come to the fire station for a basic medical assessment, there is no charge. Please note however that we can not administer drugs or perform other invasive treatments without transporting you to the hospital for physician evaluation. Unfortunately, this means that you can not come to the station for a breathing treatment because you ran out or have not been able to refill your prescription! We are not licensed to operate as a walk in/walk out clinic, and our continued ability to provide life saving services to this community is dependant on following ADHS and DEA rules and regulations.

With that said, we care about our residents, and please do not hesitate to allow us to help you in your times of medical emergencies!

NOTE: There is no charge for coming into the station to get checked out, whatever your medical problem may be.





Tuesday, January 28, 2020

Chief You Just Don't Get IT.....

Chief you don't live here and you just don't understand.

You live in Kingman. when you're up hunting and your daughter gets injured, Kingman Fire Department and EMS are only minutes away. 

A few weeks ago it took the LMRFD ambulance 2 hours to respond to an 8 month old baby with a head injury. Because there was only one person on the ambulance, he couldn't even transport the baby after arriving. After driving some distance to meet the ambulance at Pierce Ferry and Stockton Hill Rd, then waiting 2 hours for the ambulance the parents were told they could wait another hour for AMR to respond, or drive to KRMC alone with their baby. 

A volunteer EMR could have driven the ambulance while the paramedic did the care.

Why weren't the parents told it would be a very long wait for the ambulance and to drive their baby to the hospital. 

Kingman Fire Dept dispatch doesnt understand our fire district. They send fire trucks on EMS calls and the ambulance on fire calls, with no morning check ins neither dispatch or people listening have any idea if there is a crew in Meadview.. They refuse to give you an ETA on the ambulance so you can make the choice to take the person to the hospital

We need volunteer EMR's and EMT's, not firefighters. We had 79 calls in 30 days, not one fire call. We have one person on the paid crew who doesn't fight fire, only does EMS. 

It costs $250 to train an EMR who can drive and assist on our ambulance. We could train 10 EMR's for what we receive on one ambulance call.


The people inside the LMRFD who pay property taxes get the same service as those outside in White Hills who only pay when and if they need fire response.

COMING SOON
The dumbing down of volunteers
Dangerous Short Cuts Can Cost Lives
Lack of Proper Training


Monday, January 27, 2020

I was just fired from LMRFD I posted this Dec 1st 2019 Lots More to Come...

Originally Posted December 1st 2019.. 
Removed after chief agreed we could use EMR's on ambulance and that he would have the protocols for EMR's by the end of December 2019 Still no protocols by the end of January 2020 but lots of time off for hunting.

I resigned from LMRFD today, I was tired of half truths and BS. I'm 67 and too old for putting on 40 pounds firefighting gear and running into burning buildings.

I know I'm not a paramedic, I get reminded enough. But I do have about 2000 hours of EMS training. If I never touched a patient that training would be an asset as far as patient assessment. 

It's no secret LMRFD needs a second ambulance. We could have one today except Chief Bonnee doesn't want to use EMR's (Emergency Medical Responder) 

The Arizona Revised Code is clear that Emergency Medical Responders EMR's can assist and drive an ambulance in rural areas under 10,000 people like Dolan Springs.

I'm tired of people using laws, rules, and regulations they like while ignoring those they don't. Chief Bonnee has told me many times that our medical director won't let LMRFD use EMR's. 

I spoke to a KRMC ER representative today at training with Chief Bonnee. She told that EMR’s can assist the EMT or paramedic if they ask and drive the LMRFD ambulance. That's when Chief Bonnee said it was up to him and he didn't want to use EMR's because of the liability. 

I guess we need to weigh the liability of having a Nationally Certified EMR assist a Nationally Certified EMT or Paramedic by driving the ambulance, against the liability of a patient dying 
because the ambulance wasn't available because the chief just didn't want to.......

80% of calls are EMS calls and not fire calls, 80% of EMS calls are BLS Basic Life Support and NOT ALS Advanced Life Support. That means an EMT can handle 80% of EMS calls. It would be great to have two paramedics and an EMT on every call, but something is always better than nothing. 

Remember the chief and his family don't live here and need to depend on LMRFD EMS...








Wednesday, January 8, 2020

EMS What can YOU DO as a Layperson in an Emergency?

Our Emergency Medical Services have grown from a handful of people in a poor Pittsburgh neighborhood to the EMS system we know today with paramedics on most ambulances.

As emergency medicine has grown so have the life saving medications EMT's and paramedics can give in the field, so have the life saving medications a layperson can give.

In Arizona the law 36-2226 allows a layperson to give epinephrine in case of an allergic reaction known as anaphylactic shock. If you want to learn more about anaphylactic shock check out First Aid for Free's Anaphylactic Awareness page

Narcan also known as Naloxone can also be given by a layperson.
Under A.R.S. § 36-2267, any person may administer an opioid antagonist, like naloxone, to a person who is experiencing an opioid-related overdose. The statute further states, "A person who does this in good faith and without compensation is not liable for any civil or other damages as the result of the act.” 

For more information on the Arizona laws on obtaining or administering Narcan click HERE

Here's more information on How to Recognize an Opioid Overdose

Under ARS 36-2229 the Community Center in Dolan Springs and the Meadview Civic Association could have a couple people trained on how to give breathing treatments in case of respiratory distress.

Everybody needs to know First Aid and CPR... Who ya gonna call?
Learn for FREE at First Aid for Free 

Arizona EMS Laws

Emergency Administration of Epinephrine by good Samaritans 
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.

36-2226.01 Emergency administration of epinephrine authorized entities prescriptions training immunity definitions


Physicians can prescribe epinephrine auto-injectors to an "authorized entity" That’s a school, restaurant, community center, camp, or place of employment where allergens capable of causing anaphylaxis may be present.

Emergency administration of inhalers
36-2229Emergency administration of inhalers; authorized entities; training; immunity; definitions
A. A physician who is licensed pursuant to title 32, chapter 13 or 17 or a nurse practitioner who is licensed pursuant to title 32, chapter 15 may prescribe inhalers and spacers or holding chambers in the name of an authorized entity for use in accordance with this section, and pharmacists may dispense inhalers and spacers or holding chambers pursuant to a prescription issued in the name of an authorized entity. A prescription issued pursuant to this section is valid for two years.
B. An authorized entity may acquire and stock a supply of inhalers and spacers or holding chambers pursuant to a prescription issued in accordance with this section. The inhalers shall be stored in a location that is readily accessible in an emergency and in accordance with the inhaler's instructions for use. An authorized entity shall designate employees or agents who have completed the training required by subsection D of this section to be responsible for the storage, maintenance, control and general oversight of the inhalers and spacers or holding chambers acquired by the authorized entity.
C. If an employee or agent of an authorized entity or another individual who has completed the training required by subsection D of this section believes in good faith that an individual is experiencing respiratory distress, the employee, agent or other individual may provide and administer an inhaler to that individual or may provide an inhaler to the parent, guardian or caregiver of that individual, for immediate administration, regardless of whether the individual who is believed to be experiencing respiratory distress has a prescription for an inhaler and spacer or holding chamber or has previously been diagnosed with a condition requiring an inhaler.
D. An employee, agent or other individual described in subsection B or C of this section shall complete initial training for the use of inhalers and, at least every two years thereafter, shall complete subsequent training. The training shall be conducted by a nationally recognized organization that is experienced in training laypersons in emergency health treatment. Training may be conducted online or in person and, at a minimum, shall cover:
1. How to recognize signs and symptoms of respiratory distress.
2. Standards and procedures for the storage and administration of an inhaler.
3. Emergency follow-up procedures after the administration of an inhaler.
E. The organization that conducts the training required by subsection D of this section shall issue a certificate to each person who successfully completes the training.
F. The administration of an inhaler pursuant to this section is not the practice of medicine or any other profession that otherwise requires licensure.
G. Physicians licensed pursuant to title 32, chapter 13 or 17 and nurse practitioners licensed pursuant to title 32, chapter 15 who prescribe an inhaler and spacer or holding chamber in the name of an authorized entity, authorized entities and employees and agents of authorized entities that provide or administer inhalers and organizations that provide training pursuant to subsection D of this section are immune from civil liability with respect to all decisions made and actions or omissions taken that are based on good faith implementation of the requirements of this section, except in cases of gross negligence, wilful misconduct or intentional wrongdoing.
H. The immunity from civil liability provided in subsection G of this section does not affect a manufacturer's product liability regarding the design, manufacturing or instructions for use of an inhaler and spacer or holding chamber.
I. An authorized entity may accept monetary donations to purchase inhalers and spacers or holding chambers and may accept donations of inhalers and spacers or holding chambers directly from the product manufacturer.
J. For the purposes of this section:
1. "Authorized entity" means any entity or organization in connection with or at which allergens capable of causing respiratory distress symptoms may be present, including recreation camps, day care facilities, youth sports leagues, amusement parks, restaurants and sports arenas.
2. "Bronchodilator" means albuterol or another short-acting bronchodilator that is approved by the United States food and drug administration for the treatment of respiratory distress.
3. "Inhaler" means a device that delivers a bronchodilator to alleviate symptoms of respiratory distress, that is manufactured in the form of a metered-dose inhaler or dry-powder inhaler and that includes a spacer or holding chamber that attaches to the inhaler to improve the delivery of the bronchodilator.
4. "Respiratory distress" includes the perceived or actual presence of coughing, wheezing or shortness of breath.