#ambulance

Woke Vic Police should have called the LAPD before selecting EVs

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Victoria Police is renowned for its commitment to inclusion and diversity. Who could forget the push for segregated sessions in the recruitment drive? Stands to reason the coppers have introduced the Tesla Model X to the fleet to show “green” credentials. The point of a police car is instant dispatch when required to attend to a crisis situation, from thwarting a terrorist in the Melbourne CBD or rushing to a domestic dispute. It won’t look good when the police have to wait for the fast charger at the base to provide enough juice to make it the scene of the crime. Now that Hazelwood coal-fired power plant has been closed, good luck waiting on renewable energy to charge these cars for practical police use. Don’t be surprised when the shortcomings force a rethink.

What will they tell Victorians? “Sorry, in our quest to save the planet you’ll have to wait another 3 hours before we can attend to your domestic violence dispute. Bear with us. The car is on the charger!

In 2016, the LAPD bought $10m worth of BMW i3s to show its commitment to climate abatement. Sadly, the cars went largely unused as they were unsuited for police work.

CBS reported,

LAPD Deputy Chief Jorge Villegas said of the purchase, Money well worth itIt’s all a part of saving the Earth, going green … quite frankly, to try and save money for the community and the taxpayers.”

But sources say some personnel are reluctant to use the electric cars because they can only go 80-100 miles on a charge. And the mileage logs we obtained seem to back that up.

From April 2016 when the project started through August 2017, we found most of the electric cars have only been used for a few thousand miles…And a handful are sitting in the garage with only a few hundred on them.

Like this one in service since May 27, 2016, with just 400 miles on it!

That’s an average use of 6 miles a week!

With the monthly lease payment of a little more than $418, this one costs taxpayers over $15 a mile to use!… It just doesn’t make any sense!”

CM one posted this question to someone from the NSW St Johns Ambulance with respect to discussions about EV ambulances. He said unequivocally,

We have Webasto heaters in our cars in the colder areas. Running off the diesel they can operate 24/7 if needed. If we don’t have them some of our equipment doesn’t work like our tympanic thermometers, the blood glucose reader and then there is the problem of having cold fluids in the car. This is a problem if we are giving these IV because we can make a patient hypothermic if it’s cold. Then there’s just the general environment inside the cab. It needs to be warm in winter.

That is the point. Emergency services need to be able to operate on call. 5 minutes to fill up with gasoline or diesel means that efficient utilisation and dispatch is guaranteed for at least 500km+.

If end users have to weigh having their lives saved or rescue the planet, it is a no brainer which they will choose. We already know that Tesla P100Ds have done 167,000km in CO2 before they’ve left the factory. “To Protect after Charging” should be emblazoned on the doors.

First responder assaults – the shocking stats

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We must question the sanity of the world we live in. First responders – police, fire and ambulance – are generally people trying to save the community from danger by putting themselves in harm’s way. Yet the incidence of assaults against them has grown to shocking levels around the world. These are not exhaustive stats (this will come in a more comprehensive piece) but this piece paints a picture of what is going on and why we shouldn’t be surprised at the growing incidences of PTSD suffered by first responders. Something must be done. The next journey for CM is to provide a solution.

By branch:

POLICE

The FBI noted in 2016 that 57,180 (c.10% of all) US police officers were assaulted while performing their duties. 28.9% were injured (enough to enforce time away from work). The largest percentage of victim officers (32.2%) were assaulted while responding to disturbance calls (domestic violence, family disputes, pub fights).

Assailants used hands, fists or feet in 78% of the incidents, firearms in 4.2% of incidents, and knives or other cutting instruments in 1.9% of the assaults. Other types of dangerous weapons were used in 16% of assaults. Assaults on police in the US are up 17% in the past two years. 

In NSW, Australia some 2,343 (13.3%) police officers out of 16,500 have been at the receiving end of assault in 2017. That’s 6 per day. With regard to official statistics, the NSW Police Force indicated that over a three year period from 2013 to 2015, an average of 2,236 police officers per year were assaulted during the course of their duties. Around 7% of officers actually end up physically injured. 

 AMBULANCE/EMS

In the US health care professionals experience the highest rate of workplace violence (WPV) compared to all other industries, with the majority of violent injuries committed by their patients according to the Bureau of Labor Statistics. Studies show EMS responders were three times higher than the national average for all other occupations to suffer WPV. In regards to occupational fatalities, the rate among paramedics is more than twice the national average for all occupations and is comparable to those of police and firefighters at 12.7 per 100,000 workers per year.

The rate of nonfatal injuries among US paramedics was 34.6 per 100 full-time workers per year — a rate more than 5x higher than the national average for all workers.  In regard to fatal injuries, a retrospective cohort study of nationally registered emergency medical technicians (EMTs) in the U.S. found that 8% of fatalities were due to assaults. 

Males have been reported as the most frequent perpetrators of violence however, a separate study found female patients of the mean age of 32.5 years +/- 8.1 years to be the most frequent perpetrators. 

In the NSW Ambulance Service, approximately 51% of assault incidents were attributed to mental illness, 22% to alcohol, 15% to drugs. Similarly, statistics provided by the NSW Bureau of Crime Statistics and Research (BOCSAR) concerning violence against Police from July 2006 to June 2016 suggest alcohol is a factor in many incidents.  Assaults on ambos in NSW are up 8-fold since 2001. Median lost hours for those EMS crew assaulted is around 8.6 weeks.

FIRE FIGHTERS

In what world do people shoot fireys? Here are 3 specific incidents in 2016 of attacks on fire fighters in the US. 

April 15, 2016: Firefighter fatally shot, second wounded in Prince George’s, Baltimore, Maryland

Jan. 22, 2016: Ark. firefighter shot, killed on EMS call, Pulaski County, Arkansas,

Jan. 20, 2016: Denver fire chief stabbed near station, Denver, Colorado,

Fire and Rescue NSW indicated its officers do not have the sort of violence prevention training of police and paramedics better able to protect their crew’s health and safety, including in respect of violent incidents. At the Parliamentary Committee’s hearing on 14 November 2016, Fire and Rescue NSW witnesses provided the following evidence:

Basically, when a crew arrives at an incident, you have a station officer and a station commander in charge of the crew and the…truck. That person undergoes promotional programs to get to that position. Part of that is understanding how the legislation is applied in reality from a practical point of view. Also, during that experience – we are talking probably eight to 10 years for that to occur …The promotional programs…cover the responsibilities of the officer and advise around the standard operational guidelines of when to withdraw and ask for police support and what is safe or not safe.

…If we look overseas for experiences and tried to align our experience to that, you would have to say that the civil unrest that is happening in the United States probably would not occur here to that degree. However, there is also an underlying issue in the United States where emergency service is seen as part of an arm of government and there is, hopefully, a small growing trend where emergency service ambushes are occurring…random shooters are calling emergency services to locations to make a point. We hope that never crosses to this country here, but we would always have an eye on what happens in other jurisdictions…because it is quite possible someone would pick that up as a possibility in this jurisdiction….”

PRISON GUARDS

The UK HMPS note that there were 7,159 assaults on staff in the year to March 2017 up 32%YoY. Serious assaults were up 25%YoY to 805 incidents. The National Tactical Response Group (NTRG) which is only called under extreme levels of prisoner violence  surged from 120 in 2010 to an annualized 630 by the end of 2016.  

THE PTSD IMPACT

This was the fascinating part of the research. It isn’t that the job isn’t hard enough already, it’s the lack of resources to support first responders when waiting for incidents. Lots of idle time to ponder.

US FEMA note stress has not only been categorized by exposure to traumatic incidents, but also the monotonous operational characteristics of EMS organizations, such as paperwork, lack of administrative support, low wages, long hours, irregular shifts, and cynical societal attitudes toward public safety officers.

Cumulative stress associated with the monotonous duties or low acuity calls has led to feelings of desensitization for patients, and their job as a whole. Concerns have also been raised regarding sleep quality and fatigue and the impact it has not only on the provider, but also job performance and patient  outcomes. Some research has posited that organizational stress often contributes more to the development of PTSD than traumatic events.

Also noteworthy is the notion that paramedics are often the source for a lot of criticisms by society for the decisions they make in determining life or death situations for patients and themselves. This can affect EMS providers in many ways and may contribute to the slow decline in provider morale.

Burnout (emotional exhaustion) is one of many organizational outcomes that may arise as a result of violence experienced by EMS responders. The question of whether or not violence would eventually lead to burnout was first raised in the early 1990s . Exposures to violence were noted as a reason many EMTs, especially volunteers, left the profession. In an early study from 1998, 7% of survey respondents within one urban fire department considered leaving EMS as a direct result of an abusive situation they encountered while on the job. Knowing how to emotionally cope following a tough incident can help to reduce anxiety and burnout.  

Mixed methods studies conducted in the U.S. and Sweden found that violent encounters altered the patient-provider relationship. Yet, some in the industry feel that exposures to violence do not cause stress or negatively impact providers. This lack of effect has been attributed to the internalization of the mentality that violence is a part of the job.  It has been posited that years of experience may be a protective factor that allows more experienced responders to experience less stress and anxiety after violent events. 

Evidence weighing the social and economic costs associated with increased violence and burnout is based mostly upon anecdotal evidence, with no assessments conducted on monetary value. Some suggest that, as violence increases, the need for police backup also increases, thereby increasing response time and delaying potentially critical care to a patient in need. 

Other concerns include altered operations for the private sector of EMS. Intent to leave the profession is also a concern. As more EMS responders leave the profession, numerous organizational and patient impacts have been hypothesized, including increased costs for training new EMTs and paramedics, greater numbers of inexperienced paramedics serving at any one point in time, and increased error rates committed by new and inexperienced paramedics. EMS responders also report seeking a job change away from their ambulance role. In some cases, responders stated they lost interest in fieldwork and tried to get off the road and into desk positions. 

What’s clear is that not enough is being done to help first responders cope with occupational hazards and handling the stress that comes from it. That is going to change very soon. Stay  posted!

While you’re at it, why not thank those first responders randomly in the street for the great work they do. It goes a long way! They need you just as much as you will need them when you’re in a bind!

Unseen WW2 battlefield letters from North Africa

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This is an excerpt from a letter written by my grandfather S/Sgt Norman Peterson on 11th Jan 1941.

Dear Auntie Marie, (he always wrote to her the truth and sent happy versions to his wife)

“…I travelled by truck to a place called Ikingi Maryut where I caught a train at 2 in the morning to Marsa Matruh…but I couldn’t get a seat for drunks and others asleep on the floor all coming back from Cairo from leave. So I thought “bugger this” I’m not going to sleep in the cold on an observation platform so I walked the length of the train & eventually gate crashed the postal van, occupied by a real lime house cockney who told me, “Ee laad, ye carnt room in ‘ere.” I said “Like _______ I can’t!” So I unrolled my swag, took off my boots and slept on the mail bags…I soon made good friends with the Tommies who were a good crowd but were mystified by the way I rolled my own cigarettes. Apparently only the poorest classes roll their own!…

…Matruh is a very pretty place with wide tree lined avenues….but I wouldn’t give 2 bob for it now as it has been bashed and bombed into an unrecognizable rubble…while I was here I saw a gallant piece of action by two Tommies. A train was at the station full of stores and ammunition when two Italian bombers came over and commenced to lay their eggs around the place. The Tommies jumped into the cab and it was a thrill to see puffs of smoke from the engine as it slowly drew away from the station out of danger…

…I was here for two days when the word came through that our forces were pushing westward and I was sent to a post between Sidi Barrani and Matruh and did the wounded roll in. I worked on the wounded prisoners and saw some ghastly sights, One Libyan had a shrapnel wound under the left shoulder blade that had ricocheted on the bone and come out near the collarbone. The whole wound was crawling with maggots (which really isn’t so bad as they eat the putrified tissues)…

…We were here for 3 days…I was sent to the 3/3rd English 7th Ambulance. I went through the battlefield of Sidi Barrani and the quantity of material would truly astound you. Tanks, motorcycles, lorries and cars just for the taking. I had a motorbike and when she ran out of juice dropped it and picked up another….I picked up my first souvenir – an Iti tin hat – once owned by a field ambulance man. These lids are very rare…

…anyway to cut my own story short…I saw a grisly sight, a Savoia 79, a tri motored bomber had been shot down and the pilot had tried to pancake down but when he hit the petrol tank exploded thus incinerating the occupants. The pilot was a charred skeleton, both legs snapped like dry twigs, The foregunner was in two pieces, sheared in halves from the waist, the top part in an attitude of prayer though both hands were missing. The heat must have been terrific as the motors were fused together in a solid mass. The rear gunner was sprawled in his compartment, not so badly charred, his fingers stiffened in rigor mortis on the keys of the bomb rack and bullet holes in his Adam’s apple and temple. I took the builder’s nameplate as a souvenir…If I only had my camera I’d make a fortune but of course it is stowed away in Alex….

…Along the roads were truckload after truckload of prisoners who didn’t seem very dejected…however some who were told to dig slit trenches broke down and cried…the position was rather embarrassing until an interpreter told them they weren’t digging their own graves…they broke out in huge smiles and dug like hell…

…I was in a quandary as to where my own unit was…I attached myself to a section of Royal Tank Corps who had told me they saw an Australian Field Ambulance near Sollium. I spent three days with this crowd and spent a night at an Air Force refueling dump with beers and cheers and told them some bullshit about Australia…I at last found my unit to be greeted with the news A company was in Libya. Incidentally up to this time I had had neither a wash or shave and looked a fright from 9 Dec to 22nd Dec…”