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  1. #1
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    Default Responder Rule Can Cost Precious Minutes & Lives

    BRAVEST FIRE BACK

    NY POST
    By SUSAN EDELMAN
    -------------------------------------

    December 26, 2004 --
    Firefighters and a Bronx dad say wasted minutes in getting water to a house fire — in part because the closest engine company was needlessly called to a nursing home — was a fatal delay for the father's two children.

    Firefighters contend it took about eight deadly minutes after their brethren ran into the burning home of Sam and Selena Sanclemente on Nov. 26 before water could be pumped in by Engine Company trucks to aid their rescue.

    Now, with his two children dead and his wife in critical condition, Sam Sanclemente plans to sue the city — and fight what he calls a dangerous system that diverts firefighters to minor medical emergencies.

    Firefighters agreed they might have saved the kids if not for the delay. "It could have been a whole different outcome with water," a firefighter said.

    The first water truck in line to respond to the fire was tied up at a nursing home, where an 88-year- old woman was found dead in bed — "an absolute waste of time," said Peter Gorman, president of the Uniformed Fire Officers Association.

    The next-closest engine company was also delayed, due to a false alarm, officials said.

    Firefighters described a hellish struggle inside the Kingsbridge Terrace duplex as they penetrated a wall of flames and hunted for the trapped kids through thick smoke. "I was burning, and I knew the little girl was burning," one firefighter said of 2-year-old Sachiel Sanclemente, who was found in a hallway and carried out a window. She died later that night.

    Her brother, Sam Jr., 10, was invisible in the haze, firefighters said. He was found dead in a bedroom.

    Now Sanclemente, 35, says he wants to start a petition against a 10-year-old city program that forces firefighters to respond to sometimes minor medical calls. "I will fight this with all my might so this never happens to anybody else," he told The Post.

    His lawyer, Alan Ripka, said he plans to file a notice of claim against the city this week, the first step before a lawsuit.

    FDNY spokesman Frank Gribbon blasted firefighters who he said convinced Sanclemente that the "First Responder" program is partly to blame for his kids' deaths. "They're Monday-morning quarterbacking here. It's a disgrace," he said.

    FDNY spokesman Paul Iannizzotto said dispatch records show the first phone call reporting the fire came in at 7:47 a.m. Ladder 46, in the closest firehouse on Bailey Avenue, was dispatched at 7:50 a.m., he said.

    Companion Engine Co. 81 had been sent at 7:37 a.m. to the Kingsbridge Heights Nursing Home on Cannon Place on a report of cardiac arrest. The elderly woman was already dead when the company arrived.

    Nursing-home officials did not return calls for comment yesterday.


  2. #2
    55 Years & Still Rolling hwoods's Avatar
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    Angry I'm with the FDNY Spokesman...................

    IF this all went as reported, there's a SERIOUS problem here, that needs to be dealt with. And it's not with the Engine at the Nursing Home. I would think that a reported Cardiac Arrest, regardless of the location, would get a prompt response of the CLOSEST available units to deal with the situation. Blaming the loss of 2 children on a unit being on a REPORTED Cardiac Arrest is just plain WRONG. I have NO QUESTION that those who responded to the fatal Fire did EVERYTHING that they could, and more, to save those people. One thing that jumped out at me was the statement that the Fire was reported at 7:47 and the Ladder was dispatched at 7:50 WHY A 3 Minute Time Lag? Also, I'm sure that a full first alarm assignment was sent, not just the one ladder. I am acquainted with several FDNY members, and I hold them, and the Department, in high esteem,. This SEEMS, ON THE SURFACE, to be a few folks who don't want any part of EMS, using a very unfortunate situation as a means to whine about it. There is, and I'm sure there always will be, a tiny minority who hate EMS, that will do stuff like this. Thing is, we need to realize that they ARE a tiny minority. The City will win this one, and, I have a gut feeling that the local will be defending a few members from charges relating to discussing this matter in a questionable manner.
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    The fact that the engine was busy responding to a priority Cardiac Arrest call (which turned out to be too late to do anything) and that the fire happened at the same time is simply bad luck. I hate to sound like a callous ***, but ***** happens, and while thats unfortunate, its also a fact of life. The 3 minutes between the call and the dispatch are definitely a problem, THAT should be what is focused on...

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    Yea, this doesn't make sense. I almost always side with the FDNY, but had they been able to save the cardia arrest patient, it certainly wouldn't have been a waste of time? The three minute lag time certainly isn't encouraging, as that probably could have been the time added by the first due being committed. And I sat here scratching my head, wondering if the AFA could have drawn that same engine (the alarm that had tied up the second due)and if we'd be talking about the negatives of smoke detectors

  5. #5
    Forum Member MemphisE34a's Avatar
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    I thought the "responder rule" is what made us the good guys. When people call for help the fire department always sends it. I have sympathy for the father that lost his children. I have no sympathy for the FDNY guys who are basically encouraging the citizen to sue so they no longer have to make 1st responder calls. Sure I would have rather made the fire. I certainly understand that, but 1st responder calls are a part of the job. As a matter of fact, they are MOST of the job. Everyone makes more medical runs than fires. What would their tune be if they were responding on an automatic alarm. Would the recomendation be made to sue the city because they were out on a B.S. fire call when a real job came in. How bout a car fire? Bottom line they were dispatched on a call that their own policy obviously states they should be on. Whatever happens after that just happens. I will not let this tarnish the image of the entire FDNY however. Put enough apples together and you'll have some bad ones. FDNY has alot of apples. What does that tell you?

    Lt. Robert Kramer, Jr.
    Engine CO. 34-A
    Memphis Fire Department

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    Lots of things to look at here:

    First, were there any closed engine companies in this area?

    Second, why wasn't a nursing home able to provide defibrillation for this patient? There is absolutely no reason that a nursing home should not have one or more AEDs! I can think of very few other places where a cardiac arrest is highly likely to occur.

    Also, shouldn't a nursing home have staffing that can provide more definitive care than CFR-Ds can?
    FTM-PTB-DTRT

  7. #7
    dazed and confused Resq14's Avatar
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    Originally posted by WTFD10
    Why wasn't a nursing home able to provide defibrillation for this patient? There is absolutely no reason that a nursing home should not have one or more AEDs! I can think of very few other places where a cardiac arrest is highly likely to occur.

    Also, shouldn't a nursing home have staffing that can provide more definitive care than CFR-Ds can?
    I shouldn't laugh, but, given my experience with nursing homes and other "skilled care facilities"...

    LOL
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    Forum Member RescuHoppy7's Avatar
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    I know alot and have met alot of people from FDNY, I hold that department in the upmost of respect BUT... I am getting sick and tired of firefighters treating EMS as the red headed stepchild of the fire service, I run with an EMS service that has several fire departments assigned as first response units, and they bitch and moan almost everytime they are toned out, Medical Emergencies are part of the package folks, I hate to say it but your gonna have to get used to it, 30 years ago nobody thought Haz-Mat would ever be a word used in the fire service now it has become part of the job descripton, It is sad and unfortunate what happened to those children and to that family but to state what harve already said a Reported Cardiac Arrest is not a "minor medical emergency". I think someone needs to step in and address the dispatch situation a minute lapse between 911 call and dispatch is a joke...
    NYS FF1/AEMT-CC
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    Originally posted by Resq14


    I shouldn't laugh, but, given my experience with nursing homes and other "skilled care facilities"...

    LOL
    You're correct about this but why is it the fire department's problem?

    Nobody would expect First Responders to be dispatched to a hospital for any type of medical emergency...why should a nursing home be any different?

    I'm not being anti-EMS. I just think some common sense should come into play and nursing homes themselves should be held accountable for their lack of skills and equipment not the fire department.
    FTM-PTB-DTRT

  10. #10
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    I'm newer to all of this, but I'm 100% positive that the FDNY has an EMS service. Why weren't they dispatched? After all, isn't that what EMS is for? I understand that the engine companies are capable of responding as well, but why use those resources unless absolutly necessary. Then again, not being on the inside of the story, maybe using the engine company WAS absolutly necessary.
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  11. #11
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    Nursing homes are not medical facilities, and you think most firehouses are short staffed, see what N/Hs are dealing with.
    I know of several 120 to 150 bed N/Hs that have on 2nd shift;
    3 RNs, and 12 CNAs on a good nite. 3rd shift; 2RNs and 6 CNAs.

    To clarify my first statement, They are care facs. not treatment
    facs. any thing much beyond wiping the butts, handing out a limited
    range of meds., bathing, and feeding is beyond the scope of care.
    CPR certs. are not required for all.

    If you don't beleive me have your EMS crews ask some time.

    Alan

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    Default Think of this a different way...

    Not as a slam to anyone here, more of a question out of curiosity. Try to follow what my scrambled mind is thinking:

    The medical is dispatched at 7:37, 13 minutes before the working fire. My understanding of CFR engines is to provide first responder level care until a higher level of care is available. The way this situation is described, it seems almost as if it was an obvious DOA and the crew is left with the body. So here is the question- Where's the ambulance? How long did it take them to clear? A cardiac arrest is one thing, but a DOA is a different story altogether.

    A question for those of you who do run CFR or EMT/Paramedic Engines-
    Same situation happens to you, do you sit and wait? Can you leave the medic behind and run short? Would you do this [if you had a 4, 5, heck, 6 man crew?)

    My curiosity does not extend to remarks made. I am not one to judge. My curiosity extends to policy.

  13. #13
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    And what will the home owner say when a relative is in the nursing home and they go to the fire first?

    I understand his thoughts but that is why we in the fire service have more than one engine in a station and why move ups happen everyday of every hour. Did any of you ever get tired of spending the night moving around the response area dn never say a call at all. Been there done that, and never complained a bit, I knew what I was doing was important or I would not be there.

    zimm

  14. #14
    Senior Member NYI4LIFE's Avatar
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    My experience consists of being a CNA for BOTH a Assisted living facility/memory support unit (alzhiemers, etc...) and at the hospital. Plus i'm volunteering while going through EMT/FIRE SCHOOL.

    Folks, Assisted Living, Care facilites, etc. DO NOT HAVE THE TOOLS TO SAVE LIVES. All there is a couple of Rn's and CNA's that know how to do CPR! With that being said, 1 ambulance and 1 rescue (Ford F-450) will pull up under 6 minutes.

    If the Rescue (Ford f-450) jis busy, then 1 ALS Engine will pull up with a private Ambulance.

    My Point: FF's have to run those calls. They are usually the first to pull up THEN the ambulance does. It's a way of life.

    Your asking for a ton of money to be spent in training people who are working JUST FOR A DOLLAR in those places (not all of them but MOST).

    The system will just have to stay the way it is until funding AND effort is there.

  15. #15
    Forum Member RescuHoppy7's Avatar
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    I'm newer to all of this, but I'm 100% positive that the FDNY has an EMS service. Why weren't they dispatched? After all, isn't that what EMS is for?
    They were dispatched but unfortunately there isn't an ambulance sitting on every street corner ready to respond, they run multiple calls a day and were most likely coming from an area hospital unlike the CFR engine who was sitting at the station. Not to stir the pot more but Will the FDNY ever go to paramedic engines???
    NYS FF1/AEMT-CC
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    So if this guys kid was in respiratory arrest and a fire truck was at a fire and the closest truck - would he sue because the truck was doing its job?

    In this case the truck was at a medical call - even if its medical, its a legitimate call. Trucks get busy with all sorts of jobs.
    My favorite words "WHAT IF". What if the truck was at a false alarm is this a waste of time or is the company responding to a legitimate call?

    LAWYERS - GOTTA LOVE EM!

  17. #17
    Forum Member HeavyRescueTech's Avatar
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    Default Re: Responder Rule Can Cost Precious Minutes & Lives

    Originally posted by FFFRED
    Firefighters and a Bronx dad say wasted minutes in getting water to a house fire — in part because the closest engine company was needlessly called to a nursing home — was a fatal delay for the father's two children.
    so instead of being in their station, on the off chance there was a call, they were on a cardiac arrest call at a nursing home

    and I bet you if the person in the nursing home has been his mother, and the fire engines had been at the structure fire, he would have been screaming that it took the ambulance so long to get there, and that no first responding fire engine ever showed up.

    P.S. FDNY will never got to paramedic engines, it just wouldn't be cost effective. now EMT engines (instead of CFR), that I could see, but not ALS.
    If my basic HazMat training has taught me nothing else, it's that if you see a glowing green monkey running away from something, follow that monkey!

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    i would love to know more about the lapse in the dispatch time. also, i understand that nursing homes cant afford to train everyone to an als level, but some decent cpr would be nice to see when we pull up on scene. perhaps your area does a better job than mine, but here it is not uncommon to see someone pulseless and apenic with a nasal bi-prong on and no other intervention. to me thats not lack of training, thats lack of intellegence.

  19. #19
    Forum Member Dave1983's Avatar
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    A couple things...We run ALS engines and yes, if that situation came up and we had 4 on the engine we would leave one behind and go to the fire.

    And I know I'm going to stir the pot here, but if FDNY had ladder trucks that were capable of fighting fire (re: hose, pumps, water) we probably wouldnt be talking about this, as the first due (a truck) would have been able to make an attack on the fire. But I know, that would NEVER work there (or a lot of other big cities)

    (ducking under my desk now)
    Dave

  20. #20
    MembersZone Subscriber Plugmedic's Avatar
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    Okay, okay! The fact is that none of us respond to fire after fire each day. The other fact is there are more fire engines than ambulances in this country! In large urban and sub-urban areas the engine companies can respond to medicals within 4-6 minutes while ambulances can take 10 minutes or longer. The IAFF has even backed the idea of promoting ALS Paramedic Engine companies to assure the highest level of care in the least amount of time.
    If the FDNY engine had been on a baby not breathing vs. the con-home call, would that have made a difference??? The other fact is the closest or second closest companies are not always availible. What are we supposed to do, stop responding to medical calls? Then I suppose those of us who have them, should drop Street boxes also!
    Didn't the FDNY just start a few years ago putting an EMT on every eninge??? I know in San Francisco we are working towards having all of our 42 eninges ALS with-in the next 18 months. I will believe it when I see it, but it is being done in the best interest of the citizens. If an ALS engine saves one life out of 100 calls, then it has done something, hasn't it?
    I have nothing but respoect for the FDNY brothers, and I am sure they did their best to save those kids, but sometimes our best is not enough. Some situations are in gods hands the second they occur!
    But, saying we can no longer respond to anything but fires is a ancient concept and not in the best interest of the citizens we serve or our profession as a whole.
    Jason S. FF/PM
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