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Something's going wrong in FDNY EMS News

November 29, 2012

EMS News in Focus
by Arthur Hsieh

Something's going wrong in FDNY EMS

Large organizations cannot depend solely upon a centralized command structure during system-wide events

By Arthur Hsieh

It seems to be me that something's going wrong in FDNY EMS. What appears to be two massive failures to prepare for and respond to major disasters by the country's largest EMS department should be triggering a top-to-bottom review of the policies and procedures of the organization.

That review should not just be about the stuff that's written down on paper and neatly stored in three ring binders in offices, but what the field personnel should know and be equipped with at their stations and within their units.

Large organizations cannot depend solely upon a centralized command structure during system-wide events: street providers and first-line supervisors should have the ability to follow a number of standing orders that responds to the local conditions.

I suspect that there was also a likely communications failure throughout the system, as that usually happens during a major event.

Senior leadership has to keep its eyes on the big picture. There is luxury in assuming that sheer willpower will save the day during major events.

That simply puts rescuer lives at risk and ruins the system's ability to continue to perform in the worst of the conditions. Planning and preparing are absolutely crucial in maintaining readiness.

For the moment, FDNY EMS is still in the response mode, as the city continues to clean up and get back to full normalcy.

Soon though the department will need to really take a hard look at itself and make the changes necessary to be ready for the next big one.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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Patty Slocumb Patty Slocumb Thursday, November 29, 2012 7:40:00 PM As always, right on the money Art. But I believe that problem is system wide in many states. As a first responder in a major sub city in the Phoenix metro area, we do not have any standing orders. None. And even tho I'm private we are contacted with most of the major cities and are the only EMS ambulances.
Christopher O'Brien Christopher O'Brien Thursday, November 29, 2012 8:31:26 PM I don't understand what the specific problems are or what they arise from. I can only assume from Hurricane Sandy (what's the other disaster?) but don't know what you are suggesting or what the highlighted problems were. You call for an investigation... on WHAT? Structure? Procedures? Staffing levels? What is at risk? What problems brought your perceived need to light? I usually enjoy reading this column, but this one is absent any context. At this point, your request is nothing but a request to "do something" without and basis for it. I was hoping to see some kind of insight that some sort of red flag prompted your concern.
Dan White Dan White Thursday, November 29, 2012 8:50:05 PM Art, you have my respect. But we have three worlds in EMS, each with entirely different rules. We have the USA, the separate country of Texas, and the Planet of New York.
Art Hsieh Art Hsieh Friday, November 30, 2012 11:44:46 AM Thanks Christopher. We normally post the link to the original story that places the commentary in context. You can find the original story here: It might make more sense after you read it, let me know.
Alexander Kuehl Alexander Kuehl Friday, November 30, 2012 10:10:51 PM As most of you know the merger of EMS and FDNY was my baby...but boy did it get screwed up. This time around 9-11 was clearly broken...but the command structure just collasped according to most reports.
Christopher O'Brien Christopher O'Brien Saturday, December 01, 2012 8:38:54 AM Yes, now it looks like a fiasco! Thank you!
Christopher O'Brien Christopher O'Brien Saturday, December 01, 2012 8:40:27 AM I've seen many places treat "Planning" as separate from "operations". Namely, they don't include the rank and file in on what the planning procedures are giving clear direction as to who and when someone makes a particular call.
Alexandra Kahermanes-Schwartz Alexandra Kahermanes-Schwartz Tuesday, December 04, 2012 8:52:49 AM I say we should break away from Fdny all together. Let us be one. EMS
Simeon Klebaner Simeon Klebaner Friday, December 07, 2012 7:59:11 AM I worked for NYC*EMS, and later FDNY*EMS for a total of 10 years. The system in NYC is broken. It has been broken for a long time and there is no political will to fix it. What surprises me is that the is no PUBLIC outcry. When Steve Kuhr was running Rockaway EMS, we hada comprehensive plan for hurricanes. It had maps with flood zones, areas to be evacuated, etc. But of course the management of FDNY knows better, and there was no plan.... I am glad that I left the FDNY, as the system will never be a true career for EMS types, as it is run by Fire Chiefs with a fire chief mentality that views EMS soley as a call volume generator, and revenue builder.........

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