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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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