PBC Fire Rescue Facts

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Fire-Rescue FASTFacts

“Sound the ALARM!

  The National Fire Protection Association (NFPA) has declared the 2014 theme for Fire Prevention Week, which runs from October 5-11 this year.  The theme is  “Working Smoke Alarms Save Lives. Test Yours Every Month!” Firefighters are urging residents to check their smoke alarms and to make sure the batteries are fresh. 

According to the NFPA, having a working smoke alarm in the home cuts the risk of dying in a fire in half. On average, each year three out of five home fire deaths result from fires where there is either no smoke alarm or no working smoke alarm.  



The NFPA recommends: 


• Having a smoke alarm inside every bedroom

• Have a smoke alarm outside each sleeping area

• Have a smoke alarm on every level of the home

• Test smoke alarms every month by using the test button

• Replace all smoke alarms every 10 years or sooner if they don’t respond properly when tested or the manufacturer’s date shows that it is expired.

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Fire Prevention Week occurs annually in October during the week in which October 9 falls to commemorate the Great Chicago Fire of 1871, however Fire Prevention Practices and Safety Presentations typically continue during the entire month of October of each year.

Fire-Rescue FASTFacts

“Patriot Day”

Each year we gather to memorialize and reflect back on those that gave it all to save others on 9/11/01. In the Unites States this is officially observed under the title “Patriot Day and National Day of Service and Remembrance”,however most folks refer to it simply as 9/11or Patriot Day.

Has it always been called Patriot Day?On the initial anniversaries following that tragic day, 9/11 was referred to as a Prayer and Remembrance Day for the Victims of the Terrorist Attacks on September 11, 2001.  This was not an official name since the initial idea was to name it Patriot Day in the months following the attacks as evidenced by the national surge in patriotism that was observed when our citizens bonded together, gave generously to the victim’s families and to each other. Citizens everywhere flew their stars & stripes proudly upon their place of residences and on their vehicles.

Even though President George W. Bush signed a resolution into law in December of that same year, it wasn’t till later that declaring September 11thof each year as Patriot Day would begin to take shape in the hearts and minds of the American people.

Wasn’t there another day already declared as Patriot Day in America?  Technically, yes there was another day named Patriot’s(with an “S”) Dayalready in use in the state of Massachusetts.  In 1894, Governor Greenhalge declared a public holiday to commemorate the dates of the Lexington & Concord battles of The American Revolution as Patriot’s Day, which was also observed by the states of Wisconsin and Maine.  The Federal version of the named day: Patriot Day and National Day of Service and Remembranceis not an official holiday and therefore government offices, public schools and post offices all remain open on September 11thas it is a discretionary holiday.

What is Patriot Day for? When the name Patriot Day was newly declared for 9/11 there was, at first, opposition since there was already a Patriot’s Day in the previously mentioned states.  9/11 is a day to honor, reflect and remember those service men and women that fought to defend our country in those tragic hours and for all our public servants that ran into harms way in order to assist those that were trying to escape. The day is also a time to be thankful for all those currently serving in the armed forces and for our public servants that continue to protect, provide and serve us each and everyday. These include our police, paramedics, and our firefighters serving everywhere.

Should we celebrate the acts of terror by rebroadcasting the events of 9/11 on TV each year?Patriot Dayon 9/11 is a time to reflect and remember the good and wholesome of America’s people, our virtues and the high cost we pay for the freedom we enjoy everyday. It is important that we take pause to remember those that lost their lives that day to preserve this and with special recognition to those that gave their lives to save others.

Patriot’s Day & National Day of Service and Remembrance is a discretionary day of remembrance, meaning that a special designation has been set aside for it on September 11thof each year through the proclamation of The President of The United States of America each year. 

What does this presidential decree call for each year regarding Patriot Day?  The presidential request is to issue each year a decree and proclamation calling all states, local governments and the people of the United States to observe appropriate programs, ceremonies, remembrance gatherings and activities in honor of Patriot’s Day and to those that lost their lives on September 11th, 2001.  It includes a call for the White House, all government buildings and facilities to display the US Flag at Half-staff as well as encourages all private individuals at American homes to display their flags.  Additionally, the proclamation calls for the observation of a moment of silence, preferably at 8:46 AM (Eastern Daylight Time), which marks the time that the first plane flew into the north tower of the World Trade Center in New York City.  

Let us NEVER FORGET those that gave it all on 9/11/01 and those that continue to work tirelessly to preserve the freedom, safety and security that we enjoy each day. Until next time, be safe and watch out for each other and our communities.

Doug McGlynn
Professional Firefighters/Paramedics of Palm Beach County
HOA Community Relations
dmcglynn@iaff2928.com
(561) 969-0729 – O

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Fire-Rescue FASTFacts

 The Stand-alone ER; Part II

Last month we spoke about our newest medical-kid-on-the-block, the “Stand Alone ER”.  We discussed how we experienced the expansion of doctor-owned urgent care facilities through the 90’s and how those medical express centers continued to compete for our healthcare business as valid alternatives to the traditional private practice. This month we plan to expand upon those issues by digging a little deeper into the critical care intervention facilities and the medical capabilities of hospitals in our local area.

Are the hours between private practice, urgent medical care facilities and emergency departments similar?  No they are not.  Urgent care facilities often have later hours than private practice/doctor’s offices; however, they generally close early in the evenings throughout the week with limited hours of availability on the weekends.  Hospital based and off-site emergency departments throughout the county have the same hours of operation: 24hrs a day/7 days a week, including holidays.

Are the off-site ERs the same as the hospital ERs? The two off-site ER’s in Palm Beach County, both affiliated with JFK Medical Center (The Shoppes at Woolbright in Boynton Beach and the Mainstreet at Midtown PGA in Palm Beach Gardens), have the same basic services that are available that any other Emergency Room. 

So what’s the difference?As was mentioned in last month’s article, Palm Beach County has many critical care interventions that are available at some hospitals and not others.  Palm Beach County Fire Rescue has created an informational sheet titled “Hospital Capabilities Checklist” so that the paramedics know what the closest and most appropriate facility is when compared with the patient’s current condition.  For example, Palm Beach County has only two alert intervention facilities that are designed for handling critical care trauma patients (Level I Trauma Centers) and those patients must meet specific criteria in order for Fire Rescue to transport them under the trauma “alert status”.  Palm Beach County has intervention facilities that handle Stroke and Pediatric cases, but perhaps not OB or Cardiac critical care interventions.  This doesn’t mean that the emergency departments in general cannot handle patients that have cardiac, stroke or OB type history. It just means that there are designated facilities which are equipped to handle patients that fall into the respective alert criteria for certain specialized field of critical care.  

The only services not available at an off-site ER according to the “Hospital Capabilities Checklist” are critical care interventions such as patients meeting “stroke or cardiac alert” criteria. Those patients would be transported to a facility with the appropriate designation.

Can a patient over-rule a Fire Rescue Paramedic when making a transport decision that does not reflect positively in the patient’s best interest?   Of course it is always the primary goal of any fire rescue crew paramedic to reflect the patient’s best interest when making patient care and/or emergency transport decisions. However, as long as the patient is legally and medically competent and is aware of the consequences of making a decision that may, in fact, harm or even cause death, the patient has the right to make that decision.  Again, there is a strict procedure for this scenario and it is rare that it even happens.  When it does happen, a refusal form must be signed by the patient after adamant and repeated refusal was communicated to the emergency medical crew. 

If the patient wants to bypass a nearby ER in favor of one further away, can they do that?  Again, as long as the criteria described above are all met and the patient does not meet any critical care intervention criteria, then the patient can refuse a closer ER in order to be transported to the facility of their choosing.  If this decision is not in line with the paramedic’s professional judgment, and is not in the best interest of the patient’s health and well-being…..the refusal procedure described above must be implemented.

What if you are transported or you drove yourself into an off-site ER and now you meet criteria that requires that you to be transferred or admitted into a hospital?  The off-site ER has strict criteria that they follow when a patient’s condition warrants an emergency transfer to an alert intervention facility or when their condition warrants a hospital admission:

• If the patient’s condition warrants a non-emergent transfer, an inter-facility transport will be scheduled. 

• If the situation is emergent (regardless of alert criteria or the patient’s condition warrants a direct admission to a hospital), the 911 Emergency service will be utilized in order to get fire rescue on-scene immediately. Once arrived, paramedics will assess the situation and make a rapid transport decision that follows their protocols. Any deviance from this will fall within the patient refusal procedures described above.

Unless it is a medical emergency, where legal and or medical competence cannot be established (e.g.- patient unconscious and unresponsive), the patient must grant consent to medical treatment and/or transport in all situations. Otherwise, emergency crews will operate under the premise of “implied consent” and act in the patient’s best interest based on what a healthy and prudent person would decide given the opportunity.  The State of Florida has very specific language on these issues and Palm Beach County Fire Rescue trains all their paramedics on the specifics of medical consent laws and state statutes that govern emergency pre-hospital care.

Do you have a choice when being transferred from an off-site ER for an inpatient admission?  Absolutely!  Patients will be transferred wherever they wish to go.  The off-site ER will assist the patient in making the transport decision. In the case of a non-emergency inter-facility transport, it is not necessary to use Fire Rescue and a private non-emergency transport will be arranged.

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When seconds count……you can count on us!  I hope this information helps raise awareness levels within the community when making emergency care and transport decisions on your own behalf, as well as helping you to understand the provisions involved when these decisions are made on your behalf.  One thing you can be sure of…Fire Rescue crews will alwaysbe ready to meet and exceed any demand or expectation that is placed upon them when you dial 911. There is no list of services that Fire Rescue does not respond to. So we’ll continue to work with the host of urgent and emergent healthcare service departments that exist in the community. ‘Till next time, please share this information and take care of each other.

Doug McGlynn

Professional Firefighters/Paramedics of Palm Beach County

HOA Community Relations

dmcglynn@iaff2928.com

Is the Good Doctor in?

Our offices have been getting inundated with questions from residents seeking information on our medical community’s newest “kid on the block”……theStand-alone ER!  The response comes after JFK Medical Center (based in Atlantis) started opening free-standing ERs  in the north and south ends of Palm Beach County. This is not the first time a hospital has elected to expand their services with a stand-alone emergency room in the US.  In fact, several other states have been seeing the same trend; however Florida is one of the states that is leading these newest additions to the landscape of medical options available to consumers. 

Around the late 90’s we witnessed the expansion of doctor-owned Urgent Care Facilities and Medical Express Centers abroad, which competed for our healthcare business for less serious injuries and medical illnesses. They were marketed as valid alternatives to doctor’s offices since they were prepared to handle more urgent type injuries, often had less waiting times and possessed advanced equipment not typically found in a standard doctor’s office.  When a situation was indeed an emergency, patients were often referred to the Hospital for their receiving Emergency Department, or ER.

Around the mid 2000’s, a hybrid option consisting of part Urgent Care Center and  part Emergency Room (minus the hospital) started popping up in places like Minnesota, Maryland and Texas to name a few.  In 2008 Miami had its dose of controversy with the opening of a 16 bed, stand-alone ER owned by Mount Sinai Medical Center in Aventura located only a mile from rival Aventura Hospital & Medical Center.  Interestingly enough, the new facility was located twelve miles from the main hospital and didn’t require an award from the state for a CON (Certificate of Need) in order to operate. Miami residents had many questions as they do here in Palm Beach County with the opening of JFK Medical Center’s West Boynton facility (the first was opened in early 2013 at Downtown at the Gardens location in Palm Beach Gardens).

When tasked with making a medical destination decision regarding the plethora of options available in today’s healthcare marketplace, seniors are especially skeptical that they might not be informed enough about the facilities available to them in order to make the right choice.  That is what the next series of articles sets out to accomplish…… providing general information on the variety of centers, offices, ERs and hospitals in hopes of highlighting the differences between them using a “Fire Rescue Fast Facts” format.  Let’s begin:

Does a stand-alone ER offer ALL OF THE SERVICESoffered at a hospital-based ER?YES.

The state mandates that all stand-alone emergency departments must offer the same services as their hospital based counterpart in order to be classified by the state as a “licensed emergency room”.  Typical ERs are open 24hrs per day, have separate treatment rooms, designated trauma rooms, triage rooms, full service labs, their own pharmacy, advanced imaging equipment and MRI capabilities. Most importantly, ER’s are required to staff “board-certified emergency physicians” at all times. In the case of JFK Medical Center ER and the free-standing Emergency Care facility owned and operated by JFK Medical Center, the basic services are the same. The basic services are the same; however, we will discuss any critical care services next.

If you’re not standing in front, looking at the building…how can one determine which is the Hospital ER and which one is the stand-alone ER? This is a great question and in Palm Beach County we have the JFK Medical Center to use as our example.  JFK ER is the hospital emergency room located on South Congress Avenue in Atlantis.  The north county emergency room in Palm Beach Gardens as well as the western Boynton Beach location on 10921 S. Jog Road in The Shoppes of Woolbright are officially titled “Emergency Care Services at JFK Medical Center.’  Palm Beach County Fire Rescue refers to the Hospital on Congress Avenue as JFK ER, and the two Emergency Care Service facilities as “JFK North” and “JFK South”.  When you call the Emergency Care Facility directly, they call themselves an “Emergency Department” on the phone message.  JFK also has a website http://jfkmc.com/our-services/emergency-care-services-in-palm-beach-gardens.dotThe link delineates the main hospital ER from the off-site ER simply as “Hospital Emergency Care” to identify the ER at the main hospital and “Emergency Care Off-site” to identify the stand-alone facilities. 

For the purposes of these discussions, we will refer to the separate, stand-alone emergency care facility as the “off-site emergency department”.

If Hospital Emergency Rooms and Emergency Service Departments that are “off-site” have similar basic services, then how do the critical care intervention capabilities differ from each facility?  Palm Beach County has many critical care interventions that are available at some hospitals and not others.  This may make it confusing when deciding not only which hospital you choose to frequent, but which hospital you would prefer a Fire Rescue crew to transport you to.  Some hospitals are classified as specified critical intervention facilities depending on the reference or nature of illness. For instance, Bethesda Hospital East is a Cardiac Alert Intervention Facility as well as a Stroke Alert, OB & Pediatric patient facility. In contrast, Bethesda Hospital West (located at Boynton Beach Blvd/441) has all the same basic hospital and ER services as its eastern counterpart, however, only Pediatric and Stroke Alert Intervention services are available when it comes to the critical care interventions capabilities. Palm Beach County Fire Rescue has a Hospital Capabilities Checklist that paramedics are trained to follow so that each medical situation can be evaluated in order to make the most appropriate medical transport decision.  This checklist is ever changing and so is the paramedic’s quality and quantity of on-going, continuous educational training in the areas of pre-hospital emergency medicine.

Next month we plan to discuss further which services are unique to the off-site emergency dept when compared to the already existent “urgent care” facilities.  We also plan to break down the critical care intervention capabilities between hospitals in Palm Beach County as well as illustrate the sharp contrast between them.  Lastly, we will take a look at those critical intervention capabilities to discuss why these services are not treated at an off-site emergency department.

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