UPDATE: Democrat and Chronicle

The scale of Sunday’s chain-reaction pileup on Interstate 390 is best described by the numbers:

Thirty-six tangled vehicles.

Twenty-five people injured, including one teenager who later died.
Wind gusts up to 37 mph and blowing snow made seeing past the hood virtually impossible. [snip]

Buses that were headed to the Rochester Institute of Technology to pick up hockey teams were commandeered by the Gates Fire Department and used to keep people warm while the temperature slid to 18 degrees. Firefighters had requested buses as part of the rescue response, West said, but those buses “were in the right place at the right time.”

R News

Emergency crews had to cut four people out of the wreckage. The hardest part was deciding who to treat first.

“They might walk and see a person with a broken arm and say, ‘I’m sorry, you’re going to have to wait,’ as to someone with severe trauma, so that’s the hardest part,” said James Harrington, Gates Fire Chief.

Police say what caused this accident was blowing snow. This part of 390 is located just a few hundred yards from the airport runway. There are no trees to block the wind, causing white-out conditions in a matter of seconds.

A Monroe County spokesperson told R News that the county is not liable for the blowing snow or any damage it may have caused. The county says it is the responsibility of the state DOT to determine whether snow fences are necessary.

At about 12:38 p.m. EST today, the Monroe County 911 Center received a cellphone call reporting a 20 car pileup on I390. In the next few moments, a dozen more calls flooded in. Gates Volunteer Fire and Volunteer Ambulance were dispatched.

Just six minutes later a State Police officer on scene requested “as many EMS rigs as possible”. As late as 12:50 a caller reported that collisions were still occurring.

RNews

White-out conditions are being blamed for a deadly chain reaction crash on Route 390 Sunday. The crash killed a teenage girl.

Le Ngo, 17, of Rochester, died from her injuries following the 36-car pile-up that occurred around 12:40 p.m. in the southbound lane of I-390 near the Greater Rochester International Airport.

Twenty-four others were taken to area hospitals. Lyubov Klepanchuk, 18, was critically injured. The others suffered non-life-threatening injuries.

Motorists say a stopped car was hidden by blustery snow coming off the open fields at the airport. Witnesses say the collisions just kept coming.

“As we’re driving going about 40, 45, there was just a white car just stopped, just in the lane and then out of nowhere we just smashed. And then as soon as we smashed, cars just kept hitting us and it was just never-ending it seemed… It was the craziest experience of my life,” said Erik Ramos, witness.

Strong Hospital reports five people are in guarded condition and another four are in satisfactory condition. Unity Hospital says 12 victims were brought in; six have since been treated and released.

Gates responded, declared a Mass Casualty Incident, and additional resources were requested. The professionals in Monroe County and Rochester City Fire and EMS responded. Chili, Churchville, Greece, Henrietta were among the initial responders from the local region. Rochester City Fire and Airport Rescue responded with extrication tools and manpower. The commercial agencies, Rural Metro and Monroe Ambulance sent ambulances and personnel.

It’s flu season. The local hospitals were jammed. Space was made, people called in, trauma beds made available. One by one the ambulances rolled out with the injured.

The winds continued to blow. The air temperature was 13 and the wind was blowing with gusts over 20 mph. It was bitter cold and the blowing snow made conditions unbearable. These firefighters and EMS personnel did the impossible. They did their jobs.

More help was requested. Spencerport, Hilton, Perinton, Brighton and Irondequoit sent people and vehicles. A staging area was set up at the nearby Public Safety Training Center. People trapped in vehicles were cut and pried out of what was left of their cars. Ambulances continued to transport to the area hospitals.

Mercy Flight was on standby. Other ambulance and fire departments were alerted and manned their quarters or responded to other agencies to fill in for their crews who were out at the MCI.

Honeoye Falls, Brockport, Lima and East Rochester were all called upon. I’m certain I’ve left off some agencies because this was the largest incident in recent memory and a lot of people contributed.

Yes, East Rochester, my medic and I, were asked to fill in at Gates Ambulance base. Our part was very, very small; we never went to the scene and never had to cover a call for Gates. We were there in case someone in Gates needed an ambulance.

By 2:45 p.m. EST, the incident was over. All patients had been extricated and transported. The agencies involved began to recover their equipment and put their rigs back in service.

Curiously, in that two hour time frame, the county was unusually calm. There were a handful of calls but agencies like Henrietta and Gates that have a high call volume were very quiet. It’s as if there was a pause so we could devote ourselves to this disaster.

The lives of a great many people were changed today. The families of the dead and gravely injured, those who were injured or just were in the incident. And, the firefighters and EMS staff are also affected. This is one of those career calls, that everyone involved will remember their entire career. It’ll be the story the old farts tell. It will be the call by which future calls are measured.

As the crews began to return to Gates Base, I could see in their eyes and hear in their voices that change that I am all too familiar with. These brave folks now have an unforgettable memory of tragedy and success, of destruction and rescue. It may be a burden. It may be a blessing.

I cannot calculate the number of people who worked on this call this day. Well over a hundred men and women, mostly volunteers but paid folks too, all professionals. There are people alive this minute because of their work. In that two hour span, safety, succor, life was given as best as could be done by people from all walks of life, from all over the county, working together.

I am proud to be a part of the EMS community in Monroe County. Today shows why.

Keeping all of the Federal privacy laws in mind…

There’s overweight and there’s way overweight. When you are morbidly obese, you become unable to stand or move around easily, and for some people nearly impossible.

For the EMT, a morbidly obese patient presents several problems. Transportation is one. Most ambulance gurneys are rated at 500 pounds. A much larger patient risks the failure of your gurney and injury to the patient.

Such a patient may not fit through doors in his or her home. If immobile, they require six, eight or ten people to move them.

Their sheer weight tends to limit how they can be placed. Some cannot breathe any longer on their back due to the weight of their stomachs pressing up against their diaphragm.

Taking precautions against further injury may be impossible. A backboard becomes the equivalent of a thong when place under some patients.

CPR is very difficult, with your patient’s chest a foot thicker than normal, and defibrillators are an issue as well. The normal current settings do not apply to a person with that much fat covering their heart.

Some ambulance agencies have solved some of the problem. Rural Metro in Rochester, New York, has an ambulance dedicated to such patients. A ramp replaces the necessity to lift a gurney into the ambulance. The gurney is replaced with a cart, resembling nothing more than an old fashioned baggage cart from railroad days, with a mattress added to it.

When faced with a morbidly obese patient, don’t be afraid to call for lifting assistance. Eight or ten people may be needed to move your patient. If a specialized transport, like the Rural Metro one is available, get it. The alternative is a very unsatisfactory transport in the emptied back of your rig, with your patient on the floor and all the gurney devices removed to make room for your patient.

Always look for your mechanical advantage whenever you have weight to move. That is especially true with the morbidly obese. Don’t carry when you can slide. Don’t lift without enough people or without moving your patient to the optimum position for any transfer.

Remember, the morbidly obese patient is still a patient. He or she will still be in pain, scared, and have any of the host of maladies that afflict mankind. Treat your patient and not his size.

Volunteers make America a better place. It may be in a museum, with the Scouts, Little League or the thousands who are volunteer EMT’s like I am.

That has value but you wouldn’t know it. Current IRS regulations don’t allow you to deduct your time as a volunteer and you can deduct a measly 14 cents a mile when the deduction for business use of your car is 48.5 cents a mile.

Financial accounting standards for not for profits allow them to record the value of your time as income only if you have a specific skill and they would have had to hire someone if you did not volunteer. As an EMT, that would allow my Corps to recognize my time as a donation, income, but not the woman who is our secretary or the non-EMT driver in the ambulance. The skill, you see.

In other words, a doctor doing painting for a pre-school has no value on the books while a doctor volunteering time at a free clinic does.

I put in, if I do just my required time for duty, meetings and classes, 319 hours a year. That has a value to society, to the Village of East Rochester. It’s an unrecognized value for the most part.

A group called Independent Sector does research into the value of volunteer time. They boil it down by state, and their figures include all sorts of volunteers. In 2006 the nationwide value of an hour by a volunteer was $18.77. Their state numbers dated from 2005, and New York’s average hourly rate for a volunteer was $23.60.

Just my little bit for the Ambulance Corps breaks out to a value of between $5,989 and $7,528. That’s not chump change to me, being between opportunities and all.

Now, they do refer readers to the Bureau of Labor Statistics where our fine government employees track wages by occupation. For May 2006, we discover the following for EMT’s in Rochester New York.

• Mean hourly wage [average of all reported]: $13.57
• Mean annual wage [average of all reported]: $28,220.
• Median hourly wage [half of the wages reported are higher and half lower]: $13.34

The Civil Service rate for a Basic EMT in Monroe County is $12.02 an hour.

OK, so that values my time for the Rochester mean at $4,329 and at the Civil Service rate at $3,834.

We have about 25 members running duty. My hours for the year ought to be about average, though I know that several members easily volunteered over 1,000 hours in the last twelve months. Slapping all the data together shows that the minimum value to the Village for our volunteer labor with the ambulance corps for the last twelve months was $95,860 and the max would have been about $188,210.

Were I able to track each member’s hours, I could obviously come up with a better estimate. But… one of the great things about volunteers is that they don’t track their hours all the time. Our hours are a gift to society, to the Village or to whatever organization benefits from our work.

We’re talking hourly rate here, too. Accounting professionals like myself recognize that you should also include benefits when looking at the cost of an employee. Just statutory benefits alone add 10% to the cost and if benefits like health insurance and other insurances are included the percentage can grow to 25% and more.

The Civil Service rate of $12.02 works out to $25,000 yearly. With benefits, one full-time EMT costs between $27,502 and $31,252 yearly. The ambulance must be staffed by at least one Basic level EMT and a driver. Normally there are two EMT’s in a crew. You need three crews per day if you run an 8 hour shift and we’ll ignore weekends and vacations for now. Your yearly cost to cover five days a week for the entire 24 hours will run between $165,011 and $187,512. To add crewmembers for vacation and weekend coverage will increase those totals.

The Village pays about $8,800 for insurances for the Corps, primarily workers’ comp. That is the only cost to the Village of East Rochester for our personnel. In return it receives well over $95,000 in cost-free volunteer labor.

I think it’s fair to say that volunteers are irreplaceable. Or, to phrase it a little differently, you can’t afford to pay for what volunteers do for free.

The East Rochester Volunteer Ambulance Corps has been in existence since 1938. We were incorporated as a New York membership corporation in 1949.

Up until about four or five years ago, the Corps had a contract with the Village of East Rochester to provide EMS and ambulance services to the Village. The Village discontinued the yearly contract and we were told that it was unnecessary and / or improper.

We operate out of a forty year old temporary building owned by the Village. The Village allocates, in its general budget, a sum of money from which the Village pays operating expenses for the Corps. That includes building utilities and maintenance, ownership and operating expenses for two ambulances, and supplies used in our operations such as bandages and splints.

In 2005, at the request of the Village administration, the Corps undertook the effort and expense to begin billing our patients for services. The reason given us for this pressure from the Village was that certain senior citizens were being billed by ALS providers and Medicare was not paying that bill. Medicare will not pay billings for paramedic services if the transporting agency does not bill for basic level services. While we had no figures on how many people this affected, we were pressured into beginning billing.

In March 2007, the Village administrator, Tony Argento, and the Mayor, Dave Bonacci, approached our leadership with a demand. Account for the money that we had received by billing and turn any balance over to the Village. The implied threat was that the Village would cease its support of the Corps, and it was openly discussed that a commercial organization could be contracted to perform the same services. The Corps surrendered about $105,000, and since that time we have continued to turn over billing moneys. The latest balance is about $160,000. From that sum the Village has paid certain expenses for the Corps but the unused balance has continued to increase. I cannot find this sum set aside in the published budget for the Corps’s use and I believe it is included in general revenues and is being used by the Village as a new revenue stream.

The Village’s 2006-2007 Budget provides for the sum of $75,221. for the Corps, 1.25% of the total budget. This breaks down to $45,000 for general expenses, $21,573 in debt service [the replacement for a 14 year old ambulance three years ago] and the sum of $8,648 for Worker’s Compensation. The Corps costs the average taxpayer in the Village less than $15 a year.

Since March, the Corps has had to retain attorneys in an effort to obtain a contract from the Village. That contract has not been finalized.

The Corps is alerted roughly 800 times per year. We have an average of 25 people running duty. As so many other Corps have found, certain times of the workday or overnight typically do not have a crew signed on. The Corps is part of a county-wide mutual aid agreement that provides that other agencies, including commercial ones, can be summoned to calls in East Rochester if we are unable to respond. By participating in this plan, the Corps ensures that a call to 911 for an ambulance will always have a response. 100% of our calls are responded to by our Corps or another agency.

Of the 800 calls yearly, about half do not require us to transport the patient to the hospital. We do not bill for calls where we do not transport.

Each of our volunteers run 12 plus hours a month. Many run 20 plus. We provide over 6,000 unpaid hours of service to the community each year. This amount does not include training hours. Training to the Basic level of EMT is over 130 hours of work, and that NYS certification must be renewed every three years with a 60 plus hour set of courses and classes. In addition, from the Corps level on up, there are various mandated yearly training courses that add up to about 20 additional hours per member. All of this is at no cost to the taxpayers of East Rochester.

We also offer CPR and First Aid courses to the school district and the public, operate blood pressure clinics and provide other services at little or no cost.

The Village administration clearly knows what it would cost to pay to provide ambulance coverage for the Village. Our Police Department is budgeted at over $1 million for the year, to put two police officers on the street 24/7. This is approximately what it would cost to do the same for the ambulance. The Civil Service rate for a Basic level EMT is over $18 an hour.

Nearly all of the fire departments in the county provide First Responder services for the ambulance agency covering their area. That means that when certain call criteria are met, the fire department is also alerted to an ambulance call. Very often this means that a fire truck will arrive at an ambulance call before the ambulance, and the firefighters will be providing basic EMS care until the ambulance arrives.

The East Rochester Fire Department does not respond to ambulance calls. Obviously this leaves a gap in emergency services that other localities have. The Fire Department in the 2006-2007 Village budget received $407,000, costing the average taxpayer just over $78 a year.

Several conversations between Corps Officers and the Mayor or the Village Administrator have been inconclusive in resolving a host of problems created by the various actions by the Village over the last several years. As an independent corporation, how can we be a department of the Village as the Administrator maintains? Under what authority did the Village seize money from the Corps that was not the Village’s by contract? Has the Village Board voted for appropriate resolutions and authorizing these actions taken by the Village Administrator and the Mayor?

The voters and taxpayers of East Rochester should ask themselves if they are being well served by the current administration. The Mayor and Village Administrator have been highly critical of a group of volunteers who give over 6,000 hours a year to the Village at an average cost per household of $14.41. The Corps has provided for contingencies and arranged for coverage from other agencies in time of need. The Corps has operated without the assistance of the Fire Department, which the neighboring ambulance corps of Pittsford, Perinton and Penfield all enjoy.

The Village of East Rochester enjoys first rate ambulance service 24 hours a day, 7 days a week at a minimal cost to the taxpayers. The Village administration, the Mayor, Administrator and the Board would find it impossible to replace the Ambulance Corps at the current cost to the taxpayers. Indeed, the replacement cost could well amount to more than ten times the current cost.

No one likes to be strong-armed by the government. Right now the East Rochester Volunteer Ambulance Corps is being strong-armed by the Village. Pretty soon, it may be the taxpayers of the Village that get strong-armed if the current administration continues its present course.

Democrat & Chronicle

Sen. Hillary Rodman Clinton will be in East Rochester on Monday to visit the newly installed fuel cell at the Each Rochester School District, her staff confirmed today.

Clinton, the leading Democratic presidential candidate in 2008, also will announce recommendations from a “green” building conference she held in Rochester last fall.

She is expected to tour the school district about noon.

As for the fuel cell:
Democrat & Chronicle

EAST ROCHESTER — The East Rochester school district should be generating its own electrical power this weekend because of a fuel cell that has been up and running since last Saturday.

The technology is expected to cut the district’s energy bill as well as the emission of gases that, according to many scientists, cause global warming.

After seeing a Discovery Channel program on fuel cells about four years ago, Assistant Superintendent of Business Michael Mamo began efforts to bring the technology to East Rochester. With the help of an $833,000 state Energy Research and Development Authority grant, the district purchased a fuel cell from United Technologies Corp. Power.

East Rochester is the first school district in Monroe County to install such a fuel cell, which produces 200 kilowatts of electricity an hour. Liverpool’s school district in Onondaga County has one, as do a sprinkling of districts across the country.

East Rochester’s fuel cell sits in a closed room across the hall from the elementary school cafeteria. A window will soon be installed so students can watch it produce the power that will be used to cook their lunches.

Because the fuel cell looks like a 10-foot-tall box, the district’s director of technology, David Rovitelli, is planning a computer display that will show students and interested citizens exactly how this 16-ton device turns hydrogen fuel and oxygen into electricity.

The fuel cell should generate 50 percent of the school district’s electricity during the week, when energy use is high. When classes aren’t in session, it will meet all of the district’s power needs.

For now, UTC Power is taking care of the fuel cell. Soon district employees will be trained to handle basic maintenance, and head custodian Jose Correa is eager to learn more.

“Making half of our own power is pretty exciting,” he said.

The fuel cell project cost about $2 million. If the district receives the reimbursement from the state Education Department that it is expecting, $350,000 of that amount would come out of the district’s capital reserve fund.

With the fuel cell active, the district expects its energy bill to drop about $100,000 a year.

Superintendent Howard Maffucci says the fiscal savings are only a small part of the fuel cell project’s value.

If bad weather causes power failures, the district would still be able to produce energy and provide a safe haven for residents.

According to UTC Power, fuel cells are virtually pollution-free, giving off heat and water. By contrast, making electricity by burning coal, for example, produces carbon dioxide, a gas that most scientists say contributes to global warming.

The project also complements efforts to make Monroe County a hub for fuel cell technology.

“The greater Rochester area wants to be a player in alternative energy,” said Maffucci. “Here’s a real-life example of how it can work.”

This will be a great value to the district if it works as believed. I do want to point out that it would NOT have been possible without a significant amount of grant support. Alternative power sources have to be affordable to succeed.

The East Rochester Volunteer Ambulance Corps will be providing EMS for Hillary’s visit.

R News

A freight train derailed Tuesday night at Lincoln Road and Maple Avenue in the village of East Rochester.

Early reports indicate there are no injuries. Eight to ten cars are off the tracks. There’s no word on what caused the train to derail.

Authorities tell R News the derailment happened on the south side of the tracks along Maple Avenue. The train cars hit some motor vehicles but no homes.

Authorities report some power outages because of the derailment. There are also some train cars hanging over the overpass at South Lincoln Road.

R News has a crew on the scene and will update this story throughout the evening.

Lincoln Road is the north / south road at the right. The overpass is clearly visible. Maple Avenue is the street running west off Lincoln just before Lincoln goes under the tracks. You can see the many automobiles parked along the tracks, sole parking for the homes on the south side of Maple.

As of 2000 hours, East Rochester Volunteer Ambulance had two ambulances with crews on scene and had not received any patients.

Three calls last Sunday, all priority one. One patient is still in the hospital. Two calls today. Memo to self: never do four bags of crack. And then get naked. In a shower. And kick the walls out.

Democrat & Chronicle

(November 19, 2006) — East Rochester firefighters rescued a woman from a second-floor apartment today after fire broke out in a downstairs kitchen.

Firefighters responded at 12:03 p.m. to 411 W. Hickory St., East Rochester. When they arrived, the woman, who was in her mid-30s, was leaning out her apartment window. Fire crews placed a ladder to the window and rescued the woman.

The woman was treated for smoke inhalation. A woman and a small child in the downstairs apartment escaped unharmed, said Fire Chief Ray Cerretti.

Cerretti said firefighters extinguished the flames in 15 minutes. The cause remains under investigation.

Notice about a ground school for a new med evac service being held in East Rochester

Busted my hump yesterday. Four calls, three transports. Yeah, yeah… I know. You guys from the big cities laugh. Our tranports take 20 minutes. An average BLS call is an hour and a half. If the paragods come to play, all bets are off.

Latest bit of EMS wisdom I’ve learned. If a guy thinks what is on his toilet paper is important, he probably doesn’t need ALS.

Twelve hours today at the ambulance, with three calls.

The heat was tough, but not the worst I’ve been in.

FYI, when a patient says to you “I’m at extreme danger to hurt myself or other people.” take him seriously.

Never take that same patient’s boots off. Footpowder, dispersal, surprise. I’m just saying.

Four calls today. One sad one illustrative of the need for more people who care for the left out in our society. I’m beat. Bedtime.

I was asked by our Corps’s training director if I could assist at one of the state EMT training classes last night. Two of us took one of our ambulances over to Penfield’s base where we drove as the class of soon-to-be EMT’s practiced mobile CPR. Penfield, Brighton and West Webster also provided ambulances.

The instructors created scenarios and put the students to work in four groups. All we had to do was drive around a bit and kibbitz while the students did their thing. Mobile CPR is tough. It’s far more taxing to try to keep your balance in a moving and swaying ambulance and do good CPR than many imagine. These “kids” did four scenarios, which translates into a lot of CPR.

From experience, they’ll feel the burn in the back of their thighs today, and their hands will be slightly clenched from bagging for so long. They seem to have learned a great deal, and our three students in that class seem to be at least in the upper third with skills and knowledge.

More photos at this link.

From November 30, 2002

I’m sitting at the ambulance base, waiting, as I usually do, for a call. Once again, I’m only half a crew. There is no one available to join me to make a full crew.

I’ve done this sort of thing for a decade now, first as a volunteer firefighter, and for the last seven years as a volunteer Emergency Medical Technician. I’ve seen volunteers become fewer and fewer, and those who come in new often leave just as quickly.

Volunteer means that you choose to do it. Nobody makes you. It’s a choice. I can’t imagine not volunteering to be a firefighter or EMT, perhaps it’s an inborn urge to throw myself on the bomb. Duty, I suppose, the old fashioned kind that says that I have a responsibility to the people around me, including the ones I don’t know.

I see people devote hours each week to other volunteer jobs, Scouting, childrens’ sports, candystripers. That’s super. God bless you all. But, don’t you ever feel the urge to stand between your loved ones and evil? One day, out of the blue, evil comes to call. Some folks run forward, towards the danger. Others don’t.

It doesn’t take much to be a volunteer firefighter or EMT. Some training time, some on-duty time, and a willingness to help, no matter what. All it takes is a step forward.

Evil is towers crashing down. But evil is also what scares your grandmother on her last ride to the hospital, or your brother as he sits in his wrecked, smoking car. Evil is fear, and shame, and pain and I face that on every call. The 100 year old nun, the molested four year old girl, the alcoholic, the woman giving birth… I’m there so that you don’t have to face evil alone. There’s someone to stand between you and evil, with you in your crisis.

Sometimes all I can do is hold your hand, or whisper a prayer. I can stop the bleeding. I can start a stilled heart. I can be your witness as God calls you home.

So I sit here, waiting for a call. Waiting for another volunteer to take one step forward.

Updated with the pics from the procession to the cemetary.

That’s what faced us this morning as the Ambulance Corps and Randy’s family gathered for the service and burial.

Family and friends overflowed the space at the funeral home. About 150 people joined us. We had about 20 of our members. Police and fire fighters, folks from Pittsford, Perinton and Penfield’s ambulance, the SEQ paramedics. The procession was very long, easily 50 vehicles.

Our members were the pallbearers. We also provided our meeting room for the reception after the graveside service.

Prior posts:

EMS DEATH

AN ORDINARY JOE, HERO

HUMAN FRAILITY