Ambulances & Vehicle Ops

FDNY’s EMS Boats Bring State-of-the-Art Care to Patients on the Water

Issue 10 and Volume 39.

On Sunday, Aug. 3rd, a triathlete was on his way to completing the New York City Triathlon when he suddenly began suffering a heart attack during the 1,500-meter swim in the Hudson River around 8 a.m.

A lifeguard and rescue swimmer noticed the triathlete was in trouble and immediately swam to his location and called for help.

Aided by volunteers on kayaks, surfboards and jet skis, the water rescue team rapidly moved the patient onto a special Jet Ski platform and sped him to Marine 1 Bravo—one of the Fire Department of the City of New York’s (FDNY’s) special EMS boats staffed by Lieutenant Ted Carstensen and firefighters Dean Tartaro and Chris Fitzsimons. It was there he was resuscitated by FDNY rescue medics Nial Oshaughnessy and Steven Kleinberg.

By the time the specially equipped EMS boat reached a ground-based unit, the triathlete was breathing on his own and was transported to Mount Sinai-St. Luke’s Hospital.

The Bravest, the fast-response fireboat, is located at Marine 6 at the Brooklyn Navy Yard within the borough of Brooklyn on the East River.

The Bravest, the fast-response fireboat, is located at Marine 6 at the Brooklyn Navy Yard within the borough of Brooklyn on the East River. Photo Joe Pinto

FDNY’s Expanded Scope
FDNY, the world’s largest provider of fire and EMS, prides itself with its longstanding tradition of delivering first-class firefighting and EMS capabilities.

Since 1865, FDNY has provided fire protection to the 420 square miles of the city and its well-known surrounding, busy harbor.

The agency’s Marine Operations division has evolved from a large fleet of classic fireboats for fighting ship and pier fires to a multifaceted division with personnel and vessels equipped to address a wide variety of emergencies consistent with the FDNY mission.

Marine Operations is responsible for protecting the shorelines of the ports of N.Y. and N.J., as well as the bridges and tunnels in and around New York City, the city to Long Island and the Hudson River.

Since 1996, FDNY has also been charged with the provision and coordination of prehospital care for New York City after the hospital-based EMS system was merged with the fire department. FDNY’s EMS system handles more than 1 million calls annually.

Consistent with its ongoing desire to afford the residents and visitors of New York City with high-quality firefighting and EMS services, FDNY has expanded its preparedness and capabilities to fulfill its mission on the water, most notably with a new fleet of response vessels that include specially designed prehospital care suites and marine ambulances.

The new FDNY fleet, funded through Urban Areas Security Initiative Nonprofit Security Grant Program and port security preparedness grants, includes 13 vessels:

>> Two 140′ fireboats;
>> One 65′ fast-response fireboat with a designated ALS-capable transport area;
>> Six 33′ fast-response fireboats;
>> Three 31′ fast-response marine ambulances; and
>> One 33′ fast-response scuba/rescue/EMS boat.

The vessels have been certified by the New York State Department of Health (NYSDOH) as marine ambulances and are the first to achieve such certification.

Three Forty Three is staffed by a regular crew of seven firefighters/certified emergency responders at all times at Marine 1 located in Manhattan.

Three Forty Three is staffed by a regular crew of seven firefighters/certified emergency responders at all times at Marine 1 located in Manhattan. Photo Joe Pinto

 

Fireboats
The fireboats are staffed at all times by specially trained marine firefighting personnel certified as New York state-certified first responders (CFR). The boats have the ability to respond as needed throughout the harbor from any of three marine bases (located in Manhattan, Brooklyn and Staten Island)

Three Forty Three is based at Marine 1 in Manhattan and was the first 140′ class fireboat received. It was named to commemorate the lives of all 343 FDNY members who perished on 9/11. From conception, the fireboats were designed to allow FDNY to properly and safely respond to, and operate at, all incidents on the water and along the shores of New York and New Jersey. It came with chemical, biological, radiological and nuclear defense and high-yield explosives capability, a prehospital ALS suite, a decontamination corridor and the ability to transport both ambulatory and non-ambulatory victims of a water-borne or land incident. Its sister ship Firefighter II has identical capabilities and is based in Staten Island at Marine 9 adjacent to the Narrows Bay.

Three Forty Three and Firefighter II, the world’s first 20 mph/50,000 gpm fireboats, boast a multitude of features. The boats have air filtration and 12 fog and straight stream monitors capable of pumping up to 50,000 gpm, including foam if needed. In addition to extensive firefighting capabilities, each has a 50′ extendable crane with lights, a water/foam monitor and firefighter basket, rear deck/platform and a 17′ rapid deployment boat.

These large fireboats have EMS suites capable of providing both ALS and BLS care to multiple patients simultaneously. Additionally, the forward area of the main deck has been designed to safely transport both ambulatory and immobilized victims.

EMS suites are capable of providing both ALS and BLS care to multiple patients simultaneously, including a row of seats with multiple oxygen ports above them.

EMS suites are capable of providing both ALS and BLS care to multiple patients simultaneously, including a row of seats with multiple oxygen ports above them. Photo A.J. Heightman

 

Marine Ambulances
The marine ambulance boats are used for special events and planned operations with a mixed staff of marine firefighter/CFRs, EMTs and paramedics. These specially designed EMS vessels are located at Marine 1, 6 and 9 and respond as needed to medical emergencies throughout the harbor staffed with both marine firefighters and EMTs/paramedics.

The marine ambulances have the ability to transport two immobilized victims, provide BLS- or ALS- level care and, as a result of their design, can operate in shallow areas with a ballast-controlled front, similar to a military landing craft, which allows for easy transfer of patients utilizing a stair chair or wheeled ambulance cot.

A special 33′ FDNY scuba boat is based at the quarters of Marine 6. Similar in design to the 31′ medical boat, this vessel is designed for scuba/water rescues and EMS. In addition to its firefighting capability and fast speed (45 knots), this vessel has a designated prehospital area below deck in the bow of the vessel. It has the ability to transport one immobilized victim and support BLS/ALS care and extended scuba operations.

The interior of the marine ambulances are designed for the simultaneous care of two patients and are stocked with all necessary BLS and ALS supplies and equipment.

The interior of the marine ambulances are designed for the simultaneous care of two patients and are stocked with all necessary BLS and ALS supplies and equipment. Photo A.J. Heightman

 

 

Joint Training & Familiarization
The most important medical asset of the FDNY marine ambulance program is the men and women who staff the vessels. As part of their initial training, all FDNY rescue medics attend marine training as a component of the intense three-week rescue medical technician program. This program is a collaborative effort between the FDNY Marine Operations and the FDNY Technical Rescue School.

In addition to safely operating each type of vessel, the medics’ training includes New York harbor familiarization, layout of each marine vessel, water awareness and proper use of personal flotation garments.

While it’s not the paramedic’s role to enter the water to rescue a victim, paramedics must know how to safely operate in an unexpected situation on a vessel and on the waterfront.

The FDNY rescue medics are also trained in collapse rescue, confined space operations, high-angle operations and advanced medical care for the technical rescue environment. As part of these disciplines, the rescue medics train heavily on patient packaging, including packaging a patient for removal from a vessel and the water, which has been successfully accomplished on numerous occasions involving the removal of patients from cruise ships outside of New York harbor.

The marine ambulances feature a ballast-controlled front that allows for easy patient transfer. The marine ambulances feature a ballast-controlled front that allows for easy patient transfer.

The marine ambulances feature a ballast-controlled front that allows for easy patient transfer. Photos A.J. Heightman

Conclusion
Departments that serve waterways need to be proactive and prepare for emergencies and mass casualty incidents that occur away from land-based EMS units. Every municipality and EMS system has its own unique needs. The vessels in service by FDNY have been designed to meet the department’s special needs through forward-thinking, collaborative efforts by members of the FDNY’s Marine Operations division and Bureau of EMS to ensure citizens and visitors of New York City are well protected, both on land and sea.