All D.C. medics to be tested on competency skills

[SSG G-man]

Well, having lived in the DC Metro area since 1991, I have heard of no issues with Arlington. Don't pay attention to Baltimore.

I now live in Arlington, VA and will be paying much attention. DC EMS has had trouble for years. I remember a news story many years ago:

Camera crew outside build where 911 call comes from. Crew films ambulance from station approx 3 blocks away driving up and down neighboring streets. Took approx 9-12 minutes for unit to arrive from approx 3 blocks away.

That story did not make DC happy.I know that since the problem that caused this new policy, there have been a lot of changes proposed to the DC EMS department. They have had other problems recently, too.

[p3medic]

+10, Dust's assessment of Paul Pepe.

[Chief1C]

When I read that, a thought of a large premeditated plan came to mind...

Someone with serious $$ greases a FD big wig, and some big name in the government; they kill their EMS program, make some cash on the side.. Then, X service, or a new name corporation comes in and takes over EMS w/ Paramedics that couldn't get a job selling band-aids.. and the new EMS division tries to get blood out of a stone.

But, maybe it's just me.

[CBEMT]

They aren't going to have enough medics left after this to run EMS.

Considering that they have ALS engines, they might have too many as it is. Just poorly distributed/deployed.

I agree that "DCEMS" needs to happen though.

[UMSTUDENT]

At school we spent a significant amount of time studying the cluster that is DCFD. The problem stems from a very entrenched political system of deceiving the DC city council.

The Rosenbaum family had the opportunity to destroy DCFD. The liability seemed incredible. Instead, being good natured people, they took the death of their loved one and tried to exact change within the department. An investigation was launched by the Inspector General for the District of Columbia. Subsequently a taskforce was formed to make recommendations on how to improve the department. The taskforce made a lot of good recommendations-institute a form of SSM, develop a system to send the closest ambulance, retrain providers, etc. The biggest thing they missed was:

A) The medical director is not independent. One improvement was that in the past, DC Fire Chiefs would "shop around" for medical directors. Basically firing anyone with a progressive thought in their head. DC restructured the medical director's position to report solely to the Mayor. Great move, but flawed. He can still be fired and still has the city council as his primary constituency group-not the patient.

Instead of finally separating EMS from fire, the fire department saw it as a great opportunity to bring in tons of speakers who advocated combining the department to make it inter operable and "improve morale." In the past many DC paramedics were paid by the fire department, but not considered true members of the fire fighting cadre. The report blamed this lack of hokey togetherness on most of the problems. I think Boston EMS might have been the only third service agency to really have had a chance to speak on the side of an EMS only system.

In reality, Mayor Fenty should have kept good on his campaign promises to separate the two agencies.

[scratrat]

I've worked a service that NEVER did QA in my very short tenure there. For obvious reasons. This was the same service that allowed medics to RSI someone without ever speaking with a physician or having that chart QA'd.

On the flip side, I've worked for systems that critic (?) every little thing you do and makes the medics afraid to make solid decisions.

I like how this medical director has no faith whatsoever in his own system. I've never dealt with DCFD but I've seen some storied here and there. It's funny how he blatantly said people would fail and be demoted. It would have been nice to see him at least lie and say he has high hopes. Oh well.

[akroeze]

I've worked a service that NEVER did QA in my very short tenure there. For obvious reasons. This was the same service that allowed medics to RSI someone without ever speaking with a physician or having that chart QA'd.

When a physician RSIs someone, does that chart get QA'd?

[frontcrawl]

I like how this medical director has no faith whatsoever in his own system. I've never dealt with DCFD but I've seen some storied here and there. It's funny how he blatantly said people would fail and be demoted. It would have been nice to see him at least lie and say he has high hopes. Oh well.

How in the hell would his lying improve anything? I don't mean to sound like I'm praising the guy, let me be clear, maybe he's a fire department yes-man jackass, but it sounds as if you're critizing him for the modicum of truth in the dalmatian crap. Again I ask you, how would his being consistantly bad rather than rarely, rarely, sorta OK improve things?

[scratrat]

How in the hell would his lying improve anything? I don't mean to sound like I'm praising the guy, let me be clear, maybe he's a fire department yes-man jackass, but it sounds as if you're critizing him for the modicum of truth in the dalmatian crap. Again I ask you, how would his being consistantly bad rather than rarely, rarely, sorta OK improve things?

Allow me rephrase myself. I have no doubt this is probably what that service needs, along with many others. What I was conveying, was that the medical director was very candid to the news about his lack of faith in his own service. I was surprised that he didn't say something more to the effect of "This is something we felt we need to do. Let's wait and see what happens." Something like that versus telling the newspaper that you have no doubt that some of the people employeed by you, don't belong there, or are too stupid to function. What my comments were geared towards is his way of building morale amungst the people he oversees.

[scratrat]

When a physician RSIs someone, does that chart get QA'd?

I would hope so. But I doubt it.

There are so many people who believe that medics do not have the mental capacity/skills to perform RSI and therefore a LOT of places rip your chart apart should you RSI someone. In New Jersey, your individual project immediately QA'd your chart and had to forward it the State Dept of Health along with the tape of your conversation with the doctor about the RSI. Then you heard back from everyone about the case. I'm not saying this was a good thing or bad thing, but it was what it was.