Washington D.C. EMS again

[VentMedic]

Critical Condition: D.C. Paramedics Up to Par?

Evaluation of video leads to questions

posted 04/24/09

http://www.nbcwashington.com/news/local/Ar...-Up-to-Par.html

(The video is at this site.)

Video never seen before by the public shows paramedics reacting to a life or death situation -- a simulation used to evaluate their performance in an emergency.

These assessments were performed last year at the Maryland Fire and Rescue Institute at the University of Maryland. It's known as MFRI.

Where the assessments took place looks like an ambulance, but it is an advanced life support simulator. A mannequin displayed certain health problems that led to a heart attack.

The faces of the paramedics are not shown to protect their identities. To evaluate their performance we asked an nationally-recognized expert to choose and review some of the videos. Professor Paul Werfel is the director of the EMT/paramedic program at the Stony Brook University Medical Center in New York.

"Of the videos that I saw, solely on the videos that I saw, the mistakes that these folks were making were huge," Werfel said. "The performance across the board was substandard.

"I looked at 16 videos and of those 16 videos only one of which would have passed an entry level exam for competence on fundamentals," he said.

The D.C. Fire and EMS Department contracted with MFRI to assess approximately 250 paramedics to see how D.C. emergency medical personnel measure up to national standards.

"It is not an exam, it is not a test," said Steven Edwards, director of MFRI. "There was no pass-fail mark. It was simply a way to determine in a general way -- not a specific way -- where additional training should take place in the paramedic service."

D.C. Mayor Adrian Fenty and Fire Chief Dennis Rubin released a written statement to News4 saying:

* The assessment is one of the many efforts that the department is undertaking to improve the quality of EMS.

* They have used their initial findings to improve medical protocols.

* Several areas for systemic training improvements have been identified.

* All paramedics have begun receiving specific focus-area training.

But Ken Lyons, president of AFGE Local 3721, the union representing many D.C. paramedics, said only a few individuals have received additional training so far.

"Let me describe to you what remedial training was ... here' s your book, go into the room and self study," Lyons said. "That's the extent of remedial training."

The union wants training to avoid embarrassments like the 2006 death of New York Times reporter David Rosenbaum, who was found lying in the street, misdiagnosed as being drunk and died of a brain injury from a beating he suffered during a robbery.

And last December, Edward Givens complained of chest pains. He was diagnosed with a stomach problem, was given an antacid and later died of a heart attack.

Are D.C. residents well served when they dial 911?

"Absolutely not," Lyons said. "They're not well served when they dial 911 and they are not well served when they pay their tax dollars to a system that for the most part has become a fraud."

Are they in danger?

"You know," Lyons said, "I think they roll the dice."

The DC Fire and EMS Department said it is committed to reforming the system, and that the community should feel confident that they will receive high-quality emergency medical treatment and transportation.

Click here for the Washington Times' report.

http://www.washingtontimes.com/news/2009/a...ures-by-dc-ems/

On Friday, News4 gets reaction to this report from the family of Edwards Givens, the man who was diagnosed with acid reflux but died of a heart attack.

D.C. Fire Probes Allegations of Cheating on EMT Test

posted 04/24/09 7:51 am

http://www.wjla.com/news/stories/0409/616183.html

WASHINGTON - All D.C. firefighters have been ordered to cease using the Pearson VUE Facility at the College of Southern Maryland for EMT testing after allegations surfaced that tests performed there could have been compromised, perhaps by cheating, a department spokesman confirmed to ABC 7 News Thursday.

According to a statement, the allegations are "that members utilized outside materials during the National Registry Emergency Medical Technician examination process."

More at:

http://www.wjla.com/news/stories/0409/616183.html

and

City Investigates Alleged Cheating on EMT Test

- Washington Post

http://www.washingtonpost.com/wp-dyn/conte...9042304902.html

[JakeEMTP]

And the hit's just keep on coming.

I love this.

"Ironically, one of the reasons why the District selected the NREMT certification process is to ensure test integrity," Chief Dennis L. Rubin said in the statement. "If in fact these allegations are true, the D.C. Fire and EMS Department will be greatly disappointed that both the NREMT and Pearson VUE Training Center failed to meet our expectations."

The NREMT and PearsonVue failed to meet your expectations? How about your FF'S who were cheating on a very basic knowledge test? That is where the disappointment should lie Chief Rubin..

Edited April 24, 2009 by JakeEMTP

[croaker260]

And the hit's just keep on coming.

I love this.

"Ironically, one of the reasons why the District selected the NREMT certification process is to ensure test integrity," Chief Dennis L. Rubin said in the statement. "If in fact these allegations are true, the D.C. Fire and EMS Department will be greatly disappointed that both the NREMT and Pearson VUE Training Center failed to meet our expectations."

The NREMT and PearsonVue failed to meet your expectations? How about your FF'S who were cheating on a very basic knowledge test? That is where the disappointment should lie Chief Rubin..

What we are looking at is a culture of indifference to quality patient care....which is what the IG report said in review of the rosenberg death...almost verbatum.

[VentMedic]

I just don't get it. They know they have been under the watchful eyes of the public who is now all too familiar with their screw ups. They know they are being tested. And yet, they manage to muck it up each time.

Do they not know what that Paramedic patch means and the responsibility that comes with it? By the comments in the article, it seems they totally expect to be spoon fed the test and take no responsibility for their license themselves. Shameful.

I also thought these medics were already tested last year.

DC medics to be retested

Wednesday, February 27, 2008

http://emergencymedicaltechnician.blogspot...01_archive.html

In an unusual and sweeping move, Washington, DC Fire Department will retest all of its 250 paramedics for "competency." The testing has been contracted out to the Maryland Fire Rescue Institute (MFRI).

This is a bold move in a troubled department. You may recall the lawsuit filed by the family of David Rosenbaum, the journalist who died in DC after a series of errors.

Looking between the lines it seems quite a bit of power is held by Dr. Michael D. Williams, the DC medical director. After all, the medical director is ultimately responsible for the clinical aspects of an EMS system. But other angles (Rosenbaum lawsuit, legal maneuvering around union issues, politics, etc.) make the medical director the ideal person--and the most bulletproof--to make decisions stick. He says:

"I expect there will be people that fail this process," Dr. Williams said yesterday. "And I think I will be saying, 'You're really not functioning as a paramedic, so we're going to pull you out.' "

Dr. Williams said the policy could create difficulties for the department official who assigns crews to ambulances, but "my obligation sort of trumps his on this one."

Using an outside agency was also wise. MFRI is respected in the area. Offering remediation to those on the edge prevents this being an outright slaughter. I am not sure whether ousted medics will be any better as EMTs. Time will tell.

[WolfmanHarris]

Might be time for the Rosenbaum family to return to court as it seems their settlement is not seriously being followed. I'm not usually litigious, but the family did an incredibly reasonable and selfless thing by placing the fixing of the problem ahead of the need to make someone pay. DCFD is not living up to the trust given them and if it takes the courts smacking them around to get things seriously back on track then so be it.

[scubanurse]

More info from my local nbc...

http://www.nbcwashington.com/news/local/Fi...ed-Scandal.html

After both News4 and the Washington Times quoted experts saying the performance of D.C. paramedics was substandard during simulated incidents, the fire chief spoke out not only about the reports, but about the alleged cheating scandal that he said could involve between 70 and 200 emergency medical technicians who took national certification tests.

[chbare]

"I'm gonna try a mac because I just can't get it with this curve." Enough said.

Take care,

chbare.

[AnthonyM83]

They wouldn't dare try that training machine in Los Angeles... I would assume they'd get the same results. 1/16 seems about right ...

[WelshMedic]

I can assure you all that I would never defend any system that treats it's EMS as a poor stepchild. However, I do think it's fair to point out that this was a test to see where the problems were. That was the whole point, surely? Let them do their worst and we'll build from there.

These people probably haven't been back in the classroom since graduation with such a high volume system. This, to me, was a shoddy bit sensationalist journalism. Paul Werfel should never have participated, being such an influential person (apparently?).

Yes, they have major problems over there, but is it truly right to stamp on our peers from a great height with so little facts?

WM

[chbare]

I think you are correct in some ways Welsh; however, there exists a plethora of evidence pointing to the global lack of substandard providers in this specific system. Not to mention the victims of this care.

I am not going to stamp on anybody personally; however, as evidenced by my prior post, when a paramedic cannot call a laryngoscope blade by its proper name in a simulated environment, major problems truly exist.

Take care,

chbare.