DC Fire And EMS is Center of Investigation involving a Patients Death.

[unleashedfury]

http://www.jems.com/article/news/dc-fire-and-ems-officer-center-investiga

evidentially a patient dropped over in arrest across the street from the fire station. The officer on duty told them to call 911. and walked away.

I know our policy is when people show up at station or flag us down for situations instead of making them call 911 we often call the dispatch desk and let them know that we need a dispatch and what's going on.

I.E. Last year I had a patient pull into our driveway who was having chest pain was driving himself to the hospital but couldn't do it anymore. Got him out of the car assessed and in our truck While my partner called the dispatch center via radio to get a dispatch for our patient. (One of those technicality things, where if we just hauled him without telling anyone and without a dispatch a incident is never recorded) turns out he had a septal wall MI going on.

 

[SandpitMedic]

I was just going to post this. Crazy- absolutely ludicrous... At no point should a life take a back seat to politics on the urban streets of the USA. Perhaps there could be some way to spin this if the victim was down the block, around the corner, or ANYWHERE not directly in line of sight of the fire station. There is no excuse. I'm at a loss.

 

[SandpitMedic]

I found this quote in reference to this incident on another forum which I found interesting.

Well DC fire is one of the worst departments in the country. Look actual fire fighting is probably less than 5% of any departments job. There is about another 10% for service calls and the rest is EMS.

Yep a fire fighter spends 80+% of his time being an EMT. But it is not why they joined the fireservice and stuff like this shows it.

DC fire has a VF save rate of about 3-5%. Departments like this are why paramedics can't intubate anymore. For comparison King County Medic One in Washington State has a VF save rate of just under 60% and a first time intubation rate in the high 80% and intubation rates total 99%. But King County Medic One is a third service that only does ALS EMS, oh and they dont charge for services.

The old way of firefighting is unsustainable (new-dumb guys on aid/medic, old experienced guys on ladder/engine, everyone is a medic, funding/ training is focused on firefighting instead of EMS... you know 80% of your job)

When effective city managers find out how effectively things are done in the Seattle or Boston area, it is going to suck to be a firefighter.

Most cities could do away with 50% or more of their large fire apparatus and 25% of staffing. Then replace them with aid cars and EMT's . 1 ture ALS medic unit per 100,000 people. It would cost 60% as much and the level of proficiency in the face of true life threatening events would go up 10 fold."

I agree... As medical aid takes precedence above "fire fighting" it is going to shake up departments in the good old US of A. Quite soon, especially as healthcare comes closer into the national spotlight.

 

[unleashedfury]

I found this quote in reference to this incident on another forum which I found interesting.



I agree... As medical aid takes precedence above "fire fighting" it is you g to shake up departments in the good old US of A. Quite soon, especially as healthcare comes closer into the national spotlight.

the quote you provided has some valid points to an extent.

Firefighters are often forced to become paramedics. Not because they "want to be one" I know tons of Firefighters that are EMT's and they are perfectly ok with that.

We have proved that early CPR and AED use in Cardiac arrest Trumps the bells and whistles that ALS provides, If your first on location at a vehicle accident Basic EMT level skills can hold you until advanced care arrives if it is needed. The idea of having 1 paramedic per engine is not really beneficial dumping a Engine or ladder truck for medical calls is not even efficient a Chase car that EVERYONE has to ride one shift per tour would suite the Fire Dept. just fine, If you don't want to do it. Find another career.

But the idea of 1 ALS unit per 100,000 people could be a little to far extravagant. Take in consideration response times, and transport times a person may end up waiting up to a half hour for an ambulance...

 

[SandpitMedic]

I agree with some of the post as well. 1:100,000 is not sustainable in my mind either.

We all know ALS is to EMS as Fire/rescue is to Firefighting. 80% of what we do is BLS; as is 80% of fire is EMS.

However, it is important to be ready and capable of that 20%. I think BLS engines and ALS chase cars are the wave of the future. Forcing EMTs to become Paramedics is poor policy in my opinion.

 

[SandpitMedic]

When effective city managers find out how effectively things are done in the Seattle or Boston area, it is going to suck to be a firefighter.

This is what I was really eluding to. I think this is going to happen. Not just in DC in relation to this incident. Just in general.

 

[MrJones]

...Firefighters are often forced to become paramedics. Not because they "want to be one"....

That's just about as misguided as forcing paramedics to become firefighters. Teach 'em enough to be safe, know how to don the PPE and understand the culture? Sure. Require them to get their FF1 or FF2? Not so much.

 

[abckidsmom]

The fire vs EMS debate doesn't even belong here, though. Remember when firefighters used to be in the newspaper for saving puppies and kittens? Helping little old ladies off of the street? When I worked in an urban department, I used to mock the suburban departments who were effectively "boy scouting."

They visited schools, helped community members with whatever, generally had excellent customer service and proved their value to the community. If someone knocks the door to the station, someone answers the door, goes to get a partner, and then goes with the people. No discussion, no wondering what is up. Within reason, with good communication, we ALWAYS help the people at the door. Whatever their problem is, and with our eyes wide open.

If people can't knock the door of a fire station for help, where is the help coming from? Even if it's car trouble, or a lost dog. We help. Or at least we are nice about saying that we can't help in this situation, and call the right help with the people.

I'm so disgusted by this story. These people call themselves helpers. With the right attitudes, people can do anything, for anyone.

 

[mycrofft]

We are so ready to take a sensational news story (they all are) and stab someone in the back with it, when those of us who have had dealings with the press understand that story is always flawed, always wrong to some degree, and when a grieving family or a lawyer or both get involved, might as well roll down the shade and call it a day.

And Washington D.C. politicians? C'mon!….<_< no credibility. They have to pander to an electorate who voted a crack addict into office as mayor, then voted him in again after he was convicted.

If it IS right, some Lt is going to be wearing a paper hat soon, and maybe answering manslaughter charges.

 

[JPINFV]

Since when did DC FEMS killing patients through inaction become news? Isn't this kinda of their thing?

 

[mycrofft]

I thought it was Houston's thing? (stopping for pizza on the way to the hospital with a pt; charting CPR in progress running one man to a unit).

 

[JPINFV]

I thought it was Houston's thing? (stopping for pizza on the way to the hospital with a pt; charting CPR in progress running one man to a unit).

Rosenbaum.

 

[mycrofft]

Guldenstein?

 

[medicsb]

Since when did DC FEMS killing patients through inaction become news? Isn't this kinda of their thing?

The sad thing is that I highly doubt this is a problem limited to DC FEMS. How many other places does this occur, and we just don't hear about it. The main reason we hear so much about DC is because they've been under increased scrutiny since Rosenbaum.

Anyhow, I try my hardest to give the benefit of the doubt, but considering that this Lt. stepped down says a lot.

 

[Rialaigh]

Sadly there is probably a company policy stating something along the lines of aid cannot be rendered unless the unit is called for aid or has a call number or is officially "responding" and because they didn't request dispatch to give them a call number for this they couldn't help, or maybe there is a policy against self dispatch as well in which case it's a horribly flawed policy (pretty likely). Either way I bet there are policies covering them for not responding and helping...

This happens all the time in EMS too, I hear things like "well the most important thing is that I keep my job and go home at the end of the day".

I'm not saying what they did is 100% the right thing to do, but I bet there are policies that would threaten disciplinary action against them for this that and everything else...

 

[unleashedfury]

Sadly there is probably a company policy stating something along the lines of aid cannot be rendered unless the unit is called for aid or has a call number or is officially "responding" and because they didn't request dispatch to give them a call number for this they couldn't help, or maybe there is a policy against self dispatch as well in which case it's a horribly flawed policy (pretty likely). Either way I bet there are policies covering them for not responding and helping...

This happens all the time in EMS too, I hear things like "well the most important thing is that I keep my job and go home at the end of the day".

I'm not saying what they did is 100% the right thing to do, but I bet there are policies that would threaten disciplinary action against them for this that and everything else...

Yes thus the reason I'm sure if the FD assisted in 911 they would have gotten a dispatch since they run the ALS engine, I understand the concept of no self dispatching to avoid conflict or having every one with a laminated card at the scene. But I am sure if the accused Lt. did assist at the scene or notified dispatch of the incident the red carpet would have rolled out and rolled right back up after hearing the situation.