Friday, April 24, 2009

Washington Times' Shocking Exposé of D.C. Paramedic Incompetence

If you're going to have a heart attack, please don't have it in Washington D.C.

This exclusive and detailed report from the Washington Times is absolutely stunning, describing as it does not only the substandard scores and lousy performance of the District of Columbia's paramedics but the attempts of city officials to cover up the scandal rather than fix it.

It is a long story but, I guarantee you'll find it riveting reading.

A few excerpts:

...One of the nation's premier emergency medical professionals, who reviewed the materials at The Times' request, said the deficiencies identified during a sweeping assessment of the city's paramedics posed a safety crisis for the nation's capital.


"Based on what I saw on those videos, there is no question in my mind," said Paul Werfel, director of New York's Stony Brook University's paramedic program and a clinical assistant professor of health sciences. "To be perfectly honest, I think there's a real threat here. The safety of the people of the District of Columbia is at risk. It's a clear and present danger to them."...


The city has about 250 paramedics, and about 175 have been put through the assessment program at a training center in Maryland. The Times obtained test scores for at least 95 of the paramedics. Only three scored in a range to get a passing grade under the national standards for entry-level paramedics.


City officials originally threatened an investigation or legal action to stop The Times from publishing the materials, saying exposing the scores would hurt the city's efforts at improving its oft-criticized paramedic service. But after a further review, D.C. Attorney General Peter J. Nickles said too many people had access to the information to pursue any leak probe or legal action...


The statement issued Wednesday warned that examining the tests "without a thorough understanding of the testing environment and process could lead to misinterpretation of the results" and suggested that the "attacks" by unnamed people were an attempt to thwart the agency's reforms...


The lowest score The Times reviewed, below 40 percent, belonged to a field training officer, the documents stated...


"The performances I saw on these particular tapes I would not accept from people graduating a paramedic course, much less people with years of experience," said Mr. Werfel, a founding member of the board of directors of the National EMS Educators' Association.


"Almost all of them exhibited extremely poor technique," Mr. Werfel said. "Based on the videos I saw, I wouldn't be able to sleep at night if I was responsible for putting these people on the streets."...


Mr. Werfel cited one test in which a paramedic failed to notice for more than 30 seconds that his patient had gone into cardiac arrest.


The test, unbeknownst to Mr. Werfel, was taken by one of the District's senior emergency medical services administrators.


The department's medical director, Dr. James J. Augustine, who has served in the position since August, reviewed the same test with a Times reporter last month and termed it "perfect," later describing it as a "textbook" response.


But Geoffrey T. Miller, associate director for the research and curriculum development division of prehospital and emergency health care at the University of Miami, said he would also have ordered remediation for the senior EMS administrator - whose identity he was unaware of when he viewed the test. He viewed the video last month in Baltimore while attending a national conference of the Journal of Emergency Medical Services...


Three regional paramedic quality-assurance instructors with knowledge of the District's protocols viewed all the videos obtained by The Times and discussed the results but asked not to be identified because their work brings them into contact with the D.C. fire department.


The three agreed that while there are some competent paramedics on the job, the vast majority seemed deficient in their skills, with one terming more than half of the advanced life support providers "unsafe."...