Just read this report out of D.C. hope there's more to it!

 

 

 

http://www.jems.com/news_and_articles/news/2010/03/records_contradi...

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We were talking about this last weekend during one of our our NREMT-P refresher courses....over and over and over...D.C. fire/ems...they keep coming up over and over and over, never good things either. Then they did that big push, and were featured on the cover of JEMS as I remember the quote..."from worst to first"....they're still in last place it seems.
Blair and Jim,

I don't work for DC Fire and EMS but if your organization ran that many calls you would be potentially in the news more... more calls, more employees, more potential to liability.

Secondly, this is a call involving a minor, pediatrics are potentially difficult to identify as they compensate until the very end, not to mention who knows what the call's environment was like, does anyone know if the guardian refused to have the child transported on the first call?

Why don't we wait until we here more facts before we use this as a case study in a refresher, or on this forum... I think you as a provider would appreciate that if it was your call pending investigation.
THUS I STATED I HOPE THERE'S MORE TO FOLLOW!
The article didn't really say what the medics was called for except the parents called for help. Need more info on this one. Don't wana monday morning quuarterback
Ya know, I agree with you FETC about running that many calls and being in the news more. I also agree perhaps all the facts are not known. But as you pointed out, it involved a minor that often times will bite you in the butt because they will compensate so long and then crash hard and fast. But sorry, it ends there.

By, not doing a PCR means there is nothing to prove the medics even evaluated the child. Not having a refusal signed by the parent/guardian, means that there was no refusal. There are recorded time stamps of the first call which conflict with statements already made public by the department.

In my opinion, this incident screams of the need to discuss it in a class or even in this forum. Acknowledging that even though it is still under investigation, and mindful that there is nothing to indicate the outcome would be any different had the child been transported the first time. Just the mere suggestion of negligence is something no provider can recover from unscathed, and should serve to remind us that especially with children, we better have all our ducks in a row.

Unfortunately, as long as many of us have been in this business, I think it's safe to say, we all know how this will probably end.
I agree, they are busy, but at 4000 calls per truck annually, the city I work in isn't exactly slow. However, I have seen providers in that same service that blow off everything but the most obvious, and those that take the time to make sure they're doing the job right. You are correct that we don't have all the facts, but from what I understand, there wasn't even documentation done on this call back in Feburary, which would leave many questions unanswered indefinetely.

I do understand where you're coming from, but again, I didn't feature them in JEMS, JEMS featured them. Also, there are many services of that size that you don't hear about repeatedly with high profile cases like this on a semi-regular basis. Weren't they also caught with their pants down last year when it was noticed that many of their medics were being "assisted" with recertification training/testing?

Yes, when you're big, you're gonna have a SNAFU once in a while, but it seems like D.C. fire/ems has used up all their SNAFU's and is borrowing some from others as well.
Yeah, alot of times my refusal tripsheets are longer than if they had been transported. That's because when I think someone should go, they're gonna have to tell me know multiple times, and speak with my command physician on the phone and tell them no also, then tell me no again. I'm not one to sign off someone who either I know should go, or am unsure what's going on. With that being said, if they still don't want to go and are in a capacity to refuse, that's going to be a very thorough tripsheet/PCR.

A few have said that it's tough with kids because they compensate so well, then crash suddenly. Well, it seems to me then that this little gem of pediatric knowledge isn't just stored away secretly in central PA, apparently people all over the country know this. Why then, doesn't this factor in to this crew's initial assessment???

We ALL get tired of the PCR's, the long, busy shifts, etc. etc. etc....But when it comes to the point that you're guiding pt.'s to the conclusion that they don't need you, when they may, it's time to hang it up and move on.
Unfortunately, there appears to be a reoccurring problem in DC.

Fir some reason, the link isn't showing up, but Statter911 has another recent incident very simular to this one.
PCR's are kinda like going #2. The job ain't finished until the paperwork is done.
Incident now is subject to a criminal homicide investigation,

STATter911 link
Actully, there seems to be a problem with a few people that happen to work for DCFEMS.
It's not fair to blame the entire agency for the actions or omissions of a few people.

Further, in the Rosenbaum case, the patient survived for quite a while at the ED with very little care. That's not the fault of anyone at DCFEMS, as far as I can tell.

The most recent incident is unfortunate and tragic, but there were only two crews involved, not the entire department.

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