- The Washington Times - Tuesday, November 13, 2012

A plan to redeploy the D.C. fire department’s emergency medical workers in a way that would leave ambulances staffed with no paramedics during the overnight hours is being greeted with skepticism from stakeholders in the D.C. Council, the firefighters union and the community.

Fire Chief Kenneth B. Ellerbe on Tuesday outlined his proposal to pull 14 ambulances staffed with paramedics from 1 a.m. to 7 a.m. and instead have them respond to calls during busier hours from 7 a.m. to 11 p.m.

Ambulances staffed by lesser-trained emergency medical technicians would be used overnight.

While emergency medical technicians are required to obtain a certification that requires around 100 hours of course work, paramedic training lasts as long as two years and is frequently offered with associate-degree programs.

The plan would stagger the work shifts of paramedics, increasing the number of ambulances able to provide advanced life support from 14 to 20 between 1 and 7 p.m., when fire officials say the volume of medical calls is about 20 per hour — double the 10 calls per hour the department averages overnight. But the plan would leave the city with no ambulances staffed with personnel to provide advanced care for more-serious medical emergencies in the early morning hours.

Chief Ellerbe said the move is being made to provide better service to the community after the department studied a year’s worth of statistics on call volume.

The firefighters union, which represents firefighters who are cross-trained as paramedics, says the issue is manpower. Capt. Ed Smith, president of the D.C. Firefighters Association, said paramedics, who can administer drugs and intubate patients with breathing difficulties, as well as perform more-advanced procedures, have for several years been either leaving the District or turning in their paramedic cards.

He said that the department has been slow to replace them, noting the department, which is configured to maintain 14 ambulances staffed with paramedics throughout the day, has had staffing troubles. As a result, the ambulances often are downgraded and staffed with emergency medical technicians, who are trained to evaluate symptoms and perform less-complicated medical interventions, such as CPR.

“They are not covering the 14 units they have now,” Capt. Smith said.

The union president provided data indicating that on a daily basis this year an average of 4.4 units that are supposed to be staffed with paramedics are not because paramedics are not available. Chief Ellerbe disputed the union’s statistics but did not provide data on the frequency of downgrades.

“Manpower is not the primary issue,” Chief Ellerbe said. “The primary issue is call volume, us looking at the data and statistics and using that to actually make some smarter management decisions.”

For the overnight hours, the department would rely for assistance on 21 paramedic engine companies, or fire engines that are staffed with a firefighter trained as a paramedic, and seven paramedic supervisors.

Kenneth Lyons, president of the American Federation of Government Employees Local 3721, which represents the department’s civilian paramedics, spoke alongside Chief Ellerbe and said he believes that the department has enough trained paramedics to cover the overnight time slot.

“The one concern we’ve had is whether or not the system we have is flexible enough to meet the needs of the community, as well as to ensure that adequate care is provided to the community on the 24-hour basis,” Mr. Lyons said. “This plan, though not perfect, we believe does meet that need.”

No implementation date was provided for the shift. The initial plan was supposed to take effect Nov. 5, but it appears that start date was put on hold after D.C. Council Chairman Phil Mendelson raised concerns that the council had not had a chance to weigh in on the plan.

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