- The Washington Times - Wednesday, February 17, 2016

The District’s former emergency medical director on Wednesday again hammered the fire department’s top brass, telling a D.C. Council panel that she wasn’t given access to basic data to assess medics’ performance.

“I realized it was not at a place where my expertise would be used appropriately,” Dr. Jullette Saussy said during a Judiciary Committee hearing. “Their sense of urgency and mine are completely different. I won’t apologize for it.”

Earlier this month, Dr. Saussy submitted a scathing letter of resignation after having served seven months as director of Emergency Medical Services (EMS). As in her letter, she criticized fire department leaders for being unwilling to reform emergency services, adding that one change needs to take place before any others.

“Change the organization chart and empower the EMS medical director,” said Dr. Saussy, who oversaw about 1,900 medics as a subordinate to D.C. Fire Chief Gregory Dean.

“While changing the culture takes time, there were simple fixes that could have happened quickly,” she said. “But there was resistance.”

Two quick and easy fixes would allow the medical director access to real-time information on EMS services and conduct in-the-field oversight of EMS calls, she said.

When medics administer CPR or insert a breathing tube, they use a continuous waveform capnography machine that measures the amount of carbon dioxide in a patient’s system. Its data shows whether a breathing tube is properly inserted and allows providers to assess, in real time, whether care is being administered properly. The information can later be reviewed as a second-by-second analysis and provide critical oversight off the process.

“D.C. has the capnography machine, but I had no access to waveforms to assess performance,” Dr. Saussy said. “What was lacking was just the basic assessment of skills.”

Chief Dean, who has led the fire department for about nine months, said Dr. Saussy was allowed to weigh in on operational decisions and sat in on many operational meetings, adding that the department is committed to change but at a slower pace than Dr. Saussy was expecting.

“When we start talking about change — change is very difficult,” he told the committee. “The challenges we are facing did not materialize overnight. It will take time to get where we want to go.”

The fire chief pointed to his plan to hire a private ambulance company to assist the department so that medics could be taken off the streets for training without creating a gap in service.

Chief Dean did not speak directly about Dr. Saussy’s access to CPR and breathing tube data, but he rebuked those offering other paths to making EMS services better.

“Alternative solutions are conjecture until they are proven to the community,” he said.

Dr. Neal Richmond, medical director for the MedStar EMS/Mobile Healthcare System in Fort Worth, Texas, testified in support of Dr. Saussy, saying that having capnography data is critical to understanding if providers are administering the proper care.

“You have to have real-time data coming back to you to figure out what needs to be fixed,” Dr. Richmond told The Washington Times. “You have to measure how well calls are done, how CPR is administered and how breathing tubes are placed.”

Dr. Jeffrey Goodloe, medical director of the Metropolitan Oklahoma City and Tulsa EMS system, testified that there’s little hope for change if EMS officials lack access to data on emergency calls.

“There is science in 2016 that guides EMS,” Dr. Goodloe said. “If something decidedly different doesn’t occur here, the same problems will continue. That’s a sad thing for your government and for the citizens.”

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