- The Washington Times - Friday, October 18, 2002

D.C. ambulances are understaffed, are staffed by some paramedics who carry expired certifications and take too long to arrive at emergencies, the inspector general says.

The D.C. Office of the Inspector General yesterday released the results of a three-month investigation into the city's Emergency Medical Services (EMS) division that it says was prompted by media reports and public complaints about the time it takes for medics to respond to emergency calls.

The report says that, on average, medics arrive on an emergency scene quickly once they are on the road, but it calls the method for monitoring such response times "insufficient." It also says the city continues to have problems getting medics to respond to emergencies, because of poor communications and a shortage of responding ambulances.

The Washington Times has published several exclusive reports about problems in the D.C. fire department's EMS division.

According to the report, the scope of the problem is hard to calculate because "the department does not measure significant time intervals that may affect overall response times."

All calls for emergency medical service arrive at the D.C. Public Safety Communications Center and are answered by Metropolitan Police Department operators. The calls are then transferred to a call taker in the Fire and Emergency Medical Services division.

But the report says the time it takes for a call to be transferred is not recorded.

And while the time it takes to assess an emergency by phone is only six seconds off the one-minute standard set by the National Fire Protection Agency, the time it takes to locate and alert an available unit is nearly twice as long. The report says emergency workers have been slow to leave station houses once they are notified, nearly doubling the national standard of one minute.

The report identifies a staff shortage as another factor that lengthens response times.

During a 91-day period studied between September and November 2001, all 14 ambulances that carry paramedics were in service on only four of those days. The report says 21 percent of the units were not in service for 62 days.

"Unfortunately, placing [advanced life support] units out of service is becoming the rule rather than the exception," the report states.

Paramedics told the inspector general's investigators that they have concerns about the level of care they provide, saying they "believe they do not receive adequate training from the training academy."

The field providers told investigators that department instructors do not have the experience to teach paramedic and basic emergency medical training courses. "Additionally, they state instructors arrive late to class, allow students to take long lunches, dismiss class early and sometimes are not prepared to teach," the report states.

The report says some paramedics whose two-year certifications have lapsed are given extensions on a case-by-case basis. There are no written city regulations that authorize extensions of expired paramedic licenses. Twelve of the department's 211 paramedics have received such extensions.

In sometimes lengthy written responses, the department agreed with the findings of the inspector general's office and outlined plans to correct the noted problems.

"This clearly shows the efforts being made to create a more efficient and well-run [division]," Inspector General Charles C. Maddox wrote in a letter to interim Fire Chief Adrian Thompson.


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