- The Washington Times - Monday, July 28, 2003

D.C. firefighters and emergency medical service workers are pointing fingers and blaming each other for the city’s abysmal performance in responding to medical calls.

The Washington Times reported July 11 that D.C. Fire and EMS Chief Adrian H. Thompson had initiated an ambitious plan to merge the fire-suppression and EMS divisions to make better use of personnel and lower the increasing response times to critical medical calls.

But some members of the EMS division have questioned the plan, saying firefighters are not motivated to respond to medical emergencies.

In response, firefighters say medics are undisciplined and take too many breaks.

In the District, civilian medics and uniformed firefighters are represented by different unions, work different schedules and have different pay and benefit plans.

Under Chief Thompson’s plan, EMS workers will be allowed to resign from the division and apply for positions in the fire-suppression division, which would lead to a single uniformed service.

A USA Today newspaper report yesterday singled out the District’s emergency medical services division as an example of how turf wars between firefighters and medics can hurt response times and the quality of service.

The story stated that over an 18-month period ending in July 2001, about 4 percent of people who suffered cardiac arrest — the most critical of emergency calls — were saved in the District, compared with 45 percent saved in Seattle.

“We’ve been diligent in trying to work to change that persona,” Dr. Fernando Daniels, the D.C. Fire and EMS medical director, told The Washington Times yesterday. “A lot of problems you will not see anymore.”

Dr. Daniels denied that the culture clash between divisions was responsible for the small number of cardiac victims saved.

“I think that’s a bad assessment,” he said.

Dr. Daniels also said the District is in the midst of a severe paramedic shortage and that there has been less emergency-room space since the closing of D.C. General Hospital.

The Times reported in April that the number of critical medical calls reached within eight minutes plummeted from 76 percent to 55 percent after the city’s six paramedic engine companies were taken out of service in December to cut costs. The national standard is 90 percent. Two of the paramedic engine companies have since been restored.

Dr. Daniels said aggressive new protocols governing what medical interventions paramedics and emergency medical technicians may take in were put into place in February.

Now, all EMS workers and a handful of firefighters are trained on the new protocols, which include equipping every fire engine and ladder truck with defibrillators.

Dr. Daniels said Chief Thompson’s plan to staff ambulances with one paramedic and one highly trained EMT was a “step in the right direction” toward lessening response times to critical medical emergencies.

Since Chief Thompson took over the department in February, he has made EMS his top priority. He and acting Deputy Chief of EMS Operations Greg Blalock declined to be interviewed for this story.

The previous acting deputy chief of EMS operations, Stephen Reid, told The Times in April that problems with EMS as a division were “too far gone” and suggested a separate city agency to supervise ambulances, paramedics and emergency medical technicians.

Chief Reid retired in April, frustrated by what he said was a lack of resources being devoted to EMS.

Firefighters respond to medical calls because they can generally arrive about three minutes faster than an ambulance. About two-thirds of the emergencies in the city are for ambulances, while about one-third are for fires.

Some medics say they are still viewed as the “ugly stepsisters” of the fire department and that the culture of the fire department has to change.

“Rookies are not trained that a save on a fire call is the same as saving a life on a medical call,” said one D.C. medic.

But Lt. Ray Sneed, president of the D.C. Firefighters Association, said that firefighters in the District are well aware of their role.

“Being an [emergency medical technician] is a condition of employment,” he said. “We are not just hiring firefighters, we are hiring EMTs.”

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