- The Washington Times - Monday, November 3, 2003

D.C. paramedics say their ambulances have not been stocked with basic medications — such as aspirin — even though they have been trained in administering the drugs for nearly a year.

“Every time we have a patient in severe respiratory difficulties … every time we have a patient with major trauma and we don’t have these medications, all we are doing is swooping and scooping,” said Kenneth Lyons, president of the American Federation of Government Employees, Local 3721, the union that represents the city’s paramedics.

However, no official reports have attributed deaths directly to the ambulances’ lack of medications.

In May 2002, the D.C. Health Department approved the paramedics’ use of Valium, Versed, morphine, Solumedrol and other drugs; medics completed training in administering the new medications in January.

The medications include drugs designed to sedate patients, break epileptic seizures, treat asthma attacks and emphysema, and to slow rapid heart rates.

Dr. Fernando Daniels II, medical director for the D.C. Fire and Emergency Medical Services Department, acknowledged that the drugs have yet to make their way into ambulances, but said there are procedural considerations that have to be addressed.

While some medications have been ordered and are in the department’s warehouses, Dr. Daniels said, paramedics need more training on how the drugs will be accounted for and stored in fire stations and ambulances.

He said the D.C. Council approved the administration of the drugs in September 2002, but that was too late for procurement costs to be included in last year’s budget.

Dr. Daniels said the fire department has $1.2 million from the fiscal 2004 budget to buy medications and other life-saving technology that should be arriving in the city between now and February.

“It’s a progression,” he said. “Folks feel like they’re in a lull because they’ve been trained to use [medications], but now we’re trying to procure them.”

Dr. Daniels disputed the claims of field paramedics that aspirin was not available for use in ambulances. But Mr. Lyons said supplies are rarely on hand, and paramedics often buy their own from drugstores.

One D.C. paramedic said there is no justification for the delays in getting medications in ambulances. The paramedic, who spoke on the condition of anonymity, said within the past two weeks he transported a patient who was having static epileptic seizures. He said the patient did not breathe for more than four minutes.

“It’s frustrating,” the paramedic said. “I know the patient’s brain cells are dying because he’s oxygen-deprived. If I had Valium or Versed, I could have broken the seizure.”

He delivered the patient to a hospital, but he could not say whether the person lived or died.

Paramedics say they also don’t have equipment to perform medical interventions authorized under the new protocols.

In May 2001, two paramedics were suspended for performing a “needle decompression” procedure on a trauma victim when air pressure collapsed one of the man’s lungs and was crushing his organs, including his other lung and his heart. The procedure was not authorized under medical protocols at the time. The man died after he was transported to a hospital.

While the procedure is authorized under the new protocols, paramedics said, they don’t have a one-way valve that prevents air from refilling the patient’s chest cavity.

Paramedics said the procedure is needed about once a month for trauma patients, including accident and shooting victims.

“There’s no guarantee they would recover,” one paramedic said, “but we could give them a chance instead of withholding this treatment until they get to the hospital.”

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