Tuesday, March 4, 2008

D.C. paramedics by summer expect to get what their counterparts in area jurisdictions have had for decades: access to life-saving medications.

The decision to equip ambulances with narcotics comes after the department announced plans last year to run comprehensive background checks on every employee.

Battalion Chief Kenneth Crosswhite said the stocking of drugs could not have gone forward without the background checks.

“It could not have; it should not have,” Chief Crosswhite said.

The department has considered putting the drugs on ambulances for more than five years but held off because of administrative roadblocks or fears of theft.

Dr. Michael Williams, the department’s medical director, said the benefits of stocking ambulances with narcotics such as morphine and Valium far outweigh the risk of theft or abuse of those drugs.

“I’m much more concerned about not providing pain relief or not being able to break a seizure,” he said. “The nation’s capital can’t be the last big jurisdiction to have pain relief.”

Dr. Williams said the background checks would help fire officials who were “trying to make sure we don’t put temptation in front of individuals” who may have had drug problems in the past.

He said the background checks were a way of “identifying them and saying, ‘You probably shouldn’t be handling narcotics if you were convicted for X, Y and Z, 10 years ago.’ ”

National Association of Emergency Medical Technicians President Jerry Johnston said morphine can minimize heart failure and Valium can break potentially brain-damaging seizures.

“If you don’t have it, you can’t treat a seizure,” Mr. Johnston said. “You basically are helpless to watch them seize.”

Mr. Johnston said the use of narcotics on ambulances is “very common” and he was not aware of a jurisdiction that does not use them.

Fairfax County paramedics have been carrying narcotics for at least 24 years, and workers in Montgomery and Prince George’s counties have had them for about 30 years.

Maj. Chauncey Bowers, a paramedic with the Prince George’s fire department, said the drugs have improved patient treatment since the county started using them in 1977.

He also said security systems for the drugs are relatively easy to maintain and he mostly dismissed fears of thefts.

“In the course of a year, you’re more likely to replace medicine because someone damaged it when they dropped it than because it was stolen,” Maj. Bowers said. “I think part of the fear of drugs getting stolen is urban legend.”

Dr. Williams said the District’s fire department is waiting for the D.C. Council to approve funds to purchase an electronic security system for drug boxes in ambulances.

The system requires each paramedic to have a unique key and logs who uses the drug boxes.

A spokeswoman for Mayor Adrian M. Fenty said the mayor will set aside $65,000 for the boxes as part of a $3.7 million request from the council that he plans to send to the council.

D.C. paramedics have been trained since 2003 to use medications that include drugs to sedate patients, break epileptic seizures, treat asthma attacks and emphysema, and to slow rapid heart rates.

In 2002, the D.C. Council approved the administration of the drugs, but then-Medical Director Dr. Fernando Daniels III said the process of stocking ambulances was delayed because paramedics needed more training on how to store and account for the drugs.

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