The February death of a two-year-old girl after a call to 911 renewed demands for closer scrutiny of the District's emergency response services. The similar death of a New York Times reporter in 2006 prompted the creation of a task force that recommended changes, but four years later, thorny issues remain.
http://thekojonnamdishow.org/shows/2010-03-17/tragedies-and-dc-emergency-medical-services
Tragedies and the DC Emergency Medical Services
Listen Wednesday, Mar. 17, 2010 at 12:06 p.m. in Disaster, Politics, Public SafetyGuests
Toby Halliday
District EMS taskforce member
Joseph Barbera
Associate Professor of Engineering Management (Crisis & Emergency Management, and a Clinical Associate Professor of Emergency Medicine at George Washington University
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Comments
I testified to the Rosenbaum Commission on inappropriate overkill by DCFDEMS response. On the show today a 2 year old girl in a fatal asthma attack was not given proper care or transport. But a caller to your show with a dog biting her described, fire engines, ambulance , police cars all responding, 9 DC responders. This is exactly what is wrong here. I have fought the unbalanced responses, with inhuman, hysterical and medically damaging sirens in this city since I moved near Providence Hospital. Every day I experience constant destructive siren noise in my own home. Sirens are harmful, disturbing , often continous all day, and counterproductive. EMS trainers in DC have told me that the extreme noise is 40 decibels above the harmful level and agitate the driver,,actually making accidents more likely. The sound is such a dispersed shockwave that noone can even tell where the oncoming ambulance really is.
Now the poor little child Stephanie Stevens has died , likely from both the error of nontransport and the robot like rigidity of DC's mindless procedures during transport. She should have been taken to the hospital the first call but how, how, is the issue nonone seems to think about. An asthma attack, like a heart attack strikes real terror in the patient, she has extemely difficult, even blocked breathing passageways. She is terrified she'll die. My own sister at age 30 died from asthma, so I lived with this serious problem in my own family. The fear is similar in a heart atack. The proper indication according to the Chief at Bethesda-Chevy Chase Rescue Squad is to transport with haste, but lights only and NO SIRENS. The siren is so overpowering and frieghtening it causes adrenaline to increase, and causes greater panic. A woman with epilepsy told the DCEMS "please no sirens " you can cause me to seizure, they always respond we have to use sirens. In this inflexible, medically harmful EMS service but not in many other places, even as close as Maryland, their protocals allow the medical officer to decide the best choice for transport.
Our city officials have created a noisy hellhole in DC and this is a case that shows the error so well. I presume the late transport for Stephanie was with sirens blaring as FDEMS are like robots and are unneccessarily instructed to use sirens all the time, even when it is apparent to anyone with common sense it's not necessary,, even medically harmful..
I find it interesting that a Maryland Fire Chief would say this given that Maryland law, specifically Transportation § 21-106c(1),says "The privileges set forth in this section apply only while the emergency vehicle is using audible and visual signals that meet the requirements of § 22-218 of this article, except that an emergency vehicle operated as a police vehicle need not be equipped with or display the visual signals." An emergency vehicle not using BOTH audible and visible signals is breaking the law if they disobey ANY traffic law. Many jurisdictions require both 100% of the time during emergency transport for this reason.
Additionally, the number of emergency responders sent to a call is not strictly for the patient. I listened to the call regarding the Walter Reed animal attack. If the caller was unclear about location, additional units could come from opposing directions to assist in aid, the scene obviously was not secure so more personnel is understandable and in many areas, basic and advanced levels of care are dispatched to allow advanced units to go available if they are not needed.
One important statement came in the last response, "common sense." Until you have attempted to drive an emergency vehicle through a city, you really should give those helping others the benefit of the doubt. People don't yield and often don't even attempt to clear assist. The volume of calls in DC should be no excuse to ignore a single siren/flashing lights. In over 15 years, I have only seen 1 vehicle ticketed for ignoring emergency vehicles, unless they struck that vehicle. *1*.
Finally, do not read any of my comments as acceptance of the behaviors in the Rosenburg and/or Stevens calls. Any emergency worker who is not willing to transport any and every patient to the hospital should not be working there. Clear cut. One aspect of this problem I heard nobody touch on was the receiving facility's lack of ability to handle what emergency workers are bringing them. Would you want to get up at 2am for a stubbed toe, 3 weeks old, transport because the patient feels the need and have to wait 2 additional hours to be able to transfer your patient to their final destination? It is a tough double-edged sword because giving priority to 911 patients further encourages the utilization of 911 to speed care of that stubbed toe.