DC medics to be retested

In an unusual and sweeping move, Washington, DC Fire Department will retest all of its 250 paramedics for "competency." The testing has been contracted out to the Maryland Fire Rescue Institute (MFRI).

This is a bold move in a troubled department. You may recall the lawsuit filed by the family of David Rosenbaum, the journalist who died in DC after a series of errors.

Looking between the lines it seems quite a bit of power is held by Dr. Michael D. Williams, the DC medical director. After all, the medical director is ultimately responsible for the clinical aspects of an EMS system. But other angles (Rosenbaum lawsuit, legal maneuvering around union issues, politics, etc.) make the medical director the ideal person--and the most bulletproof--to make decisions stick. He says:

"I expect there will be people that fail this process," Dr. Williams said yesterday. "And I think I will be saying, 'You're really not functioning as a paramedic, so we're going to pull you out.' "

Dr. Williams said the policy could create difficulties for the department official who assigns crews to ambulances, but "my obligation sort of trumps his on this one."

Using an outside agency was also wise. MFRI is respected in the area. Offering remediation to those on the edge prevents this being an outright slaughter. I am not sure whether ousted medics will be any better as EMTs. Time will tell.

There will be more chapters to this story. You can read the entire article:
DC medics to be retested.

Living in Maine

I was living in the Maryland - Washington DC area before moving to Maine. People would literally ask, "Can you get the internet up there?" and "Do you have a summer?"

(Yes and yes.)

Stories like this don't help:

Toboggan crash injures 6

Not the multiple casualty incident you'd expect in Florida for sure.

On another note, I'm off to the DC area in the morning for the National EMS Education Standards stakeholder's meeting to see what is up with the new education standards.

If you haven't already seen them you should take a look: National EMS Education Standards.

I experienced the 1994 EMT-B curriculum change. It was quite dramatic. This one, while highly anticipated, is much less controversial than the 1994 changes. Possibly because the drafts have been available right along and also because many instructors have been through the 1994 changes. The trauma and the drama of curriculum change is old hat. The big issue isn't how they will change as much as when they will change.

A question we'd all like to know. Stay tuned...

Moo-chanism of injury

Sorry. I couldn't help it. From the Boston Globe:

Woman finds a cow in the back seat
February 2, 2008 01:01 AM

By Caitlin Castello, Globe Correspondent

A woman who was driving down a Rehoboth road found an unfamiliar passenger in her back seat after an accident Tuesday night -- a cow.

Tanya Coccia, 46, of Seekonk was driving on Providence Street when she hit two cows. After rolling over the hood and roof of the car, one of the cows fell through the back windshield into her back seat.

"It is shocking and really weird," said Coccia, who was returning home with her daughter, Haley, 14, after running errands at about 10 p.m.. "Who would have ever thought I'd end up with a cow in the back seat of my car?"

The cow that fell into the back seat survived; the other cow had to be euthanized, she said.

It is a good thing her daughter was 14 years old. If she was less than 12 she would've been in the back seat...and killed.

There's no check box on the run report for stuff like this...

EMS at Mardi Gras

I was at Mardi Gras in New Orleans last year. I rode with Ken Bouvier and his crew (or would that be krewe?) and saw some great EMS being performed. Hospital diversions and crowding were a constant issue.

This year the MGTUCC will help. (From bayoubuzz.com)

Mardi Gras Protection

The New Orleans Office of Homeland Security and the Office of Emergency Preparedness, along with New Orleans Emergency Medical Services announce the establishment of the Mardi Gras Temporary Urgent Care Clinic (MGTUCC), erected at 1927 Tulane Avenue, just off of S. Prieur Street, near University Hospital.

Following the announcement, the clinic will be open from noon Friday until noon Wednesday, February 6, and will be fully operational around the clock to help facilitate medical services in the City during the biggest weekend and the remainder of Mardi Gras 2008. All services will be free of charge.

New York based DHS Systems, LLC donated items, services, and support - worth approximately $500,000, to assist Homeland Security and Public Safety agencies. The temporary quarters are part of the Deployable Rapid Assembly Shelter, or DRASH - mobile quick erect/strike tactical soft walled shelters that integrate shelter, mobility, lighting, heating, cooling and power distribution in one flexible package. It is a modular shelter system that is man portable, rugged, reliable and user friendly. The DRASH product line, is the primary product of the company.

"This is a real boost for our Mardi Gras operations," said Col. Jerry Sneed, director of the city's Office of Homeland Security and Emergency Preparedness. "One can never anticipate the unknown, but having the necessary resources in place makes the difference in the outcome. We are eternally gratefully for their support. This will provide an important supplement to the city's efforts to ensure that every resident and visitor has a safe Mardi Gras."

The Mardi Gras Temporary Urgent Care Clinic will be staffed by Board Certified Emergency Medicine Physicians, registered nurses, licensed paramedics and Emergency Medical Technicians, and will be able to handle minor traumatic injuries and illnesses during the carnival weekend. It has an intake/triage area, a treatment area and a 23 hour observation ward. There will be a total of 16 patient treatment beds at the site.

The clinic will operate out of a series of several military grade climate-controlled tents. Homeland Security will be utilizing the J shelter (1150 square feet) and M Shelter (653 square feet) at the urgent care clinic. Additionally, a MX shelter (442 square feet) will be used for medical care on the Endymion route (Orleans and Hennessey), as well as a 4XB shelter that will function as a command post at Lee's Circle.

DRASH features six different series of shelters with 45 models of multiple widths and lengths. Although single models range in size from 112 - 1,250 square feet, all shelters can be interconnected, allowing for effective joint operations. DRASH has been used extensively by all branches of the US military as tactical operations centers (TOCs), medical facilities and forward operating bases.

Several state and city agencies and offices are providing services and resources for the MGTUCC, including the State Department of Health and Hospitals - which was responsible for the overall coordination and funding, LSU Health Sciences Center, the State Office of Public Health, the Governor's Office of Homeland Security and Public Safety - which provided communication capability for the site, Sewerage and Water Board, the Department of Property Management, New Orleans EMS, New Orleans Fire Department, New Orleans Office of Emergency Preparedness, the city's Chief Administrative Office and Reeves EMS - which is a subsidiary of DHS Systems, LLC.

DHS Systems, LLC is a leader of high-tech, soft-walled shelter systems serving medical, military, government and civilian needs. In business for more than 20 years, the company enjoys the experience and professionalism of a seasoned team of more than 400 engineers, designers, manufacturing professionals, project managers, business development and customer support staff.

My sincere wishes for a safe and fun Mardi Gras to all at New Orleans EMS.

Now that you have learned something new about EMS go to nola.com to experience a bit of Mardi Gras for yourself.

(PS. Did anyone notice the sales pitch/PR angle of this piece? DHS Systems, LLC gets a lot of mileage from this.)