Opinion

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Fixing D.C.’s dangerous ambulance service


By: Harry Jaffe
Examiner Columnist | 1/3/09 3:56 AM

A frigid wind blew hard across the RFK Auxiliary Field on Saturday, Nov. 22, when girls’ soccer teams from Wilson High and School Without Walls met in the city championship game. Running and stretching, 22 girls peeled down to their soccer shorts and did battle.

The score was tied at 1 at the end of the first half. About 12 minutes into the second half, Wilson’s Aleesha Woodson and SWW’s defender Kony Serrano both jumped high in the air to head a ball. They collided, heads knocking with the sound of two coconuts, and fell to the hard ground. Woodson got up; Serrano did not.

Parents and coaches covered Serrano with blankets. We could see her legs twitching. I called 911 and walked to the field’s entrance on Oklahoma Avenue to make sure the ambulance could find the obscure field.

I waited. Five minutes passed. Five more. A cop car cruised slowly to the scene. I heard one siren, then two. Twelve minutes after I called, an ambulance and a firetruck arrived. Emergency technicians from the ambulance stabilized Serrano, strapped her head to a stretcher, loaded her into the vehicle and drove to George Washington Hospital, all the way across town. She suffered a concussion and has recovered well.

I was left with two questions: Why did it take so long to arrive, when the Engine 8 Firehouse is 10 blocks away? And why bring a fire engine to help a soccer player with a concussion?

Let’s say the ambulance was busy, or it got caught in traffic, which might explain the 12-minute trip. Fine. But why waste gas and manpower and time to send a firetruck?

The simple — and equally bad — answer is that in D.C., the emergency medical services is part of the fire department. The investigation into the horribly botched treatment of New York Times reporter David Rosenbaum, which contributed to his death after a mugging, pointed out problems of having ambulances merged with fire services. D.C. Federation of Citizens Associations and other activists have called for separating the two. Yet Adrian Fenty has decided to continue the disastrous marriage.

Kony Serrano’s injury turned out well, but minutes seemed like hours as we watched her legs twitch and it looked as if she was having a seizure. No doubt an ambulance alone would have gotten to the scene faster.

Two years ago, when Fenty first took office, he gave hope to reformers and activists who implored him to liberate EMS.

“Rather than trying to resole an old shoe,” Citizens Association Vice President Ann Renshaw testified, “D.C. EMS should, once and for all, be reorganized as a separate agency.”

Fenty likes to say he wants D.C. to run like a “big city.” Most major cities — and Bethesda — have separate ambulance and fire departments.
It’s time for him to make EMS its own agency, before we have another Rosenbaum debacle, or a soccer player’s minor injury turns major.

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POSTED Jan 4, 2009

SgtDad: "I was 20 yrs a firefighter in a dept that also did all the EMS in the district. It works very well. The reason to send a firetruck is that many alarms need more trained manpower than an ambulance carries. Often the firtruck is minutes closer, as well. 12+ minutes for a response in an urban area is unacceptable. In our area, 2 - 3 minutes is the usual response. IKt takes a minute or two to run things thru 911, so 5 minutes at most. DC is the most ill-managed city in the country. The DCFD is the worst run fire dept in the country; its injury rate is astounding. The problem, then, lies not in the Fire + EMS concept but in the incompentent management in the city & fire dept. Making EMS its own agency will not change things. If EMS as a separate agency is managed no better than the rest of the city, your EMS will be no better -- probably worse."


POSTED Jan 4, 2009

confused: "If this situation bothered the author so much, then why wait two months to write about it? Why not file an official complaint with the department? I'm pretty sure you'd find that either your estimates of time are wrong, or the fault lies somewhere other than the fire department. I'm sure your research showed you that the police and fire service of this city are not dispatched by themselves, correct? Have you inquired with the office of unified communications? Have you filed a FOIA request to hear your time-stamped voice yet? sgtdad: Where did you find documentation of the FD's injury rate? Please post a link."


POSTED Jan 5, 2009

EMT: "The only decently-run fire-based EMS system I've yet to see is Seattle. Other than that it's usually a disaster. There's a reason why Richard Serino, Chief of Boston EMS (a separate city-operated EMS service) refused to sign the commission report post-Rosenbaum. It's because he knows separating and overhauling BOTH services is the only way the citizens of our nation's capitol to receive the protection they need and deserve."


POSTED Jan 5, 2009

milo64: "If this bothered the reporter that much he should have enquired to the DCFD with a offical complaint. He may have got some answers. First all 911 calls go through the call taker and then are sent to a FD dispatcher who then has to notify the closest units. The usual time frame is 2 to 4 minutes, the higher end in a larger city. Now just because the fire station is 10 blocks away dosent mean there in quarters. The priority of the call will depend on the info received. It may have been dispatched as a priority 3 call and 12 minutes is not unreasonable for a p-3 in a city. Its not as easy as people make it out to be. Yes DCFD needs improvemnet and maybe a third service would be better but ask questions first and then if you don't get the answers then compalin."


POSTED Jan 6, 2009

emsadvocate: "Just ask one of the ambulance crew what their job is. They will tell you FIREFIGHTER 8 out of ten times. That says something about emphasis and performance."


POSTED Jan 6, 2009

Blisty: "Confused: Wow you must truly live in DC since you are a spin-master. I like how you took someone's poor experience and turned the blame back onto the complainant. It can't be the reputable fire department because as you say, the fault falls somewhere else. However, it seems to me that the common denominator in all of the poor patient management stories is the fire department. And who is responsible for the EMS in the city? The fire department."


POSTED Jan 6, 2009

Maryland EMT: "The District is not unique in sending fire apparatus as extra hands on EMS calls. As SgtDad points out, engines are often closer than the nearest ambulance, and throughout the D.C. area, most jurisdictions' fire engines are staffed by cross-trained EMTs. Usually the ambulance crew will release the engine company from the scene as soon as they get the first responsers' report and take over patient care; in some cases, the engine crew will be asked to stay to help with patient care, traffic control or logistics. It is a medically appropriate use of resources."


POSTED Jan 6, 2009

MrBird: "Sending an engine on an ambulance run is not an appropriate use of resources. It's a sign of a broken system. If you need to send an engine to an EMS call then you don't have enough ambulances. Just because "this is the way it's always been done" doesn't make it right. And seeing as the FD was designed to fight fire and not handle EMS, you've got a solid case for removing EMS and creating a stand alone agency."



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