Monday, October 6, 2008

 

Would furloughed medic crew have made a difference?


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Point A on this map is PGFD Station 846, 1.3 miles from Point B, the 11000 block of Herrington Court.

When the woman who lives in the 11,000 block of Herrington Court in Largo, MD called 911 Monday morning because her husband was having trouble breathing, she received a prompt response. Ambulance 846, at the Largo firehouse on Campus Way South, was a little more than a mile away from Herrington Court.

But unavailable for this call was Medic 846, out of the same fire station. It wasn't because the crew was on another emergency. Prince George's County Fire/EMS Department Chief Spokesman Mark Brady confirms the reason Medic 846 wasn't dispatched is that its crew had been furloughed for eight hours.

Instead, Ambulance 846 arrived on the scene at 11:00 AM, about 6 minutes after the 911 call, unable to provide advanced life support treatment. ALS care was clearly needed because the patient was in cardiac arrest when the ambulance crew got to his side. Crew members used the units AED and performed CPR until the arrival of the next closest medic unit, Medic 820, from Upper Marlboro.

Medic 820 was at its quarters, 14814 Pratt Street, when the call came in. Station 820 is the 9th closest PGFD station to that address. According to Brady, Medic 820 was dispatched at the same time as Ambulance 846, but it took them 13 minutes to travel the 7.1 miles to the scene.


View Larger Map

Point A on this map is PGFD Station 820, 7.1 miles from Point B, the 11000 block of Herrington Court.

According to sources familiar with Monday's call, the crew from Medic 820 was able to get a pulse from the man on three different occasions before arriving at the hospital. Each time the man went back into cardiac arrest. Doctors worked the patient for about an hour at the emergency department, before pronouncing him dead.

Our sources tell us the man was recovering from heart surgery performed after his previous trip to the hospital.

The sources have asked not to be identified because they are not authorized to speak about this incident.

Spokesman Brady, contacted by STATter 911, confirmed these times for the handling of the call on Herrington Court:

10:54 – 911 call initiated
10:55 – A846 and MD820 dispatched
11:00 – A846 arrives
11:04 – A846 advised a working code and E846 was alerted to call
11:08 – MD820 arrives
11:09 – E846 arrives
11:27 – MD820 transports to hospital.

Brady added the following as part of his response to our questions about the call:

These times reflect the way the incident was handled with the appropriate units being dispatched, taking into consideration that the first due medic unit was not available. I do not see how the times could have been any better considering the patient was loaded and transported within 27 minutes after arrival of the first unit. The second due medic unit arrived ahead of the engine crew which was required to assist in loading the patient.

While I would always like to see better times, who wouldn’t, on every call, I do not see that this incident and associated times rises to the level of newsworthiness.

The Prince George's County Fire/EMS Department began furloughing firefighters and medics on September 28. The furloughs require all county employees to lose 80-hours pay before June, 2009 in an effort to close a budget shortfall.

According to a schedule obtained by STATter 911, Medic 820 and Medic 846 are on the same furlough rotation, but at different times during the day . Monday was the start of four days of furloughs for these two units, hitting all four shifts. Sources tell us while Medic 846 is shut down from 7:00 AM until 3:00 PM, Medic 820 is furloughed during the overnight hours.

Click here to see the entire furlough schedule for medic crews.

Click here for the most recent furlough schedule effecting fire stations.


Comments:
Do BLS units pick up the patient and go or do they wait till the medics get there , 27 minute time to get a patient to a hospital seems like a very long time, you can always intercept with a medic on the way. Remeber sometimes the best medicine is diesel fuel.And if it was a code why wasnt the engine dispatched originally for manpower?
 
His widow just hit the PG EMS lottery. No court is going to vindicate the actions of the department. No matter what the physical condition of the patient, PG will be found responsible for failing to provide expedient care.
Nice job PG, you just cost the county more money than you saved!
 
It would be impossible for the BLS crew to do appropriate CPR if they tried to load the patient themselves. If they only had two crewmembers, it would be impossible to do good CPR with only one person in the back. They did the right thing by calling for help and doing good, quality CPR with AED while waiting for backup... 27 minutes on a cardiac arrest are good times from on scene to the hospital... The question is if ALS were there earlier, would it have made a difference? The one thing I would like to know is did the AED advise to shock prior to ALS being there?
 
First off that patient should have been loaded quickly into 46's ambulance, CPR in progress, rolling. Medic 20 could have jumped on board at some point, provided 46 wasn't already almost to the hopsital.

Last night, trauma code from shooting on Nalley road, no Medic unit responding - furloughed. I think it does make a difference.
 
Time is tissue.

It is physically impossible to do proper CPR and load the paitent at the same time.

If you figure they didn't know the paitent was in cardiac arrest, they would have to send one person out to get the equipment. While moving the paitent no CPR would be done.

The crew did the best they could, if the further medic unit got a pulse back 3 times... imagine what could have happend with quicker ACLS interventions.

Good job Vernon, You have my vote for County Executive when Jack is done.
 
This whole event is unfortunate and forseeable. However, the county has no liability in this. How is this call any different from M-846 being tied up on another run and M-820 having to back them up. If the station had failed completely it might have been a different story but this one is not the silver bullet that everyone is looking for
 
This story would rank as not scraping the bottom of the barrel - it is underneath the bottom of the barrel with all the dirt and worms and bugs.

Mr. Statter - You must have something better to do with your time then on stories like this where you can not prove positively that someone or something would have made a difference.

Sorry the dude died but you can do better stories then this. At least you didn't put it on TV.
 
The call did NOT come out for a code. Which means that the patient had a witnessed cardiac arrest (either by the ambulance crew or the wife).

It is impractical for a two person ambulance crew to perform CPR (on apparently a viable patient) and somehow load the patient.

The furlough might not have killed this man, but it did take away his chance to live. Jack Johnson and company took away his chance. It's one thing for Medic 46 to be unavailable because they are on another call (that's just bad luck), but it's a completely different story when they would have been available without the furloughs (bad luck by design).

I see Medic 20 is being furloughed at night. I'll bet it's no coincidence that the Medic Unit protecting Upper Marlboro is NOT being furloughed during the day when Jack Johnson and friends are at the CAB and might need it.

Speaking of Jack, when will his security detail will be furloughed?
 
Not a Tic Chief:
It may not be a silver bullet, but other jurisdictions HAVE been held accountable when there is a loss where the nearest, normally available emergency unit, is unstaffed.

It happened to IAFF Local 2 when Chicago firefighters went on strike, and has happened to municipalities that practice firehouse roulette.

I understand your argument, that on another day M846 may have been staffed and on another run when a person arrested in 46's first due.

PG has the least resourced and busiest ems system in the DC area. Placing medic ambulances out of service will eventually create a perfect worse case scenario.

Being held accountable and making a change are not related. We need only look to Philadelphia, with the busiest medic ambulances and up to a 45 minute wait for paramedics ... for YEARS ... no municipal money to improve service.
 
If you're looking for some extra medics, try the training academy. There's no recruit class, yet a fully staffed academy sits waiting for one. Put some of them on a medic unit.

Or how about OSH??? It's great to have 3 paramedics doing work a civilian could easily do. Lets pay someone 100k to send out physical notices. Great management. Can't blame Jack Johnson for everything. We're our worst enemy.

Be prepared for more changes!!! Word on the street is that the furlough plan has changed yet again.
 
To the person who asked, no I have nothing better to do with my time. And yes, I did the story today on TV.

I talked to the woman who called 911 for her husband. Tennie Waller's feeling is that getting medics there at the same time as the ambulance might have made a difference.

Of course, there is no way of knowing whether Lawrence Waller would have lived, even if medics had been by his side when collapsed. I have done scores of these type stories in 23 years of TV news (remember DC's firehouse roulette). You never know for sure.

So you are correct we can not prove positively that Medic 846's absence negatively impacted the outcome. You also can't prove that it didn't. But does that mean we shouldn't do the story?

Knowing if Mr. Waller would have lived or died is not the point of the story. The question I ask, if it is your relative, do you want the medic unit to arrive in 5 minutes or 13 minutes?

We are just looking to see the impact a new policy in Prince George's County is having on public safety. I believe that is the role of journalists.

So, I will continue to hang with the dirt, worms and bugs.

Statter
 
To this comment:
If you figure they didn't know the patient was in cardiac arrest, they would have to send one person out to get the equipment. While moving the patient no CPR would be done.

Well most proper EMS units within the country would take the necessary equipment inside with them on a trouble breathing call. AED, O2, Aid Bag, Stretcher. But PGFD units see it fit to only take a clip board and pen to obtain a sign off. They don't want to help the people that pay there salaries. They would rather tell someone to drive themselves to the hospital so they can get back to personal matters or watching there Union rep on the news. I do believe when you take EMT, Paramedic, and CPR courses you are shown and practice skills as a single provider that you must pass to obtain a certification. So if you have two personnel on a unit (A846), one can run (sorry walk) back out to the unit and pick up necessary supplies and equipment to handle the emergency. Just another thing for to now sweep under the rug Sedgewick.
PGFD - Keepin It Safe - If you live in another county.
 
Oh how quick the tides turn from the other story about the volunteers going in front of counsel. I will sit here and beat up the volunteers for doing something they beleive in but when it comes to the career side under the microscope they run with their tails down.
 
For the person who had the clip board comment, dude you better check your windows because there are a few broken ones in that glass house you live in. Oh thats right the volunteers bring everything in to INCLUDE THE STRECHER on every call and start pt care immediately.

Man 1500 comedians out of work and you are trying to be one.
 
Assuming you had your aid bag and O2...you probably don't have your AED... But I will give it to you.

If you didn't know it was a code, you still wouldn't have a backboard, or suction.

The COT??? come on. Nobody brings the cot into the house until they have planed the route. Was the Pt. upstairs??

Nice try clip board. Sign here... your a tool.
 
Dave, I'm pretty sure if Jack Johnson wasn't in Hong Kong this week they may have saved enough money to keep that medic unit in service and save a life, or at least give someone a much better chance of living. In case you didn't get the moral here lol...Hong Kong, China=$$$$ the county supposedly does not have. Adding that to his trip for the olympics, the democratic convention in Denver and the Africa trips....how many police cars, firetrucks and medic units could he have kept in service????? I think that is very newsworthy when presented with a grieving widow.
 
I still stand by my point which is about liability not whether or not the furloughs are right or wrong..they are wrong.We have ambulances sitting at PG for an hour sometimes and the hospital is in the same boat PG is. The resources can only go so far. Should PG add a dozen beds so EMS units are not out of service for an hour, the obvious answer is yes. Can PG afford to? No. Other jurisdictions have had to lay off firemen/medics because they can't pay for them. Is this right? No of course not. But the reality is that governments can only fund what they have money to pay for. We can't just print money like the feds and run up a trillion dollar deficit. A government that cuts services due to a lack of funding is generally not liabile if the service is not available.The whole county government is affected by the financial crisis and the trail eventually leads to the foreclosure crisis and wall street (surprisingly, this is not the fire commisions fault, but thats another thread). Is the county culpable for feeding like a pig during good times and not seeing (or ignoring) the storm clouds on the horizon? Yes, but liable? probably not
 
Dave you need to get your hands on the new furlough G.O.from Sedgewick. they are still running scared and state clearly that no Medic unit will be put out of service now. It only took the death of a citizen to start making some changes. I would have to say they are showing guilt for the recent issue with Medic 46 with the new G.O.
 
The original question is would a furloghed medic crew have made a difference? The bottom line in this call is a citizen called for services that were needed and not available due to the furlough. The medic unit was in quarters. The medics were not... It's 2008 and PG County is too busy for this nonsense of firehouse roulette. The untimely death of this man is a direct result of the furlough's. Congratulations to County executive Jack Hohnson and all the members of the PG County Council who gave a unanimous vote for this dangerous situation. The blood of this man is truly on your hands.
 
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