Two ambulance medics have been arrested for allegedly failing to treat a dying man because "he was not worth saving".
By Richard Edwards, Crime Correspondent
Last Updated: 8:08AM GMT 31 Dec 2008
Ambulance controllers overheard a private conversation between the crew members in which they supposedly made disparaging remarks about the victim's untidy home, allegedly failed to attempt to resuscitate him, and then apparently decided to claim he was already dead when they arrived.
Barry Baker, 59, dialled 999 from his home in Patcham, near Brighton in the early hours of November 29 and said that he was suffering from severe chest pains.
Controllers sent a paramedic and ambulance technician immediately, and although Mr Baker collapsed while talking on the phone, the line to the control centre was left open as he lay on the floor.
Minutes later the control staff heard the crew enter the house. A police source said: "What they heard after their ambulance crew arrived frankly astonished them. "Apparently their first reaction was to comment on the untidy and unkempt state of the house. Then they are heard to comment on seeing Mr Baker and allegedly saying that it was not worth bothering to try to carry out resuscitation to try to save him. They then are heard discussing what to tell ambulance control and allegedly decide to say that he was already dead when they arrived. "Obviously the crew did not realise that the phone was still connected and, of course, the 999 call was all recorded on tape," said the source.
The unnamed ambulance staff were arrested after the tape was handed to the Sussex Police Major Crime Team. They have been suspended from duty and a file has been passed to the Crown Prosecution Service to consider prosecuting the pair for wilfully neglecting to perform a duty in public office.
Police confirmed the two medics, both based at Brighton ambulance station, were detained on December 5, six days after Mr Baker's death. They were later freed on bail until next month, pending further inquiries.
A spokesman said: "The men, aged 35 years and 44 years and from the Brighton area, have been arrested and questioned following the death of a man in Brighton. They were detained on suspicion of wilfully neglecting to perform a duty in public office, contrary to Common Law."
A spokesman for the South East Coast Ambulance NHS Trust said that both men had been suspended from duty.
"We have suspended two male members of staff from duty as police conduct an investigation into the circumstances surrounding the sudden death of a man at his home. We are giving the police our full co-operation in this matter and are not in a position to comment further at this time due to the police investigation taking place."
Mr Baker, who walked with the aide of two sticks after undergoing hip replacement operations, was said to be a popular local figure in village.
He was described by neighbours as a smartly dressed civil servant who was picked up by taxi every morning at 8.30am to go to the job he had been working at since he was 16.
Ralph Virgo, 79 said: "He was always picked up at the same time every morning to go to his job in the benefits office and was always smartly dressed. He had had two hip operations over the years and walked with two sticks and he was quite overweight but he was a very friendly chap and always said hello." Mr Virgo who has lived in the neighbouring house for 15 years said Mr Baker's parents had died before he moved in when he had inherited the house. "I always used to offer to help him out getting the trees cut and such like but he always said no. He didn't like to let anyone in the house." Another neighbour who asked not to be named said Mr Baker was a regular in the local pub where he liked to drink real ale and was a member of the Campaign for Real Ale. The neighbour added: "He seemed to have a good social life and by all accounts he was quite outgoing. He was a decent chap and always friendly."
Mr Baker's dilapidated detached house lies in a well-to-do street not far from the centre of Brighton.
Paul Newman, landlord of the local Ladies Mile pub, said: "He used to come to the pub every Sunday morning at opening time. He arrived by bus and met friends here and together they played a few hands of cards. He did it every Sunday without fail and was a really nice chap," said Mr Newman.
His funeral has been delayed but a memorial service is due to take place next month.
Wednesday, December 31, 2008
Saturday, December 13, 2008
High level of calls for ambulance
Ambulance chiefs urged people only to call 999 in an emergencyThe ambulance service which covers Merseyside, Lancashire, Cumbria and Greater Manchester has had an "unprecedented" number of 999 calls.
The North West Ambulance Service said the number of calls received so far this winter had been higher than ever.
A spokesman said the service had increased its resource levels and staff were working extremely hard.
But it is urging people to only call 999 if absolutely necessary so as to help those most at risk.
'Healthcare choices'
The service's chief executive, John Burnside, said: "The winter period is always a busy time for the NHS and the ambulance service in particular, with a significant increase in calls over this period.
"However, this year, we are experiencing extremely high levels of 999 calls compared with the same time last year."
He added: "The service has increased its resource levels to prepare for the winter period and our staff are working extremely hard to make sure that our patients receive a speedy and safe response, throughout these months.
"There are a number of healthcare choices available to members of the public suffering from illness, which may not require the need for an ambulance."
People are being urged not to call paramedics unless someone is suspected of having a heart attack or a stroke, or is unconscious, has a serious wound or head injury or is struggling to breathe.
Story from BBC NEWS: http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/england/7781208.stm
Published: 2008/12/13 10:54:30 GMT
Thursday, December 11, 2008
Ambulance attendants molesting patients
129 paramedics accused of sex-related crimes over last 18 months
DALLAS - They answer the call 24-7, often risking their own safety to rescue the sick and injured and rush them to the hospital. But some paramedics have been more predator than hero.
Over the past 18 months, at least 129 ambulance attendants across the U.S. have been accused of sex-related crimes on duty or off, an investigation by The Associated Press found. Some of them molested patients in the back of an ambulance.
"It's a dream job for a sexual predator," said Greg Kafoury, a Portland, Ore., lawyer who represents three women who were groped by a paramedic. "Everything is there: Women who are incapacitated, so they're hugely distracted. Medical cover to put your hands in places where, in any other context, a predator would be immediately recognized as such."
Across the U.S., emergency medical technicians have been accused in recent months of such crimes as rape, soliciting minors over the Internet and possession of child porn, according to an AP survey of the state agencies that oversee those professions.
Some shocking cases
Exactly how many of these EMTs were alleged to have committed their crimes on the job is unclear. But some of more shocking cases include:
Several EMS officials said the number of complaints is troubling but does not necessarily point to an industrywide problem. They noted that the profession employs nearly 900,000 people in the U.S.
'Is even one case tolerable?'
"That number in and of itself doesn't shock me, knowing the number of providers we have in the country," said Steve Blessing, state EMS director in Delaware and president of the National Association of State EMS Officials. "Is even one case tolerable? I think most state directors would say no. But we're bound by reality here."
In Portland, paramedic Lannie Haszard was sentenced to five years in prison in August after pleading guilty to five counts of attempted sexual abuse. Haszard, 62, was charged with inappropriately touching four female patients while they were being taken by ambulance to hospitals.
Three of the women have sued Haszard and American Medical Response, his employer at the time. The lawsuits contend that the company, which operates ambulances in 40 states, failed to react to previous complaints about the paramedic's conduct.
Haszard's behavior came to light last December when a 28-year-old single mother of three, Royshekka Herring, told police that he touched her genitals while she was en route to the hospital for emergency treatment of a gastrointestinal condition.
In a recent taped deposition, Herring's voice shook with emotion as she described how a nurse tried to convince her that Haszard was probably performing an abdominal exam.
"I started yelling at her, because I didn't feel safe," Herring testified. "Somebody I never expected to touch me touched me."
A spokesman for American Medical Response had no comment on the case.
Former Dallas Fire Chief Steve Abraira suggested ambulances carry three workers. Ambulances usually have two — one in the front, one in the back.
"If there's a person predisposed to do something wrong, there's nobody there to witness or discourage that individual from doing something," said Abraira, now the fire chief in Palm Bay, Fla.
Twenty-eight states do not automatically bar known sex offenders from working as EMTs, the AP found.
Although most insist they would rarely, if ever, allow sex offenders to work those jobs, the AP found that Texas has knowingly allowed eight, Louisiana two and Maine, Virginia and North Carolina one each. There is no indication any of those people were accused of sexual misconduct after being allowed to work EMS jobs.
Twenty-two states strictly prohibit such offenders from working as EMTs.
"This is the type of person we don't want in the back of an ambulance with your mother or daughter," said March Tucker, an EMS regulator in West Virginia.
All but one of the eight registered sex offenders certified to work in Texas victimized children ranging in age from 6 to 16.
"Oh, my goodness, that's really scary," said Winfred Dean, who supervises the sex offender monitoring unit for the Harris County probation department in Houston. "I thought people like that would more than likely be eliminated."
Texas officials said state regulations call for EMS licensing decisions to be made on a case-by-case basis.
"The only thing we can do is follow the law, and the law allows this," said Maxie Bishop, state EMS director. "We have to take a look at the crime, how long it's been, the nature of it and what that person has done since."
http://www.msnbc.msn.com/id/28179848/
DALLAS - They answer the call 24-7, often risking their own safety to rescue the sick and injured and rush them to the hospital. But some paramedics have been more predator than hero.
Over the past 18 months, at least 129 ambulance attendants across the U.S. have been accused of sex-related crimes on duty or off, an investigation by The Associated Press found. Some of them molested patients in the back of an ambulance.
"It's a dream job for a sexual predator," said Greg Kafoury, a Portland, Ore., lawyer who represents three women who were groped by a paramedic. "Everything is there: Women who are incapacitated, so they're hugely distracted. Medical cover to put your hands in places where, in any other context, a predator would be immediately recognized as such."
Across the U.S., emergency medical technicians have been accused in recent months of such crimes as rape, soliciting minors over the Internet and possession of child porn, according to an AP survey of the state agencies that oversee those professions.
Some shocking cases
Exactly how many of these EMTs were alleged to have committed their crimes on the job is unclear. But some of more shocking cases include:
- A Standish, Mich., paramedic sent to prison in March for molesting a girl who was on her way to the hospital after she was injured at her 15th birthday party.
- A Pinellas County, Fla., paramedic arrested in July after he allegedly sexually assaulted a woman in an ambulance en route to a hospital.
- A Chester County, Pa., paramedic sentenced in July to up to 20 years in prison for engaging in sex and providing alcohol to teenagers he befriended through their interest in emergency medical service.
- A Copperas Cove, Texas, paramedic awaiting trial in January on charges he exposed and touched an 18-year-old accident victim's breasts while pretending to tend to her injuries.
- A Chattanooga, Tenn., EMT accused in a lawsuit of giving a 30-year-old woman an extra dose of morphine and then completely undressing her in the back of an ambulance even though her injuries were minor.
Several EMS officials said the number of complaints is troubling but does not necessarily point to an industrywide problem. They noted that the profession employs nearly 900,000 people in the U.S.
'Is even one case tolerable?'
"That number in and of itself doesn't shock me, knowing the number of providers we have in the country," said Steve Blessing, state EMS director in Delaware and president of the National Association of State EMS Officials. "Is even one case tolerable? I think most state directors would say no. But we're bound by reality here."
In Portland, paramedic Lannie Haszard was sentenced to five years in prison in August after pleading guilty to five counts of attempted sexual abuse. Haszard, 62, was charged with inappropriately touching four female patients while they were being taken by ambulance to hospitals.
Three of the women have sued Haszard and American Medical Response, his employer at the time. The lawsuits contend that the company, which operates ambulances in 40 states, failed to react to previous complaints about the paramedic's conduct.
Haszard's behavior came to light last December when a 28-year-old single mother of three, Royshekka Herring, told police that he touched her genitals while she was en route to the hospital for emergency treatment of a gastrointestinal condition.
In a recent taped deposition, Herring's voice shook with emotion as she described how a nurse tried to convince her that Haszard was probably performing an abdominal exam.
"I started yelling at her, because I didn't feel safe," Herring testified. "Somebody I never expected to touch me touched me."
A spokesman for American Medical Response had no comment on the case.
Former Dallas Fire Chief Steve Abraira suggested ambulances carry three workers. Ambulances usually have two — one in the front, one in the back.
"If there's a person predisposed to do something wrong, there's nobody there to witness or discourage that individual from doing something," said Abraira, now the fire chief in Palm Bay, Fla.
Twenty-eight states do not automatically bar known sex offenders from working as EMTs, the AP found.
Although most insist they would rarely, if ever, allow sex offenders to work those jobs, the AP found that Texas has knowingly allowed eight, Louisiana two and Maine, Virginia and North Carolina one each. There is no indication any of those people were accused of sexual misconduct after being allowed to work EMS jobs.
Twenty-two states strictly prohibit such offenders from working as EMTs.
"This is the type of person we don't want in the back of an ambulance with your mother or daughter," said March Tucker, an EMS regulator in West Virginia.
All but one of the eight registered sex offenders certified to work in Texas victimized children ranging in age from 6 to 16.
"Oh, my goodness, that's really scary," said Winfred Dean, who supervises the sex offender monitoring unit for the Harris County probation department in Houston. "I thought people like that would more than likely be eliminated."
Texas officials said state regulations call for EMS licensing decisions to be made on a case-by-case basis.
"The only thing we can do is follow the law, and the law allows this," said Maxie Bishop, state EMS director. "We have to take a look at the crime, how long it's been, the nature of it and what that person has done since."
http://www.msnbc.msn.com/id/28179848/
Wednesday, December 10, 2008
Doctors call emergency care ‘national disgrace’
msnbc.com and NBC News
By Alex Johnson and Tracie Potts
90 percent of states get poor, near-failing grades in nationwide report card
The nation’s emergency care system is “a ticking time bomb,” with demand far outstripping the capacity of hospital emergency departments already crippled by a widespread shortage of doctors and nurses, according to a national report on the state of emergency medicine.
The annual report card by the American College of Emergency Physicians gave the nation a D- grade for Americans’ access to emergency care, saying the emergency care system was “fraught with significant challenges and under more stress than ever before.”
That stress is likely to worsen as the weakening economy forces public officials and health administrators to cut back even further on costs, the report said.
The report, which was issued Tuesday, was one half of a double whammy for America’s state and local emergency officials. The same day, the Trust for America’s Health and the Robert Wood Johnson Foundation declared in a separate study that the United States was underprepared for a major disaster, such as a biological attack or a pandemic.
Access to emergency care was one of five categories the physicians’ group assessed to come up with a C- grade for the overall U.S. emergency health system.
The group found serious problems across the board, choosing to give no state an A. Massachusetts (B) and the District of Columbia and Rhode Island (both B-) — all with high concentrations of advanced medical institutions in small geographic areas — were the top three, while Arkansas came in last with a D-.
Scores were so low — 90 percent of the states earning mediocre or near-failing grades — that Nebraska’s grade, a C+, was good for fifth in the rankings.
“That is a national disgrace,” said the organization’s president, Nicholas Jouriles, an emergency physician in Moreland Hills, Ohio. “The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine.”
Too many patients; too few resources
The organization said rising costs were forcing hospitals to close emergency departments at the same time that demand for their services was skyrocketing, thanks to a rise in the number of Americans who seek treatment in the emergency room because they have no health insurance.
“The emergency care system in the United States remains in serious condition, with numerous states facing critical problems,” the report said, concluding that “the nation has too few emergency departments to meet the needs of a growing and aging population.”
The report found that emergency room visits had grown by 32 percent in the last decade as the number of emergency rooms had fallen by 7 percent. Other factors contributing to the crisis were:
Shortages of nurses, primary care physicians, emergency physicians and other specialists.
Hospital crowding leading to boarding of patients in emergency departments.
Inadequate reimbursement from public and private insurers.
“Adverse legal environments” — that is, rising medical malpractice claims and an accompanying rise in malpractice insurance costs — that are leading emergency physicians to retire early, cut high-risk services or move to states with less liability exposure.
Chronic lack of state-level programs to address preventable illnesses, resulting in “avoidable health care expenditures and additional demands on the medical system.”
The physicians’ group stressed that it was not passing judgment on the quality of emergency room doctors’ and nurses’ care; instead, it was assessing resources and availability of critical care.
Angela Gardner, an emergency room doctor in Galveston, Texas, who is president-elect of the physicians’ group, said the emergency care system was a “ticking time bomb.”
“Doctors are working in a war zone out there,” Gardner said.
“They’re being asked to do more with less every single day. They’re being asked to see more patients,” she said. “They’re being asked to do so with fewer nurses, with fewer beds in the hospital, so they have no place to put the patients that they’re seeing.”
Comprehensive reform urged
The doctors’ group called on Congress and the incoming Obama administration to enact a comprehensive health care reform program with an emphasis on boosting resources for emergency departments.
Reform of federal and state liability regulations is also critical, the report said, to lure qualified doctors and nurses back into emergency rooms.
“Emergency medical care is the most overlooked part of our health care system, and also the one everyone depends on in their hours of need,” Jouriles said. “Policy-makers must make strengthening emergency departments a national priority.”
http://www.msnbc.msn.com/id/28148474
Video: http://www.msnbc.msn.com/id/21134540/vp/28148590#28148590
By Alex Johnson and Tracie Potts
90 percent of states get poor, near-failing grades in nationwide report card
The nation’s emergency care system is “a ticking time bomb,” with demand far outstripping the capacity of hospital emergency departments already crippled by a widespread shortage of doctors and nurses, according to a national report on the state of emergency medicine.
The annual report card by the American College of Emergency Physicians gave the nation a D- grade for Americans’ access to emergency care, saying the emergency care system was “fraught with significant challenges and under more stress than ever before.”
That stress is likely to worsen as the weakening economy forces public officials and health administrators to cut back even further on costs, the report said.
The report, which was issued Tuesday, was one half of a double whammy for America’s state and local emergency officials. The same day, the Trust for America’s Health and the Robert Wood Johnson Foundation declared in a separate study that the United States was underprepared for a major disaster, such as a biological attack or a pandemic.
Access to emergency care was one of five categories the physicians’ group assessed to come up with a C- grade for the overall U.S. emergency health system.
The group found serious problems across the board, choosing to give no state an A. Massachusetts (B) and the District of Columbia and Rhode Island (both B-) — all with high concentrations of advanced medical institutions in small geographic areas — were the top three, while Arkansas came in last with a D-.
Scores were so low — 90 percent of the states earning mediocre or near-failing grades — that Nebraska’s grade, a C+, was good for fifth in the rankings.
“That is a national disgrace,” said the organization’s president, Nicholas Jouriles, an emergency physician in Moreland Hills, Ohio. “The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine.”
Too many patients; too few resources
The organization said rising costs were forcing hospitals to close emergency departments at the same time that demand for their services was skyrocketing, thanks to a rise in the number of Americans who seek treatment in the emergency room because they have no health insurance.
“The emergency care system in the United States remains in serious condition, with numerous states facing critical problems,” the report said, concluding that “the nation has too few emergency departments to meet the needs of a growing and aging population.”
The report found that emergency room visits had grown by 32 percent in the last decade as the number of emergency rooms had fallen by 7 percent. Other factors contributing to the crisis were:
Shortages of nurses, primary care physicians, emergency physicians and other specialists.
Hospital crowding leading to boarding of patients in emergency departments.
Inadequate reimbursement from public and private insurers.
“Adverse legal environments” — that is, rising medical malpractice claims and an accompanying rise in malpractice insurance costs — that are leading emergency physicians to retire early, cut high-risk services or move to states with less liability exposure.
Chronic lack of state-level programs to address preventable illnesses, resulting in “avoidable health care expenditures and additional demands on the medical system.”
The physicians’ group stressed that it was not passing judgment on the quality of emergency room doctors’ and nurses’ care; instead, it was assessing resources and availability of critical care.
Angela Gardner, an emergency room doctor in Galveston, Texas, who is president-elect of the physicians’ group, said the emergency care system was a “ticking time bomb.”
“Doctors are working in a war zone out there,” Gardner said.
“They’re being asked to do more with less every single day. They’re being asked to see more patients,” she said. “They’re being asked to do so with fewer nurses, with fewer beds in the hospital, so they have no place to put the patients that they’re seeing.”
Comprehensive reform urged
The doctors’ group called on Congress and the incoming Obama administration to enact a comprehensive health care reform program with an emphasis on boosting resources for emergency departments.
Reform of federal and state liability regulations is also critical, the report said, to lure qualified doctors and nurses back into emergency rooms.
“Emergency medical care is the most overlooked part of our health care system, and also the one everyone depends on in their hours of need,” Jouriles said. “Policy-makers must make strengthening emergency departments a national priority.”
http://www.msnbc.msn.com/id/28148474
Video: http://www.msnbc.msn.com/id/21134540/vp/28148590#28148590
Tuesday, December 9, 2008
Controversial Exam for D.C. EMT's
WASHINGTONfrom ABC 7 News -
Click here to see the related video:
http://www.wjla.com/news/stories/1208/576376_video.html?ref=newsstory
A plan to raise standards in the D.C. fire department is stirring up a controversy.
Some firefighters are losing their jobs because they can't pass a tough new exam for emergency medical technicians.
The new exam is part of an agreement with the family of murdered New York Times reporter David Rosenbaum. Now the department is agreeing to give recruits more chances to pass the test just to keep their jobs.
Graduation day was a proud moment for JaQuante' Staton. Born and raised in D.C., he always dreamed of becoming a firefighter. After six months of training, he made it.
"You have to understand, my whole family was there at graduation. They were proud of me, they were cheering for me. To have it stripped away just a couple of months later, it's not fair," said Staton.
Staton's dream was shattered when he was among the 28 percent of firefighters who failed to pass a new national registry exam for EMTs, put in place after graduation. Staton had already passed state standards.
"I'm not disgruntled. I'm sad actually. I'm sad that they would spend the money on me to graduate, shake hands with the mayor and the chief of the fire department and then fire me," said Staton.
"It was definitely a wakeup call because by no means have I ever considered myself a failure. I still don't. It was just one of those things. It was an unfortunate event and I did the best I could," said Evan Pace who was also terminated.
Both Pace and Staton say they studied extensively on their own, but that the department offered no instruction.
"There were questions about bears and what would we do if someone got attacked by one," said Pace.
You have like 30 guys sitting in one class with no instructor, said Ronnie Williams.
Even some veteran firefighters are having trouble. Williams fought fires for six years, but has now been on the bench for 11 months. He failed the test multiple times, he says because of his dyslexia. Williams is still on the city payroll.
"I haven't done nothing on a fire truck. And that's what I wanted to do to serve my city," said Williams.
When asked what he did for work everyday, Williams responded "Just go down there, sit in the classroom, get on the computer, do some test-taking online and try to find some ways to pass this national registry," he said.
"It is not true that the recruits have sat in a classroom without an instructor. There are independent study times," said Dr. James Augustine, acting medical director with D.C. Fire & EMS.
The department says there is training as well as mentoring programs for those who need extra help, both of which are disputed by six firefighters that were interviewed.
"You have to take a look at yourself in the mirror and say did I do everything that I could do to pass this test? Did I study on my own? Did I ask for help?," said Kenneth Crosswhite, deputy fire chief.
After our interview the department said it now plans to bring Staton and Pace back for three more attempts at passing the exam.
And this time, officials say they'll make sure the new recruits have every opportunity to prepare.
http://www.wjla.com/news/stories/1208/576376.html
Click here to see the related video:
http://www.wjla.com/news/stories/1208/576376_video.html?ref=newsstory
A plan to raise standards in the D.C. fire department is stirring up a controversy.
Some firefighters are losing their jobs because they can't pass a tough new exam for emergency medical technicians.
The new exam is part of an agreement with the family of murdered New York Times reporter David Rosenbaum. Now the department is agreeing to give recruits more chances to pass the test just to keep their jobs.
Graduation day was a proud moment for JaQuante' Staton. Born and raised in D.C., he always dreamed of becoming a firefighter. After six months of training, he made it.
"You have to understand, my whole family was there at graduation. They were proud of me, they were cheering for me. To have it stripped away just a couple of months later, it's not fair," said Staton.
Staton's dream was shattered when he was among the 28 percent of firefighters who failed to pass a new national registry exam for EMTs, put in place after graduation. Staton had already passed state standards.
"I'm not disgruntled. I'm sad actually. I'm sad that they would spend the money on me to graduate, shake hands with the mayor and the chief of the fire department and then fire me," said Staton.
"It was definitely a wakeup call because by no means have I ever considered myself a failure. I still don't. It was just one of those things. It was an unfortunate event and I did the best I could," said Evan Pace who was also terminated.
Both Pace and Staton say they studied extensively on their own, but that the department offered no instruction.
"There were questions about bears and what would we do if someone got attacked by one," said Pace.
You have like 30 guys sitting in one class with no instructor, said Ronnie Williams.
Even some veteran firefighters are having trouble. Williams fought fires for six years, but has now been on the bench for 11 months. He failed the test multiple times, he says because of his dyslexia. Williams is still on the city payroll.
"I haven't done nothing on a fire truck. And that's what I wanted to do to serve my city," said Williams.
When asked what he did for work everyday, Williams responded "Just go down there, sit in the classroom, get on the computer, do some test-taking online and try to find some ways to pass this national registry," he said.
"It is not true that the recruits have sat in a classroom without an instructor. There are independent study times," said Dr. James Augustine, acting medical director with D.C. Fire & EMS.
The department says there is training as well as mentoring programs for those who need extra help, both of which are disputed by six firefighters that were interviewed.
"You have to take a look at yourself in the mirror and say did I do everything that I could do to pass this test? Did I study on my own? Did I ask for help?," said Kenneth Crosswhite, deputy fire chief.
After our interview the department said it now plans to bring Staton and Pace back for three more attempts at passing the exam.
And this time, officials say they'll make sure the new recruits have every opportunity to prepare.
http://www.wjla.com/news/stories/1208/576376.html
Monday, December 8, 2008
Ambulance crash baby 'critical'
A four-week-old baby boy who was on board an ambulance which overturned on a motorway remains in a critical condition in hospital. The "seriously ill" child was being moved from Preston to Leeds for treatment when the crash happened on Sunday morning. The ambulance is thought to have hit a patch of ice at the junction of the M62 and M621 at Gildersome. Police said two other crashes were reported in the same area. A doctor and nurse were travelling in the ambulance along with a paramedic crew when the vehicle turned onto its side and skidded along the motorway. The crew were said to be shocked but there were no other injuries. The parents of the child, who was described as being in a serious condition prior to the accident, were travelling separately. Another ambulance took the baby to Leeds General Infirmary where police described his condition as "critical but stable". A West Yorkshire Police spokesman added: "It is believed ice on the roadway was a primary contributory factor." He confirmed that when the ambulance crashed police were already driving to the scene to attend other accidents which had occurred around the same stretch of road. A Toyota Corrolla and VW Passat collided nearby and shortly afterwards a Nissan Micra hit the central barrier. | |
Thursday, December 4, 2008
City Pushes Cooling Therapy for Cardiac Arrest
By ANEMONA HARTOCOLLISStarting on Jan. 1, New York City ambulances will take many cardiac arrest patients only to hospitals that use a delicate cooling therapy believed to reduce the chances of brain damage and increase the chances of survival, even if it means bypassing closer emergency rooms.
The move by the city’s Fire Department and Emergency Medical Service, after a year of preparation, indicates a shift away from the prevailing view among emergency workers and the public that how fast critically ill patients reach the hospital is more important than which hospital treats them.
It amounts to an endorsement by the Bloomberg administration of a labor-intensive, often expensive and still-developing therapy that smaller community hospitals say they lack the staffing and financial wherewithal to provide.
Some hospital officials fear that the policy could be unfair to these smaller hospitals, depriving them of income from emergency-room patients and hurting their reputations with the public.
Since the Fire Department sent letters to hospital chief executives this week informing them of the impending change, about 20 of the 59 hospitals with emergency rooms have said they will have cooling operations ready by the Jan. 1 deadline.
Dr. David J. Prezant, chief medical officer of the New York Fire Department, acknowledged the culture change and the possibility that some hospitals would feel slighted. But he argued that scientific data shows the survival rate of cardiac arrest patients treated with therapeutic hypothermia, as the cooling process is called, is so much better than with conventional treatment that it would be irresponsible not to provide it.
“Theoretically every closest 911-receiving hospital will be able to provide this service,” he noted. “Whether that will be a reality or not is not for me to say.”
New York joins a handful of other American cities, including Seattle, Boston and Miami, as well as Vienna and London, in requiring transport to hospitals with cooling systems. But given New York’s large population and concentration of hospitals, the policy may provide the largest test to date of therapeutic hypothermia.
Most patients who suffer total cardiac arrest outside hospitals die because their brains have been starved of oxygen. But studies show that if the pulse of patients can be restarted and the body temperature cooled to about 8 degrees Fahrenheit below normal, brain damage can be reduced or minimized.
Only those cardiac arrest patients revived enough to show a pulse and whose heart problems are not associated with some other trauma are eligible for the cooling treatment, Dr. Prezant said. In New York City, that represents 1,500 to 2,000 of the about 7,500 out-of-hospital cardiac arrest cases reported each year.
Dr. Prezant said that in deference to hospital finances, the city has set no requirements for the kind of cooling techniques hospitals must use — some may start with inexpensive saline solutions and plastic bags filled with ice, while others employ sophisticated equipment manufactured and aggressively promoted by companies like Alsius, Innercool Therapies and Medivance.
The American Heart Association endorsed cooling for some types of cardiac arrest patients after two studies on its effectiveness were published in The New England Journal of Medicine in 2002. One study found that 55 percent of the patients who received the cooling treatment ended up with moderate or no brain damage, compared with 39 percent who received standard treatment. About 41 percent of the cooled patients died within six months, compared with 55 percent of the others.
But hospitals have been slow to adopt the treatment because it requires a precision of temperature regulation that is difficult to achieve, constant vigilance and cooperation among nursing, emergency, cardiac and neurological units.
The research has shown that cooling is effective for cardiac arrest from ventricular fibrillation, in which the heart muscle wriggles ineffectively.
If a pulse can be restarted quickly enough — within a matter of minutes — with a defibrillator, such patients can walk away relatively unscathed. But if not, they become comatose and suffer a cascading series of cellular-level injuries to the brain, which frequently lead to permanent brain damage or death.
Inducing moderate cooling of the body within 6 hours, for 24 hours, followed by gradual warming, slows cerebral metabolism and seems to reduce such injuries, studies have shown. (The technique’s effectiveness on other medical problems, including traumatic brain injury, is more controversial.)
Dr. Stephan Mayer, chief of the neurological intensive care unit at NewYork-Presbyterian/Columbia hospital in Manhattan, spearheaded New York’s effort by bringing the idea to a critical-care committee of the Greater New York Hospital Association and United Hospital Fund a year ago. Soon after, the committee held a symposium on hypothermia, where Dr. Mayer continued to advocate for the therapy, and the ambulance protocol developed from there.
“It was a very slow process in terms of really getting it to take hold,” Dr. Mayer said of the cooling treatment. “One reason is that cardiac arrest patients have just been surrounded by this shroud of therapeutic nihilism. They come in after cardiac arrest, they’re intubated, in a coma, everybody’s reflex thought process in terms of caregivers is ‘Oh God, there’s nothing you can do for these people.’ ”
Dr. Mayer has served as a consultant for Medivance, and holds stock options in the company, which stands to benefit from the shift. He said in an interview that he has “worked directly or indirectly with cooling technology startup companies since 1998” and helped design “the next generation of equipment” for Medivance, earning about $10,000 from the company.
He said that his main motivation was not financial but experiential, and that he had been converted by seeing patients who were comatose and given up for dead recover full or near-full function after hypothermia.
Under the New York protocol, patients would be eligible for cooling if they suffered cardiac arrest and regained a pulse within 30 minutes of the start of resuscitation but remained neurologically compromised. Hospitals without the ability to cool patients would be bypassed if one that did was within a 20-minute drive. Dr. Prezant said his goal is, within six months, to begin the cooling process in the ambulance, accelerating treatment.
NewYork-Presbyterian has been a leader in hypothermia in New York, but a number of other major hospitals in the city — including Mount Sinai, Bellevue Hospital Center and St. Vincent’s Hospital Manhattan, Elmhurst Hospital Center in Queens, Maimonides Medical Center in Brooklyn and Staten Island University Hospital — also practice cooling, and others are developing plans to start. Dr. Prezant said enough hospitals in each borough had indicated interest in cooling to keep transport time to an average of 10 minutes. “If people knew about it, of course they’d want it,” Dr. Mayer said.
One recent success story is Dr. Syed Hasan Naqvi, 56, who had just finished jogging on the treadmill in his Long Island home on Oct. 18 when his daughter heard a thud and found him on the floor in cardiac arrest. An ambulance took him to Nassau University Medical Center, where he was revived, but he remained comatose and breathing on a ventilator.
Unable to accept that there was nothing else to be done, Dr. Naqvi’s wife, Nina, contacted a neurologist at the hospital who knew Dr. Naqvi, a consulting neurologist at North Shore University Hospital. The neurologist at Nassau had recently heard Dr. Mayer describe the cooling treatment, unavailable at Nassau, and so he called him and then urged Mrs. Naqvi to get her husband to NewYork-Presbyterian.
Since more than five hours had elapsed since the cardiac arrest — the optimal time for cooling was running out — Dr. Mayer suggested putting ice packs on Dr. Naqvi during the hourlong trip to Manhattan. When he got there, Dr. Mayer said, Dr. Naqvi’s score on the Glasgow coma scale was a 4, near bottom on a scale of 3 to 15, and he had a high chance of remaining in a vegetative coma permanently.
“The brain waves were very flat,” Dr. Mayer said. “But we decided to give it a try.”
Dr. Naqvi was cooled for 24 hours, and woke up five days later, though he was confused and had memory lapses. Now, six weeks later, he is back to seeing patients two days a week, and said in an interview that he remains physically weak but has regained all of his mental function.
“The hospital does make a difference,” Nina Naqvi said. “The knowledge of the doctors does make a difference.”
Man Dies at Home After Paramedics Diagnose Acid Reflux
By Elissa Silverman - Washington Post Staff Writer
A 39-year-old Northeast Washington man died yesterday, a few hours after paramedics responding to his complaints of chest pains and trouble breathing told him he had acid reflux and did not take him to a hospital, family members said.
D.C. fire officials are investigating the circumstances surrounding the death of Edward L. Givens, who was found by family members just before 6 a.m. in his home in the 700 block of Division Avenue. Paramedics told Givens late Tuesday that he had acid reflux, instructed him to take Pepto-Bismol and left, family members said.
"I don't understand the paramedics, why, when he said he was in chest discomfort, he wasn't taken to the hospital," said Lolitha Givens, the man's mother, who lives in the home and was there when 911 was called Tuesday night. "I'm just baffled by that."
Paramedics are required by department protocol to transport by ambulance a patient who asks to go to a hospital, said Alan Etter, a spokesman for D.C. Fire and Emergency Medical Services.
Officials said the D.C. medical examiner will conduct an autopsy to determine a cause of death.
The department has launched an investigation into the call, Etter said. He said that the department will interview all personnel who responded and that top officials are involved in the review, including Fire Chief Dennis L. Rubin and Assistant Fire Chief Lawrence Schultz.
"As per protocol, we are conducting a thorough quality assurance case review, and we will determine whether proper care was provided and if the two medical events are related," Rubin said in a written statement.
Lolitha Givens said her son was in the living room Tuesday night when he yelled out to family members to call 911. He was on his back on the floor and said he had chest pains and was having trouble breathing.
A firetruck and ambulance from Engine 30 were dispatched to the house at 11:40 p.m., Etter said. The truck, staffed by three firefighters trained in emergency medicine and a firefighter-paramedic, arrived first.
Lolitha Givens said the firefighters asked her son what was wrong, and the emergency medical technicians who arrived by ambulance checked his vital signs and performed an electrocardiogram, the results of which they said were normal.
The EMTs asked Givens whether he had eaten or had anything to drink that evening, and he said he had eaten a burger, Givens said. They told him and his mother that he probably was suffering from acid reflux and suggested he take antacid.
"Six hours later, my son was on the floor, dead," Lolitha Givens said.
After the family member found Edward Givens, who was not breathing, yesterday morning, another 911 call was made.
Improving the city's emergency medical services has been a stated priority for Mayor Adrian M. Fenty (D) and Rubin since the death of David Rosenbaum in January 2006. Rosenbaum, a former New York Times journalist who lived in upper Northwest, was beaten in a street robbery, but emergency workers assessed him as a drunk and considered him a low-priority patient. He died two days later at Howard University Hospital.
A task force chaired by Rubin suggested numerous reforms, which Rubin said are being implemented.
Givens was a father of two teenagers and worked as a counselor at a group home for youths who had been victims of domestic violence, his mother said.
He was a graduate of Eastern High School and Wilberforce University in Ohio, where he majored in business administration.
He coached Little League baseball and youth football and worked with a basketball team in the Barry Farm neighborhood.
"Sports was his love," Lolitha Givens said.
A 39-year-old Northeast Washington man died yesterday, a few hours after paramedics responding to his complaints of chest pains and trouble breathing told him he had acid reflux and did not take him to a hospital, family members said.
D.C. fire officials are investigating the circumstances surrounding the death of Edward L. Givens, who was found by family members just before 6 a.m. in his home in the 700 block of Division Avenue. Paramedics told Givens late Tuesday that he had acid reflux, instructed him to take Pepto-Bismol and left, family members said.
"I don't understand the paramedics, why, when he said he was in chest discomfort, he wasn't taken to the hospital," said Lolitha Givens, the man's mother, who lives in the home and was there when 911 was called Tuesday night. "I'm just baffled by that."
Paramedics are required by department protocol to transport by ambulance a patient who asks to go to a hospital, said Alan Etter, a spokesman for D.C. Fire and Emergency Medical Services.
Officials said the D.C. medical examiner will conduct an autopsy to determine a cause of death.
The department has launched an investigation into the call, Etter said. He said that the department will interview all personnel who responded and that top officials are involved in the review, including Fire Chief Dennis L. Rubin and Assistant Fire Chief Lawrence Schultz.
"As per protocol, we are conducting a thorough quality assurance case review, and we will determine whether proper care was provided and if the two medical events are related," Rubin said in a written statement.
Lolitha Givens said her son was in the living room Tuesday night when he yelled out to family members to call 911. He was on his back on the floor and said he had chest pains and was having trouble breathing.
A firetruck and ambulance from Engine 30 were dispatched to the house at 11:40 p.m., Etter said. The truck, staffed by three firefighters trained in emergency medicine and a firefighter-paramedic, arrived first.
Lolitha Givens said the firefighters asked her son what was wrong, and the emergency medical technicians who arrived by ambulance checked his vital signs and performed an electrocardiogram, the results of which they said were normal.
The EMTs asked Givens whether he had eaten or had anything to drink that evening, and he said he had eaten a burger, Givens said. They told him and his mother that he probably was suffering from acid reflux and suggested he take antacid.
"Six hours later, my son was on the floor, dead," Lolitha Givens said.
After the family member found Edward Givens, who was not breathing, yesterday morning, another 911 call was made.
Improving the city's emergency medical services has been a stated priority for Mayor Adrian M. Fenty (D) and Rubin since the death of David Rosenbaum in January 2006. Rosenbaum, a former New York Times journalist who lived in upper Northwest, was beaten in a street robbery, but emergency workers assessed him as a drunk and considered him a low-priority patient. He died two days later at Howard University Hospital.
A task force chaired by Rubin suggested numerous reforms, which Rubin said are being implemented.
Givens was a father of two teenagers and worked as a counselor at a group home for youths who had been victims of domestic violence, his mother said.
He was a graduate of Eastern High School and Wilberforce University in Ohio, where he majored in business administration.
He coached Little League baseball and youth football and worked with a basketball team in the Barry Farm neighborhood.
"Sports was his love," Lolitha Givens said.
Firehouse brawl case ends quietly with $3.75M settlement
By JEFF HARRELL - STATEN ISLAND ADVANCE
Assault with chair 5 years ago sparked lawsuit, FDNY shakeup
STATEN ISLAND, N.Y. -- The firefighter had demanded $100 million from the
city as the price for what he branded a toxic firehouse culture that led to
his being slammed in the face with a metal chair.
Yesterday, Robert Walsh, formerly of Annadale, settled for $3.75 million.
Walsh had testified that the New Year's Eve 2003 assault by Firefighter
Michael Silvestri was the culmination of nearly two years of anti-gay slurs.
"We are pleased that the matter has been resolved amicably," said city
spokeswoman Kate Ahlers, who declined further comment "out of respect for
the parties."
Walsh, 45, could not be reached for comment.
His attorney, Jonathan C. Reiter, did not return phone messages left at his Manhattan office last night. Co-counsel Glenn Herman confirmed the settlement but declined to discuss specifics of the agreement.
After Silvestri pleaded guilty to criminal charges and ent to prison for a year, Walsh sued the city and Silvestri for $100 million over the "permanent injuries" he said he suffered when his colleague assaulted him at Tottenville's Engine Co. 151/Ladder Co. 76 firehouse on Dec. 31, 2003.
The suit proceeded in Manhattan federal court in front of U.S. District Judge Robert W. Sweet. Attorneys had been scheduled to begin summations this morning following the two-week-long civil trial, in which a jury heard doctors testify through videotaped depositions that Walsh suffered eye, jaw and skull fractures and severe back injuries, which ended his FDNY career of seven years. Neurologist Dr. Melanie B. Shulman also said Walsh sustained "post-concussive syndrome" that resulted in "moderate to sev epression" and "moderate anxiety," as well as post-traumatic migraine headaches and memory loss as a result of the attack.
The hulking Walsh -- who stands 6 feet, 7 inches tall and now weighs close to 350 pounds -- took the stand last week with the aid of a cane and told jurors that firehouse supervisors, including former Caeeney, laughed off the verbal abuse he suffered. Walsh admitted on the stand he took Silvestri's slurs part of the day-to-day banter among firefighters. Sweeney and others tried to cover up the incident by telling doctors at Staten Island University Hospital, Ocean Breeze, that Walsh was hurt in a fall on the stairs. The lie cost Sweeney his FDNY career.
Reiter maintained the city was responsible for the injuries that cut Walsh's FDNY career short of a fully vested pension, since Silecity were locked in an "employer-employee relationship" at the time. City assistant corporation counsel Sosimo Fabian argued that the city had "no notice of Silvestri's propensity for violence," since Silvestri had no prior disciplinary record.
The attack was triggered by a bet between Walsh and another firefighter over Elvis Presley's birth date. When Walsh lost the bet, Silvestri chided Walsh with a string of slurs that were met with a biting comeback. Silvestri first threatened to hit Walsh with a metal chair, then he slammed the firefighter in the head from behind.
In March, Sweet ruled against the city, saying Sweeney failed to exercise reasonable care to control a subordinate. But the federal judge dismissed Walsh's other claims of negligence and
violations of the General Municipal Law against the city.
Assault with chair 5 years ago sparked lawsuit, FDNY shakeup
STATEN ISLAND, N.Y. -- The firefighter had demanded $100 million from the
city as the price for what he branded a toxic firehouse culture that led to
his being slammed in the face with a metal chair.
Yesterday, Robert Walsh, formerly of Annadale, settled for $3.75 million.
Walsh had testified that the New Year's Eve 2003 assault by Firefighter
Michael Silvestri was the culmination of nearly two years of anti-gay slurs.
"We are pleased that the matter has been resolved amicably," said city
spokeswoman Kate Ahlers, who declined further comment "out of respect for
the parties."
Walsh, 45, could not be reached for comment.
His attorney, Jonathan C. Reiter, did not return phone messages left at his Manhattan office last night. Co-counsel Glenn Herman confirmed the settlement but declined to discuss specifics of the agreement.
After Silvestri pleaded guilty to criminal charges and ent to prison for a year, Walsh sued the city and Silvestri for $100 million over the "permanent injuries" he said he suffered when his colleague assaulted him at Tottenville's Engine Co. 151/Ladder Co. 76 firehouse on Dec. 31, 2003.
The suit proceeded in Manhattan federal court in front of U.S. District Judge Robert W. Sweet. Attorneys had been scheduled to begin summations this morning following the two-week-long civil trial, in which a jury heard doctors testify through videotaped depositions that Walsh suffered eye, jaw and skull fractures and severe back injuries, which ended his FDNY career of seven years. Neurologist Dr. Melanie B. Shulman also said Walsh sustained "post-concussive syndrome" that resulted in "moderate to sev epression" and "moderate anxiety," as well as post-traumatic migraine headaches and memory loss as a result of the attack.
The hulking Walsh -- who stands 6 feet, 7 inches tall and now weighs close to 350 pounds -- took the stand last week with the aid of a cane and told jurors that firehouse supervisors, including former Caeeney, laughed off the verbal abuse he suffered. Walsh admitted on the stand he took Silvestri's slurs part of the day-to-day banter among firefighters. Sweeney and others tried to cover up the incident by telling doctors at Staten Island University Hospital, Ocean Breeze, that Walsh was hurt in a fall on the stairs. The lie cost Sweeney his FDNY career.
Reiter maintained the city was responsible for the injuries that cut Walsh's FDNY career short of a fully vested pension, since Silecity were locked in an "employer-employee relationship" at the time. City assistant corporation counsel Sosimo Fabian argued that the city had "no notice of Silvestri's propensity for violence," since Silvestri had no prior disciplinary record.
The attack was triggered by a bet between Walsh and another firefighter over Elvis Presley's birth date. When Walsh lost the bet, Silvestri chided Walsh with a string of slurs that were met with a biting comeback. Silvestri first threatened to hit Walsh with a metal chair, then he slammed the firefighter in the head from behind.
In March, Sweet ruled against the city, saying Sweeney failed to exercise reasonable care to control a subordinate. But the federal judge dismissed Walsh's other claims of negligence and
violations of the General Municipal Law against the city.
Subscribe to:
Posts (Atom)
Posts
