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All D.C. Paramedics to be Tested for ALS Competency

WASHINGTON D.C.-- The D.C. fire department next month will test all of its 250 paramedics for competency in administering advanced life support, the agency's medical director said.

The testing, which will be performed independently by the Maryland Fire and Rescue Institute, is expected to lead to retraining of some paramedics while some others could be reassigned to positions with fewer responsibilities, said Dr. Michael D. Williams, chief medical officer for the fire department.

"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."

"I've really got to make sure that we don't let somebody out there that isn't functioning at that level."

Details of the testing plan come days after the family of journalist David E. Rosenbaum dropped a lawsuit against the city, saying they were satisfied with the District's progress in reforming its emergency medical services.

Mr. Rosenbaum was beaten and robbed in his neighborhood in January 2006 and died two days later. An investigation found that a neglectful, botched emergency response contributed to Mr. Rosenbaum's death.

A task force set up to examine ways to improve the city's Fire and Emergency Medical Services department as part of the lawsuit recommended, among other things, improving training and oversight.

Testing all of the agency's paramedics, however, was not among the recommendations.

"To our knowledge, no one's done this kind of a scope before," Dr. Williams said. He said he and Fire Chief Dennis L. Rubin came up with the plan.

He also said he thought it was important to contract the testing to an outside agency, so that the results would be "above reproach."

"They're just giving me data. And it's got nothing to do with past loyalties, past practices. It's a contract," he said.

Dr. Williams, who has served as the department's medical director since August 2006, said the results of the tests will show whether the department needs to make broad changes to its curriculum or take individual workers out of the system to correct specific deficiencies.

The testing will comprise a written exam and a practical skills test performed on a computerized mannequin. The mannequin will monitor each interaction the test subject has with it, and the test will be videotaped by four cameras to be reviewed later by Dr. Williams.

"Any really deficient folks who should be pulled, we'd like to find them on a mannequin as opposed to from a quality assurance investigation," Dr. Williams said.

Paramedics with minor deficiencies will receive remedial training until they are able to demonstrate proficiency, Dr. Williams said. Those who do not improve with training will be reassigned as an emergency medical technician, which is less complex than paramedic work.

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