An account of how a large Catholic medical center has lost its way. Go to pmmdaily.blogspot.com to see recent updates.

Friday, March 03, 2006

Questions for George, Rick, and Andrew

Questions for George Hevesy, Rick Miller, and Andrew Rand:

1. Dr. Miller, when you made your policy change during the summer of 2005, did it have anything to do with the man’s death at the restaurant? Why won’t you allow the PFD paramedics to put tubes in people who need them to breathe or protect their airways without AMT having to ask the PFD to perform this service? “A” stands for AIRWAY in the A,B,C’s of resuscitation. What happens if the PFD is at the scene first, which is not uncommon, and AMT is not there to ask the PFD to insert the tube? Why won’t you let the PFD carry the tubes on their rigs in the first place?

2. Are you all against the PFD advancing their status to paramedic? If so, why? What about an Intermediate level of service for the PFD? This only takes about 400 hours of training (instead of 1200 hours for paramedic training) and, Mr Rand, you even stated in the Journal Star in 2002, you would help the PFD advance to Intermediate service if the PFD would not go into the transport business. You suggested that Intermediate service would be more "comprehensive" than the basic service they give now. Why didn’t you help them advance to Intermediate service which could help save lives in Peoria? Because you didn’t get the 10 year contract that you wanted? Dr. Miller, could you have pulled some strings at the “resource hospital”, OSF, to get a good price on training some firemen to the Intermediate level? (OSF and AMT control the majority of the emergency medical technician education in Peoria as well.) Dr. Miller, where are your memos that the PFD should at least advance to the Intermediate level so that they could perform a more comprehensive service? Are you aware of the optional model offered by the Department of Transportation that would allow Basic providers to learn advanced airway techniques like the endotracheal tube and laryngeal mask airway? Some municipal fire departments around the state take advantage of this, why not Peoria? Where are your directives requesting that the PFD become more versed in securing the airway?

3. Dr. Hevesy, where are your memos from all your years as director of the ambulances in the Peoria area that the PFD should be giving basic drugs? Why did you not insist that the PFD give aspirin at the scene to people with chest pain, albuterol spray to people suffering from asthma and emphysema, and adrenalin to people having severe allergic reactions? You let AMT do it. Why not the PFD? Also, where are your memos that the PFD should be shocking people in with ventricular fibrillation? All basic units should have been doing this since at least the early 90’s. AMT was saving Peorians’ lives with this technique. You obviously knew this. Were you an advocate for the PFD using defibrillators and where is the proof? Please don’t say it would be “duplication of services” again because the oxygen starved brain does not care about this concept.

4. Dr. Miller, are you aware that some nursing homes in the area call AMT directly when there is an emergency in the nursing home and that they don’t call 911 first? Does this seem sound to you? What if AMT is tied up on another call and the firefighters get a late call for the geriatric patient and then they arrive late also. Remember, Rick, you won’t let the PFD perform advanced life support for the old person, so what is going to happen some of the time? Do you think the families of these people know that 911 is NOT being called for their mother when they moved her there? I have heard that AMT paramedics will call the PFD for help in situations like this when AMT can’t get there in a reasonable amount of time. This doesn’t sound good, does it?

5. Rick, Andrew, and George, how would the Peoria Area EMS system work in light of a mass casualty? Glad we don’t live on the gulf coast with you guys running the show. A bad tornado in Peoria could be devastating. The PFD could respond but not offer advanced support or transport the patients. Sounds bad, guys.

6. Andrew, is AMT paying Dr. Miller for his services as project medical director? You have been paying Dr. Hevesy for years, right?

7. Do any of you believe the statement of conflict of interest submitted to the Illinois Department of Public Health that states there is not even the “potential” for conflict of interest with Hevesy collecting a salary from AMT.? Who wrote that statement and gave that statement to IDPH from the Peoria Area EMS? Was OSF involved with this statement?

8. When I have spoken to different experts around the United States about emergency medical services in Peoria, they all laugh or grimace when they realize that Hevesy has been on the payroll at AMT and the PFD languishes in its basic non transport role. Why the reaction? (The new president of the American College of Emergency Physicians, Dr. Blum, was definitely chagrined with the news when I spoke to him in West Virginia.)

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