Paramedics Speak Out Against Reorganization


More than a dozen paramedics, nurses and firefighters testified Wednesday against a reorganization plan, telling a Los Angeles County commission that the change would jeopardize patient care.

But Los Angeles Fire Chief William Bamattre, the architect of the proposal, told members of the Emergency Medical Services Commission that the plan would trim at least two minutes off the average response time in the San Fernando Valley.

Bamattre was seeking the commission's approval of a one-year trial program in the Valley--to be expanded citywide if successful--that would eliminate the two-paramedic ambulance teams that now respond to the most serious medical emergencies.

Instead, advanced life support ambulances would be staffed with one paramedic and an emergency medical technician, who receives one-tenth the medical training of a paramedic.

Under the Fire Department's plan, a second paramedic traveling on a firetruck would join the first paramedic to respond, a so-called one-plus-one system.

Valley response times now average eight minutes and four seconds, the longest wait citywide, Bamattre said.

The chief promised that under the proposed system, the second paramedic would arrive at the scene within eight minutes and pledged to halt the trial program if target response times were not met.

The proposal also would spare the department from forcing firefighter / paramedics to work grueling shifts on busy ambulances at a time when many dual-trained firefighters prefer working on fire companies.

But after listening to a parade of speakers opposed to the plan, many of them off-duty paramedics, the commission put off a decision until March and asked fire officials to produce a computer analysis projecting the impact of the changes before putting the system to a life-or-death test on the city's hurt and sick residents.

"So many of [the paramedics] keep coming here and saying, 'This is bad, this is bad, this is bad,' " said one commissioner, Dr. Vidya S. Kaushik, a cardiologist at Martin Luther King Jr./Drew Medical Center. "This may be a great idea, but if the guys who will execute it are against it, how is it going to come out with good results? I'm very, very, very disturbed by this."

More than 100 people crowded into a meeting room at the Hospital of the Good Samaritan for the hearing, most of them opposed to the plan. The firefighters' union and two professional groups representing firefighters and paramedics strongly object to the change, as does the county Assn. of Prehospital Care Coordinators, a group representing hospitals that oversees paramedic care in the field.

Several paramedics warned that losing their paramedic partners, a critical "second pair of eyes" in life-or-death emergencies, would lead to fatigue and errors. Already, they said, city paramedics must work 140% of their regular shifts to fill vacancies on ambulances.

"In my personal experience in the field, I need my partner," said paramedic Wendy Cummings. "I am an excellent paramedic, but I need to bounce my ideas off [my partner] and my partner's ideas need to be bounced off me. Working with a different person every day, on every call, there are too many variables."

Several residents of Bel-Air and other hillside neighborhoods with long response times also lined up against the plan.

Harold Tennen, vice president of the Glenridge Homeowners Assn., said poor department planning had led to a paramedic shortage and compared the plan to watering down a meal to feed more hungry mouths.

"You're forced to water down the soup and then you proudly tell your guests it's a special light soup recipe," he told the commission.

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