Little Style and No Substance
CONTACT: Kenneth Lyons, President AFGE Local 3721 president@local3721.org
Having watched closely the progression of the Rosenbaum incident from within the DC Fire Department, I was resigned to be silent as the process proceeded. Even during the 15 months that it required for a trial board (comprised of career firefighters and not one medical professional that could be regarded as objective) to render a decision resulting in anything from a slap on the wrist to termination only have the final outcome be determined by an assistant chief, I maintained my silence. So as to the disciplinary process itself I will not comment and allow those involved the benefit of due process.
However, I cannot remain silent as the President of the IAFF Local 36 Firefighters union, Daniel Dugan a career firefighter and not a medical professional, attempts to articulate his opinion as if it were fact, all the while intimating that it was the fault of the hospital, the Inspector General, the media and even Mr. Rosenbaum for choosing to take a stroll on a crisp evening in January 6, 2006. But we all know what they say about opinions, so I will not give mine, just the facts.
Firefighter Dugan, President of the firefighters union makes the point that, “In truth, there was no bleeding or other observable signs of trauma.” This, according to Firefighter Dugan was the reason that the trial board, comprised of firefighters, rendered a decision that would later be endorsed by the Assistant Fire Chief of Operations, himself a career firefighter.
What Firefighter Dugan, President of the career firefighters union fails to mention was that the call was dispatched as a “Man Down”, and according to emergency medical technician training, a patient found on the ground is to be regarded as a trauma patient until proven otherwise. If career firefighter and local 36 President Dugan would take the time to review the District of Columbia State Medical Protocols, particularly Section A of the General Patient Guidelines under Trauma Patient Assessment, he would know that the treatment of a patient found on the ground, especially with altered mental status, is very specific, whether the injury is obvious or not. However Lieutenant Dugan concludes, “Without any visible injuries to Mr. Rosenbaum, the firefighters reasonably concluded that his condition was attributable to alcohol consumption.” Which brings me to my second medical fact.
In 20 years as a Paramedic I have attended to many patients that have appeared to be intoxicated, and even possessed the smell of alcohol on their breath. According to Firefighter Dugan’s version patient assessment, one should logically conclude that such a patient would deserve nothing more than a ride to the hospital without further assessment or concern. However, what we do know from eyewitness accounts and the patient care report as detailed in the media, was that Mr. Rosenbaum was exhibiting increasing altered mental status accompanied with repeated episodes of vomiting. Let’s stop here for a second: remember that smell of alcohol found on the patient, on the ground, experiencing altered mental status (GCS-3). Those of us who regard ourselves as medical professionals have a saying, “Altered mental status in an elderly patient is head or heart until proven otherwise.”
The District of Columbia State Medical Protocols, under the heading of, Adult Medical Emergencies: Altered Mental Status [Non-traumatic] again has specific guidelines for the treatment of such patients. Among other treatment and assessment requirements is a test to be performed on patients presenting in this manner: blood glucose check. This is a simple 30 second test to determine the value of the blood sugar of the patient. Why you may ask? Because, even assuming, as Firefighter/President Dugan suggests, that there was no blood or obvious injury, you had an elderly patient with altered mental status. Alcohol would be the ABSOLUTELY LAST THING to be considered the cause of the patient’s condition, even if the smell was present, (Diabetic Ketoacidosis anyone).
Firefighter Dan Dugan, President of the IAFF Local 36 firefighters union espouses medical opinion as if he were a medical expert and not primarily a firefighter. However if Dan Dugan feels so strongly on this issue, on June 18th, 2007 there will be an EMS Task-force meeting where the Mayor, City Administrator, Attorney General, representatives from the Rosenbaum family and members of the community will be in attendance. It is here where Firefighter Dugan can articulate to these individuals why “this culture of indifference” is regarded as “…an offense, not only to these two men but to all firefighters”, but not an offense to the Rosenbaum family and to the community at large who are tired of these excuses.
Kenneth Lyons, President
AFGE Local 3721