News

Fla. County Won`t allow Firefighters to Practice Advanced Life Support

Greg Stanley

09/09/2015

Sept. 08--A long-simmering fight over emergency response in Collier County reignited Tuesday as commissioners rejected a bid to let firefighters of the newly formed North Collier fire district provide advanced life support in their coverage area.

Commissioners Tim Nance, Penny Taylor and Tom Henning voted against the proposal, saying it would fragment care. Their opposition came despite recommendations of their own ambulance and emergency response officials to allow it and over the objections of more than a dozen firefighters and fire chiefs who crowded government chambers to speak in favor of it.

"Why would we spend all this time and effort to consolidate our fire districts and then turn around and unconsolidate (Emergency Medical Services)," Nance said. "That's like catching fish on one side of the boat and throwing it over the other side."

The move stunned fire officials.

It guarantees that residents in the North Collier fire district, which covers nearly half of the county's population and was created by the merger of the old North Naples and Big Corkscrew Island districts, will have disjointed and uneven service depending on where they live, said North Collier Fire Chief Orly Stolts.

Treatment called advanced life support (ALS) includes injecting lifesaving drugs, regulating airflow and starting an IV. Without permission from the county, firefighters who are trained paramedics cannot start those treatments until an ambulance arrives.

North Collier firefighters can use advanced life support in the former North Naples boundaries. They can't inside what used to be Big Corkscrew Island.

"This is so political it's unbelievable," Stolts said. "Three of these commissioners were up there asking questions that showed they have no idea what they were talking about."

Commissioner Georgia Hiller, who voted with Donna Fiala to allow firefighters to use the practice, called the commission's vote "fundamentally and morally wrong."

"This is about saving lives," Hiller said. "It's about the guy who is about to die of cardiac arrest. It is absolutely false to say that too much staff results in a dilution of skills. We have such a quality staff in North Collier."

North Collier has 10 trained paramedics who would have been able to start practicing advanced support. The district would have been able to put a paramedic on four response vehicles a day, Stolts said.

The county keeps one ambulance in the Big Corkscrew area, a 200 square mile stretch with a population of about 25,000. It provides one paramedic to sit on a North Collier fire engine, so those residents are served by two vehicles that have a paramedic that can start an IV on a patient, Stolts said.

"To compare, the city of Naples is 18 square miles with a population of 22,000 and has eight ALS response vehicles," he said. "That's how crazy this is. We have paramedics who can't operate in our own district. This is outrageous."

The fight has been going on for years.

The only ambulances allowed in Collier County are those run by the county's emergency medical services department. And for years, the only paramedics allowed to practice advanced life support before an ambulance arrived on scene were those employed by emergency medical services.

Five years ago, after decades of contention, debate and failed compromises, commissioners allowed paramedics with the North Naples fire district to use the advanced treatment. Firefighters routinely beat ambulances to the scenes of emergencies and commissioners have since routinely renewed the district's license to use the treatment each year with little controversy.

North Naples merged with Big Corkscrew Island in January.

The district asked commissioners to let those same firefighters use that treatment within the boundaries of the former Big Corkscrew Island fire district.

Nance said it is better to have fewer experienced paramedics than many who don't use those skills every day.

"The expansion of this based on the idea that more is better is in error," he said. "Practice and experience are key. If we start to rely on fire districts in just the Eastern part of the county then we will have two standards of service. We will divide into haves and have nots."