Fire officials hopeful they`ll get go-ahead to use advanced life support
June 15--A Collier County safety advisory board pushed ahead a measure this week that would allow firefighters in much of Golden Gate Estates to start advanced treatment on patients before an ambulance arrives.
Commissioners will be asked in the coming weeks to grant the North Collier Fire District, a newly formed district created with the merger of North Naples and the rural Big Corkscrew Island fire districts, a certificate that allows the district's paramedics to use the treatment in the former Big Corkscrew boundaries. But commissioners are running out of time before they take their annual summer hiatus in early July, which means firefighters may not get approval until commissioners return in September.
"It's discouraging that this is taking so long," said Jorge Aguilera, emergency medical services chief for North Collier fire. "We have a merged district with unequal level of services right now. We thought this would be a done deal."
The treatment, called advanced life support (ALS), has long been a point of contention between the county government and the various independent fire districts in Collier. Fire departments have trained paramedics on staff who want to be able to start an IV, regulate a patient's airflow or inject epinephrine and other lifesaving drugs, especially in North Collier where paramedics can use the treatment in half the district, but can't in the other half.
"What's funny is if we travel outside of the district on a call -- if we cross the boundaries on auto or mutual aid -- we are allowed to use ALS," Aguilera said. "But the old Corkscrew district isn't mutual aid because it's part of our district now. So if we were respond to a call in Corkscrew we cannot practice ALS because of these geographical boundaries."
North Collier firefighters asked the county in March to update their ALS certificate to include the entirety of the new district.
The county historically has argued that it is better to have relatively few paramedics practicing ALS. That way they stay sharp through repetition, knowing how best to administer drugs that can be lifesaving, but also can cause harm. Too many paramedics means too little practical experience for each. Until recently, there have been nine separate fire districts in the county, each with its own administrators and standards, and county commissioners and medical officials have been worried of fragmenting advanced medic care among the fire districts, so training or treatment standards in one neighborhood would be tossed out in another.
Early last year, Corkscrew sought and was denied this same county license to use ALS. After the denial, the district immediately took up efforts to merge with North Naples, which was the only fire district in the county with the license.
Voters approved the merger in November. It took effect in January.
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