By Aaron Hale
Naples Daily News
IMMOKALEE, Fla. — In their line of work, Collier sheriff’s deputies tend not to be the ones in the back seat of official vehicles.
Because of staffing cutbacks of medical first responders in Immokalee, that’s about to change.
When Collier paramedics need an extra set of hands at Immokalee medical emergencies, Collier deputies already on scene could be called on to ride in the rear compartment of ambulances with patients.
During transport, deputies will put their first-response training to use helping Collier County EMS paramedics treat critical patients.
That’s a task Collier firefighters, not sheriff’s deputies, have typically done. But after the Immokalee Fire Control District cut nearly a third of its paid firefighter positions in May because of budget woes, the department no longer can afford to have manpower leave the district.
It’s already led to at least two cases in which patients in Immokalee have “coded” (gone into cardiac arrest), and the district declined to put a firefighter in the ambulance, said Dan Bowman, deputy chief of Collier EMS.
Fortunately, he said, no such cases have led to disastrous patient outcomes.
Still, the reduction in firefighter levels was putting stress on Collier paramedics having to make due without the extra help.
To “bridge the gap,” the Collier Sheriff’s Office agreed to offer deputies to assist on ambulances when necessary, said Capt. Tim Guerrette, an agency spokesman.
On-scene deputies will be put in ambulances only on critical medical calls in Immokalee, such as cardiac arrest and severe trauma. Even then, that’s still at the discretion of the on-duty sheriff’s sergeant, who will have to calculate whether the temporary loss of a deputy will put general public safety in Immokalee and throughout the county at risk, Guerrette said.
Collier EMS Chief Jeff Page praised Collier Sheriff Kevin Rambosk and his agency for taking on the role.
“The sheriff stepped up to the plate realizing that there’s a need to (maintain public safety) in that community,” Page said. “He’s not just helping us, he’s protecting the public.”
Collier EMS ambulances are typically staffed by two responders - a paramedic and emergency medical technician - but sometimes a third set of hands is needed for severe calls, Bowman said.
“When things get from bad to worse, it’s good to have some assistance,” he said.
This third responder is asked to assist the paramedic with basic medical responder tasks such as bagging, chest compressions or simply handing over necessary supplies, as the county EMT drives the ambulance. Think of the paramedic as the doctor, and the extra responder as the nurse.
That extra help can be crucial when a patient has coded, Bowman said, especially in Immokalee where a ride to the hospital can take 40 minutes.
Because firefighters in Collier County are first responders to medical emergencies and are required to be certified EMTs, an on-scene firefighter is usually asked to ride to the hospital in such emergencies.
However, with six of 21 paid firefighter positions being eliminated in Immokalee in recent weeks, the fire district has been forced to rely heavily on volunteer firefighters.
Sending a firefighter out of the district is no longer an option. At least not without compromising the agency’s chief function - fire suppression - said Raul Dimas Jr., the acting chief of the distressed fire district.
Hospital transport from Immokalee is sometimes a “two- to three-hour turnaround” to get the firefighter back in service, Dimas said. “We didn’t want to be caught with our guard down.”
A busy wildfire season already saw the fire district rely heavily on mutual-aid agreements, which allow it to call for backup from surrounding fire control agencies.
Collier deputies are typically called to respond even to medical 911 calls, either to assist patients or secure the scene.
Ultimately, the decision to place an on-scene deputy in an ambulance will be taken on a “case-to-case” basis, Guerrette said. The acting sergeant could refuse to help if the law enforcement aspect of public safety would be compromised by sending the deputy out of zone.
In such cases, a second Collier EMS unit could be called to assist, Bowman said.
Collier deputies are trained in first-response skills, but few are certified EMTs.
Still, Page said, deputies won’t be asked to do anything they aren’t trained or capable of performing.
While EMS officials have praised the Sheriff’s Office for the help, it’s not completely unusual for deputies to ride with EMS - particularly when suspects needing medical attention have to be restrained.
The offer from the Sheriff’s Office is temporary, according to Guerrette, not a permanent fix.
At this point, long-term solutions have to wait until the dust settles on the Immokalee fire district’s budget crisis.
“We are finding ways to augment Immokalee the best we can,” Bowman said.
Despite the help, questions about the current state of public safety in Immokalee still exist.
In May, at the same time Immokalee fire commissioners decided to reduce staff, it also shut down Fire Station 31 in the northwestern part of the district.
Without the presence of first responders in that area, Page said, there’s a concern response times could get lengthy.
In cases of cardiac arrest, patients’ chances of survival decrease as the clock ticks, medical experts say.
The EMS chief said he has offered assistance to the fire district in addressing such concerns, such as putting a medic unit in the station.
On Tuesday, fire commissioners considered reopening that station using volunteers and paid firefighters, but Page’s offer of stationing an EMS unit wasn’t discussed.
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