Fla. FF/paramedics seek approval to use ALS skills before ambulance arrives

The rural Big Corkscrew fire department merged with another district that had its own medical director in order to use advanced skills

By Greg Stanley
Naples Daily News

NAPLES, Fla. — Big Corkscrew firefighters will try again for approval to deliver lifesaving drugs and advanced treatment to patients before an ambulance arrives.

Denied by Collier County commissioners a little over a year ago, the rural fire district immediately took up efforts to merge with North Naples Fire and Protection District, the only fire district in the county with its own medical director and whose firefighters can start advanced life support without a county medic.

Voters approved the merger in November. It took effect in January. Now the new combined district is asking commissioners to allow all of its certified paramedics to administer advanced treatment, not just those in the old North Naples boundary.

"With this we could double and triple our coverage in Corkscrew without hiring anybody," said Jorge Aguilera, the district's deputy chief of emergency medical services. "We have 10 paramedics out there who are already trained and credentialed by the district medical director."

Early last year, Corkscrew sought and was denied the same county license that has allowed North Naples fire to operate under its own medical director for the last four years. Firefighters in the sprawling rural northeastern side of the county were regularly beating ambulances to medical emergencies by several minutes. Even though the district had trained paramedics on staff, they couldn't begin advanced work, such as regulating airflow, starting an IV or administering drugs, until an ambulance arrived.

But at the time, there were nine separate fire districts in the county, each with their own administrators and standards. Ambulance response, on the other hand, has always been run under just one county department — Emergency Medical Services. County commissioners and EMS officials have long been wary of fragmenting advanced medic care among the fire districts, so training or treatment standards in one neighborhood would be tossed out in another.

Rather than allow Corkscrew firefighters to use advanced care, commissioners beefed up EMS presence in the area, adding another ambulance and hiring three county paramedics to work on a Corkscrew fire engine, ensuring that treatment could start immediately so long as a county medic was there to supervise.

By all accounts, the added support has helped.

EMS response times have improved, now getting to patients within 8 minutes on 80 percent of calls — up from just 51 percent of calls at this time last year, county data shows.

Still, with 10 trained paramedics on staff waiting to be used, the fire district could improve both speed and care by adding several quick response vehicles designed just for medical calls, Aguilera said.

And North Naples fire has proved over the last four years that its paramedics can deliver quality advanced care, he said.

EMS Chief Walter Kopka wouldn't say if he has concerns about the merged fire district handling advanced treatment in the Corkscrew area.

But both treatment and response times have improved since commissioners added staff to the area even as the population has grown and calls for service increased, Kopka said.

If commissioners were to give firefighters a green light for the Corkscrew area, Kopka couldn't say if EMS will keep the added staff in the area.

"It's too early to tell for us," he said. "Right now it's business as usual. Those units are funded for all of this year and they will be funded next year."

©2015 the Naples Daily News (Naples, Fla.)

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