Florida Commission Restricts Firefighters’ Use of ALS

Collier County – A long-simmering fight over emergency response in Collier County reignited Tuesday as commissioners rejected a bid to allow firefighters in the newly formed North Collier fire district to 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.

Earlier on JEMS: Florida Firefighters Hope to Get Permission to Use ALS Treatments

Their opposition came despite recommendations of ambulance and emergency-response officials to allow it and over 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 almost 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, or 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.

Clam Pass boardwalk

Commissioners unanimously approved a $1 million plan to repair and replace parts of the Clam Pass Park boardwalk this fall.

Hiller’s legal bills

Commissioners also voted, 4-0, with Hiller abstaining, for taxpayers to cover $16,000 in legal bills that Hiller has accumulated while fighting two unsuccessful ethics complaints filed against her. The county typically pays legal fees for commissioners if complaints are dismissed, relate to their official duties and the fees are reasonable.

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