Live saving drugs pulled from fire truck in Naples, Florida

[VentMedic]

Live saving drugs pulled from fire truck in Naples

http://www.nbc-2.com/articles/readarticle.asp?articleid=21540&z=3

Originally posted on: Thursday, September 11, 2008 by Kara Kenney
Last updated on: 9/11/2008 7:37:07 PM

LEE COUNTY: In an emergency, you trust paramedics will have the equipment and skills needed to save lives, but when members of the Naples Fire Department respond to their next call, many crucial tools won't be on their truck. We asked the fire chief and a paramedic whether your safety is at risk.

Many firefighters double as paramedics with skills and equipment to save your life.

Twelve of fourteen paramedics with the Naples Fire Department failed a test on drugs and their side effects.

Because of that, a fire truck at the main station was stripped of medicines, IVs, breathing treatments, heart monitors and other advanced live saving equipment.

Tober says Naples paramedics had a month to prepare for the test.

He decided to pull the drug boxes until paramedics learn how to use them.

"I don't think it was fair," said paramedic Adam Nadelman.

http://www.nbc-2.com/articles/readarticle.asp?articleid=21540&z=3

 

[el Murpharino]

I say good on this agency for assessing their employees and holding them accountable for their lack of knowledge. I'm sure these medics will be cracking the books and taking their continuing education requirements more seriously. It once again shows how important a proper education is in this field, and how detrimental a lack of one is.

That same paramedic, Nadelman, states that they are putting lives in jeopardy and that the failure of the medics was a fluke. First, one could potentially do more damage by giving the wrong medication than by giving nothing. Second, 12 medics failing a test that they had a month to prepare for is no fluke.

**EDIT** After rereading the article, I see it was the medical director who made the ultimate decision. I still say good for all those involved for holding them accoutable.

 

[VentMedic]

This is what happens when you memorize and don't LEARN pharmacology. The medical director was probably testing for an understanding of the medications. The month of studying probably consisted of pulling out the note cards and more memorizing.

 

[boingo]

Sounds like the fire department should be responding as first responders, and leave the medicine for the full time paramedics.

 

[Ridryder911]

This is what happens when your career is not in healthcare. Sorry, I have yet seen but a very few and rare Fire Agencies that provide excellent care. It again goes to the main focus and expert is something other than medicine.

R/r911

 

[Flight-LP]

Does Naples also run EMS or is a bunch of hose monkeys playing with drugs? I thought Lee Co. was the exclusive provider................................

 

[VentMedic]

Naples is in Collier county which has been trying to consolidate all EMS services provided in that county under Fire.

Lee County is to the north of Collier.

 

[pumper12fireman]

Regardless of whether the service is fire, private, public etc..I'm glad to see this taking place. If you don't know your stuff, you shouldn't be giving the drugs. It sounds like these guys are lucky to have their jobs still if the performance on the exam was that poor.

 

[John E]

It's not fair...?

Crikey, I haven't heard that excuse for failing a test in a long time.

John E.

 

[Airwaygoddess]

All I can say is wow..............

 

[VentMedic]

Collier County EMS has had a good reputation over the past several years. Problems have arisen out of the many Fire/EMS mergers.

Dr. Tober has been Collier County's MD for many years and has done a lot of good for the community.

Collier EMS medical director to be in national TV spotlight
By LIZ FREEMAN 10:07 p.m., Tuesday, November 6, 2007
http://www.naplesnews.com/news/2007...director_be_national_tv_spotli/?breaking_news

“I have increasingly heard the statement that a paramedic is a paramedic is a paramedic,” Tober said. “That is, all such medics from both the fire departments and EMS are state-certified and licensed, so why is there any difference in their protocols or clinical liberties? Why are they medically credentialed at different levels within our one protocol, and why do fire departments continue to hire and develop additional paramedics in their own systems? Collier County has but one single protocol.”
It is the one Tober created, he said.

“If I diluted this system down (to) another 80 to 100 paramedics, I would face serious skills and decision-making degradation,” Tober told the EMS Advisory Council board.

This is a good article.
Clash mars fire/EMS merger talks
By I.M. STACKEL (Contact)
10:19 p.m., Sunday, December 23, 2007

http://www.naplesnews.com/news/2007/dec/23/clash-mars-fireems-merger-talks/

Fire-ambulance consolidation talk still alive in Collier

By I.M. STACKEL (Contact)
9:59 p.m., Saturday, August 23, 2008

http://www.naples-daily-news.com/ne...mbulance-consolidation-talk-still-alive-coll/

 

[VentMedic]

More news from Collier County, FL

http://www.winknews.com/news/local/29644764.html

Eight emergency drugs removed from fire trucks

By Mike Essian, WINK News


Story Created: Sep 23, 2008 at 7:19 PM EDT
Story Updated: Sep 23, 2008 at 7:58 PM EDT

COLLIER COUNTY, Fla. - Eight potentially life-saving drugs have been ordered removed from all fire trucks in Collier County.

The EMS Medical Director Dr. Bob Tober says fire fighters don't need them, but fire fighters say, not having them puts you at risk.

Tober has already pulled advanced life support drugs from the city of Naples Fire Department because 12 of 14 fire fighters failed certification tests.

"It's much safer to be given basic life support and wait for the next tier of medical expertise and training to come to you than to hand you drugs that may be over your head."

North Naples fire fighters welcome more training from Dr. Tober if he thinks it's necessary, but Tober says that would be over-training them, and instead, he's focused on keeping his 120 county paramedics qualified.

 

[mikie]

I'm wondering, per the original article, if they passed the drug test the second time around.

Also, I'm curious to know what drug they found (did it mention it?). Some drug(s) I could understand (NOT JUSTIFYING IT AT ALL) whereas some, just don't belong in Fire or EMS or pretty much anything...

 

[VentMedic]

I'm wondering, per the original article, if they passed the drug test the second time around.

Also, I'm curious to know what drug they found (did it mention it?). Some drug(s) I could understand (NOT JUSTIFYING IT AT ALL) whereas some, just don't belong in Fire or EMS or pretty much anything...

I don't believe they have scheduled their 40 hour review as of this time. But, then, it will be a question of when and if all the ALS engines will get their drugs back. I'm sure it will happen eventually as the FD takes over EMS totally and a new medical director is appointed who just signs the paperwork put in front of him with no questioning the Fire Chief's knowledge of medicine.

 

[triemal04]

While I agree that pulling the drugs from the Naples Fire Dept (the one that had almost all their paramedics fail a test on the drugs they carry) is absolutely appropriate, I think at this point it's getting to be more of a pissing match between Dr. Tober and the various fire chiefs in the region; just reading the various articles (some going back a couple of years) that starts to get pretty clear.

It's even more illustrated with the second set of articles that ventmedic posted; what exactly did North Naples Fire Dept do that caused them to get those drugs pulled? Did they fail a test? Are their training hours and standards not up to par and that just wasn't mentioned in the article? Or did it really happen because "they aren't using them enough?" Sorry, but that's not always a valid arguement. Several drugs that are routinely carried by many services will be rarely used, which can be a problem for obvious reasons. Of course, the way to offset this is to train and constantly be learning about them to ensure that when the need for the med comes up it will be given appropriately. The same goes for many procedures.

Now, it very well may be that the various fire department affected by this don't keep up their education and train adequately, in which case this starts to become valid. But based on the article alone, it is just an arbitary decision by a doctor that is in a feud with several agencies.

 

[Anomalous]

If everything is as they say, I'm glad they took a stand, however, I suspect there is more to this story. If they pulled "IVs, breathing treatments, heart monitors and other advanced live saving equipment", was that an appropiate response? Maybe, maybe not. Wouldn't you like to see the test?

 

[VentMedic]

Now, it very well may be that the various fire department affected by this don't keep up their education and train adequately, in which case this starts to become valid. But based on the article alone, it is just an arbitary decision by a doctor that is in a feud with several agencies.

That is why I posted several links.

Collier EMS has has a great rep for over 25 years. When the FDs started getting into the ALS scene, they wanted to do all the protocols that the Paramedics did with CCEMS. But, their attendance for the training sessions by Dr. Tober with CCEMS was spotty at best. The chiefs have either not seen that the Paramedics are alloted time to attend or the Paramedics feel they do not need to attend until being made to do so by their chiefs.

Some of the employees of both have taken their argument public in the comments section under some of articles which is almost embarrassing for the public to read the Fire vs EMS bash fest.

It was well known what would happen when the FDs wanted ALL FFs to have the Paramedic cert. Many of the counties in Florida have already gone through this and are very familiar with the problems. Dr. Tober has also been very aware of the problems in the county on the East Coast across the state from him.

Florida has proven that a state can offer ALS to nearly 100% of its residents. However, it may also show that the ways we have used to accomplish this or encouraged the "milling" of Paramedics at the request of the FDs are questionable.

This is not the first incident that has brought this to public light. The below article concerns another Collier County FD.

Marco firefighter charged with falsifying documents to practice as paramedic
By RYAN MILLS (Contact)
5:55 p.m., Monday, April 28, 2008

http://www.naplesnews.com/news/2008/apr/28/former-marco-firefighter-charged-practicing-emt-pa/

If the FFs do not have their Paramedic upon hire, they have only 1 year to get the cert.

After this came to light and some checking was done by the state of Florida, the state had to re-enforce the standards for ALS clinicals to be done on an ambulance that actually transports the patient and not an ALS engine that arrives and leaves when CCEMS shows up when could be before or a minute after the engine. Essentially there are Paramedics that have been allowed to write their ALS patient information for school with little patient contact.

I have been part of the FD system and I know some can work better than others. I also know that the professional FFs have their concerns when people want a FF patch to become a Fire Medic. There is a concern that some of these individuals may not have their backs in a hazardous situation.

Again, this is not meant to be Fire vs EMS but the public is now becoming more educated for the cost and the headlines have caused some taxpayers to get more involved. Unfortunately, I don't believe this is the public involvement that many in EMS envisioned as recognition for their profession. It distracts from the good parts of what EMS professionals do.

Guest commentary: MITA president dissects fire assessment fee

By FAY BILES, Ph.D. - President, Marco Island Taxpayers Association (MITA)
Tuesday, August 26, 2008
http://www.marconews.com/news/2008/aug/26/guest-commentary-mita-president-dissects-fire-asse/


BTW, Marco Island consists of newer development (less than 20 years) and is in the higher price range. It is not that busy of an area and is considered to be a nice place to be a FF for the non-fire type.

 

[triemal04]

Ventmedic-

Ok, that may be the case (lack of training). But it wasn't captured in any of the articles that I read. If it is true (and I do mean really true, not just based on what Dr. Tober says...more on that later) then yes, it was the right move to make.

Collier County has come up a whole lot it seems like in the last couple of years, with good and bad things coming from both sides (fire and EMS). I understand that Tober feels very proprietary of the county EMS sytem, but even with that and the screwy way that Florida allows paramedics to get their certs, some of the things he's doing can be seen as being done because he's in a pissing match, and not because it's the right thing to do.

North Naples fire fighters welcome more training from Dr. Tober if he thinks it's necessary, but Tober says that would be over-training them, and instead, he's focused on keeping his 120 county paramedics qualified.

Now, if that's accurate, and I'm willing to bet it is fairly (maybe not fully) accurate, that's rather disturbing. The department recognizes that they have a problem and want to get it fixed, yet the medical director refuses because that would be "overtraining." Seriously, what the :censored::censored::censored::censored:!? The doc says they aren't trained enough and removes the drugs, but in the same breath won't allow for more training to fix the problem? Uh...ok.

At this point both sides are having serious issues, and without changes at the top (both fire chiefs and medical directors) there won't be a real solution to the problem. (no neccasarily removing anyone, but attitudes need to change on both sides.)

 

[VentMedic]

Many of these medics were rapidly trained by the FD to begin with and are expected to work under his medical direction. Yet, the Fire departments still want to control the medical training for their FFs. The consolidation has brought over 100 more paramedics in addition to the 120 - 150 already working for CCEMS under his direction. Now, on almost every medical call in some parts of Naples and Marco Island you have 6 - 10 Paramedics on scene. The engines or ladders won't be the ones doing the transporting or even the ALS care for the patient majority of the time.

Making everything ALS and everyone a Paramedic was not his idea and the logistics for the area made it very redundant. This situation did not come from a need for more medical services but rather "We can do that too" because all the other FDs are doing it.

On EMTcity I posted a detailed listing by station of all of the ALS vehicles we have in my area of Florida. But, not every area is going to need that many Paramedic vehicles running to every call.

 

[triemal04]

Ventmedic-
I'm not argueing that Florida is oversaturated with paramedic's (as are many cities/counties). Not argueing that the way that Florida allows paramedics to become certified isn't screwy; it is (medic mills=worst idea ever).

What bothers me here (besides the fact that once again the media is failing to accurately report all the facts associated with an issue) is that the situation involving Dr. Tober and the various fire departments has escalated to the point that both sides (though, at this point, as the media is reporting it, Tober is doing the most) are doing whatever they can to screw the other because they can. If that contines, in the end everyone is going to lose.

You say that some fire department medics are undertrained? They may be. But then some won't be too. And the same will go for private/third service paramedics too. Unfortunately, that is beyond a local issue for Florida and more of a statewide issue it seems (and a national issue). You say the fire departments in Collier want to control their own continuing education? Well, it appears they have to since Tober is refusing to train and educate the paramedics there.

If you ever wanted a nice fubar'ed situation, this would be a great example.