Live saving drugs pulled from fire truck in Naples, Florida

[VentMedic]

For the record, as he stated in the meetings which were published, he did NOT refuse to train anyone. This is not a new event. This has carried on since the ALS FD conversion started a few years ago. This is more than just getting continuing ed for their renewals. This is about the initial and ongoing training from Paramedic program to truck. The training sessions have been posted. If the medics do not choose to attend the meetings as required by their medical director for whatever reason, would you still wanting them to do RSI just because the recipe says they can by the "county" protocol? The FDs want it to be the same but different.

I believe that as a medical director, he should have some control over who does what under his license and not just sign off the paperwork. He is one of the feel medical directors that actually can recognize those working under his license because he has taken the time to be an active part of CCEMS training. What the FDs have failed to understand is that it takes more than just one or two short classes a year to keep up a good EMS reputation. It's a huge responsibility to be responsible for that many people as a MD when the FDs don't recognize the importance of ongoing medical training. Many feel the patch is enough as you should have read in at least a couple of the articles I posted. "A Paramedic is a Paramedic". Just passing a state exam does not necessarily make one a good Paramedic.

I can not see why the medical director should continue to waste his time if the FD Paramedics have not taken an interest in participating in EMS training. It is just with the recent events that have shown that skills and knowledge can go to waste if one does not use them or at least take their certification serious enough to stay current.

Even those of us on the East Coast have been impressed with some of Dr. Tober's training sessions for his Paramedics as some of them are published in the Florida Emergency Physicians update. So if we can hear about them, why can't the FD paramedics in the same county?

I have posted numerous articles on both forums and still haven't skimmed the surface of what has been in the news over the past few years with this county and others. Broward EMS went Fire and then under the SO. Ocala's EMS went FD and that left a lot of great long term EMS employees with little choice but to become a FF to stay employed. Miami-Dade has consolidated almost all of their FDs. The same with Palm Beach County.

And, as I stated before, it works in some FDs better than others. Boca Raton FD stayed out of the Palm Beach County merger and has a rep of being a great example of providing EMS. Almost all of their FFs are Paramedics also. But, they are smaller with only the City of Boca Raton to be concerned with.

 

[VentMedic]

The battle is heating up

http://www.nbc-2.com/articles/readarticle.asp?articleid=22588&z=13

Battle between firefighters, medical director heating up

Originally posted on: Tuesday, October 28, 2008 by Kara Kenney
Last updated on: 10/28/2008 6:35:21 PM

COLLIER COUNTY: The war of words between firefighters in Collier County and their medical director got nastier. Both sides are locked in a heated battle over how many life-saving medications should be allowed on the fire trucks.

The battle heated up with what some call a scathing letter from Collier County Medical Director, Bob Tober, to county commissioners.

Dr. Tober is saying firefighters should be less involved with saving lives - a notion that has firefighters fired up.

MORE AT:
http://www.nbc-2.com/articles/readarticle.asp?articleid=22588&z=13

THE SCATHING LETTER

http://www.nbc-2.com/Newslinks/CCEMS-Fire Letter to Commissioners October26 2008 (2).doc

 

[reaper]

I love the stance he is taking, but it will do no good. The politicians will bow down to the fire Dept's, because they will threaten with votes for new commissioners!!

They do not really care about the citizens they serve!

 

[John E]

3 cheers for...

Dr. Tober...

Hope the county commissioners stand by his directives.

John E.

 

[medic417]

Finally somebody putting patients first. Fire needs to focus on fire, EMS needs to focus on medicine.

 

[EMTinNEPA]

About time. EMS =/= Firefighting, despite what laypersons watching Third Watch and Emergency! want to believe.

What the f:censored: was a fire department doing with drugs on their truck anyway?

 

[VentMedic]

What the f:censored: was a fire department doing with drugs on their truck anyway?

This FD just wants to be like all of the other FDs in Florida. Almost all FFs are Paramedics in this state and engines/ladders are ALS. Right or wrong, that's the way it has been for almost 30 years here in many of Florida's cities.

 

[HotelCo]

I can't speak of other places but around here the FD has the ambulance... has the medics..

I say if they have the training, let them use the tools they are trained in to save a life. Obviously they do not use them as much as the EMS system, so they should be required to get more continuing education and be tested on their knowledge much more often.

If I were down and the truck was the first on the scene, I'd want them to be able to do everything possible to get me up.


-HotelCo

 

[jrm818]

Assuming "down" means "cardiac arrest," Dr. Tober proposed leaving Epi and Atropine (as well as benadryl) on the ALS rigs. Actually he wanted to give them to the PD.

That aside, even if they didn't have those drugs, as long as you are getting good CPR and they have access to an AED, the few minutes difference between FD and EMS getting on scene aren't going to change the outcome. Early CPR is really the key to making it out of an arrest alive....

Plus - what happens when the FD medic who hasn't tubed a pt. in ages misses and starts bagging your stomach? Hopefully the ambulance gets there fast enough to recognize that... etc. etc. Deficient skills can cause more harm than good. Would you want joe the plummer to have "all the tools" too? Of course not. You want someone who knows what the heck they are doing, and has done it in...say...the past year.

As to more training...it sounds to me like the FD isnt' even OK with doing the same amount of training...never mind extra..

 

[dmiracco]

I definately agree with the decsision made by the medical director in Naples. I also agree with most of the comments made on this thread. I think that to often we ALL see FF, Medics, etc. render care as clinicians in the prehospital setting that is questionable to say the least. I think that more than likely the biggest issue here as in MOST services, paid or volunteer, is the education or lack there of.
I have worked for numerous services in numerous states and I have found that overall initial EMS education (the basics) as well as concurrent training is usually subpar and ofcourse it depends were you live. Some are worse than others and Im not saying that there isnt great learning institutions because there out there. What I am saying is that there needs to be more accountability for Educators throughout the EMS profession.
So with that said, I pose a question to all of you,
How do you feel your initial and concurrent training is where you are employed and what do you feel could be improved? :blink:

 

[cvb7873]

For the record, as he stated in the meetings which were published, he did NOT refuse to train anyone. This is not a new event. This has carried on since the ALS FD conversion started a few years ago. This is more than just getting continuing ed for their renewals. This is about the initial and ongoing training from Paramedic program to truck. The training sessions have been posted. If the medics do not choose to attend the meetings as required by their medical director for whatever reason, would you still wanting them to do RSI just because the recipe says they can by the "county" protocol? The FDs want it to be the same but different.

I believe that as a medical director, he should have some control over who does what under his license and not just sign off the paperwork. He is one of the feel medical directors that actually can recognize those working under his license because he has taken the time to be an active part of CCEMS training. What the FDs have failed to understand is that it takes more than just one or two short classes a year to keep up a good EMS reputation. It's a huge responsibility to be responsible for that many people as a MD when the FDs don't recognize the importance of ongoing medical training. Many feel the patch is enough as you should have read in at least a couple of the articles I posted. "A Paramedic is a Paramedic". Just passing a state exam does not necessarily make one a good Paramedic.

I can not see why the medical director should continue to waste his time if the FD Paramedics have not taken an interest in participating in EMS training. It is just with the recent events that have shown that skills and knowledge can go to waste if one does not use them or at least take their certification serious enough to stay current.

Even those of us on the East Coast have been impressed with some of Dr. Tober's training sessions for his Paramedics as some of them are published in the Florida Emergency Physicians update. So if we can hear about them, why can't the FD paramedics in the same county?

I have posted numerous articles on both forums and still haven't skimmed the surface of what has been in the news over the past few years with this county and others. Broward EMS went Fire and then under the SO. Ocala's EMS went FD and that left a lot of great long term EMS employees with little choice but to become a FF to stay employed. Miami-Dade has consolidated almost all of their FDs. The same with Palm Beach County.

And, as I stated before, it works in some FDs better than others. Boca Raton FD stayed out of the Palm Beach County merger and has a rep of being a great example of providing EMS. Almost all of their FFs are Paramedics also. But, they are smaller with only the City of Boca Raton to be concerned with.

I am a firefighter/paramedic in the Naples area. I find it funny you mention areas like Broward. Broward has about a dozen fire departments providing EMS services. They also have multiple medical directors, all working together to come up with one common protocol. Here, we have 1 medical director for the entire county. In December 2006, the Naples Daily News quoted Dr Tober stating "I have a hard enough time training the 111 medics I currently have working under me, how the hell am I supposed to train the other 100 fire medics that want the same protocols." He stated himself that he can not properly train all medics in this county, why he remains the only medical director is a mystery.

This test was given to only one fire department, The City of Naples. They failed the test miserably, and all fire departments had medications removed from their trucks. None of the other departments were tested on their knowledge. In fact, Collier EMS wasn't even given the test. North Naples Fire Rescue currently has dozens of former Collier EMS employees working for their department, including their Chief of emergency medicine Jorge Agiulara (who was Dr. Tober's #2 man at EMS just a few years ago). These experienced men and women apparently are no longer skilled, because the patch on their sleeve says fire department, not EMS.

We often arrive on scene first. Collier EMS runs non-emergency, interfacility transports in addition to emergency transports. This often causes trucks to end up all over the district, and ambulances often have to respond from other areas. There have been many times where we are on scene with no transport unit for up to ten minutes. We now have no anti-dysrhythmics, no more versed to treat seizures, no atropine. In fact Dr Tober wants to cut the medications in our box down to 4. Exactly how is this a progressive system?

You mention training. The former head of EMS' training department now works for my fire department, and is in charge of training. We go through just as much training as Collier EMS. Dr Tober refuses to come in and train us on duty, though he has agreed to in the past. He just never would. We paid another physician to come in and do our training under Tober's protocols, Dr. Tober refuses to accept his training.

This battle has nothing to do with patient care, it is strictly politics. There is no room for politics in patient care. Dr. Tober is trying to keep his kingdom, and this entire system is taking steps backwards.

 

[VentMedic]

We paid another physician to come in and do our training under Tober's protocols, Dr. Tober refuses to accept his training.

This battle has nothing to do with patient care, it is strictly politics. There is no room for politics in patient care. Dr. Tober is trying to keep his kingdom, and this entire system is taking steps backwards.

And you haven't learned anything from the mistakes made in the other EMS/FD systems in Florida or other parts of the country? Sounds like you are a FF trying to help the FD to keep their own kingdom and pick their own Yes man for a doctor. Maybe he'll let you slide and just sign you off as too many have done in this profession already.

If people abandoned their EMS position to go to the FD, then they probably were burnt out with EMS and no longer had an interest to be effective medical professionals. Riding an ALS engine is not the same as an EMS transport ambulance.

Those that do use their skills and knowledge regularly have their reports used for review of their understanding of medicine. Wasn't there a part where the FDs used the excuse they didn't know how to do their reports because of a change in the system?

If 12 out of 14 FF/medics failed the test miserably, what makes you think there will be better results in other stations? Did they just put all the incompetent or weaker medics at one station? Would you have preferred the headlines to read 54 out of 60 FF/medics failed even after given a month to prepare? If the people that were to be given the test didn't prepare during that month, what makes you think it would have been different in other stations? Do these paramedics not even recognize their own responsibilty for keeping current when they hold a medical license? Do they have to be spoon fed the test like they probably were in medic school?

Dr. Tober has valid points and his interest is patient care. If the meds and skills are done so infrequently, there is little chance to maintain proficiency especially if their duties are divided with fire.

A severe problem was identified and dealt with. Dr. Tober has more of a responsibilty to the public than the egos of the FDs.

Do a little research on Denver and Seattle. More does always not equal better.

 

[cvb7873]

And you haven't learned anything from the mistakes made in the other EMS/FD systems in Florida or other parts of the country? Sounds like you are a FF trying to help the FD to keep their own kingdom and pick their own Yes man for a doctor. Maybe he'll let you slide and just sign you off as too many have done in this profession already.

If people abandoned their EMS position to go to the FD, then they probably were burnt out with EMS and no longer had an interest to be effective medical professionals. Riding an ALS engine is not the same as an EMS transport ambulance.

Those that do use their skills and knowledge regularly have their reports used for review of their understanding of medicine. Wasn't there a part where the FDs used the excuse they didn't know how to do their reports because of a change in the system?

If 12 out of 14 FF/medics failed the test miserably, what makes you think there will be better results in other stations? Did they just put all the incompetent or weaker medics at one station? Would you have preferred the headlines to read 54 out of 60 FF/medics failed even after given a month to prepare? If the people that were to be given the test didn't prepare during that month, what makes you think it would have been different in other stations? Do these paramedics not even recognize their own responsibilty for keeping current when they hold a medical license? Do they have to be spoon fed the test like they probably were in medic school?

Dr. Tober has valid points and his interest is patient care. If the meds and skills are done so infrequently, there is little chance to maintain proficiency especially if their duties are divided with fire.

A severe problem was identified and dealt with. Dr. Tober has more of a responsibilty to the public than the egos of the FDs.

Do a little research on Denver and Seattle. More does always not equal better.

I have not in any way bashed EMS, yet you feel compelled to bash fire departments. I do not know about Seattle and Denver, but I know about the fire-ems systems currently used in most of South Florida. Those systems eliminate duplications of services, and provide equal training for all medics, regardless of which truck they are on.

12/14 failed for city of naples, an entirely different department. A department obiously lacking in the training department. In fact, they dont even fight fires well. They have poor staffing, and usually only save foundations. The fact that they are inept does not mean all departments are. Testing all departments would have proved that.

As far as a yes man physician, we had a physician come in to train us. Why is that a problem? The medical director refused to come in to train us, so we looked elsewhere for training. Its called being proactive. We also had Tober's former head of training training our medics. He left that department, and now trains us. Perhaps if the City took training as seriously, they wouldn't have looked like fools. I know if we had been tested, this nonsense wouldn't be going on.

This wonderful, effecient system you speak of (but by no means know anything about) planned on laying off 24 medics just a few months ago, and planned on taking 4 emergency vehicles off the road. They have an unbelievably high turnover rate, thanks to management, not "burnout". They also run 1 medic, 1 EMT. Real progressive system. Curious, what do those dreaded fire/ems agencies run in Broward and Palm Beach? Most run 2 medic rescues, some 3.

You sound like someone who is anti fire. I am not by any means anti EMS. I just think there is no room for politics in patient care. If you had any clue what was going on here, you wouldnt be quite so fast to bash me and support Tober.

 

[VentMedic]

I have not in any way bashed EMS, yet you feel compelled to bash fire departments. I do not know about Seattle and Denver, but I know about the fire-ems systems currently used in most of South Florida. Those systems eliminate duplications of services, and provide equal training for all medics, regardless of which truck they are on.

12/14 failed for city of naples, an entirely different department. A department obiously lacking in the training department. In fact, they dont even fight fires well. They have poor staffing, and usually only save foundations. The fact that they are inept does not mean all departments are. Testing all departments would have proved that.

As far as a yes man physician, we had a physician come in to train us. Why is that a problem? The medical director refused to come in to train us, so we looked elsewhere for training. Its called being proactive. We also had Tober's former head of training training our medics. He left that department, and now trains us. Perhaps if the City took training as seriously, they wouldn't have looked like fools. I know if we had been tested, this nonsense wouldn't be going on.

This wonderful, effecient system you speak of (but by no means know anything about) planned on laying off 24 medics just a few months ago, and planned on taking 4 emergency vehicles off the road. They have an unbelievably high turnover rate, thanks to management, not "burnout". They also run 1 medic, 1 EMT. Real progressive system. Curious, what do those dreaded fire/ems agencies run in Broward and Palm Beach? Most run 2 medic rescues, some 3.

You sound like someone who is anti fire. I am not by any means anti EMS. I just think there is no room for politics in patient care. If you had any clue what was going on here, you wouldnt be quite so fast to bash me and support Tober.

FireFighter, where do you think I am from and what my background is? Did you not read my earilier post? Don't spout off anti-fire crap to another Floridian who's been around for awhile. And don't make assumptions about other systems unless you have access to their QA/QI data. How many tubes or IVs do the 4 medics on an engine and/or ladder get per year? How many lawsuits were they able to dispose of under the state immunity statute?

And don't live under a rock without knowing much about how other systems, EMS or Fire, have worked and have been proven to be effective? How could you not know about King County or even about Denver? Do you not read any literature in EMS? Any research on the latest equipment or protocols trialed? My expectations would be high if it was medical journals but at least the EMS and Fire rags that lie around a station.

How often will this Yes man physician be training you? How many calls are you running? How many patient contacts are they getting? Actual transports? How many live tubes and IVs are the paramedics getting?

As far as some of the other systems you mentioned on the East coast, why are some communities now trying to get volunteer FDs established again and contracting AMR for their EMS?

If you want to have a civil discussion, great. But don't jump to conclusions or bash a system just because they are EMS either. This FD is the one that made national headlines.

Layoffs? Where are you getting some of you information from? Sources? The only mention of layoffs at the meetings have been when the consolidation is complete and the FDs have ironed out the details of transport to where CCEMS Paramedics are no longer needed.

 

[reaper]

I have seen Fire/rescue services all over FL for almost 20 years. This is not the future for EMS. They all have serious problems with this setup. I have nothing but respect for FF's, they do a much needed job. But, that is the job they need to concentrate on. They do not need to serve two masters.

I have seen Dept's that have ALS engines, work great. But, they are backing up a full service county EMS service. They may be on scene 5-10 minutes pta of EMS. They very rarely use any drugs above D50,Epi,Benadryl, or Albuterol.

EMS is changing and changing fast. The population is aging in greater numbers and Prehospital medicine is advancing rapidly. This needs Medics that have their full attention given to pt care.

I do not know your dept or your training. It may be great. But, I do respect a medical director that stands up for better training and keeping advanced medicine to the people that do it full time. I would rather have the FF's concentrate on their duties and not try to do two jobs. You may be an exception, but most fire/medics do not have their hearts in medicine. They want to be FF's and most were forced into medicine. This is not the best way to serve the public!

 

[cvb7873]

FireFighter, where do you think I am from and what my background is? Did you not read my earilier post? Don't spout off anti-fire crap to another Floridian who's been around for awhile. And don't make assumptions about other systems unless you have access to their QA/QI data. How many tubes or IVs do the 4 medics on an engine and/or ladder get per year? How many lawsuits were they able to dispose of under the state immunity statute?

And don't live under a rock without knowing much about how other systems, EMS or Fire, have worked and have been proven to be effective? How could you not know about King County or even about Denver? Do you not read any literature in EMS? Any research on the latest equipment or protocols trialed? My expectations would be high if it was medical journals but at least the EMS and Fire rags that lie around a station.

How often will this Yes man physician be training you? How many calls are you running? How many patient contacts are they getting? Actual transports? How many live tubes and IVs are the paramedics getting?

As far as some of the other systems you mentioned on the East coast, why are some communities now trying to get volunteer FDs established again and contracting AMR for their EMS?

If you want to have a civil discussion, great. But don't jump to conclusions or bash a system just because they are EMS either. This FD is the one that made national headlines.

Layoffs? Where are you getting some of you information from? Sources? The only mention of layoffs at the meetings have been when the consolidation is complete and the FDs have ironed out the details of transport to where CCEMS Paramedics are no longer needed.

First, its fire medic, not firefighter. Second, we run all medical calls with the exception of interfacility transports. That was Tober's decision. As far as tubes, Dr Tober's own protocols call for a King Tube (unless contraindicated). You cant judge even their medics on the profeciency of endotracheal intubation, as our own protocols make them a rareity.

# of Patient contacts rival that of any on the medic unit. Contact time there is no comparison, as soon as they are stable we clear, they transport. They are gonna have us in that one. # of IV's, i dont know, many. Not sure what you want from me here.

As far as volunteer systems, two departments in all of Broward. One that had a volunteer system in place that was kicked out by the county, then reinstated. They now have AMR. Good for them. BSO should have never been there. BSO's nearest station outside of LBVS was about twelve miles away. When one unit transported, they had no coverage for awhile. Plantation has volunteer fire as well, look up what the city did to their EMS when they tried to unionize a while back. Real great place to work.

On to the layoffs. http://www.naplesnews.com/news/2008/feb/14/collier-ems-faces-24-million-budget-shortfall/ Hope that helps.

Again, as I said earlier. I have in no way bashed the current EMS system in place. You on the other hand attacked me, my ability, and firemedics in general. You seem to have an anti-fire agenda. Honestly, I could care less. There are anti-ems guys in my department too. You guys are all Dinosaurs. Fire/EMS agencies save tax payers money, and provide a more effecient system. In fact, Collier EMS medics in the field want consolidation to take place. We want it to take place. The commishioners want it to take place. Taxpayers want it to take place. The only people in SW Florida against it are Dr Tober, EMS(mis)management, and dinosaurs like yourself. Have a great day.

 

[VentMedic]

Are you the one arguing with the citizens in the newspaper about taxes? Or arguing with the citizens at the protest lines? Real professional. It really makes for a great image for the rest of the FDs that do try to do a decent job in this country even in Florida.

Guess where the EMS funds for Collier got diverted to? Think all taxpayers are pro-consolidation? Attend the meetings where the general public speaks their mind. Unfortunately the taxpayers that have tried to speak their mind in the newspaper comments section get bashed by firefighters.

Seems like the FDs in the Naples area are having a difficult time just keeping track of who's licensed or not. Maybe once they get that figured out they can deal with some of their other issues. Unfortunately your bad press gives everyone in the FDs across the state of Florida a bad rep when in the national news all they hear is Florida.

Are you counting the community in Broward that just went to volunteer FD and with AMR?

I'm glad you do agree that "Fire Medics" should be extinct with the dinosaurs. And speaking from a professional FF point of view, it is just down right dangerous to have half arsed "fire medics" watching your back at a fire scene. They do a little of this and a little of that while not doing anything 100%. There are a few exceptions to the rule but the majority of them will be honest and know where their weaknesses lie. Those that have the arrogant attitude of being great at all are just dangerous and get good FFs killed trying to watch them and their own back at the same time.

At least the King tube is not too difficult but still require some skill and knowledge. You gotta give Dr. Tober credit for knowing the abilities of the people he supervises.

If you didn't have the FF patch would you really like being a just a Paramedic and not a "fire medic"?

 

[cvb7873]

Are you the one arguing with the citizens in the newspaper about taxes? Or arguing with the citizens at the protest lines? Real professional. It really makes for a great image for the rest of the FDs that do try to do a decent job in this country even in Florida.

Guess where the EMS funds for Collier got diverted to? Think all taxpayers are pro-consolidation? Attend the meetings where the general public speaks their mind. Unfortunately the taxpayers that have tried to speak their mind in the newspaper comments section get bashed by firefighters.

Seems like the FDs in the Naples area are having a difficult time just keeping track of who's licensed or not. Maybe once they get that figured out they can deal with some of their other issues. Unfortunately your bad press gives everyone in the FDs across the state of Florida a bad rep when in the national news all they hear is Florida.

Are you counting the community in Broward that just went to volunteer FD and with AMR?

I'm glad you do agree that "Fire Medics" should be extinct with the dinosaurs. And speaking from a professional FF point of view, it is just down right dangerous to have half arsed "fire medics" watching your back at a fire scene. They do a little of this and a little of that while not doing anything 100%. There are a few exceptions to the rule but the majority of them will be honest and know where their weaknesses lie. Those that have the arrogant attitude of being great at all are just dangerous and get good FFs killed trying to watch them and their own back at the same time.

At least the King tube is not too difficult but still require some skill and knowledge. You gotta give Dr. Tober credit for knowing the abilities of the people he supervises.

If you didn't have the FF patch would you really like being a just a Paramedic and not a "fire medic"?

Again with the attacks. You just dont stop. I do attend County meetings, I have heard the taxpayers speak. Attended the meeting in support of the EMS workers about to lose their jobs. Thankfully, the County wouldn't allow that to happen. You mention professionalism, yet you continuously bash firefighters. Is that considered professional?

Look, I became a firefighter because I wanted to help people, same as anyone else. I became a paramedic to be able to provide the best possible service to the people of my community. Continue on with your anti-fire crusade, but leave me out of it. I tried to be civil, you obviously can not.

 

[BossyCow]

I'm glad you do agree that "Fire Medics" should be extinct with the dinosaurs. And speaking from a professional FF point of view, it is just down right dangerous to have half arsed "fire medics" watching your back at a fire scene. They do a little of this and a little of that while not doing anything 100%. There are a few exceptions to the rule but the majority of them will be honest and know where their weaknesses lie. Those that have the arrogant attitude of being great at all are just dangerous and get good FFs killed trying to watch them and their own back at the same time.

Wow.. pretty sad system that allows half arsed anything continue to practice. In our area the fire department is the only game in town. They are ALS. They are paid well, trained to a high standard and not only respond but transport as well.

The issue here isn't fire departments or not.. the issue is a sytem allowing 'half arsed' as an acceptable standard.

 

[cvb7873]

Wow.. pretty sad system that allows half arsed anything continue to practice. In our area the fire department is the only game in town. They are ALS. They are paid well, trained to a high standard and not only respond but transport as well.

The issue here isn't fire departments or not.. the issue is a sytem allowing 'half arsed' as an acceptable standard.

This system does not allow "half arsed" anything. One department was tested and obviously had half assed standards in terms of training. All departments had medications removed. I can speak only of my department, but I can assure you we are not "halfarsed" in terms of training.

This system, which everyone is quick to defend, is years behind those in place on the east coast of Florida. According to our protocols, a fire medic is no longer able to push antidysrhythmics to a patient in V-fib. We can not place a patient on a breathing treatment when they are suffering from asthma or COPD. We can no longer treat a patient suffering from chest pain with anything other then 02. We no longer can use Versed to treat seizures, or before we cardiovert. We can no longer give D50 to a patient with a diabetic emergency. How is this a step foward?

Dr Tober said the reason for this is he does not want the medications falling into the "wrong hands". Well, I gotta agree that The City of Naples (who bombed the test) shouldn't be in the ALS engine program. They obviously dont take training seriously. My department on the other hand takes training very seriously. Had we been given the opportunity to take the test, we would have proven that. We hired the head of EMS' training to advance our ALS engine program, had physicians come in to train us, and had firemedics do clinicals alongside physicians at physician's regional hospital.

This is strictly politics. It is about protecting kingdoms, not patients. We have never had a case where the wrong medication was given by a firefighter in this County, not even by the City. Dr Tober himself has admitted that there were times that the medications removed from the ALS engines were used by firefighters to help patients. Now, due to infighting among management, those potential life-saving medications will no longer be given in a timely manner. Dr Tober's once great system is no longer what it was.