Now, Collier County and Roving Paramedics

[VentMedic]

How many even knew Collier County existed before their EMS and Fire fights started to make headlines?

Collier county is not the boondocks and CCEMS has a helicopter for outlying parts of the county. This is becoming a "How many Paramedics does it take to...." joke. Almost every responding FF is a Paramedic as well as those for CCEMS. If you have 2 - 6 Paramedics on scene, how many more do you need? Is this due to giving up on getting the many FFs up to a higher standard for care or even baseline quality? I see more trouble coming if the most politically "correct" paramedics are not picked.

http://www.emsresponder.com/article/articl...p;siteSection=1

Seasoned Paramedics Rove Florida County in New MedCom Program

LIZ FREEMAN

Naples Daily News (Florida)

They listen to the scanner for the worst of the worst calls for emergency responders, heading to scenes of struggling heartbeats, bloodshed and trauma.

They are roving paramedics and Collier County has 12 of them now, two per 12-hour shift, but they work solo driving SUVs. Shortly, a third and maybe a fourth will be added to the shifts.

In late October, the county's Emergency Medical Services launched a new MedCom program, selecting some of the department's most seasoned paramedics to respond to calls that involve serious medical issues and injuries. Their intent is to provide an extra set of hands to support the dispatched paramedic team as necessary.

Officials hope the new MedCom program will resolve a dilemma where EMS battalion commanders were intended to be a "watchful set of eyes on the street" but over the years became administrative and supervisory jobs, said Dr. Robert Tober, EMS medical director.

About two months ago, he learned that emergency medical services in Wake County, N.C., was developing a MedCom program and he wanted to give it a try.

"Lets take a group of our experienced paramedics and deploy them for 12-hour shifts and have them swoop down on some of the complex calls," Tober said.

The MedCom paramedics are self dispatched, listening to the scanner and deciding on their own which serious calls to respond to, he said. They avoid overlapping by talking with each other to decide who is closer to a scene, he said. They are not limited to any geographic area and have no administrative, supervisory or training obligations.

If a MedCom paramedic arrives at a scene first, he or she can initiate treatment and then defer once the dispatched responders arrive. In some cases, the MedCom paramedic will ride in the ambulance with the patient to the hospital, Tober said.

The 12 MedCom paramedics were selected based on their experience and ability to not try to take over a scene from the dispatched crew, Tober said.

So far, rank-and-file paramedics have been receptive to the MedCom support, he said.

"They call them the black knights, they are so relieved to have such an experienced set of hands come on the scene," he said.

Jackie Lockerby, a paramedic for 17 years, is part of the MedCom team and agreed first responders have been open to the program.

"Whenever you get an extra set of hands on the scene, the better it is for the patient," she said. "You can't have enough experienced hands on the scene. Everybody has a role on the scene. It is teamwork."

On the other hand, the MedCom program may wind up causing further friction between EMS and the independent and municipal fire districts and the long-standing consolidation debate. More than two years ago, the Collier County Commission asked the fire districts to explore consolidation whereby the fire districts would take over EMS. Tober says firefighters are not as medically skilled as his EMS paramedics, even though firefighters with advanced life-support training have to be state certified and operate in Collier under his protocols.

"The fire districts see this as competition but MedComs further put my money where my mouth is," Tober said.

The cost is budget neutral, he said, because EMS launched the MedCom program instead of adding two more regular transport units to the street. Adding more transport units would translate into fewer calls for paramedics and ultimately would mean their skills are not being put to use as often.

"I am trying to thin down my paramedic ranks to serve lots of calls every day to maintain competence," he said.

Golden Gate Fire Chief Robert Metzger said the intent of adding an extra set of hands on a scene is good but the MedCom program flies in the face of what the fire districts are doing with firefighters having advanced life-support certification.

Metzger also questions the logic behind allowing the MedCom paramedics to decide which calls to respond to.

"All of it sounds terribly undisciplined to a service that prides itself on discipline," he said, adding that he doesn't see the program as a good use of resources.

Metzger believes Tober's launch of the MedCom program is connected to his stance on consolidation.

"He is apparently trying to institute a new type of program or make up for a loss of (Advanced Life Support) first response by the fire districts because of constraints he has placed on the fire districts to operate (Advanced Life Support) first response," he said.

He first learned about MedCom at the Nov. 19 meeting of the EMS Advisory Council, a few weeks after the program was launched. At the time, he did not express all of his concerns.

East Naples Fire Chief Doug Dyer said he has no particular thoughts about MedCom and sees the program as roving paramedic in SUV's.

"I don't particularly have a dog in that fight if that is how they choose to use their personnel," Dyer said.

http://www.emsresponder.com/article/articl...p;siteSection=1

[spenac]

These guys would never survive in my world. You are it there are not 100 paramedics coming to help you take care of that stubbed toe that you are to uneducated to take care of. Makes me sick, if you where the patch you should be able to do the job, if not they should take the patch away. Sorry this annoys the hell out of me seeing tax payers getting robbed because idiots get and get to keep patches.

[VentMedic]

One more article about the consolidaton stuff. For those that believe the public doesn't know anything about what a Paramedic is or don't have any interest in EMS, you should listen to the talk at the diners during breakfast while they are reading the newspaper. Take it as fortunate or unfortunate that all of the dirty laundry is hanging on the line. Few may come out of this with much respect. This is getting to the point of being shameful for all involved and does little to put EMS or FFs in a favorable light with the public.

http://www.naplesnews.com/news/2008/dec/08...ittee-oversee-/

Collier leaders contemplate a new committee to oversee paramedic operations

By I.M. STACKEL (Contact)

11:06 p.m., Monday, December 8, 2008

[Dustdevil]

You are it there are not 100 paramedics coming to help you take care of that stubbed toe that you are to uneducated to take care of.

10-9?? :shock:

[CBEMT]

"The Paramedics who are complaining the loudest may have the least amount of accurate information but just enough education to believe they know it all and not enough information or education to know what they don't know".

PW3NED

[CBEMT]

These guys would never survive in my world. You are it there are not 100 paramedics coming to help you take care of that stubbed toe that you are to uneducated to take care of.

I don't think it has anything to do with lack of education or skill on the part of the Collier medics, I think it has everything to do with being able to assist their own medics because the FD is now heading towards BLS-only.

[p3medic]

I actually treated a guy yesterday from Naples, Fl, even had the opportunity to educated him about the whole fire/ems battle taking place. Don't know if it matters, but one person at a time....

[VentMedic]

PW3NED

Where did that quote come from and what is PW3NED?

[FormerEMSLT297]

I knew Collier Co encompassed Naples, ... Does that count ?

[CBEMT]

Where did that quote come from and what is PW3NED?

The quote came from one of the reader comments to the story, and pw3ned is interwebz-speak for "owned."