- September 27, 2017
James Carlino, a commissioner for East Manatee Fire Rescue, said having a firefighter medic arrive as a first responder will equate to saved lives.
Now he has to convince Manatee County residents that the extra expense to stock East Manatee Fire Rescue with Advanced Life Support paramedics is worth every dollar.
“I want us to be able to have the highest level of care possible when we show up to save people's lives and give them that high standard of care from the very beginning,” said Carlino, who has been advocating for an Advanced Life Support program to be added to the trucks of the East Manatee Fire Rescue for the past two years.
According to District Chief Lee Whitehurst, Advanced Life Support is the inclusion of a firefighter medic on board a vehicle. It requires that individual to receive a certification as a paramedic in charge, which includes training beyond an emergency medical technician level, as well as testing by the county.
Whitehurst said a firefighter medic can offer a wider scope of medical services.
He is working on a report on the topic that he will present at an upcoming Advanced Life Support workshop, which was approved by the Fire Commission during a March 21 meeting.
The public workshop will be held from 1-5 p.m. June 21 at the East Manatee Fire Rescue Administration building.
The motion to hold a workshop was seconded by Commissioner Derek Foss, who expressed an interest in gaining more information. It also received a vote in favor from Commissioner Richard Jacobs along with Carlino.
Fire Commissioner Garry Lawson and Commissioner Bob Conley voted against the workshop.
Lawson cited it was the Office of Program Policy Analysis and Government Accountability that should have the responsibility to decide what spending should be appropriate in terms of staffing.
Conley said it was not necessary for a workshop to be held and that people who wanted to speak on the topic could come in and speak at the regular meetings.
Carlino said the matter is important to the role of fire rescues and that most fire departments similar in size to the East Manatee Fire Rescue already have paramedics on their trucks. He said 70% of calls for East Manatee Fire Rescue are medically related and that it thus makes sense that the best medical care should be provided.
East Manatee Fire Rescue Captain Matt Talaska said some of the additional features Advanced Life Support offers do not exist within the Basic Life Support that firefighters currently practice.
He said a machine, known as a life pack, allows those using it to intervene in a cardiac event manually and that although Basic Life Support users can only assist with nasal and oral medications, Advanced Life Support users can start IVs to administer drugs, such as those that elevate blood sugar. Talaska said other Advanced Life Support skills include performing tracheotomies, lung decompressions, field amputations and intraosseous infusion, which is an injection directly into bone marrow for an IV.
Whitehurst said other fire districts in the county currently utilize Advanced Life Support to some extent. He said the West Manatee Fire and Rescue District began five to six years ago with an Advanced Life Support program, implementing it in a pickup vehicle on Anna Maria Island. Over time, by adding personnel or sending existing personnel for additional education, it was able to expand the program to all three of its firetrucks.
Southern Manatee Fire Rescue, he said, followed about a year later, also expanding Advanced Life Support to three trucks over five years, and North River Fire District started an Advanced Life Support program two years ago and includes a paramedic on one of its five trucks.
Whitehurst said any cost estimates for East Manatee Fire Rescue to implement similar programs would not be made public until the workshop.
However, he said that the cost of West Manatee Fire and Rescue District to provide Advanced Life Support was $200,000 a year for all three of its trucks.
East Manatee Fire Rescue, he said, currently has 10 stations, with Station 1, which is located at 3200 Lakewood Ranch Blvd., featuring two fire engines for a total of 11 trucks.
Whitehurst said if existing firefighters are trained to be certified as paramedics, the cost of adding an Advanced Life Support program would have to include education of those paramedics. The cost would include the cost of bringing in additional firefighters to replace those who were training to be paramedics.
Whitehurst said staffing one truck with one paramedic a shift would require nine paramedics, to cover all the shifts throughout the week. However, he said that as more trucks were staffed, the number required would, at some point, decrease to two-and-a-half paramedics per truck.
“To embrace the cost, we must embrace what progress will look like,” Whitehurst said. “There are many different ways to go about doing it. Do we choose to go down a paved road or a dirt path?”
Whitehurst keeps records of the different calls, based on whether East Manatee Fire Rescue arrives before or after Manatee County Emergency Medical Services. He said that although it has not yet done so, the rescue can look back at those call codes to find out which fire stations see their engines most frequently arriving at scenes ahead of other first responders and are therefore most in need of paramedics.
Because a Manatee County EMS hub exists nearby Station 1, there is essentially an equal chance EMS will arrive before or at the same time as East Manatee Fire Rescue.
Other East Manatee Fire Rescue stations house ambulances. These include Station 2 west of the intersection of State Road 64 and Interstate 75, Station 7 near the in intersection of University Parkway and Lorraine Road, and Station 11 near the intersection of Wachula Road and State Road 70.
He said the stations currently with the greatest interest for an Advanced Life Support program are Station 3 on the southern stretch of Rye Road, Station 4 near the intersection of University Parkway and Lakewood Ranch Boulevard, Station 5 between Lorraine Road and Post Boulevard, Station 6 on State Road 70 just a short distance east from I-75, and Station 8 at the intersection of State Road 70 and Bourneside Boulevard.
He also noted Manatee County EMS is improving and adding ambulances which also needs to be taken into consideration when debating whether to add paramedics to East Manatee Fire Rescue.
“If we're going to fill the gap, then that's what we need,” Whitehurst said. “Where are the gaps going to be as EMS continues to improve and grow its service?”
Manatee County residents can attend the workshop to see how any changes in staffing will affect them.
Lakewood Ranch's Michelle Jimenez-Baserva said at the Fire Commission meeting that after having lived in other fire districts in Manatee County, she was surprised to learn when she moved to Lakewood Ranch last year that the East Manatee Fire Rescue did not offer an Advanced Life Support program. She previously launched a petition on NextDoor and Facebook to add paramedics to the East Manatee Fire Rescue trucks. The petition has been signed by more than 600 residents.
“In my personal opinion as a resident, I see no reason East Manatee should not, at a minimum, embark on a plan to try to put it in place,” she said. “They are always willing and able to go that extra mile to provide the best possible service to their citizens, and I feel that East Manatee Fire Rescue is lacking in respect to ALS, but not in any other respect. ALS could be the difference between life and death, and if it makes a difference even for one person, in my opinion, that's invaluable."
County Commissioner James Satcher said he will support whatever results are produced by the workshop.
"In Manatee County, the fire districts are their own taxing authority," he said. "So that would be something they have the freedom to do. I have a lot of respect for our first responders, firefighters and Sheriff's deputies, so if that's something they feel like would be wise for them to do, I'll support their decision."