Flagler Beach Fla--No Medical Director=Delay in Treatment--Officials Concerned

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Lack of medical director threatens city rescues
Flagler Beach responders can't carry, administer oxygen

By JAMES MILLER
Staff Writer

Last update: 08 June 2003


FLAGLER BEACH -- Because their departments do not have a medical director, Flagler Beach city firefighters and lifeguards can no longer store compressed oxygen and use it to save lives.

While county Emergency Services Director Doug Wright says his agency keeps Flagler Beach safe, city Fire Chief Jon Macdonald and Beach Services Director Walter Forehand say they are concerned about potentially deadly delays.

"In a drowning situation, oxygen could mean the difference between life and death," Macdonald said Thursday. "If the county ambulance is out of town, it could be 10 or 15 minutes before we could administer oxygen to the patient."

Macdonald also said oxygen is critical for people who suffer heart attacks and congestive heart failure.

The Fire Department stopped carrying and administering oxygen in mid-May. City firefighters can administer the gas only if county emergency personnel provide it at the scene and advise them to do so.

Since mid-May, Macdonald and his two full-time professional firefighters have responded to at least four incidents in which they needed to administer oxygen before a county ambulance arrived, Macdonald said. The incidents involved heart attacks or people having difficulty breathing, he said.

Wright said the county has five ambulances -- one is stationed in Flagler Beach. Each is equipped to provide oxygen and more advanced life support. The county's FireFlight helicopter and a fire engine stationed in The Hammock also provide advanced medical response, he said.

"We haven't experienced any threat to anyone's life, but for Flagler Beach to have the capability to administer oxygen would be an additional asset," Wright said.

For the Fire Department to administer oxygen, a licensed medical doctor must write a prescription and develop a protocol for providing the gas, which is considered a drug under state and federal law.

Macdonald, who became chief in April, said he removed the Fire Department's oxygen containers from its trucks when county officials told him about three weeks ago that, as far as they knew, his department's authorization had lapsed. County officials said they thought the city last had authorization from former county Medical Director John Canakaris, who resigned in September 2001.

Flagler Beach does not have a medical director.

While Macdonald said he did not know exactly when the coverage lapsed, Rich Wieser, the county's Emergency Medical Services operations chief, said oxygen prescriptions are valid for only one year.

Beach Services, the lifeguards' department, also does not have a prescription, Director Walter Forehand said.

"We still have oxygen on our units. We're not administering unless it's OK'd by the county," he said.

Wieser said a department without a valid prescription cannot legally store and administer oxygen. Because the city's Beach Services and Fire Department are separate, each needs a prescription, he said.

If Flagler Beach officials want the two departments to provide oxygen, they must either hire a city medical director or ask the county to authorize its current medical director, Dr. Carol Grigg, to write prescriptions for city departments, officials said.

City Manager Nancy Ciummo said the City Commission would consider the issue at its regular meeting on Thursday.

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Follow Up--Resolution to the problem

City clear to provide oxygen

By JAMES MILLER
Staff Writer

Last update: 02 July 2003


FLAGLER BEACH -- Weeks after they found out they could not possess and administer medical oxygen, Flagler Beach city firefighters and lifeguards have medical clearance to provide the lifesaving gas during and after the Fourth of July holiday.

On Friday, Fire Chief Jon Macdonald said he reinstalled the oxygen tanks on his department's two firetrucks after Palm Coast medical director Dr. Edwin Forsberg signed a prescription for the city. The prescription, which became valid on June 19, allows Flagler Beach's firefighters and lifeguards to provide compressed oxygen for one year, Macdonald said.

"At least I know our citizens are covered, that's the main thing," he said.

Macdonald said he removed the oxygen tanks from his department's two fire engines in mid-May after realizing that the city's prescription for compressed oxygen, which is considered a drug under state and federal law, expired as many as two years ago.

Macdonald and Beach Services Director Walt Forehand have said they need to be able to provide oxygen in case county emergency responders are delayed at other locations.

In an earlier interview, county Emergency Services Director Doug Wright said Flagler Beach residents and visitors were safe without the presence of oxygen tanks. Wright, who declined to comment for this story, said it would be an asset if city emergency responders could provide oxygen but emphasized that they needed proper medical clearance to do so.

On June 12, the City Commission voted to ask the county to bring Flagler Beach under its medical director, Dr. Carol Grigg.

Before Tuesday's meeting, the Board of County Commissioners had not discussed the request, and Flagler Beach City Manager Nancy Ciummo said Friday that city officials had not talked with the county about the prescription they obtained from Forsberg.

"At the present time, we are covered, and we have asked the county to cover us," she said. "That's where we stand officially."

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Follow Up Story

Plan breathes relief into city's oxygen dilemma

By JAMES MILLER
Staff Writer

Last update: 12 September 2003


FLAGLER BEACH -- Flagler Beach moved closer on Thursday to a fix allowing city firefighters to provide emergency medical oxygen on a long-term basis.

At its regular meeting, the City Commission approved an agreement with the county that provides county training and medical direction for the city. Before the agreement goes into effect, the Board of County Commissioners also must approve it.

"There's a lot to it," Flagler Beach Fire Chief Jon Macdonald said early Thursday. "It's a real, real good thing for the city."

In May, Macdonald removed the oxygen tanks from his department's two fire engines after realizing that the city's prescription for compressed oxygen, which is considered a drug under federal law, expired as many as two years ago.

Because the city did not have authorization, only county emergency service responders could provide oxygen in the city. Macdonald and Beach Services Director Walter Forehand, whose department includes the city's lifeguards, said their departments needed to be able to provide it immediately in situations ranging from people having trouble breathing to heart attacks.

A month later, the city got a temporary fix when Palm Coast medical director Dr. Edwin Forsberg signed a prescription allowing Flagler Beach's firefighters and lifeguards to provide compressed oxygen for one year.

The new agreement, which brings the city under the county's medical director and medical protocols, provides a long-term solution, Macdonald said. When Forsberg's prescription expires, the city will get a new one from the county medical director.

Under the agreement, the county also will provide instructors and first responder training to Flagler Beach Fire Department staff. If needed, the county could request reimbursement for equipment and personnel costs.

First responder training includes 40 hours of class work and provides students with advanced first-aid type skills.

Macdonald said city lifeguards also would be able to receive first responder training under the agreement.

County Emergency Services Director Doug Wright could not be reached for comment.

City commissioners unanimously adopted the agreement. "I think the county is being cooperative, and I think it's going to be a great service for the people," Commissioner Ron Vath said.

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