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Nevada Fire Department leading the way in providing first-responder ALS care

Pictured (from left) are the Nevada Fire Department’s five paramedics, Jeff Gilchrist, Ray Beaty, Fire Chief Ray Reynolds, Kyle Elliott, and Carrie Brown.

The Nevada Fire Department will soon provide what its leaders are calling “cutting-edge healthcare.”

The volunteer fire department was recently granted a conditional license to provide Advanced Life Support (ALS) care. This designation is an upgrade from Basic Life Support care, which the department’s first responders have historically given.

In a nutshell, being an ALS licensed emergency medical service means the department, when one of its five paramedics is on a call, can do everything an ambulance crew can do, except transport a patient. Providing care at this level can ultimately save lives.

“We are likely to have the only ALS non-transport service in the region,” said Director of Public Safety Ricardo Martinez, who looks for other fire departments to follow suit.

Next Monday, March 15, Nevada Fire Chief Ray Reynolds expects his fire department to “go live” in enacting its recently granted conditional license to provide paramedic advanced life support (ALS) care on calls.

“This license is for one year, and then the Department of Public Health will conduct a re-inspection to assure we are doing O.K. and following our procedures,” Reynolds said.

Reynolds and EMS members Ray Beaty and Jeff Gilchrist, both paramedics, have spent hours working on the steps to make ALS service a reality for the Nevada Fire Department.

“This whole idea probably started a year ago when Jeff, Chief Reynolds and I were talking about where we want to go as a department,” Beaty recalled. Beaty said they raised the question, “Do we want to keep going the same direction that we have been or do we move forward? We chose to move ahead and be a leader.”

The process included lots of research. “All three of us worked side-by-side on multiple occasions as we put all of the required pieces together,” Gilchrist said. “Chief Reynolds did a great job of providing the administrative support for Ray Beaty and myself to help make this happen.”

Gilchrist noted, “It is well documented that rural emergency medical services are struggling in the state of Iowa at a variety of levels.”


Reynolds calls the struggle a crisis.

“Rural emergency care in Iowa is in crisis mode,” he said. “There are places in Iowa where people can call 911 and not get an ambulance from their own county. Ambulances are busier than ever as patients in small hospitals are transferred to higher level of care, and that leaves a gap in the 911 response time” when waiting for an ambulance to arrive and give advanced care.

With five paramedics in its ranks, the conditional license to provide advanced life support (ALS) care means with a paramedic on the scene, the Nevada Fire Department’s first responders can give ambulance-level care to those who need it.

“I remind everyone, the best care always starts with EMTs (emergency medical technicians). Now during critical calls you may see our paramedics deploying more equipment and doing more invasive care,” Reynolds said.

The Nevada Firefighters Association has funded over $5,000 to equip the City with ALS equipment through grants. They also purchased a $3,800 high-tech manikin to provide realistic skills training rotations.

In addition, the fire department recently went through an inspection of all its records, equipment, and procedures with the Iowa Department of Public Health, which led to the granting of the provisional license.

Dr. Curtis O’Loughlin of Story Medical Center and Pharmacist Nick Lund of NuCara have been and will continue to be essential to the process. O’Loughlin, the fire department’s medical director, had to approve all protocols. Lund will maintain a supply of all medications for the department.

“I think this is going to be a great asset to the community,” Lund said. “Knowing that high level care will be readily available is extremely important and is a critical service to the residents of Nevada.”

Lund said the advanced level of care could also “truly be in the difference in saving lives.”

“We now have the ALS tools for starting IVs if needed, giving medications and providing better care when needed,” Beaty said.

It makes Martinez and Reynolds proud to see the City’s volunteer firefighters’ commitment toward keeping Nevada residents safe.

“We love to show how the rural EMS crisis can be fixed when partners are involved,” Reynolds said.

Meet our five paramedics:

Jeff Gilchrist works full-time at the Marshalltown Hospital as an ED registered nurse for UnityPoint-Marshalltown and part-time as a paramedic for Boone County Hospital.

Ray Reynolds is a critical care paramedic working at Mercy Ambulance in Des Moines and the Bondurant Fire Department.

A Critical Care Paramedic (CCP) is a higher-level endorsement. Gilchrist and Reynolds use the CCP endorsement in part-time jobs while caring for and transporting patients on ventilators. During the COVID surge, Gilchrist and Reynolds cared for many COVID-19 patients in the Marshalltown and Des Moines area. 

Kyle Elliott works as a firefighter paramedic for the cities of Ankeny and Bondurant.

Carrie Brown works as a paramedic at the Boone County Hospital.

Ray Beaty works as a paramedic at Story County Medical Center.

–Written by Marlys Barker, City of Nevada

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