OSOYOOS TIMES-November 25, 2009

By Paul Everest – Osoyoos Times

Local paramedics are voicing concerns that a new directive from their employer, the British Columbia Ambulance Service (BCAS), could cost lives.
Brad Fraser, regional vice president of the Ambulance Paramedics of British Columbia Union CUPE Local 873 for Region 3, an area that includes Osoyoos, said the BCAS issued a directive on Nov. 19 that may affect critical response times for emergencies in the South Okanagan.
Right now, he said, there are “duty” ambulances which are located at the local ambulance station and are meant to respond quickly to emergencies such as serious car crashes or heart attacks.
The response time for these ambulances is supposed to be fewer than nine minutes.
Other ambulances, referred to as “kilo” cars, are used for transferring patients between hospitals or between hospitals and doctors’ clinics.
They can also be used as backup ambulances when the duty car is busy.
The operators of the kilo ambulances are on a standby system using pagers and, unless they happen to be at the ambulance station, it could take them between 20 and 30 minutes to respond to a transfer call, Fraser said.
Under the new directive, duty ambulances will be used for transfers first, he said, leaving South Okanagan communities with only call-out ambulance coverage.
Fraser said that means if an emergency call comes in while the duty ambulance is out on a transfer, the response time to that emergency could be up to 30 minutes.
He said that the BCAS is essentially “gambling” that no emergency calls will come in while the duty ambulance is out on a transfer call.
“This is very scary,” Fraser said.
The new directive, he added, was supposed to come into effect Nov. 20 and apply to communities in the South Okanagan and Similkameen regions including Osoyoos and Oliver.
Chad Collington, an Osoyoos paramedic and the shop steward for the Osoyoos ambulance station, said the new directive has not come into effect in the area yet.
Paramedics in the community are worried, however, about what the new directive could mean for people who need an ambulance quickly, Collington said.

“We’re all kind of sick about it,” he said. “If something happens when that (duty) car is out, someone’s going to die.”
For example, Collington said, a person having a heart attack has a good chance of survival if they receive CPR and defibrillation in the first four minutes after the attack happens.
That survival rate goes down by seven to 10 per cent, however, every minute after the first four minutes are up.
Collington said the union has brought up its concerns about the new directive to the BCAS.
Larry Jackson, an executive director for the BCAS in British Columbia’s Interior region, said the directive isn’t really new.
“BCAS is reverting to a former deployment model of having the full-time or standby crews do the first call that comes in whether it is a non-emergency call, an emergency 911 call, an emergency patient transfer or a non-emergency patient transfer,” he said in an email on Nov. 23.
Right now, he added, this model is being used in Oliver and Princeton and will be put into effect in Osoyoos and Ashcroft soon.
Jackson said there will be “no significant change in Osoyoos and Ashcroft since the full-time or standby crews were already responding to first calls unless there were a number of pre-booked patient transfers which would require the on-call ambulances to be staffed.”
Through this ambulance deployment model, he added, the BCAS is hoping to save $50,000 per year “by fully utilizing the full-time and standby crews in Ashcroft, Osoyoos, Oliver and Princeton prior to calling in on-call crews.”
The reason this deployment model is being used here, Jackson said, is because the BCAS has “determined that the probability of receiving an emergency or non-emergency call and a patient transfer call at the same time is less than 40 per cent” in this community.
“It is important to note that only 30 per cent of all BCAS calls require an emergency ‘lights and siren’ response,” he said. “The remaining calls are routine (non-emergency) and patient transfers.”
According to data provided by Collington, Osoyoos paramedics have responded to 47 calls since Nov. 9.
“Of those 47 calls nine have been what we consider serious,” Collington said, adding that two were motor vehicle accidents, two were fatalities, one was a call for a patient with shortness of breath, four were “cardiac calls” and two were for falls of a distance greater than 4.5 metres.
Jackson said if an emergency “pre-hospital” call comes in “while the full-time or standby car was undertaking a patient transfer, BCAS would call in another resource such as the pager on-call crew or assign the call to a car from a neighbouring community.”
“This deployment model was in place previously and is the routine way in which BCAS responds when two 911 calls come in at the same time, during mass casualty events or periods of high call volume,” he said.
Earlier this month, the government passed legislation that ended the paramedics union’s seven-month long strike.
The reason for the legislation, the government stated, was due to increasing stress on the province’s health care system due to the H1N1 flu pandemic.
On Nov. 19, the province appointed an Industrial Inquiry Commission, led by former B.C. Deputy Finance Minister Chris Trumpy, to examine the province’s ambulance service.
The government has stated that the inquiry will look into the service’s collective bargaining structure and other areas including staff recruitment, staff workload, occupational health and safety issues and comparisons of deployment strategies and paramedic compensation with other Canadian jurisdictions.
The commission is to report back to the government by Jan. 15.
The paramedics union has stated that it will not take part in the inquiry as it feels four months is not enough time to look into what it calls a “broken” ambulance service.
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