Physicians in Fort St. James are rallying to get easier access to BC Ambulance services in northern regions of the province.
Pieter Van Zyl, chief of staff at Stuart Lake General Hospital in Fort St. James, said there is only one critical care paramedic team on-call available for all of the Northern Interior, which includes Prince George, Vanderhoof, Burns Lake, Houston, Valemount, Fraser Lake, Mackenzie, Quesnel and McBride.
“That is a massive, massive area, and I mean at any given stage, we can have a critical patient and Valemount can have a critical patient and they are six hours apart from each other,” said Van Zyl.
The BC Emergency Health Services Critical Care Transport Program provides specialized emergency patient care and transport for critically-ill or injured patients across the province.
Van Zyl said recently they have had a problem with getting patients airlifted as well. A couple of weeks ago, a patient who suffered head injury had to wait for four hours before he got to Prince George for treatment.
“The plane couldn’t land here because they needed to de-ice. We don’t have de-icing capability at the airport. They ended up landing in Prince George,” he said.
“So now that gentleman had to sit in the back of an ambulance and wait for two hours as the critical care team drives from Prince George to pick him up and another two hours back. That is four hours that the patient hasn’t received care or is delayed in their transfer.”
The process followed by the hospital as stated by Van Zyl is that they first contact a central hub called Patients Transfer Network — which then connects them to BCEHS to perform the transfer.
“However best they assess the situation, sometimes with our input, if we have someone who has a head injury and needs to see a neurosurgeon, we know that Prince George doesn’t have that capability and that patient is probably going to end up in Vancouver.”
“Sometimes, I would say [to BCEHS], that we [the patient] need someone to see in Prince George — to get a CT scan first and decide from there and sometimes they [BCEHS] would say it’s obvious — just fly straight to Vancouver.”
He suggested upgrading the airport as a solution.
“Let’s get de-icing capabilities because we have long winter months and we can hit -20 C at any stage — then let’s upgrade the airport.
“But if the answer is getting a helicopter in Prince George that doesn’t need de-icing, then let’s get a helicopter to fly in, pick the patient up, fly them to Prince George and then they jump on a plane.”
If buying a helicopter is not the solution, then sub-contracting existing helicopter companies in the community can be another way to help patients.
“I am not a politician or a guru in finding solutions, but this has been going on for over 30 years and we need to find a way to help patients get access to the health care they need,” said Van Zyl.
There has always been a struggle with transferring patients in the North in comparison to down south in Vancouver.
“I’ll give you an example: During an advisory committee meeting we had a cardiologist who stood up and said, ‘I was visiting my family in Vancouver and my niece’s kid got sick and phoned the ambulance. Within five minutes, we had four ambulances there — one with a basic life support crew, one with a critical life support crew, one with a pediatric life support crew and the cops.’
“So everyone got there in five minutes and here we are struggling to get a person with a confirmed head injury [medical care] and it takes four hours before they get to Prince George and onto a plane. That’s the sort of thing we are getting at.”
He said he understands there is distance involved and a lack of BC Ambulance Service staff in the North. He said maybe giving them more incentive to work in the North could help increase the number of staff available.
Apart from the BC Ambulance Service, Fort St. James has two ambulance carts in the community. But sometimes they have a patient who needs a CT scan and the local crew plans the transfer and drive to Prince George. But that takes one cart away from the community for at least six hours, he said.
“I am constantly going to be the patient advocate because part of my duty is be the advocate for the patient — because tomorrow it could be my wife, it could be any one of us,” said Van Zyl.
Paul Stent, physician and district councillor, said in the 90s they would use helicopters from lumber companies.
“It wasn’t an ideal situation, because there wasn’t very good access to them,” Stent said. “But, you know, the pilot is sitting in the front seat and then they take out the other front seat and put a stretcher and the doctor sits behind the pilot and the head of the patient is next to the pilot’s seat.
“You can’t hear the heartbeat of the patient and it wasn’t ideal, but it was definitely easier getting the patient to Prince George then.”
Stent said airport upgrades are far out of reach in their budget, but grants are available. It would take time he said, but it would be worth it, if they could get an air ambulance to fly in.
“That’s another problem. They [pilots] say we can’t fly up there. But you can fly to Vanderhoof and can get there in 35 minutes to Vanderhoof. Parked on the runway, we would be sitting and waiting for the plane to land. We could load the patient up — I have done that in the past before, but for some reason airlift has become less and less available,” said Stent.
Shannon Miller, communications officer for BCEHS, was unable to confirm there is just one critical care paramedic team for all of the Northern Interior.
BCEHS has a fleet of four air ambulance helicopters and seven air ambulance planes, she said. “We can call upon approximately 45 pre-qualified air carriers throughout B.C. to provide charter aircraft as needed.”
Annually, BCEHS responds to 7,000 patients that require transportation by air ambulance, she said, noting fixed-wing transports account for 70 per cent of air ambulance calls, and helicopters are used for 30 per cent of the calls.
Miller said the North accounts for 41 per cent of air transports whereas the Interior accounts for 26 per cent and Vancouver Island accounts for 13 per cent.