Ambulance response times have been a controversial topic since a major change in call priority that took effect in November.

Review backs B.C.’s ambulance priority shift

Expert says public misinformed of need for speedy response, paramedics union says cost control behind new policy

An external review has endorsed B.C.’s contentious reallocation of ambulance service in favour of the most urgent cases.

Lower Mainland cities, fire departments and their unions have denounced the changes introduced in November, saying dozens of categories of calls have been downgraded to slower responses, resulting in extreme waits of more than an hour in some cases.

Ambulances now head to many of the downgraded calls without the lights and sirens they used in the past, a change that’s expected to reduce the risk of crashes with other motorists.

B.C. Emergency Health Services contends the longer waits have averaged just 10 minutes slower in the Lower Mainland, but have enabled slightly faster ambulance responses to critical emergencies where extra seconds can save lives.

The report by Alan Craig, the retired deputy chief of Toronto Emergency Services, says the BCEHS Resource Allocation Plan takes a “careful and prudent approach” based on actual medical evidence that matches global best practices and is “superior” to the priority systems used in many major jurisdictions.

It agrees the lights-and-siren response carries serious risk to both paramedics and the public and should be limited to just the most urgent incidents.

It also says the public needs to better understand that very few patients from 911 calls need to be rushed to hospital.

The science of emergency medicine is rapidly evolving, Craig’s report says, overturning key assumptions over the past decade.

Short response times, with fire department first responders further shortening them, are no longer considered worthwhile in virtually all cases, he said.

The report says emergency doctors now agree that short response times improve patient outcomes in less than one per cent of cases – just ones involving cardiac arrest and patients unable to breathe.

“Not surprisingly, the magnitude of contemporary changes in emergency medicine may conflict with the expectations and the culture of some paramedics, some first responders and some members of the public,” it says.

BCEHS insists its changes have improved not hurt overall patient outcomes.

While the provincial government department maintains the ambulance response changes are not about saving money, the external review suggests there is a link.

Craig’s report said the public should also understand that “fixed response times for other than the most critical incidents are a major driver of EMS system costs, particularly as demand for service continues to rise.”

In a conference call Friday with reporters, Craig said cost should never be an issue with critical care, but added it may not be cost-effective to mandate speedy response times to routine non-urgent calls.

“We want to put the money where it’s needed – critical calls – not an overly strict, non-medical response to minor calls.”

He gave the example of an elderly senior who wakes up with severe back pain and needs to go to hospital emergency via ambulance.

Requiring the ambulance to arrive in eight minutes when that patient may then wait several hours in emergency because of their low-priority condition is not  good use of public money, Craig said.

Bronwyn Barter, president of the Ambulance Paramedics of B.C., said she believes the changes are aimed at at least containing the ambulance service budget.

“This is a money issue and a resource issue,” Barter said. “The call volume has been increasing in the province and the resources have remained the same. We do view this as a tactic to do more with less.”

The union head said front-line paramedics believe too many calls are now downgraded from code 3 with lights-and-siren to routine.

“We don’t think it’s appropriate to rob Peter to pay Paul,” she said. “The amount of time people are waiting with a fractured hip or after a fall – it’s not appropriate that they’re waiting that long.”

Surrey Fire Chief Len Garis was critical of the external review, saying Craig’s work guided the development of the BCEHS Resource Allocation Plan and he can’t be considered an independent, unbiased expert.

He cited the Surrey fire department’s own independent analysis, conducted by University of the Fraser Valley professor Martha Dow, which found a doubling in wait times in Surrey for lower priority calls.

“The wait times have gotten extremely long,” Garis said, adding some patients’ condition can deteriorate as a result.

“I’m concerned for the public and I’m concerned for the people who have fallen through the cracks.”

BCEHS has urged fire first responders to follow the plan’s recommendation that they not attend numerous types of low priority calls where they will end up waiting longer for ambulances to arrive.

But the service’s Dr. William Dick said each city council will have to decide if they want to provide a different level of service than what the plan has determined is medically necessary.

 

 

Just Posted

Most cows saved during massive fire on Agassiz farm thanks to fast work of farmers, neighbours

Agassiz Fire Department responded to late night call Wednesday

Risk of thunderstorm this afternoon for Vancouver Island and Lower Mainland

A special weather statement calls for heavy rain and wind over the next 48 hours

Massive fire destroys Agassiz dairy barn

Reports say at least one cow died in the blaze

First court date in Chilliwack for man accused of murdering Belgian tourist

Family and friends of Sean McKenzie, 27, filled the gallery for brief court appearance Wednesday

Another successful year for Chilliwack’s ‘We Got Your Back’ backpack program

Sponsored by local businesses, program stocks backpacks with school supplies for students in need

VIDEO: Neighbours fear impact of B.C. tent city residents

Greater Victoria residents opposed to campers voice concerns at provincial campground

B.C. premier apologizes for removal of 1950s totem pole at Canada-U.S. border

First Nations say pole was raised at Peace Arch but removed to make way for tourism centre

Tornado touches down in Ottawa and Gatineau, Que.

Environment Canada says cars and homes have been damaged by severe thunderstorms and high wind gusts

An unexpected sight: Bear spotted eating another bear in central B.C.

Cheslatta Carrier Nation Chief finds bear eating another bear’s carcass

Free vet clinic caters to pets of homeless, low income people

The first such clinic in Langley will take place later this month.

RCMP confirm death of missing BC teen Jessica Patrick

No details on cause were given. Case is under criminal investigation and police are asking for tips.

Extradition hearing set for Lower Mainland developer accused of fraud

Mark Chandler will go before the B.C. Court of Appeals early next year.

CUTENESS OVERLOAD: 2 sea otters hold hands at the Vancouver Aquarium

Holding hands is a common – and adorable – way for otters to stay safe in the water

B.C. teen with autism a talented guitarist

Farley Mifsud is gaining fans with every performance

Most Read