The province is sticking to its contentious decision to stop dispatching ambulances at high speed for less urgent medical calls and municipal fire department first responders are being urged to adopt the same approach.
Officials at B.C. Emergency Health Services have been on the defensive since the November implementation of their new Resource Allocation Plan, which slowed ambulances to posted speeds for dozens of types of routine calls with stable patients.
Ambulance response times have since averaged six minutes slower provincially and 10 minutes slower in the Lower Mainland for the downgraded calls, according to BCEHS, while enabling about one minute faster responses on urgent lights-and-siren emergencies.
Lower Mainland fire chiefs and city councils have denounced the changes as a service reduction and cite extreme delays for ambulances arriving at downgraded calls.
“We’re absolutely confident that we’re correct in the assignments that we’ve changed,” said Dr. William Dick, interim vice-president of medical programs at BCEHS. “We are getting to sicker patients faster.”
He and other officials at a Tuesday media briefing argued against sending municipal first responders at high speed to calls that aren’t medically urgent when those firefighters can only provide “comfort care” while waiting longer for ambulance paramedics to arrive under their revised protocol.
First responders are now “unnecessarily” rushing with lights and siren to 35 per cent of their calls, according to George Papadopoulos, quality and safety director at BCEHS.
“That has created a gap in response time that is being used in the media to say there’s downloading [of ambulance costs to cities],” he said. “If they implemented the changes that we’ve implemented for ourselves there would be no gap in the response times. And therefore no argument around downloading.”
Cities could save money if they adopted the same rules for their first responders, BCEHS says, and also reduce the risk of crashes between their responding fire trucks and the public.
There were 225 ambulance crashes with the public while lights and sirens were on in the last three years, and passing emergency vehicles are also blamed in other “wake collisions” where other vehicles collide trying to get out of the way.
Although BCEHS could impose the priority changes on first responder dispatch as well, it has said it will abide by the wishes of municipalities.
BCEHS board chair Wynne Powell said he thinks cities will agree to fall in line voluntarily and consultations with them are continuing.
So far 26 out of 160 municipalities consulted by BCEHS have requested more information or raised concerns. Surrey and Vancouver have submitted the most requests for reviews of ambulance call responses.
Powell called reported waits of one hour and more “outliers.”
An expert review of the changes is to report next week and BCEHS is pledging ongoing assessments in the months ahead.
NDP health critic Judy Darcy said patient safety has been put at risk, noting calls such as convulsions and electrocution by lightning are among the nearly 30 per cent of trips now downgraded to routine dispatch.
But BCEHS says such characterizations are inaccurate.
Electrocution and motor-vehicle accident calls are broken down to many sub-categories, some of which are dispatched as routine, and others with lights and siren, depending on the information dispatchers receive.
Powell also urged “complacent” motorists to pull over for ambulances now that lights-and-siren responses are reserved for more critical cases.