A new way of dispatching first responders to medical calls is putting lives at risks, according to two fire chiefs in rural Princeton.
“I would say that if it hasn’t happened already, ultimately and eventually, somebody is going to die because of this policy that could otherwise have been saved,” Dave Stringfellow, chief of the Erris Volunteer Fire Department, told the Spotlight in an interview.
Those thoughts were echoed by Hayes Creek Fire Chief Rob Miller, who was able to recount a recent experience when his members ignored direction from central dispatch to stand down, and were able to provide vital assistance to a patient in distress.
“If we hadn’t gone, he may have died. It’s ten days later and he’s still in hospital,” said Miller.
Last May BC Emergency Health Services (BCEHS) implemented a new process for dispatching paramedics, ambulances and other resources to patients, called the Clinical Response Model, throughout the province.
Under the new system first responders attached to fire departments are being called less frequently to medical incidents in their areas.
Stringfellow said that since the protocol was introduced in May, the only time his crew has been called to assist BC Ambulance personnel has been for patient transfers – although his department would normally expect to attend an average of 12 calls a year for medical emergencies.
The Erris Fire Department has 18 members, nine of whom are provincially licensed medical first responders who can perform a range of tasks from first aid to CPR, and administrating oxygen.
Hayes Creek Fire Department has 16 members with 12 trained medical first responders, including two retired Advance Life Support Paramedics. While normally responding to an average of 16 calls a year, that team hasn’t been required to attend a medical call since August 2018.
Both chiefs insist that their residents are too far from Princeton to rely solely on ambulance service. Hayes Creek is approximately a 45 minute ambulance drive from Princeton, and for patients in the Erris district that trip could be anywhere from 10 to 45 minutes.
They note those time lines are best case scenarios, providing an ambulance is in Princeton and able to respond. Sometimes those vehicles need to come from Summerland, Keremeos or Merritt.
“The first hour is the critical hour,” said Miller. “If a patient gets to hospital dead it doesn’t matter how good the hospital is, they are not going to be able to save them if they are dead.”
The Hayes Creek crew can often reach a patient in less than five minutes, he added.
Shannon Miller, a spokesperson for BCEHS, responded to tThe Spotlight’s questions in writing.
“BC Emergency Health Services’ new Clinical Response Model (CRM) is working well. The model better matches resources to the needs of patients.
A key goal of the CRM is to improve response times to potentially life-threatening medical emergencies, and the early data shows that is happening.
The CRM is based on existing, successful systems in other areas of the world, and studies have shown it improves the safety and quality of care provided to patients.”
Under the previous system, called Response Allocation Plan, both ambulance and first responders attached to fire departments were dispatched in response to a 911 call.
Now a color coding system is employed to determine if first responders are essential.
According to Shannon Miller first responders are dispatched in time-critical (purple and red) emergencies “where minutes and even seconds count.” Fire department will be notified of “moderately-urgent” calls (orange) where the ambulance is likely to take more than 10 minutes to respond. They are always dispatched for motor vehicle incidents and hazmat scenes.”
Recently the Hayes Creek Department was called for medical assistance, but by the time members got to the hall to sign in and suit up, they were instructed by central dispatch to stand down. “They said they had this,” said Miller.
“I knew the address and I knew the patient,” he said. “I decided to keep going.”
En route to the address Miller called the patient’s house.
“They said ‘Oh my God, he’s collapsed. I don’t know if he’s breathing. Where are you?'”
Miller said when his team arrived at the scene the patient was “shallow breathing, barely conscious…I couldn’t get a pulse on him. He had one but it was very weak.” Miller was able to determine the man had been in hospital just four days earlier and was diabetic.
When paramedics arrived they were unable to get the ambulance down the 2 km driveway, and were shuttled by the Hayes Creek Fire Department from the road to the house, where they were able to run an IV on the patient.
The man was then transported in a first responder vehicle to the ambulance.
The Erris and Hayes Creek fire departments are not funded by municipal, regional district or provincial tax dollars – which is not the case in larger centres – puzzling both chiefs as to why their help would not be welcomed.
“It doesn’t cost EHS or the Province of B.C. any money for fire departments to go. They don’t pay for that and we are not paid per call so there is no cost to our people who live here.”
Shannon Miller wrote:
“We know some first responders have concerns about the reduction in calls they are being asked to attend as part of our first responder program.
The CRM is a major system change and as such BCEHS is closely overseeing the day-to-day operations of the new model, including reviewing thousands of calls. As a result of this continuous review we are making adjustments to first responder notifications.
READ MORE: Exploring the path to healing rural health care in B.C.
The reality of responding to medical emergencies is that as more information becomes available from a scene, dispatch staff either increase or decrease the number as well as the type of resources needed, including notifying fire rescue agencies.
BCEHS has been meeting with municipalities and their respective fire departments on a regular basis to explain the new model in more detail, answer questions, and listen to feedback and concerns. BCEHS will meet with any fire department with concerns about the CRM, to better understand its position and regional perspective.”
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