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Former paramedic endorses B.C.'s emergency response plan in new report

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VANCOUVER - The latest response plan implemented by BC Emergency Health Services has received a healthy endorsement from a former paramedic and expert on emergency care, but a fire chief says patients are now waiting almost twice as long for an ambulance.

Alan Craig's report on the Emergency Health Services resource allocation plan finds patients' needs are being met and B.C. is a leader among emergency medical service systems.

The ambulance service recently downgraded its response to 39 types of calls, dropping them from emergency to routine, saying that would ensure the most severe cases get priority.

Craig said Friday that dispatching first responders is most useful and cost effective for time-sensitive incidents requiring care such as CPR, while lights-and-siren responses to reports of crashes, broken bones or chest pain simply raise the risk to responders and the public.

However, Surrey's fire chief Len Garis says the changes that were implemented last October mean patients are waiting too long for medical help.

"We started getting flooded with complaints by both the public and our first responders that were arriving at these calls, finding patients in circumstances that they believed should have been (categorized) as a greater urgency," Garis said.

"We're going there thinking it's one thing and it's turning out to be something else that's quite serious," he said.

"Our biggest concern is that the two largest cities in British Columbia weren't consulted about this and we invest significant resources toward this situation," he said referring to Vancouver and Surrey.

"We've met with the officials and we've explained to them that we wanted to be part of this and understand the data and how the methodology was taking place."

He said 60 per cent of Surrey firefighters' calls are as first responders, and they're frustrated about waiting longer for ambulances to show up.

"It might have been things like a senior on the floor with a broken hip, suffering from extreme, excruciating pain and the ambulance was diverted or delayed."

Martha Dow, associate professor in the Department of Social, Cultural and Media at the University of the Fraser Valley, said wait times for ambulances have gone from 11 minutes to almost 18 minutes on 74 types of code 2 calls, but have improved slightly for code 3 calls, which require lights and sirens.

Dow, whose study was released last month, said that in many cases firefighters have ended up calling dispatch to ask for a call to be upgraded to code 3.

"They're on scene and saying, 'No, this wasn't coded properly,'" she said in an interview.

Dow said more information is needed on outcomes after patients are handed off to paramedics, and from the Insurance Corp. of BC about the number of crashes involving ambulances responding to calls to verify Craig's claims.

Dr. William Dick, vice-president of medical programs at BC Emergency Health Services, said his findings indicate that response times have increased by an average of six minutes since October for code 2 incidents while they have decreased for patients with more critical needs.

He said that of the 114,000 patients who have been transported by ambulance up to the end of March, firefighters have forwarded complaints about 125 injured patients who were not in critical condition.

"First-responder groups felt there was either an error in coding or there was a delayed response," said Dick, adding he has reviewed about 100 of the cases so far and has no concerns that patients' safety was jeopardized.

"I haven't seen anything that caused me concern," said Dick, who is also an emergency-room physician at Surrey Memorial Hospital.

Craig said his findings are not based on opinions but rather on 630,000 recent medical calls from patients across B.C.

While Craig said there is no medical benefit to firefighters attending some calls and such responses depend on municipalities' decisions, the new ambulance plan has increased the number of firefighters responding to emergency calls.

He said firefighters in B.C. would respond to about 31 per cent of emergency calls, but firefighter response is much lower in Ontario, with attendance at less than 20 per cent of calls in Toronto, for example.

"What we have here, I think, is a medically proven, scientifically founded process which I'm pleased to recommend to the B.C. government."

Note to readers: This is a corrected story. An earlier version said 74 types of calls were downgraded.

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