Before the army of ambulances arrive at those kinds of emergencies, they get their marching orders from one of the most high-tech dispatch centres in North America.
The Medical Transportation Coordination Centre keeps a very low profile -- you probably didn't even know it existed.
Nestled in the old nursing-school dorms at the Brandon hospital campus, it looks like a smaller, sunnier version of a NASA control room, where dispatchers eyeball three computer screens, whip between multiple phone lines, juggle three computer mice and use a floor pedal to click their radios on and off.
Just in case the power goes out (which it won't; even the backup generator has a backup), dispatchers and call-takers write up their calls on a white board.
"Incoming!" hollers a dispatcher as a 911 call comes in during a quiet afternoon earlier this spring.
The relaxed joking among the young call-takers and dispatchers shuts down immediately, headsets click on and the bevy of software that guides each dispatcher zips into action.
First, the caller's exact location comes in automatically. When you call 911, you give up your anonymity. The dispatch centre uses your home phone to track your exact address and it pops up immediately on a computerized map the dispatcher uses to start figuring out where the nearest available ambulance might be.
Meanwhile, the call-taker is talking to the worried family member, typing answers into a computerized script that runs the call-taker through 33 possible ailments until the likely problem is identified, kind of like a Choose Your Own Adventure. The call-taker firmly teases all the relevant information out of the caller: Is the person conscious? Breathing? Able to speak? -- so it can be passed on to paramedics en route.
This one was a pretty routine respiratory problem -- privacy rules prevent the Free Press from revealing more. In little more than a minute, all the information is in the computer, the call has been given a priority code, the dispatcher has pinpointed the nearest available paramedic and passed on the location and details of the call. The computer is even able to figure out what the fastest route might be.
Take that, repeat about 80,000 times over a dispatch area the size of Afghanistan, and you have the MTCC.
"Our challenge isn't call volume," said John Jones, MTCC's director, "it's geography."
Using a kind of souped-up Google map, dispatchers can keep track of the exact locations of nearly 150 ambulances, including ones that are driving patients in to Winnipeg for scheduled treatments. Medics can be relocated like chess pieces so no part of the province goes without ambulance service for long, and the dispatch centre can keep an eye on the status of every call in the queue until it's cleared.
The MTCC and its 30-plus staff is the jewel in the province's otherwise patchy rural paramedic service. Three years ago, the MTCC replaced a hodgepodge of dispatch systems peculiar to each regional health authority, including some that were little more than a phone call to the nurses' station at a local hospital. Since then, the MTCC has streamlined and standardized the dispatch process and made much better use of the province's ambulances, in part because the centralized system always knows which ambulance is closest to an emergency, regardless of which regional health authority the ambulance might belong to.
This being Manitoba, call-takers often find themselves on the horn with family members, trying to fire an ambulance off to loved ones or childhood friends in trouble. Through their headsets, they also listen in on the province's darkest moments -- child deaths on reserves, terrible car accidents, the Greyhound murder.
Despite that, it's one of the best places to work in the province, by all accounts, and front-line paramedics say it has dramatically improved response times.
Some new gadgets are coming, too. Pretty soon, every ambulance in rural Manitoba will come equipped with an automatic vehicle locator. And, at some point down the line, Jones hopes a new national system will allow dispatcher to trace cellphones that are making an emergency call, a big help when a car accident happens in a remote location with few landmarks.
640,000 square kilometres covered by MTCC dispatchers, which is all of Manitoba outside the Perimeter Highway.
number of regional health authorities served.
number of ambulances dispatched.
seconds between when a call-taker picks up an emergency call and a dispatcher sends a first alert to a paramedic.
80,000 number of emergency calls the MTCC handles in a year.
cost in millions of dollars to build and equip the MTCC.
number of different step-by-step protocols call-takers can choose from to help deal with everything from a woman in labour to a heart attack to a car accident.
year MTCC opened at the Brandon Regional Health Centre