Fire/EMS begin to face seperation in Ab

[mobey]

Change could affect emergency response time, alderman fears

Written by Gerald Gauthier Lethbridge Herald

Monday, 02 February 2009

Given the reason Lethbridge fire and ambulance services combined 97 years ago, Ald. Tom Wickersham finds it ironic the province is poised to force the city to turn ambulance services over to Alberta Health Services.

The key issue then, as now, Wickersham said, is the speed of response to medical emergencies. He and other local officials worry that under an EMS system run by AHS — the new provincial superboard — local ambulance response times will be slower, potentially resulting in deaths of victims who might otherwise be saved.

Although details are scarce on how the provincially run system will operate when it starts being phased in April 1, AHS officials maintain the province intends to make ambulance services more efficient and consistent across the province without compromising public safety.

The Lethbridge Fire Department took over the single, horse-drawn ambulance from the Galt hospital in 1912 in response to ongoing complaints about the hospital-run service exemplified by a serious foul-up two years earlier, in 1910. A worker at the Ellison flour mill got caught in a belt which tore off his right arm and broke both his legs. Hospital staff refused to send the ambulance without a doctor’s certificate verifying the victim’s injuries warranted it. Bleeding profusely, the man went into shock while waiting more than an hour for the ambulance.

What has evolved in the decades since then is an integrated service in which all Lethbridge firefighters are also trained as paramedics, or Emergency Medical Technicians, whose skills can be used interchangeably, depending on the response required. Other Alberta cities such as Red Deer, Airdrie, Leduc and Fort McMurray have integrated fire and EMS operations but none are exactly alike. Meanwhile, in Edmonton and Calgary separate city-run fire and EMS services have been the norm for years.

“This is about taking into consideration that one size doesn’t fit all,” said Wickersham. “It is actually mind-boggling that until (Jan. 22) our department was not consulted on emergency care and how to deliver emergency care. We have a hundred years of experience and you would think we have some experience to share.”

Particularly troubling for him and his successor Fire Chief Brian Cornforth is the fact measurement of response times has been absent in discussions so far with provincial officials. Current Lethbridge EMS response standards call for arrival between six and nine minutes 90 per cent of the time.

The only response measurement provincial officials have mentioned so far, they said, is a 90-second chute time — the time it takes to get an ambulance rolling after a call is received.

“If you don’t measure arrival time, you might be out in 90 seconds, but you may not arrive for 15 minutes. Travel distance and travel time are very critical . . . because if a person isn’t breathing, you only have a certain amount of time to save that person’s life,” Wickersham said.

Several years ago, Medicine Hat looked at Lethbridge’s integrated system as a potential model for combining its own fire and ambulance services. Those plans were abandoned in 2004, however, when the province first announced its intention to centralize EMS.

“Chute time is really nothing more than dressed an en route. It’s the response time that matters for both fire (fighters) as well as (emergency) medical,” said Ron Robinson, Medicine Hat fire chief. “If you can’t intervene within that short span of time . . . then we’re in a recovery position, a body recovery posture. And what value is that?”

The province is to take over ambulance services April 1, but municipalities will likely be required to continue providing those services during an undetermined transition period.

“Emergency response times are obviously important,” said Howard Snodgrass, AHS director of EMS for the southern region of the province. “Whatever we do, we’re not going to provide a degradation in service.”

Lethbridge and other municipalities have first option to continue providing EMS under two-year initial contracts which are being offered as a chance, he said, for both sides to feel each other out before committing to long-term agreements.

For the City of Calgary, the provincial takeover means municipal taxpayers will no longer be responsible for the $27-million annual expense of EMS.

“We’ve been asking the province to take responsibility financially for EMS for some time, particularly because it has become very much a health-care function,” said Calgary Ald. Ric McIver, who heads a city committee overseeing emergency services.

To continue as a contracted EMS provider, the Lethbridge fire department would need to add 20 staff by April 1 — a near-impossible task, department brass have said, given the acute shortage of workers with such training.

They’ve indicated construction of a new downtown firehall will go ahead either way. The city has also learned it will no longer be dispatching ambulance calls from its integrated emergency communications centre which also handles police and fire calls.

What’s uncertain now is whether the centre will be moved as originally planned from Lethbridge regional police headquarters to occupy the third floor of the new fire hall. Without EMS calls, about 77 per cent of the workload would be police calls, and the remaining 23 per cent would be fire calls.

**Afterthought... should have put this in Canada's forum spot :oops:

[Canadian Caesar]

I've talked to the Chief of Strathcona EMS, which is integrated, and it turns out nothing will be changing there.

They are continuing service as usual while sub-contracted by Alberta Health.

So it doesn't look like Fire/EMS in Alberta is going the way of the dinosaur quite yet.