Air Ambulance Service Under Review

[Arctickat]

We've got a "Not-For-Profit" Helicopter air ambulance based in the three prairie provinces in Canada. It started in Alberta, and moved to Saskatchewan 2 years ago, and more recently into Manitoba. I'm going to provide you with a series of news articles in chronological order that have surfaced in relation to the Manitoba operation.

http://www.cbc.ca/news/canada/manitoba/boy-2-clings-to-life-after-oxygen-loss-in-ambulance-transfer-1.1311135

http://www.cbc.ca/news/canada/manitoba/parents-sue-air-ambulance-over-manitoba-toddler-s-injury-1.1403892

http://www.cbc.ca/news/canada/manitoba/some-stars-air-ambulance-missions-under-review-in-manitoba-1.1334951

http://www.cbc.ca/news/canada/manitoba/stars-air-ambulance-flights-suspended-in-manitoba-1.2448327

http://www.cbc.ca/news/canada/manitoba/ground-ambulances-beat-stars-times-while-service-suspended-1.2524804

http://www.cbc.ca/news/canada/manitoba/stars-faces-tough-questions-after-manitoba-flights-grounded-1.2449730

http://www.cbc.ca/news/canada/manitoba/manitoba-s-stars-air-ambulance-slammed-in-draft-provincial-report-1.2542471

http://www.cbc.ca/news/canada/manitoba/father-wants-answers-about-daughter-s-death-after-stars-flight-1.2542686

[paramedicmike]

Too many questions. Not enough answers.

[rock_shoes]

http://www.cbc.ca/news/canada/manitoba/manitoba-s-stars-air-ambulance-slammed-in-draft-provincial-report-1.2542471

This particular article probably sheds the most light so far. The final report from Dr. Wheeler should be rather telling.

[island emt]

after reading the reports : it's sounds to me like someone has a personal ax to grind & is looking to blame the air service,

Unless they are being used for routine transports , then areomedical transport is usually for those that have severe life threatening medical conditions that are beyond the capability of local hospitals or ambulance transport parameters.

[rock_shoes]

http://www.cbc.ca/news/canada/manitoba/manitoba-s-stars-air-ambulance-slammed-in-draft-provincial-report-1.2542471

Let’s pull some of the relevant pieces out of this article shall we. As a point of reference regarding the report’s author, Dr. Stephen Wheeler is the medical director of B.C. Air Ambulance and Critical Care Transport. Dr. Wheeler was commissioned by Manitoba Health to write it and is in no way affiliated with any of the affected families, STARS, or Manitoba Health (with the obvious exception of being commissioned to write said report). BC air ambulance programs have no inclination to take over rotary operations in Manitoba.

In one case, according to the report, STARS ran out of oxygen in flight, something Wheeler said “should never happen.”

Rather difficult to dispute this point.

In another case, the air ambulance crew ran out of epinephrine while transporting a severely allergic man who had been stung by a bee to hospital, says the report. The patient died.

Pretty basic stuff. Check your equipment at the start of your shift. No different than a ground ambulance crew.

“As a group, the nurses and paramedics lack adequate training and experience to work in the air medical environment,” Wheeler writes in his report.

Dr. Wheeler goes on to elaborate further regarding the issue of insufficient training.

In a section comparing other provincial helicopter ambulance programs, the report concludes that STARS Manitoba’s 10-week training program is “grossly insufficient” and “falls far short of training models in B.C. and Ontario,” where air crews must train for 12 to 24 months.

Keep in mind Dr. Wheeler is not seeking to have STARS ousted. His recommendations are entirely about remedying the issues raised. Damning as this whole thing sounds he’s actually trying to help them be successful. Here are some of the key interim recommendations he has made. The last one listed in particular is critically important.

STARS should redesign its training program and immediately supplement its crews with experienced flight personnel for a minimum of six months.

STARS should limit its transport of pediatric patients to trauma scene responses, and not carry out routine patient transfers between facilities, while it reviews its pediatric training. Emphasis should be on pediatric airway assessment and management.

The methods of dispatching STARS “lack co-ordination and need improving,” he writes.

Quality control must improve because “overall, an emphasis on creating and maintaining a culture of quality is missing.”

[rock_shoes]

The aspect of this whole thing that truly baffles me is that STARS has operated successfully in Alberta since 1985. I’ve never seen anything like this regarding a Canadian air ambulance program before.

What is going on in Manitoba that’s so different?

Is the training program in Manitoba less involved than the one in Alberta?

Does the Manitoba division have a less developed/stringent selection process for staff than the Alberta division?

I have many questions regarding this entire thing. I hope Dr. Wheeler’s report answers as many of them as possible. STARS is rather unique in Canada for two reasons. Firstly they use a nurse/paramedic combination where other Canadian rotary operations use a two Critical Care Paramedic model. Secondly they are a publically sponsored, private, not for profit (not that the provincially run programs in BC and Ontario pull in any profit).

[island emt]

Thats kid of what I was trying to figure out Rock: if they have been doing this for 29 years as an organization, then what is different ???

too many unanswered questions.

OR someone has an agenda

[rock_shoes]

Thats kid of what I was trying to figure out Rock: if they have been doing this for 29 years as an organization, then what is different ???

too many unanswered questions.

OR someone has an agenda

It's always possible someone has a secret agenda, but in this case I'm having a difficult time figuring out who that might be. ORNGE already has its hands full cleaning up the Mozza mess, BCAS has far too many financial/staffing struggles to even consider taking over services, and I'm not aware of any private for profit rotary services in Manitoba. Truth be told I have to question even running rotary transports in Manitoba. By scale most of Manitoba would probably be better served by fixed wing and ground ALS.

The only name that springs to mind for me is Medavie. Medavie is the dominant player in the Atlantic provinces and also has a few of the Ontario contracts.

http://www.medavieems.com/en-us/OperatingCompanies/Pages/default.aspx

[J306]

The article regarding response times of STARS being slower in 20/21 responses than ground ambulance is an interesting one. I wonder how they would compare in Saskatchewan or Alberta. I agree that the training should be expanded from a 10 week program to a minimum of 6 months.. I find it hard to believe that there is such a large time difference between the BCAS/ORNGE and the STARS Critical Care transport program.

The one about running out of epi is something that shouldn't have happened at all..The ground ambulance service was 5 minutes from a hospital and STARS insisted they intercept them enroute?? I sure hope Dr. Wheelers report sheds some more light on these issues.

[mobey]

The aspect of this whole thing that truly baffles me is that STARS has operated successfully in Alberta since 1985. I’ve never seen anything like this regarding a Canadian air ambulance program before.

What are you using to gauge their success?

Lack of an inquiry showing failure does not indicate success.