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New ambulance protocol delaying response: fire chief
Recent changes to protocol have led to slower ambulance response times, says Burnaby's fire chief.
On October 29, the B.C. Ambulance Service (BCAS) changed its resource allocation plan (RAP), downgrading the response to 74 medical situations from Code 3 to Code 2. Instead of an ambulance being dispatched with lights and sirens, they're treated as a routine call.
While BCAS has already implemented the new plan, Burnaby fire department has not.
In the first four months since the change there has been a "corresponding increase" in the time firefighters wait for an ambulance to arrive, said Burnaby Fire Chief Doug McDonald in a report to council.
In the three months before the change, Burnaby firefighters received 2,279 medical emergency calls. Ambulances arrived, on average, 6 minutes and 38 seconds after firefighters.
Firefighters waited more than 30 minutes for paramedics in 20 cases and for more than 60 minutes in zero cases, the report said.
But in the first three months since the change, Burnaby firefighters responded to 2,424 such calls. Ambulances arrived on average 9 minutes and 21 seconds afterwards.
There were 44 cases in which ambulances arrived more than 30 minutes later, and six cases when they showed up more than an hour later.
While B.C. Emergency Health Services (BCEHS) said in a Jan. 3 letter that most B.C. fire departments had decided to match the new protocol, that's not the case, said the report.
The B.C. Fire Chiefs Association polled its members and found 78 per cent of cities responding had not adopted the change. And 48 per cent said they were waiting longer for ambulances to arrive.
BCEHS says it made the change to reduce the risk of motor vehicle crashes while rushing to non-urgent calls. But the report said there is "no evidence" to support that concern.
In the past two years Burnaby Fire Department has only been involved in three minor, low-speed accidents. Those were cases of fire vehicles scraping a lamp standard and two parked vehicles in a narrow corridor.
Firefighters are not trained to provide the same level of emergency medical care as paramedics, the report noted. To provide added training would not only download responsibilities to the fire department, it would come at a significant cost.
Upgrading the training of half the Burnaby Fire Department would cost about $210,000 initially plus another $50,000 a year to maintain the training.
The changes were made based on clinical and statistical data, the report noted. But that ignores the fact the patient's conditions can be worse than originally classified by the dispatcher.
"Despite training, anytime an ambulance responds with ‘lights and sirens’ there is a risk that they may get into an accident. We will continue to respond to all calls. What has changed is how we drive to some calls," said BCEHS spokesperson Kelsie Carwithen by email on Monday.
"This is also not about reducing costs but rather using our resources smarter."
BCEHS will review its data six months after the changes to confirm it is working as planned.
"Since the RAP was implemented, we found that we are getting to urgent calls faster and that our response time to routine calls are approximately six minutes longer," she stressed. "We found that the six additional minutes for routine calls did not have a negative impact on the patient’s condition."
Carwithen said BCEHS is consulting with local governments and fire chiefs before further implementing the changes for first responders. Local governments also "differ greatly" on the level of response they want their first responders to provide, she said.