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ALS model could be coming for Taber |
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Wednesday, 07 May 2008 |
By Sharon Ulrich
Taber Times
Although a provincial announcement is expected June 15 to establish a new governance model for ambulance services, Advanced Life Support (ALS) is coming to the forefront locally.
Emergency services director Brad Mason, along with the area's medical director, Dr. Ryan Torrie, are working on a presentation to Town of Taber and M.D. of Taber councils regarding ALS, anticipated to be given within a month's time.
"Certainly, our recommendation will be that we make the move," remarked Mason. "For us, it's been something we've been moving towards for the five years I've been here. Bottom line is, it's all about providing a higher level of care for people, and that's really what's driving it."
Taber Emergency Services offers Basic Life Support, with two Emergency Medical Technicians (EMTs) staffing each unit on all responses who provide basic management of medical and trauma conditions. ALS has, at minimum, one EMT and one paramedic, and provides advanced management of medical and trauma conditions.
"Whether you're out in the rural location or a town, a paramedic really brings most of the emergency room right to you, and the paramedic just has a greater or broader scope of practice than an EMT," explained Mason of the differences.
"So while EMTs can provide some symptom relief and some intermediate airway interventions and they certainly still provide care on scene, whether that's at the house or at an accident or anything, a paramedic has a far greater range of treatment options available to them. "
Provincially, 64 per cent of all licensed EMS systems are ALS, and 73 per cent of all licensed ambulance units are licensed at an ALS level, according to statistics provided by Mason.
The only disadvantage of ALS is an increased cost to municipalities as a result of increased resource cost. However, monetary figures of such increases are not available until the presentations are made, Mason said respectfully.
As noted, advantages to ALS include a significantly-higher level of care provided to residents, employee retention, an increased level of service for inter-hospital transfers and an increase in positive patient outcomes based upon early provision of advanced care, especially in rural areas with longer transport time.
"The further you are from a hospital, the more sense paramedics make. That doesn't decrease the effectiveness of a paramedic in town but it can make a difference in outcome the further you are away."
That noted, challenges for certain levels of ambulance medical care in the Hamlet of Enchant have been re-addressed at the M.D. of Taber's annual ratepayers meeting, as reported.
Speaking on behalf of concerned residents in the area, former MLA Ray Speaker indicated a deficit exists with Charlie and Delta levels for ambulance medical care, the two most serious of the four levels of calls.
According to Speaker, Enchant is faced with unique circumstances in terms of its ambulance situation, with time noted as a big factor, considering it takes the same amount of time for an ambulance to get to either the Taber or Lethbridge hospitals from Enchant.
To address the situation, he told those at the meeting paramedics from the Coaldale ambulance service should be used for serious calls out of the hamlet.
To do so, he added, the M.D. would have to initiate policy changes that would see 9-1-1 Charlie and Delta calls from Enchant redirected to the Coaldale ambulance, via Lethbridge 9-1-1, and the negotiation of a fee-for-service agreement with the Coaldale Ambulance Authority would then have to be made.
All the information needed to make a sensible decision on ambulance service in the district has not been gathered yet, according to M.D. of Taber Reeve Hank Van Beers, with reference to Mason and Torrie looking into providing ALS service not just in Enchant, but to all residents.
Referring to indications of the provincial announcement next month, Van Beers said the M.D. is reluctant to make any kind of decision before that.
"I think it would be premature to start changing our ambulance service agreement, and then six weeks from now they are going to change it all. On my part, it would be safe to say that probably that decision won't happen until the government has decided which way they're going to go with the ambulance service provision."
With indications Enchant averages 10 calls a year, three of which require ALS, Andy Van Rijn, fire chief for Coaldale and District Emergency Services, said they would be willing, but noted their services cannot be stretched too thin either. With two ambulances in Coaldale that are staffed, Van Rijn said most days only one is staffed with a paramedic.
"You know if there's a school-bus accident up there and they need a bunch of ambulances it's not an issue but just for someone having chest pain, if our ambulance is out of town, then who's covering our town? We have some issues we have to work out."
To further explain, Van Rijn said 40 per cent of his calls are dispatched as ALS but once on scene, lots don't end up being ALS. Based on criteria a dispatcher receives, he explained if a person is having breathing problems or has a past cardiac history, it becomes a Delta, or life-threatening call, when indeed it may not be emergent and that person might just have a sore chest and it hurts to breathe.
"Some of those calls we get, the guy can drive himself to the hospital."
He mentioned in the County of Lethbridge, a new policy has been implemented where for Delta calls Picture Butte is dispatched, but an ambulance will also be dispatched out of Coaldale or Lethbridge depending on proximity.
"If Picture Butte gets on scene and says they don't need a paramedic, they'll cancel them. It doesn't pay to tie up your resources going to a call where it's not required."
In his opinion, he indicated Taber should have ALS and cover Vauxhall, while Coaldale could cover Enchant, while another paramedic service should be in Bow Island.
"We can't have a paramedic in every town. To keep up their skill level they have to do a certain amount of calls, and if you never use the skills you're not going to keep it up."
A complicated issue, Van Rijn indicated he can understand Enchant users who may not be happy with the level of service in the area, as well as the M.D.'s position of having the same level of service for everyone.
"So there's lots of issues, and I agree with Hank. We have to get this ambulance issue solved in the province - and why do some people deserve a paramedic and some don't? Everybody should have access to an Advanced Life Support service." |
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