The ongoing issue of whether firefighters should attend certain medical calls in Delta continues to burn for Coun. Lois Jackson.
It’s an issue the former mayor has worked on for 10 years, inspired by a personal experience when firefighters helped her daughter immensely before an ambulance arrived. Jackson says she simply wants firefighters to be able to attend medical calls to help until paramedics make it on scene.
“When you’re waiting for an ambulance, one minute can feel like an hour,” Jackson said, recalling a recent incident at Delview Park where she encountered a man who had fallen and hurt himself while walking his dogs.
“I’m not sure how long he was there but it was long enough for someone to go and get a quilt and a pillow for him,” she said, adding that it was rainy and cold outside and the man was sitting in the sodden grass for what she estimated to be about half an hour.
She noted that a man wearing a “firefighter in training” shirt and a male bystander assisted the two female paramedics in lifting the injured man and that firefighter response times are usually faster than ambulance response times.
“Why wasn’t fire dispatched? Why can’t [firefighters] help? There’s a full fire department here waiting to help people; let them help! Our guys can do a bunch of things to help people — make them more comfortable, help calm them down. We as taxpayers pay for that comfort.”
B.C. Emergency Health Services (BCEHS) runs the B.C. Ambulance Service and paramedic care in the province. Since introducing a new protocol for emergency dispatches in May of 2018 called the Clinical Response Model (CRM), Delta has been trying to get the BCEHS to notify the Delta Fire Department during most emergency dispatches.
The switch to the CRM protocol has resulted in firefighters attending fewer medical calls, even though Delta’s firefighters introduced a new program in 2015 to provide training so the city’s firefighters can provide enhanced medical aid such as minimizing pain, immobilizing the patient, taking blood pressure and helping to assess the situation and keep those present calm.
The change to 911 protocols means that now, calls are directed to and controlled by BCEHS and fire departments are only notified in certain cases.
BCEHS communications officer Shannon Miller said under the new CRM protocol, firefighters are notified if BCEHS believes they may make a difference in patient care. Fire first responders are notified of all immediately life-threatening and/or time-critical calls (coded “purple” and “red” in the CRM system) as well as urgent/potentially serious (“orange”) calls that they normally attend, unless there is an ambulance nearby that would arrive at roughly the same time (approximately 10 minutes, including call-processing time).
Fire departments are always notified of all vehicle crashes, hazardous materials sites, fire-related calls, drowning/near-drowning incidents and other calls where their assistance is needed, Miller noted.
She said the CRM was introduced to get to the most life-threatening 911 calls faster, while also improving the experience for patients who don’t require transport to hospital. The new protocol is working, Miller says, as response times for the most urgent calls have improved by one minute and 23 seconds, from 11:33 to 10:50 for red and purple calls under the CRM.
“The introduction of the CRM decreased notifications to fire departments by an average of 14 per cent across the province, including a decrease in Delta,” Miller said, noting a decrease was expected as it’s part of the model to better match resources to calls.
“We’re pretty clear: we call firefighters when we need firefighters,” she said, adding that firefighters are governed by the municipality, while BCEHS is governed by the province through the Ministry of Health.
Prior to the CRM, Delta Fire was being notified of 56 per cent of all medical emergency calls. In the first year with the CRM in place, the department was notified of 42 per cent of all medical calls, which Miller said amounts to a 14 per cent reduction, or 836 calls per year.
“Delta Fire first responders continue to be notified of close to 4,000 medical emergency calls each year. We depend on firefighters to assist with many of our medical emergency calls as our first responder partners,” Miller said in an email.
“But, we do not notify firefighters of every medical call — and never have. If firefighters are responding to a patient with a non-urgent condition, they could be tied up when we need them to respond to a life-threatening call.”
Miller said the Delta Fire Department was not notified of the call Jackson witnessed at Delview Park, as it was coded yellow, or non-life-threatening.
Delta Fire Chief Paul Scholfield said the CRM means the BCEHS has re-allocated a large number of calls to the orange category, where fire departments only get notified if BCEHS crews will be delayed in attending by more than 10 minutes. The average response time for Delta firefighters is four minutes and 50 seconds.
“We feel, as a city, that there are numerous calls where we could help,” Scholfield said. “The City of Delta would like to be able to decide which events our fire department attends within our city instead of the provincial entity (BCEHS) deciding which events we attend.”
Scholfield noted there was a resolution passed at the 2019 Union of B.C. Municipalities convention on the issue, and he’s hopeful the resolution will produce results.
“I think it’s really important to emphasize we respect and work well with B.C. Ambulance crews. We’re in no way trying to replace them, we’re just hoping to lend support and minimize any gaps.”
The Ministry of Health provided a response to the Reporter’s inquiries via email, outlining the benefits of the CRM system and saying the new model is “designed to better match resources to patients with non-urgent conditions,” but the ministry didn’t provide any comment on the UBCM resolution.
“BC Emergency Health Services and the Ministry of Health will continue to engage with communities to improve the service for the people of BC,” the response stated.
Jackson said she’ll continue to crusade for support.
“It’s got to be changed at the provincial level,” she said.
“It’s a huge public issue. A lot can happen in 10 minutes.”
By the numbers…
8,939 — Total medical emergency calls in Delta in 2018
• Purple (immediately life threatening): 155
• Red (immediately life threatening or time critical): 1,910
• Orange (urgent, but not life threatening): 2,678
• Yellow (non-urgent): 4,141
• Blue (non-urgent, further clinical telephone triage and advice, referrals to HealthLink BC): 55
3,770 — Medical calls Delta Fire responded to in 2018
• Firefighters are notified about 60-80 medical events per week
45 — Paramedics on duty in Delta at any given time
• North Delta Ambulance Station: 29 paramedics, five ambulances
• Delta Ambulance Station: 16 paramedics, two ambulances
NOTE: Paramedics can be dispatched from anywhere in the region such as a neighbouring station in Surrey, or a ground unit that is already closest to the emergency call but not necessarily from a Delta station.
35 — Firefighters on duty in Delta at any given time.
• Nine firetrucks and one battalion chief vehicle spread between seven fire halls