Call to boost health transportation

Safety report calling for faster, air-based emergency medical response gives boost to arguments for an upgraded Mills Memorial Hospital.

A call for faster air service for medical emergencies could be another argument for a new hospital in Terrace, B.C.

A call for faster air service for medical emergencies could be another argument for a new hospital in Terrace, B.C.

A recent safety report is calling for faster, air-based emergency medical response in northern B.C., and it might give an extra boost to arguments lobbying for an upgraded Mills Memorial Hospital.

The report, released last week by the BC Forest Safety Ombudsman, identifies a gap between emergency response times in the rural north and southern urban areas in southern B.C. It challenges the province to update legislation and use helicopters to speed up and improve emergency response in the north.

Faster transportation is needed in the north, because residents are already limited by fewer health services, said Roger Harris, who is the forestry ombudsman commissioned to investigate issues and highlight systematic problems affecting forestry.

“You can’t be hit twice, you can’t have no (health care) facilities, and less transportation,” he said. “Every resident of B.C., regardless of where they live, should have quick access to emergency services…Where (health care) infrastructure doesn’t exist, you should in fact have enhanced emergency transportation.”

Identifying the north-south gap, Harris summons the B.C. Government to set a provincial standard, mandating a time limit for ambulance services to get people to hospitals after an accident.

“The shorter the time it takes you to get health care, the sooner you recover and the better your outcome,” Harris said. “Everything we do should be to get people to hospitals as soon as we can.”

Since faster care means better recovery and overall cost savings, Harris says speed needs to be made the primary driving factor for medical transportation services.

His report was triggered in 2014 when a faller on Haida Gwaii had his leg crushed by a tree. It took an excruciating 11 hours before the faller got the full medical attention he needed, and his leg was amputated because of it.

If a helicopter was employed instead of a ground ambulance, the first five hours could have taken only 25 minutes, Harris said.

“I asked WorkSafe BC to investigate… the investigation showed that according to all of the rules and regulations in B.C. today, everything was done properly,” Harris said. “That tells me there is something institutionally wrong with our system.”

For the last two years, Harris has been investigating the system used by BC Ambulance Service (BCAS) and Helicopter Emergency Medical Services (HEMS).

He found that ground ambulances are always the primary way they respond to emergencies, and helicopters are used mostly for transporting people between medical facilities.

On the rare occasion helicopters can be used in a rescue, but they  usually bring patients to a waiting ground ambulance, rather than straight to a hospital.

Harris says the province needs to consider using helicopters as the primary way of moving people, particularly for long distances.

While ambulances strive for speed, Harris says the system severely limits their ability and hasn’t been changed since 1974.

“A lot has changed since then,” he said, adding that ambulance legislation needs a complete review and overhaul. “A lot of people have tried to find a way to fix this within the existing legislation…you can’t just tweak it… what this needs is a major change.”

Harris points out that both Alaska and Washington State guarantee that when an emergency hits, their residents can be brought to a trauma centre in no more than 60 minutes.

Alaska, with its similar geography to B.C., dedicates a fleet of 31 helicopters to medical transportation.

While such a service may involve a front-end cost, it would likely save long-term by enabling patients to recover much faster.

The second thing Harris advocates for is better use of first responders.

Right now it is illegal for first responders to take people to a hospital, Harris said. Despite their medical knowledge, they can only sit and wait with patients for an ambulance.

In a recent Vancouver accident, a patient was stuck waiting two hours for an ambulance, while first responders were there in 10 minutes. “Eventually they got him to a hospital, but he is now paralyzed,” Harris said, noting that timing was a key factor.

First responders man fire departments and search and rescue stations, and using them could vastly improve services with very little cost.

“That opens up a whole bunch of assets that we currently don’t use,” Harris said.

If a time limit is set, protocols for the rest will fall into place, he concluded.

“If there’s a maximum timeline by which BC Ambulance has to ensure that [an injured person gets care], that will drive them to develop protocols that allows them to do that — whether you live in Iskut, or whether you live in Vancouver,”

Harris recommends all residents have quick access to level three trauma care, and that’s where the bid for a new Mills Memorial Hospital comes in. Mills is level five, which can stabilize patients with major trauma and transfer them if needed.

So, while the province may opt for a lower standard, if they mandate a time frame for access to level three care, as Harris advises, then they’d likely need to add another level three trauma centre in the north. Right now, the only level three centre is in Prince George.

“In order for the province to guarantee access to trauma three services, they would need to add one more trauma three care centre in the north, other than Prince George.”

The city of Terrace and Northwest Regional Hospital District sent a release Feb. 2 saying they hope to use this case in their lobbying.

“The need for a level three trauma centre in the northwest is one of the primary focus points supporting the need for the replacement of Mills Memorial Hospital,” said the release.

Mayor Carol Leclerc said she hopes the province will move to equalize health care access, and if so, it could bolster the evidence for the need of a new Mills.

“If people who are living and working in rural areas, [have to be] within a 60-minute helicopter ride to a trauma three level hospital, it just adds to our argument that we do need a modern, regional trauma three level hospital in Terrace,” she said.

Terrace Standard