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Ambulance waits triple for some medical calls, says Richmond fire chief

Of those calls where firefighters arrived first in Richmond, the wait for an ambulance has tripled to 15.5 minutes from a year earlier. - Black Press
Of those calls where firefighters arrived first in Richmond, the wait for an ambulance has tripled to 15.5 minutes from a year earlier.
— image credit: Black Press

Patients are waiting an average of 15 minutes for an ambulance for some medical calls, according to Richmond's fire chief, who responded Monday to province-wide changes civic leaders are calling "downloading."

"We are seeing an increase in our call wait times when we're on the scene first," Chief John McGowan told council. "We could be waiting longer and unavailable to respond to fire calls if they did come in."

B.C. Emergency Health Services, which oversees the B.C. Ambulance Service, recently changed its response to 74 of 868 calls—downgrading 39 of them to routine, instead of a lights-and-sirens response. Those calls include everything from some minor vehicle collisions to falls.

Richmond firefighters are now first on the scene for half of the calls with a changed status, according to McGowen. Before the changes were made last October, paramedics arrived first in two out of every three such calls.

Of those calls where firefighters arrived first, the wait for an ambulance has tripled to 15.5 minutes from a year earlier. McGowen also noted that in the first four months of the change, waits of over 40 minutes were recorded 31 times, compared to just two a year earlier.

McGowen warned of possible trouble if firefighters are left waiting at scenes of lower-priority calls.

"This could impact Richmond Fire-Rescue's response capabilities to fire incidents, as fire apparatus would be tied up longer at medical events and unavailable for assignment to fire incidents."

Mayor Malcolm Brodie said the changes amounted to a "downloading" from the province.

"Because they're taking longer to get there…it's a download to the city. And of course there's no consultation, no nothing. Just there it is. So that's what we've got to fight."

Coun. Ken Johnston said when he served as MLA in East Vancouver a decade ago, ambulance wait times crept up to 23 minutes, resulting in tragic results in a handful of cases.

"If there's additional delays at these scenes in terms of the ambulance situation, even if it's nine minutes…then that is a concern."

But Dr. William Dick of B.C. Emergency Health Services told The Richmond Review ambulances are still being dispatched when called—only now they're responding to the sickest patients first.

"We know we are getting to sicker patients province-wide about a minute faster than we were. And on average the wait for the least sick patients in the changed calls is about six minutes longer on average for the province of British Columbia," said Dick, vice-president of medical programs.

Dick said his numbers for Richmond show a slight increase in wait for the least sick patients, and little change for the sickest of patients. But in other cities the change has been more dramatic. In Port Coquitlam, response to the sickest patients has improved by almost 1:45 minutes, he said.

"That's what we want to do, because if you're having a cardiac arrest, or you're suffering from a blocked airway, or you're really sick—you really need somebody there now," said Dick.

According to B.C. Emergency Health Services, prompting the review—the fifth since 1997—were paramedics complaining of over-responding, municipalities complaining of first responder use and public concern about the number of emergency vehicles responding to minor incidents.

The changes, which have no budget impact, are also meant to cut down on collisions of ambulances racing to non-urgent events, and possibly save cities money by reducing fire response.

Dick said Richmond firefighters waiting at non-urgent scenes doesn't change patient outcome.

"They don't provide any clinical benefit of being there," he said. "(Comfort care) could be a benefit, but there's absolutely no evidence of any medical outcome change."

Dick is continuing to consult with local governments—a meeting with Richmond is planned—and insists "this is a safe and rational process" that will react if any problems are discovered.

Said Dick: "Everybody would like more of everything. Firefighters would like more fire trucks, I would like more ambulances and people would love more hospitals, but we've got to deal with reality."

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