This story is part of the critical situationAnd the A series from CBC British Columbia talks about the barriers people in this province face in getting the right health care at the right time.
In his 22 years of service with the Peachland Fire Department, fire chief Dennis Craig has rarely seen so many calls to the medical service.
His department, made up of 34 volunteers, has provided first responder service since before Craig joined. In 2021, she received 352 calls from residents of the Peachland area, west of Kelowna, British Columbia.
Of those, 168, or just under half, were for Medicaid, a sharp rise from where the department was nine years ago when, according to the chairman, medical calls accounted for just under 40 percent of the department’s responses.
Craig, 48, said, “My concern is being restricted to a medical call and not being able to respond to the fire. Once our truck has committed to a medical call, it is complied with so we can deliver it to the same level of care — or higher.”
Craig notes that on some rare occasions, his crew waited 20-30 minutes for an ambulance to arrive.
With communities across British Columbia short of both ambulances and first responders, many volunteer fire departments find themselves filling in the gaps, providing emergency medical services to small towns often located within an hour or more of the nearest hospital.
But while departments like Peachland are willing to continue providing their current level of medical services, crews in some nearby communities have been reluctant to expand their work, citing concerns about training, resources and volunteer fatigue.
Dan Derby, president of the British Columbia Fire Chiefs Association (FCABC), believes that while the majority of county fire departments are involved in some level of first responder services, recent challenges, including the opioid crisis, bushfires and the COVID-19 pandemic, It left some crews wanting to limit it or re-evaluate the entire medical offer.
In early August, volunteer firefighters in Ashcroft Village, an hour’s drive west of Kamloops, British Columbia, responded to a call for an 84-year-old man who had had a heart attack.
According to Ashcroft Mayor Barbara Rhoden, Fire Chief Josh White told the caller that Ashcroft firefighters are volunteers and have not been trained as medical responders.
“It’s not something they’ve been trained to do,” Roden said. “It’s not something they’ve signed up for, and it’s going to take a heavy toll on our volunteer firefighters.”
Roden told CBC that White, who has received first aid training, came to the scene and performed cardiopulmonary resuscitation (CPR) using an automated external defibrillator from the firehouse.
His efforts were unsuccessful, and the man died while waiting for nearly 30 minutes for an ambulance to arrive.
CBC requested an interview with White, but he declined.
In a statement, British Columbia Emergency Health Services (BCEHS), which oversees the delivery, coordination and management of out-of-hospital emergency health services in the province, offered its condolences to the patient’s family.
It also noted that it has voluntary agreements with several fire departments across the county, with BCEHS notifying firefighters of a wide range of medical emergencies, including high-priority “red and purple calls” and orange and yellow “less urgent” calls. As calls that require technical expertise and equipment from fire departments, such as motor vehicle accidents, hazardous material sightings, or potential drownings.”
Meanwhile, the British Columbia Department of Health said in a statement that it “recognizes that there is an increased demand for volunteer firefighters to respond to medical emergencies” and that “increasing the number of BCEHS staff, particularly in rural communities in British Columbia” is a priority for the NDP government. .
‘False sense of security’
While it’s unclear whether the Ashcroft man could be saved with a faster response from paramedics, his death served as a stark example of what can happen when small-town residents lack immediate access to emergency health resources.
Ashcroft resident Nick Lebedoff helped perform CPR on the 84-year-old before the firefighters arrived. He believes that every small town should have a dedicated ambulance service.
“I’m worried because I’m living alone,” said Lebedov, who underwent open-heart surgery in 2014 after going into cardiac arrest. “What would happen if I called 911 and had to wait half an hour? It was too late.”
Beachland Mayor Cindy Fortin feels the county is “playing the odds” when it comes to public health, leaving small-town residents with a “false sense of security.”
“[The province] He says it’s understaffed…but that’s been happening for a long time, so, to me, that’s not an excuse.”
According to BCEHS, Ashcroft has one ambulance with eight regular paramedic positions and one “irregular” full-time position, which is described as “a permanent but irregular position, such as a pontoon, to cover on vacation days, sick leave, etc. . . .”
Peachland also has one ambulance with eight full-time regular paramedics, non-regular paramedic and on-call staff.
In both communities, BCEHS said in a statement, ambulances and paramedics could be tasked with operating in other areas.
In Ashcroft, this area includes Lytton, Clinton, 100 Mile House, and Lake Logan.
The Peachland area includes a section about halfway to stops in West Kelowna, Summerland, to the Okanagan Connector, Highway 97C (halfway to Merritt) and some backcountry and woodland service roads.
Medical training may deter volunteers
Tom Moe, chief of the 18-volunteer Cache Creek Fire Department, said his team has been asked to answer medical calls, even though they are not currently qualified or trained to handle them, with only “a few.” After they have completed Level 1 First Aid.
“None of our members are interested in making medical calls at this time,” said Mo, who has 31 years of volunteer firefighting experience in Cash Creek.
“We joined the fire department to be firefighters, not paramedics.”
Specifically, Mo said his members, who work 40 hours a week in addition to their firefighting obligations, are unconcerned about the responsibility or psychological stress that can accompany medical calls.
It is estimated that he has lost six people to fatigue in the past two years.
At the same time, he said, he felt pressure from BCEHS dispatchers and BC Ambulance recently to increase medical services at the department.
“We go to great lengths just to keep our services [firefighter] He said.
“If they start pushing towards first responders, it will cost us a lot of money and a lot more hours on our part to train us to where we need to be…adding medicine would be a huge deterrent.”
Can calls be sorted better?
In the days following the Ashcroft man’s death, British Columbia’s health minister, Adrian Dix, said the province had made “dramatic changes” in funding for BCEHS and BC Ambulance, with mental health and addiction seeing an even greater increase.
“Since 2021, we have added more than 500 new jobs for full-time and part-time paramedics in rural and remote areas to work at 24 new rural stations across British Columbia…
“Nearly 75 per cent of all permanent positions at BCEHS have been filled, and we have a strong national recruitment drive underway to fill the vacant positions,” a department spokesperson said in a statement.
However, firefighters interviewed by CBC said hiring is only part of the equation. Triage and public education about calls that require emergency services and that cannot also strengthen the BC health care system.
“We have to look at the entire system holistically to see where we can achieve efficiencies and better prioritize calls,” said Dennis Craig, Peachland’s chief of firefighting.
Meanwhile, the FCABC believes that local governments and fire departments should be the ones setting the level of prehospital emergency care.
In a position paper submitted to the Pre-Hospital Care Committee, which includes the Department of Health, BCEHS, BC Ambulance and others, the association writes that “local governments and first responders to fire understand local characteristics and are in a position to provide patient input into comfort and care delivery models.”
“The FCABC’s position is that communities must determine how their resources are used in connection with the provision of first responder services.”