BC Ambulance policy changes for Tumbler Ridge

BC Ambulance paramedic Ben Kostamo is genuinely concerned as he defines what is commonly known among those skilled in first aid as the ?golden hour?.  Says Kostamo, ?It is the one hour you have to get your patient to care (further medical help). If they don?t receive that care within that hour, their chances to survive could diminish greatly.?  

It was clearly evident at the Committee of the Whole Meeting on the evening of July 12th that the residents, health care workers, paramedics, fire department and Town Council were well prepared to address the presentation brought to the table by BC Ambulance. 

  The issue at hand is that Tumbler Ridge was presented with four options in regards to the availability of a second ambulance, referred to as ?second car?.  The function of the second car is necessary, given the fact that when the first car is already dispatched, it leaves Tumbler Ridge and the surrounding area with no medical mobile emergency help.  

 All four options were vehemently opposed by those present. BC Ambulance representatives, Bruce Chambers, Regional Director from Prince George and Ward Minifie, Superintendent for the Region, from Dawson Creek. Chambers is the director of 36 communities in our region. Representing Tumbler Ridge was Unit Chief Bill Hendley. 

In a meeting with Bruce Chambers, Rose Colledge, attending as Acting Mayor at that meeting, said initially three options were offered, with a fourth added since the meeting in early June. The options presented were:

 1) To pull the second car completely, relying on Chetwynd and Dawson Creek to handle the calls that come when the first car is in use.  

2) Second car remains in Tumbler Ridge, but volunteer paramedics will be located on a ?scramble? basis at the time of the emergency call. 

3)  24 hour exclusive use of first car in Tumbler Ridge. Dawson Creek and Chetwynd would handle all transfers to medical facilities. 

4) The second car is in use in Tumbler Ridge, operated by unpaid skill-trained volunteers. Training would come out of the $36,000 staff allocation. 

 Kostamo, adds, ?We can?t see the response time coming from Chetwynd or Dawson Creek making any kind of difference when someone?s life hangs in the balance. Then we?ve lost that golden hour.  Says Kostamo, ?They?re looking at saving about $36,000. Can you really put that kind of price tag on someone?s life?? 

Mayor Iles, and Councillor Rose Colledge represented council, who are in agreement that the options were unacceptable and needed to be further examined. When asked, Chambers stated that this decision was not a budget cut. The fourth option, as understood by Colledge, was for the District to allocate appropriate choices of future and existing paramedics. Responded Colledge, ?The municipality is not in the practice of allocating health care dollars, nor should they be.?  

The pay a paramedic receives for standby is minimal, at $2 an hour. The cost for having a second car staffed on standby costs the BC Government is approximately $96 a day, allowing $36,000 a year for standby or pager pay. With the fourth option listed above, that same money would then be used for upgrading the skills of volunteers. It is currently the responsibility of anyone wishing to prepare as a paramedic to pay for his or her own training.  

Tumbler Ridge volunteers say they cannot commit to being available at all times without having an income from a paying job. That leaves any of the options potentially without the necessary medical personnel to be available in the event of an emergency.

Brian Sipe, president of TR Cares, was on the agenda to make a presentation on behalf of his organization. Dr. Charles Helm, representing the medical staff, and Ben Kostamo, representing the paramedics at risk of losing their paid status, joined him.

Dr. Helm stated that due to our isolation, the amount of time spent in ambulance transfers is considerable, often in the range of 5-6 hours, and because of our vast drainage area, a response to an emergency in the bush can take a similar amount of time. It is at these times that we need a second car the most. ?The $35000 figure quoted is to my mind money very well spent for the peace of mind of residents, knowing that when first car is out, there is timely help available.? 

In his presentation, Chambers referred to the Tumbler Ridge Health Clinic as a hospital. The fact that it is a D & T (Diagnostic and Treatment) Centre changes the perspective on what is medically available.  Said Dr. Helm, ?It really makes one wonder about the timing of this move (given the possible extreme surge in population)?. Helm had, in fact, spent a considerable amount of time the day before the Committee of the Whole meeting in a teleconference with Chambers and Minifie, explaining the reasons why using stale demographical information was meaningless. The changes in Tumbler Ridge have gone from the 1980?s statistics and population of 5000 to a dwindling 1500 just four years ago. Many agree that while it would not have been a welcome move then either, although it would have been more understandable. Added Helm, ?It really doesn?t reflect what is going to happen here in the next few years.? He went on to say that the Committee of the Whole was for him a frustrating experience, as the exact same statistics were presented again by BC Ambulance Services ?This time to try and convince our Mayor and Council? despite his conversations the day before. Helm felt that there was a concern that in the face of logic and argument, people are not listening. He was gratified by the unity Mayor and Council showed in responding to the presentation. 

Another source of frustration for this community is the absence of consistent air ambulance, reconcilable with an improvement to the Tumbler Ridge airport. Adds Dr. Helm, ?This leaves (Tumbler Ridge) vulnerable and now with the threat of not having a second car available in a place that doesn?t have a hospital, it really doesn?t make sense. And at the moment, as medical and nursing staff, we?re actually liaising with Northern Health Authority telling them all about these changes that are coming this way and working out how we can increase and improve the services that are being offered. In fact, we?re even requesting the need for a hospital, down the road.? He then went on to say that everyone is gearing up for this growth and expansion and it seems ?totally bizarre to me, at this point in time, that an agency like BC Ambulance services would be even thinking about cutting back on what we do have.?

 Dr. Helm raised the issue that the time used in the arrival of the ambulance, added to time spent dealing with stabilizing a patient, or more than one patient and then the time transporting them was already a timely procedure. To tack on additional time in the arrival or transportation of the patients? means that golden hour is potentially lost.

 With estimates from the District?s Chief Administrative Officer, Jack Mussallem,  a conservative guess is that we can expect 600 plus additional people due to workforces from the mines. Given the possibility that the population may even spur upwards of 1000 annually, when all factors are in place, the outcome for managing with any of the four options seems dismal.

 

Brian Sipe spoke, representing TR Cares, 49 Forever and Hospice and Palliative Care. Members of these organizations were encouraged to stay for Sipe?s presentation.  He acknowledged that Town Council had already addressed many of his points, but he wished to provide information so that Mr. Chambers and Mr. Minifie could better understand that the proposals were not acceptable to this community. Sipe also offered an example. ?So what do I tell my wife? That if I had a heart attack and she called 911 and if an ambulance was in town it would be at our door in five minutes or maybe a little longer,  if they could find somebody to drive it. Or 65 minutes if coming from Chetwynd?  Or 85 minutes from Dawson Creek? Is that supposed to comfort my wife??  

From the perspective of BC Ambulance, the bottom line is that they can save $36,000 a year by having that second car either pulled completely or available on a scramble basis by volunteers likely stationed at a place of employment. That $36,000 could potentially be used to train volunteers to be skilled for emergencies. However, if the volunteers must seek employment outside of BC Ambulance, then there is nobody to man second car.  

Sipe also brought attention to the fact that while the individual cost break-down of the second car was being touted as $7000 per call, the breakdown should have reflected the number of calls the first car was out and the necessity or potential for use of the second car. Statistics showed that second car was used five times in 2004 and seven times in 2003. In comparison, the first car went out 186 times last year and 80 of those calls were transfers to other medical facilities. 

Without a second car, Tumbler Ridge is without any ambulance services during the period when the first car is dispatched.  Having Dawson Creek or Chetwynd transfer those patients taxes their time and availability, and adds to the time the patient must wait for services.  

Is it too late to influence the decision and come up with a fifth option to leave procedures as they are? While addressing Mayor Iles and Jack Mussallem, Bruce Chambers gave assurance that there would be a no time-pressure discussion and debate on what happens next. The original plan was to pull second car completely by July 1st, but  BC Ambulance granted an extension until the end of August.  

Realistically, we are all in this together. Just because you have a chronic illness doesn?t mean you?ll require an ambulance, but we are all at the mercy of fate and any one of us could fall victim to accident or tragedy.  The best way to advocate change for this issue is to write BC Ambulance and your MLA.