Newsletters Past & Present of the Sarnia Paramedic Association

The association now has a seat on the System Optimization Sub-Committee.Some highlights of the October 8th meeting are as follows:

Sarnia Fire Chief Boyes asked the committee to define exactly what was expected as far as the level of training that the committee expects from the city firefighters.Mr. Arbour, EHS London suggested that Chief Boyes should be asking the City to outline the level that the city wished the firefighters to be trained to, and that the committee was not in a position to give any recommendations.

Chief Boyes stated that currently the standard for firefighters is CPR and Standard First-Aid.

The Chair stated that it would be inappropriate to spend money on any ‘‘advanced’’ training for the Sarnia Fire Department, and that the money could be better spent elsewhere.

Chief Boyes further wanted to know when the committee wanted the fire trucks “to roll” on medical emergencies. Consensus was that the fire department should only be responding to emergencies as outlined in the Tiered Response Agreement. This would include the following types of ambulance calls:

The original agreement also states that Fire would respond when possible life threatening injuries may be present due to vehicle fire/gas spills, patients trapped and at any other time was inappropriate”. The position of the Base Hospital is that no calls except those on the Tired Response Agreement should have a fire department response. The complete original Tired Response Agreement is available for all members to review.

Stats were shown which indicated that the ambulance usually arrives at VSAs before the fire department. The fire department arrived before the ambulance an average of 29% over a 12-month period ending in June’98. Chief Boyes was unable to suggest why this had taken place.

The committee heard that miscommunications between CACC and the 911 Dispatchers at Sarnia Police Headquarters was leading to a lack of consistency with the manner in which the fire department responds to medical emergencies.Apparently the criterion of the tiered response agreement is not always being met. The complete minutes will be available to see at our next meeting.This committee is an excellent opportunity for the association tohelp make the decisions, which determine how ambulances/fire departments respond to medical emergencies. It is also a good forum to have our ideas heard by the decision makers. We need to take the time to formulate a list of ideas meeting. Sarnia Paramedic Association and have them to table at the next Think about changes which can be made that would improve how we respond to calls, dispatch policies, and when we need the assistance of allied services.

Apparently Rick has made arrangements for Sarnia to participate in the Pedi-Mate Child Restraint Study. I guess that we had better come up with a new goal for our fall fund raising. ($346 to date!)Bring ideas to the next meeting.

I have received word that we have the “go -ahead” from Canadian Tire and Lambton Mall to hold a fund-raising barbeque outside the front doors of Canadian Tire. The date for the Barbeque is Saturday, Oct 31. Tom will look after getting the food again, but we will need some volunteers to cook, serve people, and do some PR. The Brick Barbeque was a success. Hopefully this one will raise as much money. Sausage, Homburgs, and maybe hot dogs again I guess????

You should find a survey in our drawer at the base. Please give it some thought and provide your opinions so that they can be collated before the next meeting. It is important that the Association has that we can present as policy of the solid position representing the members. To do this, YOU have to give your opinion

-Golden Four Minutes- The critical period prior to shift change when calls are most likely to come in.

-Positive Samsonite Sign-Patient requests emergency response. On arrival, patient standing at the curb with suitcase packed.

Chuck is still adding new things to the web page. It looks really good in case you don’t have Internet access. Ray Pettigrew is still working on the Case Review project. Speaking of Internet, did you know that JACK KNIGHT is on the web! YOU’RE KIDDING.

Frank Willsie got re-married last Saturday. The new Mrs. Willsie is a minister, and they plan to live in the sunny Town of Bosanquet.Way to go Frank!

Handle with care

There is a great amount of speculation across the county, as the downloading of ambulance services gets closer.Uncertainty about how the upper: tier municipality will handle the complicated task of managing the ambulance services has lead to discussion at all ambulance bases in Lambton County and across the province. The decision to download the responsibility of our emergency health services onto the backs of local government was a unilateral decision on the part of the province. The unfortunate recipients of this burden, in our case Lambton County, must now acquaint themselves with a service, which up until now has been almost invisibly provided by the province, with local management compensated to deal with the day-to-day operations. The County is inheriting this vital service at a time when all levels of government are faced with a tough fiscal reality. The County needs to understand better the service that is being provided before they undertake to make decisions, which will determine the future of emergency medical services in our communities.

Speculation about which provider will be managing the ambulance services in Lambton has raised many possibilities. Examples are as diverse as the interests represented by the prospective management candidates.

The current private operators may envision themselves as an effective management team to guide our public service through the challenges, which lie ahead. Assuredly the continuation of these regional private operators represent what needs to be eradicated, that is a duplication of services and their associated costs. These “for profit” operators are paid from town to town in the county to provide essentially the exact same service. They each receive a generous profit to manage a handful of employees and ensure one ambulance is mechanically sound. The duplication of service cuts into the available monies that would be better spent on additional front-line personnel.

There has been speculation that local re departments could be the natural recipients of the ambulance services. His is a view shared only by a very w people who may only be interested pushing their departments closer to their American cousins. A desire to bolster the fire department budgets and personnel levels to attempt to justify an already overgrown burden on the payers may be the only motive yards fire department based EMS. As demonstrated in the report by Dr. McNamara, the American model that causes local fire officials to become green with envy does not serve the public with the best emergency health care that Lambton residents have come to expect or deserve. Fire based ambulance service is not seamless, does not serve the patients or taxpayers and is not the direction that Lambton County should be considering. Other potential systems are topics of speculation but I believe that Lambton County should first look at the proven ability of the hospital based service in Sarnia before it considers unproven or outdated options.

The ambulance service which has been operated by the Sarnia General Hospital for over twenty-five years is the proven, time-tested option that would ensure a continuation of a high quality, cost effective cure for the uncertainty surrounding the dilemma of what to do with the responsibility for our emergency health services. When asked where the residents of Lambton can go to receive quality health care, one naturally recalls our hospitals. We don’t necessarily think of fire trucks unless of course we have been subjected to a lot of American television. We also don’t necessarily think of for-profit operators interested in turning what Sarnia General now provides into their lucrative business. The Sarnia General Hospital provides top-notch emergency care in their ambulances, backed up by a system, which oversees the standards and reviews every call. The ambulance is a natural extension of the service that the hospital provides to the citizens of Lambton.

The residents of Sarnia and Point Edward are now serviced by level two paramedics, a service shared only with a handful of other communities in Ontario. There is a natural affiliation between the hospitals of Lambton County and the ambulance services. The Sarnia Ambulance Service has already proven itself by taking the necessary steps to ensure that its paramedics are trained to the highest level available in Ontario. The standard of emergency medical care would be raised significantly if the entire county emergency medical services were brought in under the umbrella of the Sarnia General Hospital management. The cessation of the duplication of services by paying for only one institution to operate this new countywide ambulance service would save precious tax dollars. A single provider of service would ensure continuity across the county and guarantee an improved level of service to the residents of Lambton.

How many times has this happened to you?It’s 11:52 and you hear the base pager going off,

Dispatch doesn’t seem to understand what the meaning is of Priority 1 calls. Is “deferrable” not a word in their vocabulary? With 2 dispatchers and 1 supervisor rotating through each position of call taker and dispatcher for lunches, breaks etc... It seems to them that we should be ready for these code 1s as they hand them out. Are they ill informed about our lunch/dinner times? Is there a misunderstanding about code I calls? Why is it that they will hold a code 3 call for a shift change but a code 1 has to be moved A SAP? In other dispatch centers, code 1 calls can wait up to 3 hours, and for code 2 calls are taken but the caller is advised that they (being the crew) might be late. Are we not in the business primarily as an emergency medical service? Doesn’t that imply that we do emergencies first and the transfers second as time permits?

Why is it that an out of town P1 vehicle is brought in on a code S while both Sarnia P2 vehicles are tied up on transfers? (Most times code 1s)?

Why are these out of town vehicles not being utilized for these transfers, leaving P2 cars available for the incoming emergency calls?

Do not we have an obligation to the people of Sarnia, Bright’s Grove and Point Edward to provide Advanced Life Support procedures when needed? These plus many other questions plague our day-to-day operations. It would be beneficial if we (who work the cars) and dispatchers could sit down and work out these problems thereby making the system operate as smoothly as possible. If this could be achieved there would definitely be less complaints between the crews and the dispatch. Who knows what the change in control over the ambulance services will bring, but perhaps we will be able to effect change in a positive manner if requested to participate.