Editor:
It is disheartening and frustrating to see the approach to what is perceived as inadequate ambulance response times.
I say this because I am a member of a profession predicated upon the fundamental principles of using evidence, proof of benefit and proof of safety as a basis for everything I/we do.
Contrary to these principles, the fire department is now deploying EMR trained personnel to medical incidents and it is being sold on the basis of its benefit, when in reality, there are absolutely no functions within the EMR scope of practice that provide tangible benefit beyond what first responders now provide.
Indeed there is little demonstrable benefit to having first responders at all. However, as they say, this is your dime.
Laymen often use fearful arguments like heart attacks and blocked airways as justification for the deployment of first responders. In nearly 30 years, I have only ever seen one obstructed airway and heart attacks are caused by blood clots and cannot be helped in the field at all.
What patients suffering heart attacks, strokes, trauma and a myriad of other life-threatening conditions require is early and rapid transportation to the proper hospital. Nothing that (specifically) first responders do in the field makes any measurable difference to the outcome of someone suffering a heart attack or stroke. Cardiac arrests (not synonymous with heart attack) benefit from CPR and defibrillation, which can be performed by anyone, and the earlier this is performed, the better. Public CPR awareness and public access to automatic defibrillators makes more difference than emergency service based first responders.
The Canadian Heart and
Stroke Foundation and the American Heart Association have devoted years, and hundreds of millions of dollars, researching these very issues, and have used the most highly trained and respected experts in medical science. They do not use fear mongering and the opinion of a few city employees, or counter arguments from labour groups, as the basis for making decisions regarding the treatment of patients.
If Delta really and truly wants to make a measurable difference in providing effective pre-hospital emergency medical care, then do what you can to get ambulances to a patient's side faster.
Instead of spending money on EMR-trained firefighters and using multi-million dollar trucks to shuttle first aid kits and oxygen bottles with little demonstrated benefit to patient outcome, perhaps you might consider operating your own ambulances.
Bear in mind, however, those ambulances will be taking the most seriously ill and injured people to New Westminster and Vancouver where advanced trauma, cardiac and neurological care can be provided.
You could also eliminate obstacles like traffic medians that block emergency vehicles, and you could outlaw electronic security devices in elevators that obstruct emergency responders.
You could mandate AEDs be in all public places and raise CPR awareness to be the most CPR-aware community in Canada. Evidence is impartial. Evidence often contradicts what we passionately and intuitively believe; If Delta is committed to a professional and effective approach to delivering services to its citizens, then please use evidence as a guiding principle.
I. Hames
Advanced Life Support Paramedic
