BC Ambulance improving emergency
transport in British Columbia
Starting this summer, expansion of three programs by BC Ambulance Service (BCAS) will benefit critically injured or ill patients in some remote portions of British Columbia – as well as the major urban areas of Vancouver and Victoria. In the Interior, patients suffering from major trauma will receive paramedic care faster through the Autolaunch program – the simultaneous dispatch of a ground ambulance and a critical care paramedic crew via helicopter to accident scenes. In the second program, BC Ambulance Service will transport critically ill or injured patients in the Northern Health Authority to specialty-care hospitals in Prince George or Vancouver faster through the Fixed-Wing Early Activation program. Metro populations in Vancouver and Victoria will experience new, narrow ambulances designed for urban areas.
When time is a critical factor, Autolaunch reduces the time it takes to get patients to advanced trauma care by providing rapid transport and critical care paramedics for patients who require care at a designated trauma hospital.
“Getting the right patients to the trauma centre that can best provide care for their injuries as quickly as possible is critical for patients with major injuries,” says Dr. Stephen Wheeler, medical director of the Emergency and Health Services Commission Critical Care Transport Program. “Reduced transport times to trauma centres results in better patient outcomes, reduced hospital stays and fewer costs to the health care system.”
Autolaunch – short for automatic launch – is based on information conveyed through a 911 call and is devised from a system developed by the Mayo Clinic so that an air ambulance can land directly at accident scenes. “We learned of this program about 10 years ago,” says Randy L’Heureux, director of critical care operations for BC Ambulance Service. “Mayo Clinic in Minnesota gave us a lot of assistance in 2004 when we set up our program.”
Based on information provided by 911 callers, BC Ambulance dispatchers identify calls that indicate a patient would likely benefit from an Autolaunch response. A dedicated air ambulance helicopter with a team of criticial care paramedics and a ground ambulance are dispatched immediately. The ground ambulance is advised of the Autolaunch and is given the aircraft’s estimated arrival time. Once on the scene, the ground crew of paramedics can cancel the air transport if they feel the patient does not require air transport to a trauma hospital.
The autolaunch protocol has been active on Vancouver Island, Vancouver Coastal and Fraser Health authorities, the East Kootenay and western region of the Northern Health Authority.
Fixed-Wing Early Activation Program
Knowing that timely care is essential for better patient outcomes, BC Ambulance Service’s Fixed-Wing Early Activation Program will get patients to the right place as fast as possible.
When responding to 911 calls, on-scene paramedics will immediately alert BCAS Dispatch if the patients might require transport to a hospital that provides specialized care. BCAS Dispatch will reserve a plane and notify the closest available critical care transport paramedic team to begin preparing for a flight. The on-ground paramedics will transport the patient to hospital, where the emergency department physician will decide within 30 minutes whether to evacuate the patient to University Hospital of Northern BC, Vancouver General Hospital or BC Children’s Hospital. With implementation of the early activation program, both the fixed-wing plane and critical care paramedic team are available and ready to go immediately.
“This new program goes a long way towards addressing the very real challenges of providing trauma care in rural jurisdictions, such as Northwest BC,” says Dr. Richard Simons, Medical Manager of Trauma Services with Vancouver General Hospital. “Patients there will now be able to access trauma centres and the care they need much faster than before.”
“We don’t expect that many patients will need this service,” says Dr. John Ryan, BCAS Medical Director for Northern BC and the Trauma Director for Northern Health, “but for those who do, quick access to a higher level of care can make a dramatic difference in their chances of survival and recovery.”
Les Fisher, chief operating officer of BCAS, says, “Before implementation of early activation, physicians were the only ones who could call for the critical care transport paramedic team and aircraft to rush patients to a higher level of care. Now, when paramedics throughout the north arrive on scene, they will determine if the patient may need to be airlifted to a special-care hospital and can activate the air ambulance team to prepare for the emergency flight right away.”
The Fixed-Wing Early Activation Program has been in place for two years on northern Vancouver Island and has significantly reduced the time for major trauma patients to get the specialized care they need.
New model ambulances hit the streets of Vancouver, Victoria
Narrow ambulances that will more easily manoeuvre downtown streets and are designed for shorter-distance patient transports are now appearing on the streets of Vancouver and Victoria as part of the BC Ambulance Service ground fleet. The six new model Sprinter Vans are narrower than most ambulances, feature improved manoeuvrability and maximize interior space. Used extensively in Europe, the new model ambulance, made by Mercedes Benz, is relatively new to Canada. Four will serve Vancouver and two will be located in Victoria. Two will be outfitted as Advance Life Support units, while four will be Basic Life Support units.
“Manoeuvrability is a key issue in metropolitan areas,” says Sunny Dhaliwal, director of fleet operations for BC Ambulance Service. “The new model ambulance features enhanced safety for patients and paramedics through better crash capability and an electronic stability program.”
The six new ambulances were selected as part of a pilot project after paramedics rated several model ambulances in areas such as visibility, layout, ergonomics, size and storage. Now that the units are going into service, BC Ambulance Service will begin to monitor detailed feedback that is being requested from the paramedics who are using the vehicles. Feedback covers operability, effectiveness and design features.
This model of ambulance is relatively new to Canada where it has been used on Prince Edward Island since 2011; it is used extensively in Europe.