Paramedics stand next to their ambulances at Toronto West Hospital on October 27, 2020. Frank Gunn/The Canadian Press
Paramedics across Canada are struggling to respond to emergency calls and provide care due to staff shortages and overcrowded hospitals, with 911 callers in many regions of Canada facing long delays, sometimes hours, for ambulances – and additional delays once they arrive at hospitals.
Pierre Poirier, chief of the Ottawa paramedic service, said “level zero” events — times when there are no paramedics to respond to calls — have increased at an alarming rate in recent months. There have been more than 750 level zero events in the city so far this year, compared to around 400 in 2019.
The duration of level zero events is also increasing, he said, with the longest reaching nearly 10 consecutive hours.
As dispatchers triage calls, prioritizing the most serious medical emergencies, the pressure on paramedic services is having an impact across Canada. In Montreal earlier this month, a 91-year-old woman who injured her leg died during a seven-hour wait for an ambulance. Also this month in Ottawa, a 75-year-old woman who broke her hip had to wait six hours in excruciating pain before an ambulance arrived.
Health experts say these problems are not new and have been drawing attention to the overstretched system for years. But the COVID-19 pandemic has brought additional challenges that are pushing many parts of the system beyond the breaking point.
Part of the problem is that many emergency departments in Canada are forced to close their doors for hours or days due to staff shortages. They are often the result of doctors and nurses contracting COVID-19 and having to self-isolate at home, but the shortage is exacerbated by the holidays and work-related burnout.
The lack of medical staff is forcing paramedics to drive longer distances to health facilities, which are often overcrowded with patients. As a result, paramedics must wait for hours with patients until they can be safely unloaded or transferred to the care of a nurse or doctor.
“Delays in discharge are extraordinary,” said Daryl Wilton, president of the Ontario Paramedic Association. “I’ve never seen anything like it and I’ve been doing this for 25 years.”
Mr Wilton said some paramedics were spending whole shifts waiting to offload patients, only to be relieved by new teams who had to stay until hospital staff members could take over.
“It’s not unlike mass casualty events where there aren’t enough resources to treat everyone,” he said.
The situation is similar in Nova Scotia. There, according to Kevin McMullin, business manager of the International Union of Operating Engineers of Nova Scotia, Local 727, discharge delays are 30 percent longer than before the pandemic, and paramedics are struggling to respond to calls because of the congestion.
“It’s devastating to be tied up in the hospital knowing there are calls out there that they can’t answer,” Mr McMullin said.
Stephen Skovorodko, president of the Saskatchewan Paramedic Services Chiefs, said the number of calls fielded by paramedics has increased significantly this year and is contributing to paramedic and hospital staff burnout.
“Times are tough for everyone,” he said, adding that the level of emergency calls was unprecedented in his 27-year career. “We’ve never seen the kind of pressure on the health care system that we’re seeing right now.”
Ryan Woiden, president of Winnipeg’s MGEU Local 911 paramedic union, agreed. He said the intensity of paramedic shifts drives away new hires who are desperately needed.
“I think something that’s important here is not just the sheer volume of calls, but the types of calls and the inability for a paramedic or a dispatcher to decompress from them,” he said.
He praised new initiatives in Manitoba that use what are known as “community paramedics” to ease the pressure on paramedics and help people avoid trips to the hospital. Community paramedics are people with paramedic training who can respond to domestic calls in ordinary vehicles when an emergency department visit is not necessary.
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