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B.C. fire chief says 911 dispatch system change in B.C. risks patient safety

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VANCOUVER — Patient safety is at risk in British Columbia because of changes to the 911 dispatch system, says a fire chief who has instructed city staff not to call an ambulance during medical emergencies.

Nick Delmonico of the Port Coquitlam Fire Department said aspects of a so-called clinical response model adopted by BC Emergency Health Services last May are ineffective, leaving people waiting too long for an ambulance while firefighters are not contacted in many situations.

Both firefighters and an ambulance crew previously responded to 911 calls in B.C., but firefighters are now dispatched only if paramedics can’t attend a call within 10 minutes, though Delmonico said the reality has turned out differently.

Dispatch systems vary widely across the country and within provinces, with firefighters in some departments trained as paramedics who respond to more serious medical issues.

Neil Lilley, spokesman for Emergency Health Services, said British Columbia’s policy avoids doubling up on resources as part of a first-of-its kind model in Canada that is similar to those used in other countries, including the United Kingdom, Australia and New Zealand.

Delmonico, a former medical rescue chief for Vancouver and a one-time member of the Emergency and Health Services Commission before it was renamed BC Emergency Health Services in 2013, said an attempt to save resources has eroded patient care that could be provided by firefighters, who typically arrived ahead of paramedics before the change.

“The head scratcher for us is not including fire in high-profile calls that they can’t make it to in a certain amount of time,” said Delmonico, who recently wrote a memo instructing staff at city facilities to specifically ask for firefighters when they call 911 for medical incidents.

“I believe this is important information to ensure prompt response to the citizens using our facilities, as well as assist staff who may need assistance because they are alone trying to address the patients’ medical needs during these long waits,” he said in the memo.

Delmonico said he was frustrated after several recent incidents, including a drug overdose at a recreational centre, where he said two young employees waited too long for an ambulance after finding a semi-conscious man on a bathroom floor “surrounded by needles and a bunch of white powder.”

“The next morning I got called by their manager and she said, ‘This happened in our facility last night. Why didn’t fire attend?’ I said ‘I have no idea. We were not called.’ This kind of stuff is happening in our facilities and I said enough is enough.”

On Feb. 26, an ambulance responded two hours and 47 minutes after staff at a rec centre called 911 when a woman experienced chest pain, Delmonico said, adding staff finally phoned their boss, who happened to be in a meeting with him, and he dispatched firefighters who arrived before the ambulance.

Jeff Freeze, a firefighter in Kamloops, said he realized the impact of the policy on Feb. 11, when his 16-year-old son Cohen was slammed into the boards during a hockey game.

“He was fully spinal immobilized,” Freeze said. “I play hockey, and it was one of the ugliest things I’d ever seen.”

Freeze said the ambulance crew eventually transported his son to hospital, where he was assessed as having strained muscles in his neck and a separated shoulder.

The policy is based on a colour-coded system, with dispatchers categorizing calls into one of six colours to prioritize response. Purple is at the top for serious conditions, such as cardiac arrest, and blue is at the bottom for non-urgent calls that could be referred to a nurses phone line.

It’s the orange category in the middle, involving potentially serious but non-life-threatening issues, that is causing contention, Delmonico said. Firefighters are not always dispatched to attend potentially serious but not life-threatening calls and collaboration between the first responders on how the system works is “horrid,” he added.

He supports parts of the policy change because all patients are no longer automatically taken to emergency rooms.

Lilley said ambulance response time has improved in all categories since the policy was implemented, including in Port Coquitlam, though the fire chief said Lilley is relying on data showing median response times instead of average response times.

“We’ve drawn from best practices across the world,” Lilley said. “Many different ambulance services have a response model similar to the one which we’ve introduced and it’s around ensuring that we respond to the sickest patients as quickly as possible.”

— Follow @CamilleBains1 on Twitter.

Camille Bains, The Canadian Press

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RCMP seeks names of potential victims of coerced sterilization, Lucki says

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OTTAWA — The RCMP is seeking the names of potential victims of coerced sterilization procedures and wants lawyers to help in the process, RCMP Commissioner Brenda Lucki said Tuesday.

In testimony before the House of Commons health committee, Lucki said the RCMP is willing to meet with victims, adding it would be helpful if lawyers could talk to complainants about coming forward.

“The lawyers … if they were to speak with those victims and provide them the options of coming to the police, we would absolutely sit down with each and every victim that they had to look at it from a criminal point of view,” she said.

“Obviously they are not going to release their names without their consent as well. But … if we were to have those conversations, and possibly we could convince victims to come forward through the lawyers, that would be one avenue that we could explore.”

MPs asked Lucki to testify as part of a study about ongoing concerns from predominantly Indigenous women who allege they were coerced or forced into tubal ligation procedures during childbirth.

Her testimony also followed a letter sent this spring by NDP health critic Don Davies who asked the RCMP to conduct an investigation of serious and credible allegations that have been brought forward.

Lucki told Davies in a March letter that the force would work with commanding officers in each province and territory as well as other police agencies to see if any complaints have been reported.

“To date, we have no allegations that are on file for forced or coerced sterilization that were found to be reported to the RCMP directly,” Lucki said Tuesday. She said the RCMP takes all criminal allegations very seriously and that the force has reached out to the Canadian Association of Chiefs of Police to raise awareness.

The issue has been the subject of much public scrutiny, particularly in the past two years.

In 2017, the Saskatchewan Health Region issued a public apology after complaints from Indigenous women, and a proposed class-action lawsuit was launched naming as defendants the Saskatoon Health Authority, the provincial and federal governments, and a handful of medical professionals.

Dr. Judith Bartlett, a Metis physician who co-authored the external review, told the committee on Tuesday that Indigenous women interviewed for the report often felt invisible, profiled and powerless.

She also said she does not believe women will come forward to the RCMP because there is “no safety there for them.” Those interviewed for the report were granted anonymity, she said, noting they often felt much better having been able to express the harm done to them.

Much more research is needed to understand the scope of the problem because any time an individual is asked to make a decision when they’re not in the state of mind to weigh pros and cons constitutes coercion, Bartlett said.

Dr. Jennifer Blake, chief executive of the Society of Obstetricians and Gynaecologists of Canada, told MPs that obtaining consent for tubal ligations at the time of delivery should be avoided at all costs. She also noted that when she first learned of allegations a forced sterilizations, she thought it was in reference to a historical issue.

Last Tuesday, lawyer Alisa Lombard, a partner with the firm Semaganis Worme Lombard, told the health committee she represents a client, referred to as D.D.S., was sterilized without proper and informed consent in December 2018 at a Moose Jaw, Sask., hospital

That same month, the United Nations Committee Against Torture urged Canada to act to address the issue of coerced sterilization, setting a one-year deadline to report back on progress.

In response, Health Minister Ginette Petitpas Taylor and Jane Philpott, then Indigenous services minister, sent a letter to provinces and territories proposing a working group of officials to discuss the concerns.

Health Canada said Tuesday the group has had “productive discussions” about the scope and purpose of the federal-provincial-territorial plan to “advance cultural safety and humility in the health system.” As a first step, officials decided Health Canada would take the lead on “an environmental scan of cultural safety initiatives and practices across Canada,” the agency said in a statement.

—Follow @kkirkup on Twitter

Kristy Kirkup, The Canadian Press

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Blair says more gun-control action needed, signals no new steps before election

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OTTAWA — Crime Reduction Minister Bill Blair says more must be done to address gun violence, but he’s also signalling that no new measures will be taken before the fall election.

Steps could — and should — be taken to prevent the theft, illegal diversion and cross-border smuggling of handguns, Blair said Tuesday. 

As he entered a cabinet meeting, Blair emphasized the importance of secure storage of firearms to prevent them from being stolen and ending up in the wrong hands.

The government is also open to working with municipalities to allow them to decide exactly where, or even if, firearms can be stored within their boundaries, he said.

However, the parliamentary sitting is expected to conclude shortly and the government is scrambling to tie up loose ends before the summer recess and an election campaign likely to begin in September.  

“Some of this would require regulatory and legislative change,” Blair said. “And I think it’s important not only to do the right thing, but to take the time to do it right.”

Prime Minister Justin Trudeau asked Blair last August to study the possibility of a ban on handguns and assault-style rifles after a shooting spree in Toronto.

A recently released summary of a federal consultation said Canadians were divided on the idea.

Still, Blair’s office said late last month that no options had been ruled out to clamp down on guns “designed to hunt people” as it weighed new options. Rumours of a federal ban on the popular AR-15 semi-automatic rifle began to circulate.

While Blair reiterated Tuesday there are firearms the government considers “so dangerous that there really is no place in a safe and civil society for them,” he made no firm commitment to ban or buy back such guns from owners.

Blair stressed a need to ensure secure storage, prevent people from buying firearms on behalf of criminals and deter smuggling of weapons into Canada from the United States, which he called “the largest handgun arsenal in the world.”

“There are a number of very effective measures that I believe that we can and must take to create a safer environment.”

Allowing municipalities to enact additional restrictions on handguns would not only be “wholly inadequate,” it would also be inefficient, said Heidi Rathjen, co-ordinator of PolySeSouvient, which wants an overhaul of the gun classification system with the ultimate aim of banning weapons specifically designed to kill people.

“All one has to do is consider the glaring disaster resulting from a patchwork of state and local gun laws south of the border,” she said Tuesday.

“And one has to ask: why would stricter controls on handguns be justified in cities and not in rural areas? It seems more like the Liberals chose not to deal with the highly politicized issue of banning handguns and instead decided to pass the buck to municipalities.”

The law already requires safe storage of firearms, but there has been a “significant increase” in the theft of large numbers of handguns from homes and retailers, with the guns ending up on the street in the wrong hands, Blair said.

He acknowledged there are responsible handgun owners who obey all the rules. “We may ask them to undertake additional measures to secure their weapons to make sure that they’re not vulnerable to being stolen.”

Public Safety Canada says 24 firearms were stolen from a shop in Prince Albert, Sask., by snipping one cable, raising concerns that the after-hours commercial storage regulations could be insufficient.

Some businesses “may not be fully compliant” with existing regulations, say department notes released through the Access to Information Act. However, chief firearms officers “indicate this is infrequent and businesses come into compliance quickly when non-compliance is identified.”

The RCMP says some businesses go beyond minimum requirements through measures including shatterproof glass in display cases, video-monitoring systems and alarms, safes bolted to the floor, deadbolt locks and solid doors instead of hollow ones for storage rooms.

— Follow @JimBronskill on Twitter

Jim Bronskill , The Canadian Press


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