Half the calls fire rescue crews respond to are medically-related, a figure poised to hit 70 per cent within the next few years, said Edmonton’s fire chief.
That trend has Edmonton Fire Rescue Service’s (EFRS) top brass hoping to pursue more medical training for crews which will in turn help ease the load on emergency medical services (EMS) and ambulance response times.
Last year, 68 per cent of calls attended by fire rescue crews across the city were medical and that number is expected to continue to rise, said Edmonton Fire Chief Ken Block.
“(That number) increased over the last decade from about 60 per cent,” said Block.
“It’s trending upward year over year, with the growth of our city and certainly the demographics, the aging of the boomer generation, that’s only going to continue to increase. I expect next year, or the year after, we’ll be at 70 or over 70 per cent of our events.”
The fire department has had a long history of being part of the medical response system since its origins in 1892, when the volunteer fire brigade was created. In 1908, the first ambulance was donated to the department.
After changing from being publicly and privately operated, emergency medical services is now provided by Alberta Health Services, which works with fire rescue in responding to life-threatening medical events.
Medical calls are broken into different categories — Alpha, Bravo, Charlie, Delta and Echo. Alpha calls are considered minor events that fire crews don’t often attend but would if, for example, ambulance crews need help lifting a patient.
Block said crews most often attend Charlie, Delta and Echo calls, with Delta and Echo considered life-threatening events. About 75 per cent of their medical calls are Delta and Echo.
“We respond with major crews of four people. The officer and two or three firefighters would attend that patient and see what the needs are,” said Block, adding the first steps are ensuring proper breathing and circulation.
“They would gather relevant information on medical history, any medications the individual may be on. They do a lot of pre-work that is very beneficial to the medical crews coming in from Alberta Health Services.”
Based on 2018 numbers, the top five medical events fire crews attended were 20 per cent breathing problems, 16 per cent chest pain, 14 per cent unconscious fainting, nine per cent traffic accidents and six per cent falls.
Block said crews are trained as medical first responders, are accredited as international trauma support and are very adept at CPR They carry automatic external defibrillators.
Most recently, firefighters in Edmonton — and Alberta at large — were trained in delivering intramuscular injections, in particular for naloxone to combat an overdose.
“Every one of our stations has a unit of naloxone on board and all those firefighters in those stations are trained to give that treatment. That’s been very well received by staff,” said Block.
But, Block thinks there’s room to enhance the medical services they provide, just as they did with training crews to deliver naloxone.
“There are probably other practices that the medical profession could identify that firefighters with the right training would be able to help with more,” said Block.
“I’m thinking of anaphylactic shock as an example. So a severe allergy where the airway is completely swollen shut.
“People die from that and quite frankly a dose injection of epinephrine in a timely manner will save their life. And as it sits now, the fire service can’t deliver that and that is something that can be changed.”
If their medical services are enhanced, Block said the public would benefit greatly. It would also ease ambulance response times, an issue that has been raised frequently in the past.
“You talk about response times at capacity and Alberta Health Services — that’s a busy department. I would think they would embrace any help they can possibly get,” said Block.
However, responding to medical calls does take a toll of fire crews, where exposure to traumatic scenes can contribute to post traumatic stress.
“Any time you’re responding to a medical event where the life of the individual is in the balance, that is stressful. Our folks are trained well, however they are somewhat limited in the type of medical intervention they can provide,” said Block.
“There’s some very traumatic scenes that firefighters year over year attend, whether they be falls, crushing incidents, motor vehicle collisions that are catastrophic. Suicide is an issue for the general population and our folks attend those types of events and they take a toll, they build up for sure.”
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