The frequency with which St. Albert's two ambulances are out on calls at the same time is increasing dramatically, according to the city's fire chief, which is leading to longer response times, an increased frequency in deploying fire trucks with paramedics on board to deal with calls and having inferior ambulances pick up patients.
According to Health and Wellness Minister Fred Horne, the median response time in St. Albert on a "lights and sirens" call is seven minutes, meaning half of calls take less than seven minutes and half take longer.
More telling is the fact ambulances respond to calls in St. Albert within 15 minutes, 90 per cent of the time. Before Alberta Health Services (AHS) took over ambulance service in the province, St. Albert's benchmark was nine minutes, 90 per cent of the time, which it frequently met or exceeded.
Mayor Nolan Crouse said the city was told in 2009 there would be no degradation of service, which he now finds difficult to believe, given the six-minute increase in responses.
"Unacceptable," Crouse said. "Why would I accept that as being something we should be pleased about when five years ago, four years ago, we were told it's not going to get worse and St. Albert should expect the same service."
Horne said he and Crouse have not discussed the issue, but that the province is always trying to improve.
"We are always looking to see what else we can do to improve the service."
Code red
Fire Chief Ray Richards receives an email from dispatchers whenever both St. Albert ambulances are sent to calls and there are no ambulances available in the city. That situation is called a code red, and Richards said their frequency is increasing, anywhere from a few times a week to three to four times per day.
In those circumstances, AHS will "flex in" an available ambulance from Edmonton or another community.
"What's concerning for us is the amount of time we have to wait before that ambulance arrives," Richards said. Data from last spring indicated it took an Edmonton-based ambulance, on average, more than 22 minutes to respond to a call in St. Albert.
St. Albert's units are also called out to answer emergencies in Edmonton, Richards said, which faces code reds more frequently. That degrades St. Albert's ability to respond promptly to local calls.
"They get coverage from us and others," Richards said. "What is missed is that, what about these other communities now not having ambulances? It's a bigger issue than just Edmonton."
Before AHS took over ambulance service, St. Albert could draw on as many as five ambulances if needed for local emergencies because it had five ambulances and all firefighters also had to be paramedics, meaning there were plenty of bodies available.
Today, St. Albert Fire Services has taken a different approach to using those individuals and their paramedic skills. If there are no ambulances available in the city when an emergency call comes in, the city will dispatch a fire truck with a paramedic crew that can still provide advanced life support (ALS) service, referred to as a pump assist.
While the paramedics on board can provide help, the trucks do not carry all of the ALS equipment an ambulance does and patients cannot be transported to hospital until an actual ambulance arrives.
"We can actually deliver ALS pump assist, which is added value when you consider the level of care they can prepare," Richards said.
But sometimes the ambulance tasked to respond from the region does not meet those same standards. The Gazette has learned of one incident this month in which an ALS pump assist crew waited approximately 20 to 30 minutes for an ambulance, only to have a basic life support (BLS) ambulance from Gibbons arrive, which does not provide paramedic-level service. As a result, the St. Albert paramedics had to travel with the patient onboard the Gibbons ambulance.
Richards said in 2009 St. Albert was told its level of service would not be different from ALS service, but anecdotal evidence is showing that is not the case.
Mayor Nolan Crouse is hoping to survey the union that represents the city's ambulance workers to get a more accurate picture of the city's ambulance situation. He made the suggestion to acting city manager Chris Jardine at Monday night's meeting.
"I'm hearing from sources within our community that this needs to get looked at," Crouse said. "What are our staff saying? What's our union saying?
