Town of Cochrane council is considering how to upgrade and improve the level of emergency medical service (EMS) available to residents.
At a committee of the whole meeting on June 5, Town administration presented a report outlining what would be involved in making it possible for fire services to upgrade the level of medical service available to answer emergency calls.
The Cochrane EMS Citizen Action Group (CAG) previously approached council, asking for the municipality to consider purchasing a fire/paramedical response vehicle to add to the fleet, as a way to mitigate some of the lengthy response times resulting from Cochrane ambulances being called away to other jurisdictions.
The intent of that action was to provide a warm and secure base for patient care, and possibly provide transport.
Following that request, at the April 3 committee of the whole meeting, administration presented their response to the CAG. Their reply was to reject the suggestion to add the vehicle, and instead presented a recommendation to consider increasing the level of service to achieve better patient outcomes. Administration stated that adding a transport vehicle was not the right solution.
The amendments to current policy statements needed to upgrade services were presented at the June 5 meeting. Committee of the whole meetings are for information only, which means no voting on items takes place, and any formal changes to policies would have to be voted on at a later council meeting.
As the system stands, when the arrival of an ambulance may be delayed over 10 minutes, the provincial medical first response (MFR) program kicks in. The provincial program consists of a number of categories, in order of level of care: standard first aid; Fire Medical Responder (FMR)/Emergency Medical Responder (EMR); Primary Care Paramedic (PCP); and, Advanced Care Paramedic (ACP).
Currently, Cochrane has the second level – the Fire Medical Responder (FMR)/Emergency Medical Responder (EMR).
The proposal from administration is to move up to the Primary Care Paramedic (PCP) level, which is also commonly referred to as “full-scope Basic Life Support” (BLS) level. This would increase the amount of patient intervention that appropriately-trained Cochrane fire services members are allowed to provide.
It would also add to the number of medications they are authorized to administer, allow them to provide intermediate airway control for those unable to breathe on their own, and allow them to initiate intravenous. (Intravenous involves an injection of medication or another substance into a vein, directly into the bloodstream).
Full-scope BLS would be achievable only when staffing levels and members on shift allow for the service level. When the appropriate members are not on shift, the level of service would remain as it currently is.
Mayor Jeff Genung spoke out in favour of the direction administration was suggesting.
“I really like the line around improving Cochrane residents’ experience while we’re waiting for a provincial response,” he said.
Genung noted EMS is a provincial responsibility, and that it was not council’s position to attempt to wade into those jurisdictional waters.
The mayor also pointed out that the discussion around adding another vehicle (that may or may not be able to transport patients) was not necessarily off the table, but should be added to the list of items under consideration for next year’s overall budget.
Dennis Fundytus of the CAG said they were glad to see the direction towards an upgrade, and the group is committed to working with the administration and town council toward the goal of final approval of a new vehicle as well.
"We believe that the upgrade in service will require an appropriate vehicle with a larger patient treatment compartment to allow sufficient room for personnel and the patient. We still have concerns about the administration's recommendation that the upgrade being recommended can be operational with the current support vehicle." he said. "Treatment on an injured fire department employee or on a patient with a life threatening emergency by one or two well-trained fire department employees might be truly difficult in the current vehicle."
Under the upgrade as proposed, Cochrane’s fire services would not incur overtime or callback costs in order to achieve the new BLS level, so no increases to staffing or existing operating budgets would result.
Executive director of protective and community services Stacey Loe said there have been discussions with fire services, and the general feeling is that members would be in favour of the proposed changes.
“Generally speaking, they would welcome this change to level of service,” Loe said. “Fire services members that have been responding to these calls have the higher level of training, but they are essentially handcuffed . . . they are put in a position where they have the skills but aren’t allowed to intervene.”
Cochrane emergency services currently has a rapid response vehicle, which was added to the fleet in 2019 and can accommodate up to four people. It is dispatched on first responses and can provide a warm and secure base for patients, but is not suitable for patient transport.
Currently, EMS response comprises 50 per cent of Cochrane Fire Services’ annual call volume, according to the committee of the whole report. In 2022, there was a slight increase, up to 52.9 per cent, as represented by the total of 600 calls.
Fire events take priority over the medical calls if they take place concurrently.
