Closest hospital not always the best for patient’s needs, EMS explains

For those needing the most urgent of emergency medical care, the best chance for survival isn’t always at the closest hospital.

Recent serious incidents that saw city paramedics attending to critically injured patients have raised questions about the decision to transport to Foothills Medical Centre instead of the closest hospital.

The reason, says Calgary EMS spokesman Stuart Brideaux, lies in the type of care each hospital is capable of providing.

“Under normal circumstances, if we’ve got a patient whose injuries are not life-threatening, we have a system that will direct ambulances to the hospital where they’ll see a doctor the soonest,” he said.

Called REPAC (Real-time Emergency Department Patient Access & Coordination), the system offers paramedics their two best options for destination based on a number of factors, including wait times at city hospitals.

“Once a patient is under a paramedic’s care, they’re already in the health-care system,” Brideaux said.

This week, Calgary paramedics took the 30-year-old victim of a shooting in Auburn Bay to Foothills — despite the scene’s proximity to the South Health Campus.

That, Brideaux explained, is standard procedure in cases involving traumatic, life-threatening injuries.

“Foothills is a level 1 trauma centre,” he said. “That means it has the capacity to deal with any and all levels of major and serious trauma.”

Considered the top tier in urgent care, accreditation as a level 1 trauma centre involves maintaining strict standards of care available at a moment’s notice 24 hours a day, seven days a week.

According to the Trauma Association of Canada, that involves constant staffing of trauma-trained surgeons, nurses and support staff, in-house consult capability for all major surgical specialties, and prompt access to both burn and spinal cord injury care.

Almost always affiliated with a local university, such centres serve as a training ground for advanced trauma care to both other physicians and medical students.

A recent study by Johns Hopkins University suggests critically injured patients treated at dedicated trauma centres stand a 25 per cent greater chance of survival — odds Brideaux says make the extra drive time worth it.

While any life-threatening injury could potentially be transported to a trauma centre, most consist of serious automobile collisions, falls, industrial accidents, assaults, serious burns, or penetrating injuries like stabbings or shootings.

Foothills is one of only a handful of level 1 trauma centres in Canada.

Both Foothills and Alberta Children’s Hospital are the only level 1 trauma centres in the province.