SAVING LIVES IN NEW SITUATIONS
Exploring paramedics’ evolving world
Ambulances are no longer the only place where patients are treated by paramedics — the emergency responders work in hospitals, homes and “hot zones.”
Paramedics have a constantly expanding practice. While some paramedics assess patients in emergency rooms, make house calls, treat drug addicts and alcoholics and provide community support, Tactical Emergency Medical Services (TEMS) works with the Regina Police Service’s Special Weapons and Tactics (SWAT) team.
Paramedics will be demonstrating some of their life-saving skills at an open house on Saturday from 1 p.m. to 4 p.m. at EMS Central, 1350 Albert St.
To get a sneak peek at their work, Pamela Cowan spoke with Ken Luciak, director of emergency medical services (EMS) with the Regina Qu’Appelle Health Region, about the changing, and often dangerous, shifts of paramedics.
PRACTISING MEDICINE IN “HOT ZONES”
Dressed in tactical gear, it’s impossible to distinguish paramedics from SWAT team members. Paramedics wear soft body armour all the time, but those with TEMS have additional gear that matches the SWAT team.
Paramedics began TEMS with SWAT in 2009 to respond quickly to a medical emergency in a high-risk, volatile situation.
TEMS trains with SWAT regularly and responds on calls with them, Luciak said.
“We’re going to be at those calls anyhow, but in the past our paramedics were on the perimeter and when something would go down and they would need our assistance, it would involve going into an area that wasn’t safe or delaying our ability to get to the patient because it was not safe,” Luciak said.
A quick response is vital, whether dealing with a patient who has chest pains two doors down from a house targeted by SWAT or stopping a gunshot victim from bleeding to death.
“By having our tactical medics embedded with the team, it permits them to understand how the tactical team works and it’s just a much safer operation,” Luciak said. “Now we understand how tactical works and how we can go about retrieving patients and doing so safely.”
Currently there are four paramedics on TEMS; the goal is six.
CARE IN THE COMMUNITY
Paramedics work alongside nurse practitioners, pharmacists, therapists and other health-care professionals in two Regina programs — Connecting to Care and Seniors House Calls.
The Connecting to Care team tries to prevent patients with complex medical needs — which often include mental health and addictions problems — from going to emergency rooms in crisis by providing them with appropriate community services.
“While the paramedic was in the Connecting to Care program, they discovered he had very good assessment skills and understood issues on the street very well,” Luciak said.
When the Seniors House Calls program began, it was clear patients would benefit from paramedics’ assessment skills, he said. The first paramedic started with the Seniors House Calls program in November
2015.
“It’s not just about putting community paramedics into homes, it’s a team of paramedics and nurse practitioners and therapists and each one brings skills and knowledge that’s going to benefit the seniors,” Luciak said.
The house-call program often sees seniors after they’re discharged from hospital or when they clearly need help at home.
Other community involvement includes a paramedic attached to the cardio-sciences department. He is the Public Access Defibrillation Co-ordinator responsible for the placement of Automatic External Defibrillators (AEDs) in Regina.
DETOXING PATIENTS
Paramedics have been assessing and treating drug addicts and alcoholics at the region’s Addiction Treatment Centre for the past seven years.
Over that time, there have been changes to the program. Paramedics are now permitted to directly transport individuals from their homes, the street or wherever they are in trouble, to the centre.
“Paramedics watch the airway and make sure they don’t vomit,” Luciak said. “Of course, they’re watching the whole patient, because they may have other things that they either didn’t know about or didn’t share with us.”
The Social Detox Unit is a longer-stay unit where patients receive programming and education for addiction. Although the average length of stay is six days, that can increase, depending on the patient’s withdrawal needs.
Paramedics start patients on medications for alcohol withdrawal if they meet the criteria.
Crystal meth, not fentanyl, is the biggest problem in Regina, Luciak said.
“It’s not as though we don’t deal with opiates, because we do, but right now we’ve been very fortunate in Regina,” Luciak said. “There is an increase (of fentanyl use), but it’s not hugely dramatic. It’s not to the point where we’ve having fatalities as a result of it.”
STREET-LEVEL EMS
No day is the same for Regina’s paramedics. Working out of four stations, they respond to a variety of medical emergencies and traumas. Their calls range from asthma attacks, falls and cardiac arrests to stabbings, motor vehicle collisions and shootings. In addition, they spend a lot of time doing inter-facility transports — from long-term care facilities to hospitals for diagnostic tests.
There are anywhere from five to nine ambulances in service, depending on the time of day.