Fire chief calls for train­ing

Edmonton Journal - - FRONT PAGE -

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

It’s trend­ing up­ward year over year, with the growth of our city and cer­tainly the de­mo­graph­ics.

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.”


Ed­mon­ton Fire Chief Ken Block said fire res­cue crews are re­spond­ing to more med­i­cal calls than fire calls and he sees ar­eas where fire crews can help with med­i­cal emer­gen­cies even more.


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