Calgary patients treated in ER hallways as paramedics needed for 911 calls

Calgary’s EMS and hospitals are so stressed that this week patients who would normally be tended to by paramedics were rushed to already busy hospital staff – in the hallways – so emergency workers could get back on the road and respond to 911 calls.

An internal Alberta Health Service memo obtained by CBC News called the situation a “historic event” in Calgary that resulted in “unprecedented pressure” on doctors and nurses as emergency responders were ordered to “unload patients and take them there.” relocate [emergency department] Assistance within 15 minutes of arrival.”

“This is a crisis,” said Mike Parker, president of the Health Sciences Association of Alberta, the union that represents paramedics in the province.

According to Parker, 10 ambulances were grounded in Calgary Monday night due to staff shortages. Alberta Health Services has yet to confirm that number, despite requests from CBC News.

The union has been sounding the alarm over the number of so-called red alerts – when ambulances aren’t available to take new calls – for months.

Parker said the chronic paramedic shortage has been exacerbated by high numbers of employees sick or isolated due to COVID-19 and burnout.

“The entire system is under this immense pressure. This is a key indicator of how bad it really is,” he said.

Typically, Parker said, emergency responders stay with patients in the emergency room and offer treatments such as pain control until hospital staff have the capacity to take over. This can take hours.

“In that case they get wheeled down or loaded into wheelchairs and the paramedics go back out onto the street because there are still calls that nobody is answering,” he said.

HSAA President Mike Parker says EMS offload is a protocol originally developed for mass casualty situations but is more commonly used in Alberta. (HSAA website)

Patients being treated in corridors

Calgary emergency departments, already grappling with a backlog of patients waiting for beds elsewhere in the hospital as the pandemic drags on, said Dr. Eddy Lang, the director of emergency medicine in Calgary, to deal with it.

But it was difficult.

Lang said nurses were assigned Monday to tend to those extra patients in the hallway so paramedics could get back on the street to deal with other emergencies.

“There was still no room for her,” said Lang, who co-wrote the leaked memo.

“As far as I know, nurses were assigned to these patients in the corridor, which allowed the rescue workers to get back out into the street. That’s how they became our patients out in the hallway, when they normally only…officially become our patients when they come in. “

He said doctors were also treating and examining patients in the emergency room corridors.

“It reflects the strain on the whole system because I’m convinced that if the patients that we’ve had in the ER who have already been admitted – we know what they have, their treatment has started, we just don’t have a bed.” upstairs – if they had timely access to their upstairs bed they are waiting for, we would have no problem with the EMS discharge.

Parker said the urgent download system was designed for mass casualty incidents, not routine use. But it’s happening more and more often, including in Edmonton and Medicine Hat.

Practice reserved for “extremely high demand”.

“It’s something that’s not typically practiced in Alberta, but it’s a routine practice in Quebec, where they have the same issues — they can’t bring EMS patients into the department,” Lang said.

Though the memo referred to the “unprecedented” situation, an AHS spokesman said Calgary had used this protocol before, but the spokesman didn’t give specifics as to when.

“From time to time, when the pressure on the EMS system is high, EMS and our hospital teams have the opportunity to conduct an expedited transfer of care,” the statement said.

“This transfer of care is initiated when multiple ambulances are waiting at hospitals to offload patients.”

AHS said the practice is not new. But it’s only used during “extremely high demand” periods, and patients are only referred when it’s safe to do so. The most critical patients, health officials say, are being prioritized for immediate care.

“EMS continues to see an unprecedented surge in 911 calls due to several combined factors, including the COVID-19 pandemic, opioid concerns and 911 calls related to people returning to normal activity levels,” the spokesman said.

“All call types have increased, and staff sickness and fatigue, as well as weather considerations, are also contributing to the challenges in the EMS system.”

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