Alberta's rural ambulance service criticized by veteran paramedic

A veteran paramedic says he is concerned about emergency services in Alberta’s rural south.

George Porter said ambulances are spending too much time doing non-emergency transfers, which is leaving small communities without coverage.

“We've taken patients from outlying areas into the city to have insoles fitted for their shoes, for dental appointments, for treatment at a detox centre,” he said. “They just need a ride. They don’t need an ambulance.”

According to Nick Thain of Alberta Health Services, inter-facility transfers have made up about 50 per cent of the work in small communities for the past 15 years. He said they are now trying to cut back by using a new fleet of transfer vehicles.

But Porter says transfers aren’t the only problem. He said the deployment system routinely sends ambulances from smaller communities to wait for their next call in larger towns.

“In a community I was working in I was flexed a lot and the majority of the emergency calls we got were back to our home community,” he said. “That’s the problem with flexible deployment. It’s a crap shoot.”

Response times

According to AHS, median response times for life-threatening events in most towns hover between five and 10 minutes. But the organization says it does not provide data on small towns like Black Diamond and Nanton because they receive too few life-threatening calls to establish accurate statistics.  

Porter recalls one night back in 2011 when it took him more than an hour to get to an emergency.

The call was for Durelle Bearspaw who had collapsed with chest pains in Eden Valley, a First Nations reserve near Black Diamond. Porter says if there been an ambulance in Black Diamond it could have responded in about 20 minutes.

Porter was dispatched because the nearest ambulances were on calls or transfers. When he got to the scene, an hour and fifteen minutes later, the patient had already passed away.

Bearpaw’s son Scooter says after a half an hour they called 911 again to check on the ambulance status and were told it was on its way.

“Then I felt my dad’s pulse and I could barely feel it,” he said. “I told my brother, ‘We’re losing our dad. We’re losing him slowly.’”

Porter says the incident highlights another major concern — there may not be enough ambulances to make the flexible deployment system work.  

“Before AHS took over most of the rural communities had a first line emergency crew at the station," he said. "When that car went out on a transfer or emergency, there was a second crew with a vehicle on-call.”

“The majority of these small communities don't have a backup ambulance anymore, so when they’re sent out on a transfer, the next crew needs to come from the neighbouring community.”

Willow Creek’s medical response units

People in the Municipal District of Willow Creek — which includes Nanton, Claresholm, and Fort MacLeod — were so worried about ambulance response times they went out and bought their own fleet.  

The three Medical Response Units (MRUs) are equipped much like any other ambulance and staffed by an on-call crew.

The units are sent to the scene of emergencies to stabilize the patient while they waited for the AHS ambulance to arrive. Reeve Neil Wilson says it was a measure of last resort.   

“I know of four times that we’ve actually sat down with the minister and said, ‘This is not working,’” Wilson said. “And of course, people that were advising the minister were saying, 'Oh, there’s all these good things happening,’ but our experience on the ground was, no, it wasn’t.”

Thain says response times in the M.D. of Willow Creek have actually been trending downward recently. But in spite of that, AHS decided to work with the M.D. and help run the units as a pilot project.  

Now the MRUs can actually transport a patient to hospital, rather than waiting for an AHS ambulance. But ratepayers in the M.D. are still on the hook for the bill.  

“One of the mottos from AHS is that ‘We’re all one, we’re all one service,’” said Porter. “No, we’re not.”

“Rural EMS is not getting the same coverage and the same support as urban EMS is. That’s the bottom line.”