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Annual Report

British ColumbiaAmbulance Service

09/10

H e l p i n g S a ve L i ve s

Table of ConTenTs

Message from the Chief operating officer ............................3

about Us ...................................................................................4

Top stories from the Year .........................................................6

BCAS Key to Success of 2010 Vancouver Winter Olympic and

Paralympic Games........................................................................................ 6

Responding to H1N1 .................................................................................. 7

Driving Innovation ...................................................................................... 8

Labour Dispute ............................................................................................. 8

NETCAD ........................................................................................................... 9

services .................................................................................. 10

BCAS Emergency Event Response Process .......................................10

Dispatch ........................................................................................................11

Basic Life Support ......................................................................................12

Advanced Life Support ............................................................................13

Air Ambulance ............................................................................................14

Critical Care Transport ..............................................................................15

Infant Transport Team ..............................................................................15

Special Operations ....................................................................................16

Inter-facility Transfers ...............................................................................17

Medical Programs ......................................................................................17

Emergency Planning ................................................................................18

Public education ................................................................... 19

Vital Link and Good Samaritan Programs .........................................19

P.A.R.T.Y. Program .......................................................................................20

ACT High School Program ......................................................................20

statistics ................................................................................. 21

2009/10 Total Event Volume by Region .............................................21

Historical Provincial Event Volumes ....................................................22

Delta / Echo Event Volumes 2009/10 by Region ............................22

Air Ambulance Program ..........................................................................23

Dispatch/Communications Centres ....................................................23

BCAS Fleet ....................................................................................................24

BCAS Stations ..............................................................................................24

Fees .................................................................................................................25

BCAS Gross Expenditures ........................................................................26

Table of ConTenTs

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Table of ConTenTs

les fisher

Chief Operating Officer

I am proud to be able to present the 2009/10 Annual Report for BC Ambulance Service (BCAS). Without question, the past year held

many challenges for BCAS, yet we are now positioned to move into the future.

BCAS endured a seven month long labour dispute with CUPE Local 873. The lengthy strike and its inherent difficulties had a profound

impact on BCAS; however, I am pleased to say that our patients remained our top priority. Following the conclusion of the labour dispute,

BCAS has gone through a period of recovery and is now focused on moving forward and capitalizing on the opportunities ahead.

The H1N1 flu pandemic had a mild impact on the population of British Columbia in the Fall of 2009 and early Spring of 2010. The BCAS

reaction to the pandemic demonstrated our organizations’ ability to quickly adapt to challenges and the importance of our emergency

preparedness work.

In February and March, British Columbia was host to the 2010 Winter Olympic and Paralympic Games. As the sole provider of ambulance

services to the Games, this event truly was a highlight in our services history and for all staff involved.

In 2009/10, BCAS also moved forward with improvements to the technologies in our Dispatch centres and in our ambulances. BCAS also

made improvements in our ambulance vehicle design to help improve the care paramedics can deliver from the ambulance.

I am proud to be able say that, despite the many challenges faced by BCAS in 2009/10, through the dedication and commitment of staff,

we continued to deliver high quality ambulance services and can be proud of our performance supporting the 2010 Winter Olympic and

Paralympic Games.

As we go forward in 2010/11, we continue to focus on the opportunities ahead and the areas of our Service that we can positively

impact.

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Message froM The Chief operaTing offiCer

Created in 1974, the BC Ambulance Service (BCAS) operates under

the authority of the Emergency and Health Services Commission

(EHSC) and is tasked with the provision of public ambulance

service across the Province. Today, BCAS is the largest provider of

emergency medical services in Canada and one of the largest in

North America. BCAS serves over 4.4 million British Columbians

and responds to calls for service across six health authorities

covering 944,700 square kilometres. In 2009/10 BCAS paramedics

responded by ground to 478,958 events – 372,106 pre-hospital

(911) events, and 106,852 inter-facility transfers. BCAS also

transported an additional 8,209 patients by air ambulance.

BCAS employs 3,982 individuals – 3,639 paramedic and dispatch

staff, 205 support staff and 138 excluded management staff. BCAS

operates from 186 ambulance stations, five administration offices,

and three Dispatch centres. BCAS has a fleet of 535 vehicles,

including 483 ambulances and 52 support vehicles. BCAS also

has a fleet of nine dedicated ambulance aircraft.

BCAS strives to provide timely and high quality emergency medical services by caring

for our patients and staff, providing creative solutions for changing health care needs

and collaborating with our partners in the health care system and community.

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abouT us

BCAS Operations are organized into four regional service delivery areas as well as

Provincial Programs (air ambulance, fleet, emergency management, scheduling) and

dispatch/communications.

lower Mainland Region

BCAS’ Lower Mainland Region is characterized by communities

with high population densities. The region serves the 604 and

778 area codes and stretches from the USA border, east to

Manning Park and north to Boston Bar. The region also serves

the Howe Sound corridor to Pemberton and the Sunshine

Coast. The Lower Mainland Region includes 46 ambulance

stations and the BCAS Lower Mainland Region Administrative

Office located in Vancouver.

Vancouver Island Region

BCAS’ Vancouver Island Region serves the residents of

Vancouver Island as well as the Gulf and Discovery Islands. The

Vancouver Island Region includes 44 ambulance stations, the

BCAS Vancouver Island Region Administrative Office and BCAS’

Provincial Headquarters, both located in Victoria.

Provincial Programs

Within Provincial Programs are four speciality program areas:

Provincial Scheduling, Emergency Management Office, Fleet

Operations, and Air Ambulance and Critical Care Transport.

Dispatch / Communications

Within Dispatch / Communications there are three regional centres,

the Interior and Northern Region Dispatch / Communications

Centre located in Kamloops, the Lower Mainland Region

Dispatch/Communications Centre located in Vancouver and the

Vancouver Island Region and Provincial Air Ambulance Dispatch /

Communication Centres in Victoria. Together the three locations

receive, assess and dispatch all ambulance and air ambulance

requests.

northern Region

BCAS’ Northern Region covers almost two-thirds of B.C.,

and is bordered by the Northwest and Yukon Territories to

the north, the B.C. Interior to the south, Alberta to the east,

and Alaska and the Pacific Ocean to the west. The Northern

Region includes 34 ambulance stations and is home to the

BCAS Northern Region Administrative Office located in Prince

George.

Interior Region

BCAS’ Interior Region also serves a large geographic area,

which ranges from densely populated to scarcely populated

areas. The Interior Region stretches from Williams Lake to the

U.S.A. border and from Anahim Lake in the Chilcotin to the

Alberta border. The Interior Region includes 62 ambulance

stations and the BCAS Interior Region Administrative Office,

located in Kamloops.

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abouT us

bCas KeY To sUCCess of 2010 VanCoUVeR WInTeR olYMPIC anD PaRalYMPIC GaMes

As the dust settles on Vancouver and Canadians reflect on what

has been described as a redefining moment in our collective

history, BCAS can only be proud of the role it played in the

tremendously successful 2010 Vancouver Winter Olympic and

Paralympic Games.

When the Olympics were first awarded to Vancouver in 2003, BCAS

was quickly identified as an integral part of the medical services

plan. That being said, providing ambulance service at dozens of

venues and coordinating with local and international partners,

all in the midst of unprecedented crowds was uncharted territory

for BCAS. Further complicating the role was the challenge of

finding solutions that would span the large geographic area of

the Games and last through 17 days of Olympic competition

and 10 days of Paralympic competition. Reflecting on the service

provided, it is clear that BCAS met these challenges head on.

Throughout February, the overall regional event volume

increased 10% over the same period last year, an increase of

1,530 events. The greatest increase in events occurred within the

City of Vancouver. In Vancouver the event volume was up 1,040

events, representing approximately 68% of the total increase in

events throughout the region.

Inside the security perimeters of the Olympic venues, there were

a total of 183 events requiring ambulance response, and a total

of 136 patients transported to either a hospital or to one of the

Games-time polyclinics.

By anticipating an increase in demand and dedicating additional

ambulance resources to the competition venues as well as public

areas, BCAS was able to maintain its response time performance

for the most urgent or life threatening calls.

BCAS also prepared for the Games with the early arrival of 65 new

ambulances, the temporary addition of two air ambulances, the

purchase and lease of ambulance Gators to navigate the heavy

crowds, and increased Chemical, Biological, Radiological and

Nuclear (CBRNE) capabilities. In addition, BCAS implemented

a pilot program where BCAS physicians assisted with triage

in dispatch to help deal with the increased demand. BCAS

also integrated more closely with local, provincial, federal and

international security and health partners. These partnerships

provided direct communication channels and needed situational

awareness.

The hard work and dedication of the paramedics, dispatchers,

managers and support staff who worked tirelessly planning for

and during the Games ensured that athletes, visitors, spectators

and British Columbians received high quality ambulance services

during the Games.

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Top sTories froM The Year

ResPonDInG To H1n1

The H1N1 pandemic in the Spring and Fall of 2009 had a moderate

impact on the population of B.C. Within BCAS, every reasonable

measure was taken to keep frontline paramedics and all BCAS

employees safe, healthy and ensure that staff did not contribute

to the spread of disease.

Key elements of BCAS’ H1N1 readiness included; achieving a high

degree of paramedic compliance regarding the use of personal

protective equipment (PPE); effective cleaning, decontamination

and hand-washing procedures; and uptake on vaccinations. This

was accomplished by providing:

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•

•

•

•

•

information on the status of the H1N1 outbreak;

appropriate PPE for paramedics;

a comprehensive training package;

opportunities for all paramedics to get vaccinated

protocols on vehicle cleaning and station cleaning; and

information for all staff regarding infection control measures

at work and at home.

In addition, a dedicated training course, Occupational Safety

and Health (OSH) 5: Response to H1N1 Human Swine Flu was

created by BCAS paramedics, Medical Programs, and OSH staff

and provided to paramedics. This training included:

identifying and recognizing risk;

protecting self and others from infectious disease; and

applying new procedures and treatment guidelines to

respiratory infection and risk.

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•

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DRIVInG InnoVaTIon

One hundred new ambulances were purchased from Demers

Ambulance in 2009/10, as part of BCAS’ fleet replacement

program. These ambulances are unique in that they were

designed with input from frontline BCAS paramedics and include

new features and improvements to better support paramedics

and patient care. The most notable enhancements include extra

room in the ambulance, additional stretcher positions and a

quieter engine. BCAS’ previous design included large fender skirts

over the wheels. By trimming these down BCAS was able to widen

the actual body of the ambulance by six inches. Each ambulance

is now fitted with three stretcher position options, improving

paramedic ergonomics and patient care. Other innovative design

components include: the console being integrated in the control

panel, a new lateral style double door including a unique slider,

and a LED type emergency light system.

BCAS also invested in an upgrade to in-vehicle technology,

supplying GPS units for every ambulance in the BCAS fleet. In the

past, paramedics unsure of a call location worked with Dispatch

to get more information and/or referenced a map book provided

in each ambulance. GPS technology helps paramedics find the

call location, and determine the best driving route, reducing the

chance of delay.

laboUR DIsPUTe

In 2009/10 CUPE Local 873, the union representing paramedics

went on strike beginning April 1, 2009. The strike was settled

November 7, 2009 by back to work legislation. As an essential

service, BCAS and paramedics continued to provide essential

ambulance services to the public throughout the dispute.

Although frontline ambulance services were essential and

continued to be provided a number of projects, initiatives and

back office processes such as ambulance billing, paramedic

training, and technology changes were negatively impacted by

the strike. As part of the conclusion to the strike, government

appointed an Industrial Inquiry Commission to review the service

and labour relations structure. That report provided a number

of options on future service delivery models. Government

undertook a consultation in February 2010 on the three main

options identified, and announced in March 2010 that a provincial

health model would be retained and that BCAS would transition

to the Provincial Health Services Authority (PHSA).

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neTCaD

Supporting the work of BCAS is a network of telecommunication and technology

platforms. This year, BCAS continued to work to consolidate and optimize information

technology and information management systems to provide frontline paramedics,

managers and administrative employees with improved tools and information, while

laying the foundation for future enhancements.

By the Summer 2010, BCAS will have made the final installment in its Dispatch/

Communications Centres and all three centres will run on NetCAD, a consolidated, full

function platform designed to improve the communication of event and resource

information among all Dispatch centres, field paramedics and first responders. Having

all Dispatch centres on a common computer platform allows each Dispatch centre to act

as a back-up for another in the event of a technical failure, facility issue, or other incident.

Created to meet current day-to-day business needs, while improving communications

between centres, the system enables the use of new technologies such as Automated

Vehicle Location (AVL) monitoring and mobile data terminals. The increased use of

technology through NetCAD also helps reduce unnecessary manual processes and

contributes to enhancements in real-time operational analysis and reporting.

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The diagram below illustrates the roles and actions involved in responding to a typical emergency event.

bCas eMeRGenCY eVenT ResPonse PRoCess

BCAS handled over a million incoming calls, dispatched 624,384 ambulance resources

and responded to 372,106 pre-hospital and 106,852 transfer events across the province in

2009/10.

When a patient requires ambulance services, BCAS receives the call(s), responds with the necessary ambulance resource(s) and ultimately

manages the emergency or transfer event. Events represent the unique demand for ambulance services so BCAS uses this metric most often

when discussing demand volume.

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serviCes

DIsPaTCH

BCAS’ response to pre-hospital medical emergencies and inter-

facility patient transfers begins with BCAS Emergency Medical

Call Takers (EMCTs) and Emergency Medical Dispatchers (EMDs)

in BCAS’ Dispatch/ Communication Centres. These dedicated

professionals gather critical information from the caller and

using internationally-recognized protocols, assess and triage the

incoming calls. BCAS categorises events as:

Chris Iregui

EMCT

Station 299 - Lower Mainland Regional

Communications Centre (LMRCC)

2 ½ years with BCAS

Can you tell us a bit about your

role?

As an Emergency Medical Call Taker

(EMCT), I have a role that empowers

me to help more people in a single day

than I could ever have imagined. I am

the first voice of help when people are

in need; sending the paramedics and

providing life saving instructions to my

callers.

What is the best part of being part of

bCas lMRCC?

The best part of being a member of the

LMRCC aside from my role as an EMCT

is the teamwork and support we give

each other.

If you weren’t working for bCas where

would you be?

If I wasn’t working for BCAS I would

have continued in my previous career

in Information Technology, as well as

teaching technologies at the college

level.

What’s the worst thing about the job?

When asked what the worst thing about

my job is, I struggled to find an answer.

It’s a great job. The downside is at times

struggling with the emotions when

tragedy strikes the young and innocent

and it is my voice maintaining calm and

providing reassurance during the early

stage of their crisis.

Based on the call categorization and the resources available in

the community, BCAS then dispatches the most appropriate

ambulance and paramedic resources. BCAS EMCTs and EMDs also

work with First Responders, Search and Rescue Teams, and Police

to ensure the right people and resources are on scene.

Not only will the call categorization determine the type of crews

that are dispatched but also the urgency in which crews needs

to arrive. In Urban and Metropolitan communities, BCAS aims

to arrive within 9 minutes for calls categorized as Delta/Echo.

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basIC lIfe sUPPoRT

The most common ambulance service

provided by BCAS is Basic Life Support

(BLS). BLS paramedic crews provide care

for medical emergencies and traumatic

injuries. Emergency Medical Responders

(EMRs) and Primary Care Paramedics

(PCPs) provide this service.

Working as an EMR is an entry-level

community focused position that is ideal

for people who live and work in a rural or

remote area and have a desire to make

a difference. BCAS employs EMRs on an

on-call, part-time basis. The majority of

paramedics working across B.C. work as

PCPs and have chosen paramedic practice

as their profession. They work in both

full-time and part-time positions in rural

and larger communities.

Patricia Thompson

PCP IV endorsed

Station 538 - Quesnel

23 years with BCAS


role?

I am a Primary Care Paramedic (PCP)

and provide Basic Life Support (BLS)

ambulance services throughout

the community and neighbouring

areas. My role at the station includes

Paramedic, Safety Officer, and Acting

Unit Chief.

What is the best part of being

stationed in Quesnel?

I grew up in Quesnel on a third

generation cattle ranch. Not only did

I go to school here, but my mom also

did and now my kids do to. I enjoy

having a connection to the people I

serve. I love our town and its history.

Tell us about a memorable call.

I can recall many memorable

calls! Some very funny, some very

satisfying, some incredibly sad, some

terrifying. I remember events with

partners I have worked with that

have bonded us. I think I will write a

book one day.

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When more advanced care is required, BLS paramedic crews can be supported by Ad-

vanced Life Support (ALS) paramedic crews. ALS ambulances are staffed by Advanced

Care Paramedics (ACPs) who receive additional training which enables them to perform

more advanced emergency care procedures. BCAS staffs ALS ambulances in Victoria,

Nanaimo, Vancouver, Abbotsford, Chilliwack, New Westminster, Surrey, North Vancouver,

Richmond, Kelowna, Kamloops and Prince George.

aDVanCeD lIfe sUPPoRT

Darren Waller

ACP

Station 315 - Kamloops

18 years with BCAS

Can you tell us a bit about your role?

I am an Advanced Care Paramedic (ACP),

and work to provide Advanced Life

Support (ALS) ambulance services in

Kamloops. My role involves responding to

calls designated ‘Highest Level Available’

by our dispatch centre. These types of

patients are in serious condition. As an

ACP, I am able to provide more advanced

interventions involving medications,

advanced therapies and patient

monitoring.

What is the best part of being

stationed in Kamloops?

The best part of being stationed in

Kamloops is the unusual variety of work.

Often our calls take us into rural or remote

locations, interacting with BLS crews

which allows us to mentor more than we

would be able to in metropolitan areas.

Another benefit to being stationed in

Kamloops is the lifestyle opportunities

which exist here.


I think my most memorable call would

be shortly after I started as a part-time

paramedic and our station was issued its

first defibrillator (AED). We responded to

a local bank in our small town for a patient

who was in cardio/respiratory arrest. After

numerous defibrillations, we successfully

resuscitated the man. A few months later

the patient thanked us during an awards

ceremony. This call reinforced for me that

I had picked a rewarding career.

“As an ACP, I am able to provide more advanced interventions involving medications,

advanced therapies and patient monitoring.”

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air ambulanceBCAS’ Air Ambulance Program provides the critical transportation linkages between

accident scenes, hospitals and referral centres across the province for patients requiring

more specialized care than what is available in their local community. Operating

from three flight centers located in Vancouver, Kelowna and Prince George, the Air

Ambulance Program employs a total of six dedicated fixed wing airplanes (three based in

Vancouver, two based in Kelowna and one based in Prince George), and three dedicated

helicopters (two based in Vancouver and one based in Prince Rupert). BCAS also employs

approximately 40 charter carriers throughout B.C. BCAS’ Air Ambulance program employs

highly skilled, advanced care, critical care and infant transport paramedics who have

received aviation training.

In addition to BLS and ALS emergency ambulance

services, BCAS provides a number of specialty services

including the following:

Robert Wand

Airevac Unit Chief

Station 280 - YVR

23 years with BCAS


role?

I am the Unit Chief responsible

for the air ambulance teams. I am

responsible for making sure the flight

paramedics are trained in the latest

in critical care and trauma medicine

and am also involved in moving BCAS

forward with new initiatives.

What is the best part of being part

of bCas air ambulance Team?

I work with a highly trained and

specialized team that makes a

difference in people’s lives during

their most stressful time. I am

thankful to be part of a team that can

help patients and their families.


The most memorable time for me

was my involvement in the 2010

Vancouver Winter Olympics. I

actually got to help Petra Madjic, the

Slovanian bronze medalist in cross

country skiing up onto the Olympic

podium to receive her medal after

she had been injured earlier in the

day.

“I am thankful to be part of a team that can help patients

and their families.”

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Critical Care TransportIn 2009/10 BCAS operated two ground based Critical Care

Transport (CCT) Teams: one in Kamloops that operates

throughout the Thompson, Cariboo and Shuswap areas,

and another in Trail, that operates throughout the east

Kootenay Boundary area. These ground based CCT

teams provide highly-specialized care and long-distance

transport between health facilities for critically ill or

injured patients. They enable community physicians and

nurses to stay in the community while paramedics still

provide specialized patient care.

Infant Transport TeamBCAS has specialized teams that work with paediatric,

neo-natal and high-risk obstetrics patients. All paramedics

serving on the Infant Transport Team (ITT) complete

a specific training program focused on providing care

to children, and the advanced skills specific to those

patients. In addition, ITT paramedics liaise with specialist

physicians who provide support and guidance. Formed

in 1976, BCAS’ ITT is one of only two paramedic units of

its kind in the world.

Trish fryer

ITT Paramedic

Station 283 - Vancouver

20 years with BCAS


As a member and recent graduate of

the specialized Infant Transport Team

Program, my role is to provide emergency

medical care to neonates, paediatrics,

youth and high-risk obstetrics patients

throughout the province. My job requires

me to fly around the province but I also

respond to street calls when available in

Vancouver.

What is the best part of being a member

of the Infant Transport Team?

The best part of being a member of the

Infant Transport Team is the team work

and collaboration that exists between my

colleagues, doctors, nurses, respiratory

therapists, and the staff at BC Women’s

and Children’s Hospital. We truly all work

together as a specialized team to provide

the best care for our patients.

If you weren’t working for bCas where

would you be?

Most likely I would be working in some

capacity in the same line of work.

What’s the worst thing about the job?

The shift work. It wasn’t so bad when I

was younger but after 20 years, the nights

seem to get more and more difficult to

recover from.

“We truly all work together as a

specialized team to provide the

best care for our patients.”

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I currently work in the Planning Section of Special

Operations. This job entails meeting with special

event groups and city hall representatives,

completing risk assessments, estimates,

contracts, crew schedules and developing

operational plans.

If you weren’t working for bCas where would

you be?

During my part-time years, I worked in Parks and

Recreation. I loved being outdoors and working

with the youth in my hometown community of

Port Alberni. I think I would continue on in that

field if I wasn’t working for BCAS.

Can you tell us about a memorable event?

In June 2007, the International Triathlon

Union World Cup was held in the West End of

special operationsIn addition to providing emergency medical and non-emergency

transport services, BCAS also offers contracted paramedic

services at major public, international and professional sporting

events, movie sets and community fairs. As part of this service,

BCAS deploys paramedics on bicycles and small all terrain

vehicles, known as Gators, when large crowds can limit access

and speed of response for normal ambulance vehicles. BCAS

Jana Hargreaves

PCP Paramedic

Station 264 , Vancouver Special

Operations

13 years with BCAS

Vancouver. The weather conditions for

this event were not favourable with water

temperatures for the swimming leg being

extremely low. Numerous participants

had to be pulled from the water and out

of the race due to complications resulting

from hypothermia. The impact of this

sort of event on downtown operations

and the 911 system is tremendous. It was

incredible to see how successfully the

BCAS Special Operations crews were able

to adapt to the conditions and help make

the event a success.

What’s the worst part about the job?

I can’t really think of anything that I don’t

like about being in this position. I feel

fortunate to have had the opportunity to

be involved with this department.

was one of the first North American Emergency Medical Services

agencies to organize and deploy paramedics on bicycles. The

Special Operations Unit which oversees the bike squads was

first implemented in Victoria in 1992. BCAS bike squads currently

operate in Vancouver, Victoria, and Kamloops, as well as their

neighbouring communities when required.

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BCAS employs its own Medical Programs Division which is responsible for: paramedic

medical oversight including policy, patient care and real-time advice; performance

management; ongoing education; and research. Working within the team are physicians,

educators, researchers and paramedics.

BCAS is undertaking a fundamental change in the approach to patient care through the

transition to new Treatment Guidelines, a combination of best practice and evidence-

based medicine designed to better equip paramedics to make informed decisions in the

field.

BCAS is steadily increasing the ability to provide paramedics with timely and accurate

performance information and feedback to ensure continuous improvement and patient

safety.

Continuing medical and workplace education is part of BCAS’ effort to improve paramedic

safety and enhance the quality of service delivered. BCAS delivers courses in both face-to-

face and online formats. Courses are focused in the following general categories:

Patient Care, Paramedic Safety, Leadership, Dispatch, Regional Initiatives, Orientation,

Work Tools and Emergency Management.

BCAS participates in and uses research to ensure patient needs are being met in the most

effective and efficient manner possible. Of note is BCAS’ participation in the Resuscitation

Outcomes Consortium, which is focused on research in the area of pre-hospital treatment

of cardiac arrest and severe traumatic injury.

Medical Programs


role?

I facilitate initiatives that relate

to paramedic practice. When our

medical experts determine that a

new skill or new piece of medical

equipment should be deployed into

the field it falls to me to make sure

all of the elements of implementing

the initiative are included, from

education, communications, quality

improvement and operations. I also

maintain the Treatment Guidelines

which govern, support and guide

what paramedics do.

What is the best part of being part

of the medial programs team?

I work with a brilliant group of

physicians who are experts in

emergency medicine and totally

committed to supporting paramedic

practice as an essential component

of health care.

What’s the worst thing about the

job?

Being stuck in the office. I had my

fair share of excitement, 20 years

worth, and I’m okay with leaving the

running around to those younger

than me but I do miss the street.

Paul leslie

Projects Director, Medical Programs

Provincial Headquarters - Victoria

28 years with BCAS

BCAS also coordinates and completes inter-facility patient transfers. Patient transfers are

managed through BCAS Communications/Dispatch Centres, who assign both ground and

air ambulances to patient transfer requests from health care facilities. A number of private

patient transfer operators also provide non-medical patient transfers under contract with

Health Authorities. These non-medical transfers are restricted to stable patients who do

not require the skills of a paramedic during transport.

Inter-facility Transfers

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emergency PlanningBCAS’ Emergency Management Office (EMO) is responsible for

emergency planning, mock disaster exercises, and other joint

training initiatives to ensure disaster preparedness and response

capabilities. This includes BCAS’ Chemical, Biological, Radiological,

and Nuclear (CBRNE) response team and Technical Advisors (TA)

who, in conjunction with the Regional Dispatch Centers, provide

direction and advice regarding hazardous substances. During

major events, the EMO supports the organization by ensuring

that a solid emergency management framework is in place.


I lead the BCAS Technical Advisor (TA) program,

a one of a kind safety program. I work with BCAS

managers, dispatchers and responding crews to

ensure overall scene and paramedic safety.

What makes working in the emergency

Management office unique?

My job is unique because I assist Health

Authorities, Hospitals, Fire Departments, Police

Departments, Haz Mat Technologists, and many

scientific specialists in responding to events with

unique hazards.

Can you describe a typical shift?

It’s a 24/7 hands on type of job and there is always

Rene bernklau

BCAS Provincial Coordinator Hazard-

ous Substance Response & CBRNE

Technical Advisor

Provincial Emergency Management

Office

28 years with BCAS

something to do – training, coordinating,

monitoring, advising BCAS crews on

the ground to maintain safety and also

responding to emergency events.

What part of your job to you enjoy the

most?

Being the on-duty TA and working through

responses with our front line paramedics,

dispatchers, and supervisors to provide

a safe and intelligent response, as well

as assisting the patients and receiving

hospitals to prevent further injuries or

contamination.

“It’s a 24/7 hands on type of job and there

is always something to do – training, co-

ordinating, monitoring, advising BCAS

crews on the ground to maintain safety.”

18

serviCes

BCAS participates in community programs focused on improving the ability of the

public to react in emergency situations. BCAS believes education about emergencies is

an important part of patient care and the prevention of health emergencies.

VITal lInK anD GooD saMaRITan PRoGRaMs

Support provided by quick thinking members of the public can often mean the

difference between life and death for patients. Whether performing bystander

CPR, providing critical information to dispatchers or assisting paramedics on scene,

British Columbians are an important link in the health care system. To recognize

the significant contributions made by citizens during medical emergencies, BCAS

supports two community award programs: the Vital Link Award and the Good

Samaritan Award.

The Vital Link Award is presented to citizens who are involved in saving a life

through successful cardio-pulmonary resuscitation (CPR) efforts. The Good

Samaritan Award is presented to individuals who have provided unselfish and

humanitarian assistance during a medical emergency. It is BCAS’ hope that by

recognizing contributions and reinforcing the importance of bystander support,

similar behaviour will be encouraged.

19

publiC eduCaTion

Together with local partners, BCAS is helping educate B.C. youth

about how to stay safe through the P.A.R.T.Y. Program (Prevent

Alcohol and Risk-Related Trauma in Youth). P.A.R.T.Y. is a one-day,

in-hospital, injury awareness and prevention program designed

to reduce death and injury due to alcohol, drug and risk-related

behaviours. Open to students ages 16 and older, participants follow

the path of a trauma patient from the time of injury until discharged

from hospital. During these sessions, paramedics hold a mock-crash

demonstration and describe in detail the process they go through

when they attend a serious motor vehicle collision. The program is

structured to bring them face to face with the consequences of risky

behaviour.

aCT HIGH sCHool PRoGRaM

Cardiovascular disease is the second leading

cause of death in B.C., accounting for more than

one fifth of all deaths in the province. Research

shows that a cardiac arrest victim is four times

more likely to survive if CPR is administered by

a bystander while paramedics are enroute to

the scene. With most out-of-hospital cardiac

arrests occurring at home, early recognition

of a cardiac emergency by a family member,

early access to medical help (calling 911) and

early citizen CPR are critical to saving lives.

Students in B.C. are becoming well-versed in

this life saving skill, thanks to the High School

CPR Program, an initiative aimed at establishing

CPR training in every secondary school in

B.C. by 2010. The program is made possible

through a unique partnership between BCAS,

the Advanced Coronary Treatment (ACT)

Foundation (a national charitable organization

dedicated to school-based CPR) and CUPE Local

873. By the end of the 2009/2010 school year,

the High School CPR Program will have trained

an estimated 40,000 students in CPR.

P.a.R.T.Y. PRoGRaM

20

publiC eduCaTion

2009/10 ToTal eVenT VolUMe bY ReGIon

The 2009/10 figures reported include impacts resulting from the seven months of CUPE Local 873 paramedic job action and providing

ambulance service to the 2010 Winter Olympic and Paralympic Games.

event TypesThe most common emergency calls attended by BCAS paramedics include falls/back injuries, traffic accidents, sick person (no specific

diagnosis), unknown problem (man down), breathing problems, chest pain and unconscious/fainting.

Pre-Hospital events by Region Patient Transfers by Region

21

sTaTisTiCs

HIsToRICal PRoVInCIal eVenT VolUMes

DelTa / eCHo eVenT VolUMes 2009/10 bY ReGIon

BCAS is taking action to ensure life-threatening calls are

prioritized by implementing call prioritization strategies,

reducing emergency department delays, investing in dispatch

technology, utilizing first responder resources, realigning patient

transfer responsibilities and adding additional ambulances

where needed. BCAS is dedicated to providing high quality and

timely patient care. In Urban and Metropolitan communities,

BCAS is striving to meet its target of less than 9 minutes for those

calls that are the most serious (Delta/Echo).

northern

4,164

10min 28sec

58.5%

Interior

11,457

10min 50sec

53.5%

lower Mainland

48,323

10min 33sec

47.4%

Vancouver Island

13,478

9min 21sec

60.6%

Call Location / Region:

Events:

Average Response Tme:

% < 9 min:


Events:


% < 9 min:


Events:


% < 9 min:


Events:


% < 9 min:

From 2005/06 to 2009/10, demand for

services has fluctuated with overall

demand decreasing by 1.9 per cent. In the

five year period from 2005/06 to 2009/10

pre-hospital events increased 5.5 per

cent, from 352,595 to 372,106 and patient

transfers decreased 21 percent from

135,694 to 106,852. The large decrease

in patient transfers is a result of Health

Authorities developing alternate transfer

management strategies for low acuity

patients who do not require paramedic

care.

22

sTaTisTiCs

Through BCAS’ Air Ambulance Program,

residents of B.C. are able to access needed

care that is hundreds of kilometres away in

just a few hours, or reach a trauma centre

in only minutes. The BCAS Airevac and CCT

Program is the second busiest provider of

air transport in North America.

aIR aMbUlanCe PRoGRaM

Rotary (Helicopter) Hours flown:

2,339

fixed Wing (Plane) Miles flown:

2,515,649

Air Ambulance Call Volume

bCas Dispatch/Communications Centres

Vancouver Island Dispatch

Communications Centre

lower Mainland Dispatch


Interior / northern Region Dispatch /


•

•

•

•

•

•

•

BCAS’ response to emergency events begins in one of three Dispatch/Communications centres.

Dispatches ambulances to over 30

communities in some of the province’s

most densely populated areas

On average, receives 1,700 calls and

makes 1,100 calls on a daily basis

Dispatches ground based ambulance

resources to all of Vancouver Island,

Powell River and the surrounding Gulf

Islands

On average, receives 600 calls and

make 350 calls a day

Also responsible for coordinating and

providing provincial air and ground

CCT transports.

One of the largest geographical

Dispatch/Communications centres in

North America, the centre is responsible

for dispatching ambulances in 98

communities throughout Interior and

Northern B.C.

On an average receives 800 calls and

makes 500 calls a day

23

sTaTisTiCs

BCAS’ ambulances travelled over 20 million

kilometres in 2009/10. In addition to ground

ambulances and supervisory support vehicles,

BCAS also has a fleet of bicycles and Gators

which are used at large public events and a fleet

of Medical Support Units which are used during

major incidents to support paramedics and

other emergency responders.

Total ambulances/Total support UnitsbCas fleeT

bCas sTaTIons

BCAS has 186 ambulance stations plus additional facilities which house:

•

•

•

•

station DesignationBCAS ambulance stations are classified as Metropolitan, Urban, Rural or Remote. Station classification is dependent on call volumes,

geography, remoteness, proximity to other ambulance stations and health authority designation of facilities that are in the area. 36

Metropolitan stations are staffed 24 hours per day by full-time paramedic crews. 35 Urban stations are also staffed 24 hours a day, but

use a combination of full-time and stand-by paramedics. 50 Rural stations are staffed using a stand-by model, where paramedics are paid

a reduced rate to stand-by at the station ready to respond. When they respond to a call, they are paid their full hourly wage. 65 Remote

stations are staffed similar to volunteer fire departments where paramedics are called to respond by pager.

Provincial Headquarters in Victoria

3 Regional Dispatch Centers (Victoria, Vancouver and Kamloops)

4 Regional Offices (Victoria, Vancouver, Kamloops, and Prince George)

10 local offices for Superintendents (Campbell River, Castlegar, Chilliwack, Cranbrook, Dawson Creek, Kelowna, Parksville, Smithers,

Kelowna airport and Vancouver airport).

24

sTaTisTiCs

feesWhile BCAS fees are not an insured benefit

under the BC Medical Services Plan (MSP)

or the Canada Health Act, fees are heavily

subsidized for persons with a valid BC Care

Card who are covered by MSP (known as

MSP Beneficiaries). The fee for ambulance

service is $80.

net Revenue to Government –

ambulance fees

$19.23 million

fee schedule

MsP beneficiaries – 911 ambulance

Transport: when an ambulance is requested and

a patient is transported.

MsP beneficiaries - Inter-Hospital Transfers:

when a BC Ambulance transports a patient

between hospitals.

non-MsP beneficiaries – all the above

ambulance transport/transfer categories:

persons with no valid BC Care card – e.g. visitors

to BC/non-residents, as well as work related

injuries, claims under RCMP, and other federal

agencies.

beneficiaries and non-MsP beneficiaries

– 911 Response fee: when an ambulance

is requested to a residence/workplace but

transportation is not required/refused.

$80 flat fee - ground or air

$0

$530 flat fee - ground

service

$2,746 per hour - helicopter

$7 per statute mile -

airplane

$50 flat fee

*Exemptions and Bills paid by other agencies - MSP Premium Assistance and Income Assistance Clients are

exempt from ambulance fees. The Department of Veteran Affairs (DVA) and Indian and Northern Affairs

Canada (INAC) also cover some ambulance fees for their clients.

25

sTaTisTiCs

bCas GRoss exPenDITURes

* Total expenditures include onetime extraordinary costs of labour dispute and ambulance service to 2010 Winter Olympic and Paralympic Games.

** Corporate Services includes Finance, Human Resource, Communications, Legal & Policy, Occupational Safety and Health and Medical Program costs.

26

Website

bC aMbUlanCe seRVICe

Mailing address

PO Box 9600 Stn Prov Govt VICTORIA BC V8W 9P1

location

Block C 2261 Keating Cross Road SAANICHTON BC V8M 2A5

www.bcas.ca

annual report - llbc.leg.bc.ca€¦ · the h1n1 flu pandemic had a mild impact on the population of...

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