Gabriola Fire Chief positive about BCAS dispatch model

Sounder News

Wednesday, November 28 2018

A new dispatch system introduced by the BC Emergency Health Services (BCEHS) has changed the criteria under which the Gabriola Volunteer Fire Department first responders are called out with BC Ambulance.

Fire Chief Rick Jackson brought up the new dispatch system during a report to the Fire Board Trustees, saying there has been an overall increase in call-outs this year.

The new BCEHS Clinical Response Model (CRM) “went live” on May 30, 2018.

Jackson said, “They give less calls to us, which suits us just fine. Based on their colour code, they decide on whether to page us.”

Jackson said that so far, the change in dispatch methods has been positive.

“Less calls, that’s not a problem. In the past, there have been lots of calls we would go to where we were not needed.”

He said what he’s hearing from the BC Fire Chiefs’ Association is that medical call-outs are down around 37 per cent across the province.

According to the BCEHS data, from June to Sept of 2017, there were 97 BCAS calls which also called out GVFD first responders - about 42 per cent of the total calls during that time period.

In June to September of this year, since the new dispatch model came into effect, there were 61 calls which included GVFD, accounting for 27 per cent of all calls for BCAS service on Gabriola.

Jackson said that “as long as [BCEHS Dispatch] is calling us for the critical calls, where time is of the essence, I don’t see this as a negative thing.”

The previous system, the Response Allocation Plan (RAP), was based on the premise of “you call, we come” – the idea being that if someone called 9-1-1 for an ambulance, every response resulted in a patient transport to a hospital emergency department. 

According to BCEHS, the RAP provided for three types of responses: BLS 2 (Basic Life Support ambulance going without lights and sirens); BLS 3 (Basic Life Support ambulance going with lights and sirens) or HL3 (highest level paramedics and ambulances available going with lights and sirens).

The new Clinical Response Model (CRM) recognizes alternative pathways for patients, such as advice on the phone to treat a minor infection or nausea, transport to a health service instead of a hospital, or treatment by a paramedic in the home or community (known as “treat and release”).

The previous three categories are now broken down into six.

At the top of the priority is the colour category Purple. This category includes conditions such as cardiac arrest, respiratory arrest, and total airway obstruction.

In situations at the other end of the spectrum (a non-urgent call categorized as a Green/Blue), the new system will see a caller who has a minor infection or nausea possibly resolved through advice on the phone from a nurse. According to BCEHS, the system receives approximately 130,000 calls a year that don’t require transport to an emergency department.

Shannon Miller, Communications Officer with BC Emergency Health Services, said BCEHS appreciates fire departments and all the other first responder partners in assisting paramedics in patient care.

Over time though, the new CRM is expected to reduce the need for other first responder agencies such as fire-rescue services to respond to medical calls, so they can focus on their primary roles of fire and rescue response.

Jackson was asked by Trustees if he had any concerns that first responders (those firefighters trained to respond to medical calls) aren’t getting called out the same as in the past.

“To be honest, there were lots of calls over the years that we didn’t really need everyone to be called to. I personally feel it’s moot. Their [BCEHS] overall criteria have changed - I expect it’ll have an impact on our total first responder call-outs.”

The numbers show that even with the new dispatch system, as of the end of September, the GVFD was at 186 first responder calls - exactly the same for first responder calls as it had in 2017 at the end of September. For October 2018, there were 19 medical call-outs compared to 22 call-outs in 2017.

2017 saw 186 calls for first responders to the end of September; in 2016 there were 168; and in 2015 there were 194.

Gabriola’s BC Ambulance station saw 578 total call-outs in 2017; 514 in 2016; and 526 in 2015.

In 2018, there had been 471 call-outs for BCAS on Gabriola to the end of September.

Miller said that fire departments are still continuing to be notified for:

• all life threatening and serious time-critical calls (known as Purple and Red in the new system). This includes those involving cardiac/respiratory arrest.

• all medium-acuity calls (known as Orange calls) that they normally attend, unless BCEHS has an ambulance nearby that would arrive at roughly the same time or within a few minutes. 

• fire departments and other first responders are also notified of all vehicle crashes, hazardous materials sites, fire-related calls, drowning/near drowning incidents, and other calls where their assistance is needed.