Fire Fighter/Paramedic Legislative Changes
Saving Lives, Saving Money, Improving Emergency Care
Why Ontario Needs to let Firefighter/Paramedics use their skills and training
An important regulatory change is in the works that could allow firefighters to bring dramatic improvements to emergency services for all Ontarians, allowing us to save more lives.
It is crucial that firefighters understand why we need this change and to tell friends, family and their MPPs that it has to happen. Firefighters should also support it in our workplaces because it gives us the opportunity to better serve our neighbours.
Ontario is one of the few jurisdictions in North America where firefighters who are also trained paramedics are prohibited from administering certain kinds of care to patients in emergency situations--even though those firefighter/paramedics are certified and perfectly capable of doing it.
As you all know, when a patient is in distress after a heart attack or a serious accident, minutes matter and can make the difference between life and death. The Sudden Cardiac Arrest Foundation reports that for every minute following a cardiac arrest, a patient’s survival rate decreases by 7-10% without CPR and defibrillation.
As you also know, firefighting crews usually arrive at the scene several minutes before EMS crews. Statistics show that in Barrie, for example, firefighters arrive earlier 75% of the time. This means that we sometimes have calls where a trained firefighter/paramedic arrives to find a patient in distress, is capable of providing lifesaving care, but cannot apply their core paramedic skills and treatments until the EMS paramedics arrive on the scene. As one firefighter recently told us: “there’s nothing worse.”
We believe this makes no sense. It is a waste of talent and training and more importantly puts the lives of patients unnecessarily at risk. But change is coming.
The provincial government has introduced Bill 160, which includes some important amendments to the Ambulance Act. It provides for the creation of two pilot programs (in cities yet to be named) where firefighter/paramedics would be allowed to use all of their training and administer enhanced patient care.
For those who have achieved the level of Primary Care Paramedic (PCP), it could mean providing basic trauma life support or administering life-saving drugs. In other words, giving critical care to patients in crisis situations.
OPFFA believes that this is long overdue and we are strongly encouraging the government to promptly pass the bill, rapidly launch the pilot projects and take the next step to expand it across Ontario.
About 10% of our 11,000 members are certified paramedics. That means we have the potential to add 1,100 paramedics to our emergency services provincewide—paramedics who will be on fire trucks that arrive at the scene more quickly, meaning better, faster lifesaving care for our fellow citizens.
It also means relieving the pressure on our over-stretched EMS services. The Auditor General has reported that in 2012 none of the 20 dispatch centres that measure their time to respond to an emergency call complied with the ministry’s policy of dispatching 90% of these calls within the target of 2 minutes. Meanwhile, provincial funding to municipalities for land ambulance services nearly doubled in the period from 2004/05-2011/12, but the number of patients transported only increased by about 18%. In the three following years, funding went up a further 17%, but the number of patients transported increased by only 6%.
Our colleagues in EMS oppose the change. They claim the level of expertise for firefighter/paramedics is lower than that of EMS personnel. We disagree. The training is the same, the certification is the same. The dedication is the same.
We respect our friends in EMS. We work alongside them every day. Firefighters in no way want to undercut them. They do important, lifesaving work and like the rest of society we value and honour their service. All we are saying is, let us work together to relieve the growing pressures on the system and deliver better care for Ontarians. Better care is always the most important goal for us all.
Municipalities are also critical of the bill, claiming that they will face higher costs because firefighters are paid better than paramedics. They have their facts wrong. Tapping into the full potential of firefighter/paramedics’ skills will be a cost saving for municipalities. There would be some expense, but it would be greatly outweighed by the savings generated by ambulance calls that did not need to be made. More importantly, patients in distress would get emergency care more quickly—and who can put a price on saving lives?
We should all understand that most major jurisdictions in North America allow firefighter/paramedics to administer emergency care. Ontario is an exception.
We talked to some firefighters/paramedics from places that allow them to use their skills. They passionately believe that they are providing better care for their patients and better value for their communities.
Matt, a firefighter/paramedic from Airdrie, Alberta says:
“Recently we responded to an emergency where we found the patient’s father providing CPR. We quickly determined that it was likely a narcotic overdose. As a result of having a firefighter/paramedic on the engine that responded we were able to support the patient’s respiration, initiate an IV, administer some Narcan and reverse the effects of the narcotic overdose. And by the time EMS arrived on the scene the patient was sitting up and talking to his family and was safely transported to hospital.”
Kelsey, a firefighter/paramedic from Winnipeg says:
“We’re already there, strategically placed to respond to emergencies within that 4-6 minute range and if we can use that strategic response plan to provide emergency medical care as well, I think that brings a very significant advantage to the taxpayers of our community.”
In the United States, firefighter/paramedics are allowed to use their full training in most major centres.
Mike, a firefighter/paramedic from a Denver suburb says:
“Everyone knows that time is what saves lives. The sooner we’re on the scene and providing care, the better the patient outcome.”
Barbara, an EMS supervisor from Shreveport, Louisiana says:
“Without a doubt, firefighter/paramedics on a rig increase the level of care exponentially to the citizens in the community.”
The evidence is clear. Firefighter/paramedics will make a difference in improving emergency services in Ontario.
Bill 160 is an important step that firefighters should support to ensure it passes. But we believe it is only a first step. We are encouraging the Provincial Government to allow fire fighter/paramedics across the province to use their full skills and we are also suggesting that municipalities who are not part of the initial pilot projects should have the ability to opt in and take part so that they can learn first-hand of the many benefits.
As a firefighter, look at the facts, listen to what firefighter/paramedics are saying elsewhere in North America and help us make this change. It’s good for us. It’s good for our neighbours.