Tension over changes to tiered response in Sarnia
SARNIA, ONT. -- A noon-hour traffic accident Thursday on Sarnia’s Exmouth Street is the kind of scenario many people would think of when emergency responders are mentioned.
Police, fire and ambulance all rushing to a scene, all with unique, but complimentary, roles. In this case, the T-bone collision has left a number of people shaken.
Police secure the scene and investigate the cause. Fire determines whether extrication is needed and are first to check on people still in one of the vehicles. Soon, Lambton EMS arrives and the patients are handed over to ambulance crews for assessment, treatment and, perhaps, transport to hospital.
Now, administrators at Lambton EMS have determined that their dispatch service will no longer send Sarnia Fire crews to certain calls.
“We meet with our medical experts, our medical directors, as well has review literature in the medical field and determine what types of calls is there a benefit to having a tiered response,” says Lambton EMS Deputy Manager Jeff Brooks.
“Some of the calls that were in our 2014 agreement, evidence now suggests that there really isn’t any benefit for a tiered response. So, an example for that would be someone with chest pain. In 2010 we gave people with chest pain oxygen as a routine practice, as an example. We no longer do that because we know that it’s actually, not only not helpful, but in some cases it’s detrimental.”
Brooks says there are still many calls where fire will be tiered.
“Things where we know there’s a benefit, cardiac arrest we could have CPR (cardiopulmonary resuscitation) and defibrillation, patients who are unresponsive and maybe need their airway manage, those calls we still tier fire departments to.”
Sarnia Fire Chief Bryan VanGaver says not all calls are what they appear and sometimes the chest pain can be the result of other factors; possibly the use of dangerous, potentially volatile materials.
He believes it’s almost always best to have fire on hand, even if they’re soon released by EMS, “A lot of times when a call comes in, when we get there, it’s not what it seems when the call came in. I won’t say it happens all the time, but it happens we’re not surprised when it does.“
The current tiered response agreement was signed in 2014, while other fire services in Lambton County signed new agreements in 2017.
The agreement with Sarnia was modified at the start of the COVID-19 pandemic because of uncertainty over whether fire crews had sufficient personal protective equipment.
VanGaver says, when it was recognized that that was no longer an issue, fire expected a return to the previous protocols, “I wasn’t really requesting. I was just saying thanks, in advance, for opening this back up. I was met with the response of, ‘No. We’re not going to.’”
Sarnia city council has put its support behind the fire department’s position, noting that Sarnia has five fire stations and two ambulance stations.
Mayor Mike Bradley says in most cases fire will be able to be first on scene.
“When someone’s lying on that kitchen floor after a heart attack, they don’t care about the uniform of the person that comes in there. They just want someone coming through that door as soon as possible.“
The two sides continue to negotiate, but both admit there has been very little movement. There has also been a realization that there is no dispute mechanism to help resolve the stand-off.