Medics in Quebec !

[Charles Brault <c.bro@videotron.ca>]

What next ?
An Helicopter Medevac maybe ?



Wednesday 23 May 2001
Urgences gears for curbside treating

AARON DERFEL
The Gazette
Urgences Sante is gearing up to train 20 ambulance technicians as 
paramedics under a pilot project aimed at saving more lives on the road.
Ultimately, Urgences Sante hopes that nearly one-quarter of its 800 
ambulance technicians will be able to provide advanced life support during 
life-and-death emergencies.
The move means that Quebec will soon become one of the last jurisdictions 
in North America to have paramedics riding in ambulances. Urgences Sante is 
following a key recommendation made last December by an expert panel that 
investigated Quebec's front-line medical-emergency services.
"We believe that when we reach this higher level of care, people will be 
very happy and optimistic," Marcel Boucher, Urgences Sante's medical 
director, told The Gazette yesterday.
"But the goal of this project is not just to save more lives. We also want 
to improve the general quality of care."
The ambulance service is now reviewing applications for the 20 spots.
The positions are to be filled by June 30. A three-month theoretical course 
will begin in September.
Next January, the paramedics-in-training will hit the streets under the 
supervision of an emergency physician. Six months later, they will be on 
their own.
The pilot project will cost about $600,000. If successful, Urgences Sante 
plans to train as many as 150 paramedics within the next couple of years.
One ambulance technician, who did not want his name published, said he's 
thrilled.
"This is something for which we've been waiting for almost 30 years, and 
we're finally getting it," the technician said. "It's actually good news - 
something positive for once, as opposed to all the horror stories you've 
heard."
Urgences Sante has come under sharp criticism in recent years for slow 
response times, inadequate training among its technicians and a lack of 
manpower. Municipalities like Cote St. Luc have set up their own 
emergency-medical-service teams that are the first to show up at the scene 
of an accident and provide basic life support until Urgences Sante arrives.
Richard Liebman, chief of Cote St. Luc's emergency-medical service, 
welcomed the project. "I think it's a fantastic idea. Non-physicians 
provide advanced life support in a majority of cities across North America. 
It's been a long time coming."
At present, Urgences Sante ambulance technicians are restricted in the care 
they provide to people hurt in accidents. They can perform cardiopulmonary 
resuscitation, deliver oxygen to a patient and jump-start a person in 
cardiac arrest with a defibrillator.
Paramedics, however, can perform a wide range of tasks, including 
administering certain types of intravenous medication, sticking a needle in 
a collapsed lung and intubating a patient - a reliable method of helping 
someone breathe.
There are three levels of paramedic training: basic, advanced and critical. 
Currently, Urgences Sante technicians all have basic training. Under the 
pilot project, the technicians will learn advanced life support. 
Eventually, some technicians will receive critical training, Boucher said.
Urgences Sante, a non-profit corporation that provides ambulance service 
for Montreal Island and Laval, responds to an average of 170,000 calls each 
year.
About 4,000 calls involve people who have suffered heart attacks. Urgences 
Sante is directly responsible for saving lives in only 4 per cent of these 
calls.
By comparison, cities with excellent paramedic programs boast survival 
rates ranging from 15 to 20 per cent.
Urgences Sante responds to an average of 6,000 vehicle accidents each year. 
In some of these cases, the presence of a paramedic could well mean the 
difference between life and death, Boucher suggested.
"We will be able to start treating some of these people at the scene of the 
accident, instead of waiting until they are transported to hospital," he said.
During the early 1980s, Urgences Sante hired as many as 200 emergency 
physicians to ride with ambulance technicians and provide critical care for 
high-priority calls.
Today, that figure has dropped to about 30 part-time emergency physicians. 
At any given moment, there are only two physicians on shift for all of 
Montreal and Laval.
That's not acceptable and is one of the reasons Urgences Sante has decided 
to train paramedics, Boucher said.

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