In his 22 years with the Peachland Fire Department, Fire Chief Dennis Craig has rarely seen so many calls for medical service. His department, made up of 34 volunteers, has provided first responder service since Craig joined. In 2021, it fielded 352 calls from residents in the Peachland area, located just west of Kelowna, BC. Of those, 168, or just under half, were for medical assistance, a sharp rise from where the department was nine years ago, when, according to the chief, medical calls accounted for just under 40 percent of the department’s responses. “My concern is that I’m tied up on a medical call and I can’t respond to a fire,” said Craig, 48. “When our truck is tied up on a medical call, it’s tied up until we can get it to the same level of care — or higher.” Craig notes that, on some rare occasions, his crews have waited between 20 and 30 minutes for an ambulance to arrive. Peachland Fire & Rescue Chief Dennis Craig is concerned that crews may be tied up with medical calls, potentially delaying their ability to respond to fires. (Tom Popyk/CBC) As communities across British Columbia struggle with a shortage of ambulances and paramedics, many volunteer fire departments are filling the gaps, providing emergency medical services in small towns that are often an hour or more away from the nearest hospital. But while departments like Peachland are willing to continue offering their current level of medical services, crews in some neighboring communities have been reluctant to expand their scope of work, citing concerns about training, resources and volunteer burnout. Dan Derby, president of the Fire Chiefs Association of British Columbia (FCABC), believes that while the majority of fire departments in the province are involved in some level of first response services, recent challenges including the opioid crisis, wildfires and COVID-19 pandemic, have made some crews want to scale back or completely reevaluate the medical offering. In early August, volunteer firefighters in the village of Ashcroft, an hour’s drive west of Kamloops, BC, responded to a call for an 84-year-old man who had suffered a heart attack. According to Ashcroft Mayor Barbara Roden, Fire Chief Josh White advised the caller that Ashcroft firefighters are volunteers and are not trained as first responders. “This is not something they are trained to do. This is not something they signed up for, and this is going to have a huge impact on our volunteer firefighters,” Roden said. Village of Ashcroft Mayor Barbara Rhoden is concerned that medical calls will negatively affect the mental health of her community’s volunteer firefighters. (Tom Popyk/CBC) Roden tells the CBC that White, who has received first aid training, attended the scene and performed cardiopulmonary resuscitation (CPR) with an automated external defibrillator from the fire hall. His efforts were unsuccessful and the man died while waiting almost 30 minutes for an ambulance to arrive. The CBC requested an interview with White, but he declined. In a statement, BC Emergency Health Services (BCEHS), which oversees the delivery, coordination and management of outpatient emergency health services in the province, expressed its condolences to the patient’s family. He also noted that it has voluntary agreements with many fire departments across the province in which BCEHS alerts firefighters to a wide range of medical emergencies, including high-priority “Red and Purple calls,” less urgent “Orange and Yellow calls,” as well as and as calls that require the technical expertise and equipment of fire departments, such as motor vehicle incidents, storm scenes, or potential drownings.” Meanwhile, the BC Ministry of Health said in a statement that it is “aware that there is a growing demand for volunteer firefighters to respond to medical emergencies” and that “increasing BCEHS staffing, especially in rural communities in BC” is a priority for the NDP government.
“False sense of security”
While it’s unclear whether the Ashcroft man could have been saved with a quicker response from paramedics, his death served as a stark example of what can happen when small-town residents don’t have immediate access to emergency health resources. Ashcroft resident Nick Lebedoff helped perform CPR on the 84-year-old before fire crews arrived. He believes every small town should have a dedicated ambulance service. “I’m worried because I live alone,” said Lebedoff, who underwent open-heart surgery in 2014 after suffering cardiac arrest. “What if I call 911 and I have to wait half an hour? It’s too late.” Peachland Mayor Cindy Fortin believes the small town’s residents have a “false sense of security” about emergency response times due to the lack of staff and the fact that ambulances often cover large areas of the county. (Tom Popyk/CBC) Peachland Mayor Cindy Fortin believes the province is “playing the odds” when it comes to public health, leaving small-town residents with a “false sense of security.” “[The province] he says it’s staff shortages … but that’s been going on for a long time, so to me that’s no excuse.” According to BCEHS, Ashcroft has an ambulance staffed by eight full-time paramedic positions and one full-time “irregular” position, which is described as “a permanent but irregular position, like a floater, to cover on vacation, sick leave, etc. . . . Peachland also has an ambulance staffed by eight regular full-time paramedic positions, one irregular paramedic position and on-call staff. In both communities, BCEHS said in a statement, ambulance and paramedics can take over work in other areas. In Ashcroft, this area includes Lytton, Clinton, 100 Mile House and Logan Lake. The Peachland area includes a section about halfway to stations in West Kelowna, Summerland, the Okanagan Connector, Highway 97C (halfway to Merritt), and some back roads and forest service roads.
Medical training can deter volunteers
Tom Moe, the chief of the 18-volunteer Cache Creek Fire Department, said his team is called upon to respond to medical calls even though they are not currently qualified or trained to handle them, with only “ few”. having completed level 1 first aid. “None of our members are interested in making medical calls right now,” said Moe, who has 31 years of volunteer firefighting experience in Cache Creek. “We joined the fire department to be firefighters, not paramedics.” In particular, Moe said his members, who normally work 40-hour weeks on top of their firefighting commitments, don’t care about the responsibility or mental stress that can come with medical calls. He estimates he has lost six people to burnout in the past two years. Ashcroft resident Nick Lebedoff, who lives alone, is worried he may be stuck waiting for help after an 84-year-old neighbor died while waiting for an ambulance in early August. (Tom Popyk/CBC) At the same time, he said, he has felt pressure from BCEHS dispatchers and BC Ambulance recently to increase the department’s medical services. “We go to great lengths to maintain ours [firefighter] education,” he said. “If they start pushing toward first responders, it’s going to cost a lot more money and a lot more hours on our end to train where we need to be … adding medical would be a big deterrent.”
Can calls be rated better?
In the days following the Ashcroft man’s death, BC Health Minister Adrian Dix said the province has made “dramatic changes” to funding for BCEHS and BC Ambulance, with only mental health and addictions seeing a bigger increase. “Beginning in 2021, we have added more than 500 new permanent full-time and part-time paramedic positions in rural and remote areas to work at 24 new rural stations across British Columbia… “Approximately 75 percent of all permanent positions at BCEHS have been filled and we have a strong national recruitment campaign underway to fill vacancies,” a ministry spokesperson said in a statement. BC Health Minister Adrian Dix said staffing BCEHS and BC Ambulance is a priority for the NDP government, with only mental health and addictions seeing a bigger increase in funding. (CBC) But firefighters interviewed by the CBC said staffing is only part of the equation. Triage and public education around which calls require emergency services and which do not may also strengthen British Columbia’s health care system. “We need to look at the entire system holistically to see where we can gain efficiencies and better prioritize calls,” said Peachland Fire Chief Dennis Craig. FCABC, meanwhile, believes that local governments and fire departments should be the ones to determine the level of pre-hospital emergency care. In a position paper presented to a pre-hospital care committee, which includes the Ministry of Health, BCEHS, BC Ambulance and others, the association writes: “Local governments and first responders understand local characteristics and are able to provide information to the patient models of providing comfort and care.” “FCABC’s position is that communities should determine how their respective resources will be used regarding the provision of First Responder services.”
