Wednesday, May 16, 2012

TALES OF AIR MEDICAL TRANSPORT

The death of a Northern Ontario women is making headlines in Ontario as the opposition, and her family, demand answers about the inability of the province's emergency response procedures.

Judy Dearman died last week at  Barry’s Bay hospital waiting to be transferred to an Ottawa hospital. Staff at the hospital called every 15 minutes looking for transportation.  Six hours later, barely conscious air transport arrived.

Ornge provides sophisticated medical transport for very ill and critically injured patients, in the air and on the ground. The delay in transporting Dearman appears to be confusion at Orange over how Dearman was going to be transported, by land or air. She was suffering from an infection after a colonoscopy.

I raise the issue for two reasons. The first,  I wanted to point out that other jurisdictions are experiencing foul-ups in medical service - a women should not die as a result of a routine colonoscopy, any more than a patient in Gander should not have been send home from hospital without having her blood pressure checked after complaining about symptoms of a heart attack. Both are inexcusable! Why do these things happen? Where is the accountability? What lessons have been learned?

The second reason, it gets back to this provinces lack of a realistic, coordinated  air medical transport program. Have a look at the Ontario Ornge site. This have-not province operates 11 Sikorsky S76 helicopters,  ten Pilatus PC-12 airplanes and ten state-of-the-art AgustaWestland 139 helicopters. Why, because Ontario is 1 ,076,395 km² in total area (the size of France, Spain and the Netherlands combined.)

Newfoundland and Labrador has a total area of 405,212 square kilometres, much of it remote but the emergency services provided in this province are much lighter.  The current single-engine Universal Bell 206 (or is a new retrofitted 207 which is all of four inches larger) helicopter – which cannot be used at night – is too small to provide patients with proper care was  criticized by The Association of Allied Health Professionals.




Amongst their stated concerns:

  • The Bell 206 does not have de-icing protection capabilities.
  • The Bell 206 does not provide AC electrical outlets in order to operate electrical equipment such as IV pump, ventilator, cardiac monitor, etc. These devises must be used on battery power only. This introduces the risk of power loss due to battery failure from extensive use (i.e. defibrillation; extended flight time.)
  • The stretcher system on the aircraft does not support a shoulder harness system for patient restraint and does not permit proper positioning of patients if required.
  • Oxygen and medical air cannot be carried in large cylinders, as there is no way to secure the cylinders.
  • Communications with the Medical Communications Centre at Eastern Health or with the on-call flight physician is limited due to access and function of radio systems and satellite telephone on board the aircraft.
 Health Minister Susan Sullivan told the Evening Telegram that  "her understanding is that the way they plan to retrofit the new Bell 407 will give the medical professionals on-board more room to do their work" In fact, the 407 is not much larger and does not address the outstanding issues.

The Air Ambulance service operates  two King Air 350s which provide dedicated air ambulance service to the entire province and are located in St. John's and Happy Valley Goose Bay. A Twin Otter is also located in Happy Valley Goose-Bay, but mainly services the Labrador region. Helicopters (five ) and other fixed-wing aircraft are chartered when needed. It should be noted that the choppers are not dedicated to the Medical Flight Program and are used by other government departments.
The contract for helicopters for use in the Medical Flight Program expired in March 2012.

Which gets me to the real rub. The province's double standard when it comes to the type of response time it expects the CNOPB/Offshore-operators to provide and what it provides with it's helicopter medical flight program for the entire province.

 Should it not be about the safety and well being of the patient?  If Transport Canada's assessment of the Bell is good enough for the provincial government, why do they expect so much more from others?


I'll say one thing about government, they are consistent, constantly hypocritical.







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