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Paramedic Association of New Brunswick
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Why are we still waiting?

New Brunswick native says no advanced-care paramedics meant his girl suffered far too long

by Adam Bowie
Fredericton Daily Gleaner, January 8, 2016
Originally Posted:

Jeff Dolan says he’ll never forget the terror he experienced when his little girl’s life was in jeopardy.

In July 2014, Avery Dolan suffered through an hour-long seizure as paramedics rushed her to the closest hospital.

It wasn’t until later that he learned the seizure likely could have been stopped much earlier if only New Brunswick used advanced-care paramedics within its provincial ambulance service.

New Brunswick is the only province in Canada that doesn’t use some form of advanced-care paramedic within its pre-hospital emergency service.

When Ambulance NB launched in December 2007, then-health minister Mike Murphy introduced legislation that said all of the province’s emergency practitioners would practise at the primary-care paramedic certification level as part of an attempt to standardize the level of care across the province.

Advanced-care paramedics are skilled practitioners who have completed additional training that allows them to administer certain types of medications and perform potentially life-saving interventions their colleagues with a primary-care licence simply aren’t trained or authorized to do.

Dolan, who grew up in the Moncton area but has lived on the West Coast for 20 years, said his family was visiting his mother’s home in Lower Jemseg in 2014 for a family vacation.

Early in their stay, Dolan’s three-year-old daughter, Avery, woke one morning seeming a bit sluggish. Shortly after lunch, she decided to take a nap.

“We didn’t think anything of it, but we knew she was a bit off,” he said.

Dolan left to run some errands and about 15 minutes later, his phone rang.

“My wife (Shauna) called and said Avery appeared to be seizuring in her room,” he said.

His wife had already called for an ambulance and he immediately raced to his mother’s home.

“She was breathing, but wasn’t responding to any kind of verbal command.”

It took paramedics from Ambulance NB about 30 minutes to reach the house, he said.

“They realized Avery’s seizure had begun to progress. We’d learn later from the neurologist that it had started in the right hemisphere of her brain, which affected the left side of her body. But because it went on for so long, it went global and affected her whole brain,” he said.

“(The paramedics) did everything they possibly could. They were amazing. But they were limited by legislation as to what they could do.”

Even though they monitored her vital signs and offered her oxygen, they weren’t able to administer medications that could have stopped the seizure.

By law, primary-care paramedics aren’t legally allowed to administer those types of drugs in the field. They’re also not allowed to insert catheters, perform endotracheal intubation, or manually defibrillate a patient.

Even though there are roughly 30 advanced-care paramedics currently licensed in this province, they’re forced to work at the primary-care paramedic level because of the legislative restrictions currently in place.

“It wasn’t until we got to (the Oromocto Public Hospital) at about the one-hour mark that (the medical team) could stop the seizure with medications,” said Dolan, who said he’ll never forget the terror he experienced during that 60-minute period.

He said he’s grateful for the efforts of the paramedics, the dispatchers and the hospital staff who treated his daughter during this crisis. But when he stops to think about what could have happened, a level of frustration sets in.

“When you look back on it, you wonder if the emergency personnel had been able to administer (medications) at the half-hour point, it probably could have stopped the seizure. It could have isolated it to one hemisphere and kept it from becoming global, and it could have prevented complications that occurred during the intubation process at the Oromocto hospital, which caused her to vomit into her lungs and created a whole different set of problems that kept us in the hospital for six weeks with an acute respiratory disorder,” he said.

“We could have avoided all of those complications.”

Avery was air-lifted to the IWK Health Centre in Halifax and was, at one point, placed on life-support. However, she rebounded in time, receiving care from specialists at the centre until the end of August 2014.

Avery suffered several more seizures in the days after her emergency flight to Halifax. The Dolan family was able to return to British Columbia in September 2014, but she still needed treatments with occupational, speech and physical therapists until last month.

“They wanted to make sure she didn’t suffer any ill effects in the long-term,” he said.

Doctors determined that Avery suffered the seizure due to acute viral encephalitis, an inflammation of the brain that could have potentially been fatal.

“This was an undiagnosed illness. We had no idea she could have a seizure that day,” he said.

“Her recovery has been great, but it’s been a long, often unpredictable road.”

Dolan said he believes Avery’s suffering could have been greatly reduced if New Brunswick had advanced-care paramedics in place at the time of the incident.

For years, stakeholders in New Brunswick’s emergency services industry have been calling for the introduction of advanced-care paramedics to the provincial ambulance service. It was a major recommendation in the independent, third-party report on the provincial trauma system, which was presented to government in 2010. In the lead-up to the last provincial election, representatives from the Paramedic Association of New Brunswick lobbied all of the major provincial parties to address the matter if elected.

On July 23, 2014, just about when the Dolan family was going through Avery’s health scare, then-campaigning Liberal Opposition leader Brian Gallant issued a media release saying his party would move swiftly to empower advanced-care paramedics by allowing them to work to their full scope of practice, calling the move, “a no-brainer,” that could save the health system money and improve the quality of care offered to patients.

But even though Gallant and his party would win the provincial election and form government, they haven’t said much about when the changes could be made.

In April 2015, Health Minister Victor Boudreau told The Daily Gleaner that he’s set aside $600,000 for a pilot project that would see at least some of the province’s advanced-care paramedics deploy their skills in the field.

When the newspaper asked about the status of that project earlier this week, a spokeswoman for the Department of Health said officials are still working on the file.

Dolan said it’s unacceptable New Brunswickers don’t have access to the specialized emergency care that’s available in every other jurisdiction in the country.

He was angered when he read another news story about a family in Blackville that had an eerily similar experience as his family, in which a child seizured for more than 40 minutes while being transported to hospital.

“This is going on all the time, happening to families across the province,” he said.

“This needs to be addressed before it becomes a recommendation at a coroner’s inquest.”

Dolan said citizens across the province must call on the provincial government to make these changes as soon as possible.

“The abilities are there. The skills are there. The training is there. The resources are already in place and seem to be ready to be deployed,” he said.

“But they still have a legislative limitation that’s preventing them from providing these services.”

Not only is it the right thing to do, he said, but it could even save the province some money.

“If you set the parental devastation aside for a minute, look at the unnecessary costs and effects (our family’s experience) had on the health-care system,” he said.

#thecareyoudeserve #ParamedicNB #EMS
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See an update from PANB President Phil Comeau about re-registration for 2016.
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"so much more than swooping in and saving lives"
#ParamedicNB #EMS #healthcare #paramedic
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Why are we still waiting?

Stakeholder frustrated with advanced-care paramedic project delay
by Adam Bowie
Daily Gleaner, September 30, 2015
Originally posted:

Stakeholders say they’re still waiting to see how the government of New Brunswick will introduce advanced-care paramedics to the provincial ambulance service, a move that would enhance emergency care.

Health Minister Victor Boudreau told The Daily Gleaner he wasn’t able to provide any specifics but said work is underway on a pilot project that would see advanced-care paramedics working in New Brunswick in the near future.

“It has been a bit of an ongoing (process), just trying to find the right model,” he said. “I don’t have anything specific (to share right now).”

The governing Liberals campaigned on a platform promise to introduce advanced-care paramedics to the system.

Soon after coming into office, Boudreau formed two committees and tasked them to examine how the province could roll out these changes.

But little has been said in recent months about the status of that project, leaving many of the province’s advanced-care paramedics curious as to whether or not the changes are still coming.

Advanced-care paramedics are emergency professionals who have completed additional training that allows them to perform advanced life-saving interventions and administer certain types of medications in the field.

New Brunswick is the only province in Canada and one of the only jurisdictions in the developed world that doesn’t use some form of advanced-care paramedic in its pre-hospital emergency system.

For years, industry stakeholders have been lobbying successive governments to lift restrictions that prevent Ambulance NB from using any professionals above the currently mandated primary-care paramedic skill level.

Chris Hood, executive director of the Paramedic Association of New Brunswick, said officials with the Department of Health haven’t told his organization what they have in mind.

Hood said that uncertainty has been difficult for the province’s advanced-care paramedics, who have waited almost a decade to use all of their skills in the field.

“Our members continue to be frustrated. We don’t know where it’s at, when or how it might be announced,” he said.

“We’ve been hearing that it’s coming, ‘soon,’ for a while now and a lot of paramedics have stopped believing that. These paramedics are frustrated they can’t practise to the full level of their education and their licence.”

Hood said that’s causing a problem now, notably the outmigration of skilled advanced-care paramedics who are tired of waiting for the necessary changes that will allow them to work to their full scope of practice.

“We continue to hear stories of paramedics who have had to move away to work,” he said.

“The longer we wait, the less chance there is of getting them back here for future opportunities for them to practise.”

He estimates there are now only about 25 advanced-care paramedics in the province, down from about 35 at the beginning of 2015.

Since they need to work a certain number of hours at their appropriate certification level, he said, they have to travel to other jurisdictions on their days off or for several months of the year in order to maintain the skills they need to remain an advanced-care paramedic.

“Most every one of them have obtained a licence to practise in another jurisdiction. They move between provinces in order to practise. And when opportunities arise for them to get full-time employment in those other jurisdictions, many think about not coming back,” Hood said. 

“If and when this is announced, we’ll be happy to stand with the minister and make sure this rolls out smoothly and that it improves the care all New Brunswickers receive.”

#thecareyoudeserve   #ParamedicNB  
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