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Half of fire response in Abbotsford involves medical issues
Of all the incidents that Abbotsford Fire Rescue Service (AFRS) responded to in 2013, nearly half were related to medical issues.
AFRS released its annual report to council on March 10, showing that 48 per cent of calls involved health and medical problems. About five per cent of the department’s response were to fires with property loss.
Abbotsford’s fire chief Don Beer said the increased response to medical issues and a lower percentage of fires has long been a trend for fire services across the country. He said although only five per cent of calls currently involve fires in Abbotsford, it’s never been more than 15 to 20 per cent in the last 20 years.
Last year, there were 88 structure fires, of which 50 were homes, 13 were apartments and townhouses and 12 were barns. Other fires included vehicles, grass, power poles and dumpsters.
In comparison, there were 2,779 responses to medical incidents – the most common being breathing problems at 634, followed by non-trauma fainting or unconsciousness at 454, and chest pains at 423.
The province-wide agency BC Ambulance Service (BCAS) responds to all medical calls, but as fire departments remain under municipal control, their level of response to emergencies, medical or otherwise, is set out by local governments in fire service bylaws.
Though Abbotsford firefighters attend many medical calls, they actually respond to fewer than some neighbouring communities.
Provincially, fire service support to the BCAS is determined by categories. Abbotsford uses a modified level B response, meaning firefighters respond to immediate life-threatening injury or illness incidents. In communities including Burnaby and Vancouver, the fire departments support BCAS at a level A, meaning that fire crews attend all the incidents to which ambulances respond.
As the need to battle fires decreases, firefighters have diversified their skills. All firefighters have medical first responder certification with the ability to address spinal injuries, operate automatic external defibrillators, provide oxygen therapy and other life-saving skills.
“We actually specifically respond to what we consider are high-risk, and make a difference medically, not … to hold a hand,” said Beer.
The average response time for the AFRS is between eight and nine minutes. Beer said firefighters get to a scene before an ambulance about 50 per cent of the time, but they can begin live-saving measures before paramedics arrive. Ambulances usually only have two crew members, so having firefighters on adds bodies to assist paramedics with equipment and other tasks. Beer said firefighters often ride an ambulance en route to hospital to assist paramedics with requirements such as chest compressions.
This overlap in services has been noticed in jurisdictions across Canada. In Toronto, media reports suggest the situation has led to a fight for resources by the services, which are both run by the city.
In Winnipeg, fire and paramedic services operate as separate branches of a single department – the Winnipeg Fire Paramedic Service – a practice that is increasingly being used around the world.
Though Beer said the combination of fire and ambulance could be financially beneficial, that model could not be as easily applied here, as BCAS is operated provincially and the fire department is a municipal responsibility.
Abbotsford city manager George Murray is currently conducting a core service review of all city services, adding it is important as civic taxation only represents eight per cent of the total amount of money collected from taxpayers by federal, provincial and municipal governments.
Last October, BCAS changed 74 response designations, shifting dozens of call types – often for broken bones and other incidents where the patient is medically stable – so that those ambulances now roll at posted speed limits without lights and siren, rather than code 3 at high speed.
Officials say it’s meant an average of six minutes slower arrival times to those calls, but allowed one minute faster average responses to urgent life-or-death emergencies like heart attacks, while reducing the risk of high-speed crashes between ambulances and other vehicles.
B.C. Professional Fire Fighters Association president Mike Hurley said that doesn’t match what fire department first responders are seeing.
“Our experience in the field is it’s anywhere from 30 to 45 minutes and longer for an ambulance to show up,” Hurley said of the downgraded calls.
“They’ve lessened the service to the citizens of each community.”
He said the types of calls that are now dispatched at routine speeds include serious falls, serious hemorrhages and certain pregnancy calls.
They make up about nine per cent of overall ambulance calls or 125,000 patients per year, according to a report on the reallocation plan, and mean 800,000 fewer kilometres of lights-and-siren driving each year.
Dr. William Dick, vice-president of medical programs at B.C. Emergency Health Services (BCEHS), said the changes flow from a rigorous two-year expert review that assessed outcomes for patients and the risks of high-speed ambulance driving.
“It’s safer to the driving public, it’s safer for our paramedics and it’s safer for our patients,” Dick said Wednesday.
City councillors and fire services from Vancouver and Burnaby have raised the alarm that the changes are reducing service to patients, and amounts to the downloading of costs by the province onto municipal fire services.
BCEHS maintains the changes are not a money-saving measure but are strictly to improve care by speeding response to those in most urgent need.
And it contends municipalities could make smarter use of their own resources by redeploying firefighters to other services if they didn’t opt to dispatch them to routine calls where first responders aren’t medically required.
But Beer said the BCAS changes impact Abbotsford to a lesser degree, because fire services here already use a lower response level than in Burnaby and Vancouver.
Murray said that moving forward, “the level of service from BCAS has to be considered in concert with how fire services are provided.”
Abbotsford’s fire department now focuses more on educating people to prevent fires from happening. With better building materials and fire alarms, the overall rate of fires is going down. AFRS has begun enforcing fines for false fire alarms, not to collect money, but to emphasize the importance of having alarms working properly, though the chances of eradicating fires completely is impossible. With less on-the-job experience, firefighters actually need to train more for high-risk incidents in order to respond to fires quickly and effectively.
But whether fighting fires or responding to medical issues, Beer said a quick response to any emergency is an expectation for citizens.
“Our taxpayers here in Abbotsford have an expectation that they pick up a phone in an emergency situation… (they want) a quick response.”
– with files from Jeff Nagel
Fire service facts (2013)
Operating budget: $15 million
Average fire protection cost per capita: $106
Career firefighters: 90
Fire service employees making more than $75,000 in 2012: 88
Auxiliary firefighters: 106
Vehicles in fleet: 24 total
Average response time: 8 minutes
Dollars lost in fire damage: $3.5 million
Dollars saved in property where dollar loss occurred: $70 million
Total incidents: 5,764
Fires with dollar loss: 5 per cent
Fires with dollar loss and fire alarms (potential fires): 18 per cent
Medical incidents: 48 per cent
Hazmat incidents: 2 per cent