Telegraph (June, 22): Paramedic project`s `busy`start

Advanced-care paramedics in Moncton, Saint John and Bathurst have responded to 1,100 calls since hitting the streets on April 20, Ambulance New Brunswick says.

Eric Beairsto, manager of training and quality assurance for Ambulance New Brunswick, said the province hired and deployed 16 advanced-care paramedics (ACPs) for the pilot project. In each participating region, there's two full-time employees, with casuals filling in as needed. The service is in place seven days per week, 12 hours per day.

"All three sites are very busy. But in Saint John and Moncton in particular, they're going to a ton of calls. They're very busy. But they like it that way. It's quite exciting. But I would say I'm a bit surprised at the volume," he said.

Primary-care paramedics are able to administer 10 different medications in the field. Advanced-care paramedics can treat patients with a total of 29 drugs and perform a number of complex, potentially life-saving medical interventions before the patient arrives at the hospital.

When New Brunswick's provincial ambulance service was established in 2007, replacing a patchwork of independent operations, the government of the day set the province-wide scope of practice within the system at the primary-care paramedic level. So even though dozens of paramedics working in New Brunswick for years have had the higher accreditation and licence, they've been unable to use all of their skills and training in the field.

How does Ambulance New Brunswick use these new resources in the system?

When an emergency call comes in, the dispatcher will send the closest available ambulance and a separate ACP unit to the accident scene, or the patient's house. Upon arrival, the primary-care paramedics and the advanced-care paramedic work as a team of three to assess the patient collaboratively.

If the ACP is needed, they'll put their services to use. If not, they may provide supportive help, or decide to move on.

"[The ACP] may not have anything to offer in terms of advanced care. So they'll excuse themselves from the call and make themselves available for another," Beairsto said.

Beairsto said he's been impressed by the way everyone has handled this change.

"The integration piece, we thought, might be challenging. But I'll tell you, it's working out really well," he said.

"The [primary-care paramedics], who do a great job, have really embraced this. I'm happy to see it. Because I wasn't sure how this was going to work."

Ambulance New Brunswick is collecting data, he said, that will be presented to government. That information, he said, could determine whether or not the service expands to other sites around the province.

Kyle Enright, an advanced-care paramedic based in the Miramichi area, said he's heard many of his participating colleagues have been quite busy.

He's not sure why the provincial government wanted to start with a pilot project, considering that ACPs are widely accepted in jurisdictions across the globe and that stakeholders knew the need was considerable here in New Brunswick.

"Every other place in the world basically has implemented it and has let their ACPs do their jobs," he said.

Enright said it's difficult to describe what it felt like to have the training and experience to help a patient, but be unable to act due to the restrictions on the profession.

"One of my biggest frustrations over the years was a simple thing - pain management," he said.

Advanced-care paramedics have training that allows them to administer medications that can stop seizures, reduce the damage caused by heart attacks, or relieve a patient's pain.

"One of the most horrific things in my career was listening to horrible, ungodly screams that didn't have to happen," he said.

"We could have stopped that pain instantly [if we were authorized]. Those people wouldn't have suffered the amount that they suffered."

They can also perform some advanced life-saving interventions, including minor surgical procedures that can open a patient's airway before the ambulance reaches the hospital.

"We can do more. We can give people a better chance," he said.

"We're not the docs. We're not the surgeons. But our job is to get them there in the best shape possible, giving them the best shot they have."

The Daily Gleaner asked the Department of Health whether the province is considering expanding the project.

"An evaluation of the one-year pilot program's success will help guide a wider rollout of advanced care paramedics in the province," said Sarah Williams, a department spokeswoman.

by Adam Bowie

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