'Call to call to call': Regina paramedics dealing with increase of 2.6K ambulance calls in 2022

Paramedics in Saskatchewan, particularly in the province’s two urban centres, are feeling the effects of a significant increase in call volumes this year.

The Saskatchewan Health Authority (SHA) said so far in 2022, Regina has experienced 29,430 calls for service. That’s 2,686 more than the same period last year when 26,744 calls were received.

That averages out to 244 more calls per month, or about eight per day in Regina alone.

“It’s that [paramedics] come in at 6:00 a.m. and there’s already a call waiting for you. You hopefully get your ambulance checked and everything, and off you go,” Glen Perchie, the Saskatchewan Health Authority’s south zone EMS director, said.

“It’s call to call to call to call.”

Throughout all of 2021, there were 30,522 calls for ambulance service in Regina. There were 26,183 in 2020, 26,272 in 2019 and 26,634 in 2018.

Multiple paramedics who reached out to CTV News, but could not speak on the record, said the current EMS climate in Saskatchewan is worse than it has ever been.

Perchie said there are a number of factors leading to increased volumes, including the COVID-19 pandemic and the opioid crisis.

The increased call volumes are leading to increased response times.

The SHA’s goal for the most time-sensitive calls is to respond in under nine minutes, 90 per cent of the time.

“Year to date, we are sitting at 89.56 per cent for those calls. So we’re close to meeting the mandate, but we’re not quite there,” Perchie said.

However, calls that are less urgent are waiting longer than that.

“I don’t want it to sound like everything is perfect - it’s not,” Perchie said.

At Regina’s Carmichael Outreach, staff said there has been an instance when they’ve called for an ambulance and were told there was not one available.

“We call them semi-regularly and frequency has increased, especially in the past year,” Aurora Marinari, development coordinator at Carmichael Outreach, said.

“We had a client last month who had a seizure and collapsed, hit her head on the floor and was needing medical attention. When I called 911 they said ‘we’ll get a unit out there as soon as we can, but we don’t have one available at the moment.’”

She said there were nurses on staff that day who could look after the patient while they waited 30-40 minutes for an ambulance.

“Our client was okay, but it was kind of jarring,” Marinari said.

Steven Skoworodko, the president of Paramedics Services Chiefs of Saskatchewan (PCSC), said this problem is not unique to Saskatchewan as paramedics across Canada are experiencing similar situations.

With 27 years of experience in the industry, Skoworodko said he believes delayed treatments throughout the pandemic, increasing average population age and increasing general population are also playing a role in the higher call volumes.

“In 2021, there were 143,000 calls for service in the province,” Skoworodko said. “In 2022, we’re projecting it to be about 170,000.”

OFFLOAD DELAYS

Offload delays in hospital emergency departments are also leading to increased wait times for ambulances.

Offloads typically involve one paramedic team taking care of multiple patients in a hospital hallway as they wait for beds to open up.

“The offload delays really impact [Saskatoon] paramedics the same as in Regina because if you’re standing in a hall with a patient, you’re not able to respond to a call,” Rod MacKenzie, executive director of Provincial Services-Community Care for the SHA, said

The SHA said its goal is to have a patient off a stretcher and into a bed in the emergency room within 30 minutes of arrival.

From Nov. 7-13, the wait time at Royal University Hospital (RUH) was approximately 103 minutes. The wait time at St. Paul’s Hospital (SPH) was 71 minutes.

The SHA said those numbers are an improvement, crediting some of the actions it has taken for wait times moving in the right direction.

“That 103 minutes at RUH is still outside of our target, but that’s a reduction of 60 per cent compared to where we were over the summer months,” MacKenzie said.

“At SPH, we’re already seeing a 37 per cent reduction. As we continue to roll these things out, we’re hoping that we can have a greater impact.”

Some steps the SHA said it has taken to combat offload delays in Saskatoon include a specified paramedic offload area in the emergency department for less critical patients, direct admissions to the floor by paramedics instead of going through the emergency department and more strategic transfer times into the city from other communities.

Upon approval from the College of Physicians and Surgeons, the SHA also hopes to implement a treat and release/treat and refer program in December.

“Not everybody who is seen by a paramedic needs to be transported to an emergency department. Sometimes the paramedic can offer the treatment and release them safely to stay home, or we can make referrals to a more appropriate resource for them,” MacKenzie said.

“We’re thinking the best way to reduce emergency department offload times is just not go to the emergency department at all.”

RECRUITING AND RETAINING

The SHA said recruiting and retaining paramedics is an ongoing difficulty, which was echoed by the union representing paramedics last month.

“We recognize that part of the reason our paramedics are as worked as they are is because there are some vacancies we need to fill,” MacKenzie said.

“We’re looking at increasing resources on the street but it requires our most valuable asset - our paramedics.”

In a survey conducted a few months ago, the PSCS said 101 vacancies were identified across the province. Some of those had been open for two years.

When it comes to retention, MacKenzie said current paramedics have voiced frustration over compensation.

He said the Health Sciences Association of Saskatchewan, the union representing paramedics, has asked for wages that are closer to other professionals such as firefighter paramedics.

“We certainly agree with them that we need to do some work in that area to maintain and help with our retention. We don’t want to lose our paramedics,” MacKenzie said.

He added that if issues like offload delays, lack of breaks and long shifts can be solved, the SHA believes it would help with retention.

There are also concerns with what paramedics are facing from the community.

“You’ll hear from paramedics that they get a lot of really poor treatment by the public. People can be very rude,” Perchie said.

“We have a number of addictions and mental health patients that can get very physical. I had a paramedic punched in the face last week. All that, put that together, and they’re feeling it.”

With recruiting, MacKenzie said there are 200 students currently waiting for paramedic training, but not all want to be ambulance paramedics.

“Some of them want to be firefighters, some want to go industrial, some are using this as a bridge to getting in to policing,” he said.

“We’re trying to increase the number of total training seats to try to help that 200 person waitlist.”

The SHA said it’s working with Saskatchewan Polytechnic to offer more flexible classes including online, and evening and weekend training. There are also plans to deliver more ambulance-only courses.

“Once they pass their Emergency Medical Responder (EMR) training, we’re looking at hiring them as EMRs and doing an earn-while-you-learn program while they do their Primary Care Paramedic program,” MacKenzie said.

“The idea there is they’re getting some real life experience working in an ambulance while they’re doing their training.”

MacKenzie said the SHA will do whatever it takes to support paramedics by filling vacancies.

“Anything we can do to improve their work-life balance, we’re in favour of,” he said.

MENTAL HEALTH TOLL

With more calls coming in for paramedics to respond to, the less time there is for them to decompress.

Perchie said some calls paramedics respond to are “horrific.”

“If they’ve done a difficult call, we like to be able to pull them off, cool down and sometimes do a diffusing and support them,” Perchie explained.

“But when there’s the next call waiting, and then the next call waiting, we’re not doing that as well as we’ve historically done it. That has impacted our team.”

Missed lunch breaks and extended shifts are also a common occurrence due to high call demand and not enough staff.

The SHA said Regina is considered fully staffed when 11 ambulances are working during peak daytime hours. Perchie said most days they’re fully staffed, but there are occasions when they’re down one or more units.

When they’re running short, Perchie said the SHA leans on ambulances from other municipalities.

It also has a mutual aid agreement with Regina Fire and Protective Services.

“They have a number of paramedics and they will respond. If we know it’s a serious call and there’s going to be a delay, there’s an automatic response from Regina fire. They will start care while they’re waiting for us to get there,” he said.

Staff at Carmichael Outreach said it is more common for Regina fire to respond to their calls first.

“Before it used to just be that we’d get the ambulance, but now it’s the fire truck will get here and then eventually the ambulance,” Marinari said.

Skoworodko, who also owns and operates Wakaw EMS, said he’s heard from a number of paramedics across Saskatchewan that this pressure is mounting.

He said they’ve made it clear to the SHA that it needs to be addressed.

“Being a frontline paramedic myself still, standing in the back of a hallway in not what you signed up to do. You want to be out doing calls, helping patients,” he said.

“It’s for sure taken a toll on the mental health of paramedics.”