Alberta changes Emergency Medical Service protocols amid surging demand for ambulances

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Alberta, facing crushing demand for emergency medical services and a shortage of available staff, is redirecting calls it deems low priority to other outlets and has stopped sending paramedics to traffic collisions when no one is injured.

EMS has experienced a sustained increase in calls since last February, with the provincial average up roughly 30 per cent, according to the government. On Monday, Health Minister Jason Copping attributed this growth to the coronavirus pandemic, the opioid crisis and hiccups in the global supply chain for new ambulances. The government, he said, has already implemented strategies to buoy this slice of the health care system.

The government has been under increasing pressure to address the province’s EMS system. Prior to Mr. Copping’s press conference, the Official Opposition released data showing that between Aug. 1 and Dec. 6, there were 2,276 instances in Calgary and Edmonton when no ambulances were available. In some cases, fire departments and police services have stepped in to fill the void, responding to calls and transferring patients. Last week in Airdrie, a suburb of Calgary, four calls for medical help came at once with no ambulances available. The local fire department shuttled two patients from separate incidents to the urgent care centre, with the stories spreading through local and social media.

“The delays that day were too long,” Mr. Copping said Monday. “We don’t ever want to be in a position where we put other emergency services at risk to fill the gaps in our urgent medical care.”

Mr. Copping announced a committee that will review Alberta’s EMS system and provide recommendations in May. He also said Alberta will issue a request for proposals for a third party to review the provincial dispatch system, which was overhauled last year.

Darren Sandbeck, Alberta Health Service’s chief paramedic, on Monday outlined a number of steps the province is rolling out to ease the burden on the ambulance system. In December, for example, Alberta EMS stopped automatically sending ambulances to motor vehicle crashes when no injuries were reported. It will also transfer non-emergency calls to other agencies, such as poison control or Health Link, Mr. Sandbeck said. Health Link handled 2.29 million calls in 2020-21, compared with about 892,000 the year prior and 694,000 the year before that, according to AHS’s most recent annual report.

Alberta is also testing a system where stable patients who do not need urgent medical care are transferred between facilities by means other than ambulance, Mr. Sandbeck said. The dispatch system is also being revamped so an out-of-area ambulance is not necessarily sent to a call, even if it is the closest emergency vehicle. Instead, the out-of-area crew would return to its home community, while the next-closest ambulance would be assigned to the emergency, he said.

These tweaks, Mr. Sandbeck said, are intended to be permanent. Further, Alberta Health directed EMS to create a five-to-10-year plan, he said.

There are 550 ambulances in Alberta, including 278 owned and operated by AHS, according to government data.

There were 602,283 EMS “events” in Alberta in fiscal 2020-21, according to AHS’s most recent annual report. This is up from 589,498 the year prior and 560,434 in 2018-19, the last fiscal year prior to COVID-19 dominating the health care system. Officials frequently point to opioid overdoses when explaining the spike. By way of context, in 2020, Alberta attributed 1,165 deaths to opioid poisoning; in the first 10 months of 2021, the province linked 1,247 deaths to opioid poisoning. Data for the final two months are not yet publicly available.

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