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Non-emergency callers could wait longer for medical care in B.C.

The Surrey Memorial Hospital emergency department is seen after it's official opening in Surrey, B.C., on Tuesday October 8, 2013.

DARRYL DYCK/The Globe and Mail

People calling 911 in non-emergency situations could soon wait longer for medical help as changes proposed to the provincial ambulance service's rules could mean firefighters and municipal first responders stop answering over a third of medical calls.

The change would be included in the second phase of a sweeping overhaul of the response protocols of the B.C. Ambulance Service first enacted last fall. Known as a Resource Allocation Plan, it meant dozens of 911 calls were downgraded from emergency status, leading to slower responses without lights and sirens.

First responders employed by the City of Vancouver seem unlikely to adopt the proposed standard that would see them no longer respond to 35 per cent of medical calls. While the provincially run ambulance service has wide legislative powers, the changes are voluntary for the municipal first responders that supplement and increasingly arrive before paramedics.

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"We are in the consulting phase and some municipalities want to continue to provide so-called comfort care where first responders are there to help," said William Dick, an acting vice-president at B.C.'s ambulance service. Comfort care describes situations where first responders remain with patients facing non life-threatening injuries until paramedics arrive. First responders cannot provide patients with drugs or transport them to hospital.

"There is a cost associated with that," Dr. Dick said. "We have to question the wisdom of sending expensive resources to situations where there is no medical benefit."

Since the rules were first adopted in October, patients facing severe emergencies have seen ambulances arrive one minute faster. Those with less serious situations have seen waiting times increase by about 11 minutes in the Lower Mainland. There have been no changes to the number of paramedics or ambulances on duty.

While Vancouver firefighters have reported instances where they stayed with patients for more than an hour before paramedics arrived, those situations have been called "extreme outliers" by the province.

After a briefing on Tuesday where provincial authorities expressed confidence in the new rules six months after they were first enacted, Vancouver's fire service remained critical of a change it has warned puts patients at risk.

"Our elected officials don't agree with what that briefing reinforced, they don't believe that it gets to the heart of the concerns they have expressed," said Gabe Roder, a captain in the Vancouver fire service. "All citizens should receive the best care they can possibly get in an acceptable amount of time, which includes having highly trained firefighters arriving as quickly as possible."

Due to the changes since last fall, firefighters are now "out of service" while waiting longer for paramedics, according to Mr. Roder. While the changes are voluntary, Vancouver Fire Chief John McKearney says he had success in April, meeting with provincial officials, arguing that patient comfort should be evaluated alongside the statistics. He says officials also indicated that if an ambulance could not reach a patient in a reasonable time, first responders could be dispatched. A full review of the changes is expected in September.

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