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Debate ongoing as medevac change imminent

With less than a month to go before medevac planes from northern Alberta stop flying into Edmonton's City Centre Airport and are rerouted to the International Airport outside of the city, the debate continues as to the impact on emergency services.

With less than a month to go before medevac planes from northern Alberta stop flying into Edmonton's City Centre Airport and are rerouted to the International Airport outside of the city, the debate continues as to the impact on emergency services. Concern has been raised as to the increased time it will take to get emergency patients to hospital in Edmonton.

Dr. Guy Lamoureux, chief of staff at the Bonnyville Health Centre, said a number of factors come into play when deciding on the best way to transfer an emergency patient to tertiary care at the University Hospital or Royal Alex in Edmonton. These transfer choices include ground ambulance or air medevac, using either a STARS helicopter or a fixed-wing plane, depending on the availability of the aircraft.

“If we have somebody that has been in a major motor vehicle accident and we know right away that they've got to go to the city but, in the meantime, we need to get intravenous going and we need to maybe stabilize some fractures and maybe put in chest tubes, those sorts or things, we know we're going to be tied up for maybe an hour, an hour and a half, doing all these procedures on the patient. If we call for the helicopter or the plane then they're usually here by the time we've got everything done and then they can fly the patient and that will save a lot of time,' Lamoureux said.

That transfer time between hospitals can be critical, he said, so adding an estimated 45-minute ground ambulance trip from a fixed-wing plane at the International Airport to the Edmonton hospitals is a concern for him.

“As the province gets bigger and there's more oilfield activity and there's more accidents, there are a lot more people being sent by air to the city. I think the number of times that STARS is not available is certainly growing and during those times we've been dependent on fixed-wing and now we're going to add quite a bit of time to fixed-wing,” Lamoureux said, of the move to the International Airport.

In announcing the move, Alberta Health has indicated that STARS, which has a helicopter base at the International Airport, could be used to transfer the most critical, time-sensitive patients from that airport to the Edmonton hospitals.

However, Cam Heke, manager of media and public relations for STARS, said while those conversations have taken place with Alberta Health Services, it is important to note that STARS doesn't have a helicopter and crew sitting at the International Airport specifically dedicated for transporting patients between the airport and hospitals.

“STARS does currently have one on-duty aircraft and crew 24 hours a day, seven days a week (at the International Airport) and when we're available and when it's appropriate, we certainly will assist in moving some of those very time sensitive patients. Now, that said, it's important to indicate that is when we are available because we do fly approximately 700 missions a year out of our Edmonton base.”

Heke said on average about twice a day STARS from Edmonton is out on a mission “so that means we're not at the base all the time.” He said it's too early to know if STARS will be able to fill the role Alberta Health is envisioning.

“That Edmonton base is a very busy base and the numbers have been growing year after year. So, as far as how we are going to manage additional calls going forward, right now we don't know exactly how many of those patients we are going to be requested to move, so part of it will be let's wait and see how this works out once patients start coming in,” Heke said. “We do have additional aircraft but having two at the base doesn't mean that we have an additional crew on full time, there's funding that would go along with that and we'd have to look at the need.”

Lamoureux understands the increasing demand on STARS.

“There's a lot of times we call and the helicopter is unavailable because it's out on other calls and, yes, the helicopters can come and then land on the roofs of the hospitals (in Edmonton) but it's not always available. Quite often our patients end up going by fixed-wing.”

Trevor Funk is a paramedic and one of the owners with Alberta Central Airways, which provide fixed-wing medevac service to northern Alberta. Funk is based in Lac La Biche and said the demand on fixed-wing medevac service out of Lac La Biche has been steadily increasing.

He said they might start by making an emergency trip to Bonnyville to pick up a patient to fly into Edmonton and then, once that call is cleared, be dispatched to deliver a non-emergency patient in Edmonton to Calgary or Lloydminster, for example.

“We do just an enormous variety of work, whatever they ask us to do but it usually starts with an emergency trip from northeast Alberta,” Funk said.

The estimated 45-minute ground transfer time in “perfect conditions” from the International Airport into Edmonton, is a concern for Funk. “That is where the problem is, the actual drive.”

He said right now the medevac plane lands at City Centre Airport, meets the ambulance and he can get the patient to hospital in about five minutes from there. It will be a different scenario at the International Airport.

“We land behind the big aircraft and we've got to stay in sequence with the other aircraft and we've got to exit the runway when they allow us to. At the City Centre, what we do is we land and turn off immediately at the first exit and we go straight to the ambulance, so it won't be quite as smooth.”

However, Funk is prepared to make the most of the change, as he believes there is little option.

“There's nothing we can do. We've tried what we've tried. We've let people know the delays and they are proceeding with this regardless.”

Fixed-wing medevac flights will be rerouted to the Edmonton International Airport on March 15.