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New guidelines keeping B.C. paramedics from patients

Last Saturday, a fallen hiker with a head injury waited more than four hours for medical attention, as rescuers scrambled to lift him out of a steep gully in Kelowna.

According to Ephraim Nowak of Central Okanagan Search and Rescue, the man plunged more than 30 feet down a cliff in Crawford Falls, and “was fading in and out of consciousness” as he awaited rescue.

<who> Photo credit; central Okanagan Search and Rescue </who>

Nowak said firefighters called to the scene quickly scrambled down to offer medical assistance, but BC Ambulance personnel could do nothing until he was finally lifted out.

Nowak said inaction by the paramedics was likely due to new guidelines forcing them to stay out of so-called “high-risk” situations.

BC Emergency Health Services is in charge of the province’s paramedics. Earlier this year it released a policy manual that outlines several “high-risk” situations paramedics are supposed to avoid.

The guidelines require paramedics to get verification before doing a number of things, such operating certain machinery, entering avalanche zones and working on slopes greater than 35 degrees.

According to Dave Deines, the provincial vice president of Ambulance, Paramedics and Emergency Dispatchers of B.C. (the union representing B.C. paramedics), the new guidelines are forcing paramedics into ethical decisions they shouldn’t have to make.

Deines says having to choose between not helping a patient and violating an employer’s policy is a terrible spot to be in.

“It really puts our members at an ethical dilemma every day,” he said. “Nobody should be put in that situation”

Prior to the release of the guidelines, Deines said it was up to individual paramedics to make judgement calls about what was and was not safe. He said the new guidelines are wildly out of touch with what working paramedics face, and the policy is being systematically ignored by paramedics in the field trying to save patients.

“We know for a fact that this policy is being violated every day by paramedics,” Deines said.

He said it’s important for employers to keep their employees safe, but added that a “don’t do anything that’s dangerous” policy isn’t realistic.

At the end of the day, he said, “more patients will be waiting longer for paramedic access” because of the guidelines.

BCEHS did not provide a spokesperson to talk about the new guidelines, but Trevor Pancoust, a communications director with BCEHS, wrote in an email that “keeping our employees safe is a key priority for us.”

Pancoust pointed out that the interim set of guidelines grew out of a WorkSafeBC order, and that the final guidelines “will take into account the specific risks paramedics are faced with in their respective environments and will be practical in their application.”

In response to Denies' claims that paramedics are systematically ignoring the new guidelines, Pancoust wrote that BCEHS has “every confidence that our employees and their supervisors are making the right judgment calls and are interpreting these interim guidelines properly.”

“Their ability to assess risk and respond appropriately will be further enhanced after their training is complete,” he added.

He said BCEHS’s aims to avoid putting its employees in ethical dilemmas, and that its goal is to “support our employees by ensuring they have the appropriate knowledge and training to make those decisions without putting themselves at risk while balancing the needs of their patients.”



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