On behalf of the paramedics proudly serving your community.
Jamie Ramage
Ambulance Division Chair
1CTAS – Canadian Triage and Acuity Scale
Participant Package Summer 2001,
Emergency Health Services Branch, Ministry of Health and Long-Term Care
2INFORMING THE PUBLIC DIALOGUE AROUND MEDICAL TIERED RESPONSE IN ONTARIO,
An Independent Evidence-Based Review, SEPTEMBER 2011
3Ontario Association of Fire Chiefs, Ministry of Health and Long Term Care – Emergency Health Services, Ministry of Community Safety and Correctional Services, Office of the Fire Marshal in the fall of 2005
OPSEU recognizes and supports an appropriate tiered response agreement for a distinct subset of prehospital emergency medical calls. The agreement must be locally developed, meet the needs of the community, “provide a clear response time advantage in scene arrival by one of the other partners, over the primary responding agency”3 and have statistically significant benefits.
On behalf of the paramedics proudly serving your community.
Jamie Ramage
Ambulance Division Chair
1CTAS – Canadian Triage and Acuity Scale
Participant Package Summer 2001,
Emergency Health Services Branch, Ministry of Health and Long-Term Care
2INFORMING THE PUBLIC DIALOGUE AROUND MEDICAL TIERED RESPONSE IN ONTARIO,
An Independent Evidence-Based Review, SEPTEMBER 2011
3Ontario Association of Fire Chiefs, Ministry of Health and Long Term Care – Emergency Health Services, Ministry of Community Safety and Correctional Services, Office of the Fire Marshal in the fall of 2005
When paramedics communicate with dispatch and hospital emergency departments, they all need to speak the same language. All involved must know in detail the severity of the illness or injury of the patient so they can respond most effectively.
They use what is called the Canadian Triage Acuity Scale (CTAS). It has five levels, with level one requiring immediate attention and level five the least pressing. Within each level there is an expectation that the patient will be seen and receive treatment within a defined time frame. When multiple patients arrive at an emergency, the numbers tell the hospital which cases are most urgent.
Specifically the “Level I-Resuscitation” designation describes patients that have arrested, or require active and aggressive resuscitation, or are pre arrest or post arrest. Their treatment is often started in the prehospital setting and further aggressive or resuscitative efforts are required immediately upon arrival at the Emergency Department.
Compared to a fire fighter, paramedics have much more medical training. The paramedic has graduated from a 2-3 year community college program, has passed the Emergency Medical Care Assistant examination, and can deliver a much wider range of medications and clinical interventions. The paramedic also attends more calls on a daily basis, and is therefore field-tested in the community.
The Ontario Professional Fire Fighter’s Association is suggesting that fire departments should also respond to Code 4 (lights and siren) calls that currently go to paramedics. This would mean an estimated half-million additional urban medical emergency calls for fire fighters. This would drive up fire department costs, including significant new fuel, WSIB (injury) lost-time, training and medical supply costs. Urban fire departments could see cost increases of $1 million or more.
There is no clinical evidence that increased fire department responses would meaningfully improve patient outcomes or provide relief to EMS crew workload burdens.
There is a consensus across the EMS and Fire communities that Fire Fighters make a valuable contribution to “life and death” CTAS1 emergency calls.2
OPSEU recognizes and supports an appropriate tiered response agreement for a distinct subset of prehospital emergency medical calls. The agreement must be locally developed, meet the needs of the community, “provide a clear response time advantage in scene arrival by one of the other partners, over the primary responding agency”3 and have statistically significant benefits.
On behalf of the paramedics proudly serving your community.
Jamie Ramage
Ambulance Division Chair
1CTAS – Canadian Triage and Acuity Scale
Participant Package Summer 2001,
Emergency Health Services Branch, Ministry of Health and Long-Term Care
2INFORMING THE PUBLIC DIALOGUE AROUND MEDICAL TIERED RESPONSE IN ONTARIO,
An Independent Evidence-Based Review, SEPTEMBER 2011
3Ontario Association of Fire Chiefs, Ministry of Health and Long Term Care – Emergency Health Services, Ministry of Community Safety and Correctional Services, Office of the Fire Marshal in the fall of 2005