Association of Municipal Emergency Medical Services of Winter 2008/2009 EMS in Ontario is very good...

What would it takegreat? to make it Canada Post Publications Agreement Number 40609661

EMS Matters The official magazine of the Association of Municipal Emergency Medical Services of Ontario Winter 2008/2009

Published for: The Association of Municipal Emergency Medical Services of Ontario (AMEMSO) Paul J. Charbonneau, President Frontenac Service 2069 Battersea Road Glenburnie, ON K0H 1S0 (613) 578-9400 [email protected] www.emsontario.ca Opinions expressed in articles, reports or other content within EMS Matters are those of the author and do not necessarily represent the views of AMEMSO or its Board of Directors.

Published by: Matrix Group Inc. Publication Mail Agreement Number 40609661 Return Undeliverable Addresses to: contents 52 Donald Street Messages: Winnipeg, MB R3C 1L6 Toll Free Phone: (866) 999-1299 7 Message from the President of AMEMSO, Paul Charbonneau Toll Free Fax: (866) 244-2544 10 Message from AMEMSO Communications and Media Relations Office, Jim Price www.matrixgroupinc.net

President & CEO Cover Story: Jack Andress 12 A Crystal Ball Look at the Future of Ontario EMS Senior Publisher Maurice LaBorde Reports: Publisher & Director of Sales Joe Strazzullo 16 OBAG: Evolving EMS Skill Sets and the Challenge for Medical Oversight [email protected] 18 ORNGE: Transport Medicine Linking Hospitals Together Editor-in-Chief 20 Guest Editorial by D.O. Brown: Nothing Endures But Change Shannon Lutter 22 THE MUNICIPAL VIEW—EMS Matters to AMO [email protected] Finance/Accounting & Administration Features: Shoshana Weinberg, Nathan Redekop, Pat Andress 26 HEROES AMONG US: Recalling Brave and Selfless Acts on a Tragic Afternoon [email protected] Two Years Ago Director of Marketing & Circulation 28 Global Medic: Beyond the Front Lines Jim Hamilton 30 Recognizing the Best in Ontario: The 8th Annual EMS Awards Gala Sales Manager 32 RFP Awarded: A New EMS Provider Chosen for Muskoka Neil Gottfred 34 The Realities of Pandemic Planning: An EMS Perspective Sales Team Leader 38 A “Green” Muskoka Evaluates EMS Vehicle Refurbishing Declan O’Donovan Matrix Group Inc. Account Executives Albert Brydges, Davin Commandeur, Rick Kuzie, View Points: Miles Meagher, Ken Percival, Peter Schulz, Vicki 40 The Future of EMS in Ontario: A Perspective Sutton, Jim Hamilton, Jessica Potter, Bruce Lea, Kevin Harris, Brian Davey, Lewis Daigle 42 Tough Economic Times: A View From the North Layout & Design Cody Chomiak Association Information: ON THE COVER: Advertising Design 41 Fund Raiser for the Children’s Wish Foundation James Robinson EMS in Ontario is very 43 AMEMSO Year in Review ©2008 Matrix Group Inc. All rights reserved. good but how can we 44 upcoming Events Contents may not be reproduced by any means, make it GREAT? in whole or in part, without the prior written 44 AMEMSO Board Members Photo courtesy of permission of the publisher. The opinions expressed 45 AMEMSO News Crestline Coach Ltd. in this publication are not necessarily those of Matrix Group Inc. 46 Buyer’s Guide www.emsontario.ca | 5

| Message from the President of AMEMSO |

What will be the next innovative, inspirational or radical change in our industry? Will it be how we educate ? How we deliver “community paramedicine”? How we respond under innovative dispatch protocols such as MPDS? Will it involve significant changes to our vehicles thus better protecting our patients and our staff? We would love to hear your opinion on this “blue sky” thinking.

By Paul Charbonneau, President, AMEMSO

Welcome to the second edition of EMS performance interventions which support the implementation MATTERS. Our theme this year is “Ontario EMS is very good; of new processes. The Board will release the 2009 Priority what would it take to make it great”. What innovation, direc- Worksheets to the membership at the April Business/Education tion or revelation will take us to the next level? Session. I thank the Board members for their continuing dili- Recently a good friend of mine, Jim Reid, relayed a story gence and dedication. We bid farewell to past directors Denis about his family’s involvement in ambulance service. James Merrall and Dan Chevrier and welcome Doug Socha and Larysa Reid Funeral Home, which has been in business in Kingston Andrusiak. Best wishes for a happy and healthy upcoming for over 150 years, was also a pioneer in EMS and oper- holiday season! ated an ambulance service in the early days. When young Jim approached the Boss (his grandfather) in the 1950s about adding some equipment to the ambulance, he was met with questions, scepticism and resistance. The innovation, by the way, was a box of bandages. When I entered our profession in the 1970s, the latest innovations were the administration of oxygen and the “Thomas” splint. Also new was a one year college-based, para- medic training program. Over the ensuing 30 years we have seen truly inspiring changes in how the industry has “Taken it to the Street” (the theme of our recent annual conference). But evolution must not rest. What will be the next innovative, inspirational or radical change in our industry? Will it be how we educate paramed- ics? How we deliver “community paramedicine”? How we respond under innovative dispatch protocols such as MPDS? Will it involve significant changes to our vehicles thus better protecting our patients and our staff? We would love to hear your opinion on this “blue sky” thinking. I hope you enjoy this latest edition and allow your mind to wander through the thought- provoking articles it contains. Will you be part of these changes that will make Ontario EMS GREAT? From a Board perspective, we shall focus on 2009 stra- tegic planning at our December meeting using and expanding upon the recent membership survey, plus our 2007 and 2008 Priority Worksheets. We plan to refine our approach for the future of EMS in Ontario and AMEMSO by incorporating your recommendations for improvements and recommending

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| Message from AMEMSO Communications and Media Relations Office | One note that I find interesting is that, although the AMEMSO role is that of an advocate, its vision is external and not internal.

By Jim Price, Communications and Media Relations, AMEMSO

When we introduced EMS Matters as a machine work. Issues are identified, researched, options deter- winter 2007/8 issue, our focus was to highlight the exciting mined and decisions made. All members of the Board contribute growth of EMS in Ontario. We chose to be inclusive and share the and individual skills are optimized. spotlight with our strategic partners and colleagues. It appears One note that I find interesting is that, although the AMEMSO to have been well received. The use of a collage on the cover role is that of an advocate, its vision is external and not inter- was meant to illustrate the diversity of players and events that nal. The activities and promotions are on behalf of the public, are EMS in Ontario. Our focus continues to be seeking informa- its clients if you will. Quality patient care, employee safety and tive, first-person articles about real life and real challenges con- cutting-edge technology are normal topics for Board delibera- cerning EMS in Ontario. tions. AMEMSO is a vibrant organization whose volunteer Board I hope you enjoy this issue. To our many friends, be assured represents all geographical regions in our great province. As a that AMEMSO will continue its quest to make EMS in Ontario resource person, I have the unique opportunity of watching the “GREAT”.

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| Cover Story | A Crystal Ball Look at the Future of Ontario EMS By Tom Bedford, with thanks to Chiefs Doug Socha, Mike Nolan and Norm Gale for their input into this article This article borrows generously from the Emergency Medical Services Chiefs of Canada (EMSCC) white paper, “The Future of EMS in Canada: Defining the New Road Ahead” which is available on the EMSCC website. It is intended as a road map for steering our industry into the future. Thanks to the members of the White Paper Steering Committee as well as Bruce Farr, Chief of Toronto EMS and President of EMSCC for all their hard work and foresight.

The transition from the both emergency and non-urgent situations. Funding 20th Century “ambulance service” to the Demographic trends will increase demands Currently in Ontario, EMS is essentially 21st Century “paramedic service” involves for conventional EMS. In a sample Ontario funded through municipal tax levies plus more than just a catchy name. The future of community, it is estimated that over the provincial support. While this article cannot paramedicine in Canada is to be at the cen- next ten years, while the general population begin to deal with this complex and contro- tre of the community, providing health care will see a moderate growth of less than 10 versial matter, ongoing sustainable funding in a mobile setting. Changes in the health percent, those aged 65 or over will grow by will be key to the future of EMS. The pur- care system require a redefinition of the way 21 percent. This has the potential of doub- suit of a more predictable funding formula in which paramedics provide services. An ling the current call volume. will enable more consistent service deliv- aging population, transitions in the social This increase in our seniors will place ery, long-term planning, and an enhanced safety net and the current capacity for hos- greater pressures on all areas of the prov- research and innovation capacity. pitals to accept patients demand changes in ince. The regionalization of specialty pro- the way the systems works. cedures, the shortage of rural physicians, Systematic improvement An investment in community based EMS the lack of evening and weekend medical EMS needs to keep pace with technology, can save money in health care costs and can care by family physicians and the process equipment and best practices in order to save lives. Paramedics treat more than two of have shifted the burden to EMS enhance overall system improvement. While million patients a year in Canada. As the causing “wait time” delays. This overloads improved technology exists, it is costly and population ages, these statistics will grow and increases the costs of EMS through exponentially. Chief Farr said, “as medical the need for surplus ambulances and sciences improve and new technologies and staff to compensate for the extra procedures are developed, EMS professionals time spent waiting in the emer- can play an increasingly important role in gency departments. the evolution of health care in this country.” Comparatively speaking, EMS is a The White Paper provides a foundation, young profession and is still developing with six key strategies: its own identity in response to the • Clear Core Identity; public’s changing needs. EMS must • Stable Funding; offer more than emergency and • Systematic Improvement; inter-facility transport. The training, • Personnel Development; skill sets, and responsibilities of para- • Leadership Support; and medics are evolving into a larger role. • Mobilized Health Care. Ontario EMS must further its train- ing and scope of practice, work Clear core identity on matching skills with the appro- AMEMSO needs to define and embrace priate responsibilities, and achieve a clear core identity. The traditional role recognition of its capabilities amongst of paramedicine has focused on emergency policy makers and other health care transport and inter-facility transfer for professions.

12 | rarely available to most EMS systems. An have its own Canadian accreditation sys- retention issues, as well as limiting the investment in updated technology could tem. It is in the best interest of Ontario ability of the EMS profession to advance increase the effectiveness of EMS and and Canada’s EMS to have a made in itself. the standard of care it provides. This Canada, ongoing accreditation program, Leadership must keep pace with the investment will allow for interoperabil- to ensure the quality of paramedic service changing environment. Previously, other ity between emergency service providers delivery. entities were the ones planning and and investment in new technology would developing the paramedic profession. EMS enhance communication systems. Personnel development is stepping up to the plate and assuming New technology can augment the In order to increase the level of care the role of the leaders in its field. amount and level of home care and health and professionalism within the paramedic In order to foster this leadership care monitoring provided by EMS. In addi- culture there needs to be a commitment role, continued support in training and tion, new technology is capable of provid- to personnel development. This needs to developing of both current and future ing paramedics with a patient’s health be both service and individually driven, leaders is imperative. Cultural shifts in history on scene. This technology can also which will support the increase in para- demographics of our staff require the offer a detailed outline of treatment and medic scope in assessments, levels of need to increase leadership and think- assessment steps, thereby improving the pre-hospital treatments, and appropriate ing skills. Recognizing that this leader- emergency care received by the patient. transport destinations. ship gap exists may allow EMS to look at EMS does not currently possess the There needs to be a shift to personal creating formalized leadership programs, research base and data collection capabil- ownership by independent practition- designed to develop talented managers ity required to systematically evaluate and ers with less reliance on employer driven capable of advancing the EMS profession provide guidance for the improvement mandates. As paramedics take an active while improving service delivery. of overall levels of care. EMS research is role in their personal development, oppor- constrained by funding, the absence of a tunities to expand in research initiatives, Mobilized health care federal EMS agency, lack of a central data personal growth and long term goals con- As a key component in linking the repository, and underdeveloped technol- tribute to the overall success of the pro- health care community, our profession ogy infrastructure creating an insufficient fession. Furthermore, services need to has the unique ability to help solve some base for research. support their staff in areas of growth and other “traditional” problems. Current While there are varying opinions about commitment and work with stakeholders successes in cardiac and stroke by-pass the relationship between response time to ensure patients receive the highest protocols have developed from trauma and quality of care, establishing univer- possible care. by-pass protocols. These programs could sal guidelines for response time has the As a profession, EMS has human resour- be expanded to include community para- potential to enhance the level of service ces challenges in the areas of staffing and medicine, paramedics working in the ER delivery. career development. EMS systems across and other non traditional roles. There is currently only one EMS system the country face an aging workforce and As new programs are developed, EMS in Canada with quality accreditation and high retirement rates. advocates need to be incorporated into this accreditation is received though an There are limitations on the ability LHIN discussions to achieve a positive American agency. Currently EMS does not of paramedics to move between prov- impact on the future direction of our pro- inces because training and certification fession. It is these initiatives that Ontario are provincially administered. The lack of needs to expand upon and develop to a national registry hinders career mobility break down the pre-hospital silo and look and development. While most provinces at the pro active approach to treating our have the same titles for different practi- citizens. tioner levels, the actual length of training It will take awareness, dedication, varies considerably between provinces. courage and political support to continue Standardization of professional respon- to move Ontario EMS forward. sibilities and essential skills are essential to a nationally recognized competency profile.

Leadership support Most EMS services do not dedicate adequate time and resources to leadership or career development efforts. Limiting career development and progression of EMS professionals will contribute to Left to right: Chiefs Doug Socha and Tom Bedford.

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| Reports |

OBAG: Evolving EMS Skill Sets and the Challenge for Medical Oversight

By Rob Burgess Rather than just determining if the intubation attempt succeeded, we are looking to see that the paramedics

At first glance one might managed the patient in an optimal fashion. Where the think that this article discusses tradition- first item only needs a binary answer (e.g. yes/no), al paramedic skill sets and the impact on the latter requires an array of data that helps paint a medical control. It does—but only to a degree. picture of how the paramedics managed the patient I want to look at this issue in broader from a clinical perspective. terms. The paramedic skill set in Ontario, and throughout the world for that matter, These two papers highlight what is Where the first item only needs a binary is becoming more sophisticated. probably the most important practical answer (e.g. yes/no), the latter requires Clinical and skill retention in a prov- challenge for base hospitals—mainten- an array of data that helps paint a pic- incial system that is not only adding ance of competency. The evolution of ture of how the paramedics managed advanced care paramedics in many juris- paramedic skills is not something new. In the patient from a clinical perspective. dictions, but where decisions made by all fact we have always faced the problem of This approach will allow us to be better paramedics are becoming more complex, trying to ensure that our providers prac- informed as we continue to optimize our is a key challenge. There have been two tice in a safe fashion. Typically, however, maintenance of competency processes. recent papers that have examined this the focus of our concern has been ACP In his paper Vrotsos said that, “com- issue using an evidence-based approach. and symptom relief skills. Now, we are petency is affected by skill exposure, skill Vrotsos and his colleagues (Vrotsos et. faced with the need to think of this in a complexity, and training program qual- al., 2008 pg. 302) noted that, “limited broader context that may include a more ity.” I suggest that the first two elements exposure to critically ill adult and pediat- precise level of clinical acumen. (exposure and complexity) present the ric patients reaffirms that high-risk skills Current examples include the trans- key test for our system today. Like Craig are performed infrequently.” In this study, port of patients to selected centers for and Vrotsos, we need to ensure that our field paramedic practice was compared to STEMI or stroke presentations, and the decisions are driven by evidence that will regional benchmarks set to establish cer- application of continuous positive pres- be found in the data. A sound partnership tification requirements. The authors cau- sure ventilation. Each of these “skills” between base hospitals and EMS services tion that increasing the number of para- certainly has specific technical exper- will provide us with the expertise we need medic providers will impact their overall tise but more intriguing is the challenge to properly address this issue. clinical abilities. presented to paramedics to ensure that By now you are probably familiar with their patient assessment skills are prop- References: Alan Craig’s work (Craig, et. al., 2007) that erly honed. Thus, base hospitals need Craig, Alan., Schwartz, Brian. and examined matched patient and dispatch to develop ways to ensure that we are Feldman, Michael. “Development of data to derive response plans that optimized looking at the broad brush strokes in the Evidence-based Dispatch Response Plans advanced care skill sets. In addition to the prehospital setting. Sure, monitoring the to Optimize ALS Paramedic Response in obvious benefit of better meeting a patient’s performance of controlled acts to ensure an Urban EMS System” Paper presented needs, the tool also demonstrated that the patient safety remains our primary role, at the annual meeting of the National number of ACP providers needed in a system however, we are beginning to step back Association of EMS Physicians, Registry can be predicted, thus effectively providing and look at the patient encounter from a Resort, Naples, FL, January 2007. this cohort with a reasonable number of different perspective. Vrotsos KM, Pirrallo RG, Guse CE, calls to maintain competency. This is help- Rather than just determining if the Aufderheide TP. “Does the number of sys- ful information when one is attempting to intubation attempt succeeded, we are tem paramedics affect clinical benchmark manage the fine balance between resource looking to see that the paramedics man- thresholds?” Prehosp Emerg Care. 2008 availability and skills retention. aged the patient in an optimal fashion. Jul-Sep;12(3):302-6. PMID: 18584496.

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| Reports | Ornge: Transport Medicine Linking Hospitals Together Ministry of Health and Long Term Care in June 2007. The first phase was introduced earlier this year in the Ottawa area, with the next phase slated for introduction later this year in Peterborough, Windsor and Toronto. These distinctly Ornge vehicles will be designated for use to provide inter-facility transport to critic- ally ill or injured patients. These patients often require ongoing administration of medications and/or blood products during transport that is above and beyond the scope of practice of primary care paramed- ics. Some patients may require the use of specialized equipment or monitoring devices during transport such as ventila- tors, multi-channel infusion pumps or an IABP and are at high risk of deteriorating during transport. There is a body of evidence which suggests that utilizing specially trained Transport medicine is Smitherman, Minister of Health and Long- transport medicine teams can increase the about delivering specialized Term Care introduced Bill 171, the Health chances of survival and reduce complica- medical care in a mobile environment. System Improvements Act which received tions for critically ill patients. Unlike the It could be a fixed-wing or rotor-wing royal assent in June 2007. This legislation EMS land program, whose focus and man- aircraft, or land transport. It is the con- designated Ornge to create an integrated date is to respond to 911 emergency calls, nective tissue for the hospital system—it land and air system for the transport of the Ornge Critical Care Land Transport links hospitals together enabling access to critically ill patients between hospitals. Our program focuses on transporting critical specialized care for the people of Ontario. history, scope of practice and resources put patients from one hospital to another, Ornge transport medicine paramedics and Ornge on solid footing to design and imple- while maintaining the level of care they pediatric transport paramedics are trained ment the program. require. Transition of care from one facil- to provide care for critically ill or injured The creation of an integrated land and ity to another can average 30 minutes patients outside the traditional bricks and air medical transport system is designed for an uncomplicated patient and up to mortar of a hospital. They are experienced to benefit not only critically ill and an hour for a complicated patient. The and highly trained in providing specialized injured patients needing transport, but Ornge transport teams consult with the care to patients in the medical transport also municipalities, land ambulance ser- Transport Medicine Physician who retains environment—our virtual hospital. vices and hospitals. For municipalities the medical responsibility for the patient’s benefits may include relieving pressure on care in transport. The integration of land and air land ambulance services allowing them to The health and well being of patients In 2004, substantial consultations were focus on their municipal mandate and 911 who are admitted by Ornge for medical trans- conducted through the Inter-facility Transfers emergency calls. For hospitals this change port in our virtual hospital is our number Working Group which was a sub-committee of may lead to a reduced need for the provi- one priority. We continue to work together the Land Ambulance Committee. The working sion of escort staff to accompany critical internally and externally with our healthcare group completed their final report with rec- care patients on transfers. partners to deliver on our promise. ommendations in January 2006. This report The implementation of the integrated If AMEMSO members are interested in was then sent to the Ministry of Health and land and air transport system is being having an Ornge representative address Long-Term Care for consideration. In introduced through a number of phases in their group, please contact Kelly Long at December 2006, the Honourable George communities that were identified by the [email protected].

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| Reports | Nothing Endures But Change (Diogenes Laertius 3rd century AD)

EMS research, integrated seamless com- secondary school program in paramed- munications services and unique informa- ic studies which supersedes the OSSGD. tion gathering and sharing technologies. This Regulation change also removed Ontario’s ambulance fleet is considered the exemption for selected volunteers to be one of the safest in the world and to hold an “F” class driver’s license. This is recognized internationally as such by amendment also provided one final exten- experts in EMS safety. sion to December 31, 2010 for part-time Ontario’s Emergency Medical Services Emergency Medical Attendants to achieve have much to be proud of and much to the training and qualification of Advanced celebrate as upper tier municipalities, Emergency Medical Care Assistant designated delivery agent, Base Hospitals (AEMCA). Part-time patient care providers By D.O. Brown and the Ministry of Health and Long- in a certified ambulance service will no Term Care continue to move forward in longer be eligible for employment subse- The world of Emergency partnership to pursue new and positive quent to that date. Medical Services (EMS) is one of change in this industry. In keeping with Also, following consultation with the the most dynamic workplaces in society. the philosophy of ensuring a climate of medical community and the office of the Each and every day, the people in EMS progress the , fol- Chief Coroner, an amendment to Section are confronted with the need to change lowing extensive consultation with muni- 12 of Regulation 257/00 provides an the way they think and do business. In cipal and medical stakeholders, has again improved legal framework to support the Ontario, change in EMS has been a real- made legislative change to improve the implementation of a standard to guide ity since the mid-1960s when Dr. Norman delivery of EMS. paramedics in their interaction with per- McNally led the transition that resulted In July, 2008 the government approved sons with Do Not Resuscitate orders and in Ontario having one of the largest and two new Regulations which amended an for persons for whom heroic resuscitation most sophisticated, integrated EMS sys- existing General Regulation relating to efforts would be futile. This amendment tems in the world. the delivery of ambulance services. also paves the way for improvements in During the past four decades, Ontario The first regulatory change (Ontario the way in which paramedics will deal has standardized paramedic credentials, Regulation 268/08) amends the General with persons who are deceased. More delivery of patient care, ambulance con- Regulation (257/00) under the Ambulance information will be provided with a soon struction, patient care equipment and Act. This change begins by revoking to be released amendment to the Basic the operational delivery of service. We the requirement that paramedics have Life Support Patient Care Standards relat- have seen the introduction of internation- an Ontario Secondary School Graduation ing to Deceased Persons. ally recognized programs related to the Diploma (OSSGD) or equivalent. This cre- The second regulatory change training of paramedics, medical control dential is no longer relevant, as para- (Ontario Regulation 267/08) made under through Base Hospitals, out-come-based medics are required to complete a post the Ambulance Act involves amending

20 | integrate into their plans the efforts Ontario’s ambulance fleet is considered to be and achievements of other emergency one of the safest in the world and is recognized response (e.g. PAD programs) and public safety agencies (e.g. , fire) in the internationally as such by experts in EMS safety. community. The Ministry will be working with its the General Regulation 257/00 to cre- “persons in the municipality” and around municipal partners over the next number ate a new regime and municipal obliga- the resources and specific characteristics of month to sponsor a number of educa- tion to replace the legacy land ambu- of each jurisdiction. tional forums and meetings beginning in lance Response Time Standard. The legacy A vital feature of the new response October 2008 to explain the new response Standard was implemented in 1997 at the time performance scheme is that patient time performance standard and how it time of the transition of responsibility for outcomes will be a central focal point will work for the benefit of patients and the delivery of land ambulance services to for the municipal response time plans the providers of land ambulance services. the municipal sector. This new response and reporting. In short, beginning in Acting in conjunction with stakeholders time performance requirement comes fol- 2010, municipalities and delivery agents who were involved in the consultation lowing extensive consultation with repre- responsible for land ambulance services process, the Ministry will also be spon- sentatives of the municipalities, the EMS will develop and file with the Ministry soring the introduction of a workbook industry and the medical community. a response time plan for 2011 for emer- that will guide municipalities, delivery The new response time performance gency calls involving patients with para- agents and EMS providers in the planning measurement requirements set out in the medic assessed CTAS 1 through 5 con- and reporting process that has been intro- Regulation will be phased in over the ditions on transport. Specific segments duced through this recent change. next two and one-half years. This new of each plan will address the needs of Once again as we continue the con- regime will provide municipalities and victims of Sudden Cardiac Arrest and CTAS stant of history, all of the partners in the delivery agents with the opportunity to 1 patients. As part of the new scheme, development of these changes are work- design land ambulance response time municipalities and delivery agents will, ing hard to bring important modifications performance plans around the needs of for the first time, be able to include and to the EMS environment in Ontario.

www.emsontario.ca | 21 | Reports | THE MUNICIPAL VIEW: EMS Matters to AMO

services and are maintaining strong rela- establishment of these new local stan- tions with the Ministry of Health and dards is another example of how our asso- Long-Term Care. ciations have collaborated to deliver good AMO was pleased to take a leading public policy outcomes. Further improve- role in reversing what appeared to be a ments were achieved with the govern- change in the Ministry’s radio replace- ment’s investments in additional nurses ment policy—a change which would have to ease ambulance offload delays. These added pressure to strained EMS equipment changes occur with thoughtful and patient budgets. Further, the collective efforts of advocacy. the Land Ambulance Committee and its Above are examples in which we have Response Time Standard Working Group successfully sought improvements to By Peter Hume, AMO President have led the Ministry to recently adopt land ambulance service, a critical part new local land ambulance response time of our health care system. Of course we It is a pleasure to contribute to the standards. This change, to take effect will continue to face new challenges. second edition of EMS Matters. On behalf by 2011 is based on the best evidence Municipal efforts to maintain and improve of the Association of Municipalities of available will provide for enhanced muni- the existing provincial-municipal funding Ontario (AMO), I can say with confidence cipal flexibility and equity. Through AMO’s ratios for ambulance services will con- that EMS matters a great deal to munici- Memorandum of Understanding (an agree- tinue. AMO’s efforts will be guided by palities and the citizens we serve. ment around pre-consultation) AMEMSO our past achievements with AMEMSO and I am especially pleased our two asso- and AMO representatives worked together our joint desire to deliver nothing but ciations have been working together over two years to achieve these chan- the very best possible ambulance service to improve the delivery of ambulance ges, working with Ministry staff. The across Ontario.

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| Features | HEROES AMONG US: Recalling Brave and Selfless Acts on a Tragic Afternoon Two Years Ago

By Lou-Anne Hunt / Photography by Constable Darren Smith

him and tried to lose me but I persisted by driving my Jeep through alleyways. He wasn’t going to get away from me.” Leon finally caught up with the young man in a nearby alley. A police officer arrived in a cruiser and apprehended the suspect. “The officer told me that he could hear my directions clearly as they were broad- cast across the police radio; the dispatcher patched my cell phone directly over the air,” says Leon. Shortly after the arrest was made, a police sergeant came to the scene to assist the officer and received a call that the man Leon had witnessed falling to the ground was a 14 year Windsor Police veteran, Constable John Atkinson. Leon and the (Left to right): Police Chief Gary Smith, Kyle Wilkinson, Michelle Wilkinson, Leon DeSalliers, and Windsor Police two officers stood together and cried. Service Board Member Toni Scislowski. As soon as he could, Leon called his wife and began to relay his story. “Why would you Annually, the third week back; I was just going to buy our weekly chase someone with a gun?” she questioned. in May represents a time for the Windsor lottery tickets.” Leon responded by saying, “All I did was Police Service to reflect, pay tribute to As Leon pulled into the store’s park- act on instinct; it had to be done.” our officers and honour the civilian heroes ing lot in his Jeep, he heard one shot He explained how his father was killed among us. May 5th, 2006 was a warm and followed by three more, and then saw a in the Second World War when Leon himself beautiful day, but after 2:07 that after- young man running from the scene with was just 13 months old. He was convinced noon, a wave of shock would begin to something in his hand…presumably a that he was at the scene when Cst. Atkinson pass through our city. It would be felt handgun. was shot and killed because he “had to be nationwide and would not be forgotten. Leon then watched in horror as an there”. The convenience store at the corner of apparent victim fell to the ground. His Kyle and Michelle Wilkinson are both Seminole St. and Pillette Rd. would soon instincts told him to chase the young man paramedics who were off duty and driving in be surrounded with turmoil and emer- who was on the run. He watched as the their truck preparing to enjoy an afternoon gency services personnel, after an urgent figure cut between houses in the area and of shopping. As they were heading south on call was received that a shooting had just he tried to follow the fleeing figure in his Walker Rd. they heard several sirens, and taken place. Jeep. He drove his vehicle into alleys but Kyle knew instantly that the sirens were from Leon DeSalliers had pulled up to the was met with obstacles. police vehicles, fire trucks and ambulances. store shortly before the shooting. “I had The young man reappeared in the area Coming from a family of Emergency dropped my wife off at home after spend- of Reginald St. and Francois Rd. head- Service employees, Kyle instantly ing a beautiful morning together in the ing towards AKO Park. His pursuer then knew “something big was happening”. woods enjoying lunch and a spa day, com- dialled 911. Michelle encouraged Kyle to turn on the pliments of our children,” Leon explains. A visibly shaken Leon relives the inci- handheld scanner they carried in their He adds, “I told her I would be right dent. “He saw me and knew I was chasing truck to find out what was happening.

26 | At the moment of switching on their spotted the same youth sitting with a bus up and arrested the male,” explains scanner they heard the dreaded words, pass in his hand at the bus stop at Walker Michelle. “officer down”. Rd. and Ottawa St. She dialled 911. For these three Windsorites, May 5th, Kyle immediately dialled his father The tinted windows on their truck 2006, started off to be a beautiful spring on his cellular phone to try to get more concealed the fact that they were try- day as many similar days have been; little information about the situation. His fath- ing to follow the youth. There were did they know that they would become er relayed to Kyle that a police officer had no buses in sight and the nervous considered to be heroes that afternoon. just been shot and killed a short distance young man impatiently started running Kyle and Leon both stated, “We’re not from where the couple was driving. from the bus stop. Michelle and Kyle the heroes; the Windsor Police Service At the moment of receiving the news continued to follow him and relayed officers are the heroes.” about John Atkinson, Michelle was star- his direction of travel and complete All three were honoured at the Windsor tled by seeing a young man wearing baggy description to the 911 dispatcher, along Police Service Awards Banquet. They were black shorts and a white t-shirt running in with details of a tattoo they could see on thanked on behalf of the Service for their their direction at full speed, reddened in the youth. heroism and their assistance in appre- the face and carrying a look of panic. “It felt like an hour before anyone hending the two suspects charged in con- For a moment they lost sight of the came to our area, but it was within min- nection with the shooting of Constable running figure but seconds later, Michelle utes that two plainclothes officers pulled John Atkinson.

www.emsontario.ca | 27 | Features | Global Medic: Beyond the Front Lines By Wesley Normington, Manager, Emergency Programs, GlobalMedic

GlobalMedic paramedic Josh Hehner, in the middle of a 12 week deployment in Africa, was sleep- ing in Gemena, a town in the Democratic Republic of Congo (DRC), when he was shaken from his slumber by the sounds of machine gun fire not far from his com- pound. Hehner was deployed to the DRC from May to August of 2008. The DRC has suf- fered through repeated periods of conflict some of them with life-threatening injur- worth $1 million. GlobalMedic partnered and civil war since the late 1990s which ies. Working in an extremely inadequate with World Vision, ADRA, and Save the have killed more than 4.5 million people. medical facility, Dawson and Mclean were Children to provide clean . Hehner was in Africa providing vital able to provide tremendous support to the GlobalMedic also partnered with Muslim Emergency Trauma Training to the medical medical staff. Aid and the IRC in order to distribute over staff of the Mines Advisory Group’s (MAG) In May 2008, Rebecca Thomas 450,000 additional essential medicines. DRC team in all corners of the country. (Northumberland EMS) traversed one of Then on May 12, 2008, the worst The machine gun fire that night was part the most volatile places in the world, to hit in over 30 years of an ongoing conflict allegedly between Sudan. Thomas overcame derelict living struck Province, affecting 46.24 the police and military. conditions and a persistent language bar- million people and killing 69,207. In For all its beauty and intrigue, Africa rier to provide essential CPR and First Aid response to the earthquake, members of can be a difficult place to work. The first training to members of Save the Children. the GlobalMedic Rapid Response Team half of 2008 saw some of GlobalMedic’s In March 2008, Danny Kerr (Niagara EMS), provided access to clean drinking water. paramedics, who work the front-lines here Laura Taylor (Toronto EMS), Joel Johnson The team distributed 5 million water puri- in Canada every day, go beyond the front- (Toronto EMS) and Steve Hallam (Ottawa fication tablets; installed a Nomad water lines and provide hope in some of the EMS), facilitated the training of over 50 purification unit, providing 70,000 people most dangerous places on earth. Nations medical staff for MAG Cambodia. Robin with emergency drinking water; and suffering from decades long conflicts such Young (Coordinator at Conestoga College) installed 20 systems in as , Sudan and the DRC, were just ventured back to Cambodia in August isolated regions to service 9,000 benefici- a few of the places GlobalMedic team 2008 to run a train the trainers program. aries. The team also trained local water members have ventured to this year. The first half of 2008 saw two incred- bureaus and members of affected com- Jeff Dawson (Frontenac County EMS) ibly destructive natural . First, munities on the operation of water puri- and Ian Mclean (Calgary EMS) made the hit on May 2, fication units. GlobalMedic has received arduous journey to Puntland, a breakaway 2008, affecting some 2.4 million people; additional funds from the Canadian region of Somalia. Dawson and Mclean almost 140,000 people were killed International Development Agency (CIDA) were training the MAG Somalia medical or remain missing. In response to the which will provide 100,000 people with staff. One morning, while in the middle Cyclone, GlobalMedic deployed a five clean water for over 2 months. of training, their facility trembled with person Rapid Response Team, including The success of GlobalMedic missions brute force. Children had been playing Toronto EMS paramedics Michael Larsen are all dependant upon the same fac- with an anti-tank bomb nearby, which and Rahul Singh, to provide clean drink- tors—paramedics with the ability to adapt exploded, killing one of the boys instantly ing water and essential medicines. The within another culture; paramedics willing and injuring several others. Dawson and relief items delivered included 101 water to leave their families and travel to the Mclean rushed to the local hospital to purification units, 5 million water puri- other side of the world; paramedics who assist in treating victims of the accident, fication tablets and essential medicines care.

28 | www.emsontario.ca | 29 | Features | Recognizing the Best in Ontario: The 8th Annual EMS Awards Gala The N.H. McNally Award of Bravery The N.H. McNally Award recognizes The EMS Exemplary Service Medal The Richard J. Armstrong acts of conspicuous bravery by pre-hos- The Emergency Medical Services Leadership Award pital professionals in the performance of Exemplary Service Medal, created on The Richard J. Armstrong Leadership their duties. The Award was established July 7, 1994, recognizes professionals in Award is to be awarded annually to an in- in 1976 to honour Dr. Norman McNally the provision of pre-hospital emergency dividual recognized for both outstanding whom many regard as the father of medical services to the public, who have leadership and significant contributions Ontario’s ambulance system. The award performed their duties in an exemplary to EMS in Ontario. Nominations are evalu- in his name has a rich history of acknowl- manner, characterized by good conduct, ated by the AMEMSO Board and are based edging individuals who risked their lives industry and efficiency. upon the “Dimensions of Sustaining to rescue or protect others from harm. The Award is not merely a long service Leadership” which he exemplified and in- It is not an annual award, and is only medal. It is first and foremost an exem- clude: presented based on merit. Nominations plary service award presented to those • Partnership and voice; are subject to a careful review process by eligible members of the pre-hospital emer- • Vision and values; the Ontario Awards Committee. gency medical service who have served for • Knowledge and daring; at least twenty years in a meritorious man- • Savvy and persistence; and ner. To qualify, at least ten of these years • Personal qualities (including: of service must have been street level duty strength of character, general matu- involving potential risk to the individual. rity, patience, wisdom, common sense, Nominees must have been employees on or trustworthiness, reliability, creativity, after October 31st, 1991, but may now be sensitivity). active, retired or deceased.

Middlesex-London Recipients.

Recognizing Excellence in Ontario EMS The 8th annual Ontario EMS Awards Gala was the highlight of the 2008 AMEMSO Conference in London, hosted by the Counties of Elgin and Middlesex. The London Convention Centre proved the perfect setting for the crowd of 600 award recipients, family members, friends, and EMS senior staff from around the Province. On a stage decorated with the flags of 52 AMEMSO member municipalities, 111 paramedics and other EMS professionals, received the Governor General’s EMS Exemplary Service Medal. Presented on behalf of the Governor General by retired Major-General Richard Rohmer, the medal honoured exemplary careers in EMS, spanning at least twenty years in duration, with a minimum of ten years involving potential risk to the recipient. Two of the medals were presented posthumously to family members of paramedics Paul Fegan (Brant) and Barry Van Niekerk (Simcoe). In addition, three paramedics received the coveted N.H. McNally Award of Bravery. Peel Region paramedic Sheri Sutherland and Prescott-Russell paramedic Sylvain Veuilleux received the Award for separate incidents where they each risked their lives to rescue patients trapped in burning vehicles. Toronto EMS paramedic Robert McColeman received the Award for containing a violent psy- chiatric patient armed with a knife. By doing so, he likely prevented numerous injuries in a crowded Toronto hospital Emergency Department. While the McNally Award recognizes Acts of Bravery by on-duty EMS personnel, AMEMSO President Paul Charbonneau used the Gala to announce the creation of a new Award to honour paramedics who conduct themselves in a similarly remarkable manner while off-duty. As yet unnamed, the Award will be eligible for presentation for the first time at the 2009 Awards Gala. Finally, the R.J. Armstrong Leadership Award was presented for the first time this year with Region of Waterloo EMS Director, John Prno as recipient. John has been an integral part of EMS in Ontario for many years. He is well known for his work with the Chancellery of Honours and is a recipient of the Lorne Bareham Memorial Award (1999) for activities promoting interagency coop- eration among emergency services.

30 | President Paul Charbonneau and Chief President Paul Charbonneau and paramedic President Paul Charbonneau and John Prno is delighted to receive the R. Michel Chretien, who is accepting the Robert McColeman, a McNally Award winner paramedic Sheri Sutherland, a McNally J Armstrong Leadership Award from the McNally Award for paramedic Sylvain from Toronto. Award winner from Peel. man himself. Veuilleux from Prescott-Russell. Our 2008 EMS EXEMPLARY SERVICE MEDAL recipients listed by provider area (i.e. county or region):

BRANT – Wayne Buckley, Paul Fegan (posthumously) Kevin OTTAWA – Michael Bowen, Stephen Calkins, Robert Page, Hilton Robinson, Michael Silverthorne Radford, Garth Tourangeau BRUCE – Bill Ernest, Elaine Lang, Bonnie Jeffrey Little PEEL – Gerry Corram, Peter Dundas, Brent Gallaugher COCHRANE – Gary Girard, Pierre Lavoie, Richard Loiselle, Serge PERTH – Richard Gerber, Jim Kirby Richard RENFREW – Wendell Croken, Richard Luesink, John McPeak, Gordon CORNWALL SD&G – Doug Green, John Guthrie, Lee Montford, Tom Panagapko, Terry Recoskie, Richard Slater, Brad Smith Todd SIMCOE – Robert Elliston, Ron Lacroix, Bob Lewis, Paul ELGIN – Allison Crossett, James Hesser, Arthur Hill Lizotte, Robert Murtha, Brian Parkes, Barry Van Niekerk ESSEX-WINDSOR – Wallace Buckler, Ronald Drouillard, Joseph (posthumously) Nardone, Brian Perisic – Randy Boomhower, Norm Gale, Wayne Gates, Ted GREY – Bruce Fidler, Dean Hill, Elgin Vanwyck Neill HALTON – Michael Butt, Michael Corney, David Extance, Don TIMISKAMING – Michael Tinney Goldrup, Doug Hodge, Richard Millar, Roman Nowickyj, Seamus O’ TORONTO – Glenn Brown, Fraser Cameron, Tom Goegan, Steven Connor, Joel Smith, Ray Williams, Glenn Woolvett Henderson, Mike McCallion, Claude Muir, Edward Owen, Kelly HASTINGS-QUINTE – Graham Christie, Duane Dryden Sheppard, Michael Toliver HURON – Mario Oliveira, Cynthia Stickland WATERLOO – Jim Gatenby, Dave Hobler, Gary Mifflin, Sharon KAWARTHA LAKES – Robert Deshane Penlington, Paul Schlichter LANARK – Steve Allen, Douglas Ferrill, Dale McCabe, John McElroy, WELLINGTON – Robert Hill, James MacIntosh Peter Vander-Putten, Rick Warren YORK – Marc Desjardins, Geraldine Lindgren, Andrew Liski, Ian LEEDS-GRENVILLE – Frederick McLeish McAdams, Mike Ristich LENNOX-ADDINGTON – Timothy Clark, Kathryn McCabe MANITOULIN-SUDBURY – Debbie Collin ADDITIONAL SERVICE BARS: MIDDLESEX – Edward Anderson, Charles Gelbard, Alan Hunt, BRANT – Charles Longeway Ronald Liersch, David McLean, William McLeod, Michael Wraith, HALTON – William Kennedy, James King Bruce Wright HAMILTON – Robert Orchard MINISTRY OF HEALTH – Al Duffin, Alan McInnis LEEDS-GRENVILLE – Dan Chevrier, Chris Lloyd NIAGARA – Blaine Bittman, Graham Garrett, Dennis Graveline, SIMCOE – Joe Lundy Randy Hague, Edward Levere, David Mathews, Robert Mercer, John THUNDER BAY – Huguette Marchak Scalzo, Paul Taylor NIPISSING – Richard Desjardins AMEMSO congratulates all of the Award recipients ORNGE – Robert Marshall, Percy Pilatzke, Todd Ritchie, Mike and thanks them for their contributions to Ontario EMS Steinman, John Wismer excellence.

www.emsontario.ca | 31 | Features | RFP Awarded: A New EMS Provider

By Terri Burton Chosen for Muskoka

It has been a busy time in 7. Provides stability of services for 5. Key personnel/firm profile; Muskoka. It was determined in 2007 that Muskoka, the contractor and para- 6. Transition plans; the District would issue a Request for medic staff through the establish- 7. Reporting and working relationships; Proposal (RFP) for ambulance service ment of a long term contract for ser- 8. District of Muskoka reporting; delivery. The contract with the current vice; 9. Value added; and provider, Muskoka Ambulance, was sched- 8. The ability to look at medical trans- 10. Pricing. uled to expire December 31, 2008. portation as part of the RFP in addi- Muskoka received six submissions and Muskoka is responsible for ensuring tion to emergency call demand; and Medavie EMS was the successful respond- the supply of vehicles, equipment, ser- 9. The ability to issue services in whole ent. Their submission met and exceeded vices and information for the provision or in part as defined in the RFP. the expectations of the RFP. Their expertise of land ambulance service in Muskoka in and resources will assist them successfully accordance with The Ambulance Act and Choosing a provider implement land ambulance service delivery Regulations. The objective of any RFP is to ensure in Muskoka on January 1, 2009. In the last two years, Muskoka has the best provider is selected—a provider Medavie EMS has positive patient care transitioned the contract for ambulance who can provide a quality service at a accountability, demonstrated by customer service from a full service provider to a reasonable cost and one who would not satisfaction and the ongoing monitoring of contract more typical of a staffing provid- only meet Muskoka’s immediate needs but protocol compliance and clinical tracers. The er. Muskoka owns all vehicles and equip- would develop the service to meet the liaison with the Medical Director and Base ment, and by 2009 will own all stations needs and demands over the life of the Hospital is seen as a positive and neces- except for a leased station in Port Carling. contract. sary relationship in order to exchange data Muskoka beats overall public account- The RFP team evaluated the docu- and ensure excellent prehospital care is ability for the quality and cost of ambu- mentation submitted by respondents and delivered. The Medavie process for timely lance service provided and therefore can scored their evaluations based on the fol- recognition and management of noted clin- be disadvantaged by any agency who does lowing areas: ical deficiencies is maintained through daily not follow public policy. 1. Patient care; quality assurance and restorative education. Some of the advantages to proceed 2. Patient transportation; Medavie is well known for their provision of with the RFP were: 3. Support services/administration; ongoing medical education sessions based 1. Testing the market to identify poten- 4. Asset management; on clinical trends, research and ambulance tial cost savings; 2. Opportunities to introduce new ideas and vision for ambulance service delivery; 3. The ability to clearly establish expectations between Muskoka and service providers to achieve strategic initiatives; 4. The ability to better define and improve service levels by designing a perform- ance based RFP which would measure response times, public education, para- medic education and other measures to evaluate the quality of the ambulance service being delivered; 5. Increases the ability to promote muskoka Muskoka EMS under the next con- tract; 6. Maintains third party relationship for employment of paramedics and labour issues;

32 | industry best practices. The provider is noted when necessary, will allow Muskoka and reduce fuel emissions, consumption and for their responsiveness, quick turnaround to Medavie to achieve the fluid manage- unnecessary travel. requests, and thorough follow-up of clinical ment of unit hours necessary to meet Medavie EMS is well versed in emergency and service related inquiries. and exceed the contractual and public preparedness. Their experience will be an Medavie EMS practices the collection, expectations. The reduction of “empty” asset to emergency planning and the con- processing and presentation of meaningful unit hours will increase efficiency. tinuity of ambulance services in the event operational and clinical data in a timely The philosophy of Medavie EMS is in of a public emergency or potential threat. manner and will provide to Muskoka, the line with Muskoka’s vision to improve driv- Their experience includes train derailments, key services indicators required. er training and vehicle safety programs. plane crashes, weather including hurri- The use of the Performance Indicator Their program promotes a culture of pub- cane Juan Category 2, and severe winter Database (PID) to capture information lic safety, lower fleet maintenance and storms including White Juan, all in the last from patient care reports will be used to vehicle insurance costs, improving para- 5 years. After 911, Medavie EMS partici- support the continuous quality improve- medic morale, and creating a leadership pated in patient care coordination with all ment processes. structure, which is consistent with other planes rerouted and ongoing patient care Medavie EMS provided the most com- high performance EMS systems. The train- for those stranded travelers. Medavie EMS prehensive value added response. They ing program with instruction and mon- participates annually in provincial exercis- are experienced in the area of electronic itoring reinforces a “low-force” driving es including EMO, RCMP, and local police. patient care record management. Muskoka philosophy and has significantly affected Staunch Maple was the most recent exercise plans to implement this type of sys- the driving results in other Medavie EMS on May 2, 2008, held in Nova Scotia. The tem in 2009. Their expertise will assist operations. Their history and demon- cruise ship Aphrodite, played by a navy ship Muskoka in the training and transition strated cost/claim/100,000 kilometres has docked at the Shearwater jetty, was at the of this program. They have trained over been reduced from $1725.00 to $416.00 centre of the exercise, which included an 900 Paramedics to date, retrofitted 150 over a 3 year period. As Vehicle Safety on-board explosion, injuries and passengers vehicles and configured 160 tablets in a Program Paramedic scores improved, there with Legionnaires’ disease. Provincial environment for patient record were quantifiable reductions in the cost In closing, Muskoka recognizes the management and data collection. of insurance claims required to repair col- contributions and efforts made to date by Medavie EMS has been able to dem- lision damage. This program will be imple- its current contractor Muskoka Ambulance. onstrate cost savings, and has taken the mented in Muskoka to translate to reduce Muskoka Ambulance has provided a high opportunity to introduce new ideas and cost, less damage to the vehicle, and level of patient care and is recognized for vision for ambulance service delivery in increased public safety, paramedic safety its public relations activities. Muskoka. Their submission is most notable and patient safety. We wish to welcome Medavie to and has defined improved service levels Medavie EMS has a proven environment- Muskoka and look forward to a long work- by designing a performance based ambu- ally friendly record of efficient Mileage ing relationship. You can view their web- lance service, which will not only measure Management and Anti-Idling Programs to site at www.medavieems.com. response times, but also measure minute- by-minute performance maximizing the use of resources. Medavie EMS has demonstrated con- siderable knowledge and extensive experi- ence in managing on-time performance for their EMS systems. By using time interval models, they will continually evaluate ambulance responses. This will enhance Muskoka’s current deployment plan and will assist in the approved staffing pattern and deployment model review to deter- mine further operational efficiencies and ensure optimal performance. Medavie EMS has worked to understand the call volume and call types in Muskoka, which is the key to predicting ambulance unit hour allotment. The implementation of a staff-to-demand model, in combina- tion with clear policy on reassignment of units to higher priority call responses

www.emsontario.ca | 33 | Features | The Realities of Pandemic Planning:

By Richard Armstrong An EMS Perspective

air travel to contend with as significant numbers of people are confined together for hours at a time, moving around the world and spreading disease. By the time the threat is recognized and air travel is restricted, it will be too late to slow down the spread. The scenario has the potential to mirror Stephen King’s novel The Stand, but hopefully with a much lower mortality rate. The health-care facilities will quickly be overwhelmed with patients experien- cing flu symptoms. The limited number of pressurized rooms will be full within the first few days of the first wave, and any external resources such as mobile hospital facilities will also be expended, provided sufficient staff can be found to staff them and provide care. As the facilities are overwhelmed, many will die at home, and one of the major issues will be what to do with the deceased. Currently, plans involve moving the deceased to ice rinks, We have all been involved It is not unreasonable to anticipate freezer trucks or other private cold storage in pandemic planning for some time a peak of 50 per cent, or greater, loss of facilities that can maintain a temperature now and have read the numerous arti- employees in all segments of the work- between four and eight degrees Celsius. cles, reports and papers in respect to force. This will impact significantly on However, this will create its own prob- responding to a pandemic outbreak—but the delivery of food, water, fuel/energy, lems. Who will process the deceased and are they realistic? First and foremost, we supplies and equipment, not to mention watch over the storage facilities? Should should remember that a pandemic is the essential services such as infection con- mortality rates be higher than predicted, rapid transmission of a communicable trol, health care, ambulance, police, fire, who will care for and possibly rotate bod- disease for which there is no vaccine or security, food processing and inspection, ies should they have to be stacked until effective treatment. mortuary, etc. Even with the availability burial or cremation? It is important to consider the pro- of effective anti-viral medications the The handling of the deceased will jected volumes of employees lost dir- health-care sector will likely suffer higher require a quick confirmation of identity, ectly to a pandemic (30 to 40 per cent), losses due to infection as a result of early determination of cause of death and dis- plus those that remain home to care unprotected contact and higher rates of posal of the remains, with very limited for their families or just choose not to exposure. resources available to complete these come to work due to increased risk of We must accept that the spread of a tasks. The 2008 Plan for exposure. During the SARS outbreak it communicable disease of this nature will an Influenza Pandemic states: was discovered that a significant num- be far more rapid then ever experienced “Under current legislation, phys- ber of health care providers worked for in the past. We are an extremely mobile icians complete the majority of Medical multiple employers or at multiple sites. civilization with millions of people travel- Certificates of Death. Consideration is This in itself will reduce the availability ling around the world every day. Just con- being given to modifying the regulations of staff, as they will likely be restricted sider how many people commute over an under the Vital Statistics Act to allow for a from working for more than one employ- hour to work every day; that factor alone broader spectrum of health care profession- er or at more then one site during a will assist with the rapid spread of the als, including nurses and paramedics, to pandemic. disease. In addition, there is the issue of perform this function.”

34 | That means that in addition to many own community, though I doubt any com- ensure adequate protections are in place other challenges that will be facing para- munity will be able to prevent the spread in respect to future liability. People will medics, they may be charged with this of the disease. be unwilling or at least hesitant to make responsibility as well in many commun- As we start to realize the real loss of decisions outside of the norm if the risk ities. It’s also easy to presume that should staff it will become more and more dif- of future liability is too great. the number of deceased overwhelm local ficult to maintain operations and creative I can see that in EMS there will be a resources mass graves and/or cremation solutions will need to be implemented. significant shortage of staff, and the roles may become a reality in many commun- These will be outside of the current and duties of the paramedics will change ities. legislative requirements and standards dramatically as the pandemic spreads I have also noticed that many of the and the legislators that are still avail- and peaks. They will likely become more plans I have reviewed do not address the able will need to be able to react quickly involved in treatment in the field with- needs of non-infected patients. What hap- to support alternative solutions and to out transporting. This will be particularly pens to all of the other patients requiring medical attention if the health care facili- ties are full of influenza victims? What do you do with trauma and heart attack patients, and those requiring surgical or medical intervention? It may be more appropriate to keep influenza patients out of health-care facilities especially if there is no treatment or intervention that is effective. There should be more emphasis on how to care for influenza patients in the home or in reception centres where care could be provided without impacting on the health-care facilities. This would allow health-care facilities some ability to continue to treat the other non-infected patients or those requiring treatment for non-related emergency issues. Many plans include a reliance on resources from adjacent communities, municipalities or the Provincial or Federal Government. This is likely not realistic. These adjacent communities will be in the same position and also looking for assist- ance from other sources. I believe the most effective plans will be those developed on internal resource capabilities within the individual com- munity/municipality. Depending on the locations of the epi- centers of the outbreak (and there will likely be hundreds of them), and just how fast the infection spreads will deter- mine what resources may be available from other communities and agencies. Even those communities not yet experi- encing and outbreak may not be as forth- coming as one might think. Many may wish to hold back their own resources for their own potential outbreak needs and requirements. They may also feel that sharing their human resources will open them to increased exposure within their

www.emsontario.ca | 35 true in support of patients suffering from ambulance. These patients (approximate- We will need to look at acquiring people to influenza at home or in reception centres. ly 25 per day) had been transported by a drive the ambulances so we can concentrate EMS may be called upon to provide sup- regional medical transport bussing service on the patient care side of the business. plies and equipment to these locations, prior to this. We quickly responded with an Fire, police and other emergency agencies and to also provide education and train- alternative to staff the bus with a paramedic will not likely be able to assist as they will ing to the public and other agency staff. who would train the bus drivers in the use be experiencing similar staff losses and will We have experienced this already during of Personal Protective Equipment (PPE) and have their own increased demands and pres- the SARS outbreak. screen every patient before they got on the sures to deal with. We also had to develop alternative plans bus. This alternative allowed us to meet the One of the alternatives to consider would to some of the provincial directives issued needs of the patients while protecting them be the use of bus drivers and other relat- during SARS as we did not have sufficient and the bus company staff from exposure. ed agencies such as St. John Ambulance. staff to implement them. One of these Alternatives for staffing and operating These individuals already have the appropri- issues was a directive to transport all of even the most essential services will require ate licence and experience in driving larger the patients requiring dialysis by individual creative and dynamic thinking and solutions. vehicles and could be trained and orientated to the ambulances early on. It is highly unlikely community and school bussing will continue during a pandemic since the use of public transit would be a mechanism of dis- ease spread, therefore they may be an avail- able resource to EMS. Public Works and other local trucking agencies may also be a source of alternative manpower. It would be wise to acquire these individuals as early as possible into a declared pandemic so they could gain some experience in driving the ambulance and be monitored by the paramedics before they are actually required. Access to supplies and equipment will also become an issue of some significance particularly as the pandemic wears on and fewer people are available to manufacture and deliver items. Many of us are stockpiling items of PPE already but storage space is limited and stocks could be depleted quickly. There is also the requirement to acquire all of the other supplies including oxygen, drugs and other medical supplies and equip- ment. Laundry service may also be curtailed due to the lack of available staff. Alternative sources should be built into your plan and confirmed in advance. Provided you know where the supplies and equipment are, you can always find a way to access them and deliver them to your service. We definitely need to participate in pan- demic planning, but need to do it as realis- tically as possible. Planning for the worse- case scenario is the best and most effective approach to take. If your plan addresses the worse-case scenario, then it should provide an adequate framework for decision-making with or without your personal involvement. All of your staff needs to be able to contrib- ute to the planning process either directly or through reviewing the plan and being asked to provide comments. This is something we are currently working on during the

36 | development of our own plans, which They must have the confidence to respond to any situation that may arise are not yet complete. make decisions that may be incorrect. and assist each other as much as pos- We also need to mentor our staff However, they also need to be able to sible regardless of the situation. in creative problem-solving. They need recognize any errors through effective In closing, please remember many to participate actively in this form of monitoring and make alternative deci- of us may be the first victims of a pan- decision-making whenever possible to sions to resolve these errors quickly. demic and the remaining staff should develop the skills and confidence to I believe that if we all take this be sufficiently familiar with the plan, deal with crisis before being faced with approach and share our plans as they and have the confidence to step up and something as complex as a pandemic. are developed we will be able to take control.

www.emsontario.ca | 37 | Features | A “Green” Muskoka Evaluates EMS Vehicle Refurbishing By James Gibbons and Terri Burton The three R’s (reduce, reuse, and recycle) is a proven green strategy that provides We have stewardship responsibility to care for our significant dividends. Muskoka has seen environment. The Kyoto Protocol, green house gas emissions, rising energy costs, over $650,000 in savings since 2003. environmental impact, carbon credits, taxes and the new climate exchange engine and transmissions are backed by a initiative are dominating our conscious- 2-year 40,000 kilometre warranty, while ness. The three R’s (reduce, reuse, and replacement parts are backed by a 1-year recycle) is a proven green strategy that pro- 20,000 kilometre warranty. vides significant dividends. Muskoka has Recycling existing assets is good for the seen over $650,000 in savings since 2003. environment. The first step is the disassem- Conservation has enabled funds to be allo- bly of the ambulance mechanical structure. cated to other ambulance initiatives such Each of the components removed is sent for as the District’s new Gravenhurst ambulance recycling. Engines return to the manufac- station. turer, metal and plastics go to recyclers. In Vehicle refurbishment has existed in the a carbon credit-trading environment one can emergency vehicle fleet market for years measure the carbon footprint of this action. resulting in substantial savings to the In the near future, these carbon credits will municipalities who embrace the strategy. have market value. The new Montreal cli- Replacement of the vehicle’s major systems mate exchange has opened to trade carbon with new factory issued parts returns the credits. American EMS Services have been ambulance to full warranty and may in some ambulance, and an increase on the return on refurbishing vehicles for years. In 10 years cases, double the life cycle of the ambu- investment. of refurbishments, the million dollars saved lance. Extending the life of an asset is good by the District of Muskoka is equivalent to Replacement of the engine, drive train, business. High mileage ambulances are over 127, 000 metric tons of carbon emis- suspension, steering, heating and cooling, structurally sound while mechanically worn. sions. For a third of the price ($60,000 sav- exhaust systems along with restoration to Experience has now shown that operating ing for each vehicle) you put a “like-new” the driver and patient cabins enable the and maintenance costs for the refurbished ambulance on the road. The need to stretch vehicle to attain a second life cycle at half vehicle are equivalent to new units. The limited financial resources is common to all the cost of a new unit. Muskoka realized restored vehicle carries the original equip- municipalities. The ambulance community an immediate saving through reduced cap- ment manufacturers warranty that is hon- has a significant opportunity to go green ital outlay for the second life cycle of the oured by the national dealer network. Ford and get more for their money.

38 | www.emsontario.ca | 39 | View Points | The Future of EMS in Ontario:

By Norm Ferrier A Toronto Perspective

Ontario was a leader in This is further complicated by the fact other levels of care. We need to start find- the evolution of the standards governing that all of the physicians, nurses and ing ways to keep those patients away from what we now call Emergency Medical paramedics from the same generation are crowded—and often faraway—emergency Service (EMS). First, minimum entry-level also aging, and in many cases, reaching departments. Rather than being “gate- training standards were developed. In retirement age. Numbers in these profes- keepers”, Ontario’s paramedics might very many cases this involved a month or less sions are shrinking at precisely the time well become the “greeters” of the health of training, but it was, at least, a start. when demand is increasing. Currently, care system; assessing people’s needs and This was followed by more comprehensive more than one Ontarian in ten is without either providing immediate service, or training standards involving community a family physician, and there are thirty directing the patient to an appropriate colleges, and the knowledge level of the percent fewer hospital beds than there location where their needs can be met. average “ambulance attendant” began were twenty years ago. In the face of Ontario’s paramedics should be finding to grow. These changes were followed by increasing demands and limited resour- ways to identify these patients as early in the advent of paramedicine in Canada, ces, the system will be challenged to find the call as possible, and referring them to and eventually grew to involve a level of new ways to provide the required levels more appropriate healthcare or social ser- care which permits medical intervention, of service. EMS will be forced to play a vices. Smaller rural EMS services, who may instead of simply recognizing symptoms role in this problem solving; indeed, we not have a wide range of local alternatives and driving fast. In today’s Ontario, EMS are already feeling the effects of these to choose from, are likely to focus more staff are finding new, professional, and in problems, in terms of ambulance diversion on primary patient care services, such as some cases highly-specialized roles in the and “offload delay” in many parts of the chronic illness follow-up, and treating healthcare matrix. province. minor illness and wounds directly. Ontario’s health care system is cur- To some extent, those of us in Ontario It is not difficult to find examples rently under unprecedented stresses, EMS are the victims of our own success. of paramedics expanding their scope caused primarily by evolving demograph- We have been telling people for years of practice and diverting patients ics. The environment in which our profes- to call us any time they have a prob- away from emergency departments at sion operates is rapidly changing, with lem; and people HAVE been listening. the high acuity end of the spectrum. new challenges and opportunities on the Unfortunately, we don’t always have the In July 2005, the Ottawa Paramedic horizon. As the “baby boomer” generation ability to deal with every problem that Service implemented a trend-setting aged, they have become “net consumers” they present. Generally speaking, a person program that gets specific cardiac of health care. Unprecedented demands calls EMS when they don’t know where patients the care they require are being placed on a healthcare system else to get medical help. In many cases, and reduces the patient flow to that is already at or beyond capacity, in someone may actually need paramedic the ED. It starts with the rec- much the same way that the same group care and transport to ognition of S-T segment eleva- created a space crisis in the education an ED, but some of tion in the field through 12-lead system thirty years earlier. our patients require ECG acquisition, resulting in

40 | advanced prehospital intervention; the already expanding their scope of prac- Meanwhile, specially-trained com- patient is diverted away from the emer- tice by delivering non-emergency care munity paramedics are sent to calls gency department and brought directly to isolated island residents or mem- where emergency medical intervention to definitive care at a Percutaneous bers of First Nations communities. is likely not needed, to assess and Coronary Intervention (PCI) lab that Such programs involve providing care, redirect patients to other resources is available 24 hours a day. Toronto is assessment and education services that will better serve their needs. In now following Ottawa’s lead, as well as for conditions such as diabetes and the Netherlands, paramedics in the implementing a system to quickly send hypertension, and in some cases, even communication centre direct low-acu- Advanced Care Paramedics to “rescue” performing procedures such as sutur- ity patients to local clinics, and in STEMI patients from community hospi- ing in the field. These efforts are all some cases, make arrangements for a tals, bringing them quickly to a 24-hour directed at permitting the provision of home visit by a family physician. PCI lab where they can receive the care patient care not otherwise available Such examples are only the begin- that they urgently need. locally, and avoiding long journeys to ning of the next stage of EMS evolu- Other examples of bold, new care overburdened healthcare facilities. The tion, and their full potential has yet by paramedics include plans to change low-acuity situation which is addressed to be fully explored. The profession of the manner in which post-cardiac arrest before it reaches crisis stage is both an paramedic is poised to move from the patients are managed. This too will be EMS call and an E/R visit that will never category of technician to that of prac- significant; in some Ontario centers need to occur. titioner; in many cases, functioning post-arrest survival has climbed from These roles are not unique to independently. This evolution is already 2 percent to more than 20 percent. Ontario, or even to Canada. Around occurring in the U.K., Australia, and Patients (and a LOT of them) who used the world, our colleagues are also South Africa. As paramedics and EMS to die are now going on to return to adapting to pressures in their own systems continue to evolve, the oppor- productive lives, thanks in part to the healthcare systems. Australia has tunities to provide more comprehensive actions of Ontario paramedics. As a expanded the role of the paramedic to care and services will occur. Ontario direct result, the manner in which we include community healthcare by spe- paramedics will have the opportunity to manage both cardiac arrest and post- cially trained paramedics in remote move from their traditional role in the arrest patients is becoming increasingly areas of the country. In London, and community, and to explore other oppor- critical; we ARE saving lives, and we increasingly elsewhere in England, tunities in the ever-changing healthcare may have the potential to save even paramedics are found in the com- matrix. We have come a long way in the more! munications centre triaging low- past thirty years. The role of Canadian At the opposite end of the acuity acuity patients. These patients are EMS is changing dramatically, and the spectrum, our colleagues in some areas diverted to other healthcare providers future will be bright, for those who are of Nova Scotia and rural Ontario are before an ambulance is dispatched. up to the challenge.

Fund Raiser for the Children’s Wish Foundation

John Murden is a professional artist working from his studio gallery nestled in the solitude of the Muskoka region. This award winning artist is well known for his beautiful watercolour paintings. A large number of John’s limited editions embrace the Muskoka theme. Please visit his very interesting web site. AMEMSO commissioned John to create a print that captures the purity of compassion in the daily life of street-savvy paramedics. This print, created in his comfortable style, is offered with the majority of income from sales going to the AMEMSO-chosen charity, the Children’s Wish Foundation. The unique part here is that the print is alive and can be tweaked to accommodate the individuality of each Ontario EMS service. There are two print choices: Limited Edition and Artist Proofs. As well there are multiple choices of frames and liners plus options for laser appliqués to insert a service crest and/or brass commemorative plates. These options plus costing can be found on the AMEMSO website. www.emsontario.ca.

www.emsontario.ca | 41 | View Points | Tough Economic Times: By Norm Gale A View From the North

Though these are indeed health care agencies in that this eco- in an effort to establish more appropri- troubled times for the provincial nomic climate demands that we become ate means of transportation. This is a economy, the economic conditions in the more efficient and find ways to increase particularly pressing problem and it will north are in dire straits. A decimated and improve service. only become more severe in the next dec- forestry industry combined with signifi- Amidst increasing costs and financial ade. Hospital administrators are doubly cant decreases in tourism-generated rev- accountability, hospitals, long-term and frustrated, as EMS has rightly moved to enue have struck a blow at the core of alternate care centres and other health reduce the amount of transfers provided. the economy of the north. As a result, care facilities and social services agen- While they understand the importance of northern municipalities, especially small cies have been forced to cooperate to find emergency coverage, these administra- rural communities, have been grappling more efficient ways to provide service. In tors know that many EMS stations in the with shrinking tax bases combined with Ontario, EMS has been unique as it has north have low call volumes. They wonder, increasing costs for the delivery of muni- been isolated from other aspects of health “what are they (the paramedics) doing, in cipal services. Costs for emergency ser- care delivery following provincial down- that they can’t move our patients?” vices have led the way with increases loading; this occurred as historical factors Across the north, paramedics are sta- amidst a declining economy and shrinking contributed to a general reluctance on the tioned in communities with low call volumes. municipal revenue. Accordingly, in order part of EMS to work closely with hospitals. In some stations, paramedics will perform to improve, EMS providers must find ways Despite this, there are ways in which EMS, one call every two or three days. Clearly, to become more efficient to provide more particularly in the north, may be able to the presence and timely response from bang for the buck, so to speak. provide enhanced service while grappling paramedics is doubtless necessary. Could As municipal administrators and pol- with difficult problems. more service be provided, however, without iticians under severe financial pressure The provision of long-distance non- adversely impacting on emergency response grapple with budgets, they face the prob- emergent patient transfers poses a vexing time and call availability? The answer is an lem, of course, of EMS demanding an problem for rural northern EMS agencies. unequivocal yes. Paramedics in rural areas, ever-larger slice of a smaller pie. It is Often, non-emergent yet medically neces- for example, have a golden opportunity to inconceivable that this will continue. In sary transfers are completed by paramed- become an even more integral part of their this climate, EMS administrators and para- ics, thus for hours at a time removing community. Initiatives such as EMS guided medics must work together to increase the from the community its sole ambulance. PAD programs, the provision of commun- value of services provided. While no one Although these patients do not neces- ity first aid and CPR programs, supporting will dispute the value of the service pres- sarily require the care a paramedic or public health units in the provision of public ently provided by paramedics, EMS is no even the use of a stretcher, paramedics health in rural areas in particular, and even different than other are used because a broadened presence of paramedics in com- there is simply no munity health clinics could have a profound alternative trans- impact politically and for society. portation. Should That municipalities in the province in a 911 call come in general and the north in particular are under during the transfer, extreme financial pressure is not in doubt. the closest ambu- It is also clear that EMS has placed ever- lance is generally increasing demands on municipal budgets one hour away. while providing service under increasing dur- As the status ess. Although we have enjoyed some success quo is clearly in the provision of this service, improve- unsatisfactory, EMS ments need to be made. Certainly EMS must find a way to should continue to concentrate on our core either provide this business: response to 911 calls. In order for important service northern EMS to be great, however, we must without comprom- find ways to further integrate our operations ising emergency with the broader scope of health care pro- coverage or work viders while increasing our value to the com- with the hospitals munities we serve. | Association Information | AMEMSO Year in Review ANNUAL EDUCATION DAY through the media. Mr. Bill Blackborrow, AMEMSO AGM AND AWARDS A key area of interest for the AMEMSO MHSA, provided a full review of Section 21 GALA membership was to have a continuing changes. Mr. Michael Morton of Emergency London, Ontario was the location of opportunity for education. Our Annual edu- Management Ontario provided an interesting the 2008 AGM co-hosted by Middlesex- cation day this year was held, Wednesday explanation of the EMO role and common London and Elgin-St. Thomas EMS. The February 13, 2008 in Toronto. President Paul concerns with AMEMSO members. hard work of co-chairs Denis Merrall and Charbonneau welcomed 140 members and Larysa Andrusiak and their conference guests. EMERGENCY MEDICAL SERVICES team was very evident as the business, Mr. John Saunders and Mr. Mark Mason WEEK (2008) social and exhibitor venue all ran very presented on the following topics during Emergency Medical Services Week brings smoothly. The event was generously sup- their Human Resources Challenges Workshop: together local communities and medical per- ported by 55 vendors and local area busi- bargaining updates, decertification/deacti- sonnel to publicize safety and honor the nesses. vation, flu vaccine, meal breaks, accommo- dedication of those who provide the day-to- At the AGM of the EMS Directors, Chief dation for disability and pregnancy, fitness day lifesaving services of medicine’s “front Doug Socha was elected to replace the testing, innovative HR practices and solu- line.” In 2008, organizations across North outgoing Dan Chevrier for the Eastern tions for off-load delays. Mark also presented America recognized May 18 – 24 as “EMS Region and Larysa Andrusiak was chosen the latest wage settlements throughout the Week” under the international theme, “EMS: to replace Denis Merrall for the Southwest. province. Your Life is Our Mission”. Base Hospital Program Managers, Medical Dr. Bruce Sawadsky, Vice President, Directors and Board members met as did Medical Affairs, ORNGE presented the latest EMS CHIEFS OF CANADA the T.O.R. working group. A highlight was operational issues within ORNGE and dis- The annual EMS Chiefs of Canada (EMSCC) the plenary session featuring Dr. Nadine cussed future plans. Ms. Jennifer Amyotte Conference took place recently at the Laurel Levick who presented her findings on the from Sudbury EMS and Mr. Greg Bruce from Point Inn, in Victoria, British Columbia. impact of collisions on occupants inside Simcoe County discussed Infection Control This outstanding conference, hosted by the the ambulance box. The business focus including, due diligence, training opportun- British Columbia Ambulance Service (BCAS), was provided by Rick Baldwin of Matthews ities, networking, risk management & health ran from May 26-30 and hosted some 200 Dinsdale who reviewed realities of labour & safety issues during an outbreak. delegates from across Canada, the United issues and current trends. Fittingly, The education day is always well States, England, Australia, Wales and New the closing day saw funds raised from attended. Please watch our website at www. Zealand, and featured speakers from around the Charity Golf Tournament and Silent emsontario.ca the world. Included in the conference were Auction being presented to representa- for updates and agenda for the spring 2009 an International Roundtable on Community tives of the Children’s Wish Foundation education session. Paramedicine and the Annual General and the Children’s Hospital of Western Meeting of the EMS Chiefs of Canada, as well Ontario. MID YEAR CONFERENCE as the main conference content. EMS Patron, Major General Richard The membership gathered at the Toronto Of note, Tony Di Monte (Chief, Ottawa Rohmer was presented with copy number Airport Hilton Hotel on May 6-7 to hear Paramedic Service) was elected to the 1 of the John Murden print. Denis Merrall updates on the affairs of the Association. Executive Committee as president-elect and and Larysa Andrusiak received copies 2 Guest presenter Laura Babcock of Powergroup will shadow the current president, Chief and 3 respectively, all with the respect Communications provided a powerful “media Bruce Farr (Toronto) for the next year. and appreciation of the AMEMSO Board appreciation course” which highlighted the The 2009 EMS Chiefs of Canada Annual and membership. The Region of Durham awareness necessary to provide accurate Conference will take place in Niagara Falls, will host the event in 2009 followed by and sensitive communication to the public Ontario, followed in 2010 by Quebec City. the District of Muskoka in 2010.

Memories from the 2008 Awards Gala.

www.emsontario.ca | 43 | Association Information | Upcoming Events 2009

March June National Paramedic Skills Competition EMSCC Conference March 28, 2009 June 3-5, 2009 Durham College Niagara Falls, ON

April September AMEMSO Spring Meeting & Education Day AMEMSO AGM and AWARDS GALA April 20-29, 2009 September 22-25, 2009 Hilton Hotel, Toronto Airport Ajax Convention Centre 2008 Co-hosts Denis Merrall and Larysa Andrusiak. May Ontario EMS Patron, Major-General Richard Emergency Medical Services Week Rohmer (Ret). May 17-23, 2009

AMEMSO Board Members AMEMSO Executive Board Support

President Past-President Vice President Treasurer Secretary Kate Bearman Paul Charbonneau Terri Burton Dan Mccormick Michel Chrétien Neal Roberts Administrative Frontenac County District Municipality Rainy River Prescott-Russell Niagara Region Assistant of Muskoka United Counties Secretary Zone Directors Central Eastern Northern South/Western

Richard J. Armstrong Tom Bedford Joseph Nicholls Charles Longeway Amy Black Durham Region County Of Lennox and City of County Of Brant Special Assistant Addington

John Lock Doug Socha Mike Trodd Larysa Andrusiak Jim Price City Of Toronto Hastings Quinte EMS District Of Timiskaming Elgin County Communications

44 | | Association Information | Canada’s First Ambulance Museum Opens June 27, 2008 (Information and photo courtesy of The Windsor Star)

Canada’s first-ever ambulance museum is officially open, on the rural grounds of the Canadian Transportation Museum & Historic Village in Essex, Ontario, adding a rare “emergency-service” dimension to the sprawling site’s vintage vehicle experience. The museum is a new building, looking like an old dispatch centre, showcasing 11 ambu- lances ranging in age from 18 to 61 years old. The homage to ambulances is largely courtesy of one family. “I’ve been a collector all my life, and what do you do with all this stuff? So we thought that it would be good to put it on display to show people the past, pres- ent and hopefully future of ambulances,” said Len Langlois, the former operator of the Chatham and District Ambulance Service. “My family and I built this museum to share the collection with people.” More than $250,000 worth of ambu- lances are on display, including the oldest, a red-and-white 1947 Cadillac that helped launch the Amherstburg Anderdon Malden Rescue and First Aid Squad. Among the interesting rescue vehicles are a black 1952 Firedome DeSoto, notable because stretchers were side-loaded, and a blue-and-white 1969 Ford which became one of the first van-style ambulances. Other paraphernalia abound as well: stretchers, badges, transport incubators, first-aid kits, sirens, emergency lights, switchboards and more. Reflecting on the past, Mr. Langlois mused, “They had resuscitators weighing 100 pounds. Carry those things up a couple of flights of stairs and I don’t know who needed oxygen more, the patient or the ambulance operator.” Mickey Moulder, vice-chairman of the Canadian Transportation Museum - an intriguing 100-acre, $3.5-million site which boats the oldest existing vehicle made in Canada, the 1893 Shamrock - said the addition of the ambulance museum makes the facility even more engaging. “It’s another dimension for us,” Moulder said. “An ambulance museum is a little off the beaten track, which is its value. If we didn’t do it, who would?”

An AMEMSO First… Canadian Enhanced EMS Management Credentials By John Prno

In partnership with OMMI, the Ontario Municipal Management Institute, AMEMSO is now pleased to offer the Emergency Medical Services Professional and Emergency Medical Services Executive credentials. Available in conjunction with the Institute’s Certified Municipal Manager des- ignation, these profession-specific credentials fill a long time void in career development for EMS managers and administrators. The EMS Professional credential allows AMEMSO members in middle management positions the opportunity to develop needed municipal management skills through OMMI programs and other formal education. As members move into senior management positions, the EMS Executive designation acknowledges their lifelong learning efforts and better prepares them for the new chal- lenges that are sure to arise. To ensure continued relevance, the criteria for credentialing is developed, maintained and evaluated by an AMEMSO subcommittee made up of Chiefs Michel Chretien (Prescott-Russell), John Prno (Region of Waterloo) and Sharon Montgomery-Greenwood (Parry Sound). This same subcommittee is responsible for recommending new EMS Professional and Executive recipients to the OMMI Policy and Credentialing Committee. OMMI is a non-profit association established in 1979 by Ontario’s local governments and associations to enhance management skills and strengthen the quality of local government administration. More than 350 local governments participate in OMMI training and accreditation activities with some 1,500 local government managers holding one of the four CMM designations and its fifteen profession-specific enhance- ments. AMEMSO is the ninth professional association to partner with OMMI in providing professional designations, joining our provincial emergency services colleagues: The Ontario Association of Chiefs of Police, Ontario Association of Fire Chiefs, and the Ontario Association of Emergency Managers, to name but a few. For more information on these exciting new CMM and EMS credentials, visit the OMMI website at www.ommi.on.ca.

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