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COVID-19: Canadian military preparing to send ICU nurses, medics after Ontario’s request for help

Kilted

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I wasn't thinking so much of the platform as the certification who can operate an ambulance service and who can operate an ambulance. For example, the St. Johns folks you see at events are not 'certified to transport'. Patient transfer services can move stable patients between facilities but they are unregulated and only have very basic training. This might already be covered in the EMCP Act or could be fairly easily waived by an emergency order (Regulation). Communications with designated base hospitals might be an issue as well.
St John Ambulance can transport when directed by a higher Medical authority. They were used for patient transport during SARS. However, not every member has the required F license. You do however have many members who are paramedics or firefighters in actual employment who have that license as part of their job.
 

mariomike

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St John Ambulance can transport when directed by a higher Medical authority. They were used for patient transport during SARS. However, not every member has the required F license. You do however have many members who are paramedics or firefighters in actual employment who have that license as part of their job.
Regarding that. Private-for-profit medical transport services provide routine, non-emergency transports and coverage for special events. But, the City is the only provider permitted to service 9-1-1 calls.

In extreme circumstances, a City employee, specifically a police officer, ( police do not require a Class F, if requested at a scene to drive by a solo paramedic ) can drive to a hospital. This could happen at a multi-patient scene where one paramedic stays behind to triage.

For accident insurance purposes, it is necessary that whoever drives any City vehicle be a City employee.

Firefighters have a Class D, which does not qualify them to drive a Class F vehicle. However, ( only during SARS ) firefighters - as City employees - were authorized to drive Class F vehicles ( staffed by a single paramedic ) owned by the City. This was due to so many paramedics being on quarantine.

However, it didn't come to that. Because Toronto paramedics were put on "Working Quarantine", ambulances were always fully staffed.
 

medicineman

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I wasn't thinking so much of the platform as the certification who can operate an ambulance service and who can operate an ambulance. For example, the St. Johns folks you see at events are not 'certified to transport'. Patient transfer services can move stable patients between facilities but they are unregulated and only have very basic training. This might already be covered in the EMCP Act or could be fairly easily waived by an emergency order (Regulation). Communications with designated base hospitals might be an issue as well.
There would likely be some sort of Federal/Provincial waiver put in place, as I'm willing to bet they'd be using something along the line of a Critical Care Transport Team with ICU RN's, MD's and Med Techs for both Air or Ground movement. Communications these days would likely not be as bad as you think because of cell phones and radios can always be added to ground based units on civvy freqs. Aircraft still have to communicate within Canadian Air Traffic Control pathways, so would be able to patch onto civvy freqs anyway. I seem to recall that when I was a Superintendent with St John Ambulance in Kingston that all that was required for us to be able to transport folks was an order in council - this was in place for special circumstances like a disaster. We would of course have had to have radios added/updated to be on freqs in use by local hospitals/EMS - again, advent of cell phones has changed that somewhat.
 

mariomike

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This "what if" stuff is hypothetical. The reality is, the only time I saw the Army deployed into the streets of this town was when Mayor Mel declared war on snow.
 

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lenaitch

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There would likely be some sort of Federal/Provincial waiver put in place, as I'm willing to bet they'd be using something along the line of a Critical Care Transport Team with ICU RN's, MD's and Med Techs for both Air or Ground movement. Communications these days would likely not be as bad as you think because of cell phones and radios can always be added to ground based units on civvy freqs. Aircraft still have to communicate within Canadian Air Traffic Control pathways, so would be able to patch onto civvy freqs anyway. I seem to recall that when I was a Superintendent with St John Ambulance in Kingston that all that was required for us to be able to transport folks was an order in council - this was in place for special circumstances like a disaster. We would of course have had to have radios added/updated to be on freqs in use by local hospitals/EMS - again, advent of cell phones has changed that somewhat.
No doubt. I think Ornge already uses sat phones in remote areas. The use of cel/sat phones would probably make a lot more sense than trying to quickly find and cobble together radios. Ontario land ambulances already use the province-wide trunked emergency services network (don't know about GTA) and back when I had any involvement in, trunked radios were not approved for aviation use but that has probably changed. Using aviation radio frequencies for 'back of the bus' traffic would likely require some action by TC to dedicate a frequency or two, but way above my pay grade.
 

daftandbarmy

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Perhaps we should also build hospital ships like the American Mercy and Comfort.

Except that the Comfort was basically idle for the whole show in New York:

Hospital ship Comfort departs NYC, having treated fewer than 200 patients​

The Navy’s hospital ship Comfort departed New York City today after spending the last month supporting the region’s COVID-19 efforts.

The ship arrived in New York’s Pier 90 exactly one month ago with the mission of accepting non-coronavirus patients to alleviate the burden on local hospitals, but a minimal number of patients admitted during the first week prompted officials to modify the ship’s mission.

 

mariomike

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Mayor Mel took some ribbing. But, NYC calls in the National Guard during snowstorms. Even in anticipation. Their City has been hit pretty hard by wrongful death lawsuits over EMS delayed response times when they didn't.

Damned if you do. Damned if you don't. 🤷‍♂️

"FDNY EMS has a aprox 5 hour delay to Emergencies. FDNY personal are advised not to do CPR more then 20 min due to high vol of jobs." [ sic ]
FDNY-EMS reported a backlog of 1,300 9-1-1 calls and a 3-hour to 12-hour delay in response to critical cases, including cardiac arrests and heart attacks.
A report of a mother unable to breath. Her daughter called 9-1-1, but could not get through for 50 minutes. A neighbour administered CPR, but EMS was unable to arrive for another 45 minutes, and they still had to walk to her house. The lady did not survive.
A man died of a heart attack after it took paramedics three-and-a-half hours to arrive. It took another 28 hours for a city medical examiner to pick up the body, which had been resting in a bag on a bed.
A 22-year-old pregnant woman started contractions. Because of the ambulance delay, she began walking from her home to the hospital, but couldn't make it. She stopped in a building lobby. 911 was called again at 8:30 a.m. By 4:30 p.m. she had started crowning and 911 was called again. Around 5:20 p.m. police arrived (by foot since driving was impossible) and found the woman attempting to leave and walk to the hospital again. She was brought back inside and the baby was delivered. Despite the efforts of police and neighbors the baby was lost.
Sources said FDNY-EMS requested a state of emergency be declared, but the Office of Emergency Management denied the request. A Hearing is to be held in early January.
Jan 19, 2011
"Family of NYC Woman Who Died in Blizzard Plans $20M Lawsuit:
Suffering a heart attack during the New York City blizzard after Christmas, Yvonne Freeman "never had a chance," her daughter says, because an ambulance took three hours to reach her over unplowed streets. By the time it got there, it was too late.
Now Freeman's family is planning a $20 million lawsuit against the city -- the first blizzard-related wrongful death case.":
"...the city is slammed for failing to declare a snow emergency."

In the aftermath of the snowstorm, the Chief of NYC EMS was demoted and replaced. No explanation as to why.
Bill O'Reilly of Fox News had this to say, “The root of the problem is the same that we had in Katrina, that the local mayor- [Ray] Nagin- and the governor- [Kathleen] Blanco- of the state didn’t ask for the feds to come in and people died."
 
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