An 11-year-old with no vitals, a “level zero” paramedic on the phone

tomtidgewellDecember 2, 2022

Level zero has become more common during the pandemic, partly linked to delayed ambulance jams while waiting to drop patients off at busy hospitals.

File photo: Paramedics in Ottawa Photo by Tony Caldwell /post media

There were no ambulances in Ottawa, but on October 1, an emergency 911 call was received from an elementary school concerning an 11-year-old girl with no vital signs, as confirmed by the head of Ottawa’s emergency medical services. rice field.

Deputy Peter Kelly said in a statement that Ottawa ambulance services were at level zero when the call was received in the early afternoon of Oct. 25, meaning there were no ambulances available immediately. Stated. For emergency medical care in the city.

Level Zero is a growing crisis in Ottawa and across the state in recent years. In part, it was related to jams for delayed ambulances while waiting to drop patients off at busy hospitals, exacerbated during the pandemic. It is expected to be well over, with off-road delays for paramedics projected to be 60,000 hours.

People at the school gave the girl CPR until help arrived. Bystanders were able to use the school’s public access defibrillator within four minutes of her 911 call, according to a statement from the City of Ottawa.

The girl, who had been confined to a wheelchair due to muscular dystrophy, was pronounced dead after being transported to Cheo. The local coroner’s office is investigating her death.

The girl’s family declined to comment, but a person close to the family said they were not worried about her handling of the medical crisis.

“CPR was started immediately. That’s the important thing.”

Initially, help came from the Ottawa Fire Department. Paramedics arrived later, and at least one had just quit his job and was alert to the unfolding situation, according to a source familiar with the incident, who asked not to be identified because he wasn’t authorized to speak about the situation.

Firefighters arrived at the scene four minutes after the call was assigned and continued to treat the girl, Kelly said in a statement. Paramedics trained to administer heart medications as well as equipment to intubate patients arrived 11 minutes after her, treated the girl and transported her to her CHEO.

The state goal for 911 response time for sudden cardiac arrest is 6 minutes.

Response time is defined as “If a public access defibrillator is available on-site or by the arrival of paramedics, police officers, firefighters, or OC transpo-security, all vehicles are equipped with a defibrillator. will be deemed to have been fulfilled if ” in the email statement.

“During this call, the Ottawa Ambulance Service was experiencing Level Zero. By implementing countermeasures, we will mitigate the occurrence of offload delays and level zeros,” Kelly said.

According to sources, paramedics were dispatched to the scene from an unknown distance.

The Ottawa Emergency Medical Service “along with other emergency medical services across Canada continues to experience unprecedented service impacts” as a result of the ongoing system-wide medical crisis across the country, Kelly said. said.

“Offload delays experienced by hospitals, in addition to consistently high call volumes, put an extra strain on our resources and continue to contribute significantly to our Level Zero incidence.”

In August, then-Mayor Jim Watson asked the state to fund 42 new paramedic jobs in Ottawa to help the city reduce Level Zero incidents.

He said new ambulance crews would be deployed at four of Ottawa’s hospitals to care for patients with low vision and help ambulances get back on the road more quickly.

“This cannot continue. We need state government help. Health care is the state’s responsibility,” Watson said in a letter to Prime Minister Doug Ford.

There was no direct response from the prefecture to this request. A Department of Health spokesperson said she is working with emergency medical services, hospital leadership and other sector partners to “increase ambulance availability and reduce ambulance drop-off times to ensure that all Ontarians have access to the services they need.” We will make sure that people have access to the care they need when they need it.”

Department of Health spokesman Bill Campbell said states have strategies to address ambulance unloading times, improve patient flow and avoid unnecessary trips to emergency departments. . on the road.

Campbell also said, “My deepest condolences to this family for this tragic and sudden loss.”

According to sources familiar with the case, a better ambulance 911 triage tool—a tool many municipalities and paramedics have been demanding for years and is used by some municipalities in Ontario—is , says even few ambulances could make a difference in cases of sudden cardiac arrest. Available.

There are two ambulance call triage tools used by the Ontario Ambulance Communication Center. Ottawa, like most local governments, uses the Dispatch Priority Card Index. Some local governments use advanced medical priority dispatch systems. It is widely used in North America and does a better job of prioritizing calls, including sudden cardiac arrest calls where minutes can mean life or death.

Anonymous Ottawa social media accounts tracked Level Zero incidents in the city and tweeted details of an incident involving a girl in October. The team that treated the girl and transported her to the hospital. Paramedics were able to regain her pulse, but she was pronounced dead at her hospital.

Aware of the situation, some paramedics rushed to unload patients and clean equipment, but were sent to other Code 4 calls waiting in queues, including falls and unknown situations, according to the Twitter account. In systems such as those in Ottawa, various calls are prioritized. Once an ambulance is assigned to Code 4, dispatchers cannot transfer it to another call unless another ambulance arrives sooner, according to a briefing on a system made by Hamilton’s local authority.

“In the current prioritization system by the Ministry of Health, all Code 4 calls are assigned to the nearest available ambulance service in the order in which they are received. , in immediate danger,” Kelly said in an email.

A coroner’s investigation into the 2004 death of Greeley resident Alice Martin from heart failure found paramedics not responding to patients promptly; was recommended. Existing Ottawa system.

For a young girl, her obituary said she He has addressed many health challenges with “admirable courage, strength, grace and faith” and has invited those who wish to donate to the CHEO or Muscular Dystrophy Association.