Local Emergency Medical Care Enhanced

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The Essex-Windsor Emergency Medical Services (EMS), Leamington District Memorial Hospital and Windsor Regional Hospital have announced the implementation of a health care system plan to address some of the issues facing all three organizations regarding access to timely Emergency Department services.

Officials say that over the past ten years the number of Emergency Department visits and ambulances transporting patients to the Emergency Departments in Windsor has increased. Since 2001 the number of semi urgent, “less acute” patient calls to EMS has increased from just over 11,000 annually to over 20,000 annually.

Current legislation requires Paramedics to transport a patient to the closest most appropriate facility or, as an option, to a hospital Emergency Department as requested by the patient. Paramedics can and do treat patients at the “site” of their call and this may result in the patient deciding that they need not attend an Emergency Department. However, absent of this agreement, Paramedics are mandated to transport any patient requesting to be transported to an Emergency Department.

They say that one misconception that many patients believe is that attending a hospital via EMS results in more expedient service or “jumping the queue”. Emergency Departments still triage patients arriving by ambulance, along with walk-in patients using the Canadian Triage and Acuity Scale.

By using CTAS, some patients that attend by ambulance will need to be placed in the waiting room, possibly with other “walk-in” patients. The CTAS levels are designed such that a Level 1 represents the patient’s threat to Life or Limb while Level 5 represents the least ill patient. Level 1 patients are sudden cardiac arrest, major trauma, for example, while Level 4 and 5 may be acute in presentation but are non-urgent in the aspects or treatment or assessment.

With the increase in general acuity and the number of “less acute” patients growing, conditions referred to as Code 7’s and “Ambulance Off Load delays” will remain at the hospital waiting to “off load” their patients into the Emergency Department, thereby depriving the community of the much needed emergency resource. Ministry of Health and Long Term Care has funded additional hospital resources for nurses to be with the “offload” patients while they are waiting for a “space” in the Emergency Department. Even though some success has been realized with this additional funding from the Ministry of Health and Long Term Care, and it is greatly appreciated, Off Load pressures continue and escalate during “peak/busy” periods. As a result, EWEMS, WRH and LDMH have consulted and have come up with a “systems” solution.

Starting immediately for patients located in Leamington, Kingsville, Essex, Lakeshore, Tecumseh, Amherstburg and LaSalle and are assessed as a CTAS 4 or 5 by Paramedics, they will be transported to Leamington’s Emergency Department for care and treatment. LDMH has capacity to see and treat these CTAS 4 and 5, “less acute”, Emergency Department patients in a timely fashion. Any issues regarding transport back home for the patients being taken to LDMH will be addressed by the hospitals.

This partnered systems solution will be in place anytime the level of EMS services for the community is strained due to call volumes, Code 7’s and “off load” delays.

In addition, EMS, LDMH and WRH will continue to advocate with the Ministry of Health and Long Term Care to approve and continue the Off Load Nurse Funding.