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Health services under pressure during busy summer

Crankworx puts doctors and nurses to the test, questions raised over ambulance response time



Whistler needs a high-tech hospital on wheels and a beefed up ambulance service, for major events like Crankworx and high volume long-weekends, according to local doctors.

That could be one of the biggest lessons learned from Summer 2013 — jam-packed with festivals and events with more room nights booked than ever before in June and July.

Both Whistler's mayor, Nancy-Wilhelm-Morden, and the Whistler Health Care Centre's chief of staff, Dr. Bruce Mohr, plan to raise the issues as de-brief meetings on the summer take place with resort stakeholders.

During Crankworx this year, said Mohr, doctors, nurses and paramedics at the Whistler Health Care Centre were stretched to the max dealing with one successive major trauma after another on one day in particular — despite doubling doctor coverage for the festival.

"It was dealt with. It was safe. But boy, one more for example, it would have been tough to deal with," he said.

"You have events like this where it's almost for sure there's going to be major trauma, and yet the capability isn't increased. It doesn't make any sense."

Said Wilhelm-Morden: "We have very serious injuries coming off both the bike park and the terrain park and they've got to be dealt with."

If that means more funding from other sources to beef up ambulance, or for other health care funding, so be it, she said.

"The amount of tax revenues that come out of this town to the provincial and federal levels of government, there's got to be a

quid pro quo," said the mayor, adding that medical and ambulance services are typically "top-drawer."

Added to this concern over capacity, a Pique investigation this week revealed two separate incidents of slow- or no-show ambulance service this summer.

Chris and Rachel Walter waited for almost an hour for an ambulance to respond to their 911 call on Sept. 1.

The Walters were playing golf at the Fairmont Chateau Whistler on the Sunday of the Labour Day long weekend (Sept. 1) with their four-year-old son and Rachel's father.

On the 10th hole, one of the furthest from the clubhouse, one cart drove into the other, wedging Rachel in between and causing a significant gash down her right shin.

"For sure," said Chris Walter from Vancouver, when asked if he was concerned about the response time. "Ultimately, we had stopped the bleeding, but if it had carried on bleeding obviously an hour would have been a long time, really. We would have had to try something else."

While a medic with the golf course responded fairly quickly, it was about an hour before the ambulance arrived at the scene. The Walters tried to stay calm for their son's sake, and ward off shock despite the gaping wound and growing fears that the bone was broken.

"We got the leg elevated," said Walter. "We stopped it bleeding. We spoke to the paramedics and they just said 'keep it raised, keep light pressure on it.' They gave us advice and guidance on what to do. So it was just waiting really, trying to keep calm."

Wilhelm-Morden couldn't help but express her concerns upon hearing the Walters' story, particularly after reading a recent letter from the Four Seasons, detailing similar concerns. Except in that case, the ambulance never showed up.

The letter, written to municipal administrator Mike Furey and copied to the mayor, details an August incident where a guest slipped and fell at the hotel. When the ambulance failed to arrive, the fire department was called directly.

The patient was put onto a spine board but the fire department is prohibited by legislation from transporting patients.

They waited for 35 minutes. But when an ambulance failed to arrive, the patient was taken to the clinic in his own vehicle.

"The fact that I've heard about two in one week, yes, I am concerned," said the mayor.

She put herself in the injured party's shoes.

"At the best of times it feels like it takes hours when in fact it takes minutes, but if it is taking longer than minutes, that's just unacceptable," she the mayor.

BC Ambulance Service (BCAS) confirmed that two ambulances (each staffed with two paramedics) are in service in Whistler each day. In 2012, BCAS responded to 1,062 urgent calls — three per day — with an average response time of 13 minutes.

"BCAS uses an internationally recognized dispatch system to triage calls based of patient acuity," wrote Kelsie Carwithen, BCAS's manager of media relations, in an email response. "Patients with life-threatening injuries (i.e.: cardiac arrest, trauma etc.) are prioritized above patients with non-life-threatening injuries."

When asked if BCAS increases staffing levels for long weekends and large events in Whistler, Carwithen wrote: "BCAS works closely with event organizers in Whistler and across the province. Large events often contract BCAS ambulances/paramedics (to supplement first aid support during the event) to ensure appropriate resources are available for potential increases in demand."

There were two ambulances working on the Sunday of the Labour Day long weekend.

According to Mohr, there has to be a concerted effort from all resort partners — from the provincial government to the local health authority, the event planners and the municipality to ensure adequate coverage.

His comments come on the heels of Tourism Whistler's announcement that June and July 2013 broke room night records in the resort, potentially making this summer the busiest on record — taking the resort population to as high at 40,000.

When staff at the Whistler Health Care Centre do a rehash of the Crankworx mountain bike festival, as they do every year, compiling the numbers and the acuity and plotting it on a graph, Mohr doesn't doubt he'll be making recommendations to Vancouver Coastal Health, chief amongst them a request for a Mobile Medical Unit, the surgical unit the province has at its disposal to respond to major events, for the 2014 festival. The MMU is a legacy from the 2010 Winter Olympic Games.

"We'll be certainly making recommendations at least to VCH in terms of what we might do to mitigate the potential for not being able to deal with the trauma," he said.

"These major events that come to our little town, they're huge," he said.

"They might not all be like the Olympics, but the potential for even more injury and trauma and illness to deal with is actually just as big an impact as the Olympics."