Nova Scotia's ambulance fleet could drop from 100 to 30 vehicles covering the entire province if its 800 paramedics go on strike this weekend.
The 30 ambulances would be staffed by managers who are qualified paramedics, but officials say it will not be business as usual.
Car-accident victims needing urgent care would not take a LifeFlight helicopter, but would rely on the nearest ambulance.
There could also be cases where an ambulance is needed, but none is available.
Jeff Fraser of the Emergency Health Services said it could cause problems.
"There is going to be an impact and there are going to be times when we're going to be much longer than we would like responding to these calls," he said. "I think the reality is there is no way we can move to a component like this without any of those compromises."
He said they would do the best they could with limited resources. "In operations, we hope for the best, we plan for the worse. We hope we have systems in place to prevent that, but there are no guarantees at all," he said.
The Nova Scotia government won't say whether it's taking steps to avert a strike by the province's 800 unionized paramedics.
They can legally take to the picket lines on Saturday and no new talks are planned.
Dexter hopes for solution
Speaking at an announcement at the IWK, Premier Darrell Dexter said he understands the looming possible strike is stressful for Nova Scotians.
"The reality is you're talking about the safety and security of the people of the province. Really the last thing in the world you would ever want to see is anything like that become the subject of uncertainty. I don't want to see that happen. What I want of course is it all to be resolved," he said.
"What I'm saying right now is we have nothing new to report on. Obviously, there will be before Friday," he said.
He wouldn’t disclose if he plans to recall the legislature if a strike goes ahead, only saying he’ll comment when there’s something to say.
The paramedics have already rejected three contracts.
Last week, union members voted 73 per cent against a deal with Emergency Medical Care that would have given the province's 800 paramedics a defined benefits pension plan, a key union demand.
Union members said they want better wages, with some saying they are looking for a 15 per cent pay hike over three years rather than the 11.1 per cent over almost five years that was offered in the tentative agreement.