Quebec's lack of emergency air ambulance system 'embarrassing,' renowned doctor says

In the wake of the fatal bus crash in rural Saskatchewan, a prominent Montreal doctor is imploring Quebec’s health ministry to develop an air ambulance system that could quickly transport trauma victims to hospital.

Dr. David Mulder says getting more patients to hospital in the 'golden hour' could save lives

Dr. David Mulder, the former Surgeon-in-chief of the Montreal General Hospital, says helicopters could help trauma victims reach hospitals quickly during the critical window for care after an incident. (CBC)

In the wake of the fatal bus crash in rural Saskatchewan, a prominent Montreal doctor is imploring Quebec's health ministry to develop an air ambulance system that could quickly transport trauma victims to hospital.

"I couldn't sleep the night after I watched the sad story from Saskatchewan, a place where I grew up, a place where I played amateur hockey, where I travelled on the bus — probably a similar type of bus that was involved,"said Dr. David Mulder, a renowned trauma specialist and the team doctor for the Montreal Canadiens.

"I know the area well and it certainly tugged at my heart strings. It was a disaster that any parent couldn't stand. So I thought, 'What would happen in rural Quebec?'"

​Quebec is one of the only provinces in Canada that does not have an organized, pre-hospital emergency air ambulance system, which could save lives if a tragedy were to happen in a rural part of the province, Mulder said.

"The single most important factor in trauma care is what they call the "golden hour." In other words, the shorter the time from injury to definitive care, the better the results, the lower the mortality and the fewer the complications," he told CBC's Daybreak.

"Any distance from Montreal, the only way is road ambulance and, in this day and age, that doesn't meet the requirements of the golden hour.… I have a lot of friends in the trauma world and I'm embarrassed that Montreal is the largest urban centre in North America that doesn't have an organized helicopter program."

No comprehensive system

Mulder said he was relieved to see three air ambulances on scene ready to transport victims from the Humboldt Broncos bus while watching news coverage on the weekend.

Three air ambulances, one of which can be seen here in a photo provided by 650 CKOM/980 CJME, transported patients from the scene of the bus crash in rural Saskatchewan on April 6, 2018. (650 CKOM/980 CJME/Associated Press)

The helicopters were part of the STARS air ambulance service, which transports victims to the nearest trauma centre. STARS is a charitable, non-profit organization that is funded through contracts with the provincial government as well as fundraising.

In Quebec, a private helicopter air ambulance company called Airmedic exists, but it's emergency services are not government-funded and only serve people who have signed up for memberships that work like a combination of travel insurance and a CAA membership. It's only government contracts are for transportation between hospitals.

There are three fixed wing air ambulance planes that are linked to the provincial health network, which Mulder says have helped communities in the far north, but no helicopters.

"If we could augment the pre-hospital program with a helicopter, we would make enormous inroads not only in trauma but in stroke care, complicated obstetrics, complicated cardiac cases, neonatal care and even inter hospital transport," Mulder said.

Progress made

The province has made strides in trauma care in the past two decades, in no small part due to Mulder's efforts to have care coordinated through the system. In 1993, the province launched Trauma Quebec, a care network dedicated to ensuring quick access to services.

There are currently three Level 1 trauma centres for adults in Quebec and two for children.

According to statistics published by the McGill University Health Centre, the mortality rate dropped from 51.8 per cent in 1992 to 2.5 per cent in 2007. 

Mulder thinks that an air ambulance service could not only help bring that down further, but also assisted in cases of complicated obstetrics and cardiac cases and neonatal care.

The doctor, whose decades of work was recognized in 2005 when the MUHC renamed its trauma unit in his honour, wrote an open letter to Health Minister Gaétan Barrette, published in La Presse, and said he also texted the health minister personally to push for immediate action.

"I think in this day and age, it's just unacceptable," he said. "It means if you have a similar car crash in downtown Montreal verses Victoriaville, your chances of surviving are grossly different."

Mulder said he has not received a response. Barrette would not comment on the issue while heading into the National Assembly today. 

"All we have to say is that there is work in progress," the minister's press secretary Catherine Audet said.

with files from CBC's Daybreak and Angelica Montgomery