Ottawa

Ottawa paramedics facing 'unprecedented' number of level zero incidents

Ottawa's paramedic chief says a six-hour wait for an ambulance last week was the result of a high number of calls and delays at hospital, but admits the service has no ambulances to dispatch more often.

Ottawa has already had no ambulances available 750 times this year

Shortage of available ambulances a sign of ‘health-care crisis,’ Ottawa paramedic chief says

2 months ago
Duration 0:56
Pierre Poirier, Ottawa’s paramedic chief, says the service is seeing more “level zeroes,” where there are no ambulances available to respond to emergencies. He says that’s what happened on July 21, when a woman had to wait six hours for help after falling in her driveway.

Ottawa's paramedic chief says the six-hour wait for an ambulance a woman faced last week was the result of an unusually high number of calls and long delays at hospital, but admits the service is experiencing more incidents where there's no ambulances to dispatch.

Elaine Deschenes' family called 911 around 5 p.m. July 21 after she fell and fractured her hip in her driveway. She had to wait six hours before paramedics from Cornwall took her to a hospital.

Pierre Poirier, Ottawa's paramedic chief, said there were "almost continuous" level zeroes from 5 p.m. that day until past midnight  — meaning no ambulance was available to be dispatched.

"There were a couple of occasions where the crew that was assigned to that residence was diverted to a higher-priority call. It is kind of, I would say quite honestly, an expression of the health-care crisis we're in," Poirier said.

"We're always dismayed when we aren't able to provide the service in as timely a manner as possible."

There were 10 other calls of the similar lower priority, or Code 3, in the queue during the Deschenes' wait, Poirier said, and "level zeroes" have a cascading effect on how ambulances are dispatched.

This year's going to be unprecedented in terms of the number of level zero events.- Pierre Poirier, Ottawa Paramedic Service

Poirier said that on July 21 the approximately 40 crews that were staffed would've been sufficient to meet normal demand, but there was "exceptional" demand and delays leaving patients at hospital.

He said there were about 500 calls that day, a 20 per cent increase from normal about three months ago, and in about 10 per cent of cases paramedics were tied up at hospital for longer than three hours. 

Police said they took a shooting victim with non-life threatening injuries to hospital that night after officers "were advised that an ambulance was not available."

Poirier said that was a high-priority call and an ambulance arrived at the scene three minutes after police left with the patient. He said the patient should've been taken to the trauma centre at the Ottawa Hospital's Civic campus but was taken to the wrong facility.

"The police made a choice to transport which we never condone. We don't support that in any manner," he said.

In a statement, police said the victim was transported to the closest hospital, which would be The Ottawa Hospital's General campus according to Google Maps.

The police said they are discussing the call with paramedics and it's the only recent incident of which they are aware.

'Unprecedented' level zeroes in 2022

Ottawa has already hit more than 750 instances of "level zero" in the first seven months of 2022 — as many as the service had for all of 2021. 

"This year's going to be unprecedented in terms of the number of level zero events and the time spent at level zero," Poirier said.

When it hits level zero, the service reviews whether patients are in worse condition when they're en route to hospital than at the initial time of the call.

Poirier said it's "extremely rare" that a patient is higher priority and there have been no deaths related to delays this year.

"The system still works. It's in a difficult spot, but it's still working," he said.

Paramedics prepare a stretcher in front of a garage.
Six hours after 911 was called, an ambulance arrived and paramedics from outside Ottawa prepared a stretcher to transport Elaine Deschenes to hospital. (Submitted by Cathy Deschenes)

He said the service is not accepting the status quo and is working with local hospitals, including recruiting more paramedics and stationing paramedics in emergency departments to help receive patients and return ambulance crews to the road.

The Queensway Carleton Hospital said it has matched that paramedic with a dedicated nurse 12 hours a day.

That hospital said, with ongoing staffing challenges and an emergency department that's overcapacity, off-load times range between 60 and 90 minutes, rather than the goal of 30 minutes. 

The Ottawa Hospital General campus and Montfort Hospital also have off-load paramedics and a similar project is in the works for the Civic campus, Poirier said.

Montfort said it's optimistic the program will improve off-load times. The Ottawa Hospital did not respond by deadline.

Ontario's Ministry of Health said in a statement Friday it has increased funding for dedicated staff to receive patients at hospital in the coming year as part of its response to ambulance availability issues in eastern Ontario. 

The ministry said it is also working to address hospital flow issues, space limitations, hospital culture and access to non-emergency care alternatives.

ABOUT THE AUTHOR

Matthew Kupfer

CBC Reporter

Matthew Kupfer has been a reporter and producer at CBC News since 2012. He can be reached at matthew.kupfer@cbc.ca and on Twitter @matthewkupfer

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