Paramedics call for more training 

Backcountry rescuers can't administer narcotics - yet

Local paramedics and search and rescue are calling on the government to investigate allowing them to administer narcotics when attending backcountry rescues.

Under current guidelines for the B.C. Ambulance Service only those paramedics licensed for advanced life support can give narcotics. They only work in designated areas and Whistler is not one of them.

Wayne Flann, with Whistler Search and Rescue for 15 years and a paramedic for 20, believes it's time for that to change.

"We need our paramedics to be trained to give basic narcotics for pain management and if we had that it would be a Godsend for a lot of people," he said.

He is not alone in this thinking.

"I think what (the government) has to look at, and this is only my opinion, is... the regional needs of the community and design trials and protocols around those needs," said Bill MacDonald the unit chief for Whistler’s ambulance station and a paramedic. "They need to step out of the box."

The issue has come to the forefront again after a challenging rescue in the backcountry three weeks ago.

"It was tough for both (Flann) and I to sit there for another 45 minutes and have a person that is in (extreme pain)... and we were having to deal with having to provide what I would call inadequate pain management," said MacDonald.

Trials have been run successfully in Whistler in which paramedics have contacted doctors by phone to get the go-ahead to give narcotics. But there are concerns about the move. People rarely die from pain but there can be serious complications from narcotics, which may not be able to be dealt with appropriately in the backcountry.

The two most serious side effects of narcotics are a change in blood pressure or the patient can stop breathing. Dealing with these in the backcountry could be very challenging.

Currently paramedics can carry an antidote to narcotics but when it is administered it actually suppresses the bodies own ability to deal with pain, so the patient can be in even more pain than before the narcotics were given.

The B.C. Ambulance Service is open to discussions about the idea, said Susan Dolinski, director of client relations for the organization. There is even discussion about stationing a Critical Care Transport team in the corridor.

But for now the situation won’t be changing, she said.

"Opportunities are considered on a case by case basis," said Dolinski. "At the present time we can’t commit to anything, but depending on the ability to bring a (Critical Care Transport team) to Whistler, other models could certainly be considered.

"But I don’t believe we are considering any special circumstances at this point."

The B.C. Ambulance Service is currently running a pilot project with a Critical Care Transport Team based out of Trail. It is composed of paramedics trained at the advanced life support level with air evacuation endorsement and nurses trained for critical care.

This is something the B.C. Ambulance Service is looking at for rural and remote areas.

"They can coordinate using whatever transportation means necessary, appropriate care, and transport of the patient," said Dolinski.

"We have seen tremendous success with the project in Trail. We are looking at how that model fits into other areas of the province, and Whistler is one of the communities that is on the list as far as considering this type of project."

Concerns have also been raised in Whistler about the need for paramedics to pay for clothing, other items, and training for backcountry work themselves.

Dolinski said there is a committee that looks specifically at these types of requests.

"There is a process if there are unique circumstances that people or regions would like to have considered for special equipment or clothing."


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