Clarington Fire's new EpiPens save bee-stung senior
Emergency medicine for severe allergic reactions added to fire truck equipment just this year
Clarington This Week
By Jennifer O'Meara
CLARINGTON -- A Newcastle firefighter saved an unresponsive senior from a severe allergic reaction by using the department’s new EpiPens, added to Clarington fire truck equipment just this year.
“We put our first one to use,” said Clarington Fire Chief Gord Weir.
A man in his mid-70s who is highly allergic was stung by a bee on Friday, Aug. 7. He didn’t have an EpiPen on him and had a friend drive him to a Newcastle pharmacy to buy one. The pharmacy was out of stock and the man began to go into anaphylactic shock.
Emergency crews were called and the firefighters were at the pharmacy within three minutes. By the time they had arrived the man was unresponsive. Firefighters injected the EpiPen into the man’s right thigh.
By the time paramedics arrived, the senior was again able to open his eyes when spoken to by emergency workers. He was taken to hospital.
Epinephrine auto-injectors, or EpiPens, are used to help treat anaphylaxis, a life-threatening allergic reaction some people have to certain foods, insect bites or medications. Patients suffer swelling, hives, low blood pressure and increased heart rate. If anaphylactic shock isn’t treated quickly, it can be fatal.
With firefighters often responding to local emergency calls before paramedics, Chief Weir said the pens improve firefighters’ ability to respond to severe allergic reactions.
In the fall of 2014, both adult and child EpiPens were added to the list of life-saving equipment on three Clarington fire trucks. All eight of the municipality’s pumper trucks were carrying the injectors come 2015. Firefighters were trained in how to use the EpiPens before the medicine was placed on the trucks.
March 18, 2015
Winnipeg Free Press
We, the leadership of the Winnipeg Fire Paramedic Service (WFPS), express our profound dismay with
Mary Agnes Welch’s column of March 11, 2015 (“Firefighters skilled at manipulating the political system”). Ms. Welch had an opportunity to research and report facts as a service to your readers; instead, the article used only select facts that do not paint an accurate picture.
In this limited space, it is difficult to fully describe the tremendously successful integrated EMS-Fire model of the WFPS. Perhaps we can interest the Winnipeg Free Press in publishing a series of articles to fulfill that task. For now, we are hopeful the following facts will be published to assist readers in seeing beyond the limits of the article:
The majority of paramedics who work on Winnipeg’s ambulances are primary care paramedics (PCPs). They hold the same emergency medical education, qualification, and licence as those who work on Winnipeg’s fire trucks. In fact, the vast majority of paramedics in Manitoba are PCPs. Ms.
Welch’s characterization of “hand-holding” is as wrong as it is offensive. Regardless of the uniform they wear, PCPs are the foundation of Manitoba’s EMS system. PCPs are proud of the emergency medical care they provide, as are we.
A community’s fire service is part of its infrastructure which attracts investment of business, industry, and residents. Proper fire resourcing reduces the insurance premiums of homeowners and business owners, on the order of $2 in savings for every $1 of taxation to support fire service.
Fortunately, fires don’t occur continually, resulting in an inherent response capacity in the fire protection service.
Placement and staffing of fire resources is solely determined by response time to all parts of the City for fire-related calls. The National Fire Protection Association (NFPA) guideline 1710 describes the response time standards to which urban fire services are held.
Integrated fire & EMS departments provide service to almost 60% of Manitoba residents, as this model is also used in Brandon, Thompson, and Shilo. Integrated service has existed in these communities for many years. As well, a number of other Canadian communities employ this model, and it is very common in US centres.
Winnipeg’s integrated model arose in the late 1990s and early 2000s due to the lack of capacity of the existing, standalone EMS service. Using the inherent response capacity in the fire service avoided significant duplication of resources. The integrated model framework was recommended by several independent consultants, was created in the mid 2000’s, and culminated in 2007 with negotiated work sharing agreements. These agreements remain in our practice today.
The popular myth that fire departments bolster their call volumes with medical calls to preserve their staffing is categorically false. In fact, if Winnipeg’s fire service ceased medical response, our staffing and resources would not change at all, and our net cost would increase significantly with the loss of several million dollars of funding we receive for our fire service’s contribution to the EMS system.
Equally false is the notion that sending a fire apparatus to a medical call is a waste of tax dollars. As noted above, that crew and apparatus would be on duty and paid regardless of their involvement in medical response. Indeed, not responding with that crew would truly be a waste of tax dollars.
In 2014, our integrated system provided average travel times to the highest priority calls of 3.72 minutes. Had we relied only on our ambulance resources, the average travel time would have been 6.73 minutes. Welch’s statement that “speed doesn’t matter” on these calls demonstrates a lack of understanding of medical and traumatic emergencies. We are confident that anyone who has called 911 for themselves or a loved one in medical distress would agree that having a skilled paramedic arrive almost 50% faster is critical, regardless of the vehicle in which they arrive.
In 2014, fire-based PCPs responded alone to 11,192 calls. Almost 90% of these were “person down,” “falls,” or “assist police.” This represents the call volume of approximately three, 24-hour ambulances. Without fire involvement, these three ambulances would have been unavailable for calls more likely to require advanced care and/or transport to hospital. The addition of three ambulances would further add to the tax burden.
Fire crews DO NOT respond to every medical call. We have used our many years of experience to hone the system responses to send the most appropriate resources to different types of calls.
Of 63,000 calls for emergency medical service in 2014, fire resources attended just over 31,000, less than half. We send resources according to the initial information in the call, then scale up or down as the situation presents.
·The efficiency of our system is demonstrated by impartial comparison to other cities. Winnipeg participates in the Ontario Municipal Benchmarking Initiative (OMBI), which involves many facets of municipal services. The 2013 data shows Winnipeg as providing among the highest number of ambulance service hours servicing the most calls at the lowest cost per hour among 13 cities. Winnipeg was among the busiest fire services, with the second lowest unit staffing costs among nine cities.
All of these bona fide facts were available to Ms. Welch for the asking. We publicly presented the OMBI data during our budget presentation on March 9, 2015. Regrettably, the only fact that Welch chose to verify with the City was the percentage of female firefighters in the WFPS. Her insertion of this figure to insinuate a gender issue borders on salaciousness.
While the focus of the article was clearly limited to observations on a political landscape, the selectiveness of factual reporting has led to an imbalance that not only slights the paramedics who serve our city, but also does a disservice to your readers by not accurately representing the integrated model citizens are served by. The March 16 column by Dan Lett (“Firefighter-paramedic rift harmful”) exacerbates the misunderstanding of the integrated model and its benefits to our citizens. We respectfully urge the Free Press to address this imbalance.
John A. Lane, BSC Tom Wallace
Chief Deputy Chief
Winnipeg Fire & Paramedic Service Winnipeg Fire & Paramedic Service
Rob Grierson, MD Joe Seewald
Medical Director Deputy Chief
Winnipeg Fire & Paramedic Service Winnipeg Fire & Paramedic Service
Winnipeg Fire & Paramedic Service
Keeping Emergency Responders Safe
Dr. Donald Stewart, Medical Director, Fairfax County Public Safety Occupational
Jim Brinkley, IAFF Director of Health and Safety
So far, the IAFF's
series of videos on Ebola preparedness and response has focused on exposure
protection. In the fourth
video, Dr. Donald Stewart, medical director for the Public Safety
Occupational Health Center in Fairfax County, Virginia, addresses some of the
medical and behavioral concerns related to responding to possible cases of
Watch the entire series of
More information on Ebola preparedness is also available online
and on the IAFF Frontline app. The IAFF will be continuously updating this site with
the latest information on the Ebola virus.
As you may be aware, municipalities across Canada are preparing and revising emergency protocols that deal with how emergency responders react to a potential Ebola patient. The OPFFA has a representative at the Ebola Advisory Table to offer our perspective on this emerging issue.
At a provincial level, the Ministry of Health has described the threat of Ebola to first responders as low risk. Instead, the province wants to ensure we prevent individuals from exposure in the first place. Five airports across Ontario are screening passengers travelling from or through African countries for symptoms. Ten hospitals – including four pediatric hospitals – have been designated as Ebola-ready facilities.
Emergency staff in hospitals have received a directive (Directive 1) detailing their protocols for dealing with a potential Ebola patient. A response protocol for EMS responders is expected in the coming days. We will advise you when it becomes available.
The 2014 Ebola epidemic is the largest in history and has spread to multiple countries in West Africa. The first confirmed case in North America was recently reported in Dallas, Texas, where the 9-1-1 system was used to treat and transport the patient to the hospital. The patient has since died. The ambulance crew - all members of Dallas, TX Local 58 - have been taken off duty with pay and are under continuous medical observation at their homes. For more information on what you need to know about Ebola, click here.
It is highly likely that more individuals infected with Ebola will seek assistance from emergency response personnel as the disease spreads. The IAFF is urging every affiliate to conduct a "safety stand down" with their employer and review all infectious exposure policies, procedures and guidelines. You should assess your department's preparedness for responding to and caring for patients with possible symptoms of the Ebola virus and whether you have the equipment and training needed for safely responding to worst-case scenarios in potential Ebola exposures should this virus spread in the United States and Canada.
All policies, procedures and guidelines should at a minimum address the following:
Use standard precautions, including fluid resistant and or impermeable long-sleeved gowns, single or double gloves, eye protections, leg coverings, and disposable shoe covers. The IAFF recommends N95 respirators for all patients with respiratory symptoms.
If there is a potential exposure, or the crew thinks they have been affected, DO NOT return to the firehouse. After transport, remove the unit from service while at the hospital. If an engine and EMS unit both respond, they should stay together throughout the call to keep other fire fighters from potential contamination. Exposure reporting should be activated from the hospital or while in route to the hospital with the patient.
Establish follow-up and reporting measures after caring for a suspected or confirmed Ebola patient.
Develop policies for monitoring and management of EMS personnel potentially exposed to Ebola. Policies should be flexible in terms of the amount of time required for monitoring and potential isolation of exposed personnel.
Establish sick leave policies for personnel that are non-punitive, flexible and consistent with public health guidance.
Ensure that all personnel, including staff who are not directly employed to provide patient care but provide essential daily services, are also aware of the sick leave policies.
Ensure that fire and EMS personnel exposed to blood, bodily fluid, secretions or excretions from a patientwith a suspected or confirmed Ebola virus immediately:
1) Stop working and wash the affected skin surfaces with soap and water and irrigate with a large amount of water or eyewash solution.
2) Contact an occupational health supervisor for assessment and access to post-exposure management services.
3) Receive medical evaluation and follow-up care as appropriate. Medical evaluations should include fever monitoring twice daily throughout the Ebola incubation period, which is two to 21 days.
Establish return-to-work protocols according to EMS agency policy and discussions with local, state and federal public health authorities.
Fire and EMS personnel who develop sudden onset of fever, intense weakness or muscle pains, vomiting, diarrhea, abdominal pains or any other symptoms after an unprotected exposure should NOT report to work or, if at work, immediately stop working, isolate themselves, notify their supervisor (who should notify local and state health departments as appropriate), contact an occupational health supervisor for assessment and post-exposure management service and comply with work exclusions until they are considered no longer infectious to others.
Identify a single occupational health representative for reporting exposures.
Fit test all personnel for use of N95 masks and provide them, as well as appropriate eye protection.
The transmission of the Ebola virus occurs through direct contact with blood and bodily fluids of an infected person. It can also be transmitted through exposure to objects that are contaminated by the bodily fluids, such as needles. Healthcare workers, including fire fighters and EMS personnel, are at the highest risk of becoming sick because they are exposed daily to many patients with common symptoms of Ebola and other infectious diseases.
The IAFF stresses the importance of consistently using standard precautions during every patient encounter and having the proper training and equipment to safely respond to and care for individuals exhibiting signs of Ebola.
The Centers for Disease Control (CDC) provides important guidance documents, most notably the Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients With Known or Suspected Ebloa Virus Disease and EMS Checklist for Ebola Preparedness. For more CDC infection control guidelines, click here.
For more information on what you need to know about Ebola, click here.
ABOUT BOX RUN Box Run is a charitable initiative started by Mike Strange in 2012 in an effort to "knockout" childhood cancer. The goal was to raise awareness and funds by running across a portion of Canada, starting from the point where Terry Fox was forced to stop his run in 1980. The inaugural Box Run took Strange nearly 3,200kms down the Trans-Canada Highway, from Thunder Bay, ON to Victoria, BC. The run raised over $100,000, all of which was donated to Childhood Cancer Canada.
MISSISSAUGA - All fire trucks in Mississauga now carry life-saving EpiPens to treat people experiencing a severe allergic reaction. Mississauga Fire and Emergency Services officials brought the news to City councillors last Wednesday. EpiPens are used to administer ..........read more