Each year in Canada, 200,000 are hospitalized due to trauma-related injuries, costing $19.8 billion annually in direct and indirect costs. If someone has such an injury in Metro Vancouver, there's a 12 per cent chance of dying. In northern B.C., that jumps up to between 73 and 82 per cent.
"That's nuts," said Roberta Squire, the author of the thesis. "It's 73 just around the Prince George area and the further north, east or west you go, you're looking at 82 per cent of people dying before [they] can get the treatment [they] need."
Additionally, the thesis highlights a 2012 ICBC report, which reported that in 2012, 3,430 people were injured in motor vehicle accidents in Northern B.C. The same report said in rural areas, one in every 25 accidents has a fatality, compared to once in every 136 in rural areas.
Reasons for the higher mortality rate include limited cell coverage, remote highways, delayed responses from emergency personnel due to distance and the need for volunteer emergency personnel to assemble, said the thesis. Compounding the problem is the ability of Northern B.C. medical facilities to deal with trauma, as there's limited capacity to transport the injured to different facilities and there's only one Level III Trauma Centre in the region, located in Prince George. Level I and II facilities are located in the south of the province.
"I couldn't believe that," Squire said. "So I needed to look into it more."
Most of these limitations could be mitigated with a helicopter ambulance service that's able to bring medical professionals to the injured and then bring injured to the hospital within that vital first hour, said the thesis. Such a service exists in Alberta, Saskatchewan and Manitoba, provided by the Shock Trauma Air Rescue Society.
Currently, the B.C. Ambulance Service in Northern B.C. is primarily ground-based, using fixed-wing and helicopters when necessary.
"When a 911 call is received from any area of the province, including Prince George, the call is assessed, triaged and the appropriate resources are deployed," wrote Kelsie Carwithen, a spokeperson with the service, in an email. "As a provincial system, we are able to send the most appropriate type of ambulance, ground or air, regardless of the patient's location."
The service has a fixed-wing aircraft based in Prince George and contracts from a list of pre-approved charter helicopter carriers if a helicopter is required at the scene. In 2011-12, the service's Prince George-based ground ambulances responded to more than 6,500 pre-hospital events. In the air, fixed-wing aircraft transported 672 people. Only four people were transported by helicopter, wrote Carwithen.
By getting the injured to the hospital faster, a helicopter service would be able to reduce their recovery time, the time needed in rehab and the time they'd have to take off work, said Squire. As a result, claims to the Workers' Compensation Board could be reduced.
The thesis also cites a study from Nova Scotia-based Dalhousie University's department of emergency medicine, which said 5.61 more lives were saved per 100 patients when they were transported through the air as opposed to the ground.
There's also the moral argument, Squire said, that every Canadian should have the same level of healthcare available to them no matter where they live. Another consideration is the potential for more economic growth in Northern B.C. coming from mines, as well as potential pipeline and LNG projects.
"That means thousands of additional people working and living in remote areas. With that demand, we definitely deserve a dedicated air service," she said.
The thesis said studies dispute if a helicopter ambulance costs more or less than its ground-based counterpart, but it highlighted a Massachusetts-based study, which said one helicopter service with five full-time nurses and paramedics cost $1.7 million U.S. in 1991, compared to a six-vehicle ground-based service with thirty full-time nurses and paramedics costing $3.8 million. The thesis said more current figures were not available.
Squire did provide an estimate of how much a helicopter ambulance would cost.
"We're looking at anywhere between at $3.5 to $4 million [per year] to have this thing in the air, fully functioning and saving lives," Squire said. "With a half a million dollars, we would have a helicopter leased and personnel being hired. It's not a ton of money."
That price tag wouldn't include a needed helipad at the University Hospital of Northern B.C., which had one until the late 1990s.
quire wrote the thesis because she wanted something that could be used at a future date.
"I wanted a document that was going to make a difference," she said, adding that the university's MBA program gave her the support and skills necessary to be successful in the endeavour.
The president of the Northern B.C. Helicopter Emergency Rescue Operations Society, which has been working to establish a helicopter ambulance service for around two years, said the thesis was useful for his organization.
"Roberta's extensive research on the province's current emergency medical response system has proven invaluable to us on the [society's] board," said Brent Marshall in a media release. "It was another incredible indicator and basis for the immediate need of this service in Northern B.C."
Carwithen wrote that the ambulance service is aware of the society's efforts.
"[The service's] staff met members of [the society] in April 2013 to discuss their plan in greater detail and was interested in learning more about group's future plans," she wrote. "Since that 2013 meeting, the organization has not received any updates on [the society's] continued interest in this area."
Since Squire has finished her thesis, she's been hired as the executive director of the society.
"I was just thrilled and honoured that they appreciated my work on the paper so much that it just seemed natural to accept the position," she said.
The society is now preparing a campaign to inform citizens of Northern B.C. about a possible helicopter ambulance service, as well as raising money.
UNBC student makes case for helicopter ambulance service
July 16, 2014, Vancouver - Northern B.C. needs a dedicated helicopter ambulance service to ensure those with traumatic injuries get proper treatment, according to a research thesis written by a UNBC student.
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