Paramedics would save lives in Quebec, Opinion

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OPINION      November 18, 2004     The Gazette

Health Minister Philippe Couillard should worry less about the initial cost of training 18 paramedics at Urgences Santé and be more concerned about the need to have Paramedics in the first place.  Quebec is indeed in desperate need of Paramedics.  Paramedics are the difference between life and death for victims of heart attack, diabetic and asthmatic crises, severe allergic reactions, burns and a variety of other medical and traumatic emergencies.  Paramedics are emergency medical providers, highly trained in Advanced Life Support (ALS). ALS includes advanced airway management, administration of intra-venous solutions and life-saving medications.  Paramedics, along with other emergency personnel (i.e. ambulance technicians, police, firefighters and first responders, professional and volunteer), providing rapid intervention to the sick and injured save lives and alleviate suffering.  Paramedics are, in essence, the eyes and ears of the doctor.  They also happen to be illegal in Quebec.

More than 100 Quebec municipalities (including the majority of former MUC suburbs and Conference of Suburban Mayors) and the Union of Quebec Municipalities have passed resolutions in favour of Paramedics. Leading experts across Canada and the U.S. support the concept of Paramedics in Quebec including the Canadian Society of Ambulance Personnel, the Canadian Coalition for Emergency Cardiac Care, internationally renowned professor in the field of resuscitation, Dr. Joseph Ornato, and the President of the American College of Emergency Physicians.  Some have warned of dire consequences that could result in the absence of ALS in Montreal.

Ten years ago, the physician coordinator of Urgences Santé predicted that plans to eliminate ALS intervention would seriously jeopardize pre-hospital emergency care and would have a direct and negative impact on illness and mortality. This position was supported by the Association of General Practitioners of Montreal.

The Quebec Auditor-General and successive coroners have agreed that ambulance services must improve the level of care and maximize efficiency in order to save more lives and safeguard tax dollars.  Finally, Urgences Santé recognizes the need for Paramedics.

Decades of medical research also show that many victims of cardiac arrest can be saved when the proper “Chain of Survival” is in place.   The chain has four links:   1. Early access to EMS (9-1-1);  2. Early CPR;  3. Early defibrillation (shocking the heart);  and  4. Early ALS response.  Because we are missing the fourth link, people are dying needlessly in Quebec.

Quebec Ambulance Technicians are trained only in Basic Life Support.  They cannot provide ALS skills, as do Paramedics.  Continuing to restrict Paramedics in Quebec is dangerous and unacceptable.

An EMS system with Paramedics, in constant communication with physicians, would allow for a substantial increase in survival rates, as well as improved post-hospital quality of life. This would provide a cost-effective, ideal level of patient care.

Government planners aching to find places to cut should realize that the cost-effectiveness of Paramedics would be startling:  They could competently cover a much wider area at much reduced cost compared to Urgences Santé physicians who used to traverse the city and have been cut back to negligible numbers. Furthermore, rapid Paramedic intervention results in shorter hospitalization, thereby saving the health care system millions of tax dollars in the long run.

The proof Dr. Couillard is looking for is clear – legalization and implementation of a province-wide Paramedic system of pre-hospital care as is the case throughout the rest of Canada and the U.S.  Our MNAs have a responsibility to address this issue promptly.  It’s time to change our outdated and inadequate system.  Legalization of Paramedics would save many lives in Quebec each year.

Glenn J. Nashen served more than 11 years as  City Councillor in Côte Saint-Luc and has chaired the local Emergency Services Committee since 1990.  He served as an Emergency Medical Technician with Urgences Santé for 17 years as well as with the all-volunteer Côte Saint-Luc Emergency Medical Services. He co-founded of the Coalition for Pre-Hospital Advanced Life Support and has advocated for the legalization of Paramedics for the last 25 years.

Resolution in support of pre-hospital emergency care

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Adopted by the City Council of Côte Saint‑Luc

15 March 1999

WHEREAS the Auditor General of Quebec has issued a report on March 20th

1999 wherein certain observations and recommendations have come forth

with regard to Pre‑hospital Emergency Care in Quebec with a view to its


WHEREAS the City of Côte Saint‑Luc has consistently promoted the need

for a higher level of training for Ambulance Technicians, and has long

advocated the recognition of Paramedics in a manner similar to that of

other Canadian and U.S. jurisdictions;

WHEREAS twenty‑one (21) municipalities in the MUC have already passed

resolutions declaring support for the recognition of Paramedics;

WHEREAS the City of Côte Saint‑Luc has vigorously promoted the teaching

of CPR to as broad a spectrum of its population as possible;

WHEREAS, in his said report, the Auditor General has pointed out the

inadequate ambulance response times and the relatively low percentage of

citizens of this province who are trained in CPR;

WHEREAS the City of Côte Saint‑Luc remains convinced that First

Responders must assume greater importance with the Pre‑hospital

Emergency Care system;

It was

MOVED BY   Councillor Glenn J. Nashen

SECONDED BY Councillor Ruth Kovac


“THAT the City of Côte Saint‑Luc reiterates its call for the

recognition of Paramedics and that they be permitted upon certification

to provide Advanced Life Support;

THAT Urgences Santé  be directed by the provincial authorities to

improve their ambulance response time;

THAT First Responders Services be encouraged by provincial authorities

and be provided with the tools necessary to provide effective and rapid


THAT the Ministry of Health, in concert with the Ministry of Education

require that every student graduating from high school be trained in


THAT the Ministry of Health, in concert with the Ministry of Education,

establish  a paramedic programme including Advanced Life

Support at the CEGEP level;

THAT a copy of the present resolution be sent to the following:

Auditor General of Quebec

Ministry of Health

Ministry of Transport

Ministry of Education

Opposition Critic for Health

Opposition Critic for Transport

Opposition Critic of Education

Executives of the Régie Régionale de la Santé  et des Services Sociaux de

la Région de Montréal Métropolitain

Director General of Urgences Santé

MNA for D’Arcy McGee

MUC Executives

Member Municipalities of the MUC.”


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