April 4, 2013

The Québec Ombudsman’s report on the organization of off-road emergency response services: Optimize off-road coverage to save lives

Québec City, April 4, 2013 – Today the Québec Ombudsman released a report on the organization of off-road emergency response services, which sheds light on the need for these services to be better organized with a view to improving quality and accessibility. The purpose of the intervention it undertook is to save as many lives as possible and reduce the risk of permanent disabilities in off-road accident survivors, especially in isolated areas.

Background

Each year in Québec, approximately 1,000 people are injured while engaged in off-road recreational and tourism activities; some 250 sustain multiple traumas and require specialized medical care. On average, these activities will prove to be lethal for 25 victims.

The purpose of pre-hospital emergency services is to prevent deterioration of the condition of a person who has had an accident, sustained an injury or is experiencing a health problem, and to take them, usually by ambulance, to a health institution for the required care. Since the aim of this kind of intervention is to save lives, it is crucial that it be just as effective at providing quality care as at acting quickly to do so.

In order to examine the organization of off-road emergency response services and identify ways of improving it, the Québec Ombudsman formed a multidisciplinary team of experts in the field of emergency medicine, paramedical care, municipal administration and civil protection and safety.

The Québec Ombudsman’s main findings:

Concerning prevention, intake of emergency calls, and organization of emergency response services:

  • Sports and recreational activity enthusiasts and public and private promoters are not sufficiently aware of or accountable in terms of the risks associated with off-road activities.
  • Telecommunications coverage (cell phone and emergency coverage) of Québec’s land base is deficient; 75% of Québec is not covered by 9-1-1, which complicates the organization of off-road emergency response services.
  • Responders are lacking in alerting and coordination skills.

Concerning the accountability of the main responders:

  • Neither ambulance technicians’ nor firefighters’ mandates include the formal obligation to come to the assistance of citizens off-road.
  • There are disparities in the organization of off-road emergency response services from region to region and among the municipalities within a same region:
    • There is confusion about the main responders’ roles and responsibility sharing.
    • The fire safety cover plans that govern the work carried out by firefighters do not include off-road rescue; firefighters’ mandate therefore does not include the obligation for them to come to the assistance of citizens off-road.
    • Often, no responder is mandated for rescues that call for specialized or highly specialized expertise (rescues at sea, on ice, in cramped spaces or by helicopter).

Concerning available material resources and required training:

  • There are deficiencies in terms of accessibility to personal protective equipment for ambulance technicians and the equipment firefighters need to perform off-road rescues. This equipment and the training required for carrying out off-road rescues effectively and safely are not available to all responders or in every region.

Concerning volunteer accident insurance:

  • Coverage of volunteers formally mobilized to participate in off-road emergency rescues is sometimes inadequate.

Concerning evaluation of the off-road emergency response system:

  • There are no performance indicators for monitoring and evaluating the off-road emergency response system with a view to continuous service improvement.

Resulting recommendations:

  • Make enthusiasts and public and private promoters accountable
  • Improve telecommunications coverage (cell phone and emergency coverage)
  • Clarify alerting to emergency calls and improve coordination of emergency responses
  • Mandate ambulance technicians to intervene off-road
  • Establish emergency service response protocols on a regional basis
  • Provide volunteer accident insurance
  • Evaluate the performance of off-road emergency response services

The government departments concerned are on board

The Québec Ombudsman would like to draw attention to the collaboration and support it received from the two main government departments for which the recommendations were made. The Ministère de la Santé et des Services sociaux agrees with the findings of the report and for the most part approves of the recommendations intended for it and pledged to propose measures and a timetable for implementing them. Among other things, it indicated it was willing to mandate ambulance technicians to carry out response operations off-road and to provide them with the personal protective equipment they need to do the job safely.

The Ministère de la Sécurité publique recognizes that integrating off-road emergency response services within fire safety cover plans and clarifying the respective roles and responsibilities of the various responders is important. It believes that in order to encourage municipalities and RCMs to come on board, a financial assistance program for things such as training and equipment for safe off-road rescue operations would be a worthwhile incentive.

Reorganizing the current structure rather than a building a new one

Currently, even if responders are not formally mandated to come to the assistance of citizens off-road, rescues are still organized, with all the costs that this entails. Starting from this general observation, the Québec Ombudsman considers that the cost of implementing its recommendations is negligible compared with what is already spent on off-road emergency responses. Rather, the recommendations would simply optimize the effects of the budgets already dedicated to these operations.

Given the estimated direct and indirect cost of paraplegia and tetraplegia of several million dollars per person, better organization of off-road emergency response services is a wise and socially responsible investment.

To be consulted:

Source: Québec Ombudsman

Press relations

Carole-Anne Huot, 418 (646-7143)/418 (925-7994)
carole-anne.huot@protecteurducitoyen.qc.ca