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Autopsy of an excessive emergency response

April 8, 2016

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Friday morning (April 8) in the McDonald’s in the 1400 block of West Broadway Avenue, between 10 a.m. and 10:30 a.m., restaurant staff could be seen and heard repeatedly trying to wake up a homeless guy who was sleeping in a back corner booth seat.

There was nothing unusual about one of us homeless people falling asleep in McDonalds early in the morning (yawn) but it was something when a red Vancouver Fire and Rescue Services “Fire/Medic” truck bearing two firefighter medics rolled up in front of the restaurant at about 10:45 a.m.

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It looked serious when, a minute or so later, an ambulance pulled in behind the Fire and Rescue truck and disgorged two B.C. Ambulance Service paramedics. However, when a second ambulance appeared not three minutes after the first—bringing the total number of responders to six—the emergency response began to look seriously overdone.

And when a big Vancouver Fire and Rescue Services pumper truck hove into view, with its lights and sirens going, a slight groan was heard in the restaurant.

All this for a sleepy homeless guy? How touching!

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Except for the sleepy guy, everyone in the McDonald’s and the general vicinity seemed to be paying attention  to what was happening, including four floors-worth of bank employees watching from across the street.

The second ambulance was waved off by the crew of the first ambulance and the pumper truck barely slowed down before it turned north on South Granville Street. (likely it  just happened to be passing by on its way to another call.)

This left four emergency responders to crowd around “sleepy head”, who was remarkably responsive and cooperative now that he was surrounded by uniformed authority figures.

Under the questioning of one of the paramedics, the young fellow admitted to taking “brand name” drugs but certainly nothing like heroin or any other street drugs.

A regular customer named Graham, who commutes from the Downtown Eastside to the Fairview McDonald’s for his morning coffee almost every day, watched the emergency response through the knowing eyes of a former crack cocaine addict and didn’t believe a word of the fellow’s denials.

The guy may have been acting, as Graham said, like someone who was in the throes of a drug high but none of the responders felt that he needed medical help.

After talking to the fellow and each other for about 45 minutes, the responders finally packed up and left.

A few minutes after that, the object of all this attention, alert and refreshed, finally got himself up and out of the restaurant.

An embarrassingly disproportionate response

One of the McDonald’s managers on the morning shift was a bit red-faced when I asked her about the emergency response. She had only wanted one police officer, she explained, not all the paramedics that she got.

The manager told me that after she had woken up the fellow a few times,  she knew that he wasn’t overdosing or ill; he was just trying to grab some shuteye and he had no intention of listening to mere McDonald’s employees.

So she finally asked one of her staff to call the police using the non-emergency number. She said it was the dispatcher on the other end who chose to send Fire and Rescue and B.C. Ambulance.

“Like a flock of vultures”

There’s something about the sight of six emergency responders turning up to deal with a person who has fallen asleep in a restaurant that prompts onlookers to complain about the government wasting taxpayers’ money.

My retired friend Martin, who held down two skilled jobs and has lived in the same Fairview apartment building for 30 years, watched the emergency response with much griping and head-shaking.

My homeless friend Henry—who smokes and injects crystal meth with a frequency that makes him a medical emergency waiting to happen—insisted that the responders were there to pad their expenses and look busy.

Graham, the former crack addict from the Downtown Eastside, said much the same thing.

I’ve heard the basic complaint before—that having different fire and ambulance people responding to the same call is a wasteful duplication of services and behind that, the vague accusation that all the responders somehow profit by showing up at the scene.

Getting all fired up about emergency responders

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One thing that seems to especially irk some Vancouverites is the presence of Vancouver firefighters at medical calls, as if the firefighters are wrongly intruding on the exclusive domain of ambulance paramedics.

But any notion that Vancouver firefighters should stick to fighting fires and leave the medical stuff to the B.C. Ambulance Service is over thirty years out of date.

According to the Vancouver Sun, buildings just don’t burn down like they used to. But fewer fires doesn’t necessarily mean that the city can just willy-nilly eliminate firefighters or neighbourhood fire halls. Firefighters still need to be close enough and numerous enough to quickly get to and extinguish any structure fires that do start.

These days, fully 70 percent of the dispatch calls to Vancouver’s 20 fire halls are traffic accidents or medical and only 30 percent principally involve fire. That’s why Vancouver’s fire department is now called Vancouver Fire and Rescue Services. It’s been repurposed over the last 30-some years to become the city’s principal first responder to any emergency.

Fire and Rescue personnel and ambulance paramedics are now seemingly equally equipped and trained to deal separately or together with medical emergencies, with the exception that ambulances are still required to physically transport people to hospitals.

Blame the dispatchers not the responders?

When you call 911 or any of the non-emergency 10-digit numbers, to reach fire, ambulance or police services anywhere within the Metro Vancouver region, your call is handled by an operator/dispatcher working not for the emergency services but for a sort of regional crown corporation called E-Comm, that was established by the B.C. provincial government following the 1994 Stanley Cup riot in Vancouver.

Any criticism concerning the number of responders that turn up to a call in Vancouver should probably be directed at E-Comm. It really can’t be laid at the doorstep of the B.C. Ambulance Service, the Vancouver Fire and Rescue Services or the Vancouver Police Department because none of these services appear to control the dispatching of emergency responders.

As for profiting by simply showing up at an emergency, the only appearance-related fees that I can find for emergency response are charged by the B.C. Ambulance Service. These are mostly called 911 fees but I think they apply to non-emergency calls also.

When an ambulance is requested but transportation is either not required or is refused, the requesting party is charged a $50 911 Response Fee. And when an ambulance is requested and a ‎patient who pays provincial medical services premiums (MSP) is transported to hospital, the requesting party is charged a 911 Ambulance Transport fee of $80.

When people who are not MSP beneficiaries are transported to hospital by ambulance, the fee is $530 for ground service, $2,746 per hour for helicopter and $7 per statute mile for airplane.‎

Technically the 911 Response Fee applies to both residences and businesses and could mean that the owner of the McDonald’s in the 1400 block of West Broadway will be on the hook for $100 because two ambulances were dispatched but never transported anyone to hospital.

However McDonald’s staff never wanted the ambulances that they received and they never received the visit from the police that they did want so it’s hard to see how the owner could be charged for anything. Click the images to enlarge them.

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One Comment
  1. Jet permalink

    Obviously the 911 operator did not deem the call worthy of a police visit.

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