Attention Ontario Paramedics and Ambulance Communications Officers:

We would like to bring to your attention a project that will begin soon to better understand the reasons behind trauma scene call cancellation with the intent of improving timely access to trauma care for severely injured patients.  We are asking for your support in helping us gather the necessary information during the communications and dispatch process.
 
What is the project?
The project will involve many phases, the first of which is to obtain accurate, timely and actionable information on why Ornge is being cancelled from trauma scene calls.  The purpose is to understand why Ornge is being cancelled from a call and to follow-up to see if patients are eventually transferred to a trauma centre or are able to have appropriate care provided at their local hospital.
 
Why is this important?
We know that injured patients who are treated at a trauma centre have better odds of survival and better outcomes than patients who are treated at non-trauma centres.  We also know that delays to getting patients to a trauma centre can also result in patient harm.  Understanding the reasons why Ornge is being cancelled from a trauma scene call will provide the framework for future interventions aimed at reducing scene call cancellations for patients that should be treated at a trauma centre.
 
What does this project mean for Paramedic Services?
Today, Ornge Communications Officers will typically ask the Ambulance Communications Officer (ACO) why Ornge is being cancelled from a trauma scene call.  As stated in the Air Ambulance Utilization Standards:

 If the call’s circumstances and patient(s) fail to meet the guidelines and an air ambulance is known to be responding based on the merits of the initial request for ambulance service, the paramedic will contact the CACC/ACS and advise that an on-scene response is not required and why. (emphasis added)

While cancellations happen routinely (according to a recent study in the GTA, approximately 35 per cent of Ornge helicopter trauma scene calls are cancelled), oftentimes we do not receive accurate information with regards to the reason for the cancellation.  In phase one of this study, we have created a standardized list of responses to that question in order to ensure we receive complete and accurate information.

Effective August 17, 2020, when Ornge is being cancelled from a trauma scene call, we will be asking the ACO to provide us with one of the following four reasons:

• Patient did not meet Field Trauma Triage Standards
• Land EMS taking the patient directly to trauma centre
• Patient is pronounced deceased
• Patient refusing transport

If the ACO has not obtained this information from the attending paramedics, when possible, they will contact the crew directly to confirm the reason.  It is recognized that during certain calls, this may not always be possible.  However, we ask that you assist us in this process as much as possible, as it is crucial to this project that the reasons for cancellation are correctly identified. 
 
I have questions. Who can I reach out to?
Please reach out to Dr. Brodie Nolan, Ornge Transport Medicine Physician and Trauma Team Leader at St. Michael’s Hospital with any questions, comments or feedback on the project.  He can be reached at bnolan@ornge.ca.

We appreciate your assistance as we seek to make a measurable improvement in outcomes for air ambulance trauma patients.
 

• Healthcare Partners
• Patients and Families