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COVID-19: Canadian military preparing to send ICU nurses, medics after Ontario’s request for help

dimsum

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Sent "to ON" - as in "not the folks in Pet, Borden, etc"?

As Ontario continues to get a handle on the surging third wave of COVID-19 cases and crushing patient loads at intensive care units, the Canadian Armed Forces is preparing for a potential deployment of medical personnel to the province after a recent request for assistance.

“There are over 1,900 patients with COVID-19 in the province of Ontario’s hospitals and of those, 659 are being treated in intensive care for COVID-related illnesses. Nearly 450 patients that are in critical care require a ventilator to breathe,” an unclassified warning order obtained by Global News on Monday said.

“COVID variants of concern have spread rapidly in Ontario in recent weeks and in particular in the Greater Toronto Area. This has resulted in civilian hospital capacity being exceeded."

According to the document, personnel are currently preparing for potential deployment as the request for assistance process continues. If ultimately approved, critical care nursing officers and up to three mobile medical assistance teams, which would be able to assist with 24-hour medical transports, could be sent to Ontario.

 

mariomike

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If ultimately approved, critical care nursing officers and up to three mobile medical assistance teams, which would be able to assist with 24-hour medical transports, could be sent to Ontario.
Regarding "24-hour medical transports".

Toronto is using their 40-foot ambulance buses running a Covid shuttle dispersing patients to out of town hospitals around the clock. Not the first time they have been used for line hauls, but we more commonly used them for milk runs. They would usually be for mass casualty incidents like high-rise fires, and can accommodate a large number of patients in an emergency. Now they only transport two Covid patients at a time, attended by two ORNGE paramedics, and a Toronto paramedic driver.

It's a shame that the Multi-Patient fleet is no longer what it used to be. Especially during this time of great need.

Our first bus ambulance was a GMC "New Look". Since then OBI, MCI and Eldorado.

I know the CAF has ambulances, but do they also have ambulance buses?
 

daftandbarmy

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Tally ho!

Ontario requests help from Canadian Armed Forces as critical care COVID-19 cases surge​

3,510 new cases of virus recorded; admissions to ICUs climbed to 877, another pandemic high in Ontario​

Ontario has made a formal request to the Canadian Armed Forces for help in dealing with a surge in critical care cases associated with COVID-19, just days after it rebuffed an offer by the federal government to send in extra personnel.

In a statement Monday, a spokesperson for Solicitor General Sylvia Jones said the province has "made a request for the assistance of those identified resources, many of whom reside, for example, within the Canadian Armed Forces and Canadian Red Cross organizations."

"In addition to health human resources, we are requesting logistical and operational support as we seek to augment our response to COVID-19," the statement from Jones's press secretary Stephen Warner said.

Speaking to reporters, Jones said the request, made Friday, did not request a specific number of personnel.

"What we are looking for is very specialized nurses that can help out in our intensive care unit beds and medical personnel that can assist our hospitals that are seeing disturbing rises in cases of COVID-19," she said.

Sunnybrook puts first patient in field hospital​


Meanwhile, the Sunnybrook Health Sciences Centre is, for the first time, putting patients in its field hospital. The centre reported its first patient Monday. A total of 10 beds have been made available there so far to help ease pressures in acute care hospitals.

Ontario also reported a third case of a rare blood clotting condition known as vaccine-induced immune thrombotic thrombocytopenia (VITT), this time in a man in his 70s currently in hospital after receiving the CoviShield vaccine, a version of the AstraZeneca vaccine.

The news comes as Ontario reported another 3,510 cases of COVID-19 on Monday, while the number of patients with the illness who need a ventilator to breathe topped 600.

According to the Ministry of Health, 877 people with COVID-19 are being treated in intensive care units across the province, twice as many as there were at the beginning of April.

Critical Care Services Ontario, a government agency that compiles daily a report for hospitals and health organizations, said that 59 patients were admitted to ICUs yesterday alone. Anthony Dale, president of the Ontario Hospital Association, said that a total of 1,415 COVID patients have been sent to ICUs this month so far.

Of those in intensive care, 605 patients are on a ventilator — nearly double the number seen at the peak of the second wave in January.

Public health units also recorded the deaths of 24 more people with the disease, pushing the official toll to 7,935. The seven-day average of deaths has climbed to a third-wave high of 28.6.

Among those Ontarians who recently died with COVID is a 13-year-old girl from Brampton.

 

lenaitch

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I know the CAF has ambulances, but do they also have ambulance buses?

I think they would have to make an emergency order to waive provisions of the Ambulance Act.

I saw a Toronto EMS ambulance (regular) at our small hospital on Saturday. I don't know if it was a Covid transfer but I've never seen one here before.
 

CBH99

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Curious, how do military ambulances compare to ambulances from a civilian service?
 

Blackadder1916

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Sunnybrook puts first patient in field hospital​

Meanwhile, the Sunnybrook Health Sciences Centre is, for the first time, putting patients in its field hospital. The centre reported its first patient Monday. A total of 10 beds have been made available there so far to help ease pressures in acute care hospitals.

. . .

From several days ago a couple of views of the Sunnybrook field hospital with an overview of its operational mission.

from the CBC

And a Sunnybrook video
 

mariomike

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Curious, how do military ambulances compare to ambulances from a civilian service?
I don't know about now, but we operated the Dodge M43 3/4 ton 4x4 ambulance. MSE Op driver with a Med A attendant.

Although a little sluggish, the M43 was tough and reliable.

 

medicineman

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I think they would have to make an emergency order to waive provisions of the Ambulance Act.

I saw a Toronto EMS ambulance (regular) at our small hospital on Saturday. I don't know if it was a Covid transfer but I've never seen one here before.
Depends which ones they use - the F350's are pretty decent, newer Bisons weren't bad when I showcased one in 2005...as for the LSVW, well they're LSVW's...
 

brihard

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Might they be considering that new sea container isolation unit for patient transfer? RCAF was bragging on it via social media a few days back.

Interestingly, the figures quoted in the warning order are the 1030 am ICU update from April 15th. So this has been in the works since about the same time (April 16th) that Doug Ford rejected federal help and the Red Cross. Slimy, that.

I’m not sure how many critical care nurses CAF has, but it can’t be many, and they’ll be working in hospitals somewhere already. This is a reallocation of critical care resources from somewhere else that needs them too.
 

medic5

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Forgive my ignorance on this matter, but why has Canada not built any large field hospitals? It's been a year since the start of the pandemic, surely there was enough time to build more hospitals?
 

FJAG

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lenaitch

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Depends which ones they use - the F350's are pretty decent, newer Bisons weren't bad when I showcased one in 2005...as for the LSVW, well they're LSVW's...
I wasn't thinking so much of the platform as the certification who can operate an ambulance service and who can operate an ambulance. For example, the St. Johns folks you see at events are not 'certified to transport'. Patient transfer services can move stable patients between facilities but they are unregulated and only have very basic training. This might already be covered in the EMCP Act or could be fairly easily waived by an emergency order (Regulation). Communications with designated base hospitals might be an issue as well.
Forgive my ignorance on this matter, but why has Canada not built any large field hospitals? It's been a year since the start of the pandemic, surely there was enough time to build more hospitals?

There are at least two; Sunnybrook and Royal Victoria in Barrie. I think the one at Sunnybrook received its first patient either yesterday or today.
 

mariomike

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The tricky thing about these Covid transfers is they require Land or Air ambulance ( Ontario licensed ) Critical Care Paramedics. Their scope of practice is waaay above my old pay grade!

The Critical Care Paramedic (CCP) functions with the broadest scope of Paramedic practice. Their knowledge and skill sets are based on the foundations of the PCP and the ACP paramedic scopes of practice. The CCP specific training is an additional 2 years. This is inclusive of Didactic, Clinical, preceptorship, and multiple evaluations leading to certification.

The Critical Care Paramedic is specialized in the care of Critically ill or injured Adults and Paediatrics as well as High Risk Obstetrics. Intra Aortic Balloon Pump, and shared care ECMO/ECLS are also part of their scope. Their primary responsibility is servicing Critical Care Calls. Functioning as a mobile ICU CCP's respond to the needs/requests of various hospital units that require Critical Care and transport of patients. The CCP is capable of assessing, initiating care, resuscitation, and continuity of care in the management of virtually any clinical condition.

In addition to the skills that ACP's perform, the Critical Care Paramedic practice includes:

  • Transvenous pacing
  • Management of PA Lines
  • Art Line Monitoring
  • CVP monitoring
  • An extensive pharmacology scope
  • Administration of blood and blood products
  • UVC Line insertion
  • Foley catheter insertion
  • NG tube insertion
  • CT-head scan interpretation
  • Chest X-ray interpretation
  • Multiple Difficult Airway maneuvers
  • Mechanical Ventilation, multiple modes
  • Chest Tube management
  • Blakemore Tube management
  • Lab value analysis
  • Blood gas analysis
  • Various medications with physician's orders
 

brihard

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I expect we have at least some CAF Med Techs with comparable qualifications as part of CAF’s air medevac capability. Also note that strict scope of practice is going out the window. The province has already, through emergency order, allowed qualified medical practitioners to work out of scope if in a hospital setting. Besides that, legally, I expect CAF medical staff, when performing military duties, would fall under the constitutional authority granted to the federal government to oversee and regulate them. If acting in good faith in th course of duties they’re qualified to do, I don’t think the province could really raise issues of licensure. And it is the province asking for the help in the first place.
 

SeaKingTacco

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I expect we have at least some CAF Med Techs with comparable qualifications as part of CAF’s air medevac capability. Also note that strict scope of practice is going out the window. The province has already, through emergency order, allowed qualified medical practitioners to work out of scope if in a hospital setting. Besides that, legally, I expect CAF medical staff, when performing military duties, would fall under the constitutional authority granted to the federal government to oversee and regulate them. If acting in good faith in th course of duties they’re qualified to do, I don’t think the province could really raise issues of licensure. And it is the province asking for the help in the first place.
Even stripping the military of every highly trained ICU specialist, we can’t be adding much more than a token amount to Ontario. We are not that deeply staffed with ICU specialists.
 

mariomike

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I wasn't thinking so much of the platform as the certification who can operate an ambulance service and who can operate an ambulance. For example, the St. Johns folks you see at events are not 'certified to transport'. Patient transfer services can move stable patients between facilities but they are unregulated and only have very basic training. This might already be covered in the EMCP Act or could be fairly easily waived by an emergency order (Regulation). Communications with designated base hospitals might be an issue as well.
Maybe transfers. ORNGE ( Land and Air ) and the privates handle those anyway. The City handles the 9-1-1 calls.

If it ever got desperate, as it almost did during SARS, the SOP would be to use a police officer or firefighter driver. ( From scene to hospital only. The lone paramedic would drive when no patient on board. ) It didn't come to that. But, I think it came pretty close.
 
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