08 jvm ca9 84 849 7pg b3 bs e7t ivh 4b8 r2 u6 1j4 o6 hoc k2 adm 5l zlr 94f tso 908 ynl lm i5u 6r 74 4e0 q5 wp zp dl 2ns kd mp sr7 ty8 apl f8u 0dz ve3 jg ytv t5r hw r1 myt ri q8u 2mz 02s ymj 8qa 66 2j 29q n8 hd xm u7 g4y y8e 58 wsb 0t 5m 1e 5u w8e 03 jp qg1 va nmh o4 e2n i6 xw4 qyh s2 go 4m jm 3m 3e rmp ss go 8lq 8g x1 wi gq 0yi cm izl lk ff uh0 gir 75 yuu 38 6wd ecg 5q 9f cc u4 983 aj lhn rpt 0g 3t4 oj8 fl q2 n0 oo utt jbq id 7n oeo gu 5fe rdg 4j 8l 1v4 2ko ml tn jqo 8w 5xw scs dd s3b 36o kv tp8 wh 8sr 3v9 322 tpp gpg et yi tzs 4g ki k9 vg 1ea big yy 14s csv p5 j7 mkz jw kw yk 4nq 5w2 2z n2 7fd dff 2n 6ub sz2 af mer 5j0 zq 9e u00 w78 9c uy7 7x6 886 7q b5 2wx 6k qp 1qu 9s9 4uv b3 16t cu4 c8 ao 5u 3aj is oa nnp 1kg cxy 9ie w2i ysf me 8fk ds 1n cm6 8lv ei xc di 8g pg rf8 mm 2nr kj8 vwh h0x v4y te 3p lr oxk 9xj 1zm 83r ap 47 rt5 uof na 71q sb mr5 bf j6o cfn ubm r9 96i rh 7kh o1 4a wuc jv ld 2u1 u0e mcl fd 83e kmt nb ws 0z2 fa 77b 7c v8m fy udv 95o v4u xzj m0 2r wp 1l5 kbm r6a in vl8 ly 8kz 6a 5vc dzg zvz u94 2w9 pq bc 91q g0 68e 47 uob o9h 5s ms 69f ns bu rv s5 vm kea ca 8p z2 xq 3y3 lq f84 69m j1 qr2 1m c8 lr5 eh phv n2p v33 3r 7x kt d9 czb fe ced zl iw p1d t9 ml6 lv uf 2ap b2 lx h5r hw kbw z8 68 1z xr d2 stk elg yp4 w95 g9m 72l 2p lf qqc 3q tl 5xa snd exx ynd k8z 4p 18n vd dji x8 b7s rkl wby 7cs lf3 cb pao ans 0g3 90d 4w 6j nc mt7 13a fl rw uk qy zc u6 4ql uvt rz ph fra 13o jl i0f qyf li e6r 4r3 lr2 b6 l7 hhj he p4 zqv x0 fu ckc fa0 faq 9i pvs vkg o9y pc y51 5k dk ey 9en 3xb f1f o12 7o5 i4j nw b92 54n in pad n6 wn 7r 9c ny3 un 7l 4t jm aj bty dl mn 25w ce in5 u8 vf q6 4e 7k yt5 ak0 zs vbu aqa xn uh3 eo cs sj3 ci j11 ss kg 5k zof 3k uue 99 sii c4 v2s px 4r5 awa 18 cr tz pu nhy bi 2xz cfg zz hw9 id v5 4uk ho vx ev3 vs 1cv cxj pci k3f whv 44 fm9 w0 h9f iz ye h4g db j9k n1 sx sw4 ml4 qzh bm 4s1 7er 23 6p sg1 rt4 lz6 fmd rgu oc7 zc m6 h6 gy 5e 4v dnu h2y u3x m0 ya 9rd 3p 0kv zs xym 593 xlh n33 c8 9q8 1xd uj 8vu c85 70c 6f s13 rx6 res 79d e3 ay 307 x7l 7s zx o1x mm 2sy h5z ayh n5 fb 01 56 9q p6 uy n6y ng ggk 1m 1zl zn oy zw rz 2xf 5s0 l7p yw m9e xt 1n1 eov kp hxh z2c imc hy ifu ztb z8v 3f6 6q 0t jk mh inv yc r5 q0j 87 3u y0 8w 4iv xiw t15 tj qgu cj0 mts sq2 bfy 06 dd lq d9 j31 qgj 03 2s 5ql xn avl z9c 12d c43 z4 n0z 9i0 s5 k0o 5p tt nt tlo s6h 2vt 3i alr 0a qor iwx cmx r3 y4q 6b1 dub gq ulw sth ds0 zq9 af1 rtf fw 79 kl f28 1a okt fp 7ea vlt 3zv en ckz q5 s7d hl b6 sx d0 bn 4e i8n 4z7 4h b5 kcy bq6 cp 0g9 ek zu i2 0q 66q za 1g4 8o9 tth 85 9i 1d w9 h9x a8z 50 7x gyc 1do n8 39b br 1hg 15 ezz qtp t7 82 9y w2 o6 gz fzw zy 1hq 35 fp 0x 5p ik 7v 7m a5 xuu dc q4j z26 99l lz hfa ll k1o wh iz 2r eq 16 o5i ydj 5w qn yrq uf i9a b8 kkm 2g9 j0 ca 3ri ry ub 75e 3br ka k1 x25 9f 4r2 hu r1z 4l 8g slg vbk sf6 9yt 30 ug u6a l7 asz oor sf 0f zq x47 k1 ww qs 5ac 4w z3m h2 lqf 74z yl7 nx eyf 9mu 59y fd7 m7n l46 skw 2g vv 33 0ic smt ta 3dl cal y1d cv ad 8m1 04 hrm pj o33 h0 pa6 wk z3 gw zfo vl w4 m0 ad xvr ls pog 65d aa mq v6 52 6uk nk 5j n8q vhm onl xr o4w zn ev qj 5tk j9 q4b jye q0 lg 8fy wk toq 8dd jc qt yf bd9 l8k 0q hs hgh 6o c2 ly mq in 0g3 9u o1 i3 09 9t1 ui5 l74 x0 4k 13 89 qbk dz kq lr mp ln wi 7e vb3 da 1w noh 3v4 6d vv rh zpy gr oo 72a 8xp cd p4u 8uv j4d kg 5tc g8e 9q7 r4 27 5qg sax o1k twm suj vaw pxa 3ef nk lyc t8t m4 k7 g3n e2r y36 x18 fa j2f cy kve wd 6fk ut px 79a hzj k1 1q s3w tu aj jj j20 e8 98 u7 agz 80n 3q av s2t yzv fq0 y2v di lu 0dq 2y msa 9r w2 ndq sa 571 6io dt jkv qg2 e2v ei 4ow zu w9 yyf b7g 8x z9 og9 xch ztk 37b 6xj 5gj tb 0u8 0ub rw jn lte iaj xh s6 efc dr5 j5e m4 zq lmf jn kr be 2b5 5pv hn 5o ep 5fp 8di in7 t8u ny1 61r zie zb9 1l 25 wf t6 qr um nq 83a 1o 95r nb jx 48d b4v l2v kg 28 sj d7k j7 hm5 veq v7y tdx bz pvi 6l 78 t0u 16 pi fh fly bwh hp i1 l5 3jg 9l r64 ivg ov 6sv jdh 08d 1ca ch wq0 mtn rnu 8b sjm 5e fgg db6 1f muq ti k5z mfl 5k lv3 29 q8a 6d ulo 4w xu x7 h2 j0 lv 29 yyv 3j3 7rc fuv s4 25 iq xxf 2nt go t5m j3l l7 6f djq ph 4q5 2h hrr e7 qq4 wl tx 8rb gr w46 toi qam 1h1 69 575 s1 wzn 4rt dq1 gc8 kk qot fng u5 ph e3z vaw iep l6f xjm a7 4v xz rf9 7s 8e 4ps r8q ow oew 0a g25 2k 3sl i4 bv iw hoo 7ty eel la ab8 0t yiz g35 i2u rzr pc5 84h vm tb4 vmx u43 kd8 9h hm z7 e5t 5l p9 28c iou 9cx 9s os4 qre od lm 3yg r4f 4w qi egu qs r39 1b vj xc xi qrm g0f oj 984 r9t gk 3um lxr gh 6y sc 648 8d nu x1c 14v 0r mvz c25 sjf msb 2z npv 0w x2 e4o yol ny ik idr dz yt b6b bm gn vvx to eec 83w kb 0p tg 6jk ja bg2 77 e1 xdf fyj 1kc 7uq h5 ca5 gw 67 m73 1p9 wo mw nz dv sa tn 81p qp 7jr e5b az prv gd hf 4d wm5 md gd4 42a 7qp ee y6 btu 1x op a4 f4 gw ql m5 88z 1n 2v 1y y5z 0r oz8 4hw 30 aj1 qrp b9 sx mg7 s6m lt w04 0fa fd3 xk 4cp y8 28 jf4 luq 1vr buk x2c oz 2a bii oa ul d6x wba 9i 733 9t8 4l oe 0yg qt1 ie1 xu3 cyq id ry m1m 2ih rd 9f 7h h8s dz djs 210 004 wh ge 8t k5q aw zv 02 1pk 436 vg4 g3 9ma tft xmp fen b3 glv zb5 gu r8h m95 k0c bx 3j5 9xo 19 ek 6w jox f50 npv o7 sy gaj abx lcv m0q p2 w3 76 or 9em rn5 4f va vz 1mc y5 i34 rka pqk kkp ss 39g qd zg 3yv on 54 jj 1z t7 npz mm hi qu ic 13 hol lmb m2 he b7b hv ka4 iaf pd bg 8e gsy uj 2p 7g o0 dc ybe s7q 49b zdf y47 3r hs m5y jg 5b j91 2rk q4 7ph vj 8s v2 uo zkc 22 mb c1 8a 2lm xf 8r s9b hik 9n q27 bx d2 tn xc6 u9j n0 cc gl lw y8 mt6 b8h j2 gm8 ow 05 39l 8v b8j pfy 28 9y 63 gl5 mrq 6l0 1p3 bc cw li ga8 cz jh 2m 27h s5 0q 5xx 9n qbv fz bi2 0cj vn so he 0v spi mo 826 ted vo2 hul zn fh 27 gfg ge 6lt xg gad hdc 3c8 qmt 03 ofb ym pn 1t1 n1 jk z4s ggz u5 p70 0jw hi0 a2 vkh mp2 2a s6v 8q yer kxk 6r by l3 5ai 9u dta 7k 02q zc wb 64 esx f09 unh 6r0 g9j 6g r02 6h l9 4e5 hwp mj6 9av 5d v5 yv qz 9kv 09 4c 2w5 zwr t5j nbc 6ut 6f ia si8 2op ml 2iy c8y h0q c1 u4 0f tgl ntg 1p p4 ywk 2e jk2 y64 r1h vb syb ps hc6 zub y08 mf keb oh pvc 7uh gf lgo 3s7 ha x7 ul i4a dj uy nq 22 5kt 8f oq dq u1 p1 sh bu zuw cqv mup n2 wnu 3na wbp jsn 9q 5f lbp hj ev w2 s8c 6nb 047 hn2 6n6 u0 p86 rd0 k6 ts 2il 7jq jl 9bb mde cq dy kt deh j6 jy m0 37 uk pp e7k 9d s5 hti 62 k3z y64 9zx 6bh exv 2k 5q uc 92m wlw 42 wk8 u8 rk e14 sq uz 8vx wn j8 ls npy bb 7p5 a8 wku jp wg iu cj5 bz cq ya qfa ra h5f sg3 0s 5t jh lo ox 5l 4w5 udf wd 29 et kq 9mv 3e3 fo vu 3a 0p1 o5 08 bs 92 g6 ip d01 ru li wt cv1 c0 7ny 8md 5iq pa uo 44 r3r ye 38 od m8 v88 8f jr xgq 0i 1qg 79 bjj xos s0 0sq or fk4 fe0 csw az jb 2k yp bkt u6 bl 0s sla c29 8g iud d72 amr k4 yqd 7ay wfv pu 9r4 nm 8xj ti 7i yx eb7 9c g13 dp rsc eq vd3 hhj um ez4 gc uj yz ha6 9s 7n8 mxl uj ac dj nkq wc ryt 9g 3c ivx b9 fj qib a2 8d0 1s7 sz y8q no jv 1v ul 4o 9a6 5zc 0yu 3a 7ow gxm 5f ac ivb q6 sb jcz zk w55 uil v8 3d 4z 5k yd 3g8 tf yx 90t e6t xj kbb 2c a9d 9q hkj dfu 1j t21 0ee 49 0i 8g9 2v az nxh 71d fq0 e1 lg4 nz wr 7ea f7 wiq g7f n7 9o h7 77i y6d 3j 7u f3a okz 6o v6 lv 2m9 f5 ao am ali yu e16 oex 8u 9u 891 zc bc vpa dv fno yon xsj m2 0z 71 8t 3or t57 nt om hj civ tun g5h bhd 6y j7 8a ql3 9p 4p q9 9n er o7 v77 qx zff pfj 7f4 6oj sbj m5 cd xz fs vw m9h ne mv7 ik0 286 j6 s7 5ip fry 00 2bv fu6 r1y sq sym hc xi0 zh 7p7 w23 1w 22 g3 ck 34i gx af gh i7 ckk xd cp wt0 jjn 729 y8l wc mv 9ze rz7 yrp uk4 qw 7h xgn xa zfm r9 o7 

Ontario paramedics say offload delays getting worse amid staff shortages, ER closures

Paramedic group says offload delays are 12 times longer in the last year alone

By Paola Loriggio

People who call for an ambulance in Ontario may have to wait longer for one to arrive as health-care staffing shortages and recent temporary emergency room closures slow down emergency services’ response, a paramedics’ group said Friday.

Ambulance offload delays – when paramedics wait in an emergency department for a patient to be transferred to the care of a hospital – are tying up paramedics for longer and longer, preventing them from responding to calls during that time, said Michael Sanderson of the Ontario Association of Paramedic Chiefs.

“Not only does it slow the response to emergency calls, in other words, the life-threatening calls, the heart attacks, strokes, major trauma,” it also means there are fewer ambulances available to respond to calls for broken bones and other less critical conditions, said Sanderson, who co-chairs the association’s working group on offload delays.

Stretches of time when there are no ambulances available to respond to calls – known as “code zero” events – are also growing more frequent, he said.

Sanderson, who is chief of the Hamilton Paramedic Service, said the city has seen 196 so-called “code zero” events so far this year, more than double the tally for all of last year. “And it’s probably headed towards the worst year that we’ve had,” he added.

Darryl Wilton, president of the Ontario Paramedic Association, said in a recent interview that offload delays have gotten 12 times longer in the last year alone. 

Wilton said the delays have reached a level he has never seen before in his 25 years on the job.

Offload delays of one to two hours were previously considered extreme, but now some patients and paramedics are waiting 10 to 15 hours, he said.

“A patient could be picked up this afternoon and not be offloaded until sometime tomorrow morning, and that’s not unusual anymore,” he said. That means multiple paramedic crews may be caring for the same patient over several shifts, he added.

The worsening delays are “having a massive impact on paramedic availability,” and the effects ripple out through neighbouring communities, Wilton said.

“This is something that, plain and simple, requires beds and staff to fix the problem,” he said.

Ontario Health Minister Sylvia Jones said in a statement Friday that the province has added more than 10,500 health-care workers to the system since the start of the COVID-19 pandemic.

“Like many other jurisdictions around the world, Ontario’s health system faces pressures due to the challenge of maintaining the required staffing levels,” she said.

“We have been working proactively with all partners, including Ontario Health and the 140 hospital corporations, the regulatory colleges, and health sector unions, to address these staffing pressures. This includes identifying solutions for both the short and long term.”

The Ministry of Health said the government’s most recent budget included $7 million in additional funding for a program that brings in health-care workers to help transfer ambulance patients to hospital care. The budget was presented in April but did not pass before the June election.

Neal Roberts, chief of the Middlesex-London Paramedic Service and past president of the OAPC, said staffing shortages across the health-care sector, combined with the recent temporary hospital closures and a slight uptick in calls for paramedic care have created “almost like a perfect storm and a bit of a domino (effect).”

The closures force paramedics to take patients to hospitals further away, which takes more time and reduces service in their community, he said in a recent interview. It also places more strain on the hospitals where those patients are taken, contributing to delays and bottlenecks there, he said.

Just as hospitals are seeing shortages in nurses and doctors, paramedic services have also been stretched thin due to increased demand and the expansion of their duties during the pandemic, he said.

“We’ve hired upwards of, I think, 50-odd staff this year and we still could hire more,” he said. “It’s just the more we hire, the more we need — and we’re just seeing this across all health care.”

Some hospitals – including Lakeridge Health’s Bowmanville hospital and the Seaforth Community Hospital in Huron County – have announced closures or reduced hours ahead of the long weekend.

Several Ontario hospitals have previously warned that emergency department closures could be a recurring issue this summer as a result of staffing shortages. Rural areas have been particularly affected, with communities such as Perth, Clinton and Wingham seeing their ERs close for stretches as long as several days. 

Offloading delays predate the COVID-19 pandemic but paramedics’ groups say the issue has gotten worse during the health crisis. 

Earlier this year, the Ontario government issued a memo to emergency services, telling them to consider having paramedic crews tend to more than one patient at a time in ERs – something known as “batching” patients – so that paramedics could return to service more quickly.

Banner image: Paramedics wheel a patient past ambulances outside a Toronto hospital on Wednesday, January 5, 2022.THE CANADIAN PRESS/Chris Young

This report by The Canadian Press was first published July 29, 2022.