The vast majority of Ontarian’s, as many as 12 of 13.5
million residents, live within the 90 minute catchment of a regional cath lab
when transported by land ambulance. One notable exception is the tens of
thousands of people that migrate to Muskoka and cottage country during the
summer months, especially on weekends. By design cottages are remote places and
access is complicated by kilometres of twisting gravel roads and in many
instances the need to cross water. Achieving 90 minute DTB times using land
ambulance is not possible from most cottages. The cath labs at South Lake in
Newmarket and Health Sciences North in Sudbury are tantalizingly close but not
quite attainable. Even the proposed cath lab at Royal Victoria in Barrie will
lie outside the 90 minute window for most of cottage country. The new cath lab
at Peterborough is now accessible from many cottages in the Kawartha Lakes and
Haliburton regions, but certainly not all.
It is the right time to consider the viability of having an
air ambulance dedicated to Muskoka and cottage country, perhaps only as a May
to September program, perhaps only from Friday to Monday. The appropriate first
step is a review of EMS call volumes for the past several years, looking at
calls – cardiac, trauma and other – where air ambulance was requested or where
the patient may have benefited from air ambulance. If the data suggests that
call volumes warrant a dedicated helicopter for Muskoka a deployment strategy should
be developed. This may involve having a helicopter based out of Muskoka Airport
in Bracebridge during peak volume periods.
The high cost of building and maintaining Ontario’s world
class STEMI response program has been met. The cost of providing access to the
program for tens of thousands of people that have a permanent residence within
the 90 minute window but spend a significant number of days each year cottaging
or vacationing on the periphery is incremental. A dedicated air ambulance for Muskoka, tasked
with getting STEMI patients to the cath lab within the 90 minute window, should
be viewed as a value added proposition, not an expense. It was the tax dollars
of the people in cottage country that in no small part funded the development
of the Province’s STEMI program, it seems only fair that a relatively few
additional dollars be invested to provide them with year round access.
The true value of an air ambulance access program will be
realized when patients that would have been left debilitated (or dead) and
facing months of expensive rehab are now coming home within days of their MI
with little or no loss of heart function, little or no death of heart muscle
and enjoying a rapid return to a lifestyle that in many cases is better than
what they were experiencing pre-heart attack.
The cost saving to the healthcare system when these outcomes are
achieved is significant.
Leading Cause Prevention Strategies, along with many other
CPR and First Aid training agencies and local EMS services, is dedicated to
providing Cottager’s with the knowledge and tools to achieve the best possible
outcomes for cardiovascular emergencies. The first step in achieving good
outcomes is early recognition and management of the warning signs and symptoms of
heart attack, stroke and cardiac arrest. Even if first responders restore a
blood pumping rhythm to a cardiac arrest patient with early CPR and early
Defibrillation patient outcome is compromised if there is no early access to
advanced care. Even if first responders recognize the signs of heart attack and
Call 911 immediately, patient outcome is compromised if there is a delay in
restoring blood flow to the affected part of the heart. The work that we do
helping Lake Associations and cottage families build cardiac safe environments
will be lost if patients do not have rapid access to advanced care and cardiac
cath labs.
