Part One: emergency services on the Prairies a chaotic dance

“As I got to the gate, I could hear the click of the emergency brake letting go (on the tractor),” said Chad Rogers in a video featuring his accident on the STARS website.

He is what the Shock Trauma Air Rescue Society (STARS) calls a Very Important Patient (VIP).

Rogers, who had been opening a gate, ran after the runaway tractor and the baler it had been towing.

The Assiniboia-area farmer almost reached the door, but his leg was dragged out from underneath him and the tractor and then the baler ran him over.

He texted his mom, who called 911. She also called a neighbour and a few friends who were local first responders to go to the scene.

A few of them stood beside the roadway to flag down the ambulance.

Rogers had a shattered pelvis and cracked vertebrae and was bleeding internally.

The local hospital didn’t have the pelvic brace needed to hold his injury together and stop the bleeding. Luckily for Rogers, a STARS helicopter arrived with the necessary device.

The helicopter also carried the blood needed to replace the nine units he had lost.

Rogers said he owes STARS his life. 

“I don’t know what we did without them before . . . it was a different outcome for sure for a lot of different people.”

As a paramedic for more than 15 years, Willem van Lankvelt already had a deep appreciation for STARS before becoming a VIP patient himself.

After a collision with a truck, while riding his bike on a family vacation, the crew that picked him up and stabilized him technically knew who he was through work, but due to the nature of his injuries, they didn’t recognize him.

“Even as an advanced care paramedic, I would have had a very difficult time managing myself, said van Lankvelt about the extent of his injuries in his STARS VIP video.

The medical attention he needed was beyond what the local medical facility could offer, but emergency dispatchers and coordinators, RCMP, and paramedics in rural Saskatchewan and Manitoba work every day to ensure that people receive the care they need.

If that care isn’t available locally, the patient is transported by air or ambulance to a larger centre.

According to the STARS website, 3,365 missions were carried out from six bases in Alberta, Saskatchewan, and Manitoba from April through March of the 2022-23 fiscal year, with trauma and vehicle incidents making up a combined 37 per cent of those calls.

“There are many more moving parts to this “chain of survival” than people realize,” said Andrea Robertson, a former STARS CEO.

“We rely on RCMP. We rely on city police. We rely on fire. So, when we’re coming, someone is securing the scene for us. Someone is out making sure that that scene is safe for us to land. That’s often EMS, fire, police, and RCMP. Don’t forget the small rural hospital that picks up the phone and says you know what, we need to get someone into Saskatoon or into Regina.”

Darcy McKay, the provincial director of STARS in Saskatchewan, calls it a “chaotic dance,” a logistical challenge that his team members have repeatedly overcome.

“All the logistics and coordination are remarkable.”

It starts with dispatchers

McKay said 911 dispatchers are invaluable in gathering the details and coordinating the services required to respond to a call.

From one central location, the Shared Health Emergency Medical Services and Medical Transportation Coordination Centre in Manitoba handles all emergency calls outside of Winnipeg and coordinates inter-hospital transfers.

“You’re stuck in that room, you’re hearing all that information,” said McKay. 

When an emergency takes place, Shared Health director Kyle Sneesby said his staff works closely with emergency services from across Manitoba, from EMS to STARS and other helicopter services, to get the right services to the right places.

While dispatchers are not on the scene, being involved in every rural emergency across the province takes a mental and emotional toll, even when they’re not directly responding to it. When someone calls, it is on the worst day of their lives when they or their loved ones are in pain, and Sneesby said his staff does an exceptional job in making sure patients get the right care when and where they need it.

“It’s a real unique environment and it takes a unique skill set to excel at it. I think the staff that we have are incredible at the work that they do in managing the stresses and the challenges with the job,” said Sneesby.

Part of the success of the response is also the information coming from the other end of the line. The best caller is one who is physically there, he said. However, people don’t realize the valuable information they have even if they can’t stay on the scene.

“They may be able to provide a lot more information than they realize. Just answering those questions as accurately as they can really help to ensure that the right resource, the right level of care, is sent as quickly as possible to that scene.”

Like many provinces and rural areas, Sneesby said the biggest challenge is geography.

“Not every community has its own ambulance, so part of the challenge is making sure that you maintain a real good response time, a reasonable response time to as many populated areas of the province as possible.” 

According to the Manitoba Association of Health Professionals, staffing shortages at the Medical Transportation Coordination Centre, which is based in Brandon, can sometimes mean callers in rural and northern areas can wait up to 10 minutes for a dispatcher to pick up the phone. 

Whenever a call comes in and STARS is needed, a helicopter is ready to take to the air as quickly and safely as possible while a team on the ground is already fighting against time, injury, and the elements.

While STARS has been an invaluable service for those living in areas that rely on air ambulances, the number of helicopter pilots in the country is on the decline.

Transport Canada issued 62 helicopter pilot licences in 2012. But in 2022, that number dropped by 80 per cent to just 12, raising concerns over what that means for air ambulance services.

Learning how to be a helicopter pilot can be prohibitively expensive. A student interested in such a career can pay up to $100,000 for the training.

One suggestion to attract new recruits is to increase pilot pay so they can pay off their student loans. But outreach is also needed, letting students know that there are a growing number of vacancies in aviation, which wasn’t the case even five years ago.  

Minding the weather and the utilities during an emergency

As the director of intelligence services with the Saskatchewan Public Safety Agency (SPSA), Brian Schafer manages many different emergency situations, from water rescues to large-scale accidents. His team is on the clock to gather information and make the calls on whether a situation needs local EMS, STARS, or even a Hazmat team. 

When a train derails, like the one that occurred near Macoun, Sask., in December 2022, information about weather and infrastructure is needed quickly.

“That information helps the incident commander on scene, make those types of decisions of what’s the next play and what’s our future plays? The weather can be calm right now, but come 11 o’clock tonight, those winds can be coming out of the west at 80 kilometres an hour,” said Schafer, causing the situation to change from hour to hour, even minute to minute.

Shifting wind could have forced the evacuation of Macoun, 2.2 kilometres away from the blaze, along tracks that ran just metres away from Highway 39.  

Emergency crews closed the highways, and some rural residents evacuated their farms.

The SPSA has meteorologists on staff and the ability to connect to Saskatchewan crown corporations at a moment’s notice to know how to deal with overhead and underground utility lines like gas and power.

Without that knowledge, utilities can worsen a disaster. For example, during Quebec’s 2013 Lac-Mégantic rail disaster, blazing oil flowed into the town’s sewer drains, causing flames to erupt from manholes, chimneys and basements further down the pipeline.