Volunteer Firefighters A Lifeline In Rural Alberta With Stressed EMS System
When firefighters got to the scene of the crash, they knew it was going to be a difficult day: the woman trapped inside was the wife of a firefighter who was rushing to the scene.
“My heart sank,” Glendon, Alta., firefighter Derek Cote said of the call, “I [still] didn’t know how bad it was.”
On a blustery winter morning, volunteer firefighters tore off the pickup truck’s roof with the teeth of their life.
Her truck had rolled into a ditch on Highway 28 in northeast Alberta. The driver was bumped into a smashed door buried in 60 centimeters of fresh snow.
About 16 minutes after receiving the emergency call, the first firefighters arrived at the scene. Next came RCMP and finally paramedics, about 25 minutes after the first call.
The ambulance drove away with the patient on a stretcher, her husband at her side. Luckily her injuries were minor.
In a small town like Glendon, with a population of 448, firefighters are used to waiting for an ambulance as the emergency call center is 25 miles away in the town of Bonnyville. But the pressure on the volunteer crews has increased in recent years.
From 2017 to 2022, emergency responder numbers in Alberta grew 39 percent, according to a report released in January, with rural areas seeing even faster growth. Over the same five-year period, the average ambulance response time increased by 18.5 minutes.
That’s taking a toll on the volunteers, said Glendon station manager Dan Amalia.
“There are times when we do 15, 20 minutes of CPR and it’s just physically demanding,” Amalia said. “[If it’s] someone you know who can have quite a mental toll while you wait and wait for emergency services to arrive.”
Nearly 80 percent of all firefighters in Canada are volunteers, according to the Canadian Association of Fire Chiefs survey.
A long way for country paramedics
One of the biggest issues with retaining local paramedics is that rural ambulances regularly travel long distances in non-emergency situations, said Bonnyville Regional Fire Authority chief Dan Heney.
On a typical day, one of the three ambulances available in Bonnyville is driving someone to Edmonton for medical attention. Normally, the round trip takes about six hours, but if there’s a delay at the hospital or another call within the city, the trip can take a full 12-hour shift.
“One ambulance that’s moved from here to Edmonton means one less ambulance that’s here to respond to community emergencies,” Heney said.
EMS transfers between facilities require fully trained paramedics traveling long distances, often for non-urgent healthcare needs such as a specialist appointment, CT scan, or surgery.
According to Alberta Health Services, EMS processed over 176,000 inter-facility referrals in the last fiscal year. The province recently announced several measures to reduce the number of non-emergency ambulance transfers.
A call for proposals to outsource some of these paramedic transfers to private contractors was published on February 2. The province said once on site, 44,000 transfers could be diverted by paramedics. But it would only help with inter-facility transfers within the Calgary and Edmonton regions, not rural communities.
In Bonnyville, about 50 percent of EMS calls are non-urgent transfers, according to Heney.
The problem is just a symptom of an already overwhelmed system, said Jason Stedman, a Lac La Biche paramedic and also a councilor on Lac La Biche County Council.
“Rural EMS and rural fires require attention because I’ve never seen the system like this,” Stedman said.
In his 22-year career, Stedman said he’s never faced so many daily emergency service bottlenecks.
According to the EMS report, Alberta’s growing population and health issues such as the opioid epidemic are contributing to an increasing number of paramedic trips. It also cites COVID-19 and hospital wait times for longer ambulance response times.
Paramedic staffing shortages have become so severe at Lac La Biche that ambulances are unable to perform transfers between facilities, Stedman said. This means that patients who do not need urgent medical attention outside of their community must find their own transport or travel on the local medevac plane.
“Things are happening to address it,” he said, “but realistically it’s going to take a while for it to sort itself out — and the public should be aware of that.”
support for firefighters
As the province continues to develop its plan to address emergency service shortages, some initiatives are specifically aimed at helping rural firefighters deal with the number of medical emergencies.
An Alberta program called Before Operational Stress has allowed more first responders to access mental health services since it received federal funding in 2022. A study found that trauma and injuries from workplace stress are the top reasons firefighters need to take time off.
Heney said since mental health resources have become more available, he’s seen first responders who left the service return to work.
“Looking back on my career, we’ve only just scratched the surface of post-traumatic stress and haven’t done well in making people aware of it.”
Heney said he’s heartened to see that firefighters don’t face the same stigma they once did when it comes to trauma.
“Now nobody looks sideways at you when they find out you called for help,” he said.
A growing number of Alberta communities also have first aid medical programs in their local fire departments.
The training allows firefighters to be better prepared to keep someone in a stable condition until paramedics show up or reach a hospital. These skills can cover a wide range of training, and as the EMS report noted, the services provided by MFR vary from community to community.
Paul McLauchlin, president of Alberta’s rural communities, said the province needs to recognize that volunteers are doing more medical work.
Last fall, the RMA passed a resolution to lobby the government to compensate rural communities that have MFR-trained firefighters.
McLauchlin, as Reeve in Ponoka County, said it’s frustrating to have seen situations where volunteer firefighters are called to keep someone alive when an ambulance isn’t around.
“If [the province] end up paying to stop using our medical first responders as stopgaps for inefficiencies in the emergency medical system,” he said.