In good hands, at all costs

Peter Mostyn can only handle a couple more infant deaths before taking a desk job. The Whitehorse paramedic has been on the job about 15 years, and has seen more death than most people would in 10 lifetimes.

Peter Mostyn can only handle a couple more infant deaths before taking a desk job.

The Whitehorse paramedic has been on the job about 15 years, and has seen more death than most people would in 10 lifetimes.

He’s also seen more life.

Mostyn has delivered babies on the access road to the Marsh Lake dump with his partner acting as catcher, wedged against the back doors of the ambulance.

And he’s rushed critical patients to Whitehorse hospital, watched the medevac plane take off and, three weeks later, they’ve walked out of Vancouver General – a life saved.

Last Thursday, Mostyn and advanced care paramedic Andy McCann had just come on shift and were still running through their ambulance gear inventory – spinal kits, extrication chairs, defibrillators – when the first call came in:

A two-vehicle accident at the top of Two-Mile Hill and Range Road.

Ambulance One took the call, pulling out of the hospital onto Lewes Boulevard into morning traffic.

Across the bridge at the first light, a car sat blocking the intersection and the ambulance had to wait for the light to change.

It happened again on Main Street.

And again before the ambulance got past Boston Pizza.

“That’s normal,” said paramedic and station manager Terry Klassen, who was also on the call.

In fact, it was a fast run through town compared to some days, he said.

At the crash site, there were “walkers”- a good sign.

Both drivers were out of their vehicles walking around, but the paramedics checked them anyway, “to make sure they are OK and don’t just think they’re OK,” said McCann.

They also rescued a passenger still trapped in the vehicle, a small German shepherd puppy that looked a little shaken up.

This was a good call.

Many aren’t.

The Whitehorse ambulance station responds to more than 5,300 calls a year.

And of those, roughly 3,300 are alcohol related.

That’s high.

Way higher than almost every other jurisdiction in Canada.

Klassen came from Saskatchewan, where roughly 30 per cent of the calls were alcohol related.

In Whitehorse, it’s 70 per cent.

“Whitehorse is really unique for all kinds of reasons,” said emergency medical services director Nicholas Tilgner.

It’s the only city where he’s seen ambulances get parking tickets.

And it’s the only place where residents come up and complain the ambulance shouldn’t be left idling – even while paramedics are working on patients.

After caring for the accident victims on Two-Mile Hill, the ambulance crew headed to its second base, a portable trailer set up just below the Canada Games Centre, attached to the Wildland Fire building.

The ambulance has to be left idling outside, because the holding bay still needs a working garage door.

And the vehicle has to stay warm to make sure it starts and to keep all the medicines, fluids, IVs, oxygen tanks and electronics onboard from freezing.

The garage door was supposed to be installed by September.

But the EMS crews are still waiting.

They’re also waiting for a new station at the top of Two Mile Hill.

With that second station, we wouldn’t have had to come from Riverdale and had those traffic issues this morning, said Mostyn.

The second station has been in the works for years.

But no one’s sure when Community Services will break ground.

“It’s anywhere from breaking ground in the spring ‘til we don’t know,” said Mostyn.

In the interim, Whitehorse crews will remain in the Riverdale station, which was built in the late ‘80s for a crew of four.

Today, there are 44 on staff. And a dayshift sees 12 people sharing the small, crowded building.

But the paramedics are used to close quarters.

After spending some time at the Two-Mile Hill trailer, the ambulance crew headed to a breezy hangar at Alkan Air holding two Beechcraft King Airs.

Their long, cramped cabins are outfitted with life ports, to hook up IVs and oxygen, life slides, to clip in stretchers and a glorified powerbar to provide advanced life support on medevacs.

With two patients and at least two paramedics on board, it gets crowded, especially when all the wires and tubes are hooked up, creating what the paramedics refer to as a “spaghetti factory.”

The planes flew 700 medevacs last year and fewer than 20 of those were scheduled.

The rest were emergencies, said McCann.

A trip to Vancouver is $18,000.

In-territory medevacs are in the $6,000 range.

McCann, who’s been on a lot of them, has even flown to Halifax with patients to find empty mental health beds.

That trip takes three days, one way.

McCann came up from Atlanta, Georgia, three years ago to work as part of the Yukon’s medevac team “because it’s one of the best in North America,” he said.

Alkan’s pilots are no exception.

Exploding windshields, bird strikes, snapped steering cables and even the odd engine fire are all in a day’s work.

The only time McCann’s known them to turn a medevac flight around is when the heating system failed at altitude with the temperature hovering around minus 67 Celsius.

For Yukon residents, medevacs and ambulances are free, a rarity in Canada.

But they’re not free for visitors, including Canadians from Outside.

“The level of care provided here is some of the best in Canada,” said Klassen.

In Saskatchewan, a ride in an ambulance starts at $1,500, he said.

In Whitehorse, some clients use the ambulance to get a free taxi ride, said Mostyn.

“And some people are even brazen enough to admit it.”

The paramedics have their regulars, there are about 14 people they see almost daily.

And when they don’t see those regulars, they go looking.

“We want to make sure they’re OK,” said Tilgner.

“And because we see them every day, we know if something’s not right in their world, like a bloodied nose or a sore stomach.”

The paramedics deal with a lot of drunks, some with blood-alcohol levels that would kill an average person.

Across Canada anyone blowing 300 in a breathalyzer requires medical care.

In the Yukon, that number was upped to 350 because there were so many people blowing over 300.

“I’ve had 14-year-olds blow lethal amounts of alcohol and 20-year-olds blow 375,” said Mostyn.

To put that in perspective, getting drunk to the point of puking and being hung over for a few days usually sees people blowing in the 100s.

Whitehorse doesn’t have a medical detox, which means anyone blowing over 350 has to be taken to the hospital.

“They’re all dumped on the emergency department, which is not the best place,” said Mostyn.

Whitehorse needs a staffed, medical detox, he said.

If both ambulances are attending regulars downtown, the crews can’t go out on another call, even if a baby’s choking.

Leaving one patient for another would be “abandonment,” said McCann.

The Salvation Army, which sees the paramedics almost nightly, has a parking spot reserved for the ambulance.

The colossal amount of alcohol-related calls in the Yukon is a huge drain on its health-care system, said Tilgner.

Every year more and more calls are alcohol related, and “the numbers aren’t sustainable,” he said.

The emergency department is not the best place for many of these clients, he added.

“How do you provide long-lasting health care when people don’t have a roof over their head?

“How do you keep your wounds clean if you have no place to live?

“We lack options to ensure the continued health care of our clients.”

Tilgner’s originally from Ottawa, where Canadian Medical Association president Dr. Jeff Turnbull has set up homeless shelters that run as clinics with nurses, doctors, a medical detox and even vets to care for the down-and-out clients and their pets.

There are also street nurses who track down patients in alleys and under bridges to make sure they’re taking their meds.

Turnbull’s shelters save Ottawa’s health-care system more than $3.5 million a year.

“Turnbull had a lot of detractors, but he’s proven it works,” said Tilgner.

Whitehorse would benefit from a place like that, where the homeless can sleep, have warm food and get medical attention and supervision from staff they trust, he said.

“Right now, that defaults to the paramedics.

“And if my crews have one source of profound stress, it’s that.”

The paramedics in Whitehorse are like family, eating together, working out together, saving lives together and mourning together.

And that kinship extends to their patients.

“When a regular we’ve treated for years passes away, it’s almost like a friend has left us,” said Tilgner.

Most people become paramedics “because they genuinely want to help people,” said McCann.

And when they do help people and save lives, “those are the good days,” he said.

“Those are the days we live for.”

Contact Genesee Keevil at

gkeevil@yukon-news.com

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