Photo: My Paramedic Blog

Numbers on BC Emergency Health Services' website give an idea what the province's paramedics are up against when they put on their uniforms.

517,309 patients treated or transported in 2017.

23,570 patients treated or transported this year.

1,402 patients treated or transported yesterday.

Glenn Braithwaite has been an emergency paramedic for 40 years, a decade of that as B.C. Ambulance Service district operations supervisor for the Okanagan.

"At the end of the day, everyone that puts on the uniform is professional. We understand there is an expectation from the public for us to provide the service they are literally paying us to do," he says.

Dr. Jeff Morley says "paramedics are probably exposed to some of the most trauma of any of the first-responder groups ... and, they are often not as celebrated or honoured in the media or the culture as some of the other first responders."

It's a point that sticks with Braithwaite.

Rates of PTSD, mental health disorders and suicide are extremely high for paramedics. Research shared in the Canadian Journal of Psychiatry in 2017 showed that "paramedics report experiencing very high rates of exposure to human suffering, for which they often feel responsible."

"At the end of the day, it can be a little bit difficult to disconnect after everything you've witnessed through your shift," said Braithwaite. "We see so many things that happen out there."

"It's the accumulated effects," says Morley. "Paramedics have attended dozens or perhaps hundreds of traumatic calls; whether it is a fatality, a suicide, an unexpected sudden death ... they are dealing with the effects of it."

"Those types of things pile on after a while," says Braithwaite.

"Most people will drive down the road and see an accident and think, oh my gosh, that looks absolutely horrible.... They are not getting close to the front line.... I'm walking right into the passenger compartment of the vehicle, and this is where my term unimaginable comes into play."

Compassion Fatigue

With respect to the stress, Braithwaite says "years ago, it was pull up your big boy socks and get on with the next call." That has changed.

The B.C. Ambulance Service developed a resiliency program that has proven to be an effective tool in helping first responders recognize and deal with catastrophic calls.

Today, there is a much better awareness of the psychological impact.

"We encourage them to reach out to their friends and family or the support services and programs we have in place for them," says Braithwaite.

Those services range from a critical incident stress program to more than 115 counsellors available 24/7.

However, Braithwaite added, "before it gets to that level, you have to have a very robust awareness of yourself, and what it is you are dealing with, and be able to put it into the context of what it is."



The Delta Nine

"Our critical-care paramedics are some of the highest trained pre-hospital professionals anywhere," according to Braithwaite. "Their skill set is the highest level of medical care available outside of a hospital."

Braithwaite shared the story of how nine young adults were saved in one horrible night.

In September 2016, a group of "kids" as Braithwaite put it, were having a party in Tsawwassen. "Of course, they didn't know that the cocaine they had bought had been laced with fentanyl."

Calls of multiple suspected overdoses started coming in in the early hours of the morning.

"One person got their cocaine and left and did it a couple of blocks from the party scene, and was found in full cardiac arrest." Braithwaite said the person was essentially dead. "The heart had stopped, and breathing had stopped."

Then, another person was found around the corner in a similar situation, not breathing. And shortly after that, they received a call at the party that there were more people unconscious, not breathing.

"We responded to all of those situations, and just as we were finishing, we received another call."

There was one male missing from the party. With the help of Delta Police, they tracked down the man, unconscious in his own backyard. They were able to resuscitate him.

"This was all at 4 o'clock in the morning. By the time his family woke up, they would have found him dead."

Everybody survived that night. And Braithwaite says that's just one of the 500,000 stories each year that ambulance paramedics are part of in B.C.

Paramedics have a term they like to use: "The emergency stops when we arrive."

"When we come to your front door, you have an expectation that we are going to help you. And sometimes you have to dig down really deep-down to do that. You do need to go through each shift prepared to meet the expectations, but also the responsibilities of the licence that you carry in your pocket."

"After 40 years," Braithwaite said, "I consider it a privilege to have been given that responsibility."

In part four of Front-line Frequencies, we talk to firefighters in "Do not use the term hero."