The union representing Nova Scotia paramedics has been tweeting for five months using #codecritical to raise awareness about ambulance availability.

It's hoping the province will come up with ways to fix administrative delays in offloading patients at hospitals.

But that hasn't happened yet.

Michael Nickerson, business agent for the International Union of Operating Engineers local 727 in Sydney, said the paramedics group met the provincial minister of health in April and asked for a summit with other health-care partners to discuss solutions.

There has been no meeting and ambulances continue to be delayed at hospitals, he said.

Tracking ambulance availability

On Sunday, the union tweeted that no ambulances were available in Halifax Regional Municipality.

Last week, it tweeted out when only one was available in rural Cape Breton Regional Municipality.

"We're probably having a lot more code-criticals than we're tweeting out," Nickerson said. "It happens every day, all across the province, unfortunately. I'm not sure if it's getting any better. I would say it's probably status quo."

It's mainly a problem at the Queen Elizabeth II hospital in Halifax, but it also happens at the Cape Breton Regional Hospital and other hospitals across the province, he said.

An EHS ambulance waits in the New Waterford Consolidated Hospital parking lot. (Tom Ayers/CBC)

Nickerson said Emergency Health Services, which operates the ambulance system in the province, uses what is called dynamic deployment.

He said it's an efficient system that ensures if an ambulance is delayed at one location, another is brought in from elsewhere to fill the gap.

Missing the mark

But the system still needs some work, he said.

"It is a good system, but I still think we're missing the mark, and we need to come up with solutions and ideas on how to mitigate offload delays," Nickerson said. "I think that's where it starts, to get the trucks back out on the roads."

The union is not trying to scare the public, he said, but it is hoping to use public pressure to solve the problem.

"If you call 911 you will get an ambulance," Nickerson said. "We're not saying that you won't. You will. I'm not sure how long it will take. It may take a while.

"We've had reports in some instances that it has taken up to two hours for an ambulance to arrive on scene within the province. I'm not sure exactly where that is, but we have had that reported to us."

New program in the works

Jeff Fraser, director of operations for EHS, said a new community paramedic program being designed for Cape Breton and to be launched in the new year should help relieve the logjam at local hospitals.

The program will improve hospital discharge protocols to free up beds faster, examine possible ways to help repeat ambulance patients without taking them to the emergency room and allow a dedicated ambulance unit to help people with chronic disease get treatment in their homes.

"Not all these people necessarily need to go to the hospital and so the ability to have a program that's tailored to meet the needs of the people in Cape Breton is really what we're aiming towards," Fraser said.

The community paramedic model is based on a similar program launched in Halifax seven years ago, with paramedics attending nursing homes to help relieve some of the stress on hospitals.

The ambulance service is also working with the provincial health authority on different solutions in other communities, Fraser said.

"You need to look at what the needs are for the specific communities, and so we're doing that work with the health authority now," he said.