CALGARY— Firefighter Mike Skipper enters every medical call with extreme caution. With a fire, he says, the task is straightforward, but overdoses are different.

“When you go to an overdose, you don’t really know what’s going to happen. You don’t know how much of the drug they’ve taken, how much NARCAN (a nasal spray containing naloxone) is going to need to be administered to get them out or even if you’re going to get them out,” Skipper said.

Still, amid all the uncertainty and an ever-increasing number of overdose calls, firefighters in Calgary and Edmonton seem confident. They’re adapting their practices, “embracing” naloxone and training others to follow suit.

Yet at the same time, a spokesman for Alberta’s paramedics says his people — among the most qualified to take on the opioid crisis — are stretched too thin and feeling the strain.

Read more:

Part one | Alberta’s opioid battle: Contact with drugs making first responders sick

Part two | Calgary police officer describes her close call with possible secondhand opioid exposure

Edmonton bouncer finds herself on the front line of the opioid crisis

Last year, Calgary firefighters responded to 1,115 overdose calls they link to fentanyl; according to Fire Chief Steve Dongworth, that’s two and a half times the number of calls the department responded to the year before. When it comes to treatment, Dongworth said, firefighters administered naloxone 318 times last year.

This past January was especially bad, totalling 133 fentanyl-related overdose calls — the worst month since 2012.

Meanwhile, in Edmonton, all firefighters were trained to administer naloxone in early 2017. That year, Fire Chief Ken Block said they used the life-saving antidote 101 times, starting in February. That’s about 25 per quarter, and it’s “still trending up,” said Block.

“We were hoping to have seen a plateau, but clearly we’re not there yet,” he added.

Working side by side with Alberta’s firefighters are the paramedics. These are the professionals who administer life-saving first aid and transport overdose patients to hospital — sometimes passing information to concerned firefighters eager to know whether that patient made it.

Mike Parker, president of the Health Sciences Association of Alberta (HSAA) and a front-line paramedic for 23 years, said these essential workers are being run ragged.

The union determined via a Freedom-of-Information request, released last month, that the number of calls of all kinds has increased by 20 per cent since 2012, while funding to EMS grew by just three per cent.

“When the frog is in the pot, you don’t really notice it, so it was slowly increasing,” said Parker, referring to the growing opioid crisis. “And then, all of a sudden, everyone looked around and realized ... this is the real deal.”

The situation has put paramedics under strain, Parker said.

“When you’re asking about responding to calls about people affected by fentanyl, that’s part of it,” Parker said. “You see the waste of life of a young person, or a tragic loss of an older person.... You’re dealing with that stressor of, ‘There’s just not enough of me,’ and every time I get out of the hospital there’s two or three calls waiting for just me. This is the workload stress that you don’t see.”

He said other professionals thrust onto the front lines of this crisis aren’t properly equipped and trained, especially when they’re told naloxone can help save a life.

“I’m talking even a worker in a library who goes to check a washroom and finds someone. There is no level of training that has gone on that is appropriate for the folks who are trying to deal with this,” said Parker. “If you’re not managing airways appropriately, you can give them all the NARCAN you want, but they’re still not breathing.”

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That’s why he feels it’s so important for paramedics to be available for calls, because they’re the best chance patients have to come back from opioid poisoning.

Read more: Experts agree naloxone is central to fighting Canada’s opioid crisis — but they also say it’s not a ‘wonder drug’

In the province’s latest budget, Health Minister Sarah Hoffman said there’s funding on the way to address paramedics’ resource concerns.

Calgary’s Chief Dongworth said that even before the crisis hit, firefighters had experience dealing with dangerous substances. They’ve always had breathing apparatus, medical-grade gloves, goggles and disposable coveralls. To date, they haven’t recorded any second-hand exposures.

Calgary’s fire department created a training program when they rolled out the use of naloxone in 2016, sharing tips with the Calgary Police Service, Calgary’s Corporate Security Division, peace officers, the Tsuu T’ina Nation, agencies in Regina and Halifax as well as Edmonton’s fire department.

So far this year, Edmonton firefighters have administered naloxone 34 times. None of those doses were used on firefighters, who according to Edmonton’s Chief Block call in HAZMAT teams when needed around opioid powder.

While always “concerned for their safety,” he feels the city’s firefighters have truly “embraced” naloxone.

“Having been a firefighter for over 27 years on the trucks, firefighters want to help people,” Block said. “And so this is one more tool in the tool box that allows us to do that.”

The Calgary fire department has two medical response units: vehicles equipped to respond to medical calls. But recently, the department began sending a fire engine along on medical calls for backup so that firefighters can focus on the patient and other workers can hold the scene to make sure they’re not interrupted.

“There’s more manpower, more hands on, so more things can be accomplished,” Skipper said. “Everything from ... administering oxygen, CPR compressions, just scene security — everything.”

He said most of the calls they deal with have a positive outcome. But, despite all their preparation, that’s not always the case.

“I try not to let it impact me,” Skipper said. “We’ve been called there because it’s an emergency situation. It’s part of my job, and at the end of the call, at the end of the day, if we’ve done everything we can to provide them with the opportunity to live ... if that doesn’t happen, it’s OK.”

With files from May Warren and Jennifer Friesen

Helen Pike is a Calgary-based reporter covering social justice, democracy and immigration. Follow her on Twitter: @Metropike

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