Province looks for air transport staff as Lifeflight doctors refuse to fly

The province is searching for nurses and doctors to help out with the air transport of critically ill patients, as Lifeflight doctors refuse to board the private planes Manitoba now relies on for its air ambulance service.

On Tuesday morning, Gordon Jebb, a 53-year-old man from The Pas, suffered a massive heart attack. He was in a coma on life support all day at St. Anthony's General Hospital in The Pas while a doctor made repeated calls to try to get him transported to the waiting ICU bed in Winnipeg.

"I could just feel the frustration in his voice, I could see that he was frustrated that he couldn't do nothing to send my brother to Winnipeg, because they were told there's no medevac," said Patrick Young, Jebb's 59-year-old brother. 

At 10:30 p.m. on Tuesday, 12 hours after his admission to hospital, a plane staffed with three medical personnel that Young said were paramedics arrived to transport Jebb out.

"I'm relieved that my brother's getting the help that he needs, but I was also feeling angry and frustrated, the process we had to go to get him there."

Citing safety concerns, the 17 doctors that staff Lifeflight have not been boarding air ambulance planes for the past two weeks, since the province grounded Lifeflight's two Cessna Citation jets. It laid off nine pilots and a maintenance crew last week in the final moves to privatize the service, ending the provincially run program's 34-year term.

The province has used private air ambulance companies half of the time in the past year, which often use smaller King Air 200s. On June 28, Babcock Canada, in partnership with Vanguard Air Care, which is a Division of Fast Air, took over Lifeflight operations on an interim basis.

Over the past year, Lifeflight physicians repeatedly warned the province they would stop flying if their concerns over the private carriers were not met.

In a June 15 memo circulated to Manitoba's health authorities and clinical leaders, Shared Health chief executive officer Brock Wright issued a call-out, writing: 

"For patients with more critical needs, we may need staff from your areas to assist transport staff. Neonatal and pediatric transports are covered … but it is possible that some adult transports may need assistance.

"We are supporting government in working with private air carriers to match available staff to the needs of patients needing transport."

'People are going to die'

A rural physician whose clinic received the memo says lives are now at risk.

"People are going to die for unnecessary reasons," said Ashley Blais, a family medicine and ER doctor in Ste. Rose du Lac, Man.

"It affects absolutely everybody and everybody needs to know."

She said Shared Health's call-out for doctors and nurses across the province to backfill the medevacs puts unrealistic and unsafe expectations on staff.

"Most docs outside of the large centres do not know how to operate a ventilator. They're asking us to get on these planes and manage critical care patients outside of our facility and outside of our scope of practice and outside of our level of skill or training," she said. 

"Lifeflight is an ICU on wheels in the air. And there's special doctors and special nurses that run ICUs in any hospital."

She added remote physicians are not trained on the physiological changes that happen when a person's body is in the air, let alone on life support, and the situation draws northern physicians away from their patients. 

"Your local surgeon or anesthesiologist may not be available because they are having to step in for Lifeflight." 

Working toward better service

Manitoba's health minister did not acknowledge the absence of Lifeflight physicians from the air ambulance program, but responded to Jebb's situation.

"While this patient was taken to hospital in Winnipeg without incident, it took too long to provide clinical transport. We have instructed departmental staff and clinical leadership to review this case in order to speed up that process," said Cameron Friesen, in a statement.

He added a triage team decides from a combination of doctors, nurses, respiratory therapists and paramedics on who staffs the planes, based on the patient's needs. He said patients receive continuous care between the Lifeflight teams and medical experts in their community.

"We continue to work to provide better service as the transition of the air ambulance program continues," he said. 

"This is completely unfair and almost completing colonization with northern Manitoba communities," countered Blais.

She said those living beyond the 200-km radius outside of Winnipeg, which is the limit for where STARS air ambulance flies, are at risk. She wants the Lifeflight program, including its planes and pilots, reinstated.

"Most people that live in the north are native and Indigenous of some degree. I do feel that if there was a bunch of politicians that lived outside of the 200-km radius, we would be having a very different discussion," she said.

Details on the request for proposals for a private company to take over the entire contract have not been released.

In past correspondence to the health minister, Lifeflight doctors cited concerns about the private planes' smaller size, accessibility of heart rate monitors, issues with lifts and noise when compared to the Citations, as well as concern over a lack of meaningful consultation with government about the transition.

 Amanda Lathlin, NDP MLA for The Pas, helped advocate for Jebb's family while they waited for a plane. She said she expected private planes, but not a gap in service for the north. 

"This is a crucial example that there's no plan in place," she said. 

"It just seems like this government is more concerned about saving money rather than saving lives."

Gordon Jebb made it to the Health Sciences in Winnipeg but is still unresponsive, according to family. His brother is calling on government and doctors to sort out their dispute.

"They need to do something, work together to resolve the situation before … people die. Plain and simple," said Young.

"People need that medical attention right away when they need it. And they can't wait at the hospital all day like my brother did today. That's ridiculous."