Paramedics in the Interlake-Eastern Regional Health Authority were concerned and confused after a notice was sent out telling them not to go to Winnipeg emergency rooms, their union says.

"They are professionals that know their job, and to get a directive like this that could put patients in jeopardy was definitely something that concerned them greatly," said Michelle Gawronsky, president of the Manitoba Government and General Employees' Union, which represents paramedics.

The notice from EMS director Louise Alarie said all patients in the health region, except those having a stroke, were to be transported and treated at the closest open regional hospital. It went out to paramedics on July 13.

That meant a patient just outside the Perimeter Highway could be driven kilometres farther to an Interlake emergency room, rather than just coming to Winnipeg.

Gawronsky said there's also an added risk because it's not necessarily the closest regional hospital, it's the closest open facility. Depending on doctor availability that can change daily, if not hourly, in rural areas.

That means paramedics could have been forced to make decisions that may not have been the best for patients, she added.

"When they make a judgment on which hospital to take a patient to it is always because it's in the best care of that patient," Gawronsky said. "So [they were given] a directive that says something differently or takes away their ability to make a decision when they are on scene."

On Wednesday, Alarie issued another memo retracting the earlier decision.

"The change was implied with good intent, but the quick impact was grand in scale both internally and externally," the memo said, adding paramedics should once again go to the closest emergency room without any regional considerations.

"It doesn't seem that the right hand knows what the left hand is doing. I think all Manitobans should be quite worried and very concerned about it," Gawronsky said.

In particular, Gawronsky said, she is concerned the decision was made in response to the restructuring of health services in Winnipeg, including the closing of half the city's emergency rooms. There currently is no indication it was related.

The original memo was misleading, an emailed statement from a Interlake-Eastern RHA spokesperson said.

"All patients should be transferred to the nearest facility that can offer the most appropriate care. The memo attempted to ensure services are being provided in the most appropriate manner for our residents, but that does not always mean taking patients to an IERHA facility — sometimes appropriate care is located in Winnipeg (depending on the case)," the statement said.

It added that the first memo gave a different impression, and that's why it was retracted and replaced with the second memo.

Gawronsky said the memo wasn't misleading, it was clear that the region wanted to implement a policy that could hurt patients.

"If this is any indication of what is going on, this memo itself … definitely states why Manitobans should be concerned about this," she said.