Hours of waiting for the ambulance with a dislocated hip

In Montreal, an evening with friends took a bad turn when a guest had the misfortune to make a wrong move. She then found herself on the ground, her hip dislocated. Unable to get up and beset by intense pain, she had to wait four hours before the paramedics came to her aid.

“The slightest movement hurt me horribly. I remained lying on the kitchen floor, without moving, until the ambulance arrived,” says Nathalie Paquin, a young fifty-year-old who had a hip prosthesis fitted ten years ago because of of a congenital malformation.

If she had already had to call the ambulance services in the past because her hip had already dislocated, she had never waited for help so long. “In shock”, Nathalie Paquin saw, on the night of November 26 to 27, the minutes turn into hours under the worried eyes of her friends.

“She was unlucky”

According to the prioritization system for calls made to 911, the degree of urgency of Nathalie Paquin’s situation was halfway between high priority and low priority. Thus, it was established that, despite the fact that her state of health carried a “risk of deterioration”, she did not face an imminent danger of death. So she could tolerate some waiting.

For cases similar to that of Nathalie Paquin, the spokesperson for Urgences-santé Jean-Pierre Rouleau specifies that the wait after the call is ideally within half an hour. Consequently, a response time of four hours is “unacceptable”, but remains “circumstantial”, he explains.

Mr. Rouleau adds that on the night of November 26 to 27, « there was a lack, at the very least, of about fifteen ambulances on the territory », for lack of manpower. Added to this was a particularly high volume of calls. It would be this combination of circumstances that would have ensured that on four occasions, the ambulances which were initially to provide assistance to Ms. Paquin were diverted to higher priority calls.

The spokesperson for Urgences-santé specifies that during the wait, three telephone interactions with Ms. Paquin’s friends confirmed the stability of her condition. « Yes, she was in pain and it is excessively sad, but there is nothing to indicate that her life could be in danger. »

During the waiting hours, Nathalie Paquin (on the right) was surrounded by friends, including Caroline (on the left). Photo: Courtesy, Nathalie Paquin

“It fights at the doors to leave, not to return”

For the president of the pre-hospital union, Claude Lamarche, the inability of paramedics to respond quickly to a call like that of Nathalie Paquin is attributable, « without wanting to excuse it », to the crying lack of staff in the paramedical services sector. .

In Montreal, he mentions that it is “very frequent” that Urgences-santé does not manage to deploy the “safe” personnel necessary to cover the territory during the three shifts. And this, despite the incentives offered, the overtime offered or imposed and the reinforcement provided by placement agencies.

One of the causes of the problem of retaining and attracting manpower, according to Claude Lamarche, is the current working conditions of paramedics. “People quit their paramedic careers because it’s not an attractive job. We are still the least paid in the health and emergency services network.”

For his part, the Urgences-santé representative wishes to reiterate that every effort is being made to “hire paramedics as soon as the opportunity arises” in order to prevent this type of “regrettable” situation from repeating itself.

The consideration of pain in the prioritization of calls

When help arrived in the early morning, Nathalie Paquin remembers having seen paramedics with “catastrophic” mines apologizing for their delay in intervention. “The paramedics told me that the emergencies treated before me had not turned out to be as urgent as me.”

Shaken by this experience, she regrets that the pain does not seem to have been a determining factor in the priority of her call by the emergency services.

“It is sure that they first help people whose lives are in danger, she agrees. I couldn’t die from the dislocation in my hip, but it’s as if the suffering was not taken into account.

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