In Case of Heat Domes (etc.) New West Pioneers Emergency Centre

July 17, 2024

The 2021 heat dome inspired New Westminster to consider a new way of responding to extreme heat events.

New Westminster is pioneering a new way to respond to extreme heat events that overwhelm the resources of local first responders.

The development of the emergency monitoring centre came out of the devastation of the 2021 heat dome, in which 28 New West residents died of heat-related illness. The emergency monitoring centre (EMC) is designed to increase the capacity and resilience of the fire department, ambulance service and hospital emergency department during mass casualty events such as extreme heat events.

Acting fire Chief Brad Davie, who started working with New Westminster Fire and Rescue Services in 1999, worked on the deadliest night of the heat dome. He described it as being one of the worst nights of his entire career because services were overwhelmed to the point that first responders were unable to respond to all of those in need.

Following the heat dome, New Westminster Fire and Rescue Services did an internal audit to determine how it would respond if faced with a similar incident in the future.

Because the heat dome was a regional event, Davie said cities could not get support from neighbouring communities and partners, as they normally would in the event of incidents such as fires.

Here in New West, he said crews were going from call to call, but there were more calls for service than fire trucks available to respond. At those calls, firefighters were required to wait with patients until an ambulance arrived.

“And the ambulances are running from severe call to severe call to severe call, and they never come to your call. So, you're effectively not available for service until they can get to you. But meanwhile, more severe calls are coming in at the city,” Davie said. “Eventually, you could end up with all of your apparatus unavailable because they're engaging moderate- or low-risk calls, and nobody now is available from fire department to respond to high-risk calls.”

A new way to respond

Recognizing the challenges posed by regional events that stretch the resources of first responders, the fire department began working with Fraser Health Home Health on the establishment of an emergency monitoring centre.

The centre will only be activated when certain criteria is met – an extreme heat event that is overwhelming the ambulance service and hospital’s emergency department.

“What it would be is we would be overwhelmed, for lack of a better word, or we would have a demand for service that was so high that we'd be struggling to keep ahead of it,” Davie said. “And then we would contact the province and the province would confirm that our temperatures outside are 33 degrees during the day, about 17 degrees at night and expect it to be so for two or three days.”

The province, through the Ministry of Emergency management climate readiness, approves activation of the EMC.

The EMC will be located in a central venue that’s air-conditioned, has a backup generator, is accessible to ambulances, and is pre-stocked with supplies.

In order to implement the EMC program, New Westminster Fire and Rescue Service had to train its firefighters to be emergency medical responders.

“The whole intent was to we could do a better patient assessment model. We are now also allowed to transport,” Davie said. “But then there's a side benefit that in every call we go to every day, the community gets an enhanced service as well.”

When the centre is activated, firefighters responding to medical emergency calls will assess a patient’s status – people assessed with low-acuity conditions will be taken to the EMC, where they’ll be monitored, while sicker patients will be taken to the hospital by the ambulance service.

According to a report to city council, this frees up fire apparatus, reduces the demand for ambulances, and decreases the congestion in the emergency department.

By taking folks to the emergency monitoring centre, rather than waiting with them at their homes for an ambulance, firefighters will be freed up to respond to other calls – including fires.

The centre will be staffed with nurses, firefighters and care aides who can monitor multiple patients.

“If something happens, we have the nurses and the firefighters at this centre monitoring these patients,” Davie said. “We have direct radio communication, and an ambulance now comes; the ambulance can come to the monitoring centre and then transfer that person to the hospital.”

Dry runs

Davie said the emergency monitoring centre has been in place since 2022 but it has yet to meet the criteria needed for activation.

“We do a dry run once a year, to make sure that we're ready to ready to go,” he said. “I think this has come to the forefront because Emergency Management and Climate Readiness BC attended our sessions, and they're like, ‘Wow, this is good. We have to expand this out more.’”

Davie said the current plan is to activate the emergency monitoring centre during extreme heat events in New West, but there’s talk that it could be expanded to be part of the response to other types of emergencies.

“There's nobody else in the province that does this, and other cities are starting to look at us in the emergency management. And the reason I know that nobody else does is because emergency management and climate readiness has told us that,” he told the Record. “They want to see this program expand and they want to see other cities do it. I think they're evaluating it at this point as to whether that would happen. So, we're not sure where it's all going to land yet.”

New Westminster city council recently endorsed a submission nominating the EMC project for a Union of B.C. Municipality’s 2024 Community Excellence in Service Delivery Award.

Fast facts:

How will people get to the emergency monitoring centre if first responders deem that’s where they should be?

“Once people have been assessed and referred to the centre, they would be transported to the venue in a couple of different ways, including taxi (escorted by emergency medical responders) and a low-acuity van operated by the ambulance service,” Davie said. “We didn't want to lock down to one form of transport over another simply because we're going to use the one that's the quickest to free up the apparatus, the quickest to go to another call.”

What happens when people arrive at the emergency monitoring centre?

On arrival at the centre, individuals would be assessed by a nurse, who confirms they’re where they need to be. Staff will take steps to track any personal belongings, such as canes, that people may have brought with them.

“We do have some chairs and seated areas and lounge areas that are air conditioned within the area, where people can go to and people can be,” Davie said. “We have washrooms. We have food and water if need be.”

What happens if someone’s condition worsens while they’re at the EMC?

“It’s set up and ready to go to treat anything we could potentially have to treat within our scope,” Davie said. “So, we would start treatment there and call for an ambulance.”

Who will be staffing the Emergency Monitoring Centre?

Once activated, Fraser Health would send out two nurses and two care aides, who are trained and familiar with the centre. Two firefighters would be sent to the site, which means one truck is temporarily available to respond to calls.

“We'd call in two new people off-duty that would come in, and the province would pay for that,” Davie said. “And then they would get that truck back in service.”

Is it ready to go?

The centre has not met the criteria required for activation since being created – because the call volume has not reached the level seen during the heat dome. The EMC is ready to open if and when it is required.

 “Every spring when it starts to get warm, we do a walk-through with all the staff and everybody to make sure everybody's ready to go, check all our equipment again,” Davie said. “We’re pretty confident we will operate quite well because we've done that so many times now.”

[Top photo: Officials from the City of New Westminster and Fraser Health do a dry run of the emergency monitoring centre each year. From left: Ryan Weber (parks); Cory Hansen (New West Emergency Management Office); Brad Davie (fire); Tracey Demibras (Fraser Health Home Health); Nikki Paash (Fraser Health Authority); Stephen Minoza (FHA); Nana Anoh (FHA).]