Public Safety Committee on Oct. 2nd, 2018

[Jocelyn Grondin]

No, not at all. Ultimately, it is one more thing that helps us. We cannot respond to all the calls we receive, and we avoid any conflict. Some paramedics like to engage in union or other squabbles and argue that they alone can use defibrillators and that they are responsible for saving lives. We do not agree with that, and we are the first to celebrate if someone's life is saved by an ordinary citizen, a firefighter, a police officer or even a butcher.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

My question is for both groups of medical first responders here today. Are the standards for training and use of the machines the same across Canada?

[Philip Girouard]

In Quebec, everything is standardized and the programs are consistent.

We are not aware of what the rest of Canada is doing.

[Shawn McLaren]

Our training is standardized across the country. The CPR and AED training that's received in Nova Scotia or Ontario is the same as the training received in B.C. and the Yukon.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

Is this training valid if someone moves to another province?

[Philip Girouard]

Are we talking about paramedics or the rest of the population?

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

We are talking about paramedics.

[Philip Girouard]

Our paramedics can practice only in Quebec, not in Ontario.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

OK.

[Philip Girouard]

Paramedics must go through an equivalency process to practice in Ontario and vice versa.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

I asked this question because, as you know, that is the case for many professions. It would be interesting to discuss the recognition of credentials in reference to training costs.

Cst Gendron, you talked about storage and the fact that you do not leave the devices in the vehicles mainly because of the cold. Is that right?

[Cst Bruno Gendron]

That's right. At the end of their shift, especially during winter because of the cold, police officers bring the AEDs inside the station to prevent problems with the batteries and electrodes.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

Are there special requirements for storing the devices?

[Cst Bruno Gendron]

No, they are stored in a Pelican case and protected. They are quite sturdy.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

OK, thank you.

That's it for me, Mr. Chair.

[The Chair, Liberal, John McKay]

Thank you.

Mr. Spengemann, please, you have seven minutes.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

Thank you very much, gentlemen. Thank you for your service. Thank you for being with us.

I think the problem is partly the geography of our country in the sense that in our rural centres we have a problem with response times and getting to places quickly enough. In our urban centres we may have the problem of not having enough of these around and potentially having multiple incidents in which an AED is required.

How important is complementarity of access? Is it only first responders who should have them, or should we widen the discussion to say we should have them in community centres, at hockey rinks, in schools and in seniors' residences? In many places they will already be there, but maybe not systemically enough. The idea is that we want to bring an AED within a radius or a time access point to an individual suffering an incident, to cover the entire country.

[Andrew Stanzel]

As I said earlier, I think the more out there the better it is and the faster time we have to get them in places. As far as arenas are concerned, in the city of Ottawa alone there have been multiple instances, even this year, of people being resuscitated at hockey rinks on the ice with their equipment on. They just cut the uniform off and shocked them right on the ice and got them back in those cases.

The issue with having static ones is with who is responsible for picking that up from the community centre and taking it somewhere else.

The more there are out there the better, because the better chance of survival there is by having one as close by as possible. Again, I don't think it necessarily takes away that element of having mobile ones out on the street as well, unless you're going to have somebody who would go to the arena and pick it up, but again, that would mean a time lag in getting it to the scene you need it at.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

We may not have exact numbers, but can you give the committee an appreciation, even if it's anecdotal, of how much better the odds of somebody surviving a cardiac event are if an AED is on hand?

[Jocelyn Grondin]

Some studies indicate that the likelihood of surviving a cardiac arrest is approximately 70% higher when an AED is used. As for whether they should be available everywhere, I will ask you the following question: does anyone question having fire extinguishers in public buildings today? The answer is no. To save physical assets, no one was afraid to make those investmens and raise public awareness about having an extinguisher. The same applies to AEDs. There will never be enough AEDs.

Of course, as I mentioned, the device cannot perform miracles. Whether we are talking about the rate of resuscitation or the chance of survival, we know that the Seattle region has the highest number of AEDs in North America. This city has the highest rate of training. It has the most AEDs. According to figures we have seen, Ottawa ranks second in North America. As we said, there are AEDs in all police cruisers, and it is the city where the largest number of people receive training.

When we spoke to the people at the Ottawa Paramedic Service a year or two ago, they told us that they had given CPR and first aid training to more than 15,000 people in recent years. If I go into cardiac arrest when in one of these cities, I have a better chance of surviving. That is not just chance. In fact, it has to do with the fact that measures were implemented, people were trained and they have the tool they need to respond.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

Thank you.

Again, anecdotally, if you as a first responder get called to an incident where somebody is in cardiac arrest, and somebody may or may not be doing CPR, what are the general odds of that person surviving?

[Andrew Stanzel]

With no AED, they're zero. You're not going to get them out of VT or VF, which are the two shockable rhythms, without applying an AED on them. CPR only keeps you in that rhythm long enough for either drugs or an AED to be applied.

My real job outside of volunteering is as an ICU nurse. You will not get someone back who's in VT or VF without medication or an AED. All CPR does is buy you time to get those things in place.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

Right, and more often than not if an AED isn't on hand, the odds are slim for that person.

I want to flip that around and talk to you as first responders about PTSD. This committee has done a lot of work on PTSD and OSIs. Not only would it improve the odds of the victim, obviously as the first priority, but what would it do for you as first responders to increase significantly the odds of people you're encountering and to be able to resuscitate them successfully?

[Andrew Stanzel]

Can I take that one again, just given our recent incident? We did our critical stress key debriefing last night with my members who were involved in that resuscitation. I was actually on the scene as well for it. It makes it a lot easier when you're having that debriefing to be able to say that the person's doing well rather than that the person hasn't come back. The ones you get back don't bother you. It's the ones you don't get back who will bother you.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

I appreciate that. Thank you very much.

From a completely different angle, is there an economic opportunity for Canada to manufacture and/or service, and/or distribute, these items, or are they coming from elsewhere? We always try to put on an economic lens.

Where are the ones you know of now being manufactured, and is it something we could explore, in theory?