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Ontario considers changes to ambulance rules

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TORONTO—Proposed changes to ambulance rules in Ontario could see paramedics take patients to facilities other than a hospital emergency department, or treat them and release them on scene.

People calling 911 for medical assistance could also be directed to other facilities in the community.

The proposals, posted this week on the province's regulatory registry, are aimed at easing hospital overcrowding.

“We know that there are a lot of people who are brought to hospital that don't necessarily need to be there and they end up spending hours, sometimes days in the emergency department and that is contributing to people being treated in hallways, storage rooms and so on,” Health Minister Christine Elliott said in an interview.

“The hospitals end up sort of being the place where everybody goes when they don't know where else to go.”

Ontario is contemplating phasing in the various changes, starting with letting paramedics take patients somewhere other than an ER, such as a mental health facility for someone in crisis.

Paramedics could also treat a patient on scene and refer them to a health-care provider outside of an ER, or simply treat them on scene.

“Often (patients) are taken to hospital where the paramedics may have to wait with them for hours, where it may be something that can be treated on the scene or treated in a local clinic or other community-based facility,” Elliott said, giving an example of someone falling and having scrapes but no broken bones.

The province is also contemplating changing the rules so an ambulance wouldn't necessarily be sent for callers with “low acuity” complaints.

Health-care professionals such as nurses would be working at ambulance communication centres to provide clinical advice to some callers, suggesting an appropriate care facility for them to go to.

Patient safety is the paramount consideration in all of those decisions, Elliott said.

“It's going to be necessary that whoever is going to be making the decision, whether it's the person at the dispatch centre or the paramedic . . . that they need to be properly trained and it needs to be within their scope of practice,” she said.

Ontario's spring budget mentioned that the government would explore allowing paramedics to take patients to facilities other than the local emergency department, and the previous Liberal government had said in 2017 that it was going to make that change.

People can submit comments on the government's proposed changes until Oct. 6.

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