Wellesley firefighters to receive additional medical training through new agreement with Hamilton Health Sciences

By Galen Simmons, Local Journalism Initiative Reporter

Firefighters in Wellesley Township will soon have the opportunity to pursue additional medical training that will better equip them to respond to calls involving opioid overdoses and life-threatening allergic reactions thanks to a new agreement with Hamilton Health Sciences.

Currently, the fire department is limited to managing airways, oxygen administration and taking patient vitals while responding to people experiencing opioid overdoses and severe allergic reactions. The new agreement with Hamilton Health Sciences – the base hospital for Region of Waterloo Paramedic Services – will provide medical oversight and training that will allow local firefighters to perform delegated medical acts such as administering naloxone to people experiencing opioid overdoses or epinephrine to people experiencing severe allergic reactions.

“The skillset is not going to change significantly,” said Wellesley Fire Chief Paul Redman at township council’s committee of the whole meeting Nov. 12. “We’ve had discussions in the past about bringing on epi and … we’re not really adding a lot of skillsets, we’re just doing what we can do at the calls we already go to. The big one there would be the possibility of epi, which is one I’d personally like to see, just with the distance and the timing and the need for it. We’re already doing defibrillation … so that’s not going to change. … It will be reviewed by the base hospital, so every time we have a (vital signs absent), they will take our printout from our defibs and they’ll analyze the time structure of how effective our CPR is.

“There will be peer review from our advanced-medical committee reviewing what we’re doing. Overall though, it won’t be a big push. There’s probably going to be some firefighters who don’t want to do it. We have 65-plus (firefighters) and we find a lot of them do; a lot of our younger recruits are coming in, they’re going out on their own and doing advanced medical training. We don’t find a lot of problem with people trying to take that extra stuff on. It’s a win for the community and for the service we’re providing, and I think we’ll have a pretty good buy-in from most of the firefighters.”

The protocols for administering epinephrine and naloxone – a drug that temporarily reverses opioid overdose – are set out by the base-hospital physician and every call involving a delegated medical act will be reviewed for quality assurance. Hamilton Health Sciences will also be providing focused training for local firefighters in airway management and birthing.

Hamilton Health Sciences operates the Centre for Paramedic Education and Research (CPER), which offers outreach programs that provide medical, health and safety education to clinicians and fire services. CPER will train Wellesley firefighters who possess advanced medical skillsets (i.e. paramedics) to be the in-house trainers who deliver the yearly recertification to all department members. The cost to certify firefighters is approximately $80 per member and will be paid out of the department’s operational-training budget.

“Naloxone, when administered to some patients, the patients become very excitable after,” Coun. Shelley Wagner said. “ … What are we going to do to protect our firefighters who are on scene for that type of an event as far as protecting them from being injured by somebody who they’ve gone to assist?”

Redman said the medical criteria a patient needs to meet to have naloxone administered will come from the base-hospital physician, meaning firefighters will only administer the drug in specific circumstances.

“When we can get to that point, we can actually add in extra criteria and … with most of our medical committee being paramedics, there is a push to keep firefighters mostly doing adequate airway, as opposed to (administering) Narcan (naloxone),” he said. “One of the problems is the patients can come out in a very heightened state – aggressive, violent. So, if we are to get to that point, our protocols in-house on top of the medical requirements would probably be very strict on how many people we have there, law enforcement being on scene, that type of backup because our firefighters are there to provide medical assistance. We’re not there to subdue people.”

Redman said the process for getting firefighters trained to administer naloxone and epinephrine will be a long one, the first step of which is to train those members who will be peer trainers.

“By the end of next year, we might have only hit the oxygen-administration (training) and then defib the year after that. It’s a lot to get 65 firefighters coming in. We could not even be, maybe, at the delivery of naloxone for two or three years.

“These are big steps,” Redman said.