Welcome to 'level zero': Ottawa's daily struggle to find enough ambulances

Every day in Ottawa sometimes multiple times a day there are no ambulances to respond to an emergency, a situation that'soccurring more frequently and suggests the city's paramedic service isunder too much pressure.

"It is happening daily," confirmedAnthony DiMonte, the city's manager of emergency and protective services.

"Having it multiple times a day isabsolutelyan indicator of a system under pressure. And demand is outweighing our capacity."

The Ottawa Paramedic Serviceroutinelyexperiences what's called "level zero," a state in whichthere are no available ambulances to dispatch. Andaccording to Di Monte, the last time the situation was this critical was 12 years ago.

'Level zero' occurred 22 times over 2-week period

Even if the paramedic service is fully staffed during a shift,it can run out of ambulanceswhen there's a sudden surge of emergency calls for example, during bad weather.

But the frequency with whichparamedics runout of ambulanceshas been increasing. The dispatchcentre recently had to send out level zeroalerts to all Ottawa hospitals 22 timesover a two-week period.

"An alarm goes off when it happens. And it should be alarming," said Darryl Wilton, president of the Professional Paramedic Association of Ottawa.

A level zero alert "puts every paramedic on edge," Wilton added.

"There are people out there who havedialled911 with life-threatening emergencies who have no access to medical care," he said.

For life-threatening emergency calls, paramedics are sent in emergency sedans calledrapid response units, in addition to the next available ambulance. And in thecase of "cardiac arrests, other emergency partners (such as the Ottawa Police Service and Ottawa Fire Services) may also be tiered to respond to the call," the city said in a statement.

'It needs to stop'

Butneighbouring municipalities say they've also beenforced to pick up the slack when Ottawa has no free ambulances.

"It needs to stop," said Mike Nolan,chief of the County of Renfrew Paramedic Service. "Frankly, it's disheartening to paramedics, but it's dangerous to the public."

The alerts can last more than an hour, meaningparamedics from outside the city have to travel long distances into Ottawa to help.

Nolan said his staff sometimes spends up to six hours more than half a typicalshift responding to calls in the capital.

'Broken' system

The fact that Ottawa routinely runs out of ambulances is the latest revelation in a growing dispute between the city's paramedic service and paramedic services in neighbouring municipalities.

Counties outside of Ottawa have becoming increasingly frustrated by the growing numbers of calls they answer in the city. For instance,Prescott-Russellrecently filed a complaint with the province about a specific night last August when Ottawa called theirparamedics for help 13 times.

That led toa damningreport suggesting theOttawa Paramedic Service has systemic problems.

• Ottawa paramedics dispute damning dispatch report
• ANALYSIS:Prescott-Russell paramedic complaint part of larger problem about who pays for what

Due to changes in provincial policy, adjacent municipalities are no longer reimbursed for attending to Ottawa's emergency calls. The counties are unhappy that the city is now refusingto pay for those services, an issue that Di Monte says is at the heart of the discord between the two sides.

Renfrewparamedic MattRousellesaid he believes Ottawa's system is "broken."

Rouselle told CBC News he became a paramedic to keep his two children, aging parents and community safe. Now, he said, hefinds he's spending more and more time away from his home.

"I grew up inArnprior,my family still lives here," saidRouselle. "I'm frustrated with the amount [of time] we are spending in Ottawa right now. It just seems it's so one-sided."

Calls to help out in Ottawa emergencies growing

Paramedics from all jurisdictions are quick to say that they're happy to help in an emergency. And Ontario regulations require whicheverparamedic is closest and available to respond to emergency calls. Because rural paramedics are sometimes dropping off patients at Ottawa hospitals, they may find themselves the closest first responders when a 911 call comes in.

But they also feel that the types of calls they must respond to aretoo broad.Nolan says his paramedics are often responding to potentially minor troubles like dizziness andbroken bones.

We overuse this 'good neighbours' relationship. That shouldn't be. I have to admit it.I feel really bad about this, because it is true.- Coun. Eli El-Chantiry

This fall, five municipalities adjacent to Ottawasent a letter to the premierasking for help with the volume of emergency calls into the city.

According to that letter, calls from Ottawa toneighbouring rural paramedic servicesincreased by 60 percent in June 2016 compared to June 2015.

Prescott-Russell saw service calls from Ottawa shoot up105 per cent, while neighbouringLanark County has seen an 88-per-cent spike.

"Honestly, I'm not going to sit here and defend it," said Coun. Eli EI-Chantiry, who represents Ottawa on the Rural Ontario Municipal Association.

"We overuse this 'good neighbours' relationship," said El-Chantiry. "That shouldn't be. I have to admit it. I feel really bad about this, because it is true."

City resources not keeping pace with demand

Response volumes for calls in Ottawa have increased almost 24 per cent over the past five years, according to the most recent annual report. And resources haven't been added to keep pace, saidEl-Chantiry.

"God forbid, I don't want somebody anywhere whether in the city or a neighbouring municipality to lose their life or their loved one just because we couldn't provide an ambulance," El-Chantiry said.

The city's budget, approvedlast week, includes money tohire 24 newparamedics and buy five emergency response vehicles.Another 12 staff members were also hired earlier this year,

However, according to the paramedic association, while the new resources might have been enough to addressdemand levels two years ago, they may fall short if the number of calls continue to increase in 2017.

"We're playing catch up, without adoubt," said Di Monte, adding that the additional resources will still help.

The paramedic service is also hoping to get 14 more paramedics and two ambulances in 2018, Di Monte said, although that plan still has to be approved by Ottawa city council and the number could go up or down.

"I think we're taking the issue head on," said Di Monte. "We're attacking the problem."