Dr. Damian Paton-Gay raced through the halls of the Wainwright Health Centre on Saturday night as chaos swirled around him.
asserted
chaos → race → him
Nearly every corner of the 100-bed Alberta hospital was crammed with gurneys holding patients suffering from severely scorched skin and in need of intensive care.
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corner → cram → care
His job was to take stock of the condition of the 39 injured soldiers arriving from the nearby military base where they had been engulfed by flames during a training exercise.
asserted
they → take → exercise
Calmly but swiftly, he determined which needed to go elsewhere for specialized treatment, and how soon first responders could get them there.
uncertain
responders → determine → them
For Dr. Paton-Gay, this was a first – a scene of mayhem that he said would prompt someone watching a medical drama to say, “Well, this TV show is taking a bit of artistic license.”
asserted
show → say → license
But this scenario is precisely the type of mass casualty event that senior leadership in both the civilian and military health care systems in Canada have been simulating – and warning that the country is woefully unprepared for.
asserted
country → simulate → Canada
For two years now, this group of experts have run war games involving the repatriation of hundreds of war zone casualties arriving from overseas for a sustained period to determine how Canadian health care systems would fare.
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systems → run → period
Burns have featured heavily in the exercises.
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Burns → feature → exercises
What played out on Saturday night in Wainwright, a town about 200 kilometres east of Edmonton, is just a glimpse of how the capacity of Canada’s health care system can be challenged in an instant, said Adalsteinn Brown, dean at the University of Toronto’s Dalla Lana School of Public Health, and one of the experts involved in these planning simulations.
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Brown → play → simulations
If the Wainwright fire and another tragedy elsewhere in Canada occurred around the same time, the system would falter, Dr. Brown said.
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Brown → occur → time
“If we continually run the systems as close as we can to the bone, we don’t focus on resilience, we don’t build in that capacity, and we don’t practice being ready to deal with not just one but many.
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we → run → one
Then we’ll find ourselves in real fundamental existential difficulties with the health system,” Dr. Brown said.
asserted
Brown → find → system
The Canadian Armed Forces relies on the country’s civilian, public health care system, which is often operating at maximum capacity, for specialized care.
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which → rely → care
Canada also depends heavily upon imports for critical supplies such as skin and blood bags, leaving its supply chains vulnerable in the event of war or another large-scale mass casualty event.
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Canada → depend → war
Those involved in the simulations are campaigning for better co-ordination of health care preparedness at a national level, especially between the civilian and military systems, to ensure Canada emerges resilient in the face of a crisis much larger than Wainwright.
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Canada → involve → Wainwright
In December, NATO Secretary-General Mark Rutte warned in a speech in Berlin that, “Conflict is at our door.”
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Conflict → warn → door
He added, “Russia has brought war back to Europe, and we must be prepared for the scale of war our grandparents or great-grandparents endured.”
asserted
grandparents → add → war
For Canada, this call to action doesn’t mean only investing into arms and soldiers, but also, health care: “You really can’t talk about the defence of Canada without investing in a resilient civilian health care system,” Major-General Scott Malcolm, surgeon-general of the Canadian Armed Forces and a participant in the Canadian war games, said.
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Malcolm → mean → games
Similar disasters in the past have done little to spark change, said Gen. Malcolm.
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Malcolm → do → change
He referenced Quebec’s Lac-Mégantic disaster in 2013, during which a fiery explosion killed 47 people.
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explosion → reference → people
That prompted calls to be better equipped for burn care in Canada, he said.
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he → prompt → Canada
But little changed.
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little → change → ?
Being prepared for an influx of burn patients is top of mind for Gen. Malcolm because of the types of injuries being documented in Ukraine, which are different than wars past.
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which → prepare → wars
“We’re seeing burns and a greater volume of patients in general,” he said.
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he → see → patients
This has raised flags at home for the surgeon-general, where the Armed Forces often rely on the civilian health care system and lack burn surgeons among their ranks.
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Forces → raise → ranks
Modelling shows that capacity, supplies and specialized personnel in the civilian system are limited in terms of surge capacity.
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capacity → show → capacity
When Dr. Paton-Gay was making calls from the Wainwright Health Centre on Saturday night, one of the things he asked was how much space hospitals could open up for the incoming burn victims.
uncertain
hospitals → make → victims
Were there existing patients who could be moved around to open up room in intensive and emergency care?
uncertain
who → exist → care
Seven of the injured soldiers landed in his own intensive care unit at the Royal Alexandra Hospital in Edmonton where he works full-time as a physician.
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he → injure → physician
Dr. Paton-Gay walked into his Edmonton home on Sunday morning roughly 12 hours after receiving the call for aid in Wainwright.
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Gay → walk → Wainwright
By Monday morning at 7 a.m., he was back at work in the ICU to begin his first shift of a seven-day stretch.
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he → begin → stretch
“There is some fatigue,” he said.
asserted
he → be → ?
“But no one’s going to shy away from caring for people who volunteered their service to protect our country.”
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who → go → country
Many of his waking hours this week, as well as those of his colleagues, have been spent caring for the burn patients.
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Many → wake → patients
“It’s minute by minute for the nurses at the bedside,” he said.
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he → ’ → bedside
The care includes painful dressing changes that often require painkillers or sedation, ensuring the patients’ airways remain open, frequent surgical procedures, and keeping their bodies free of infection and at the right temperature.
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bodies → include → temperature
It’s precise work and critical, until they are ready for the intensive surgeries necessary to replace their damaged skin.
asserted
they → ’ → skin
This aspect of their recovery underscores another feature of the Canadian health care system that mass casualty experts say is deficient – a steady supply of tissues, such as skin, cornea and tendon.
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experts → underscore → skin
In the U.S., there are more than 100 establishments accredited by the Association for Advancing Tissue and Biologics whose members’ work includes tissue recovery, distribution and storage.
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work → be → recovery
Canada imports the majority of its tissues from the U.S., said Dr. Graham Sher, chief executive of Canadian Blood Services.
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Sher → import → Services
…and 17 more, not listed.
The Aporia
