Emergency pre-hospital services (911)
- 40% of hospitalized people are transferred to hospital by ambulance.
- These services are accessed by calling 911, and are available 24 hours a day, 7 days a week, 365 days a year throughout the Outaouais.
- Whenever someone calls 911, the call triggers a response process involving several actors in what we call the chain of emergency pre-hospital services.
Actors in the chain of emergency pre-hospital services
A witness to an incident, he provides assistance to the victim either by calling 911 or by administering first aid while waiting for emergency services to arrive.
This centre receives the emergency call and redirects it to the applicable emergency service (police, fire department, ambulance technicians).
Health communication centre
This centre receives and prioritizes emergency calls requiring ambulance intervention. Ambulances are dispatched based on the emergency level of calls and the availability of ambulances. By asking specific questions, the dispatcher first determines the priority of the call and dispatches resources as quickly as possible.
First responder service
Some municipalities have first responder service personnel with special training to provide emergency response before ambulance technicians arrive. These responders are able to perform simple life-saving acts. For example, they can respond to incidents of allergic reactions by administering an “Epipen”, apply an automated defibrillator to help patients who have suffered cardiac arrest, and assist trauma victims.
Ambulance technicians take charge of the patient’s care using medically-based clinical intervention protocols. Once a person is evaluated and stabilized, he is transported to the nearest hospital or to a hospital deemed more appropriate.
Hospital or receiving institution
Responsibilities of the CISSS in providing emergency pre-hospital services (EPS)
- Organize and manage EPS in the region (e.g., issuance of permits and signature of service agreements with ambulance companies, training for ambulance technicians).
- Coordinate continuing education and skills development for ambulance technicians.
- Perform service quality control (presence of an EPS medical director and of a team of ambulance technicians).
- Provide medical coaching covering response techniques among ambulance technicians.
- Maintain ongoing relations with the Centre de communication santé de l’Outaouais (CCSO).
- Provide support to municipalities wanting to develop their first responder service.
- Promote access to the “Hero in 30” training and facilitate general access to automated external defibrillators (AED).
Cost of ambulance transport
Each year, approximately 28,000 ambulance trips are provided in the Outaouais. Even where 911 calls are made by someone else, the cost for ambulance transport to a hospital is usually borne by the person transported.
The government of Quebec assumes the lion’s share of the funding for the emergency pre-hospital system, and the amounts charged to the individual represent just a fraction of the actual cost of his ambulance transport.
The basic cost of transport by ambulance is set at $125 for the pickup, plus $1.75 per kilometre travelled to the hospital. A $35 fee is charged for any additional patient.
The cost for a non-resident of Quebec is $400 for pickup, plus $1.75 per kilometre travelled.
These rates, which came into effect on July 30, 2010, may be indexed annually. There are no additional fees for someone accompanying the person being transported.
The Government of Quebec, or other organizations, covers the entire cost of ambulance transport for the following:
- People injured in a road accident
- People injured in a work accident
- People transported between two institutions within the health and social services network
- Persons 65 years of age and over
- Persons receiving Income Security
In some cases, the federal government covers the cost of ambulance transport for:
- Members of the Canadian Armed Forces
- On-reserve First-Nations and Inuit populations
Even where a person is eligible for an exception, he may be billed for the transportation if it is deemed to be medically unnecessary.