Emergencies in Quebec are overflowing to such an extent that emergency physicians want to consider using the armed forces and ambulance technicians to unclog waiting rooms.
“You have to bring arms. At the moment, everyone has their tongue down and there is nothing that will improve anytime soon, ”says the president of the Association of Quebec Emergency Medicine Specialists, Dr.r Gilbert Boucher.
Friday noon, the occupancy rate of stretchers was close to 215% in the emergency room of the Pierre-Boucher hospital in Longueuil. And the picture was hardly better elsewhere: this rate reached 184% at the Suroît hospital in Salaberry-de-Valleyfield; 160% at the Laurentian Hospital in Sainte-Agathe-des-Monts; 158% at the Jewish General Hospital of Montreal; 158% at Sainte-Croix hospital, in Drummondville; 154% at Hôtel-Dieu in Lévis; and 152% at the Lanaudière Regional Hospital Center in Joliette.
Not to mention the situation in the Outaouais, where the emergency room at the Gatineau hospital is only partially open after being closed from June 25 to 30, for lack of staff. It will reopen on Sunday, but only between 8 a.m. and 6 p.m.
It is important that the machine is set in motion because here, the month of September is going to be horrible
Faced with this glaring shortage of personnel, Dr Gilbert Boucher believes that no option should be ruled out, including calling the Canadian armed forces or using paramedics in emergencies. “These people have medical expertise,” he says. They are able to do vital signs, assist nurses in maneuvers, ”he notes. They could also be used to disinfect equipment, notes the doctor.
In the office of the Minister of Health, the idea is rejected. “These are alternatives that were deployed in the worst times of the health crisis, while today, the epidemiological situation is stable and under control,” said Christian Dubé’s press secretary, Marjaurie Côté-Boileau. However, she recognizes that the situation is “critical” in several emergencies, particularly in the Outaouais and Montérégie.
At a press briefing on Friday, Minister Christian Dubé said he was betting on strengthening primary care to relieve emergencies. His government has asked family doctors to take care of more patients, “even those who have certain symptoms that could be similar to COVID-19,” he recalled.
Family medicine groups will also have to extend their opening hours “to return to what we were in pre-pandemic,” he said.
However, we should not hope for “miracles in the very, very short term,” the minister said.
Summer is likely to be painful, according to Dr. Gilbert Boucher. Many patients go to the emergency room for lack of an in-person appointment with their family doctor.
The emergency physician does not anticipate any changes despite the measures announced. “I don’t expect that tomorrow morning there will be more time slots with family doctors arriving. But it is important that the machine is set in motion because the month of September is going to be horrible. “
Quebec plans to close as of September 6 the designated assessment clinics that welcome patients with symptoms related to COVID-19.
The head of the emergency pediatrics department at CHU Sainte-Justine, Dr Antonio D’Angelo, dreads this moment. The emergency department of the pediatric hospital has already recorded record numbers for five weeks and the staff have the impression of living a flu season in the middle of summer, he illustrates. “There are still many doctors who [ne] font [encore que] telemedicine, because it is available, ”notes the emergency pediatrician. Result: children end up in the emergency room for a mild respiratory virus or gastroenteritis.
The Dre Chantal Guimont, medical director at GMF MAclinique Lebourgneuf, in Quebec, is also worried about emergencies.
His clinic welcomes patients who present with symptoms related to COVID-19, but who have received a negative screening test. “I think there is still a lot of reluctance to see these clienteles [symptomatiques] in a “cold” clinic. Our experience in a “lukewarm” clinic has enabled us to tame this risk, if you will. Until June 27, MAclinique Lebourgneuf was a designated evaluation clinic. It is no longer; only one remains in the capital.
The Dr Mathieu Pelletier, deputy director of GMF-U north of Lanaudière, also welcomes symptomatic patients in person, provided their screening test is negative. He argues, however, that family medicine groups have their own challenges, such as sourcing personal protective equipment and setting up “lukewarm” waiting rooms.
In any event, its GMF will extend its opening hours until 8 p.m. from 1is August, although many of its nurses (7 of 12) are absent, on sick leave or deployed elsewhere in the network. The doctor says, however, that his GMF will be ready to take over from the designated assessment clinics on September 6. “They are communicating vessels”, he sums up.
The limits of telemedicine
The Dr Antonio D’Angelo, he hopes that the machine will follow. He also regrets that doctors are prescribing antibiotics to patients they have not seen.
Teleconsultation has its limits, he pleads. “I had a case of a child who was repeatedly treated with telemedicine because the doctor was afraid to see him. He wanted to do the best for the patient […], but he prescribed multiple doses of antibiotics when, finally, it was a child who had a fever repeatedly because he had leukemia. We found out when he finally came to the emergency room because he had other symptoms. “
This is a rare and “sensational” case, however, underlines Dr D’Angelo. “He was taken care of on time,” he says. […] It’s just that maybe he could have been seen a few weeks earlier, and maybe suffered less from it all. “
And his parents would have more confidence in the health care system today.
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