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Study: mobile trailer a success in caring for opioid overdose patients
Each year the Canadian Centre on Substance Use and Addiction joins organizations across the country to observe National Addictions Awareness Week – November 26 to December 2, 2018. This week is to highlight issues and solutions to help alcohol and other drug-related harms.
In the fall of 2016, the opioid crisis was tearing its way through the streets of Vancouver’s Downtown Eastside. Paramedics were responding to an average of 30 overdose calls a day, with about half of those patients ending up in emergency. Pressure was extreme for first responders and the ED at St. Paul’s Hospital.
Emergency physician and researcher with the Centre for Health Evaluation and Outcome Sciences Dr. Frank Scheuermeyer describes the chaos, “We averaged 10 opioid overdoses in the ED, and had as many as 25 patients in a 24-hour period.”
While plans were in place for more permanent treatment facilities in the DTES, something needed to be done immediately. Vancouver Coastal Health, BC Emergency Health Services, the City of Vancouver, nurses and social workers came together and brought in the Mobile Medical Unit (MMU).
Owned by the Provincial Health Services Authority, the MMU partners with all of BC’s health authorities to help build health care capacity. As a hospital on wheels, it brings clinical education, emergency and disaster relief, public health outreach and business continuity to communities across the province. During the opioid crisis, the MMU was placed in a vacant lot in the heart of the DTES. It had space for four chairs and one stretcher with cardiopulmonary monitoring.
Dr. Scheuermeyer says the team was fairly confident low-risk patients with presumed fentanyl overdoses did not need the advanced care of an ED, and with careful screening by paramedics, the mobile unit would be a safe way to more efficiently care for this vulnerable population.
Another goal was to reduce ambulance use. For paramedics, drop-off time at the trailer was just a few minutes, but in the ED, crews were often tied up for half an hour or more.