Paramedics in Calgary and surrounding areas are now able to increase capacity in the Emergency Medical Services (EMS) system, thanks to the CANet-funded project, CASMER, Community Alternatives for Syncope Management in the Emergency Room.
CANet investigator, CASMER project lead and professor at University of Calgary’s Faculty of Medicine Dr. Satish Raj, together with a team of medical researchers, doctors, and paramedics, recently launched CASMER in Calgary and surrounding areas within a radius of 45-60 minutes.
“Most patients with low-risk syncope, otherwise known as a temporary loss of consciousness
or fainting, have excellent outcomes because the diagnoses – vasovagal syncope and initial orthostatic hypotension – are non-life threatening and thus, do not merit a trip to the hospital,” Dr. Raj says.
Both, however, are continually recurring features of low-risk syncope, and alarm patients to such a degree that it often prompts unnecessary trips to emergency departments where tests and costs rapidly escalate. Even worse, often patients inconveniently have to wait several hours to be seen, adding to the overcrowding in the emergency departments.
With CASMER, paramedics are now using simple checklists to determine whether syncope patients are low-risk or not.
If they are low-risk, paramedics treat and refer patients on-site. Severe cases are transported to a hospital.
“CASMER allows us to provide better care for our patients while freeing up ambulances to be available for the next 9-1-1 call,” says Ryan Lee, paramedic, and CASMER research coordinator.
Within Canada, studies estimate about a hundred thousand syncope-related visits to emergency departments occur yearly.
Barely a quarter of patients are admitted – about 0.1% of patients benefit from CT scans, head MRI, EEG, or ultrasounds which significantly increases healthcare costs.
According to Dr. Gerald Lazarenko, Medical Director for Research for the Alberta Health Services Emergency Medical Services (AHS EMS) system, and CASMER co-investigator, AHS EMS transports approximately 2000 syncope patients a year to emergency departments.
“Most of them could stay at home safely,” he says.
“Paramedics are unable to look after more serious cases like heart attacks if they are looking after low-risk syncope patients,” adds Dr. Raj.
“We want to provide a cost-effective, efficient, and exemplary healthcare system that improves the lives of syncope patients and lessens the burden on Canada’s healthcare system, its doctors, and its paramedics,” says Dr. Anthony Tang, Scientific Director and CEO of CANet.
The CANet-funded CASMER project has also empowered patients with support groups, information resources and website to help them better understand syncope and manage their health.
CANet is committed to reducing syncope hospitalization and emergency department visits across Canada, and lower syncope-related health service expenses by 30 per cent.
After Alberta, CASMER will be launched in various cities across the country.
“We are excited for its outcomes in Calgary and nationally in the future,” Dr. Tang says.