Propelling lives through innovations in medical tranpsort

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Three years ago a sunny spring day turned tragic when a terrible accident left an Ottawa-area toddler clinging to life by a thread. Then just 18-months old, Caylen Laberge suffered catastrophic injuries after being run over by a lawn mower.

“My first thought was, he doesn’t have a face,” Marcie Beaudoin, critical care flight paramedic (CCP) with Ontario transport medicine service provider Ornge, says of her first look at the toddler’s injuries. Ms. Beaudoin and fellow CCP Patrick Auger were on duty when the Ornge Communications Centre, located near Toronto’s Pearson Airport, received the call to airlift Caylen. His injuries were the worst case of trauma the rural hospital that first admitted him had ever seen, and a helicopter was required immediately to take him to a facility with more specialized care.

What followed is an amazing story of human resilience, compassion and ingenuity. Saving Caylen would draw on the little boy’s remarkable will to live, and require the existence of an incredible development in modern patient care – transport medicine. The concept is simple to understand, but complex to execute. It involves the provision of sophisticated care for critically ill and injured patients, at the same time they are being transported to or between medical facilities.

In the vast province of Ontario, which has a total area of more than 1-million square kilometers, the Ornge transport medicine service was founded in 2006. Named for the distinctive colour of its helicopters, airplanes and land vehicles, Ornge’s roots go back to 1977. It was then the fledgling idea of medical transport began in the province, through the inaugural flight of a single helicopter more than thirty years ago.

“The service has developed dramatically in subsequent decades. It now stands at the cusp of a new frontier in medicine,” says Dr. Christopher Mazza, trauma physician and the president and CEO of Ornge. “This company is on the forefront of a movement that says we can provide a level of care that meets or exceeds that within bricks and mortar, anytime, anywhere. It’s a very modern concept, and one that quite simply did not exist in the past,” he adds.

Calls for transport are taken at Ornge’s sophisticated communications centre. The flight and pediatric transport paramedics who respond are highly skilled, and undergo rigorous and ongoing training at the Ornge Academy of Transport Medicine. They are able to administer a wide variety of drugs and carry out complex medical procedures, all within the highly challenging atmosphere of a moving vehicle. Calls are triaged 24/7 by a transport medicine physician, or “doc in the box,” who also provides front-line staff with medical guidance and expertise.

Ornge responds both to on-scene trauma calls and requests from medical facilities to transport patients to more specialized centres. Caring for such vulnerable patients requires both medical expertise and a true passion for and dedication to helping those in need.

In Caylen’s case, the doctor’s relief was palpable when Ms. Beaudoin and Mr. Auger arrived at the local hospital. “Shock had set in, and the extent of his injuries made starting an airway quite a challenge,” Ms. Beaudoin says. Damage from the lawnmower’s blades had left no teeth, lips or bones, which would normally be used to help establish an airway for Caylen. Ornge’s paramedics were able to successfully establish an airway, and to insert an intravenous needle directly into the child’s leg bone to help stabilize him with the replacement of vital fluid and blood.

After he was flown there by an Ornge helicopter, the skillful team at Ottawa’s Children’s Hospital of Eastern Ontario reattached Caylen’s arm, and it has completely healed. The four-year old has made a remarkable recovery, and is a precocious little boy who loves hockey and playing with his siblings.

Every year Ornge transports more than 18,000 patients, responding to calls everywhere from urban centres to the remotest reaches of northern Ontario. Yet it remains one of the best-kept secrets of the health-care system. “When we reach people they are often at their sickest and most vulnerable. Many of them will never know who it was that took care of them, and in many cases saved their lives,” Dr. Mazza says.

The paramedics who treated Caylen, however, were thrilled to have the opportunity to reunite with the boy whom Mr. Auger calls a “miracle.” Caylen’s father, Gus, says the Laberge family feels the same way about Ornge. “We think about them a lot, because if it wasn’t for them, he wouldn’t be here.”

If you’d like to share your story about being transported by Ornge they’d love to hear it. You can e-mail them at media@ornge.ca, or call them at 647-428-2107.