This reads to me that the calls to acknowledge that our HC system is in a medical "state of emergency" were not actually "misguided". It took 8 days to get a whole bunch of "generals" to stand-up and admit the troops are actually in trouble...

1/4edmontonjournal.com/news/local-new… I wonder, if HUNDREDS of physicians hadn't added their voices to the cry for help, if govt hoped this would just go away after officially and publicly gaslighting concerned vocal HC advocates?
2/4

I received a message from an Alberta ED colleague that stopped me cold. He treated a very elderly pt - a retired Charge Nurse who began her career as WWII ended. She waited 8 hours in the WR for care. Her assessment of our current reality is devastating....
1/8 She told the doc she has never seen it this bad. Not even before we had a formal healthcare system. But her most damning observation wasn't about the wait time or the lack of staff. It was about safety.
2/8

Let’s go into more depth as to why a state of emergency and ACTUAL PROVINCIAL COORDINATION of care MUST happen immediately to maintain a semblance of safe and timely care in EDM hospitals: 🧵
1/12theglobeandmail.com/canada/article… When one zone becomes overwhelmed there are emergency escalation measures that can be implemented to help maintain safe care
Some of which are:
- provincial wide load levelling
- bypassing a zone that is flooded - ex northern pts skip EDM and are sent to Calgary
2/12

Let’s look at REAL TIME DATA for our EDM Adult EDs RIGHT NOW:

Our EDs have become HOSPITAL WARDS that see the odd Emergency patient!
(Think about that: they can no longer care for undifferentiated new pts, forced to run in-pt ward care vast majority of their time)
1/8 The entire EDM Zone is operating with ~ 38 FUNCTIONAL Emerg beds for the entire city! (worse if you consider the MIS is MINUS 21 beds over non-surge capacity)

Couple of notes based on this real time date from TODAY:
2/8

Seeing more and more weighing in about how the GNH Triage nurse/ED team should be held to personal account makes me realize that the avg AB just doesn’t understand what an utter dumpster fire our major EDs have been for months/yrs.
1/9 It’s why it’s been in the news so much… and why I'm wasting so much breath trying to alarm the public … it is utter chaos and only getting worse.

Let me say this loud and clear: this case was tragic, but this is absolutely NOT the only death due to ED overcrowding.
2/9

Anybody who reads about this tragic case and thinks this has to do with a HCW not recognizing the severity at triage has simply NOT been paying attention.


1/14threadreaderapp.com/thread/2004381… Our triage system completely fails when we have DOZENS of triage level 2 and 3 pts in our WRs, with added severe overcrowding and unsafe levels of EIPs (EIP = SICK admitted pts that should be on specialized wards in the Hosp).
2/14

This is a tragic event, and my heart goes out to the pt's family.


1/14globalnews.ca/news/11590698/… I cannot speak to any specific details of this tragic event, but I do feel it is very important to state:

there is NO SITUATION where it is normal for a pt to wait >8hrs with severe chest pain if there is ANY meaningful flow in an ED that is functioning as it should be.
2/14

Take a read


Couple of things:
1 - BRAVO to this paramedic for speaking out. Let’s hope he doesn’t get punished for doing so (a JUST and SAFE culture simply no longer exists in AB)
1/9globalnews.ca/news/11588568/… 2 - nice to see ACA has to respond now, given that AHS has NO input into EMS anymore whatsoever! (I wonder if Dr. Diamond has a clear strategy for this byzantine org yet?)

3 - But let’s examine the govt/ACA “talking points”...
2/9

So the Premier has finally stated her vision for AB: hand over our Social Safety Net to FOR-PROFITS, non-profits, and let Charity cover the leftovers.
Not a lot of profit in "Orphans and widows", so let's hope our religious charities really ramp up.
Let's check some facts🧵
1/10

Let’s talk AFFORDABILITY in AB RIGHT NOW, before the Premier DESTROYS what is left of our social safety net:
2/10

https://x.com/TheBreakdownAB/status/1999697758555635944?s=20

There you have it: the Premier wants to take Canada to pre-WWII
She wants govt out of the social safety net.

Definitely not fiscally conservative:
You can pay for a child’s health and education now (cheap), or for policing, incarceration, and HC bankruptcy later (expensive)

https://twitter.com/thebreakdownab/status/1999697758555635944

She wants charities to provide HC?

Did she run on this retrograde vision for AB? Did Albertans vote for this? Do they want this?

Once our social safety net is destroyed it will be soooo much more expensive to rebuild it… rather than repair it now.

CONDOLANCES to my colleagues and the patients in the Edmonton Area.

They seem to be breaking overcrowding records everyday in Edmonton.

Last night the RAH ED had over 100 (ONE HUNDRED!) pts waiting in its waiting room.

Just try to imagine that...
1/6 Over 100 sick pts, many accompanied by family members, seeking medical attention, and being stranded in a waiting room that was never even designed to hold even 50 pts in it...

They had to spill over into internal waiting rooms and hallways and EMS hold spaces...
2/6

This highlights what so many HCWs have been worrired about: the UCP government cannot be trusted with the operation, the funding, or the integrity of our health system.
1/11theglobeandmail.com/canada/article… This is a SCANDALOUS MESS with numerous allegations that demand a PUBLIC INQUIRY.

They’ve betrayed every conservative promise of fiscal responsibility…

THEY CANNOT BE TRUSTED WITH YOUR MONEY: $614M WASTED.
2/11

I don't disagree with the premise that there is TOO MUCH Two-tier HC in Canada already... far too much.

Every day in our EDs, we see the ramifications of this.
1/9theglobeandmail.com/opinion/articl… Because we already DON'T:
- pay for someone's diabetes medicine but rather spend THOUSANDS of dollars on hospital care when they get really sick from their poorly controlled diabetes.
2/9

“This was a scandalous mess from beginning to end, with terrible planning, ignored guidelines, denial of evidence and, finally, complete failure.”
Let’s just outline SOME of the HC things this govt has already F’d up:

1/6calgaryherald.com/opinion/column… 1-Children’s Tylenol – 70M wasted
2-CorruptCare Scandal – 100s of Millions wasted on sole source contracts
3-Public Health Destruction – Millions wasted on Measles containment and treatment, much much more to come
2/6

Everyone should listen to this excellent question – w excellent points that the Premier didn’t bother to answer...

But let's break this down, shall we?

TLDR: when Premier says “they” she is deflecting cuz “they” = GOVT
1/13

https://x.com/thebreakdownab/status/1987607384077025547?s=61

Actual concerns raised: Privatized delivery will just drive our critically short workforce out of the hospital (fact), while there are empty ORs in a lot of our major hospitals (fact), and CHAOS in the current system that needs to be addressed (fact).
2/13

Real ED Case in AB 🧵 :

Elderly couple 91 and 92yo, living in their own home caring for each other. Slowly declining, as one has worsening dementia, and they can no longer live on their own anymore.
No beds to place them in continuing care from the community
1/5 Brought to the ED by 2 EMS crews, with no acute medical issues, but they need to be admitted to hospital to wait placement.
They are confused and anxious, and will be STRANDED in an ED for days, and then in a hospital for WEEKS/MONTHS... STRANDED because LTC spaces rare
2/5

Let's run through just ONE example of what will enfold with govt's new TESTING PRIVITIZATION PLAN
Simplifying in broadstrokes a common example:
Take a 35yo female with heavy pelvic bleeding and irregular menses, who has no FM doc.
🧵 1/10
buff.ly/wf7leEA - pays for a lab test and Hemoglobin is low (not critical though so no reimbursement)
- pays for an ultrasound that shows a mass (don't know what it is so no reimbursement)
- pays for an MRI (looks like a complex fibroid, but still needs a biopsy, so no reimbursement)
2/10

Albertans are witnessing the deathblow to fair and equitable HC access right here, and all without even a discussion to see if there is a mandate for govt to do this.
This is not hyperbole or fearmongering.

Let's pick 10 quick highlights🧵:
1/15
buff.ly/dzaXRPF 1 - Govt is NOT creating any new capacity here, they are simply splitting the queue for all lab/DI/screening into private and public pay streams.
2 - There is no new workforce to deliver the new stream (that could develop in decades??? while the public system is starved?)
2/15

RURAL ED CLOSURES - REAL AB Case #3
- patched through a bystander call from 911 dispatcher to online doc, significant trauma from an ATV accident
- literally not a single EMS crew in the vicinity, local ED closed, all resources actively transporting patients
1/5 - trying to talk a bystander (not first responder) through what to do over the phone for an extended period of time
- trying to involve RCMP, forestry, all other resources as known significant delay for any EMS crew to be able to respond
2/5

RURAL ED CLOSURES - REAL AB Case #2

- Pt in their 40s, witnessed cardiac arrest
- EMS responds and begins resuscitation
- Only mins from nearest Hospital, but the ED is CLOSED
- Adjacent Hospital ED Closed too
- EMS crew NOT aware of ED closures
1/7 - EMS calls hospital staff for help - crew in significant distress because there is nowhere to take this patient
- Local nursing staff tries calling physicians in the community
- One provider is 25 minutes away
- Resuscitation terminated pre-hospital - "no receiving site"
2/7

RURAL ED CLOSURES - REAL AB Case #1
- ABs are not aware of how frequently rural EDs are closed, and the impact on the people in these communities.
- the ever-worsening stats are meaningless
- it's important to put a human face on what's happening.

Anonymized Actual Case #1:
1/7 Before giving example cases...
Here's a refresher of a recent post on the growing issue across AB:


2/7 buff.ly/FIHAlkb