paramedic suspected fatal uvic call was more serious than 911 report
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a veteran paramedic dispatched to the university of victoria to help two students having seizures was suspicious that diagnosis was wrong, and feared the medical emergency was likely more dire.
david stanton, who has responded to “hundreds, maybe thousands” of overdoses since the toxic drug crisis began a decade ago, suspected the students were seizing due to a lack of oxygen reaching their brains after consuming drugs laced with fentanyl.
he told his partner to drive their ambulance faster.
“there is not a chance that there are two epileptic patients sat next to each other that both started having an epileptic seizure. i said the most likely course of events here is that these are hypoxic (lack of oxygen) seizures secondary to a narcotic overdose,” stanton testified monday at a coroner’s inquest.
this “is the most likely thing for a couple of 18 year olds away at university.”
he remembers telling his partner: “these two patients are about to go into cardiac arrest. we need to hurry.”
when sidney mcintyre-starko and her friend collapsed in a uvic dorm on jan. 23, 2024, student witnesses told 911 they were “seizing” and turning blue.
the 911 call-taker believed they were having seizures, which led to a delay of seven minutes before dispatching an ambulance. it would be 13 minutes before uvic security guards at the scene delivered the overdose-reversing drug naloxone, and 15 minutes before cpr was started.
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as fentanyl stops a patient from breathing, sidney died of oxygen deprivation. the inquest is examining the circumstances of her death with a goal of preventing a similar one in the future.
stanton, an advanced care paramedic, testified that when he got to sidney’s side at 6:52 p.m., a full 20 minutes after her friends called 911, the 18 year old had no pulse, was not breathing and was unresponsive.
it was unclear to him how long she had not been breathing but said it takes, on average, four minutes of no oxygen intake for brain cells to begin dying.
the 911 call-taker had concluded sidney was “breathing effectively” based on a test she told the security officers, who have basic first aid training, to perform.
the call-taker and guards have also testified they delayed considering the use of cpr and naloxone because the only student at the scene who knew the girls had taken drugs initially denied that was true.
stanton, however, testified it “happens all the time” that people are afraid to admit drug use, and he has to deduce from information at a scene what has occurred. he also said naloxone is “benign” and cannot harm someone, even if they are not overdosing.
the vial with drugs that university of victoria students found in a box of coolers in downtown victoria, was seized by police after their overdoses. source: b.c. coroner’s service
merette, sandrine [phsa] b.c.
ambulance service lawyer eric stanger asked if receiving false information from witnesses can cause significant difficulty at the scene.
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stanton answered he tries not to let that happened, and instead performs so-called “veterinary medicine” — an unconscious patient is similar to an animal in that they cannot tell first responders what is wrong.
“we were taught to go through any form of an ambulance call without receiving any information, or also with receiving incorrect information. as long as we don’t allow clinical biases to get in our way, we still have a job to do and a procedure to follow,” he said.
stanton agreed with stanger that paramedics have access to more information at the scene than call-takers do over the phone.
he said, for example, that if he sees an unconscious patient’s pupils are “pinpoint” tiny, then that is a sign the person could be overdosing.
he said, for example, that if he sees an unconscious patient’s pupils are “pinpoint” tiny, then that is a sign the person could be overdosing.
the uvic security guards did not check sidney’s pupils nor did the call-taker ask them to.
both stanton and saanich fire captain jerry tomljenovic testified that they have a routine, rapid-fire assessment they use when responding to unconscious patients: check for a pulse, an obstructed airway, and breathing. this is done in a matter of seconds, and then whatever “critical intervention” is required would be started immediately.
“it would take 15, 20 seconds to do an airway, breathing and circulation check. … that initial care assessment would happen very quickly,” tomljenovic said.
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“and then both (first responders), working together, would have initiated cpr straight away.”
does he wait to provide treatment, asked anthony vecchio, the lawyer for sidney’s family.
“no.”
tomljenovic was in the second fire truck sent to the scene, and said he arrived roughly 15 minutes after the 911 call was made. the delay was due partly to confusion over the number of patients at the scene and their medical needs.
once they were on scene, paramedics made several medical interventions, including putting a tube down sidney’s trachea to deliver oxygen, attaching an iv bag to provide fluids and medicine, and using an oxygen mask and giving “high quality” chest compressions. her heart was restarted, but her brain had been starved of oxygen for too long for her to survive.
you can follow ongoing coverage of the inquest here:
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