Crews treat a range of critically injured patients at Icefield rollover
When the call came into the STARS Emergency Link Centre (ELC) that a glacier sightseeing coach filled with passengers had overturned, with many fatally and badly injured patients, crew members at all three Alberta bases jumped into action.
In Calgary, transport physician Dr. Mike Betzner launched an urgent assessment of where all the STARS resources were, and a decision was made to dispatch helicopters to the scene from Grande Prairie, Edmonton and Calgary.
When transport physician Dr. Eddie Chang received the call, he immediately drove to the STARS base in Edmonton, where he is medical director. He met up with the STAR-3 crew to gather extra medical equipment and supplies before they were flown to the scene of one of Western Canada’s largest mass-casualty incidents in recent memory.
Roughly 400 km south, Dr. Jamin Mulvey was alerted to the incident. Dr. Mulvey, medical director at the Calgary base, was too far away to drive, but he knew Alpine Helicopters from Canmore was also preparing to help, so he hitched a ride.
As we approached the scene, all three physicians predicted that the mission, to a remote and picturesque mountainous region, would be long, challenging and tragic.
“We were in the middle of nowhere, with no health-care facilities nearby, terrible cell phone service and radio signals, and the sheer number of critically injured patients meant it would be a complex mission,” said Dr. Chang, who has worked with STARS for 20 years.
The crash happened at 2:09 p.m. on July 18, 2020 at the Columbia Icefield tourist site just off Hwy. 93, near Jasper National Park, where the bus was making its way to the Athabasca Glacier. By the time the scene was cleared of patients, just before 9 p.m., three people had died on the scene, and 24 were injured, 14 critically.
When the call came into the ELC, the communications staff led a multi-agency coordinated effort. They researched the geographic region, reached out to emergency rooms to let staff know patients would be coming, and set up landing zones for the incoming aircraft.
They dispatched three helicopters, each carrying the standard flight crew of a flight nurse, flight paramedic and two pilots, plus Dr. Brett Shaw, a resident fellow from Calgary.
“Three helicopters going to the same scene is extremely rare,” said ELC director John Griffiths.
In another rare move, a fourth helicopter and crew were brought into service at the Edmonton base in case of other incidents in Alberta. As it turned out, STAR-4 was dispatched that afternoon for an unrelated mass-casualty incident.
Meanwhile, Dr. Betzner oversaw the event from the ELC. For the next nine hours he allocated resources to patients, decided whether they would go to Edmonton or Calgary trauma centres, called those sites to prepare them for the influx of patients and remained connected with the on-scene incident commander at the icefields until the last patient was treated.
“It was complicated from a logistical standpoint,” said Dr. Betzner. “I was working off three different devices, receiving hundreds of calls and texts triaging where these patients were going to go and how they were going to get there.” Dr. Mulvey recalls witnessing the aftermath from the sky.
“There was a landing zone set up in a nearby parking lot for all the helicopters, a row of ambulances close to the scene ready for patients, and buses lined up end-to-end to block the view from the highway,” he said. “I saw the overturned coach and some walking wounded.”
At the staging area, Dr. Chang paired up with the incident commander and assessed, prioritized and treated patients while Dr. Mulvey also treated the injured, including three of the most critical at a secondary staging site. STARS’ paramedics and nurses, meanwhile, performed critical procedures to stabilize the patients and cared for them inside the helicopters along the way to urgent care hospitals.
Because of the remote location, difficult terrain and no road access to the site, some patients were treated and triaged near the bus, while others were ferried from the incident scene to the primary staging area by sling rescue technicians. Then, they were transported by ground EMS to the STARS staging area, roughly three km away.
“One by one they arrived for help, every 10-15 minutes,” said Dr. Mulvey. “The most severely injured came first. We saw a range of critical injuries, including blunt trauma, internal and spinal injuries. At one point, eight patients were lined up waiting for help.”
Once they were triaged and treated, patients were placed either in helicopters or ground ambulances and taken to hospital.
STAR-5 from Grande Prairie transported a male patient to University of Alberta Hospital in Edmonton in critical, potentially life-threatening condition.
STAR-1 from Calgary transported a female patient to Foothills Medical Centre in Calgary in critical, potentially life-threatening condition.
STAR-3 from Edmonton transported a female patient to Royal Alexandra Hospital (RAH) in Edmonton in serious but stable condition.
Dr. Chang stayed on the scene until the last severely injured patient was placed in an ambulance at 7:10 p.m. Then he accompanied paramedics in a ground ambulance and continued providing care en route to the Seton-Jasper Healthcare Centre. There he performed a stabilization procedure before travelling with the patient by ground to RAH, where he arrived
12 hours after the event happened. Griffiths and Dr. Chang characterized the medical response as a herculean effort with first responders throughout the province working together to save lives.
“The pre-hospital system works,” said Dr. Chang. “These are people who don’t know each other, most have never worked together before, and suddenly we all have to come together in a short period of time for the patients. That takes trust, dedication and continuous collaboration.”
EMS crews from Calgary, Jasper, Nordegg, Banff, Rocky Mountain House, Canmore, Hinton, Edmonton and Sundre responded to the incident. Fixed-wing air ambulances from Slave Lake, Lac La Biche and Edmonton, a chartered helicopter out of Canmore, and Dr. Shonna Imlah from Jasper, were also on scene. — Source: Alberta Health Services and STARS