911 transcript: Richardson showed "signs of confusion, a concussion" soon after noon.

[pnwmom]

The severity of the fall was then classified as "possibly dangerous."

And yet the first ambulance that arrived about one o'clock was cancelled, and the second ambulance wasn't called until 3 p.m. Why was a person with signs of confusion who had been subject to a serious fall allowed to refuse treatment for more than two hours? (Showing confusion after a known fall is an important exception to the rule that a patient may refuse treatment; only a competent patient -- not a confused patient -- may refuse treatment.)

http://www.theglobeandmail.com/servlet/story/LAC.20090328.RICHARDSON28ART21352/TPStory/National/?pageRequested=3

Dispatcher sends out a Priority 3 call for a woman who has had a fall at Mont Tremblant. The call is received at 12:43 p.m. and is assigned by 12:44 p.m.12:43 p.m.: On the hill

"Priority 3, Tremblant resort ... (inaudible) ... female, 42 years old, 17 Bravo 1 ... 12:43, assigned 12:44."

Code 17 means a fall. Bravo 1, or B-1, means possibly dangerous. Priority 3 is the second most urgent emergency call from the public. It requires medics to get to the scene immediately and turn on their sirens if they're held up at an intersection.

The ambulance technician

responds that he's arrived but the patient, Natasha Richardson, isn't there.

1 p.m.

"10-17. Uhh, we're still waiting for the patient."

10-17 is code for arrival at the site.

The ambulance technician tells central dispatch that he's been told the assignment is cancelled.

1:11 p.m.

"There's a (ski) patroller who just went by, who tells me it's a 10-3. Did you get a call about that?"

10-3 means cancelled job

Despite this delay, at 3:55 p.m, just before arriving at the local hospital, Richardson's vitals were good, and her Glasgow score was a 12, leading doctors to say that her condition at that point was still highly treatable. But by the time she arrived in the trauma center, more than two hours later, her pupils showed no response and her condition was "dire."

A helicopter trip directly from the resort to the trauma center would have been completed in a half hour, versus the four hours it took her to reach it via and ambulance with a stop at the local hospital. In other words, if there had been a helicopter she would have been at the trauma center at 3:55 instead of approaching the local hospital.

3:55 p.m.: In the ambulance

"This is vehicle 112 do you hear me well?"

"I hear you 5 out of 5."

"I'm arriving with a female in her 40s, presently at verbal (responds to verbal stimulus but otherwise fades out), disoriented 0 out of 4. It's following a story, a ski fall that happened at noon. Soon afterward she presents signs of confusion, a concussion. Glasgow at 12 ... vital signs: 124 on 86, breathing 100 per cent with O2, cardiac sequence at 70. We'll be there in about eight minutes."

The Glasgow coma scale measures degrees of consciousness after a traumatic brain injury. A rating of 12 is consistent with a moderate brain injury. Vital signs of 124 over 86 refers to her blood pressure. The cardiac sequence is her pulse. She is being given oxygen so her oxygen level is 100 per cent.

Dispatcher sends out call to pick up a patient at the Sainte-Agathe hospital and transfer her to the Sacré-Coeur Hospital trauma centre in Montreal.

[soothsayer]

1. Bummer. That's really a shame.