Winter can be a challenging time for EMS systems. Beyond regular call volumes (falls, accidents, illnesses) that don't stop, there are seasonal surges of flu--and this year, even worse, H1N1.

To deal with 9-1-1 callers potentially infected with this new virus, plus regular flu victims and the inevitable worried well, Calgary EMS is deploying four special flu-response units (FRUs) during peak call times.

"It's not a response to H1N1 in particular," says Public Education Officer Stuart Brideaux, EMT-P, "but they help us to maintain our regular operations as best we can, and keep our ambulance fleet available for 9-1-1 calls."

The units (SUVs) are placed strategically around the city and dispatched for callers with symptoms of influenzalike illnesses. The single practitioners staffing them evaluate callers and can call for ambulances if emergency care or transport is needed. Alternatively, they can direct patients to follow up with higher-level caregivers (such as their family physician or a walk-in clinic) or instruct them on self-care.

Those staffing the FRUs are specially trained to identify and understand ILI symptoms and help educate callers to care for themselves. They begin all calls wearing personal protective equipment above and beyond that normally worn by Calgary providers, including gowns and masks.

It's important to note, Brideaux stresses, that those needing the capabilities of a full ambulance, including transport, still get them. The FRUs merely help relieve some congestion from cases that, based on 9-1-1/dispatch information, don't appear to be complex or life-threatening.

"Of course, what we're called for, what's at the scene and why we transport can all be three different things," he says. "But by and large, the calls the FRUs are attending are medically appropriate. They're bringing a lot of education on self-care to people displaying flulike symptoms, and where callers are unstable or having a greater threat or emergency, then we send an ambulance. But the FRUs are helping keep our operational levels normal by curtailing some of the responses for people who don't require transport, or more just need education and information."