Emergency Medical Services in New Brunswick: Numbers and Process
In a medical emergency in New Brunswick, dial 9-1-1; ambulance services are provided by Ambulance New Brunswick (ANB) with fees applicable for transport, and response times are faster in urban centers but can be lengthier in remote regions.
Overview of EMS in New Brunswick
Emergency Medical Services in New Brunswick are delivered through a single, province-wide system designed to provide standardized care. The system is a publicly funded, privately operated model.
The system aims to balance coverage across diverse landscapes, from dense urban areas like Saint John to sparsely populated northern communities. According to ANB's 2022/23 report, they responded to approximately 115,000 calls annually.
Differences from National Policies & Other Provinces
While Canada's 9-1-1 system is national, EMS delivery is a provincial responsibility, leading to key differences.
| Aspect | New Brunswick | National Context / Other Provinces (e.g., Ontario, BC) |
|---|---|---|
| Service Model | Single, centralized contractor (ANB/Medavie). | Often multiple municipal or regional services (e.g., Toronto Paramedic Services, BC Emergency Health Services). |
| Ambulance Fee | Fee for service (~$130-$150 for residents). Not universally covered by provincial health plan. | Varies widely: Free at point of service in some provinces (e.g., QC for residents), partially covered in others (e.g., ON with $45 co-pay if covered by OHIP), or full fee (BC at ~$80-$530). |
| Air Ambulance | Provided by LifeFlight (fixed-wing) and STARS (rotary-wing under contract), heavily subsidized but can involve high costs for non-residents. | Similar models exist, but funding and patient cost-sharing formulas differ significantly. |
| Dispatch | Centralized Medical Communications Centre (MCC) for the province. | May be regional or municipal. Some use advanced Medical Priority Dispatch Systems (MPDS) more extensively. |
Local Enforcement & Regulatory Differences
EMS operations in NB are governed by a mix of provincial statutes and the terms of the ANB contract.
- Governing Legislation: The Emergency Medical Services Act and Ambulance Services Regulation (94-117) set standards for vehicles, equipment, and personnel certification.
- Enforcement Authority: The Department of Health is the regulator. Compliance is monitored through the contract management of ANB, rather than direct policing of multiple operators.
- Protocols: Treatment protocols are standardized province-wide and approved by the Provincial Medical Director (a physician). Paramedics operate under these “standing orders” and through direct online medical control with hospital physicians.
- Key Local Rule: Unlike some jurisdictions, NB paramedics have specific regulations governing the transport of patients between facilities (inter-facility transfers), which are a significant part of their workload in rural areas.
The EMS Response Process: From Call to Hospital
Understanding the process can help citizens interact effectively with the system.
- Activation (9-1-1 Call): Call is answered by a 9-1-1 operator who determines the service required (Police, Fire, Ambulance) and transfers to the Medical Communications Centre (MCC).
- Triage & Dispatch: An Emergency Medical Dispatcher (EMD) uses a structured protocol to assess urgency, provide pre-arrival instructions (e.g., CPR guidance), and dispatches the closest appropriate ambulance unit.
- Response: Paramedics respond with lights and sirens based on call priority. ANB uses a dynamic deployment system to position ambulances in anticipation of demand.
- On-Scene Assessment & Care: Paramedics perform a patient assessment, provide necessary interventions (e.g., oxygen, medication, defibrillation), and stabilize for transport.
- Transport Decision: Paramedics decide, often in consultation with the MCC or online medical control, on the appropriate destination (e.g., nearest emergency department, specialized trauma centre, stroke unit).
- Hospital Handover: Upon arrival, a verbal report is given to triage nurses, and the patient is transferred to hospital care. Paramedics complete electronic patient care records.
Key Local Government & Health Agencies
- New Brunswick Department of Health: The overarching policy-maker, funder, and regulator for EMS.
- Ambulance New Brunswick (ANB): The operational service provider. Website contains fee schedules and service information.
- Regional Health Authorities (RHAs): Vitalité Health Network and Horizon Health Network operate hospitals and collaborate with ANB on patient flow and protocol development.
- EMANB (EMS Managers Association of NB): A professional body representing EMS management and advocating for system improvement.
- New Brunswick Paramedic Association (NBPA): The professional association representing paramedics.
Local Costs: Ambulance Fees, Medical Fees & Potential Fines
Costs associated with EMS in NB are a mix of direct user fees and public subsidy.
| Service | Typical Cost (Resident) | Notes & Exemptions |
|---|---|---|
| Ground Ambulance Transport | $130 - $150 (base fee) | Fee is for transport, not for care. Additional per-kilometer charges may apply for long-distance transfers. Exemptions may apply for seniors in special care homes, social assistance recipients, and victims of certain crimes (with police file number). |
| Ambulance Response (No Transport) | $100 - $130 | Charged if paramedics assess/treat but the patient refuses transport (AMA). |
| Air Ambulance (LifeFlight) | ~$10,000 - $15,000+ | Massively subsidized by the province. NB residents with a valid Medicare card pay only the ground ambulance fee. Non-residents or those without provincial coverage are billed the full cost. |
| Hospital Emergency Care | Covered by Medicare | No direct fee for medically necessary physician/hospital services for residents with a valid Medicare card. Non-residents are billed. |
| Potential Fines | N/A | No fines for legitimate 9-1-1 use. However, knowingly making a false 9-1-1 call is an offense under the Emergency 911 Act and can result in penalties. |
Billing & Insurance: Bills are sent to the patient. Many private health insurance plans cover ambulance fees. It is the patient's responsibility to submit the bill to their insurer for reimbursement.
Essential Emergency Numbers & Contacts
- Life-Threatening Emergency: 9-1-1
- Non-Urgent Health Advice & Info: 8-1-1 (Tele-Care). A free, 24/7 nurse advice line.
- Poison Control Centre: 1-800-565-8161 (Toll-free within NB)
- Mental Health Crisis Line: 1-800-667-5005 (CHIMO Helpline)
- ANB General Inquiries (Non-Emergency): 1-800-461-9191
- Department of Health (Ambulance Services Info): 1-888-762-8600
Response Times & Geographic Coverage
Performance is measured against the Response Time Performance Plan in the ANB contract. Targets are tiered by population density (Urban, Semi-Urban, Rural, Remote).
Challenges: Rural and remote areas face longer times due to distance. For example, a call in a village like Blacks Harbour may see a response from St. George or Saint John, impacting times. ANB uses a system of over 90 standby stations and "posting points" to optimize coverage.
Coverage Gaps: While the goal is province-wide coverage, extreme weather (snowstorms, flooding) can temporarily isolate communities, delaying both EMS arrival and transport to hospital.
Paramedic Levels, Training & Capabilities
New Brunswick recognizes three primary levels of paramedics, aligned with the National Occupational Competency Profile (NOCP).
| Level | Training Duration | Key Capabilities | Typical Role |
|---|---|---|---|
| Emergency Medical Responder (EMR) | ~120-160 hours | CPR/AED, basic airway management, oxygen therapy, spinal immobilization, hemorrhage control. | Often in industrial, event, or rural volunteer first response units. May assist on ANB crews. |
| Primary Care Paramedic (PCP) | 1-2 years (college diploma) | All EMR skills + advanced oxygen/airway, administration of select drugs (e.g., epinephrine, nitroglycerin, salbutamol), glucometry, semi-automatic defibrillation. | The backbone of most ambulance crews, especially in rural areas. |
| Advanced Care Paramedic (ACP) | Additional 1-2 years post-PCP | All PCP skills + advanced cardiac life support (ACLS), manual defibrillation, 12-lead ECG interpretation, intravenous therapy, administration of a wider drug formulary (e.g., for pain, cardiac conditions). | Typically deployed in urban centers or as "fly-cars" to support PCP crews on complex calls in rural zones. |
All paramedics must be licensed with the New Brunswick College of Paramedics, which ensures ongoing competency and professional conduct.
Patient Rights & Refusal of Care (AMA)
Patients in NB have specific rights when interacting with EMS.
- Right to Informed Consent: Paramedics must explain the proposed treatment and its risks/benefits. You have the right to consent or refuse.
- Right to Refuse (Against Medical Advice - AMA): If you are mentally competent (able to understand the situation and consequences), you can refuse any or all treatment/transport. Paramedics will:
- Ensure you understand your condition and the risks of refusing.
- Offer alternative options (e.g., seeing your own doctor).
- Ask you to sign a Release From Liability form.
- May involve online medical control (speaking to a doctor) to ensure your competency is assessed.
- Right to Privacy & Confidentiality: Your health information is protected under the Personal Health Information Privacy and Access Act (PHIPAA).
Community Programs & Public Access
Several programs enhance community resilience and access to care.
- Public Access Defibrillation (PAD) Programs: Many public buildings (arenas, government offices) have Automated External Defibrillators (AEDs). ANB and the Heart & Stroke Foundation promote their use.
- CPR Training: Widespread courses are offered by Red Cross, St. John Ambulance, and others. Some communities have targeted "CPR in Schools" or "Hands-Only CPR" campaigns.
- First Responder Programs: Many rural fire departments or community groups have trained EMR-level First Responders who can stabilize patients until an ambulance arrives.
- Vial of Life/Smart911: Programs encouraging citizens to keep a list of medications and medical conditions on the fridge or in a secure online profile (Smart911) for dispatchers and paramedics to access.
Frequently Asked Questions (FAQ)
What is the emergency number to call in New Brunswick?
A. In New Brunswick, as in all of Canada, dial 9-1-1 for any life-threatening emergency requiring police, fire, or ambulance services. For non-urgent medical inquiries, you can contact Tele-Care 811.
Is ambulance service free in New Brunswick?
A. No, ground ambulance service in New Brunswick is not free for everyone. There is a fee, typically around $130-$150 for residents, though costs can be higher for non-residents or for specific transports. Some individuals, like those on social assistance, may have fees covered.
Who provides EMS in New Brunswick?
A. Emergency Medical Services in New Brunswick are primarily provided by Ambulance New Brunswick (ANB), a service operated by Medavie Health Services under contract with the provincial Department of Health. Some First Nations communities and industrial sites may have separate agreements.
What should I expect when I call 9-1-1 for a medical emergency?
A. Stay calm. The dispatcher will ask for your location, phone number, and the nature of the emergency. Be prepared to describe the patient's condition, level of consciousness, and breathing. Do not hang up until instructed. Follow any first aid instructions given over the phone.
How are EMS response times in rural vs. urban New Brunswick?
A. Response times vary. In urban centers like Saint John or Moncton, the target for the closest available unit is often under 9 minutes. In rural areas, travel distances can significantly increase response times, sometimes exceeding 20-30 minutes. ANB uses a system of strategically located stations to optimize coverage.
Can I refuse ambulance transport or treatment?
A. Yes, if you are mentally competent, you have the right to refuse treatment or transport (Against Medical Advice - AMA). Paramedics will ensure you understand the risks of refusal and may ask you to sign a release form. You may still be charged a response fee.
What is the difference between EMR, PCP, and ACP paramedics?
A. These are different levels of paramedic certification. Emergency Medical Responders (EMRs) provide basic life support. Primary Care Paramedics (PCPs) provide advanced first aid, oxygen, and some medications. Advanced Care Paramedics (ACPs) can administer more drugs, interpret ECGs, and perform advanced airway procedures.
Where are New Brunswick's major trauma centers located?
A. The province's two designated trauma centres are the Dr. Everett Chalmers Regional Hospital (Fredericton) and The Moncton Hospital. The Saint John Regional Hospital also provides critical care. EMS uses a triage system to transport patients to the most appropriate facility.
Official Resources
- Ambulance New Brunswick (ANB) Official Website - Fee schedules, service areas, news.
- GNB - Ambulance Services Information - Government page on exemptions and billing.
- Emergency Medical Services Act (NB) - The governing legislation.
- New Brunswick Department of Health - Main health portal.
- New Brunswick College of Paramedics - Paramedic licensing and regulation.
- Heart & Stroke Foundation - New Brunswick - CPR & AED resources.
- Smart911 - Secure safety profile service used by some NB dispatchers.
Disclaimer
This guide is for informational purposes only and does not constitute legal, financial, or medical advice. While we strive for accuracy, EMS protocols, fees, and contact information are subject to change. Always rely on official sources and call 9-1-1 in an emergency.
Liability for actions taken based on this information is expressly disclaimed. Refer to the official Emergency Medical Services Act and regulations, and consult with the New Brunswick Department of Health or Ambulance New Brunswick for the most current and authoritative information.
User assumes all risk. The website operators are not responsible for any errors, omissions, or outcomes resulting from the use of this information.