The death Wednesday of British actress Natasha Richardson after she tumbled on a Quebec ski hill is raising questions about the province's lack of an emergency helicopter system.
The wife of actor Liam Neeson, and member of the Redgrave acting dynasty, suffered what was at first deemed to be a minor fall Monday, while on a beginner's ski hill near Montreal.
Richardson, 45, refused to be taken to hospital after the accident, but her condition worsened about two hours later. The actress was then transported to a hospital in Sainte-Agathe, Que., a 40-minute ambulance ride from the Mont Tremblant ski resort.
After she was stabilized, Richardson was transferred to a Montreal trauma centre by ambulance, because, unlike most provinces, Quebec has no emergency helicopter system. The trip took about one hour while a helicopter ride would have carried her to Montreal in 15 minutes.
Trauma specialists have been warning of this lack of service for years, saying it could lead to unnecessary deaths.
"This is like not having a fire department in a community," said Dr. Tarek Razek, head of the trauma team at the McGill University Health Centre.
Timeliness is crucial after major head traumas, he stressed.
"You need to get to a trauma centre fast, and the faster we can organize that, the more likely you are to live," he said.
He stressed that Quebec is one of the few jurisdictions in North American and Europe that don't have emergency medevac helicopters.
"I'm really worried. What's going on? Why do we have this gap in our services?" he asked, adding even the smaller province of Nova Scotia has this service.
The Quebec Health Ministry has been studying the shortage of medical helicopters, and a report is expected to be handed down to the provincial government in "a few months."
"We are looking at what it would take to get that system in place, the cost and the impact of such services," said Andre Lizotte, co-ordinator of air health services and first respondents for the department.
The province has an air ambulance that takes patients who need urgent medical care, and another one will be added in 2010. But these planes are used for long distances, not to carry patients from an accident site to a hospital.
In Richardson's case, seven hours passed between her fall and her arrival at the specialized trauma hospital in Montreal.
The provincial coroner office said it has no intention of investigating the accident, since the actress died in New York.
Razek declined to comment on the Richardson case, but said the lack of medical helicopter service in the province is decreasing the likelihood that people will survive major traumas.
But paramedics said even a helicopter may not have saved Richardson, because it's difficult to tell if someone has seriously injured the brain in a fall.
"Yes, medical helicopters would be great but, in this case, I don't think it would have made a difference," said paramedic Yves Coderre of Ambulances Radisson, the company that serves Mont Tremblant.
He noted that his paramedic team sent to help Richardson minutes after her fall was turned away, and did not have a chance to check her injury.
"This is very frequent. We try to tell people that they could die from even a minor head trauma and they need to go to the hospital, but most times they laugh at us," he said.
A medical examiner said Thursday that Richardson's death was ruled an accident in which a "blunt impact to the head" caused an "epidural hematoma" ? a type of traumatic brain injury when blood builds up just below the skull. She was not wearing a helmet on the ski hill.
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