The horrific van attack on Yonge Street that left 10 dead and 16 injured served as the ultimate test for how Toronto’s emergency crews respond to a mass casualty event.
But for paramedics who were on duty that day, they say their training carried them through the minutes and hours following the first call.
“We just kept hearing about multiple patients struck and multiple patients critically injured and I wasn’t sure if this was something that was ongoing or what was happening,” Toronto paramedic Christopher Rotolo recalled in an interview with Global News.
Just before 1:30 p.m. on April 23, emergency crews were called to Yonge Street with reports that a white rental van hit a number of pedestrians while driving south toward Sheppard Avenue from Finch Avenue. Twenty-five-year-old Alek Minassian was arrested by police minutes later and later charged.
Toronto Paramedics told Global News 26 vehicles (primary response, advanced care paramedics, and support units) ultimately were sent to the scene along with seven units from York Paramedics. In all, approximately 50 Toronto paramedics, supervisors and dispatchers along with dozens of police officers and firefighters, responded to Yonge Street.
Rotolo said he was at Mount Sinai Hospital finishing with a patient when he heard a lot of “commotion” over the police frequencies of his radio. He and his partner quickly worked to clear themselves from the hospital and notified dispatch. They were quickly assigned to respond.
“You see the news and you see this stuff happening all over the world, but I never thought I’d be in the driver’s seat of an ambulance responding to a call like this,” Rotolo said.
He said he and his partner were assigned to go to the Yonge Street and Park Home Avenue area, just north of Mel Lastman Square. Rotolo said he was only on the scene for moments before he had to jump into work. On-scene crews, whom Rotolo commended for their triage efforts, were loading a patient onto a stretcher destined for Sunnybrook Health Sciences Centre. He said he quickly jumped into the back with the patient.
“Seeing all those people lying on the sidewalk and stuff like that wasn’t easy,” Rotolo said while recounting his experience after arriving on scene.
“But at the same time, a patient is getting wheeled towards me and there’s a task to be done.”
Meanwhile at Toronto Paramedic Services headquarters, John Shirley was on duty as an educator in the service’s communications centre. He was working with someone who was returning to work when Shirley said he and that staff person were the first ones to field calls.
“I stood up, I looked for the supervisor, and at the same time the calls were just coming in from all over the place,” Shirley said, noting the communication centre was full of red lights — lights that represented active calls.
“From dispatch, it was chaotic. It’s a little overwhelming at first. We’re getting all kinds of information from all sorts of people on scene who have seen it – good information though that we were able to determine we had a lot of patients that needed a lot of help.”
Shirley said while he was helping with the mobilization of resources, he could hear staff working with Good Samaritans who called in to provide CPR instructions and basic first aid to control bleeding.
“I know a lot of our call-takers who were on the phone that day were providing life-saving instructions over the phone to some of these citizens on scene and they were trying to make life-saving interventions on scene,” he said.
For Shirley and Rotolo, they both said the sheer number of patients and calls made the response particularly challenging.
“I’ve been a paramedic for quite some time now, so I have seen a lot of pedestrian struck calls. But just nothing to this volume where we have multiple patients and crews having to make decisions of who’s first and who’s second out,” Rotolo said.
“I think that’s why we train so much for events like this so that we fall back on our training, so that we have something to think about during the event,” Shirley said.
“It brings a sense of duty to all of us to make sure that we do everything right. It’s got to be done right for the patient. It’s got to be done right for the community.”
In the hours and days that followed the initial call, Shirley and Rotolo said they experienced difficulty immediately after. However when it came to media coverage of the attack, they took different approaches.
“It was really hard to shut my brain off that night,” Rotolo said, noting he went to watch a hockey game after finishing his shift at Sunnybrook hospital.
“I found it kind of to be helpful to see some of the images on TV … everybody came together and it kind of gave me some closure. It was all hands on deck and everybody did exactly what they were called to do that day and everybody gave it their all.”
“Playing it through my head over again. We tend to think the event over, start to finish, over and over again just to make sure that we’ve done things right, that everything makes sense,” Shirley said while noting he tried to stay away from media reports.
An important resource for Toronto Paramedics staff that respond to traumatic events is an internal peer support team.
David Laskovski, who normally works as a dispatcher, was off duty on April 23. However, his phone began to ring moments after emergency crews learned of the attack and he said he came in without hesitation to listen and help colleagues talk through what they experienced.
“We’ve never had our own safety sort of shaken the way it was, so people sort of had this sense of disbelief,” he said while recounting generally the conversations he had with coworkers.
Laskovski said he and others with the team spoke with their colleagues in the hours that followed. He said it was important that his colleagues knew there is support from the peer support network for those who experienced difficulties after responding that day.
“It makes them like they’re not alone and that they don’t have to suffer in silence alone,” he said.