Dispatching rules for B.C.’s 911 calls are under the microscope as CTV News has learned of two new cases where a patient may not have been given timely help.

In one case, a man with his hand stuck in an industrial machine waited almost 40 minutes before first responders arrived with the hydraulic tools to free him. He lost his thumb.

The Sept. 9 incident has his union demanding that firefighters be sent by default to industrial accidents where paramedics who want to help a victim might not be able to.

“Anyone trapped in a machine is a worst-case scenario,” said Douglas Lea-Smith, president of ILWU Local 333, which represents workers at the Cargill terminal in North Vancouver.

“An industrial setting, particularly in a waterfront setting, all calls should be accompanied by the fire department,” he said. “The potential for danger and hazard is very high.”

Firefighters were also not called right away in a drowning death in Lynn Valley in August. In that case, dispatchers waited seven minutes for a caller to say where exactly he was in the water — about as long as it would have taken firefighters to get there and look directly.

All of this comes amid new scrutiny of dispatch protocols after a Coquitlam woman with a stroke waited three hours for paramedics, and then died.

BC Emergency Health Services brought in a new model for calls that cut firefighters from all but the most serious, life-threatening situations in 2018. The idea was to focus resources on more serious calls, and officials say broadly the system has worked and saved lives.

Over time, firefighters have been called back to fill unanticipated gaps in service, including in overdoses and when access to a patient might be difficult, such as the situation in the death of Tracey Gundersen. In that case in 2018, paramedics couldn’t access her building’s elevator.

The issue prompted a response from candidates from two parties.

“We need to get involved. We need to look at the situation,” said James Robertson, the BC Liberal candidate for Port Moody-Coquitlam. “The government should lean in and look at it and do a full lessons-learned analysis,”

Health Minister and NDP Candidate for Vancouver-Kingsway, Adrian Dix, said his government added 119 new paramedics in 2018 to reduce wait times.

“Our paramedics, our dispatchers, do a great job,” he said. “But every time there’s a problem we need to review it and as these problems are brought to our attention we review them.

In the Sept. 9 incident, a 911 call at 11:56 a.m. was categorized by dispatch as "orange," meaning serious but not immediately life-threatening. The first paramedic crew arrived at 12:04 p.m.; another crew arrived at 12:25 p.m., and then called for firefighters at 12:27 p.m., who arrived at 12:34 p.m.

By that point, other millwrights were able to release the man’s hand themselves, Lea-Smith said.

“He could have received a worse injury without their help,” Lea-Smith said. “He lost his thumb and that could be a consequence of this.”

In the Aug. 25 Lynn Valley case, E-Comm received a call for help at 4:29 p.m. At 4:33 p.m., BC EHS said dispatchers had it. It took until 4:40 p.m. for the caller to give location details, and firefighters were notified at 4:41 p.m., BCEHS logs show.

It would take about that long for the firefighters to get to the rough location of the drowning and search directly.

BC EHS says the established protocol is notifying fire departments of any calls that require technical expertise and equipment, including motor vehicle accidents, hazmat scenes, and potential drownings, or as requested by paramedics or someone on the scene.

However it does not have a policy that is specific to industrial sites.