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For Kalani Polson, Unit Chief for Vancouver’s Critical Care Team at Station 280 YVR, the journey into paramedicine began with a Scout camping trip on the West Coast Trail in high school.
He and his fellow Scouts had done first aid training, and he ended up having to put his new skills into practice in the backcountry when one of the other teens got his hand entangled in one of the large cable cars’ pulleys on the route.
“At the time, we were separated from the (Scout) leaders,” Kalani said. “You had to winch each car across and so we were separated from the rest of the group by a canyon over a river crossing. So it was just me trying to figure out first how to get this kid's hand out of the big metal wheel, deal with the significant crush injury, and send the cable car back over to bring the leaders back to help.”
“It was that first opportunity to put the training into action. It went relatively well and ended up with a Coast Guard extrication from a nearby lighthouse – obviously not coordinated by me – but it was that initial involvement that really sparked an interest.”
Kalani was 13 or 14 at the time, and the experience had a profound impact on him, reinforced by TV shows of the time like Rescue 911. When Grade 10 came around, Kalani enrolled in a career development co-op class, where he expressed a strong desire to become a paramedic.
Kalani Polson with an ambulance in 1991
Kalani’s career aspirations were supported by Lynn Klein, a founding pioneer of BC’s ambulance service. In 1991, after spending decades on-car and in the air as a paramedic, Lynn had become the Superintendent of Media and Public Relations for the BC Ambulance Service (BCAS), as it was called at the time, and he was instrumental in getting Kalani into ambulances, planes, and helicopters.
“I remember [Kalani] coming in and he said, ‘I'm going to be a paramedic,’ to which I said, ‘Well, I guess you're exploring the idea of becoming a paramedic,’ or words to that effect, and he said, ‘No, I'm going to become a paramedic.’” Lynn recalls.
BCAS took Kalani in for two years of extensive work experience that totalled several thousand hours across all aspects of the organization. He was immersed in dispatch, air ambulance operations, ground operations for both basic life support (BLS) – now called primary care – and advanced life support (ALS) – now called advanced care – and more, but once he’d spent some time in the air, he was hooked.
“Coming back to my co-op class on a weekly basis after flying around in a private jet and helicopter was kind of addictive,” Kalani said. “I actually have a strong memory of flying an Air Evac on government air with Randy L’Heureux, who ended up years later being my Director in air ambulance. Randy was an ALS Air Evac paramedic at Station 121 in Victoria at the time, and he just was staring at me on the plane, and I thought, ‘What did I do?’ I was super nervous. And he said, ‘You've got the bug. Once you have the bug, there's no going back.’”
Things weren’t always as smooth on the ground given the unpredictable nature of the calls crews attended.
“There were some crews that refused to take him because they felt that a 15-year-old boy being exposed to perhaps some of the traumatic events they might encounter may put a mark on him for the rest of his life,” Lynn said. “Some of the advanced life support crews declined to host Kalani, however, he was not going to give up.”
Kalani said while being rejected by some crews was disappointing at the time, Lynn was able to pivot and send him to Vancouver, which opened up a whole other world of rapid-fire calls and experience.
“I look back now and I've got a 15-year-old son, and I'm like, ‘Oh my god,’” Kalani said. “My opinion of it has completely changed over the years, because it's not every day that you go to a terrible call, but they certainly happen. Fortunately, nothing broke me in the early days, and I realize that I was turned down with my wellbeing in mind.”
“There were no mental health resources or anything like that back then, but there was a lot of care and attention paid by a small group of people, like Lynn, to make sure the matchings were good with who I was going to be with, and those medics took me under their wing, kept me safe, and taught me so much. I was incredibly lucky to be exposed to the service at a time when many of the true pioneers of BCAS were still around. The work that was done in the first 15 to 20 years of the service was world class: ALS and Infant Transport Team (ITT) training, an air ambulance service that covers nearly a million kilometres of some of the harshest terrain on earth. I feel really honoured to have caught the tail end of that era.”
Kalani had connected with longtime BCEHS paramedic Glenn Braithwaite during the course of his extensive ridealongs in Vancouver, and when he was old enough to get hired on, Glenn’s advice came in handy once again. Glenn had moved up to Penticton, where he was unit chief at Station 329, and encouraged Kalani to apply to Station 316 at Big White, which was a seasonal station, and to a few other remote posts. He ended up being hired into Big White and spent a few years there while also working out of other stations in the Okanagan and the Lower Mainland during Big White’s off season.
After a while, the itch to try something new arose, and Kalani applied for a position in the Vancouver Dispatch Operations Centre (VDOC). When he was hired as a dispatcher, the system in Vancouver was still paper-based, and over the course of his six or seven years there, he helped implement Vancouver’s first computer-aided dispatch (CAD) system.
Lynn said he kept tabs on Kalani over the years after his work experience phase had ended – and it seemed like his appetite for learning only got bigger once he’d received his paramedic license.
“A couple of years later, all of a sudden, he's up in one of the communication centres in Vancouver,” Lynn said. “Then all of a sudden, I find that he's enrolled in an ALS program, and he completes that, and goes on to be a very good practitioner. And then he goes on to become a critical care flight paramedic.”
Kalani’s career involves a few notable milestones – not just for him, but for paramedicine in B.C. as a whole.
“I actually ended up being the very last EMA II before they switched it to PCP,” he said. “I’ve still got the December 29, 2004, license – that was the very last EMA II license issued by EMALB.”
He spent time at Station 242 in downtown Vancouver before eventually seizing the opportunity to enrol in the ALS program.
“Funded ALS training had gone away, and then it came back briefly. I was fortunate to be successful in the application process, but didn't have the seniority to clinch a spot. So initially I didn't get in, but then a few people dropped out, and I was placed into the ALS class partway through semester one,” Kalani said.
The process repeated itself several years later when he applied for the critical care paramedic (CCP) program – he was admitted to the course late and had to catch up to his classmates.
“There had been equivalent to CCP classes before, but it wasn't a separate license level,” Kalani said. “During our graduation in 2011, the ceremony was actually delayed while the Executive Director waited for a phone call to confirm that the legislation had passed to be able to tell the grads, ‘You guys are officially the first holders of Critical Care Paramedic licenses in BC.’”
Previously, advanced care paramedics (ACPs) worked with an Air Evac endorsement, but there had been so many additions made to the course that the licensing was upgraded to reflect the education and skill set, in line with national standards for CCP qualification.
And it wasn’t just the license level that got an upgrade – the gear that CCPs use has improved significantly over the years.
“When I first started riding along on Air Evacs in the 90s, there was a single jump kit with a one-syringe pump and no ventilator, other than your hand squeezing a BVM (bag-valve-mask),” Kalani said. “If you fast forward to today, we carry a total of ten kits with sophisticated multi-mode ventilators, multiple infusion pumps, a video laryngoscope, and all sorts of advanced diagnostic equipment – ultrasound, cardiac monitors, point-of-care lab testing devices. So certainly a major evolution from those days.”
In recent years, the most notable improvement has been the addition of pre-hospital blood and thawed plasma. In 2019, Adam Greene, Interim Director of Air Ambulance and Critical Care Operations, and Kalani partnered with Vancouver Coastal Health to facilitate the project, and BCEHS became the first paramedic service in Canada to offer pre-hospital blood.
“It has been the single most impactful addition to our scope, with a total of 159 transfusions to date,” Kalani said. “Blood products allow us to buy time to get some of our most critically injured trauma patients to a surgeon. Previously, many of these patients would expire in the field. It has absolutely saved lives right before our eyes.”
Kalani also notes that things have transformed rather dramatically in dispatch since he started.
“At the time that I was working in Vancouver dispatch, we would go down to a minimum staffing of four people at night and about seven or eight during the day. You compare that to peak staffing of around 30 today in the dispatch centre, and we were dealing with a daily call volume of nearly 1,000 calls,” he said. “That was all done on paper. Each night, for the hour before midnight, you would take a stack of call slips and, as you were dispatching crews, you would just sit there with a rubber date stamp and stamp the date on hundreds of slips for the whole next day of 911 calls. By the end of a 24 hour period you'd end up with a stack of call slips that was about a foot high. We would rubber band the whole thing together, and then it would go into the closet as the dispatch records. Our dispatchers and call takers today work equally as hard with ever-increasing call volumes and are often the unseen heroes working behind the scenes.”
In 2024, Kalani isn’t the only paramedic in his family: a few years ago, his daughter, now 21 and a part-time PCP in Central Saanich, came home and told him that she had enrolled in an emergency medical responder (EMR) program, completely out of the blue. Kalani had taken her out for Grade 9 ‘Take Our Kids to Work Day’, but said she hadn’t talked about paramedicine as a career path in the intervening years – though in some cases, it seems like a case of history repeating itself.
“Interestingly, she had her own moment as a young teenager, before I had taken her on that Grade 9 day, where she was in a friend’s pool out in Chilliwack where a toddler drowned,” he said. “She was the one to notice the child at the bottom of the pool and then called attention to it – and it was certainly a bigger call than my hand in the wheel thing. Her and a parent fished the kid out in respiratory arrest – there was CPR done, a PCP and ACP response, and a helicopter dispatched. Every layer of our system kicked into high gear and collectively saved the child’s life, which reminds me of our old slogan – ‘One Team, One Goal, Working Together for Life.’ Apparently that stuck in her mind as well, as it was such a successful outcome.”
Kalani is excited about the future of the service, saying he sees a lot of bright people entering the profession – and praises the evolving education and credentials. But while things like the Scope of Practice Expansion project, which is adding new medications and skills to paramedics across all license levels, are extremely valuable, Kalani said he always comes back to something Lynn Klein told him while driving around Vancouver Island when he was a high school student.
“‘There are all sorts of things that you can do to people, but people mainly just remember if you're nice to them,’” he recalls. “That’s such a huge thing that can't be lost as we add all these skill sets.”
“Most people, statistically, call an ambulance once in their life, so you have one opportunity to make a positive impression upon them for the entire paramedic profession,” Kalani said. “At the core of it, we're there to take care of patients and their families as human beings, no matter which level you practice at, because I can do a thoracentesis or an arterial line on somebody – they're not going to remember that, but they are going to remember if I gave them a blanket, kept them warm and was nice to them and their family members.”
Kalani Polson with an ambulance, in 1991
