A new coalition of Canadian health workers hopes to “revolutionize” frostbite care in Canada, in part by promoting an innovative treatment protocol popularized years ago by several Yukoners.

Whitehorse General Hospital surgeon Alex Poole and pharmacist Josianne Gauthier, part of the new Canadian Frostbite Care Network, published a study in 2016 describing a treatment for severe frostbite using a medicine called Iloprost.

Since then, this approach has been used on Himalayan climbers in Kathmandu and saved fingers and toes Helsinki. But it is not yet widely used in Canada, where conventional treatment for frostbite can force patients to wait months before potentially having an amputation.

Iloprost was approved for use by the FDA in the United States earlier this year, but is still not commercially available there. It currently requires a special access request to Health Canada.

Dr. Catherine Patocka is an emergency physician and head of the Department of Emergency Medicine at the University of Calgary. She remembers reading Poole and Gauthier’s article in 2016.

“It was galvanizing for some of our leaders here who said, ‘Well, why don’t we do this in Calgary?'” Patocka said. “We’re seeing a lot of frostbite. It looks like we could have a major impact on a particularly vulnerable population.”

Frostbite often disables people who are already homeless or struggling with drug addiction.

“The goal is always to try to help patients get through this and get back to a life where they’re not dealing with these challenges,” Patocka said. “And you can imagine that keeping your digits, your feet, your toes is extremely important to being able to walk around and make a living.”

Patocka credits the treatment protocol popularized by Poole and Gauthier for helping reduce amputation rates in his city.

The treatment is now available in most areas of British Columbia, parts of Ontario and Quebec, and Calgary. But with the increase in amputations due to frostbite Edmonton, Winnipeg And Torontothere is still a way to go.

What’s taking so long?

Via email, a Health Canada spokesperson told CBC News that it is the responsibility of pharmaceutical companies to sponsor new drugs and “present substantial scientific evidence of the safety, effectiveness and quality of a product”.

But if a company chooses not to begin this process, drugs like Iloprost may remain difficult to access for Canadian doctors. CBC News reached out to Iloprost manufacturer Bayer for comment but did not receive a response.

Several doctors also told CBC News that because provinces and territories have separate, independent health authorities, it may take time for new treatment approaches to become standard practice nationally. .

It may also depend on the willingness of individual doctors to research new treatments and advocate for their use.

“This highlights the enormous amount of work that Dr. Poole, the doctor who originally published the protocol, had to do to try to improve the care of the patients he was seeing in the Yukon,” Patocka said.

Data on frostbite is ‘fairly thin’

Poole said the treatment he and Gauthier introduced to the Yukon helped reduce the amputation rate for the most severe cases of frostbite, by 50 percent during the first five years they started using Iloprost.

The Canadian Frostbite Care Network aims to improve the treatment of frostbite and understand the full scope of its impacts across the country.

“Most of the data on frostbite is pretty thin,” Poole said. “We know some things, but we don’t know as much as we’d like to know.”

Poole says every winter, the Whitehorse hospital receives calls from doctors across the country seeking advice on treating frozen patients.

He’d like to see a national database of frostbite cases, as well as a better way for health-care workers to share their findings and compare notes – and he hopes the Canadian Frostbite Care Network can help him.

“We see a handful of serious cases in the Yukon every winter. But if we spread that across the country, if we collected data on all the cases, we would probably be able to understand frostbite better.”