The BARS Tool is the BC Ambulance Risk Stratification Tool, an evidence-informed risk assessment.
The tool can be used to assess patients with mental health challenges who are to be transferred by air ambulance, who may pose a potential risk to themselves, the crew or the aircraft.
The BARS Tool is performed exclusively by psychiatrists who have been trained in the use of the tool, and is used when moving patients with mental health issues to or from tertiary mental health facilities across the province.
The BARS Tool was formally introduced province-wide in March 2017. Psychiatrists in the four provincial tertiary mental health care facilities across BC (Hillside Psychiatric Centre in Kamloops, BC Children’s Hospital in Vancouver, Burnaby Centre for Mental Health & Addictions in Burnaby and the BC Psychosis Program in Vancouver) have been trained in use of the tool, as have a number of psychiatrists operating out of smaller facilities across the province. Facilities requiring transfer by air ambulance can access the trained psychiatrists to perform a BARS Tool assessment.
For more information about the BARS Tool, please watch the video below.
Health care professionals and BC Emergency Health Services (BCEHS) personnel have faced challenges while transporting patients with mental health issues via air ambulance. Challenges exist in geographical areas where there are infrequent transfers, and the population to be transferred can be of any age and may have varying degrees of illness. Patient behaviour can be difficult to predict, and prior sedation protocols may have not worked reliably. In addition, people with a mental illness whose behaviour is not challenging are sometimes managed in the same way as those whose behaviour is challenging, resulting in high levels of sedation that are not required. This puts the patient at unnecessary risk.
In 2012, representatives from BCEHS, BCMHSUS and the regional health authorities developed a risk stratification tool and sedation and recovery guidelines to address these issues. The BARS Tool was created to facilitate an evidence-informed risk assessment of patients with mental health challenges to be transferred by air ambulance.