Health workers are pushing for better access to frostbite treatments that are popular in the Yukon

A new coalition of Canadian health professionals hopes to “revolutionize” freeze care in Canada, in part by promoting a groundbreaking treatment protocol popularized years ago by several Yukoners.

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

The approach has been applied ever since Himalayan climbers in Kathmandu and saved fingers and toes in it Helsinki. But it's still not widely used in Canada, where conventional freezing treatments can lead to patients waiting months before ultimately receiving amputations.

Iloprost was approved by the FDA for use in the US earlier this year, but is still not commercially available in this country. Currently, a Health Canada special access request is required.

Dr. Catherine Patocka is an emergency medicine physician and department head 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 to say, 'Why don't we do that in Calgary?'” Patocka said. “We're seeing a lot of freezes. It looks like we could have a big impact on a particularly vulnerable population.”

Freezing often disables people who are already homeless or struggling with substance abuse.

“The goal is always to help patients get through that and get back to a life where they're not struggling with those 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 live for yourself.”

Patocka credits the treatment protocol popularized by Poole and Gauthier for helping reduce the number of amputations in her city.

The treatment is now available in most areas of BC, some areas in Ontario and Quebec, and in Calgary. But now the number of frostbite amputations is increasing Edmonton, Winnipeg And Torontothere is still a way to go.

Why does it take so long?

Via email, a Health Canada spokesperson told CBC News that the onus is on pharmaceutical companies to sponsor new drugs and “provide substantial scientific evidence of a product's safety, efficacy and quality.”

But if a company chooses not to start that process, drugs like Iloprost could 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 since provinces and territories have separate, independent health authorities, it may take some time for new treatment methods to become standard practice nationwide.

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

“It underscores the tremendous amount of work that Dr. Poole, the physician who originally published the protocol, must have done to improve care for the patients he saw in the Yukon,” Patocka said.

Freezing data 'pretty slim'

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

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

“Most of the data regarding freezing is quite limited,” Poole said. “We know some things, but we don't know nearly as much as we would like to know.”

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

He would like to see a national database for frostbite cases, as well as a better way for health care professionals to share their findings and compare notes – and he hopes Canada's Frostbite Care Network can help.

“Every winter we see a handful of severe cases in the Yukon. But if we spread this across the country, if we collect data from all the cases, then we could probably understand freezing a lot better.”