Segmented Information - Summary of Operating Segments (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Revenue	$ 120,385,274	$ 112,749,380
Operating costs	105,703,079	92,454,250
Operating income (loss)	14,682,195	20,295,130
Finance expense	6,609,618	4,567,327
Depreciation and amortization expense	35,009,070	31,486,055
Anesthesia Services [Member]
Segment Reporting Information [Line Items]
Revenue	110,306,431	101,790,165
Operating costs	94,506,039	81,079,150
Operating income (loss)	15,800,392	20,711,015
Finance expense	2,994,654	1,138,200
Depreciation and amortization expense	34,908,764	31,394,245
Product Sales [Member]
Segment Reporting Information [Line Items]
Revenue	10,078,843	10,959,215
Operating costs	4,647,719	5,022,737
Operating income (loss)	5,431,124	5,936,478
Depreciation and amortization expense	25,534	68,509
Other [Member]
Segment Reporting Information [Line Items]
Operating costs	6,549,321	6,352,363
Operating income (loss)	(6,549,321)	(6,352,363)
Finance expense	3,614,964	3,429,127
Depreciation and amortization expense	$ 74,772	$ 23,301