HellsBells

Just call ALS back up and move on with your assessment. In scenarioland they amost always need advanced care. I'd say you're overthinking this one.

Yes, we do have the hockey obsession, not so much lacrosse, although there are a couple professional teams up here.

This is a very positive move for ACP, I think.

Personally, I've never routinely tested orthostatic changes with a CC of abdo pain. Perhaps in the case of presyncope, or dizziness on ambulation, perhaps. However, don't really know why they changed your protocols. Maybe its due to possiblity of a syncopal episode, and further injury from a fall?

y Alberta is like Texas north, pretty much...Except for the heat, coastline, and obsession with high school football.

In Alberta Canada: (Close approximation) EMT-A (or PCP, as above)- makes $24-30hr. EMT-Paramedic (combination of ACP and CCP as above)- makes $28-$40hr My tax return gross was about $95,000.00 last year, with around 35% tax rate. Seems like a lot on paper, but strangely not much left over at the end of the day!

If there is any chance to relocate for you try western Canada...Alberta in particular. There are plenty of well paying jobs here, although you may have to work in the oil and gas industry, as an EMT B. Anyways, check out this site collegeofparamedics.org

Yep, your best bet is to talk to the press... but why not aend it to the local level as well... it will make them look very bad if they fail to act on it.

I agree with the above comments. If this guy is bold enough to include this in an email with his name on it, think of what he is willing to do in the dark. It is true that if this fellow is well connected, you may have some pushback. However, I'd strongly suggest you expose this to the media as well. A little bit of public heat on the issue may make the old boys club reluctant to make an example of you.

I would assume that in most cases your "scenario" would be serious enough for ALS back up to be called. At least thats how its always been in every test or exam scenario I've ever done. Very rarely do you get one with minor injury or benign medical compliants.

Wow Dwayne, I was unaware that the term "blacks" was now considered insensitive. Personally, I would agrue the phrase "african american" is incorrect, as it doesn't refer to any whities who have immigrated to the USA. Perhaps people have to stop having such delicate sensibilities.

Actually, I was going to comment on dispatch here. But, before I get started, I'm not trying to rip on dispatch in general, but relate some personal experiences. Our dispatchers are hired as laypersons (generally) and trained on the job. They use the medical priority dispatch system (MPDS). So obviously they have to follow the directions as predetermined by the card system. Now, this system is alright if the dispatcher can interpret the meaning of the cards adequately, but due to profound lack of any medical knowledge, they can't. Its amazing the sheer number of pts who are allegedly "not breathing normally" or are "clammy" as per dispatch, but have compliants completely unrelated to those 2 modifiers Furthermore, we have a standing policy where a Fire Engine Co-responds on all Delta or Echo responses. This policy drives me crazy. In the vast majority of Delta calls the Fire Dept is sent away before, or seconds after they arrive on scene. This of course pads the Fire Depts stats and ensures funding, but puts all responders at increased risk by adding a Fire Engine to the L/S response. Anyway, its to the point now where I will choose how to respond based on the notes written by dispatch on the call, not the bravo, charlie, delta, etc determination.

Here is a link from a recent study on the subject. http://www.calgaryherald.com/news/calgary/Ambulance+response+times+critical+patients+survival+study+finds/6080857/story.html?id=6080857

The only fluid we have is NaCl 0.9% and D5W to mix for amiodarone drips.

Edmonton was the first area to do this survey, their negative response is the reason its been expanded to the rest of the province.

I suppose its a theoretical possibility, but frankly, not something I live in fear of, or consider too often. However, I do will grant that civil court is a possibility following a mistake, but unless one is grossly neglegent I'd say the risk of conviction is low. As for it can happen at any time for any reason? Really? Thats not my experience with the job

To all you Alberta Paramedics (with expection of Edmonton) I suggest you fill out the HSAA employee satisfaction survey, its online http://www.hsaa.ca/home

Well, nypamedic, thats laying it on just a little thick, don't ya think? It is true, it takes dedication to get through school and clinincals, its certainly not something one can do half-assed. You will also be called apon to make your own decisions, and act on them, sometimes with little support or back-up. As for screwing up, I'm not really sure how a mistake leads to the complete destruction of life and liberty as you know it (possible jail time?), perhaps nypamedic can expand on that one. However, the job holds a certain amount of responsibilty, so you you will be held accountable for your actions. The job can be stressful, and some shifts are exhausting, but there are many different shift patterns out there, not everyone works 33-48hrs. The wages again are varible. I'm in Canada and make what I consider a fair wage for the job. I live comforably, and can afford to buy a home. Yet, Im not what one could ever consider "weathy" or "well off." As for the USA, I have no experience there, so cannot speculate. Personally, I do not consider the job "tough" per se, but it requires a good work ethic and, I can't stress this enough, sound decision making abilities. If you're not sure about the job, do a few ride alongs with the local ambulance and see what you think.

Care to expand on that? Or do you just enjoy making moronic statements?

http://www.bryanbledsoe.com/handouts Third power point down.

Yeah I agree Kiwi, I rarely ever use an NRB unless totally nessesary, however I think that the research cited for this article is woefully incomplete and some new research could be very illuminating.

I agree with a lot of what Bernhard is saying. Lights/siren help us get through traffic jams and intersections for the most part, otherwise they don't help much. I take exception with the statement that only a few minutes are saved by an L/S response though. In urban centers during rush hour a L/S response can make a good 20-30 min difference easy. That said, when traffic is at a low ebb, it makes little difference. Also, as Bernhard states, low speed is key, particularly when your transporting the sick pt to hospital. There is nothing worse than an inexpeirenced rookie driving like a manic, tossing the attendent to and fro in the pt compartment. Not Cool.

Hardly a convincing statistic, there could certainly be a lot of under factors at play here. However, as said earlier in this thread, there is no reporting on the amounts particular amount of 02 given to subjects in this study. Howver, this is an interesting piece, I look forward to more study on the subject.

Its interesting that Edmonton has these type of problems, where a city of comparable size, i.e. Calgary, is much more effecientally run.

Exactly, its just a matter of a manager responding to a scientific study with an opinion. Who care why stated abuse happens, it happens.