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rock_shoes last won the day on April 24 2017

rock_shoes had the most liked content!

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About rock_shoes

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    Alta. EMT-P/BC ACP
  • Birthday 04/27/1984

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  • Gender
  • Location
    British Columbia
  • Interests
    Paramedicine, Climbing (rock,ice,alpine), Mountain Biking, Photography, Music

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  • Occupation
    Alta. EMT-P/BC ACP

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21,443 profile views
  1. Exciting mental health history & EMS/fire hiring

    Nobody works in EMS as part of a get rich scheme, but making enough to be able to participate in the lifestyle you desire outside of work is certainly of value. EMS workers in countries like Canada, Australia, and New Zealand are afforded a different level of pay/respect than that received by most US providers. As much as pay and respect can't be primary motivators, those two things have a powerful effect on career longevity. If you choose EMS as a career the most disastrously unhealthy thing you can do is allow it to become your everything. Your non-EMS friends become a lifeline to the outside world. Don't let them go. Whatever your other passions are maintain them. As for helping ourselves, frankly we're lousy at it as a group and certain risk factors will never be avoidable. Night shifts will always exist, paramedics will always be placed in stressful situations, and schedules will always make healthy diet/exercise habits difficult (but not impossible).
  2. Exciting mental health history & EMS/fire hiring

    I still love my job but it has changed a lot over the last 10 years. I started out in a rural community where the station did 700 calls a year (working as an EMR which is essentially the same as an EMT - B). Presently I'm most of the way through a Critical Care Paramedic program and working fixed wing/rotary air-evac (CCP programs are a Canadian thing involving roughly 5 years of post secondary education and a tremendous amount of clinical time). Every once in awhile I do get to be the cog in the machine with the ability to prevent disaster for someone. That part is an incredible privilege. The give and take in this job is not to be underestimated. Paramedic education programmes are rigid/inflexible as a rule. I've missed numerous family events and important happenings as a result. The tolls that missed events, long stressful shifts (particularly nights), and in your case as a US citizen lousy pay, take on you add up. I know without question my life will be shortened as a result of my service. Think long and hard about whether the increased mental health risk, increased heart disease/stroke risk, and shortened life-span are acceptable trade-offs for doing this job long term.
  3. Smartest thing youve ever seen a patient/family member do

    Agreed P_Instructor. Some of the most useful family members I've ever dealt with were grandchildren who were able to translate like a boss. No one seems to have picked up on one of the obvious ones though. Timely good quality CPR after calling 911. If nobody does CPR for 6-8 minutes before I get there odds of bringing back a brain are pretty damn low.
  4. Pulse confirmed. Brain function... Well... it might need some work.
  5. SAVE ME

    Too bad. I guess only the Canadian medics get to laugh at it until the content makes it to youtube.
  6. Exciting mental health history & EMS/fire hiring

    I've never met nor assessed you medically so I really can't give advise as to your suitability to any position (never mind one in the emergency services). What I will say is this, working in emergency services is a well known precipitating factor to the development of critical mental illness (most frequently PTSD). Do you want to work in such a field when you yourself have already expressed mental illness from which you have not yet recovered?
  7. EMT in Africa

    Do you have the option of taking your paramedic training in South Africa? South Africa is well known for having excellent advanced paramedic training programs.
  8. boots

    I'm with Ruff. I don't expect you'll go wrong with a proper pair of Red Wings.
  9. City of Ottawa Firefighter

    I'm very proud of my Ottawa brothers and sisters for being awesome enough to convince a firefighter to switch teams (to EMS). Oh and welcome to the city.
  10. Infusing Blood

    The Medsystem III has blood product administration sets made for use with it. I've always just used the designated blood sets or eyeballed the drip for the remainder of the infusion when doing a transfer.
  11. SAVE ME

    CBC Canada's public broadcaster has recently started airing a series of short films surrounding paramedics and the calls we respond to. They're some of the best I've seen and intended to be funny. Just be prepared they might make you cry. SAVE ME
  12. second line seizure medications

    I'll often insert a NPA in addition to O2, patient positioning, frontline benzo's, and all the usual assessment pieces (vitals, BGL rhythm, etc.). In the end it all come's down to suspected cause. TBI's are going to have a much lighter RSI trigger than say a known epileptic with a history of poor medication compliance.
  13. second line seizure medications

    The caveat always being ability to maintain oxygenation/ventilation. In my own experience the decision to intubate these patients prior to the 90 to 120 minute mark has nothing to do with seizure control. Perhaps Canadian ER's are a little more cautious about taking these patient's airway's? I can only speak for myself but the only time I've ever intubated one of these patients in the field was because the patient was hypoxic, high risk for aspiration, had already aspirated, or they were in ventilatory failure (air-evac transports being a somewhat different of course as that initial 90 to 120 minute may have passed before our arrival). Emergency medicine has a bit of a "shoot from the hip" reputation amongst the ICU crowd and I think in many ways they have a great deal to learn from each other. Emergency medicine can learn that it isn't always necessary to shoot first ask questions later and Critical Care medicine needs to understand that in the initial phases of treatment morbidity/mortality can increase by failure to act decisively. ED patient's are not typically admitted intubated with initial ventilation optimization and appropriate central/arterial lines. ICU's are presented with patients where critical interventions have been completed making it easier to armchair quarterback how things were done after the fact. This is actually great feedback for the ED but it must be delivered tactfully or the message will invariably be lost.
  14. second line seizure medications

    Our air-evac crews carry phenytoin, propofol, and worst case scenario paralytics in addition to the usual benzo's. We can also make use of any second line agent a sending hospital has in stock if we need to. We use second line agents for certain categories of intracranial bleed with a propensity to seize more often than anything. Scene responses are mainly trauma patient's for us which typically respond to benzo's. Inter-facility patients are definitely where we use them the most frequently. Second line agent's aren't terribly useful on a city ALS unit and require a pump which few ground services have. For a rural unit with long transport times I can certainly see potential value in carrying a second line agent. The further you are from a hospital the more valuable second line treatments of any variety become. The amount of gear we take with us on air-evac calls can attest to that lol.
  15. Afib RVR

    ERDoc makes two excellent points in this case. First off, blindly following protocols can be dangerous for patients. Secondly, patient history is needed for sound clinical decision making in this case (was onset within the last 24-48 hours? do you have the option of rate control with a calcium channel or beta blocker?).