rock_shoes

It's now an $85.00 flat fee in BC. This includes ground and air crews with no mileage charge. There is of course an entirely different fee schedule for people from out of province. If I remember correctly ground crews are somewhere in the 5-600 dollar range. You don't even want to know what air-evac costs for people from out of province. Better mortgage the house.

In the small isolated place there are no morgue attendants. Only places with a coroner have morgue attendants. It is just a small locked cooler at the hospital. That's what we have here in Lillooet BC anyways.

It's a beautiful area. Your welcome to come out. Maybe retire and become a mortician?

While I agree with you it is inappropriate to take a car out of service to move a body sometimes you don't have a choice. In some of these small isolated communities the only vehicle capable of moving a corpse appropriately (within a range of 2 hours or more) is an ambulance. We don't do it often. Maybe 2-3 times a year total. It's hard for a community to justify a transport vehicle for 2-3 transports a year. The other thing to keep in mind is that a second car remains available during that time.

Usually we leave the body for the coroner or funeral home however sometimes we do transport to the morgue. Either at the request of the coroner (closest one is over 2 hours away) or the family (nearest funeral parlour is also over 2 hours away).

That's a tough call all the way around. Personally I probably would have kicked the fire guy out of the ambulance since it becomes your domain once your in the back. It's hard for me to imagine fire being in charge of the scene. Whenever I work with fire they defer to us and basically just do whatever we ask. That includes everything from a medical call to an MVI(Motor Vehicle Incident). They never tell us what to do they ask us what we need from them. So far it's worked out great and we have few problems maintaining a good professional relationship. Don't beat yourself up about it too much. It sounds like your system needs an overhaul from the ground up and that is not your responsibility. Just continue to be the best medic you can with the knowledge and experience you have. I guarantee any similar call you get in the future will not go the same way.

If you take a good hard look at what you've typed out here and I think you'll have your answer as to why you were passed over for this promotion. You give the impression that you believe being an over achieving youth gives you the right to automatically assume a position of leadership in the adult world. This is not an assumption you can make. It's a good lesson and you should be thankful you were able too learn it at 19.

At 19 you would be better off working out how you can become a medical professional than worrying about losing out on a supervisory role in a volly service. It's all about priorities and at 19 education should be at the top of the list.

Never deny O2 to a patient with clear signs of inadequate perfusion. This patients poor perfusion and SOB is of much greater concern than the outside chance that the high flow will cause respiratory depression. Low flow O2 for COPD patients is for those who are able to maintain adequate perfusion on low flow.

We are allowed a maximum of 16 working hours. That however does not include time spent on standby (at the station) or on pager for the rural lower call volume areas. In the rural areas standby and pager time are counted as hours of rest because employees can sleep during that time. If someone "times out" (has spent 16 hours working on car in the last 24 hours) they must be off car for a minimum of 8 hours before they can go back on duty.

Wow that sucks. I look at it as a crew and patient safety issue. If you leave it running without the anti-theft you run the very serious risk of having the ambulance stolen or otherwise entered by undesirables. If you shut down for any amount of time so that you can lock it you run the risk of ruining medications, freezing or broiling your patient on entry etc.. Most of the cars in our service reside in climate controlled bays at the stations(There are some exceptions unfortunately) and only a few specialty cars (read 4x4) don't have the anti-theft. Of course the cars without anti-theft are not exactly used in areas where that could be an issue.

I'll take number 1 . It isn't anywhere near as bad as the other two options. Not that it isn't still a very special kind of hell. :twisted:

Don't they all have that feature? I know all of ours do.

I would think they will be much easier to work with if you find them a viable new tenant. The less you leaving interrupts their cash flow the kinder they will be.

Sounds about right.

You make a very good point with regard to taking layering too far. All the layering in the world won't help if you bind things so tight you impede circulation.

They are manufactured by PriMed. They look similar to the straps for applying a sager but are set up with velcro tabs so you can us them in multiples to get whatever length you need. They're also great for applying direct pressure to a wound instead of using a loop tie. PriMed didn't have a picture on their site so I'll have to have a hunt around for a picture. If I can't find one I'll just take a picture and post it.

For an unstable pelvis we use "zap straps". At least that's what we call them. They're wide elasticized straps that keep even pressure across the pelvis.

I'll leave the scoop if the transport time is short because it's going to reduce painful patient movement as it will be needed again to move the patient onto the hospital bed. If it's a long transport I'll remove it for patient comfort.

That's the interesting thing about medics in the Canadian forces. They spend an enormous amount of time functioning in a clinical capacity and in fact could easily be mistaken for doctors or nurses. Canadian medics are initially brought to the PCP (Primary Care Paramedic) level and from that point on are brought to a higher level in modules as their rank increases. Eventually some of them will be selected to become Physician Assistants. Once they become PA's their scope of practise is a big as the supervising physician deems appropriate. Including actions such suturing, and prescribing of medications. PA's can in fact bridge into physicians.

Well Dwayne I can't really say if this is the norm with Canadian military medics or not. I know it certainly isn't the case in civilian EMS in Canada. I would venture to say the medics you've dealt with may be burnt out having done multiple tours with very little home time in between.

You may very well be correct but based on the typical results I've seen that just isn't the case. People who are truly interested in becoming an EMS professional don't ask about finding a school and receiving funding to go there. They ask for opinions on the best paramedic program and why the respondent feels said program is the best.

I can't help but feel as though anyone who is truly interested in EMS as a career would manage to find the required information on their own. I agree with Dust that someone who hasn't expressed any interest in medicine prior to the age of 27 is extremely unlikely to be getting into EMS for the right reasons. It really isn't a path you want to start down on a whim. Pay scales in the US tend to suck (pay scales reflect the medic mill programs not the degree programs) and it doesn't exactly promote a healthy family life.

Get creative, because every situation is a little bit different. Just do whatever you have to do to put the patient in the best position of comfort and eliminate unnecessary movement.

Oh my. :shock: That's just terrible :twisted: