rock_shoes

You must be referring to the "success only learning" programs that were attempted in elementary schools during the 90's. They were in fact a total failure. The students did learn the information however they completely fell apart at the first sign of adversity. IE the first time they had to think for themselves. All that garbage was going on at the same time I was going through school. Fortunately for me I had parents who didn't abide by that garbage and made sure I actually received an education. For me the big tell with any program is the quality of the medics that program turns out. If a program puts out quality people and includes sound medical education then It's worth consideration.

Dust likes eating the young. :wink: Mmmmm... younglings. You didn't mention the Paramedic courses involved in the program. You only mentioned some of the team-building exercises. I suspect that's a big part of Dust's concern. Sounds a little bit like sunshine coming out of everyones rear at first glance. Myself I think these kind of programs could have some promise if the entrance process is carefully monitored to avoid some of the riff-raff who would be attracted to the program.

JIBC New ACP Entry Requirements There is absolutely no mention of any different progression for people already in possession of a PCP license.

Exactly. That's the problem I have with what is being done. We've played by their rules and now they've arbitrarily decided to change them and leave the lot of us hanging in the wind. That's the screwed up part. From what I can gather they still intend to run the PCP program.

It isn't appropriate to eliminate PCP for two reasons. First, the vast majority of attendants will not be capable of making the jump from EMR to ACP all in one step. Second, PCP is an appropriate pre-requisite for those of us who are capable of going from EMR to ACP straight through without working as a PCP. I'm not saying you shouldn't be able to go from EMR all the way through to ACP. I'm saying that PCP needs to remain a recognized step in the process.

I agree that it is a slap in the face to those of us who have taken or are about to take the PCP step. Going straight to ACP school upon completion of PCP would be great, but eliminating PCP altogether is not appropriate.

If you don't mind my asking Mobey which school did you apply to? Sounds like a program worth checking out.

Thanks for the tips bosc. I've since been hired and have been working at 318 in Lillooet as of the 1st of January. I'm about to start my PCP course with The Academy of Emergency Training on the 26th of this month (Let's just say my experience with the JI through SAR put me off of them). All in all it's been an interesting ride so far.

$^&#*! Are you telling me I just spent $5000 on tuition and books for a PCP course I no longer need to take to get to ACP (starting on the 26th by the way)? I don't think having PCP as a pre-requisite for ACP is a bad thing. It's forcing people to spend years as a PCP before taking their ACP that's a bad thing.

I'm a real "Show me the money" (Jerry Maguire) kind of guy. If hard evidence can be provided that it can be effective in the pre-hospital setting then I'm all for it. Until then I think it should be left to the "alternative medicine" crowd.

A lot of the time I have no need for signatures. In British Columbia you only need a patient signature if they refuse transport. If you leave a patient in police custody you need the peace officer to sign for them. Physician signatures are only required if you perform an invasive procedure or administer medications.

If the US military wants to provide these returning soldiers with an education that will provide them a job when they return, why not educate them as such before sending them over seas? In Canada military medics are put through PCP school before they are ever deployed. If you combined that with putting these medics on civilian cars for periodic rotations when they are home the transition time would actually be minimal.

If it's fairly set up I believe in the concept of performance bonuses. Multiple pay rates based on performance are great for those of us willing to put in the effort required to provide an excellent standard of care.

Sounds like the service you're working with made good use of what your PCP's are taught. I think the confusion for our American counterparts is that we consider PCP to be a BLS level of care. PCPs are taught to interpret 12-leads. The problem comes from the fact that the older PCPs were not taught this and have never been upgraded. Also PCPs who were taught then never get to apply the skill lose it. It's one of those use it or lose it things. I don't buy the lowest common denominator argument. The lowest common denominator needs to either up there standard or get out. I'm not a proponent of this "no medic left behind" crap that seems to perpetuate.

The irony of it all is that patients in rural areas with long transport times stand to benefit the most from interventions like RSI. For these lower call volume medics to maintain there abilities, excellent medical oversight, regular ED/OR intubations, and frequent "tours of duty" in busier areas would be needed. All this lowest common denominator stuff really irks me. As far as I'm concerned the lowest common denominator either needs to up there standard of care or get the hell out.

I use a Garmin Nuvi 250W in my personal vehicle. I also take it with me when I do calls in areas outside my own. The navigation is quick and accurate with very few errors. On the rare occasion it does fail I still know how to read a map :wink:. For SAR operations I use a basic no frills Garmin e-trex. No base map or anything. A good topo is way more accurate than the base map in most GPS units anyway.

We do this in my area as well. The nearest coroner is over 2 hours away so we transport to the hospital morgue. Then the coroner can come when it's at least a 2 for 1 and save themselves a trip.

I think it's a great idea to put kid's through some testing prior to putting them on stimulant medications. All in all these medications are way over prescribed. More often than not ADHD can be controlled through behavioral methods. Having been on Dexedrine for ADHD myself I can assure you these medications aren't the cure all many would have you believe. The side affects can be terrible.

Sounds like a "knee-jerk" reaction on the part of your director. Appropriate help from a mental health professional should be made available to you if you need it. There is no justifiable reason to force someone into a CISD for a call like this. So you were exposed to a dead body on the job. Big deal. It's not exactly an unusual occurence in EMS.

Why are you satisfied with an OPA? Please tell me you're kidding. Intubation ,provided the requisite education has been received by the caregiver, is a far superior method of securing an airway. I realize intubation opens up a pretty big can of legal worms but the fact of the matter is we aren't lawyers. Our concern should be for our patients. Please don't take this as an attack. That isn't the intention. I just believe that improving the standard of care to the highest level possible is the best course of action.

The best use in EMS is as a quick drug reference. Anytime you come across a drug you're unfamiliar with you can quickly look it up and have all the indications, contraindications and, just as important, drug interactions.

No question that BC and AB are the two biggest proverbial “sticks in the mud” when it comes to the formation of a national registry. That being the case we would have to send you a Critical Care team rather than an Advanced Care team. :wink: Like I mentioned before current licensing protocols don’t accurately reflect the state of practice. I do recognize that. Even by licensing protocols though morphine is not a patch it’s part of the standard drug list. So is D50. There are also allowances made for use of chemical restraint. It isn’t really designed for the experienced ALS provider. It’s designed for the “fresh out of school” ALS provider (For whom I think it’s actually 6 months). For someone just out of school I still think it’s a great idea. Yes 3 months is long for someone who has been in the game for a while. There should probably be a competency based method of shortening it up for the experienced out of province providers. Just remember the amount of beurocracy we have to deal with here. You may very well be correct on that. We shall see when the time comes. WCB has a habit of sticking their nose into things they shouldn’t while ignoring some things they should be taking care of. I don’t like it either. I’m sure the other provincial equivalents can be just as much of a pain in the rear.

I agree with you on the poor system of reciprocity. Credit should be given for experience. Unfortunately reciprocity sucks in both directions. If I want to work in Alta. once I finish my upcoming PCP course I will have to go through their also nightmarish reciprocity process. The only way to get around those issues is a national standard of practice with a self regulated national licensing/registration body. Just don’t be too quick to judge ACP practice in BC. The ACP’s we do have are excellent. We just don’t have nearly enough of them. A team of three women from BC did just take home the national title not too long ago. What are antiquated in BC are our licensing protocols. Fortunately they aren’t really used in practice. The switch has been initiated to “Treatment Guidelines”. Under treatment guidelines any procedure or medication that falls under your scope of practice is available for your use at any time without having to fit it to a rigid protocol. A good example would be giving someone with a severe allergy the benadryl before they go anaphylactic as opposed to waiting until you have to give epinephrine first (protocol is epinephrine then benadryl). You just have to be able to provide sound reasoning for your decision. I think you already know we disagree on this one so I’ll leave it at that. Personally I don’t see what the problem is as you would be paid your full ACP rate during this period anyway. No disagreement from me on this one. WCB will only recognize an OFA ticket or an EMR license currently. Join the 21st century for crying out loud. To work in the patch in BC as a PCP or ACP you need to do a 1 day “Bridge to OFA” course to be recognized. Then you can work to full scope if you have a medical director willing to sign off on you.

Well I don't know about Dust but I say this subject is exempt. I'll even let it slide that she's dressed up like a fire fighter.

Precisely. Unfortunately in some of the far flung regions of my home province "better than nothing" is the best that is provided. Remote stations in BC are so close to volunteer it hurts. Responders are on pager and paid a 4 hour "call-out" when an ambulance is called in their area. Many of them are driver only/EMR crews (EMR is roughly equivalent to EMT-. BC Ambulance is simply unwilling to provide a higher level of care when the call volume is 30-40 a year. In reality these outlying areas need some kind of "paramedic exchange program". Send medics from the busier centres out to these low volume places for a block every so often (Full timers in BC work a 4 days on 4 days off rotation). Think of it like a working vacation. Most likely these medics will get some time to de-stress but if something does happen the people in these outlying communities will get the experienced crews they deserve.