nwoparamedics

Wow... it has been a LONG time since I've ventured back to EMTcity... my last message in my inbox was from Dustdevil on my birthday back in 07... 

Sad to hear that Rob's no longer with us... was great being able to chat with EMS folk from around the world back when these forums were in their infancy and that little thing called the internet was still so new to be playing on.

 

Dustdevil  256

Started conversation: 14 Sep 2007 · Report

Way to go Glen

True Off-Duty Heroes

Pair rescue man from burning car

By BRIAN GRAY, SUN MEDIA

Wed, July 11, 2007

http://torontosun.com/News/Canada/2007/07/11/4329927-sun.html

http://www.theglobeandmail.com/servlet/story/LAC.20070711.RESCUE11/TPStory/TPNational/Ontario/

Ha... think I'm with a few others here... costs were a bit cheaper way back when (then again... so were the wages)... but our new grads are putting out roughly 20-30g's for the PCP program... and one of our medics whom took the ACP program while living at a relatives put out 20 g's for that year.

Actually the most underutilised piece of equipment is your common sense.

Have to agree with that one.... without a doubt....

As professionals we need to look at total patient care. Patient care does not end with what we do, and we need to think beyond us.

Ahh yes...

Many of, if not all our patients involved in MVC's have to be sent out to the city for a CT to clear the spine and it is common to have them on the rigid boards for upwards of 8 hours. Whether it be sores that come of this, or the fact that the patients cannot remain immobile for that length of time on something soo uncomfortable... maybe it is time we investigate this further.

Don't know if better/worse... but the JEMS article shows the new plastic "Ferno Scoop EXL" and "The Hartwell Medical CombiCarrier" as alternatives.

From the Editor: Out of Sight, Out of Mind

The Pittsburgh researchers used high-tech methods to conduct their study, securing electromagnetic sensors over the nasion (forehead), C3 and T12 spinous processes of 31 adult subjects in a human motion analysis laboratory. All participants were familiar with the rigors and requirements of EMS and were used as both subjects and immobilizers.

With rigid cervical collars in place and their movement recorded by a goniometer (a motion analysis system), each subject was tested on both the LBB and the FSS. The long backboard was applied by logrolling the subject 90°, placing the LBB underneath them, logrolling them back to a supine position and performing a "Z" maneuver to center them on the LBB while maintaining spinal alignment. The scoop stretcher was used as designed, and no subjects were logrolled onto it.

The sagittal flexion, lateral flexion and axial rotation were recorded during each of four phases: 1) baseline, 2) application (logroll onto LBB or placement of FSS around the subject), 3) logroll and 4) lifting.

All subjects were required to remain secured on each device for 20 minutes to simulate time spent while on an ambulance cot during transport. Afterward, they were asked to complete surveys on security and comfort. The subjective comfort scale included overall comfort as well as specific comfort points of the occiput, thoracic spine, sacrum and heels. Participants were asked to choose which device they preferred overall. The comfort and perceived security of each test subject were assessed on a visual analog scale.

The results: The scoop stretcher caused significantly less movement on application and offered increased comfort levels. During baseline conditions (i.e., while subjects lay quietly on the ground), range of motion was less than 1°. The researchers found that the application, logrolling and lifting of subjects on long boards resulted in greater motion in all planes and induced three to five times as much movement as the FSS, primarily because of movement induced during application of the devices.

There was approximately 6–8° greater motion in the sagittal, lateral and axial planes noted during the application of the long board compared with the scoop stretcher. Although greater sagittal flexion occurred at the nasion and T12 (1.2–2.7°) while lifting the subjects on the FSS than on the LBB, this finding was not considered clinically significant because studies have shown that 5° is a safe amount of movement. No difference between the devices was found when a secured patient was logrolled onto their side to simulate a fluid drainage or vomiting episode.

Most participants (24 of 30 subjects) felt that the scoop stretcher offered superior comfort and made them feel more secure in its cradle shape than when they were strapped on a flat backboard. Comfort ratings at each of the body segments, except for the occiput, were also greater after subjects lay on the FSS compared with the LBB. Padding is needed under the patient's occiput with either device to keep the patient from being uncomfortable.

This study looked at complete spinal immobilization, whereas most studies have looked only at the efficacy of specific devices in the immobilization of cervical spine injury. This factor is significant, particularly because we know that up to 10% of people with one vertebral fracture will have at least one other vertebral fracture.

But the most important outcome is the documented reduction in unnecessary movement when a scoop stretcher is used, which can reduce the risk of further spinal cord injury. That brings us right back to the real reason we immobilize patients — to reduce further injury in patients we suspect are already injured.

The study proves that the logroll maneuver we've used for years to place our patients on a long spine board may be outdated and detrimental. It cited another study that showed that just 2.1 cm of lateral movement in the cadaveric lumbar spine during a logroll on an unstable spinal injury completely occluded the spinal canal.

Medline Abstract: Comparison of the Ferno Scoop Stretcher with the long backboard for spinal immobilization.

I stole this from another thread, but it seems that everyone believes tha the KED is the most ignored peice of equipment on the rig.

I disagree, I think that the scoop stretcher is the most ignored and under-utilised peice of equipment we have. In so many occasions it would cause less patient movement, and more patient comfort. I find most people don't even know how to use one properly, or when it is indicated.

The KED... one of most used pieces of equipment for our MVC's for extrication. The scoop... definately a plus for those in house falls where space is limited, as well as the ejections from the MVC's along side the road.

Least used... the two bilat. sagars that take up room in the rig.

Found some more information for people to keep track of with regards to wages.

The Alberta Ambulance Operators Association has a brief of thier ongoing Salary Survey (since 1997).

Click on the link on the left side of the page.

Salary Survey Results

The Alberta Ambulance Operators Association has been conducting a Salary Survey every year since 1997. This survey is sent to all our Active & Affiliate Members each year, and only those that respond to the whole survey, receives the results of the complete survey.

Sorry this is an older announcement I just found... but thought I'd share it here as this latest one is geared to our neighbours south of the border (hope it's not too late).

I do have the flyers as well and even though I can't seem to upload them here... put them on rapidshare for anyone to download at:

http://rapidshare.com/files/20251400/Durham_Competition.zip

Canadian National Paramedic Competition looking for U.S. teams

The 5th annual Durham Paramedic Association National Paramedic Skills Competition is taking place March 31st. 2007 in Whitby Ontario, Canada.

The Competition now in its 5th year is looking for the inclusion of U.S. teams.

"We would love our U.S. counterparts to come up and compete with us", The Competition is a great learning experience and growth opportunity for everyone involved, we also have a lot of fun" said Rob Johnstone a member of this years organizing committee.

Teams compete in 3 divisions. Student, ALS and BLS.

The competition has grown to be a major event in Canadian EMS and last year attracted major media attention.

The competition includes a pre-event meet and greet, small trade show and awards gala dinner.

Sponsorship opportunities also exist.

Interested teams can contact:

Jim Harris

(905) 431-2356

jharris@basehospital.lakeridgehealth.on.ca

For an information package.

and here is some other information that wasn't posted in the Canucks forum

Durham Paramedic Association Paramedic Skills Competition

The Durham Paramedic Association is proud to announce the 5 th Annual National Paramedic Skills Competition will be held March 31st. 2007 in Whitby Ontario, Canada.

The Competition now in it's 5th year challenges competitors in a one day challenge utilizing the latest of Human Simulation technology. (SIM-MAN http://www.laerdal.com)

With a mix of academic tests, real life scenarios and other team challenges medics of all levels both military and civilian compete in this popular event.

"There's an element of adrenaline and pressure in the competition-you're being judged"

Rob Burgess

Toronto Star 2006

The event is an excellent learning and growth opportunity for all those who participate and challenges even the most seasoned of veterans in a realistic learning focused environment.

The nations Paramedics are available in some form to all Canadians. As a growing profession it is important to showcase what we do.

" Being a Paramedic has changed allot over the years, it's no longer just a ride to the hospital. I think the public who attended this years event really saw that"

Rob Johnstone

JEMS.Com 2006

Canadians are interested in their Emergency Responders and Health Services.

The Durham Paramedic Associations Paramedic Skills Competition is open to spectators and we encourage the attendance of the general public.

"We would love the public to come out and see what Paramedics do"

Jim Harris Competition Chair

CKDO Radio 2006

A media facilitator will be available prior to the competition and at the venue through to the awards ceremony. Planning committee members and teams may also be available for interviews.

Teams practice well in advance of the competition and a teams(s) may be available for shadowing prior to the competition.

A demonstration of the "SIM" technology SIM MAN and SIM BABY at our simulation centre may also be available.

The Competition is non-profit and raises money for charity every year at its silent auction during the awards ceremony.

The goal of the Competition is to provide Paramedics with an enjoyable, challenging educational experience to enhance the delivery of pre-hospital care to our communities.

"Excellence through challenge"

Interested media are invited to contact.

Rob Johnstone

Public Affairs Officer 2007.

(905) 419-0743

rob_wj@yahoo.ca

Heh FireMedic47:

This first rig was brought online around 2000 by the North Bay Professional Paramedics Association. It was a unique idea at the time and seems to have caught on quite well as it was one of the first conversions to be seen by John Deere.

Here is a good write up on it...

North Bay Professional Paramedics Association

This newer Gator is from Essex-Windsor EMS...

And lastly... this was a winter rescue rig purchased in Thunder Bay, ON many years back (has since been sold to a Mountain Rescue Team in the US).

Full Time / Part Time

Salary based on years of experience as recognized by the OAASC

1st year $90 000.00

2nd year $95 000.00

3rd year $100 000.00

4th year $105 000.00

5th year $110 000.00

Signing Bonus

This Company just laid off 99% of their ACPS

Yea... and unfortunately with all the Ornge changes going on... definately a cut back in services to the entire air ambulance system. Kind of reminds me of the late 80's and 90's era when we relied on only a few dedicated bases and nurses to do our jobs on all other flights.

Q. When a car accident occurs, and someone who has some medical knowledge and training (Like an EMR, MFR) stops to help, to assist with what is needed, provided the actions are in his/her training/authorized ability to do so. EX. Keep a clear airway, hold manual C-Spine, CPR, protect from elements with blanket, update EMS, etc.

If you were responding to this emergency. How do you feel, has this person done the right thing by stopping to help, or should s/he, who has the ability to help, just drive by, and only call 911?

Maybe it is because of the region in which I work, maybe it is because of the long distances travelled from the scene to the hospitals, maybe it is because we only have one rig every 100-200 km.... but I'm with MedicNorth on the fact that anyone trained in even the basics of First Aid can be of assistance.

Most of the calls that we have people stop to help are on our main Trans-Canada highway... and the majority of the accidents involve the highway being shut down. There are two of us.... in some areas we have First Response (EFR's) that show up just before or soon after and in all areas... the Fire Services show up sooner or later (along with one or two OPP).

Back on track though... due again to the locations... often our dispatch center has only a rough idea of where the accident occurred in the first place as there is not much to identify the areas besides rock cuts and lakes... so... go ahead and call 911 with better location information.

If there are only two people, or all are in the one vehicle... most bystanders usually don't come up and ask if we need help as they can see we have things under control ... but the majority of times... with multiple vehicles and multiple patients... damn rights my partner and I could use the help... and even sitting with a patient is better for them than being scared and alone.

One of the best things to happen at one of these scenes is when you look up to see one of your off-duty coworkers (from our community, or from somewhere in our region) at the ready, or one of our local air medics whom is stuck in traffic due to the accident. It's great to have that extra set of hands that you know and trust...

Next up would be the local Docs and RN's (whom are used to being in a fairly controlled environment unlike the ditches/swamps or in torn up vehicles along the highway)... and then our bystanders with some First Aid experience... whom all could be put to good use doing something even if it again is just being beside a patient and monitoring them until we can get to them.

I truly enjoy the environment in which I work, the demands placed on oneself due to the region and lack of manpower, and with regards to this topic... truly appreciate our First Responders whom stop and help out. The ones whom are calm and in control... we put to use beside us, the ones whom are hesitant or a bit flighty ... we get them to do other things away from the patients (i.e. bring supplies, set up landing zones, etc...).

$240.00 a paycheck.

Wow... now that's a sweet shift differential. :wink:

We make about $.65/hr for Nights, same for weekends (about $52 extra per pay?)

Here are some Ontario rates for ya

The Professional Paramedic Association of Ottawa wage comparison charts

ACP_Wages_in_Ontario___2005_07_05.pdf

PCP_Wages_in_Ontario___2005_07_05.pdf

PARAMEDIC_Wages_in_Ontario__complete____2005_07_05.pdf

http://www.ottawaparamedics.ca/links.asp

OPSEU Local 277 Ontario P1 Wage Survey - July 18, 2006

http://www.freewebs.com/local277/index.htm#94081065

and I know this isn't what you are looking for, but curiousities sake... a recent posting for an ACP(F) has this listed (I just luv this one) .

Full Time / Part Time

Salary based on years of experience as recognized by the OAASC

1st year $90 000.00

2nd year $95 000.00

3rd year $100 000.00

4th year $105 000.00

5th year $110 000.00

Signing Bonus

and as 'ad-driven' as JEMS is

Unfortunately... that's probably half the problem.....

If our version of it had the revenue... maybe there could be more content

Guess I should join in on this....

EMCA, A-EMCA, PCP... whatever it's called these days (waiting for the next change)... from the backwoods of Northwestern Ontario.

Two things....

One:Where? What emergency ambulance service in Canada does not receive public monies?

And two: Of course I am right.

And three (okay, three things):How are the other provinces services "drastically different"? Could you justify that statement with some examples?

Ha... k Hammer... but it'd be soo much easier just to say... go to www.google.ca and spend a few hours...

1. All Ambulance Services in Canada receive money from the public is some way shape or form. Whether it be private companies here in Ontario (look to air ambulance) billing the province for each person they carry, to our district run services which bill the taxpayers in their communities (as well as billing US residents, out of Province residents, etc...), to Private companies which are contracted out by a region or community in Alberta/Saskatchewan/Manitoba/etc... which either bill their regional health authorities or those whom use the service (from what I understand there is usually a limit per call, plus mileage can be added on). blah blah blah... Ha... we all get public monies from somewhere, whether it be a volunteer service asking for public donations, provincially budgetted and funded systems, or whatever....

2. Ha... sure...

3. Drastically different... hmmm... where to start? Do I start with the EMT style system as compared to the Paramedic system like the national standards are proposing. How about the length of time to even complete the various programs from province to province (i.e. pcp), or how about Provincial run EMS systems like BC with a provincial union, hospital based systems, Private Services, Fire run EMS, etc..... Ooops... ya wanted me to tell ya how we don't have to collect monies from our patients, yet provinces which are run differently than ours (like EMT6388's) might have to?

Hmm... guess the quickest/best way for me to answer this would be to say... EMT6388... why'd you bring this topic up? Ha... hammer thinks your services are run like ours(?) and could ya give him some more info on your province and how things are run? I know, the lazy way out... but I've already taken this topic way off in the wrong direction (might be an idea for new thread though eh?).

Sorry guys and gals... didn't mean to have this subject go off topic...

Did you forget that we're in the 51st state?

haha... oh yea... forgot, dang... Wahooo anyways... I'm a Yankee (is that good?)

ahh, but hammerpcp, even in Canada we have private services that must bill patients to keep them afloat.

If you are on social assistance here, then you don't get any bill. If you are employed/ earning your own money, then you pay 45$ per call. Some how they accomplish billing without us, as paramedics, ever inquiring about financial status. Why don't you find out how they manage to pull that off here (Ontario). Or better yet, tell your boss to do his job and figure it out himself.

Actually , in Ontario if you are a Senior, Native or on Social Assistance... you are exempt from the $45 surcharge. If you are from out of Province, then there will be the full cost charged.

With respect to whom collects these monies here in our own little part of the world (which is unique to say the least)... thats a complicated issue due to some of the problems associated with the downloading of services to the districts a few years back.

The OHA made a big stink about losing the funds generated by having Hospital based EMS services (not to mention the free labour), and thus the government allowed them several concessions. The receiving facility now collects the $45 surcharge, essentially billing for services another provider renders and does not forward this on to the Provider. I don't even want to get into how the government downloaded services they could not maintain to their own standards, and in the mean time, allowed the OHA providors to keep the EMS buildings which the Emergency Services Branch paid for, and in turn allows the Hospitals to now bill the providers to use the Ambulance bases that they have resided in for soo many years... but that is another topic entirely...

As for those patients we see from out of Province, many providers have left it up to the receiving facility as well to collect the monies due to the simple fact they have a system in place to do so, and then at a later date they get the re-imbursment for those patient calls.

So you are right in the fact that we as Paramedics do not have to deal with the issue of payment for services here in Ontario, yet it is a vastly different system in even our other Canadian Provinces, let alone the US.

Our Provider collects what monies they can from the recieving facilities, and yes... we have nothing to do with it... that's our bosses job.

Dang.. haven't seen this in quite awhile... thanks for posting it...

Wahoo... I'm 39% Dixie. You are definitely a Yankee.

Now what's a Yankee again?

I like that one Dsmittty911, well said....

I was in class today and a few classmates started talking about stupid things they've done/said on the road. This one girl said she was on the scene of a Code 5 (obviously dead) and she walked up to the pt and said "Sir, how are you today?"

Ha... don't laugh MedicMal, I use that line all the time. :wink:

It takes a while for each of our new students to open up and actually talk to the patient (instead of just doing vitals/patient care/etc...) and to get them into the habit of realizing there is an actual person in front of them... I make 'em a little wager.

Whomever talks to the patient first wins the little wager... the other one has to buy coffee for the person that talked to the patient first.

It's amazing how quick they actually start talking to patients (esp. when I'm getting java handed to me after each call) even if it is just... "Hi... my name is... " or whatever...

As soon as they start catching on though... and it's costing me java (um... what's the right thing here... oh yea... as soon as they have caught on and are being more vocal)... well... I usually get my one last java with the vsa patients. VSA or not, they are still a patient... never said they had to talk back to us....

hahaha... I'm still laughing at the "down here in the states" comment....

Dustdevil... you're gonna have everyone here thinkin' your a canuck livin' in a trailer park with the boys pretty soon