canuckEMT

K I may have missed it in the thread, but I didn't see anyone mention checking MCL 1 for reciprocal changes which would also heighten your suspicion for infarct with a 3 lead monitor. Although it can't confirm like in a 12 lead, still would be evidence enough to start on the CP protocol and administer 160mg ASA. As well as being able to make an ALS rendevous (if applicable to transport time) or give to the recieving physician.

We are using 2 different 12 lead texts in our program. 12 Lead ECG- The art of interpretation by T. Garcia 12 Lead ECG in Acute Myocardial Infarction by T. Phalen

Combivent x2 Salbutamol prn refractory to combivent methylprednisolone magnesium sulfate epinepherine SQ (nebulized in peds)

We just had our first class in FBAO yesterday. The algorhythm so far is this: Find Pt unconcious Check verbal no, pain no response visualize in mouth, nothing seen head tilt chin lift with ventilations via BVM, no air entry reposition and try again, still no air entry begin chest compressions Prepare laryngoscope, magill forcepts and Ett stop compressions visualize airway and remove object with magill, if not seen, insert ett and attempt to ventilate again So you are adressing the airway while attempting to dislodge the obstruction with the chest compressions. I may have missed something being we have only covered this one day so far. If I have please feel free to add in where my information is lacking.

A rigid splint with velcro closures. Sorry should have used a little different terminology.

Well how much more could one add to what has already been said? The only way I would apply a traction over a B splint in this scenario is if I had enough people in the back of the bus to help. I would definately not be wasting time on scene applying a Sager.

darn

Fart

I was wondering if anyone had any good links or websites about how to write a research paper? I have an assignment where I have to wrtie one on a condition ( illness or injury) that is going to be covered in our Enviromental Emergencies module. It has to be 5 to 7 pages and cover BLS, ALS and Emergency room Tx of the given condition. In addition, we have to cover a non traditional Tx regimen ( Holistic, Faith healing etc) and develop a protocol as well. I have never written a research paper and the llinks we were given did not give me much information either. It was mentioned to use the MLA style but the only information I can find on that was a link to thier textbook. Any information would be greatly appreciated.

Our shift change is 0800. Most will show up between 0745 and 0755 but I usually get there around 0730 just in case a call comes in that would put the other crew into OT. Most of us like to go home right at change so I try and do my best. There has been quite a few times I have gone on calls though with one person from the previous crew as my partner did not show up until like 0759.

In agreement with the above posts, full set of baseline vitals then Pt on stretcher semi fowlers into the unit to do 12lead which I would expect to see A-fib with RVR. First guess to rhythm due to the Cardizem(diltiazem). I would also check lung sounds and for any signs of JVD. With not being able to relieve the pain with position I would also be putting Pericarditis in the back of my mind. Any Hx of cold or flu-like symptoms in the recent past? What was her tympanic temp? Has this ever happened to her before? Any change in pain on palpation? As far as Tx enroute to hosp, she seems to be mentating well so I would start with NC@3 Lpm, saline lock while asking Pt if this is a normal BP for her ( if she knows her normal), If not I would try 1 250 mL bolus and reassess for any changes, also questioning would also include asking Pt if she is diligent with her medications ( not just today but in the recent past as well), check 12 lead and patch findings to hosp, rest of Tx would depend on 12lead findings and Pt presentation.

Calgary EMS has and does hire EMT's. To get hired by Calgary as an EMT though you have to be a first or second year paramedic student. I have had four friends that have been hired by Calgary EMS and they were all first year medic students, hired while they were attending classes @ SAIT in the Calgary EMT-P Outreach program. As for EMT's in Canada, or should I say Alberta ( as our training seems to be a little higher than the national scope), is that we get IV's, Cardiac Monitoring, Entonox, Nasotracheal Suction, Pneumatic CPR, MAST Pants. And soon to be the symptomatic relief module of Ventolin and Atrovent administration via nebulizer ( and not Pt assist ), Epinepherine IM, Glucagon IM, D50W - D25W. If I have missed anything I apologise as I am lacking sleep. Also another difference in Canada is that Ontario's training for EMT (PCP) is two years whereas Alberta's is approx 8 months depending on practicum placements. I am unsure though of the duration of EMT programs in the USA. Basically a general comparison done between Canada and the US is : Canada EMR = EMT-B in the US Canada EMT = EMT-I in the US ( depending on scope between the different states)

There is me and my partner right? On a BLS unit, so anyone that can walk on arrival is a green, truck guy if he has a pulse and is breathing is a red, moaning bush is also a red, the occupants of the jeep will have to wait until the arrival of other resources. Get the walking Pt to control bleeding on the Pt in the truck if possible and me and my partner will c-spine the unconcious female and get her into the unit. We will then get moaning bush c-spined and into the unit, followed by pt in the truck and the walking Pt. Having them all in the unit will protect from the enviroment and give us some time until the arrival of other resources. You cannot transport these pt's until there are other resources arriving to take over. That would be abandonment as you know they are there, even though they are probably going to be tagged black in this situation due to lack of resources. But even then, when they do finally get extricated they would be candidates for resussitation due to the freezing water and " they're not dead 'til they're warm and dead" addage. See if you could get the chopper to the pad that is 10 min away and advise them of your situation. Also, see if the responding Fire Dept could pick up the chopper crew enroute to the location, this would give extra hands, then when they arrive you could transport to the pad and they could take 2 of your red pt's, then transport the walking Pt and the pickup Pt to the local ER and return to the scene to deal with the Jeep occupants post extrication. Rescue should have a minimum First Aid training and if they have them extricated prior to your return could start CPR and basic resuss efforts.

Well, finally finished with " exceeding expectations" and an A+ grade on my first practicum. It was an awsome experiance finally getting to work with an ALS service. My preceptors were awsome and the crew at the hall made me feel like one of the guys letting me get involved in training with them as well. Up to my mid-term evaluation, I was being assessed on BLS skills and treatments. After that point, my preceptors pushed me a little further to the neat level that I am going to be assessed on in my next practicum by studying meds that they use and integrating them into calls, after being able to convey why I would use them in a given situation. I was also giving all the reports to the RN's including the ALS calls. This practicum was such an awsome experiance and I am looking forward to January when I will be starting my 2nd ambulance, ER and OR all in the first 2 months of next year. Now I just need to start pre-reading for next semester that starts in Sept. Cheers,

Would anyone be interested in doing a mass e-mail campaign to TNT and let them know our total disgust with this show? I would like to meet the one who is the " professional advisor" regarding the skills portion of the show. I know if it was me I would quit if they wouldn't make it look a little more realistic.

There is a write up on this show in the new JEMS issue. I breifly read it and the editor in chief of JEMS contacted the producers of the show and " ripped " them about the way that EMS is portrayed. I am also sick of EMS being portrayed in a negative way. Most of us have our demons in real life, but we are still able to remain somewhat professional in our appearance and the way we treat our pt's. Oh and to the reference to AMR...... There is a reference in the show to the company that our star works for being taken over by NMR. Think that will ruffle some feathers???? Bring back Johnny and Roy!

Nessie, I am going to assune that you are in Alberta. And if you are, you are an EMT NOT A PCP. The Alberta College of Paramedics has not adopted the title of PCP in Alberta. True, almost all the programs in Alberta are instructing to the NOCP level of PCP, you just don't get the title. I don't have a problem with the PCP title as there is a distinguishing factor in the 3 titles as well. Primary, Advanced and Critical which have different knowledge level and skill set. You wanna start another one, ACOP want's to give EMT-P's in Alberta the title of CCP whether you work in the air or on the ground. I don't mean to sound condescending, but, there are greater things in EMS to worry about than what title you have. Keep doing what you are doing though in the aspect of educating your pt's. That is one responsibility that I believe is gone by the wayside with alot of practitioners these days.

a little update on my progress so far. We haave completed first semester didactic and I passed with a 3.7 GPA. I am now on my first ambulance practicum which lasts for 386 hours. I hope to keep the GPA for second semester as it entails about twice the work as first semester with a load of pharmo.........yipeeeeeeee!

Dwayne, I did pre study prior to my medic program. I also researched a little to find out what books were being used. Let me tell you, it sure helped me and also helped to reduce the workload a little. i would advocate for anyone to do pre study prior to beginning a program. The amount of information that is included in a Paramedic program is emense and you have to be prepared. It also shows a dedication to furthering your career. We used Human A&P by Elaine N. Marieb sixth edition and also Pathophysiology: The biologic basis for disease in adults and children 4th edition by Katherine McCance, Sue E. Huether.

Our transfer is complete once report is given to the recieving RN and Pt is transfered to their bed. If there is an initial consult, and the RN did not tell you what bed to put him/her in then you are still responsible for that Pt. If it was a suicidal Pshyc Pt then I would have wheeled behind a curtain and gave a urinal. Technially you would still be responsible for that Pt as our protocols state. Then again check with your supervisor and/or Medical Director and protocols.

My apologies in the wording ( I was fairly excited after writing my last exam) it is actually 384 hours or 8 TOURS (32 shifts) the schedule is 4 on 2 off 4 on 6 off. In the 4 on it is 2 10 hour days and 2 14 hour nights. Little better explanation after coming down off my high of finishing the didactic with a 3.5 GPA.

Well I just completed my 17th exam to end our first semester didactic element of our program. Tomorrow I have my orientation for our introductory ALS ambulance practicum. It is to be 360 hours or 8 tours in duration. This practicum is to critique my assessment skills and reinforce the learning we did in the didactic portion. Although I will be able to assist on ALS level calls, they will be run by my preceptor. I will be expected to apply and begin to interpret 12 leads, calculate, draw and administer meds as directed by the attending medic. Also it will be expected to advance my learning via studying and doing a paper or two on a case study of a Pt chosen by the preceptor. It should be an interesting experiance and I am so looking forward to it. I will try and keep you all posted on my progress.

Hello crown and welcome to EMT City. I am a EMT-P (ACP) student here in Alberta and this link might get you the information that you are requesting. Also two questions: 1) As a PCP in Sask do you have certification in IV Therapy? This is a skill in Alberta (not sure about Sask) 2) Was your training institute CMA accredited? That might make reciprocity a little easier. If you have any other questions and can't find the answer on the website just give them a call. Here is the link: ALberta College of Paramedics Hope that information was useful.

Now I do not answer any direct questions from local law enforcement but..( yes there is a but) if I am sitting at the counter and the officer happens to look over my shoulder and see information that might warrant him to try and get a supeona, so be it. But if they called me on the phone, no way, I won't tell 'em nothing.

It is up to the individual provider to know his/her scope of practice for the area/service they are working for. It is taught here in our courses that we have to have an understanding of all the corredsponding legislation that governs your scope of practice. I am not sure if you are working for a service right now, but if you are, one of the first priorities you have as a new employee is to familiarize yourself with that services protocols. Also have a knowledge of your national and state protocols. As google is a good way to find out, if you do not have a computer, try going to your local EMS station or office and ask them as well. Most services (around here anyway) don't mind answering questions regarding scope of practice questions and what is included in local protocols.