Quakefire

Tniuqs of course you can play

No where on my person does it say registered or licensed, but we do still use the old terms due to the fact that Paramedic is protected by law to belong only to an EMT-P. Our Operations Manager, who came from Edmonton to our little private service did propose the use of bars instead of titles on our shoulders but would having 3 or 4 bars (supervisor) really solve the arguing over titles?

Of course the patient has the right to choose as long as their conscious and A/O, they can be PRS'd by their choice, and if the people started to demand it, i'm sure most private ambulance companies (like much of Saskatchewan is) would work that into their contracts with the health regions. More money for them.

Ahem dont you mean they have slipped under our noses the AHS also is trying to dictate what union those "paramedics" are to be represented by, CUPE in Calgary is still in the courts over that little "item"

Regardless of Alberta or BC lots of EMS workers are being bent over the cot to be shown whos boss

Maybe we should move away from having a 'Paramedic' decal on the side of our units, maybe its time we moved to neon signs, so that when an ALS crew hops aboard they can flip a switch to inform the public

Maybe we should be looking at a National Solidarity perspective, instead of a getting screwed over by ACoP or AHS one? Get us all along the lines of the Nurses and Fire Fighters, instead of fighting our little battles alone, we can fight as Canadian Paramedics, not Alberta, or Saskatchewan or BC medics

We can only give Nitro where a patient has their own prescription or with direct medical control, Chances are if we are giving nitro the patient has their own to self medicate with any way. I agree we should have a line in place first in case that access is required very quickly. With the 12-leads it will give the hospital an idea of any changes over that last few miniutes (or up to half an hour from some places in our service area) and allows for preparation of proper treatment

Here is a good example of the publics perception of EMS in B.C. I was having dinner at the home of a colleauge who is a registered Alberta Paramedic (ACP). His father in law was visiting from B.C. and asked why we had such a backward EMS system where only some personnel are paramedics and the rest are EMTS, because in B.C. everyone is a paramedic. My partner did his best to explain the difference between the PCP/ACP for about ten minutes, was met with a blank stare and the statement, "OK, but I think care is better in B.C. because we only have paramedics."

So following along with this, when I show up at his door with my partner, and both of our epaulets say EMT. Now is he going to believe in us enough to let us treat him, when really he called to get a paramedic at the door? What about when I work with a paramedic, will a patient let me attend to them or should the demand the paramedic regardless of the severity of their illness or injury? I understand the worry with ACoP and AHS finding ways to cut ACP's out of the picture as a cost saving measure all the while having a lower level of car slipped in under their nose, but there is also the perception of the public on the industry as a whole. Unless they are a paramedic, they are not capable of caring for me or my family.

Should we go back to the days of paramedics and Ambulance Drivers? It seems when I work with a paramedic I get called that a lot more

While we are trained to interpret 3-lead ECG's we are not allowed to interpret ECG's, aparently I cant tell a NSR from Vfib but thats besides the point. The new skill will allow us to capture a 12-lead ecg, not diagnose/interpret it

That would be the definition according to the University of Saskatchewan, not exactly the whole province. I was using Primary Care as referred to "Primary Care Paramedic". But lets move to the Primary Health Care idea. Is it not part of our job to educate the public when possible? And are we not moving towards being able to handle more and more homecare type issues such as replacing and maintainence of catheters instead of taking these people into the ER? So while the U of S shows Primary Health Care as shifting the responsibility onto the public, its most definitely being shifted onto our shoulders as well

Alright, as far as the rest of the country using the Saskatchewan is only partway there. While my certificate says I am trained as a Primary Care Paramedic, I am unable to use that title, or be licensed as such. Now in protocol there is a difference between an EMT and a PCP trained EMT, just like there will be a difference when they drop the ICP(EMT-A) title and make them into EMT's again. All of our units say Paramedic across the side, as far as the public is concerned, do you think they should turn down a BLS crew and tell them to send a Paramedic? What the public needs to know is that no matter who shows up at their front door that they will be receiving highly trained care. Mobey has a point in saying that our PCP program provides alot of education, and we have national standards. Why shouldn't we want to show that we stand out? I understand that it takes alot of time, and alot of work to become a Paramedic, and the respect the title should bring, but I think we need to be more worried about respect for EMS as a whole.

And for the record, I think EMR's belong in rural services as first responders while waiting for an ambulance, you should never call 911 and get a car with 2 emrs.

I am an EMT (PCP) so I may be biased. I dont have lines, I have very few drugs, and I admit that my scope isn't as big as it is in other places, but I do feel that based on the amount of education we receive the "Primary Care" title is appropriate, just like with all the extra education an ACP receives, a title of "Advanced Care" fits.

ArticKat I started this wondering more along the lines as to what other people are seeing, and what other services are doing. We have had discussions during staff meetings and we have all of the health canada bulletins up as well. One of the things I like about forums is that I have access to people from all over the country to get ideas. I didn't know there were different levels of filters for the Bipap or intubated patients which makes me wonder what our hospital is using. We were told that with the "closed Loop" masks were not required

We were innoculated as part of the hospital staff, because in Saskatchewan we are mostly private services, we were treated as health region employees. We so far have no specific instructions as to deep cleaning our units after these calls, we try and get a mask on the patient before getting into the unit, but we haven't done a full deep clean after, just the wipes on all surfaces.

Has anyone tried to avoid the use of nebulizer masks as i've heard that it actually puts the crew at higher risk?

Our average transfer (which is what us call in crews do alot of) is about 260km - 280km round trip it adds up pretty quick, our 2006 unit has over 350 000 on it already

So far I swear H1N1 is tied to the full moon (very long night) but regardless of the tides flu season seems to be in full swing so I figured I would ask a few questions find out whats going on out there.

For your confirmed (or heavily suspected) cases

What seems to be our average time for onset of symptoms

What do you wear for BSI? Are gloves good enough, do you wear a mask from the second you get out of the unit? after initial assesments? N95 or Surgical? Mask your patient as well?

What similarities are you seeing

Did you get innoculated? Just H1N1 or both? were you required?

What are your disinfection policies regarding your unit after transporting these patients?

Anyone else have any questions?

Do you actually use padding? Under knees? In between knees? Blanket over the board itself? On EVERYONE?

Not normally, but occasionally a flannel on the board, especially for MVA's or anything outside in the rain, keep a flannel under the head of the stretcher and throw it on right before the patient, so he doesn't get more wet

How do you immobilize head? Do you use head wedges? Cheese blocks. The styrofoam triangles and head pad? Rolled up blankets. Does it depend on patient?

Our service uses the orange ferno blocks and straps usually but we carry headrolls too

Do you use backboards always? Or do you have the hard foam boards?

Our protocols only allow spinal immobilization on a LSB or KED, we also carry wooden short spinebords for some reason, no one uses them. Our scoops are the old metal kind and therefore not suitable for spinal immobilization.

Spider straps? "Box Method"? Straps that click in like an X over chest? Binders? (Pre-ripped sheets that wrap around)

We strap with an X over the chest and one across the pelvis, sometimes a 4th strap for the legs depending on the patient, but there are some services that have nice vacuum backboards and other goodies

Do you ALWAYS immobilize cervical if immobilizing lower back? Vice-versa?

Depends on MOI, chances are yes unless we are moving them from hospital to hospital

Do you use tape over the neck? Does it go straight across or angled up (perpendicular to the forehead tape).

We use the velcro straps, angled as much as possible on the chin of the collar and across the forehead, same with head rolls just with cloth tape

Do you use the arm straps? What do you do for unconscious patient's extremeties. Leave one arm out for IV? All in and you unwrap later for IV access?

I avoid strapping a patients arms in, even though I have no IV access I need an arm for BP's and such. for an unconscious patient I take a triangular bandage and tie it in a loop, put their hands across their chest and loop it around their elbows, easy to get arms out and holds them in place nicely

What type of thermometers are you using disposable ?... As that was found to be the focus/ fomite / vector in an ICU when we had a huge break out of MRSA in ICU, non disposable btw ... the ones found on the wall blue cover for rectal, red for oral ... was the entire attached wire and device that was swabbed to find the cleaning staff were told not to wash them.

Wow I would freak out at that hospital, but here blue is oral and red is rectal, then again the only difference is taste.....

Regardless of volunteer or paid, at least the laws here, if you are on call and you are dispatched and refused you are abandoning the patient even without contact. There is no reason this person should be allowed to practice, they have no dedication to the profession, and have no right to be allowed anywhere near a patient

So far all of our board members are at least EMT's but a large portion are ACP's with the current president also being the program coordinator for SIAST's Kelsey campus EHC program. So it nice that the college actually represents the practitioners but they have more than doubled our registration fees this year

Check out Deuter, one of the larger bags should let you fit individual kits (like an IV kit or intubation kit) on the inside as well as various other pockets. Even has a built in rain jacket

I doubt we will be able to wait a year for new units, our one main unit is so close to 700 000km its painful, I liked working in the GM chassis on my practicum, guess we will have to see

So far my favorite part of the whole series, was the guy in the collar beating the crap out of the rig with a baseball bat over his bill. Extreme yes but i'm sure there are alot of people who have thought about doing it.

I look at it this way, the car I usually end up staffing as our second car/transfer car has a stryker electric stretcher. Last i looked its rated for a 700 lbs lift (i'm proudly Canadian and very metric, but the stretchers American) so if the hydraulics on my fancy stretcher are unable to lift your giant butt we have a problem, not to mention my service doesn't own a center mount. These people are just not going to fit. If we need to buy a bariatric unit and stretcher, plus call in another on call crew (min 3 hour call outs) we should be able to charge extra. The other thing I see is that yes while there is extra cost for the equipment, there is alot of extra wear and tear on my back, and some of that money should goto me and my partner, or atleast to employee benefits of some kind. That or we just need the fire department and a SHAMU (think thats how its spelled, big tarp with many handles

Yeah there have been questions about the training modules the college has approved, even though we have completed ours we have been advised to avoid using the king while the college makes up its mind.

Arctickat any other insights into whats comming down the pipe for the PCP's and ACP's in Sask?

Any opinions on the freightliner or international chassis? Is the bigger mod well worth it? And has anyone noticed the floor in the GM chassis gets really warm behind the captains chair

I just told my girlfriend that yes even in rural saskatchewan every day i work is just that exciting, and yes I delivered 4 babies and apprehended the mother for being a world class bank robber all at the same time. Mobey will attest to just how exciting it is in the life of a sask emt

I work for a service that is rumored to be replacing two 10ish year old Ford E350 ambulance with something new, probably crestline but it may be Demers. All of our units a diesel with the exception of our rover which is a gas expedition. With for discontinuing the diesel ambo prep what are other services looking at for chassis for new units? Chances are slim for GM just due to the fact that the chev dealer in town wont be a chev dealer soon with GMs cutbacks. We do alot of highway and alot of bad dirt roads.

Just want to see peoples opinions of what the options are

I'd like to point out that at the service I work for, 4 out of 8 of our paramedics were trained and employed in Alberta before moving to Saskatchewan, as well as out Operations Manager, So as much as I love the mountains, jump the border and come on over.

I have a feeling there are lots of managers looking to see whats happening in BC, if there is a precedent to cut staffing and force OT, in the long run it makes it cheaper for the employer and they will do it. Even if you dont care about BC, support them anyway before your service figures out they can own your ass too!

It was probably Regina that bought 28 power stretchers, they have a full no lift policy now. More than 3 stairs....Fire department

The white plastic thing is supposed to be used to move the tongue. But it bends too much. I got one for free from the inventor. Like most new devices that pop up in JEMS, I ask a question, and voila. Get one in the mail. NuMask, SAM Sling - yes.. a fricken SAM Sling, for free.. Those rolled up trauma dressings, gauze in a syringe. A tip from the training table. Keep a packet of lube with it, tends to get stuck.

Jeez aparently I need to ask more questions, I like free stuff

Hey Rock_Shoes it isn't so flat is Saskatchewan, I moved from Calgary to Saskatoon and its alot better than the southern part of the province.

Most of our services are private (just kinda the way EMS started here) but we just became self regulated. So far the president in the PCP program head in Saskatoon, and a couple of the members at large and council members are instructors of mine so I think we are doing pretty good so far, I just hope we dont have the horror stories some of you do in a few years.

Personally I think the unions should have challenged the courts order, with the labour laws in mind. The governments can't just ignore laws they dont like, didn't work for Nixon and shouldn't work for them either.

I wonder how much the public understands that yes the paramedics refusing OT may seem selfish to them at first, but it BC starts losing people due to burn out faster than it can replace them it might last longer than a weekend, or a week or even a month. I wonder if they are prepared to wait for the next graduating class to have even BLS coverage again