Quakefire

I'm sure IV's are comming, there is word about making us the same with Alberta. I'm looking forward to the kings personally, especially because our service doesn't carry a CPAP machine.

Howdy.

Acording to the new Sask Health Protocols Sask EMT(PCP) practicioners are now able to use Entonox, King LT's, CPAP, and 12-lead ECG's. There is also the possibility of expanding our Nitro protocols with med control.

Seems like a move in a good direction, especially for rural BLS services.

I used the Ferno power stretch on my practicum and my current service has a stryker version. Overall the controls on the stryker and the "smoothness" are way above the ferno. I dont know if its just me, but the bare stryker seems heavier than the ferno and I like how the ferno charges when in the unit which the stryker does not, never had a dead streatch with the ferno, the stryker on the other hand... The replaceable battery is great if you have the charged spare with you

That is a silly argument... My degree at ITT tech won't get me the job over your degree at MIT... I should have chosen a better school that is recognized by employers and society alike. Students need to make informed decisions about their education, and should know the possible ramifications of their choices.

Its hard to justify that without looking at all the other factors. I work with a couple people who are taking their ACP with distance learning just because they cant afford to take the 2ish years off and second, the only ACP school in Saskatchewan is in Regina, I work over an hour out of saskatoon in the wrong direction. So yes choosing a better school is a good idea, just not always a possible one. Besides generally if your going to ITT tech and spending 3 times what you would have at a real university, theres probably a reason (like not being able to get into a real university)

How do they back into base?

This issue they want to strike over seems more that they have medics that attended very similar programs, same education, only School A can give a diploma and school B cannot. That would make it rediculous to cut the pay of providers that are missing the papers

The service I work for currently only runs one car of 2 paramedics, and the rest of us emt's are on call, does this affect patient car? Maybe, but atleast in Calgary they will have easy access to an ALS intercept, and the EMT's can deal with the drunks and the medics can get to the realpatients. Using an AAA as an example for the detriment of BLS vs ALS is silly any way, if it bursts then a ambulance isn't going to save your life, ALS or not

Its a good idea but UV light is what kills plastics and rubber. So the rubber handles, vinyl seats and such would start to degrade. Plus there might be problems with suction, ett, and bvms if they are exposed at long intervals. Plus the areas under the stretcher and so forth that are shaded would not be disinfected. A portable unit that can be used at base may work. Something like a smoke machine with disinfectant may be more through though

Well I just found a new way of cutting costs of running an Ambulance Service.... Steal their kits.... That is all

Wow its amazing how well laid out and organized your rigs are. Usually our LP's and sitting on the bench, sometimes even belted down, but not often. Cool to see really different rigs compared to what i'm used to seeing. On the first page of pictures, the stretcher seems to been in some form of box, is this a loading ramp?

So after a quick search, and following Scuba's link (USA only i'm afraid by the looks of it) i'm still kinda at square one.

It was my understanding that their best bet is to sue everyone involved, and while the services you work for should have some form of coverage, anything over and above that becomes the responsibility of the medic. We operate under a doctors license but unless we bring him online its our call that makes the mistake, not theirs. I think hiding under the face that "its their license" would be a bad mentality for anyone to develop

I'm sure everyone hears in school about the horrors that can befall you if your documentation is a little off or if you actually screw up, and the large financial penalties you may face in court. Doctors protect themselves with malpractice insurance in the event they kill/injure a patient, should we protect ourselves the same? Can we even get malpractice insurance, and does anyone actually have it?

I'm new to the industry, and in the near future I want to buy a house and start a family. Having all this taken away is a frightening thought

The only issue I would have with chemical restraint ( besides I dont have a protocol for it) is that if he is going down hill, its going to be harder to detect any continuing change in LOC. If given the choice it'd prefer to use my own fabric style restraints instead of hand cuffs if he if going to be fighting alot, easier on the patient, and gives something nice and long to hang onto when transferring from cot to bed. I agree with a psyc diag. but i've been surprised before.

Did the world end???

It is going to be awesome when Ab loses 50% of it's medics to other provinces and careers once they realize they are underpaid and underapreciated compared to other places.

That mean your moving back here Mobey?

That would be a horrifying experience, to be fully aware but paralyzed.

Man you guys have a low tollerance for the odd, or mine is just way to high. I love the sound of the crunching glass. I be this guy has new appreciation for just how strong his sphincter is

If you read down he states that he has scripts for the meds from several different doctors who all know each other and that they are for personal use only or for his family. The fact that he has enough morphine to supply all of Saskatoons ambulance service is besides the point

My question is he has 10 different pain killers. Some very, very strong ones. There is a reason they are not used in prehospital care, they dont make sense. Why would he carry morphine, dilaudid and vicodin?

Its a great kit, and if I worked in a unit that had a kit that clean and organized, i'd be in heaven, personal use, i'd scale that way back.

So he was morphine (injectable and tablet), percocet, dilaudid vicodin, plus IV administration with things like D5W and a heparin flush. Yet he doesn't have a pulse oximeter because he doesn't know how to use one. This guy scares me

Let us know if you need anything else!

Alright. Not alot changes from your respiratory scenarios to your cardiac scenarios. This is where ALS will be needed more (they never come but call anyway), do your assesment, look listen and feel, palpating can tell you alot in a chest pain case. Learn your rhythm rules and know them well, you get marks for interpreting the correct rhythym.

Really our treatments dont vary much. You want your abc's you want your vitals, and you want your full assessment just like all your scenarios. Most of your patients will get oxygen, some may get nitro. The treatment is simple, whats hard is getting into a groove where you go through everything the same way every time. It helps, you forget less.

Some tips I learned. BSI " I'm protecting myself from the patient, and the patient from me" (thats very basic but you get the idea)

Keep the head to toe idea in your brain at all times (it will really help in trauma) Airway: is he breathing is he talking Breathing: fast/slow, laboured, depth Circulation: is there a pulse, fast/slow regular/irregular strong/weak Skin lots of people forget this, temp,color, and is it dry/moist/sweating like hes on trial

Next JVD (your instructor may want you to check for pitting edema here as well), is the trachea in the center,what does his chest look like is there urticaria, swelling, paradoxical movement and so on. What do the lungs sound like. Does it hurt more when you press on the area. Is there pitting edema.

Thats the order that I used for all my cardiac scenarios, and with a little modification it fits almost everything, just get an order down. You'll think less about what you need to ask, and what you need to check and more about what you found and what that means.

On a side note, if your get a patient with subcutaneous emphysema in your practicum, or after, feel it. Not many medics find it in the field and its a weird sensation/sound

Where are you in your program?

Mobey I was waiting to see you in this thread hehe