Arctickat

Option 3. It's an ambulance, so it has oxygen and NRBs. Who said that I can't throw an NRB on myself?

Exhaust fans too

http://www.news.com.au/couriermail/story/0...from=public_rss

AMBULANCE officers are being called out to treat sunburn and shaving rashes - despite a $400,000 awareness campaign about the correct use of 000.

Fed-up paramedics have told The Courier-Mail they have seen little change in the attitudes of patients about the appropriate use of the emergency number.

I don't think it will replace the blood tests in the hospital at any time in the foreseeable future. These tests are qualitative, not quantitative, but I can see them being used in the field as regularly as an ECG.

The most comprehensive test I have provides positive readings if:

Cardiac Troponin I exceeds 1.5ng/ml

CK-MB exceeds 5ng/ml

Myoglobin exceeds 50ng/ml

A positive reading is indicated by the simple appearance of a line for the control and one for each marker, a negative reading by the appearance of only the control line.

My understandings of cardiac markers is that they take some time to appear and return to normal. I believe I have a previous post in here regarding the time it takes for this to occur. These tests will provide positive results only if each of these markers is present in the blood stream at sufficient levels as noted above. Any of these levels indicates muscle damage, especially the troponins.

PM me if you'd like further information, I can send you to the website of my supplier.

The tests that I use actually give results in about 5 minutes and should not be used as a reference after 20 minutes, but as I have stated before, they are blood tests, not saliva. I never wait around to make a transport decision based on this blood test, but it is always ready by the time I radio into the ER with my report. Usually what I do is a small blood draw off the IV start. If the patient doesn't warrant an IV start, then I don't do the blood test.

Thanks Doc, I knew something didn't look quite right with those x-rays, but I couldn't quite put a finger on it. A little slow this morning.

I don't buy that for a second. I have been through SEVERAL departments that have had to increase the base rate plus milage rate that is charged to a patient, with the first one actually being an almost 300% increase! No dip in calls...in fact, because the area was growing, the calls have done nothing but increase in frequency.

Fortunately for those without insurance there are no EMS operators with the courage to try it. Not many people can afford a $5000.00 ambulance trip to the tertiary centre. It's moot anyways, the rates for ambulance services are determined by the Ministry of Health, not the individual operator. A private operator out here couldn't raise his rates even if he wanted to. Besides, how would you like to go to work for your four 12 hour shifts and do about 4 calls a month? Pretty boring job if you ask me.

If they can afford to pay you and all of your cohorts about 125-150% of normal pay, why cant they afford to pay just a handful 100% of usual pay ? But I do understand that situation, i worked a parttime job in a county like that, where a busy day was 3 calls. As long as you are happy with it, I guess its cool.

Because to properly staff the ambulances they would need to pay 300% and that kind of money just isn't realistic unless user fees are also tripled. then no one would call the ambulance, call volume would drop off, and the service would be shut down because of a lack of calls. Your part time job sounds pretty much exactly what we deal with. 350 - 400 calls a year. Roughly half of which are transfers to a tertiary centre lasting anywhere from 7 - 10 hours on average depending which centre we go to.

Actually, we are only required to report for duty at 0930 every morning to ensure the ambulances are properly equipped and cleaned. Typically, we sit around and drink coffee for a couple of hours, maybe do some con-ed. By noon we are all at home waiting for a call to come in until 0930 the next morning. Do you get paid full time hours to go home and sit around? Maybe even work a second part-time job that permits you to leave for a call? We're still required to be on air within 7 minutes of being dispatched, but in a town of 1000 people, it's a short drive back to the office.

To be able to have a unit staffed with people at the base 24 hours a day would cost about triple the current gross annual income of the company and be a waste of money. As things stand now, I make about $85,000 per year, the basics are making over $62,000.

I'm a pilot, although not rotary wing, I do have some insight. This http://www.tc.gc.ca/CivilAviation/commerce...39/section9.htm is the Transport Canada Guide to Air Ambulance Operations for helicopters. I will see what else I can find, I'm looking through the CARs for more information. Waht i do know is that they must still follow the weather minima for VFR flight. At night, that can be difficult.

Then there is mine, paid $21.61/hr for 8 hour days $2.19/hr for 16 hours standby, any calls taking place in that 16 hours is paid at $32.46/hr

Keep this in mind.

Exchange rates cannot factor cost of living and are not reflective of living costs as money is bought on the exchange based on desirability. An oil change costing $40 CAD a few years ago at the exchange rate of .65 still costs $40 CAD while instead of costing $27 US at the old exchange rate cost $33 at the US current exchange rate. The only relevance the exchange rate might have is if someone from the U.S. decided to work in Canada but live in the U.S.

As to the previous poster, he makes a good point. Annual wage is not as relevant as the hourly wage. Fresh out of school new EMTs make $21.611/hr new medics make $26.413/hr. I guess it depends on what the shifts in Atlanta are like and how many hours are required to work to make that wage.

My medics start at about $52,000 a year but they also get at least 20 hours a month in overtime which equates to another $10,000 or so. Basics start at about $43,500. As well as a cost shared benefits and retirement package.

Greetings group, some of you may already know me from another EMS message forum website, but for those of you I've yet to meet here's a little info. I own a small EMS service in rural Saskatchewan Canada. I've been in this business since 1978 and have seen many changes over the years. I took my EMT training in 1985 and paramedic training in 1993. My service averages 350 - 400 calls per year and has 9 full and part time employees both basic and advanced. We are the only ambulance service in the area and provide both 911 and transfer services to the residents of our small community. Our fleet consists of two full time ambulances and one part time/spare.

Our paramedics also work on a contractual basis at remote health clinics along with a nurse practitioner, the nearest ambulance is located about 120 kms (75 miles) away.

So thats where I posted the joke. I thought I had posted it before but lost track of it. Sorry for the dual posting. I had thought I forgot to hit the submit button.

typically we will either scoop or use the spineboard to move the patient with pillows under the knee of the affected leg to abduct the hip joint. They tend to be most comfortable like this.

As God was creating the Earth an angel noted he was spending a particularly long time on one spot. Curious, the angel questioned God as to why he was working so hard on this one piece of the world.

God put his arm around the angel's shoulders and said look there. This is going to be the jewel upon the crown of my creation. To the West the ocean surf will crash upon rugged mountains that will reach up to the clouds. They will be the source of pristine water that will flow from the mountains over vast prairies. This rugged coastline to the East will be the most adored by any person to visit. The vast ice fields to the North will be the climate control centre for the entire world.

Life will flourish and prosper. When humans discover and settle here, they will call it Canada and earn a reputation as the most polite and peace loving folk the world over because the land will suit any sort of personality. There will be sprawling cities to quaint hamlets from sea to sea to sea. These people will be generous to their fellow man, ready to help whenever asked. They will know the words, "Please" and "Thank You" and will carry a respect for the needs of those around them. They will also fiercely protect those who need protection. They will gain a reputation across the world as excellent fighters, but never the aggressor.

This jewel will become the shining example that all the world will one day need.

Agape with awe, the angel shortly recovers from the stunning oratory and asks one last question.

"Please my lord, I do not understand. You are a being of balance. When you created day, you also created night to balance. When you created land, you also created water. Why is it that this land, this jewel of your crown is such a perfect place?"

God cast a kindly look upon his angel and winked, "Wait until you see the belligerent A-holes I'm putting South of them"

Lawyers should never ask a Mississippi grandma a question if they aren't prepared for the answer. In a trial, a Southern small-town prosecuting attorney called his first witness, a grandmotherly, elderly woman to the stand.

He approached her and asked, "Mrs. Jones, do you know me?"

She responded, "Why, yes, I do know you, Mr. Williams. I've known you since you were a young boy, and frankly, you've been a big disappointment to me. You lie, you cheat on your wife, and you manipulate people and talk about them behind their backs. You think you're a big shot when you haven't the brains to realize you never will amount to anything more than a two-bit paper pusher. Yes, I know you."

The lawyer was stunned! Not knowing what else to do, he pointed across the room and asked, "Mrs. Jones, do you know the defense attorney?" She again replied, "Why, yes, I do. I've known Mr. Bradley since he was a youngster, too. He's lazy, bigoted, and he has a drinking problem. He can't build a normal relationship with anyone and his law practice is one of the worst in the entire state. Not to mention he cheated on his wife with three different women. One of them was your wife. Yes, I know him."

The defense attorney almost died.

The judge asked both counselors to approach the bench and, in a very quiet voice, said, "If either of you idiots asks her if she knows me, I'll send you to the electric chair."

Maybe in this guy's world it's a Fleg, but he needs to learn to talk like a real Canadian. Eh?

As God was creating the Earth an angel noted he was spending a particularly long time on one spot. Curious, the angel questioned God as to why he was working so hard on this one piece of the world.

God put his arm around the angel's shoulders and said look there. This is going to be the jewel upon the crown of my creation. To the West the ocean surf will crash upon rugged mountains that will reach up to the clouds. They will be the source of pristine water that will flow from the mountains over vast prairies. This rugged coastline to the East will be the most adored by any person to visit. The vast ice fields to the North will be the climate control centre for the entire world.

Life will flourish and prosper. When humans discover and settle here, they will call it Canada and earn a reputation as the most polite and peace loving folk the world over because the land will suit any sort of personality. There will be sprawling cities to quaint hamlets from sea to sea to sea. These people will be generous to their fellow man, ready to help whenever asked. They will know the words, "Please" and "Thank You" and will carry a respect for the needs of those around them. They will also fiercely protect those who need protection. They will gain a reputation across the world as excellent fighters, but never the aggressor.

This jewel will become the shining example that all the world will one day need.

Agape with awe, the angel shortly recovers from the stunning oratory and asks one last question.

"Please my lord, I do not understand. You are a being of balance. When you created day, you also created night to balance. When you created land, you also created water. Why is it that this land, this jewel of your crown is such a perfect place?"

God cast a kindly look upon his angel and winked, "Wait until you see the belligerent A-holes I'm putting South of them"

The temporal release patterns of the three cardiac markers have significant differences, all three are useful tools in the determination of the source and timing of the onset of chest pain. Cell injury from AMI has been shown to result in a level of blood myoglobin above the upper limit of normal in approximately 2-3 hours after the onset of chest pain. Maximum concentrations are generally observed after 9-12 hours. CK-MB and troponin I are found in blood at elevated concentrations approximately 4- 6 hours after the onset of chest pain and peak at 12-24 hours. However, whereas CK-MB levels return to normal values in about 72 hours, troponin I levels remain elevated for up to 5-7 days. The use of these three markers is therefore complementary since they detect cardiac tissue damage over a wide range of times after myocardial infarction.

For this reason I prefer to use the test that provides results for all three, this gives me the opportunity to determine if the infarct is a new one or an older one.

we are out in bumfuck nowhere.

Nice, profanity, the last thing I'd have expected from an intelligent, literate and well educated individual.

I suppose not when your argument has no basis to it. In that picture i can see a tire pressure monitor, rear view camera and what looks like a control head for a CD changer. Looks to me like a boss who cares about those who work at his company.

What Im pondering is, would it be benneficial for BLS to conduct monitoring?

Simple answer is YES!!!!!!!!!!!!!!!!!

Here is a true story. BLS crew is the only unit available to respond to a client complaining of repeated episodes weakness and dizziness for several days but getting worse. They arrive to a 69 yr old male with a heart rate of 28 and a BP of 98/54. Slap the LP10 onto him and run off a few seconds of lead II. They had no idea what it was, but kept it for the doc, turns out it was a 3rd degree block. 30 seconds later, patient was fine, ECG was NSR, BP normal. The patient was seen at the local hospital and sent to a tertiary facility for pacemaker insertion because of a transient 3rd degree block based solely on the strip taken by the BLS crew.

So, what other safety innovations would you recommend prior to this one?

So you feel that added safety is a waste of money? Perhaps you'd be more impressed if the money was spent to give you a bigger Christmas bonus. The owner should have just pocketed the money rather than invest in the safety of those he employs I suppose. Wasn't there a recent LODD involving a medic who was ejected from the ambulance after her partner swerved to avoid a deer and ripped the side of the mod when it hit a tree? In Kentucky I believe.

Maybe you just live in a city where this would be useless, but out in the open countyside with transport times of 2 or more hours and open road, 130kph makes those headlights pretty useless. The added warning this provides is invaluable, not to mention the search and rescue capabilities.

I doubt that it will replace anything, but it will enhance the ability to detect AMIs that the ECG might miss. Right side, posterior, and Non-STEMI would all have elevated cardiac enzymes and could be missed on a standard 12 Lead ECG. Pretty simple to use too. When I start an IV line I attach a piece of extension tubing, aspirate a ml or 2 with a syringe, then attach the IV tubing and flush the line. Viola, blood test completed with no time wasted for an added evaluation.