Skuter

Hey gang. It's been a while but I'm back. As far as students riding with ACP/PCP my approach has always been to let the students do everything within their future scope of practice (i.e. BLS, SR etc.) up to the point that ALS interventions are required. I also make them babble a lot about what is going on in their mind. Furthermore, once the ALS interventions are completed, on-going patient care and monitoring can be done by whoever is closest to the BP cuff and the "record" button on the Zoll. In my mind a "skill" (eg taking vitals, hooking up ECG, and SpO2) is something that can be learned with practice -- just like putting the puck in the net. The challenge is learning to think like a medic. Also, I have found that most students are lacking is the ability to communicate with effectively patients, allied agencies, concerned family members, grumpy triage nurses etc. This is a skill that can only be learned on the road and it does not matter where you ride out you will always have to deal with grumpy triage nurses!!! Skuter

My specific questions are: 1. All things being equal, which is your preferred method of operation on an ALS medical run? Why? In the house but on the stretcher. At least get the basics done, first round of meds or whatever. Being on the bed means no laying in god-knows-what on the floor of the the house and a quick exit if required. 2. Does your agency have an SOP covering this? If so, what is it? No. We are pretty much left to do what we need/want to do, when and where. 3. Did your instructor or school ever tell you which way was the "right" way or the way you should do it? NO. All good road guys with lots of experience who knew that there are no "right ways" to do things in this job -- Embrace the grey! :wink: 4. Does everybody in your agency operate the same way, or does the controversy still divide the profession? NO and NO but we always armchair quarterback every call and discuss how and why things were done the way they were done.

I have to agree with you about the Excursion. We are running a couple of them for First Response and they are brawny. We are also using the GMC Yukon. They are a nice ride, have the 4WD when needed (i.e change on the fly). Lots of power and enough room for comfort. Our fleet services guys custom built a box for the rear that has a large capacity roll out drawer for extra gear and has tie downs for response bags and defib. Good luck with the project. Skuter

"Pappy, I got a Zeke on my tail!!!!" Riding around with my friends with our bikes in "echelon left formation" (cough, cough, gasp!!!) Skuter

"We can rebulid him!!" Lindsay Wagner as the Bionic Woman. She was hot a-la Stevie Nicks. Now she's selling beds!!!! :-s Does anyone remember Ultraman?

Actually Dust -- while I can't speak for everyone north of the border -- our uniforms are very much like PD. In the part of Ontario where I work, we don't wear badges on our duty uniforms. But we do wear them on our dress uniforms -- something that has only happened in the last few years. We have the standard navy blue shirts with our service crest on each sleeve. We also wear epaulets to show our level of certification. One stripe for PCP, three stripes for ACP. It gets kind of funny when you get ex-military guys (especially veterans) calling you "Lieutenant-Colonel"! (Canadian Army/Air Force Lt-Col. wear three stripes on their uniform to display rank. I think US is a silver Oak leaf???) I totally agree that we should have a distinct uniform. Skuter

Attaboy Kev. Can-Con Mine would be 5-straight Stanley Cup wins by the Habs. Leather tie (very thin and black)!! Adidas school bag!! Emergency! (and not reruns!!!!!!!) AAAAAAGGGGGGGHHHHHHH!!!!!!!! Skuter

Ummm.... Nascar?!?!?!?!? NHL training camps open this weekend!!!! :lol:/ =D> :lol:/ =D> Go Habs Go

This one happened this morning. Dispatch -- "31XX could use please rendevous with 33XX (support unit)" 31XX -- "Roger" Dispatch -- "31XX apparently he needs to change something on your unit" 31XX -- "Roger.....is he going to kiss me first!!!!" I nearly drove off the road

Hey gang. I guess I kind of fall in the middle. Pretty extensive medical directives, use them as needed. Lots of training (close to 1000hrs of theory/clinical/field perceptorship) to get to this point. That's on top of the 2-year course to be a PCP and in most cases a couple of years on the road. Have the telemetry (we actually call it a "patch") for those cases where its CYA or anything outside of the directives. We don't send ECG, we give our interpretations to an ER doc. We have to patch for orders to do cardioversion and needle decompression. (However, just to be confusing, we have an open order to perform these procedures if pt condition "warrants immediate action".) Also have to get orders for Amiodarone, Adenosine, Dopamine and Narcan. I'm not sure where that puts me on the poll. I'm happy to have the ER Doc available if needed but content with the directives I have. Skuter

Things I learned from Johnny and Roy (and the rest of the gang!!): Have you seen my Avatar?!?!?!?!? Everyone gets morphine! Everyone gets Ringers! Radio patches! But mostly I learned how to NOT carry a stretcher. (Man those ambulance drivers must have just destroyed their backs!!!!!!!) KMG 365!!!!

Just curious to know how many of you SWAT/Tactical/Special Ops/ERT (etc) medics are sworn police officers versus civilians providing Tactical Emergency Medical Support? Our unit is civilian and doing regular calls until our police tactical unit is called in. We are notified and then pulled off regular calls to "join up" with the guys on scene. We train with the guys as much as possible and are involved four-times a year for big practice scenarios. Took a while to gain the trust of the police guys but now they like having us around. For the record -- and let the arguements begin -- we (the medics) are unarmed. Unlike the guys Stateside we have only really been involved with TEMS for a couple of years. I'm only aware of four teams in Ontario (Toronto, Ottawa, Halton, Thunder Bay) and I think outside of that there's Calgary, Edmonton, Vancouver(?). I also believe that OPP and RCMP (Ontario Provincial Police and Royal Canadian Mounted Police) have operators who are trained as medics. Now that I've read this I guess I'm looking for general info about other teams out there and specifically Canadian TEMS. Skuter

Our medical directives allow us to remove the barbs from anyone >16 years old who has the capacity to consent to the procedure. However, removal is contraindicated if one or more of the barbs has punctured above the clavicles, in the nipples, scrotum or genital area....OUCH!!! Skuter

Hi. Sorry this is a bit late...but I'm new!! We had the pleasure(?!?!!?) of taking a one or three second zap during our initial training. Those that were really sadistic could "Ride the Five" if so inclined...funny, no takers!!! No barbs were harmed during this bit of torture we just taped the wires over our clothes. One was enough for me!!!! Squealed like a girl...fell to ground....still getting laughed at by the rest of the team!!!! On the serious side has anyone had any trouble with barb removal or post-tazer medical complications?

Hi Gang. Our service adopted a couple of remounts during a realignment in 2000. We have one left that has about 150,000 kilometers on the cab-and-chassis but the box is on its third cycle. (Sorry to our U.S. friends I think that's about 95,000 miles). This vehicle -- "The Pride of the Fleet" -- is currently sitting in one of the stations and is only pressed into service when there are no other spares available. Needless to say it will be around for awhile!!! Last year there was much excitement around work as this unit was going for a "retrofit" on the box. We all thought the third cycle box was coming off to be refitted with an entirely new box...WRONG!!!!! A bit of new floor covering, a bit of new vinyl and its back in the garage. Apparently this effort cost about (Canadian)$40,000!!!!! Skuter