PCP

Great story!! Sure is nice to read about a accident that turns out good. Happy to hear the driver was okay and that you such a good team on your side.

Did you find out what caused the accident?

Yes I did question myself on both calls and talked to both my partners who have both been working in the EMS field for 20 years each. They both said we did everything possible for the pt. The poor lady had a chance if the grandson had called for an ambulance when she said was experiencing crushing chest pain. My partner at the mine site who also my boss and just happened to be at the site that day said he felt comfortable leaving me with the pt. and transporting him to the hospital in my care as at the time we did not know what was wrong with the pt. and do to training he felt I was able to deal with what ever was happening with this pt. I am the only first aid attendant who is a Primary Care Paramedic that works for him and that is why he felt comfortable letting me be the one to transport this patient to town and if it was one of the other attendants who only had their OFA level 3 ticket he would have taken over the call and transported the patient. My boss mentioned to me whan I got back to the mine site he was impressed by me because I had the thinking to cut the patient's coveralls off and expose his entire body and that he would probably not have done that. Because I exposed my patient I was able to pick up the distension of his abdomen which he would have not of picked up on because he said he probably would have just exposed the abdomen at first then covered him back up. He thanked me for cutting the coveralls off and doing a full assessment like I did as he learned from me that day and it goes to show that even though he has been a paramedic for 20 years he can still learn from the jr paramedics.

Thank you for all your support in this post to all of you. I have learned from both calls and I know that having a pt. die in your care is part of the job. I can say one thing for sure is after dealing with both calls that I have a better understanding of being able to tell the difference between pt that are really sick and those ones that are not as sick.

I am still green and have lots to learn and always will learn from each and every call I do and hopefully will never stop learning!

I am ready for my next patient!

Squint,

I have TGA and had surgery at 6 months old. The Dr. put in a baffel between my chambers rather than switching the arteries back. The procedure I had is called " Post Mustard procedure " I am on no medications and never have been. That might change when I go and see my cardiologist in two weeks.

My cardiologist has never said anything about WPW. I do have murmurs, but not sure what grade? I don't drink pop, energy drinks, chocolate, but do dirnk one or two cups of coffee a day which is very had for me to give up, as I have 21 month old twins at home and plus working shift work. I am working on it and hope to not be drinking coffee by next week!

I had to use the pulse Ox to check my heart rate due to not have 12 lead monitor available at our ambulance station as we don't have ALS. I have never had a problem in past until that week and have not had any other episodes since. When I look back now on both times it happened I had not eaten much that day and had 3 large coffees!!

I did do a in depth physical before hiring and no proplems came about. I am starting at a new station this month and I am not scheduled to start until after I have seen my cardiologist. I am working at the mine site still, just can't afford to be taking a month off work before seeing my dr. in Vancouver.

Hope all is well with squint and that your summer is going well

Happiness thank for the tip on listening to the stomach for any swooshing sounds. I will remember that for next time. As Happiness has explained we do not do 12 leads in BC as a Primary Care Paramedic and we do not have Advanced Life Support in the town I was stationed at.

My partner at the mine site and I discussed calling for a helicopter due to the pain the pt. was in but we did not know why the patient was in so much besides what he was telling me about his lower abdomen and groin. Its sucks to say, but now that I have had my first pt. with a triple AAA I hopefully will be able to recognize it sooner and hopefully get the person to where they need to be sooner. Not saying all triple AAA patients will show the same signs and symptoms as I am sure they don't.

I feel good about the treatment that I gave to both my patients and I feel comfortable that I did everything that I could for them, just that it was out of my hands at that point.

Thank you to everybody who commeted on this post.

Brian

three weeks ago I was working and within a week I experienced two episodes of PSVT. The first time I working on a transfer car and we had just finished driving and I got out of the ambulance and I felt light headed, sick, and a little confused, along with some chest comfort. We had a nurse with us and he noticed I rubbed my chest and asked if I was okay. Of course I said yes. I finished transferring the patient from our cot to the other ambulance crews cot. Mean while still feeling light headed and sick with chest discomfort. I should add as well that I have something called Transposition of the the Great Arteries. Any ways I stood at the back of our ambulance and was hanging onto the back door when the nurse said get in and I will hook you up to my heart monitor. I handed my partner the keys and said you can dirve, not mentioning that I was not feeling well.

I sat in the sit at the head end of the cot while he hooked up the leads and when he finished he turned on his machine and it with in seconds he told me to lay down on the cot and told my partner to drive code 3 to the hospital which was 1/2 an hour away. It turned out my heart rate was 284 beats a minute. He started line and took my BP which of course was high for me I believe it was 150/90 something.

while in route I shifted and my heart rate dropped back to 137 and then slowly whent down to 110 and stayed there. I was released from the hospital within hours and was told to stop drinking coffee and working so much and to start eating better. They also mentioned that I need to reduce the amount of stress in my life. I was cleared to go back to work a within four days and again the following weekend after doing a cardiac arrest call an hour or so later I felt my heart racing again. So put on the pulse OX and it read 240 and that episode lasted about 5 minutes. Just as we reached the hospital I could feel my heart was not pounding and I felt fine.

Same thing told to take time off and to rest. I have an appointment with my cardioligist who I see every two years in a few weeks.

I did some research but could not find much to tell me what causes PSVT and what if anything I can do to prevent this from happening again.

My quesiton is what typically causes PSVT?

I know you can't give me any advice but any information about PSVT would be appreciated.

Thanks.

Last week was my worst week so far since I began working in EMS and as a first aid attendant. Started off on a night shift when we paged out for a S.O.B call. On our arrival we got a hx from the fire dept. that the pt. was a diabetic and was complaining of back and was confused. The pt. was lying on the couch on her side and was moaning. I introduced myself and asked what was wrong? The pt. responded by stating that her back hurt. Airway was clear, breathing was laboured, and the pulse was weak, skin cold to the touch. RBS was remarkable, SpO2 was 89% on adult face mask, heart rate was between 79 and 86. My partner switched the adult mask to a non rebreather. I asked the pt. if she had suffered a fall due to the back pain and she said " Yes " and then said " No ". At that moment her grandson walked by and I asked him the same question and he responded with a " Yes " and then just kempt walking. My partner was getting the vital signs while I was trying to get more information from my patient. The grandson walked by again mentioned that he thinks she is an Asthmatic as well but was not sure? My partner said she had equal air entry bilatral to the bases. I questioned her if she was experiencing any chest pain? Her response was no.

Mean while she kept on trying to sit up but would just slump back over. At this point I had the fire guy's bring in our clamshell and set up our cot at the top of the stairs located just outside of the basement sweat, as I made the decision at this time that my pt. was very sick and needed to be at the hospital. As the fire guy's where finishing up strapping the pt. to the main cot, I had a chance to ask the gransdosn who had called for an ambulance what had happened and what prompted him to call for the ambulance. That was when he told me a very vital piece of information. He stated that earlier in the day he had come down to check on his grandma and he found her laying on the kitchen floor which was around 1pm. He helped get up and from there she seemed to be okay, but said to him she was having CRUSHING Chest pain and felt like vomiting. I said thank you and walked away.

As my partner and I where wheeling the pt. to the ambulance I mentioned the new information that I had just obtained. The fire guy's asked if we needed any help once we got the pt. loaded up and we said no thanks, but thank you for your help and we sent them on their way. within 2 minutes of sending them away our pt. when unresponsive on us. The pt. had gone into cardiac arrest. So with only two of us stuck in the back of the ambulance running the cardiac arrest call and doing a million things at once I mangaged to get my portable radio off my belt and radio dispatch requesting our kilo car to respond to our location code 3.

It seemed to take for ever and of course it was one of the hottest days we had had all summer long. Once the other crew arrived my partner contacted the ED and he requested that we bring the pt. to the hospital due the arrest being witnessed and that we mangaged to get one shock. Once we arrived at the hospital we worked on her for about 15 minutes before the dr. pronounced her.

For me this was a good call but also a not so good call. It was good because it was the first time inserting the OPA, nasopharngeal airway, as well as the King LT airway, hooking up the AED on a actual pt. and setting up the bag valve mask. In the past when doing a cardiac arrest I did not have my endorsemant for the KIng LT and typically the pt. was being ventilated by the fire guy's on our arrival. I was able to run the entire call from start to finish. I wish the outcome was better and I always think what could I have different. I couldn't believe the grandson had not mentioned to us on our arrival that previously in the day the pt. had been experiencing crushing chest pain. At least we would have had that information alot sooner and we would have probably loaded the pt. alot sooner and had been more prepared for any cardiac realted problems.

Now the second thing that happened that week was I had just started my first shift at my full time first aid job at a mine site two days later when I got a call for a worker who could not stand up. I responded underground to find my pt. pale, cool, diapheretic and complaing of abd. and groin pain and vomiting. I did not waste much time underground and loaded him onto the stretcher and brought him to surface where I had the onsite ambulance waiting. No signs of trauma on my RBS and vital signs where stable. We are an hour and half away by ambulance to town and at this point I did not know what was wrong with my pt. I questioned him on having any chest pain, ulcers, diabetic, bowel momemants and his response to each question was No chest pain, no ulcers, not a diabetic, good bowel movemants. I could tell this guy was sick and needed to be at the hospital and my suspicion which I told him due to him asking was he had a internal bleed. But I was not 100% sure of course. The pt. was unable to sit still, so I was unable to get a BP the entire way to town, his heart rate was within the normal range, SpO2 was 98% on High flow O2. I administered Entonox for pain, but did not help him at all and also his SpO2 stats dropped to 90 so I put him back on HIgh flow O2.

Abiout half way to town I popped my head through into the cab and told my driver to get me to the hospital as soon as he can cause at this point my thoughts had gone to thinking he might have been experiencing a Triple AAA due to some reading I had done and he was showing signs and symptoms of a triple AAA. I noticed when we were about 20 minutes from town that his abd. was slightly distended and for me that confirmed he had internal bleeding. After I gave my report to the attending nurse I stood back and listened to the dr. and he confirmed that it was a Triple AAA and that he was going to be flowen to another facility.

I learned that night that he suffered a cardiac arrest while en route to the hospital in the helicopter. The following day was tough as I had to face his coworkers and answer questions by his coworkers and upper managemant as well as the mine inspector. I know things happen and I did all I could do for my patient, but when you acutally know the person and have had detailed conversations with that individual its harder seeing someone in so much pain and knowing you are doing everything you can for them and its not helping.

Sorry for such a long post but I just wanted to share my experience of having my worst week so far since working in the EMS field. I just hope my next pt. I deal with has a better outcome than my past two pt's. Sure is different doing a call where you are talking to pt. then within minutes they are in cardiac arrest or you find out that they did not make it and you where the last person they may have seen or the last familiar face they had seen.

Thanks for reading and be safe out there everybody.

Brian

Congratulations!

Hi and welcome to the City! You will find some really helpful medics on this site who can answer pretty much any question you may have.

We have different shift patterns from 11hr, 12hr, and 13, 12, and 14hr night shifts. We have two bedrooms with two beds in each room. Typically we don't get much sleep on nights when working on the Alpha car (full time car), but on the Kilo shift it is usually a little slower. But you still don't get much sleep if you are staying at the station while on the back up car (Kilo car) because the full time car is usually busy enough that the crew is in and out of the station most of the night. So you get to hear their pagers go off.

I am there to work not sleep and the busier we are the better!

I live in Nanaimo BC, work in Port Alberni for the BC Ambulance service part time. Full time at a mine site as a first aid attendant.

Welcome to the City Doris and Uri. You will find some great information on this site. Feel free to jump in to any discussion and ask questions.

Brian

CAN919:

You can apply and through BC Licensing and get your card, but realistic access to FT employment from my experience as an ACP is limited by BCAS and moreover CUPE, like climbing a ladder that is sitting in quicksand. I believe a court challenge is needed i.e. the Inter Provincial Labour Mobility Agreement before their is real reciprocity in Canada.

I have yet to be considered to be interviewed for the 3 positions I have applied for, and they are not the most bid areas btw, apparently "applicants from IN House have priority" well, so I am told from the horses mouth, no matter experience or what or what credentials one may have.

Better Question is do you know about the cost of living in the Lower Mainland and Kelowna area (s) ?

PCP ... Ok question: If you were in Gold River (low call volume hence patient contact) how did you maintain "Patient Contact Hours" as working in AB I can not by law (re: Health Care Information Protection) cannot pass fill out the on line reporting ethically .. I believe I will just let my let censure expire then apply again from out of province ... way easier that doing Con Ed reporting in 2 provinces and 3 regulated professions .. maybe time to push the peas off my plate with slim to none chance of working in BC myself. btw sans = without .

Dear Crotch: 2 + 2 = 4 your ethical standards are questionable, the rules of employment in Canada are a bit more stringent, we require Criminal Records checks vulnerable sectors and mandatory yearly reporting in Alberta AND if you are terminated from any position for any reason of competency it is reportable to the regulatory body, to apply for licensure in BC from AB requires full disclosure.

Sorry still don't and can't figure out how to only reply to the certain portion of your post that is direct at me. When I was hired I had just finished my EMR and just started my PCP training. I had not gone to licensing for my EMR, due to thinking I would be completed my PCP course within the nine months. BCAS hired me under the terms I complete my PCP and go and get my EMR license. So I was a driver only for pretty much the entire two years I was in Gold River! I still had patient contacts, as you know as a driver we do lots to help out in the call.

so yes, I did not have to submit patient contacts. Actually this reporting period is the first time I have to submit contacts. I am also working on getting my 25 IV starts so I can submit that to licensing and have that added to my license. It has been a long road due the strike and trying to complete school.

Good luck in the interview!

If possible, try and get an interview coach and have them run you through some mock interviews. As already mentioned do as much research on interviews as possible. Do some research on the company you are having the interview with, as this may help you answer some of the questions or if they give you a chance to ask your own questions, you can question them on their service.

http://www.bcas.ca/

Here is the offical website you can get more information. Unfortunantly you are trying to get into stations that are very highly wanted withing the BCAS employee listing. There are other stations in BC that are isolated or rual that you will have to start with and then by getting your senority and doing lateral moves. Good luck.

PS. PCP I'm not even going to comment of the Monkey comment except to say that is in bad form.

Happiness I apologize for that comment, as it was wrong of me to say Sorry if I upset you or any other BCAS member on this forum. I will think what effects my post or wording I use may have on others or on my credibility.

I understand why it upset you, as it is putting down our service, which I did not think about before hand. I was just attempting to say that the interview portion is not that hard compared to other interviews I have done. That is what I should have said.

Welcome to the City!

Hope you find the information on the site useful and I am sure you will and have, as there are many, many, knowledgeable and skilled Paramedics on the site.

Brian

Iam a certified PCP but havent worked in a service since graduation (1year ago). So im a paramedic sans ambulance. Ive sent applications to Mainland and Interior regions but my station selection is limiting me. Coquitlim, port Coquitlim, Richmond, Vernon, Westbank and Kelwona were my choices.

Ive travelled to BC several times on vacation so I am not very certain about the job prospects around the province.

Any one have suggestions of better station selections within the areas Ive mentioned that would allow me a better chance?

Thank you so much in advance

First of all welcome to the City!

where did you get your certification from?

Where do you live now? I am assuming you don't live in BC or you would know that you have no chance in getting hired to any of those stations, well not for a long while anyways.

I have never heard of Sans Ambulance before. Where are they located?

If you are looking to work at either of those stations you need to put in some time with BC Ambulance service. First of all you need to apply to BCAS, which then you do your interview( which a monkey could pass). Once you get hired you get posted to a rural station like Gold River, Sayward, Boston Bar which is located about two-three hours from downtown Vancouver. Once you have completed your six months of probation then you can lateral to a different station, which would not be in Vancouver or any of those places you named. To be able to work in Richmand, Port Moody, Kelowna, Vernon and some of those place you need probably at least 3 or more years of service.

To be able to work in the Vancouver post you need to post for a full time position which usually takes 5 years. Which at that point you get hired full time irreg. which means you get posted to a station, but you work out all the station located all over Vancouver. From there you need to apply for a full time position which means you get a regular station with a regular partner.

I have been with BCAS now for 3 years, not very long and I started in Gold River. We did 200 calls a year. Now I am working out Port Alberni and we do almost 5,000 calls a year, big jump from only 200 a year. We run three cars out that station 1 full time car, 1 kilo car (second car out) and a transfer car, as well as a spare care.

When you work part time for BCAS like I do ( the pay is not very good to start. You get 2 bucks an hour while you carry a pager while working on the KIlo car and then once you get paged out you get a minimum four hours pay at your base rate. Most of the rural stations only have a Kilo car, so you will need another job! you have to put in a minimum of 8 shifts a month, that does not mean you work 8 shifts that is just a number you have to submit for availability to keep your senority. We have about 4,000 EMR, PCP, ALS, CCP, ITT that work for BCAS, so that is a huge factor when it comes to applying for full time. Just cause there are so many of us trying to get a full time position that have taken their PCP training.

I am not a 100% sure how long it would take to get a station like West Bank, Vernon, or Kelowna, but I am going to guess a while since they are located in the Okanagon which is a very popular place to live due to the great weather! Kelowna is about the size of Nanaimo maybe and for me to lateral to Nanaimo is going to be about 4 years. We run two stations out of Nanaimo and we have two stations in Nanimo and out of those two stations we have three PCP man cars, 1 ALS car, and 1Kilo car to respond to a town with over 100,000 people living there. Kelowna is probably about the same so, yes it would take a while before you get a posting there part-time.

Feel free to pm me with any more questions or on this forum.

Brian

I am sure he will, but it is a good feeling knowing if you are stuck you have someobody you can ask that has the experience

Good choice in going to EMT-B school. Bieber will be a big help to you, as he has lots of knowledge and as long as you enjoy the course and have the passion to learn you will do well at it.

Good luck and welcome to the CITY!

...but bad things happen to people who don't carry a gun too. If the wrong person gets a hold of a gun, that just means that the innocent victim should have fired sooner. If you (generic "you") have a problem with shooting bad guys, then don't carry for the reason PCP elaborated on. If you carry a weapon, you have to be prepared to take a life. As far as someone else getting shot, I'm perfectly happy with bad guys being shot after attacking, or making a move towards, a victim. In fact, if someone is shot robbing a house, the criminal's estate should have to pay for the clean up.

Quick question PCP, what are you going to do between being attacked and the police arriving?

Well hopefully I don't get attacked as I am a very nice person. If the situation occured and the person had a gun, I would do everything I could do to not upset that person, by doing what he asks. If the person was attacking me and turned out he had a gun, well I would do everything in my power with the martial arts training I have to defend myself.

I agree if you carry a gun you need to be prepared to take a life, but also be prepared to defend your reasoning for shooting that person., I do agree if someone is attacking someone and they get shot then too bad for the attacker.

I just feel that there is a time to use a gun such as being abused by your spouse or being raped, attacked, but when they break into your house to steel stuff. Now if they broke in and where using physical violence towards you then yes shoot the SOB. I feel a person should not be allowed to carry a weapon on their persons while out grocery shopping or walking the dog due to them maybe missjudging the situation and shooting someone who just wants to steal their wallet or car.

I honestly don't know what the rules are for carrying a gun such as age limit or being conceled or not so maybe I should not have responded to this thread due to my lack of knowledge of firearms and the reasons why people carry them.

Maybe some of you could give me an example as to why someone feels they need to carry a firearm, so I could better understand the reasoning behind it.

What are the rules for being allowed to carry a firearm down in the United States?

rat115,

My thoughts and prayers are with you and your family. Being a dad myself I could only imagine how worried you are for your son.

Keep us posted.

Take care,

Brian

I say go for it! Good for you for doing something you have always wanted to do. I feel age should not make a difference, as we have many EMRs and PCP in our service that have retired from a different job, but wanted to persue a career in EMS.

All the best to you and good luck!

Brian

That is just perfect!

This is a interesting question. As Happiness posted I call for the RCMP and have them remove the gun, as I am not trained to deal with guns as a paramedic. There has been a case where a patient was brought inside of an ambulance and when asked to undo his coat so they could check for further injuries, he declined. After attempting multiple times for him to remove his coat, the paramedic requested the RCMP cst. to assist him in the back in removing the coat. When the coat was removed there sat a gun in the guys waist band.

This is not normal practice where I live. People only carry guns for a few reasons, Hunting, or shooting people to pertect their drugs and if you are carrying a gun in your vehicle it can not be loaded. I just don't understand why someone needs to carry a gun. Sure you may feel safer doing so, but bad things can happen when carrying a gun. The wrong person may get a hold of it while you fight with them and then what? Either you get shot or someone else gets shot.

Different places have different rules I guess, but I just don't see the reasoning behind it. If you don't feel safe, maybe take some self defence classes.

Kate, this post is not directed at you in any way, as you have every right to carry a gun with you. Since I live in Canada where it is not normal for people to be carrying guns I am ignorant when it comes to this subject, but I am happy that the genral puplic does not carry guns in Canada.

What sport awards the Stanly Cup? Does the NHL know this? I can't imagine Lord Stanley being terribly happy with someone stealing the name of his cup. And misspelling the name to boot! Or was that to avoid copyright infringement?

paramedicmike,

That was just my dumb ass mistake Mike when I typed it out last night. No excuses just bad spelling.

I was driving home in the pouring rain this evening and was thinking... not usually a good combination, but tonight, I had a question that I'm not entirely sure the answer to.

In Colorado as in many other states, certain people can carry a gun concealed. I happened to be carrying tonight at the time I thought of this. If I were in a wreck, unconscious and unable to inform the providers, you backboard me and in the process of assessment find the gun. What would you do? My hopes would be to discover the gun while still on scene with LEO's a plenty and can hand off the gun to the officer....but what if you didn't... I carry inside the waist band and so it may not be felt on initial assessment, especially a rapid trauma/extrication.

I only practiced in a state where CCW was non-existant so I was never posed this question in training or came upon it during my experiences. I know we have a few CO providers and a few TX providers, both states that allow CCW and both states where most people do.

Opinions?

That is crazy that you folks can carry a gun!!