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Everything posted by cprted

  1. I would challenge your assertion that drug users don't call 911 when they or another drug user overdoses. They do. Not as much as they probably should, but they do call. Maybe the police have a slightly different mentality up north of the 49th, but when the police attend OD calls, they're not worried about arresting people. I would say the largest barriers to addicts seeking help from heath care providers is the attitudes of health care providers themselves. The number of times I've had addicts refuse transport because, "they're all assholes in the hospital, they treat me like shit because I'm an addict," is astounding. Again, maybe this happens more North of the 49th than south, but street narcan kits are quite prevalent up here. It's a little kit with 0.8mg of Naloxone preloaded in a syringe. I'm sure with IN naloxone becoming more common, the street kits will transition to that form over time. The major problem however is that so few overdoes involve a single toxidrome. Most ODs are polypharm and opiates are but one of the agents on board. If you want to look at public health initiatives that really do make a difference, read up on Supervised Injection Facilities. There are a number in Europe along with one in Vancouver, Canada and one or two in Sydney, Australia.
  2. In the Canadian Forces, our Med Techs take the Primary Care Paramedic course and get licensed as PCP as part of their training. CF Medics regularly do shifts on civilian ambulances during their time in the forces to keep up their skills when it comes to things beyond dealing with healthy 20-40 year olds. Makes the transition to civilian paramedicine fairly easy if that's where they choose to go.
  3. And then consider whether having the providers being armed would have prevented their deaths. In many cases, the answer is no. When it comes to being ambushed, the reaction will always be slower than the action. You topic seems to assume that Paramedics should be armed. Be wary starting a research project from a bias like that. Instead, maybe your research question should be, 'would giving Paramedics weapons for self defence increase their safety?' I think you're going to have trouble with this one either way. The topic of arming and guns is political and rife with polemic dissertations disguised as science (on both sides of the issue) that I think it'll be difficult to do any meaningful research without already being a use of force expert in the field. If you can pick a topic yourself, why don't you research a disease, or a comparative look at cardiac arrest resuscitation techniques ... something that might inform your clinical practice in the future?
  4. http://www.jems.com/behind-the-mask
  5. I watched it and thought is was funny. Is it realistic? Heck no, it's a sitcom. It's is meant to entertain not enlighten.
  6. If you're based in BC and want to work for BCAS, you should look at the JI. The JI, EMA Licensing, and the BCAS ALS residency program are becoming more and more integrated and give students a pretty smooth transition through practicum, licensing, and residency to get new ACPs out on the road and practising.
  7. No, under the BC Motor Vehicle Act only emergency vehicles are permitted to have flashing red lights. The only exception to this is Volunteer Fire Chiefs are allowed to have red lights on their POV, but most choose not to. The permits are required for amber light only. No fire apparatus or ambulance I have driven in BC has a flashing red light permit. Amber light permits are available, but you need a legit reason. ie, traffic control vehicle, public works truck, vehicle on a site that requires use of yellow lights (ports, airports, etc).
  8. A truly iconic member of our service. Rest in peace Tim. Tim was featured in a documentary about SAR in Canada, called "To The Rescue" that aired last week. http://www.cbc.ca/doczone/episodes/to-the-rescue
  9. 82% not bad for a Canadian
  10. All our cars are coming from Demers these days. Chev gas chasis. The Sprinters are a limited trial.
  11. If it were me, I'd start with 0.2mg IV and see what the result was.
  12. In my service we would run L&S to that call because the MPDS system would spit it out as a 17D1, "Fall with Injury to Dangerous Body Area." Can't tell you how many 17D1s I've been on where the only injury is a 1/2" lac above their eye that has stopped bleeding by the time I get there ... but to the computer, its a head injury ...
  13. I didn't mean to suggest that RC doesn't support new instructors, they certainly do and the RC Instructor Training program is a really good one. One of the big differences between teaching for SJA and RC is the delivery model. SJA delivers most of their courses directly through a branch and the instructors of employed on contract with St. John. RC delivers its courses through "Training Partners." Neither requires you to be a paramedic to go through their instructor training, though you do need to have some sort of First Aid/Health Care experience and be solid with your skills.
  14. If you're not an experienced instructor already, I'd recommend getting in touch with your local St. John Ambulance branch. SJA has a good instructor training program with lots of follow up mentoring with seasoned instructors to help you develop. They are really great at supporting their instructional staff.
  15. Thank you vaflightmedic for reviving this thread! Man, oh man, that guy was funny ... handcuffs, combat training, rescue ambulance, and a nissan pathfinder decked to the nines with blinking lights ... pure comedy gold!
  16. In my service anyway, we don't do CPR just for show. We've had some good training around death and dying, grief management etc, and the message that keeps getting given to us is be honest with people and don't give them a false sense of hope. If I get on scene and the patient is obviously dead, I do my assessment and then tell the family that their loved one has died today. At that point, they become my patient now and I'm there to support and help them.
  17. Entonox is widely used in Canadian EMS as it is the only analgesic we have at the PCP (BLS) level. I don't have a "Skills Checklist" type page for Entonox, we check it off using the standard Medication Admin checklist. Here is the Drug Monograph we give to students. Classification: Analgesic Supplied: Compressed Gas Cylinder Actions: An analgesic to reduce pain. Inhalation of a mixture of 50% Nitrous Oxide and Oxygen produces central nervous system depression as well as rapid pain relief. Route: Inhalation Dosage: Self-administered. As the patient becomes drowsy, the mask will drop away from the patient's face. Administration is patient controlled until pain is relieved. Indications 1) Chest Pain 2) Musculoskeletal trauma 3 )Burns 4) Other conditions (labour pain, etc) Contraindications 1) Inability to ventilate enclosed treatment area 2) Inability of the patient to comply with administration instructions 3) Suspected inhalation injury 4) Suspected air embolism or pneumothorax 5) Decompression sickness 6) Pt has taken Nitroglycerin in past 5 minutes Cautions 1) Abdominal distension 2) Shock 3) Hx of COPD 4) Major facial trauma 5) Pt on depressant drugs
  18. Google the "STAR" format and read up on interview strategies. The format of your answers are just as important as the content. You can have a great story, but if you don't articulate it in the STAR format, you won't score very well. Alternatively, you can have a so so answer, but if you nail the STAR format, you'll get a decent score. So just to review: Situation-What's the context? Task-What was the task at hand? Action-What did YOU do? Result-How did it turn out? The questions are rather broad and you can draw from all aspects of your life. Yes things are kind of geared towards employment, but you can from all aspects of your life. School, volunteering, youth group, a sports team, etc. For example, "tell me about a time when you has a disagreement with your supervisor." If you don't have a work example, there really isn't any reason you couldn't make your answer about something else where you had a supervisory relationship. These answers don't have to be earth shattering life and death stuff, you'll get the best scores for sticking to the format. Also your story doesn't have to have a positive result. The "R" part could be, "turns out I was wrong and the project blew up in my face. But what I learned from that was ... "
  19. In Canada, only in-hospital deaths are eligible for organ harvesting. Anyone we bring in in Cardiac Arrest is ineligible.
  20. Up here we call motorcycle helmets "Brain Buckets" ...
  21. Funny thing was, last year there was so much interest, they actually produced a limited run and sold out rather quickly,
  22. We only transport with CPR if we can identify a treatable cause or in special cases like paediatric arrest. Otherwise, we work it for 30 mins on scene and then consult with the Doc regarding discontinuation. Here is the link to our Treatment Guidelines http://www.bctg.bcas.ca/Category/Principles/105
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