WolfmanHarris

Good point. I'd have to double-check, but I don't recall seeing any Boston EMS employees listed on the full list of those who falsified recert.

Frig that one got me and I've seen it before. Passed on to the world at large via FB (which seems to have become my soapbox for things like this). Really glad I'm not working New Year's Eve this year. Last year's sucked.

How long are these refresher courses they've been blowing off? Either way it's unacceptable, just curious how lazy, negligent and dishonest they were being. I'll never get the bitching about CME. Thankfully it's an incredibly small segment where I work and CME is provided in house (and mostly paid time), but a few people always seem to be down to the wire on their self-guided CE. As a PCP I take 36 hours of classroom CE and two self-study packages to stay current. This is nothing. I easily do double of triple that in formal education each year and countless other hours in reading and study.

Last weekend I attended the Paramedicine 2010 conference. One of the sessions covered selective spinal motion restriction. Specifically the Ottawa C-spine rule, state of the research supporting it and progress on moving it fully into the pre-hospital setting. Ottawa Paramedic Service has already done a study where Paramedics were documenting whether a Pt. would meet the rule and whether they could rule out SMR while still using SMR on everyone. Starting in the new year they will be the trial site in Ontario for full implementation with the hope of it quickly expanding throughout Ontario. Here is a link to the Conference website. They've posted some of the presenter notes from the conference there including the notes on Ottawa C-spine. Session Notes Most of the research cited wasn't news to me, but having them all together in context was really enlightening.

And never forget the exceptions that disprove the rule. Case in point for #31. Responded last winter for a 69 y/o M c/o sudden onset CP. Radiating to the L-arm and jaw accompanied by SOB, diaphoresis. Pt. had been shoveling snow when symptoms started. Hx of angina and prev. MI. Taken three sprays NTG w/ no relief. 12 lead showed clear ST-elevation in V2, V3, V4. No artifact or anything. We called for ACP back-up, administered ASA and 2 further sprays 0.4mg NTG. Pt. starts to drop his systolic as ACP back-up arrives. ACP starts a line, follows up with more NTG and fentanyl and takes over for transport. L&S to hospital bypassing ED right to cath lab. Pt. gets PCI for 90% occlusion LAD. Leaves hospital 3 days later. Sends a thank-you card just on time for Christmas. I practically expected to look over and see a prof with a clipboard.

Hugely underutilized piece of equipment. That being said, I haven't used one outside of class. On MVC's my patients have either been so stable that boarding was practically cosmetic, or so unstable there was no time. We carry two on each truck.

Based on number of Pt.'s I'd have two more units attend as well as SRU. (Count them as a single ACP for the purpose of the scenario) Once the vehicles have been cribbed and fire's comfortable with entry I'd get a medic into each vehicle for assessment. Where do we stand for each patient on: - LOC/GCS - Gross hemmorhage - Rapid trauma survey Prolonged extrication is sufficient to pre-alert HEMS to respond. How's the weather and time of day as well as distance to Regional Trauma centre?

Agreed Dwayne. I'd stopped posting a lot recently for many reasons: It had started getting really slow around here, repetitive topics thriving while good ones flounder, but mainly I was trying (and failing) to do more non-work related things on my time off. But, in the last bit as it's picked up I've been findings myself drawn right back in and enjoying it.

In terms of cost to benefits I don't really see any benefits in most cases. Not only do I have to get in the phone, but then I have to find a person to contact who will be useful to the situation, hope they answer the phone, I then have to explain to them who I am and what's going on AND then finally hope they can provide useful, relevant information for this situation. Since my Pt. isn't providing it to me at this point, I'll assume I'm in a critical or potentially critical situation where my time could be better used. We've all managed a Pt. before with little to no history, this is no different. On the side of using a Pt's cell phone to contact next of kin, this is a job I leave to PD or the hospital. By the time Police or Hospital staff are able to contact family the situation has been given a chance to settle and hopefully the family can be presented with a clear prognosis when they reach hospital, rather than a call while the situation is still developing.

As per an e-mail from our Chief this evening, all flags at Stations and HQ will be at half-mast in respect to our fallen colleagues.

Thoughts are with the BC medics and the families of those lost today.

Congrats! That's awesome!

I don't think we've got the white light. I'll have to check when I pull OT on a unit with it installed. As for Fire, we very rarely run into another emergency vehicle on route to a scene. They don't come to many medicals and they usually have a good headstart to any structural stand-by's. Either way, good advice, you don't want to end up with this:

Luckily most of our traffic signals have them. The Region (County) took over installing and upkeep since all the transit buses use Opticon as well. Good point. I guess as long as people continue to drive defensively and with due regard there shouldn't be too many problems since the vehicle without a green will have to come to a complete stop. What did you mean by flashing white light? (I work North district where they haven't implemented this yet.)

Well some exciting news from the Community and Health Services committee at our Regional Council. After a three month trial of the opticon system on ten of our vehicles an average response time savings of 58 seconds was realized (from 8:09 to 7:11). Since staffing increases to obtain such a decrease would amount to ~ $3.6 million (3x 24hr Ambulances) the committee gave final endorsement to the system and the rest of the fifty front line vehicles are going to be refitted in 2011. Now I know response times are something of a myth that we continue to perpetuate in EMS, but the danger of crossing intersections against a red signal is not. So while the region will be getting the response time decrease they desire, we'll be getting safer operations. One shortcoming of the plan is that the opticon system is linked to our emerg lights, so L&S responses will not be decreasing at all, they'll just be safer. Anyone else use the system and have any insights they wish to share? Personally I think they'll find them of limited utility in our North district, which is far more rural, but with how vehicles can end up far out of their district on busy days I can see why they'd want to equip them all. The report to council is fairly interesting reading and may be useful to others looking at the system. I've summarized the findings here but if anyone would like the original report, please PM. As is my rule, I won't post the link publicly as I try not to obviously identify my service in my posts.

The "DONATING" link may have a problem. I clicked and got a page that said "Fatal Error"

It's likely an easy sell as far as the public goes. People call us to go to the hospital and as long as they're getting there they are unlikely to really care what toys we may or may not have to help them. In the eyes of the public EMS is still primarily how they get to the hospital and until the services we provide are relevant outside of such a narrow range don't expect a huge public outcry or even notice. Let's look at sanitation as a parallel. People may care about recycling, but a cut to a recycling program likely won't catch more than the passing attention of the public as long as their garbage bins and recycling bins are empty after pick-up day. That's the end they expect. The work going on behind the scenes may be important, but to the public it's secondary at best.

I just got home from a night shift, so I'll be brief and blunt. Services are progressive. Paramedics are progressive. The education system is progressive. Most of the Base Hospital Programs are progressive. The Ministry of Health is not. We need a College. And a real one, not like Alberta's. One where people show up and get involved and where the college listens.

News Article Found the fact the Fire Trucks are now going to have to move about the city to some extent interesting. At my service we don't do SSM, but we do move about to different bases to cover for high call volume areas.

Worth noting that Dr. Macnamara is a former Paramedic himself (15 yrs on the road). Other than that, VS-EH beat me to posting the letter.

Our system for lift assist and bariatrics has a few parts. For lift assist we are under policy and dispatch rules to be sent another EMS unit rather than FD unless FD is specifically needed for rescue/extrication, or another EMS unit will be delayed. Lift assist request is entirely at the discretion of the crew and can be based on terrain, close quarters, or weight. Currently all our Ambulances have the Ferno tracked stair chair. We also have 3 stryker power cots in service that we initially trialed with more coming for all the trucks. We have also been told that when it's available for purchase to expect the power load system on all our vehicles as well. All part of the service's transition to "No Lift." For true bariatrics (over 350lbs) we have a few vehicles in each district that have the infrastructure to be converted for bariatric. They have the extra wiring and mounting points to centre mount the stretcher and install the winches. The idea here is that it is more likely that one of the bariatric capable trucks will be available to co-respond along with the initial crew. The bariatric equipment is carried by the Special Response Unit in their single response trucks. This includes airbags, slider boards, the ramps and winches and the large body adapter deck for the stretcher. They respond to the scene, set up the equipment and truck and coordinate the movement while the initial crew focuses on the call.

While I think the councillor is being ignorant, let's not freak out here folks. First, for him to get any traction on this he has to first get past the relevant legislation that requires siren use. In fact, I bet if he thinks it's bad right now, the crews can start following the letter of the law and using their siren constantly rather than intermittently, as needed to clear traffic and intersections. Second, EMS in Alberta is (and specifically Edmonton) is provincial. I don't see them changing their policies jurisdiction by jurisdiction to placate local politicians. But finally, what does it matter if he gets his way? L&S is psychological and PR more then it's good medicine. Let the service and the politicians hash out the effects on response times, all the crews should worry about is arriving safely and providing competent care. If that means that do to no, or quiet sirens they have to inch through every intersection and drive slower, with due regard to conditions, then great. They should be doing that anyways. Sure in heavy traffic this may make a bigger difference and if so, report the delay to dispatch, continue to respond safely and once again, let management and the politicians hash this out.

CONGRATS! Always good to be able to go home to work. And as for the Fire thing. I find it really hard to knock somebody for making the jump. With the comparison in pay, benefits, job security, pension, workload, to most privates in the states, it's instantly understandable. With a family to support and a life to live, how can you ask any individual to stay in a crappy work environment for the potential good of a profession? The onus is on the rest of EMS to become a career option people can stay in and even that won't fix the issue entirely. Even up here where we have third services with comparable pay and benefits and no fire based EMS, Medics still jump ship for Fire. Because as good as we have it in EMS, Fire's got the warm beds, better workload and schedule and early retirement. It's about what's best for you and your family. Anyways, congrats again and good luck!

Seems to me that if Fire is going to start charging a fee for service, then their funding should reflect that. Private EMS is expected to support themselves on billing. I'm not a fan of fee for service for Fire, nor do I support it for EMS, or Police, or Public Health, etc. BUT, if the citizens of a given community vote clearly to discontinue funding Fire in exchange for a public, non-profit, membership and fee for service, then so be it. That's democracy in action. You can't have it both ways though. That's just gouging the tax payer twice.

I strongly disagree with the cafe's owner. However, they was well within their rights to exclude the officer as a customer. I also give grudging respect that by the articles account it was done is a calm measured way. I give even more respect to the officer who obliged without incident, doing his profession proud. I do not envy the job of the Police, who in a free society must constantly walk the ever shaking line between upholding order and respecting the majority, protecting the individual and their rights and following the lawful orders of the Government. These are not mutually exclusive aims, but they certainly don't always blend well. Their job (like ours) is all but ignored when things go well and is quickly vilified when a signal individual makes a mistake or breaches the public trust. But if you got into law enforcement, or EMS for that matter, for public adulation, you're going to be sorely disappointed.