WolfmanHarris

10-4. Hope I didn't sound judgmental. Nosy sure. But I wasn't implying that I thought you guys had f'ed up. Actually the mom as a Basic makes it all quite clear. Also brings to mind a cliche about glass houses.

Did something go wrong over the course of her care? I mean all cynicism aside, most people sue over a perceived wrong, not just because they're scammers with dollar signs in their eyes. The wrong may not be grounds for a suit (providers were rude) or it may be a shotgun approach (care screwed up by MD, sue the whole continuum of care), but there is still a perception of being wronged somewhere. Unless they're crazy. My one and only complaint against me the patient was horribly unstable. I won't go into details but when I followed up with the Sup, I was told that when he called to follow up with the Pt. she immediately started screaming at him and hung up. That and mine and my partner's incredibly detailed incident reports and the narrative of the ACR made the complaint go away.

AGM is not just a Canada thing. It's an Annual General Meeting. In this case of the Alberta College of Paramedics. Where College equals a professional oversight body, rather than an academic institution. That is all the help I can be on this thread I'm afraid. Not an Alberta provider.

Heck, due to a quirk in the language of the Ambulance Act, even all the Air Ambulance medics in Ontario still have to maintain a valid "F" Class license to work legally. This is why I'm glad the ambu-taxi business is separate from EMS around these parts. With the thousands of routine transfers every day, placing a medical professional in the role of taxi driver, day in and day out is a recipe for complacency. Sure we do the odd stable, non-emerg IFT here, but they are rare and usually the patient has a complicated medical history to warrant a Paramedic crew attending. (In my district most are repatriations of recent MI's from the PCI lab to their community hospital.) Now the transfer industry here is in desperate need of regulation and standards, but at least it's not part of EMS. None of those yahoos will find themselves running a 911 call the next day. As for your partner, I'd suggest just doing it yourself until he gets the picture. When you put the patient on the stretcher just hold up for a minute in place and say "Hang on one sec, I'll just grab some baselines for you while you get history from the patient/staff."

Union or no, up here you'd find yourself not collecting a paycheque until the ministry and base hospital was done with you. In this case I'd imagine that if the medics knew their cert was fraudulent they'd have their A-EMCA pulled by the Ministry of Health and the Medical Director would pull their ticket. Precedent has so far shown that the Union has no standing in issues of certification maintenance as it is outside the employer-employee relationship. The employee would be fired on the grounds they were no longer qualified for their job. I'm not sure how this could happen on a large scale up here though, all programs have to be approved by MOH-LTC (Ministry of Health and Long Term Care) before that student can write their provincial exam. Maybe some out of province grads seeking equivalency could sneak in from a bogus course, but they still have to write the test. Then complete the written and practical testing needed to get hired and then pass Base Hospital certification. Yes all these providers need to be fired. Depending on the specifics of how they committed this fraud and the wording of the applicable statutes they may even be guilty of a criminal offense. But moving past that, this illustrates a need for better quality control and oversight at a state level to ensure that providers are properly licensed.

Our oldest vehicles are 2006 (spares, and their on their way out come summer) but their lighting package doesn't have rotating anything, just lensed strobes. All our 2008 and onwards Demers trucks are 100% LED on the warning systems. Scene lighting is still standard; I guess LED's don't have the same throw. I think a few of the trucks in our northern neighbour service still have some rotaters in their older trucks.

One of our bases has an old filing cabinet where one of the drawers is just full of old phones and the other manuals and warranties for every computer or piece of electronics that's ever been in the base. I guess we could throw them out, but we have no need to keep files either. This same base had a huge four bedroom apartment above it that's entirely vacant.

Attended our recognition night "Night of Stars" last night. It was really well done! In front of the banquet hall was a PRU and Ambulance parked side by side with lights on. When you entered the hall the Chief, Deputy Chiefs and various Superintendent were in a short receiving line to greet every one. In the front hall during the cocktail hour were appetizers, punch and cash bar. Two of our medics played their guitars and sang as people mingled. Off to one side they had a neat display: on one side a Ferno #30 with a dummy set up attached to the old heartstart and genesis. On the other a dummy on on our our 35X stretcher, hooked up the LP15, intubated under the Lucas CPR device. Really cool then and now display! This also marked the 10th anniversary of the service (post provincial download) After the cocktail hour, everyone settled in. The Honour Guard and a Police piper lead in the Chief and guests of honour (Regional Chairman, Commissioner of Community Health Services, our Make-A-Wish Child for this year, etc.) A really well done video on EMS and on the service was played. (Trying to get a copy to post, but may not be able to.) Awards recognized: - This year's ACP grads - Recent recruits to the Special Response Unit (SRU) - Stork pins and certificate for everyone who delivered a baby this year - Rookie of the year - Casual of the year - Community Involvement - Leadership (awarded to partners) - "Shining Star" (just call it MVP) - Recognition of those awarded the EMS Exemplary Service Medal this year (a national medal issued by the Governor General's office) Other items of note: - Handing over the keys to a donated decommissioned vehicle to GlobalMedic which will be part of a midwifery team in Haiti - Handing over of the big cheque to Children's Wish Foundation by our service's "Medics for Kids" charity - Speech from our Make-a-wish child (Paramedic for a Day) that brought everyone to tears. - Our Deputy Chief in charge of Logistics shared the top 10 list for medics who's run the most calls (#1 had over 8600 and also happens to be the medic whose seniority date is 1968) in the last ten years and for the medics who spent the most time on offload delay (the #1 had spent the equivalent of 186 days on offload) - Recognition of a medic who was awarded a medal for bravery from the Police for pulling a lady from an overturned car that landed in a pond. - Recognition of the efforts of one of our Sup's that has ensured that an Ambulance and medics from our service are present along the Highway of Heroes to pay respect to every fallen Canadian soldier on his or her way home. - Speeches from bosses and big wigs to make everyone feel warm and fuzzy Oh ya and we had a dinner followed by a dance. I know I bitched earlier about a lack of recognition for medics during EMS week. I take it back. Sure my ticket for last night cost me $30/person, but what we got was worth way more than that. (And I imagine the service must have subsidized a good chunk)

Latest EMS week festivities: One of our Regional Hospitals put up a "Happy EMS Week. Thanks for all you do." banner, just inside the Ambulance entrance. And apparently one of the nursing homes in North District had a muffin basket. But they were letting fire have some too, so...

Actually that's what's bugging me a bit about EMS week. The service is doing tonnes for public education and promoting the profession, but not all that much for the crews. Even the BBQ we had at the family day wasn't free for on-duty crews. But you know in the grand scheme of things, I'll benefit more I hope from good public education about the profession, then a free hotdog.

For me I'm unfortunately working for most of it. My service's EMS Week Committee is doing the following: - Participating in a big kick off event in Downtown Toronto w/ 8 other services. Showing off trucks, staff and equipment for the public. - EMS Family day at a local community centre with BBQ, CPR and AED awareness, displays, children's activities and a sponsored free skate in the rink - Lunch and Learn for other regional staff: Non-ems regional staff get to come for a free lunch and learn CPR from our Paramedics. - Displays at local malls and public buildings with staff and vehicles on hand to teach the public - A large TV segment on TO's Breakfast Television this morning at one of our stations. I only caught some of it, but what I saw was a reporter wearing a Tactical Medic's body armour, attempting to intubate a dummy. - Paramedics preparing and serving lunch to a group of seniors at a local church. - EMS Recognition Night: Annual staff banquet and awards night. - Large sandwich board signs out front of most EMS bases I think there's a few other events going on but I can't remember at the moment and for some reason the service intranet isn't letting me access it to check.

Thanks for the link. That thing is awesome! I'm looking forward to trying it out. My only concern with my service pushing no-lift is that crews will get spoiled such that they lose any conditioning they had when they have to make some bad akward lifts. We don't have a culture of fitness in EMS and the more widespread these assistive devices come the less likely I see a cultural shift being. So will we cut down on minor workplace injury claims at the cost of increasing the severity of the injury when it does happen? I'm not saying I'm resistant to power cots, tracked stair chairs and the like; I'm strongly in favour of it. I think it just reinforces the need for EMS to push a culture of health. So add that to the list of crap we need to fix in this industry.

This sort of whining worked well in Toronto. They managed to get a city bylaw passed that requires Toronto EMS to be hired for EMS standby's at movie shoots, festivals, etc.

We had a trial here a few months back and reviews were pretty good. Apparently the service will be buying both them and power cots in the next few years as part of the transition to "no loft". Unfortunately Stryker doesn't seem to have any info up on their site, so I'm yet to see the darned thing myself. If you can, (I know it's a new product) snap and post some photos please.

I was under the impression that the waveform is an indicator of reliability. My preferred set-up on the LP12 is Leads II and aVf and SPO2. If I've hooked up the ETCO2 then I'll drop one of the leads and put the CO2 waveform up.

Attended for a ~60y/o M, epistaxis. Became clear on scene that even with his extensive mental health history (call at a group home) not all was normal with him. Took a BGL found it was 2.5 mmol/L. Started to explain to the pt. that we were going to give him a shot of glucagon to correct it and when I reached for the drug bag my partner put a tube of oral glucose in my hand and smiled. Right, if I can explain to the pt. what's going on and chat with him, chances are he can handle the glucose.

I don't believe ORNGE has NVG's. They only perform scene responses during daylight. After dark they must land at a lit helipad (usually a Hospital) as part of a modified scene response. Remember though that ~90% of the calls performed by ORNGE is critical care transfers from one facility to another and that the original purpose of air ambulance in Ontario was to serve the extremely remote areas of the North which is where you'll still find the majority of air ambulances.

Especially since they're all management types. Our Superintendents sleep less than the rest of us since they're always being called on their cell, or being asked to attend to scenes. They do manage to snag some downtime too in their various district offices.

Everyone sleeps at work at my service. Our stations all have couches and usually lazy-boys in the crew room. As long as base duties are complete, truck's clean, stocked and ready to go than we're welcome to sleep, eat, watch tv, read, etc. I have slept in the truck for a bit too when at a standby or stuck on offload at the hospital (alternating partners) but I don't unless I'm really tired as I can usually only get a catnap. Now our response times are good and not getting any bad press...

Our protocol says that in the event of a Emergency Button activation the only accepted response is "[unit #] Alpha Charilie, 10-2000 Alpha Charlie" Saying "I'm fine" or "Sorry accidental activation" will receive an acknowledgment but PD and Back-up will still be dispatched.

we have to do a thorough exam in order to report anyways. We have to document how we determined death.

That's why I love the new Demers trucks and their side compartments. Less unsecured baggage in the back and my lunch, PPE and pillow and blanket have a convenient spot to stay. I think the key with lunch breaks is to create an obligation on the service's part. During our breaks we're only immune from standby's, routine transfers and non-emerg (Code 3) calls. If an emerg (Code 4) call comes in, you still have to go, but then you're supposed to get another meal break right after. Failure to have a meal break in your designated window (3-5th hour and 7-9th hours) allows you to claim an extra $15.00 per missed break. The service has financial incentive to provide adequate coverage for crews to get downtime, but the public's safety isn't compromises by having calls ignored.

I had a bit of a "pucker factor" moment a few months ago after pronouncing an obvious death. (Rigor, fixed dependent lividity, opacification and pulseless/apneic for good measure) I'd informed the family who essentially already knew and had grabbed the coroner's package from the truck when my partner passed me a six second strip. It wasn't flat. Both my partner and I were fairly new and it took us a few seconds to not only recognize a pacemaker, but convince ourselves that it couldn't be anything else. I think that was the day I was sure I'd mastered my ability to mask those "oh crap" moments. (Like when your partner passes you a STEMI 12 lead, or a positive SAS test for a CVA.)

PCP's generally make between $29 and $38 per hour in Ontario. Casuals get around 14% on top of that in lieu of benefits and vacation. ACP's generally make between $32 and $45 per hour . Problem is all these numbers are meaningless without knowing the relative cost of living for an area. A computer programmer friend of mine was just over $130k to move to California (San Francisco I think). He took one look at the cost of living vs. where he is now and realized it wasn't that big an increase over what he makes now. (~ 90k, self-employed)

The study done in Ontario by Rescu (prehospital research group at UofT) found that ITD's increased ROSC but did not affect survival rates. The results haven't been published yet but from what I understand the preliminary results are attributing the increase in ROSC more to the close monitoring and feedback of CPR and ventilation that was done during the study rather then the ITD itself. Rescu ROC PRIMED Study And if you scroll down the main page to "What's New" on the left side, you'll find part way down the pdf's for the suspension of the trial and the early results. I scanned the published articles section and couldn't find a PRIMED article yet, so I imagine they haven't published just yet.