vs-eh?

Oh silly child.... Silly, silly child...His name is Thunderchild145 right? 1) When you say "your license" does that mean mine or yours. I didn't say any paramedic in Ontario has a license, and most US medics (from what I see on these forms) don't either... 2) Practically all level of EMS, especially the EMT-B level have zero, yes ZERO education compared to their Ontario counterparts. 3) Again, so you think that if people are told that "Nitro helps chest pain" or that "RSI helps people with their airway" that should be so. 4) Ridiculous!? It is reality my friend! This is the reality that basically everyone who has started out in EMS (in Ontario) for the last 5 years faces. Again skills/scope = education in the grand scheme. Are people possibly telling me that 1200-1600 hours of education are analogous to 200 hours of training? You aren't serious....

I'm still curious why itku2er was on neb morphine...

If you have a medical condition and/or are on medications that may directly influence a significant medical situation wherein you may be unable to inform the proper medical personal about said condition/medication? You should be wearing a medic alert bracelet/have some sort of ID about said condition at all times. Any EMT or Paramedic worth ANYTHING should be able to adequately manage an emergency situation prior to an MD's intervention, bloods, etc... But seriously... How many EMS services carry a laptop or have computers that allow USB drive access such as this? Or hospitals for that matter? In the end...THE ONUS IS ON THE PATIENT.

http://www.cno.org/reg/nonmemb/progs_rn.htm

Agreed. On all points.

1) I was referencing only one person that I recall. But even if that was consistent across Ontario...Do you not think that is a problem? You being an EMT-P in North Carolina, yet a PCP here? That your education would only (potentially at maxiumum) allow you to practice as a PCP. I am not degrading PCP's (or EMT-P's) for that matter, I am just making a point. Dustdevil, I believe was looking at reciprocity in various provinces, maybe he could shed some light... 2) People see scopes of practice and equate that to education. That is poor reasoning. Again, would you rather have an educated paramedic practicing at a lesser scope, or a lesser educated paramedic at a more advanced scope? Plus in this province (for the most part), you don't have options. 3) I tried looking at your education via the website you linked in your myspace. I couldn't tell for sure what the curriculum was. Please link or clearly spell out what the curriculum was with your EMT-B and EMT-P program.

Reading the several posts regarding Centralized Testing and overall lack of jobs for PCP's in Ontario, it lead me to this post. I have asked this question before within other posts, but I never seem to get a response. So here goes, I will brake down some givens (i.e. for this argument assume you have these) to facilitate the overall descision making process... American EMT-XYZ wishing to work in Ontario... 1) You are able to work in Ontario, and cost of living is not an issue 2) EMT-B or under is not worth anything in your application process. You have to do 2 years of education. 3) EMT-I...I'm not sure but assume it won't be worth anything and very likely you won't be allowed to challenge provincial exams and the PCP process. You will have to do 2 years of education. 4) EMT-P...I only recall one person on this forum mentioning reciprocity for Ontario. I believe that person was an EMT-P (I don't recall which state or whether they were NR, which I'm not sure would even matter here) and was only granted reciprocity for PCP. This means that you would have to do another year of college to be an ACP (EMT-P equivalent but likely with a much lesser scope). 5) You're a firefighter as well? Wouldn't mean much of anything. Paramedics and FF function separately here, and FF are arguably more difficult due to lesser overall required education, more people for spots, etc... Basically let's go under the assumption that you want to come to Ontario and become a paramedic (PCP). You have no prior experience in EMS and have no post-secondary education prior. You are now in a program. The programs themselves are generally quite difficult to get into (say they take about 5-10% of applicants, which will obviously vary depending on where the college is). But for this argument, you are in... 1) 2 year full-time college course load (I won't discuss 1 year programs). Tuition is say 6-8 grand for the 2 years. 2) You will likely be competing with a fair number of university or college educated people that have degrees or diplomas prior to entering the program. This obviously has an advantage. The reason I will not give the average American prior post-secondary education is because generally speaking on this forum, it appears they don't have it/not available. 3) The average attrition (failure) rate seems to be around 40-50%. This means in a starting class of say 50 people, 20-25 will not make it through to the end. Most of these people are gone after first year. 4) A portion of the education (as it should be) are breadth education modules. Meaning you have to take electives that are not EMS related. Say these encompass 1-3 hours of in class time per week. The grade to pass non-EMS related courses is 60%, for EMS courses it is 70%. 5) All in you will spend 800-1000 hours didactic, 100-200 hours clinical, and 350-500 hours precepting. Your scope of practice will then be comparable to an EMT-B with 5 drugs available to them. So you can handle that... 1) You enter into a process where upwards of 700 people are competing for say 70-100 jobs. Basically say you have a less than 20% chance of being hired. Keep in mind that you could have been stellar in class, but had a bad day in one of the 3-4 days of testing. You are basically SOL for a year with most of the "major" Ontario services. There are other options but for the most part (all things being equal) say the odds of getting a job as a PCP in Ontario are ~ 20%. The benefits? 1) Pay - The average PCP makes anywhere between $25-$34 per hour. Usually can get overtime pretty good. It is not unheard of here for PCP's making $100k+ here. Obviously ACP's make more (but not that much more) per hour than PCP's. 2) Basically all municipal service's - corresponding union, health/insurance, job security/mobility. There is obviously some play within those, but if you manage to stay on with a service for a year or more, you basically have a job for life. 3) Education. With all that, if you could, would you move to Ontario to become a PCP? Please answer the poll and offer a response to your decision. Any anybody can correct me if I am in error on points made.

It happened here and Ontario is likely as rural and probably, (assuming you aren't in Alaska or something) a harsher environment. People will obviously be grandfathered to a point. Eventually however a 2 year college diploma BLS provider will be required. So people want better pay right? So...do you think that you should have better pay first, or better education? Where exactly can that line be drawn? What kind of cash will it take for people to accept a 2 year college diploma for BLS? So say you make $8/hour for your 150 hours of EMT-B greatness. Will a move to say $12 be sufficient? That is a 50% raise...Not too shabby...What if it was only a year and not 2 years? The move from 1 year to 2 years in Ontario for BLS happened from '99-00 (I think). The pay increase since then has roughly gone up 33%. I believe PCP's around 2000 were making high teens/low 20's. Now PCP's make mid 20's to low 30's per hour. Keep in mind that the majority of Ontario PCP's DO NOT have 2 year college diploma's. The cascade effect that new education brings. I am sure the people that were educated in the 80's that are still BLS today, appreciate the salary they now make (thanks in part) to the new REQUIREMENTS that PCP's must have.

What is even more impressive is that judging by his most recent posts (say about a month ago), he is an EMT-B. Lee County EMS must be one of the greatest EMS service's in the world if a person with 3 months education can accurately assess a complex medical patient and have appropriate Tx and transport on the go within 8 minutes...Sorry it ain't happening... Maybe this whole 2 year college thing up here for BLS is overrated... I call BS too...

I find that funny, due to the fact the people preach about doing things "for the patient" when the are either ill equipped or educated to truly know anything about anything... I agree that people who want skills above education (the majority) are simply in it to look better for themselves and are not doing it for the patient. This is a theme that runs DEEP in EMS education and amoung EMS forums. An educated BLS provider with a lesser scope is VASTLY GREATER than an uneducated BLS provider with an advanced scope. Replace the "B" as you see fit...

Nice. Top-Gun-High-Five

Good stuff.

Yup, it had been about a year and a half... You must offer your opinion, regardless of your poll answer. If you select a poll opinion without an opinion it is worthless. I vote "Yes", for obvious reasons considering PCP(BLS) is a 2 year college diploma here. PCP is minimum to work on an ambulance.

I have seen them around here. From what I have seen they at least appear more professional than some of the other service's (specifically Ambutrans) that frequent the GTA. I still don't know what these guys are doing with that stethoscope around their neck. Anyway... There really should be a company that buys out all of these services and sets in one provincial private transfer service. Get universal vehicles (I like those hightop van types that Voyageur uses) and have everyone have their MFR/EFR minimum +/- paramedic student. I don't know why this isn't done, it is quite lucrative from what I have heard. This would at least show some universality (is that a word?) to the private transfer biz, will "clean up" some of the disrespect that these services get from real paramedics, and will (potentially) eliminate public misconception regarding these services. It really irks me when I see certain transfer services that have "paramedic" sprawled across the front of their vehicle... If I had a few million kicking around I would seriously think of investing...

I didn't know people that were "professionals" had approximately 150 hours of training...Or a 2 week "boot camp" (In some states)....But either way... What a joke... Stop lying to the public. I guess here we should start calling lifeguards "professionals" or McDonald's employee's "professionals".

They used nebulized morphine with you for what?

Hmmmm.... Quite a story you have there... 1) You are allowed to do your fantastic ACP scope, while you are traveling out of province? And even in your own province, you are allowed (while off duty) to carry these things and practice to your full scope? Assuming you could (potentially) have? You are legally allowed to do what you did out of province with your own equipment? What did the doctors in Ontario say? What did they say in NS? I assume you (at minimum) have to advise your physicians in your province what you did (provided you were actually allowed to, which I doubt you are). Educate me on Nova Scotia's allowance for ALS practice out of province (as an off-duty paramedic). Please supply references if possible. Why do I get the impression that you think that HIV can be transmitted to you by using a toilet seat or shaking hands...

Oh...People are talking about stopping at an accident when an ambulance is already on scene? God no... Listen, the paramedics can call for additional resources as needed. Knowing paramedics, the vast majority will not be that receptive to people stopping and offering help. At the very least they will think you are a "Rescue Randy" that they will have to keep an eye on. Unless there are bodies strewn everywhere or it's an 80 car pile up with one ambulance, leave the paramedics to themselves. Long story short - Unless somebody collapses in front of you, is in a car accident in front of you, or some other random thing, just save your life saving skills to the pro's...No professional paramedic, RN, MD, etc... Is going to "intrude" on a scene or "offer more help then needed" when a crew is already there. They have enough to do.

First and foremost ASK THE PERSON if they want help or want 911 called. I find too many people taking it upon themselves to activate 911 when THE PATIENT doesn't want police/fire/ambulance called. People have this diluted sense of "duty" when they see every Tom or Sarah slip and fall and call 911 BEFORE talking to the patient. Or the same people that call 911 for some guy that is being carried home drunk by their buddies, WITHOUT TALKING TO THEM! Then we come and police/fire and the people are like WTF!? Then the bystandard says stuff like "I am obliged to call" :roll: Now they will be sitting on our stretcher for hours tying up an ambulance, instead of being watched at home, which most sane people would do... I have never stopped at an accident/scene. Unless I see something that totally warrants my attention/intervention as an off-duty paramedic, I will carry on. If you have some kind of education be it first aid or doctor, please ask the person if they want help or want 911 to be called. DO NOT BLINDLY CALL 911. You use your own 2 hands to help, nothing more. Basic ABC's and as good of a Hx as you can get to give to the paramedics. The best bystandards are the educated ones that intervene as they can, give a good concise report, ask if they are needed, and leave. Anybody that does this, gets a "Where do you work?" question from me....and it is always either a MD or paramedic and it is followed from them with a "We good? Ok, later man"...

Ontario (not a state) requires a 2 year college diploma for PCP (BLS). The minimum to be on an ambulance. Perspective.

Exactly. Education = confidence, so maybe you are screwed. Remember, in the end it's all ABC's... ... Wait a sec... A - what if their airway is obstructed by a hematoma? Or any of 97,632 other things that you can't fix B - A is screwed and besides some first responder over-aggressively ventilated/oxygenated them and gave them bilateral pneumo's C - They are hypotensive (but aren't bleeding)....Trendelenburg position! Wait! It doesn't work.... NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO! Mendoza!!!!!!!!!!!!!!!!!!! PS - You'll be ok (potentially). Don't run.... (WHO RUNS ON CALL!?)

If you are querying a tension pneumothorax on this patient, remember that tracheal deviation is a LATE sign and that tracheal deviation goes toward the UNaffected side... Hypotension would have been PRONOUNCED in this patient (if they were still alive and indeed had a pneumo), and is significantly more important for clinical determination. Do people actually check hyperessonence in these cases (or at all)?

Succinylcholine is rapidly distributed in extracellular water. Children have larger relative volume of EC fluid than adults. At birth 45% of the weight is extracellular fluid water (EFW); at age 2 months, approximately 30%; at age 6 years, 20%; and at adulthood, 16%-18%. The recommended dose of succinylcholine therefore is higher in children. The benefit of too much SCh far outweighs the risk of an inadequately paralyzed patient. Taken from Manual of Emergency Airway Management (2nd Ed.) - Ron Walls et al.

I find it quite interesting that over 50% of the poll respondents (28 people total have responded as of my posting) have bachelors degrees or higher, and the majority have at least an associates. Hmmmm.... Considering that there are maybe 50 people (out of 10,000+ members) on this forum that contribute regularly with good/reliable/honest EMS information, I call BS. Even more amazing considering most people balk at 2 year college education for PCP here, when PCP's only carry 5 drugs and basically lack IV's in scope of practice... Two PhDs eh? Where did you do your undergrad and post-grad education? What was your dissertation on?

1. I am not in your country. 2. Perhaps the doctors think that your education is to little. Perhaps your educational institutions should push harder for more time, or simply not allow you to graduate until you meet better standards. 3. A lot of people know (vaguely) what RSI is. At least what the words mean. I don't think RSI should be on normal land ambulance, and I have a fair bit of education. PAI works generally just as well, and at least you aren't paralyzing people. RSI is very dangerous, 2 nasals and an oral with proper BVM technique will adequately ventilate and oxygenate a patient in the VAST majority of cases. Ay least for as long as it takes them to get to a critical care team or hospital. 4. Good, don't touch the succs...