Bethadone

401Commuter - I'd be offended, but clearly you don't know what you're talking about considering even the most basic of research methods courses emphasize that ALL research, even natural science research, is biased by researcher perspective. My "narrow, biased thesis" is what I seek to prove and revealing my bias is part of the research process. A better question would be "why would anyone put any stock" in something that doesn't make a point, or take a side? Thanks for the advice, as misguided as it was....

I am in the early stages of a 4th year honours thesis on the debate between provincial versus municipal EMS in Canada and which is more effective (more on how I define this below) and am hoping some EMT City'ers may be able to help a bit with the research. Depending on the quantity and quality of information I find, I may limit it to a comparison between 2 or more provinces (Likely AB, BC, ON and NS) but am open to information from all provinces at this point. Basically what I am looking for is published articles, case study examples, or even personal accounts for which you would be willing to undergo a short interview (while I'm sure you all have valid personal opinions, please limit this to action taken within a local service that may not be published, but has, at minimum, been addressed by management). If you know of something that may assist in my research but do not have a link to the article, please send me some basic information about the date, publication and subject and I'm sure I'll be able to track it down. The following are general guidelines for the subtopics of information I'm looking for: 1) Examples of disparity in levels of care (ALS, BLS, EMR or protocols), type and condition of ambulances and emergency response time standards between municipal services or within a provincial service. 2) Public understanding and respect of the EMS profession, public advocacy and awareness of EMS affected by the existence of either municipal or provincial services. 3) The effects of either model on large scale emergency management capabilities including the level of collaboration and coordination between dispatch, ground and air ambulances, and the provincial health care system. 4) Internal labour conditions and standards for professionals in EMS, essential service legislation, bargaining power for EMS professionals to collectively advocate for themselves within either type of service (aside from info about the Calgary EMS debacle this summer, I've got lots on that). Also, while I will be arguing for the transition to, or maintenance of, provincial EMS instead of municipal or private, I welcome any information you may have against my point of view as I would like to address both sides in my research. Please e-mail me any documents you have at bethadone (at) hotmail.com Thanks for your help!

Terri Schiavo's death (the original cardiac arrest that led to the brain damage and subsequent coma) was due to a potassium imbalance from bulimia. There have been other cases, but it is fairly rare Excessive vomiting in any patient (whether bulimic or from other causes) will cause electrolyte imbalances, deydration and vitamin and mineral deficiencies. Electrolyte imblances especially can put the patient at a high risk of arrythmias, plus bulimia is often accompanied by laxative, emetic and diuertic abuse which puts the patient at further risk of cardiac complications. I personally haven't had a patient suffering from complications of bulimia but I suppose it is something EMS providers should be aware of as a young female isn't a 'typical' cardiac patient but could be suffering cardiac complications. In terms of binge eating disorder, I've heard of people eating to the point that the stomach actually ruptures. Hellooooo sepsis. A good tip off that your patient may be bulimic would be the rotting teeth and vomit breath.

Letter sent to Jame Rajotte, MP for Edmonton - Leduc. Anyone else?

Thanks for the replies. In response to your questions: I have been asked me to consult with the staff regarding suggestions for "capital purchases" as the municipal district partially funding the service would like a five year plan for capital purchases which they have agreed to fund. Now, we have just ordered 3 brand new ambulances with all the bells and whistles, plus new LP12's for all the units so all the "big" stuff is out of the way, and we have some money to play with. Our ground transport times in our more remote bases range from 3-4 hours. It is up to the discretion of the attending medic/EMT whether or not to medivac the patient and for me personally I've had several OBS calls where the only complaint is "the baby hasn't moved in a couple days" and mom is just looking for a reassurance that everything is OK. So 4 hours later we get to the hospital, they take out the doppler and find a normal FHR, and then send her home. I think "why can't WE do that?" Now, I'm aware of the dangers of this being used as a "diagnostic tool" in EMS, it will definitely be a huge part of the training that having a doppler does not make the medic an obstetrician, and they should still go with what the patient is presenting with to decide whether or not to transport. Also, I've had some maternity/trauma and maternity/alcohol or drug abuse calls where unless mom is in a critical condition, she gets transported by ground. The FHR monitor would allow our medics to have any additional piece of information to help them make the decision of whether or not to fly the patient out. Even if mom is totally asymptomatic, I can use the doppler to find signs of fetal distress - fetal bradycardia/tachycardia and decreased FHR variability and maybe with that new information, will fly the patient out instead. In terms of training, I agree that it is important and if we purchase these, will definitely be a part of the process. But using a doppler isn't rocket science, after all - they rent them out to everyday expectant moms! Granted, finding the FHR can be tricky sometimes and I think we'll have some patients where it just won't happen but that is no different that the ped. you can't get a BP or pulse oximitry on so you use other assessment tools... these are tools we can use to assist us in making transport decisions and I think the more the merrier. The model we're looking at piloting is the Huntleigh FD1+, manufactured by Huntleigh Healthcare. We would probably purchase three in total eventually if they get enough use and are used properly. It's pretty cool that my job right now is to make a shopping list for the service, but I want to make sure it's money well spent.

Our service is considering the purchase of fetal dopplers to carry on-car as we are a rural service with extended transport times, and lots of OBS calls. Does anyone have any experience using these in EMS, if so...any comments on how useful a tool it was for you? Also, any suggestions for a particular model/brand? Thanks!

I'm suddenly so self-conscious of my Canadian-ness...and shocked that a BBQ is known by any other name!! Camp eh? Only in Northern Ontario. In Southern Ontario it would be a mickey, a 2-4 and a "party at the cottage, eh?", out west it would be a mickey, a case and a "party at the cabin, eh?" Actually, in ALL provinces, but some the drinking age is 18, others it's 19. I think the list is a little outdated. Also, you missed a key Canadian special thing...Rye! Which, as I discovered after a lengthy discussion with a bartender in Boston, is known to you Yanks as "Canadian whiskey"

I can't believe you didn't post the last paragraph (and funniest part): "The Metropolitan Fire and Emergency Services board said: "MBF firefighters were tied up for some time but disciplined and controlled firefighting contained the blaze to one room on the second floor of the two storey building."

In Ottawa the only requirement is standard first aid and CPR. All other training is done in-house - so you don't *necessarily* need to have that 8 month course to work for a larger city dispatch.

So what exactly do you hope to accomplish by complaining to HIM? Do you think a bunch of angry emails are going to make him resign on his own accord? Doubtful. Also, looking into this further I see that I was mistaken and that Forrest is President of the Winnipeg Firefighter Association and that the joint Paramedic/Firefighter union has not formed. Meaning Forrest has no incentive nor power to have paramedics recognized in a memorial. Where is the EMS side of the Winnipeg Fire/Paramedic service in all of this? This may be something for them to bring up at the Manitoba Labour Board hearings beginning on April 26. Clearly some lobbying needs to be done on their part. I'll submit a letter to the editor to CBC and the Winnipeg Free Press, that will do a lot more good than engaging in a private battle with Mr. Forrest I think.

I'm a little confused - to whom is this letter writing campaign directed? Alex Forest of the Fighter Paramedic Union directly? Or is this something you would like addressed in an editorial? In that case, you'll be better served by targeting more local media than the CBC. Clearly Mr. Forest has made up his confused little mind regarding the role of paramedics in "protecting society", more press coverage of this arbitrary decision to not include paramedics in the same category as firefighters and peace officers might help him see things a little more clearly. Some letters to the editor of newspapers offering coverage of this would help, I'm sure. I'm appalled myself at his response - especially considering his union is meant to REPRESENT the interests of paramedics as well as firefighters. I can't imagine how offended the paramedics of the Winnipeg Fire-Paramedic Service must be. I'd like to help, and will contact you with my response/letter - this is totally unacceptable and paramedics accross the country should be rallying to support our brothers and sisters in Winnipeg.

I'm an Alberta EMT and though I went through a CMA approved PCP program, it seems like far too much trouble to jump through the MOH's flaming hoops to transfer to an Ontario PCP, so I won't be stealing any jobs from the Algonquin graduates! I figure working casually for a patient transfer service will be a good way to keep some skills/knowledge up while I finish my degree at UOttawa before moving back to AB. Thanks for the input

Has anyone ever worked for or have any information (good or bad) about Travois Medical Transfer? Apparently they've bought out pretty much all the rest of the patient transfer services in the Ottawa area and before I apply I'd like to get some information about how they are as an employer. Thanks!

Video: http://www.youtube.com/watch?v=IBbUmMnb4t

Ottawa for 8 months a year, Edmonton for xmas/summer (and whenever else I get an excuse to get out of Onterrible!)