BEorP

To most people in the general public, when they hear that you are a paramedic, they automatically assume that you are capable of performing all the skills that a "PARAMEDIC" (ACP or CCP) can. This, to me is very misleading.

Do you really think that the public thinks at all about the scope of the person who comes with the ambulance when they call 911?

I think when people hear you are a Paramedic they assume you have an ambulance and will drive them to the hospital.

After 4 years in school, a degree in Paramedicine, and passing the AEMCA I think I should be able to call myself a "Paramedic."

Do you not think that the title is earned by the education (even if just 2 years) and critical thinking abilities rather than the skills that can be performed?

It seems like the thing that new PCPs in Ontario will need to keep in mind as we graduate is that although we each have our ideal service to work for, a job is a job and we're not paid on commission.

Unlike most ACP programs in Ontario, I do not see any hours or years of experience requirement listed on the Algonquin site.

I'm just wondering if they really let you go in right after doing the AEMCA and if any other of the ACP in Ontario programs do.

We don't have a lot of wide open runs at calls, mainly cramped major city streets. And yes I know that doesn't make a difference, but I have never heard of a paramedic being killed here when in the ambulance after getting into an accident (and yes, I know that doesn't matter either).

I don't mean to hijack the thread but it sure seems like fatal ambulance crashes are much much more common in the U.S.

When riding out I buckle up in the front but not the back. This is the same as most of the medics I've ridden with (never have I seen them buckle up in the back).

I believe there are some Level 2 TEMS Tractical Medics

As an RT, I must point out that SaO2 and SpO2 are not interchangable and you can have a great sat and a crappy PaO2. For example if you have a severely anemic patient you can have a 99% sat and the patient may only have a PaO2 of 70mmHg. So while PaO2 and SaO2 are related, and you get both values from a blood gas, they are not the same, and SpO2 is only an estimation. I've never seen anyone mistake a SpO2 for a PaO2....just so you know especially since they have totally different units (one being a percentage and the other being measured in mmHg or kPa depending on where you are (US vs. Europe and Canada I believe))

I don't really think I'm in much of a place to argue with an RT on a topic like this, but from Brady Essentials of Paramedic Care:

"The oxygen saturation measurement obtained through pulse oximetry is abbreviated Sa[sub:de25d97509]2[/sub:de25d97509] (oxygen saturation). When pulse oximetry first came into use, some authors abbreviated the oxygen saturation measurement as SpO[sub:de25d97509]2[/sub:de25d97509]. However, this was sometimes confused with the PaO[sub:de25d97509]2[/sub:de25d97509] obtained during blood gas measurement. SaO[sub:de25d97509]2[/sub:de25d97509] is recognized throughout the paramedic profession."

Umm ... first of all, level of certification does not equate to quality instructional skills.

Why does it matter that if you are taking a PCP course that your instructor is ACP or CCP? I know plenty of variable levels of medics who are genuine instructors, as they've developed those skills of being able to relate the material to the learner. Quite the contrary as well ... many paramedics who get frustrated teaching because some people can't apply it fast enough (myself included).

peace

It matters if you are learning to assist in ALS skills... I'd rather have an ACP teaching me what they want done to help than a PCP teaching me what they do to help.

Also having ACP or CCP instructors most likely means that they will have had more experience on the road that they can bring to the classroom.

Can somebody confirm please that SaO2 and SpO2 can be used interchangeably? I am a bit confused with the information provided by the health authorities. They require a NON INVASIVE pulse oximeter with the SaO2 module, and they are saying that there is no typing error. According to the specifications of the oximeter SaO2 looks a lot like SpO2. Can somebody comment please before I get nuts?

They mean the same thing.

Some people now prefer to use "SaO[sub:4c20fde55f]2[/sub:4c20fde55f]" for O[sub:4c20fde55f]2[/sub:4c20fde55f] sat since SpO[sub:4c20fde55f]2[/sub:4c20fde55f] was sometimes confused with PaO[sub:4c20fde55f]2[/sub:4c20fde55f] obtained from a blood gas measurement.

How many services actually carry epi pens?

What is so hard about having an amp of epi and a syringe?

I'm not going to Centennial because from what I've heard, it's too political, and relies too much on theory rather than clinical. Humber has a pretty decent reputation, but Algonquin has been ranking #1 in the graduate testing for the past three years, so it comes down to those two choices.

I am a Semester 2 student at Centennial and hate the politics (but I don't know how much worse it is than any other school). That being said, I do not think that there is too much theory at all... we definitely do a lot of practical stuff and are expected to spend a ton of time in lab practicing. Riding out in Toronto also sounds like it will be a definite plus going by what I've heard from the Semester 4 students.

Congrats on being accepted into all those programs!

To make things worse, I had an overall grade after that final of approx. 80% in the class, but since I didn't pass the Final Exam, they said they have to give me an F in the class for the first half of the semester. It's written in the policies for the program that way. Well, this was a 10 credit hour class, and that F is going to destroy my 3.48 GPA I had, obviously.

My question is if any of you have ever heard of a Paramedic program doing this, and is there anything I could possibly do? This whole experience at this college has *almost* turned me off to EMS, but I won't let them win like that.

Colleges can usually do whatever they want if it's written in the policies for the program. In my PCP program (and I believe many in the province) you could have a 99% in the academic work for the prehospital care class and still fail just for failing your final scenario.

If you're not doing enough scenarios in class then get a group together and start practicing. In my PCP program right now we only do 4 hours a week of lab time with the instructors but spend at least 15 hours a week practicing on our own. The academic work is important, but when it comes down to it, this is a hands on job.

No, I don't think it's that much different. You "sliding scale" of what you decide to report is different, but there'll still be some things you do and some things you don't, even while on-duty. If you recognized one of the guys in the house a murder suspect or you saw a map of a terrorist bombing on the kitchen table or some other extreme example, you'd still report it, despite you being EMS. Now, I believe in having some level of trust and confidentiality with patients, so they're not scared to call 911 for a medical, but see it all depends on the crime.

Also, yes by being EMS got you into their house, but they invited you in. There was time to move him into the hallway before FD arrival if they had that much drug content inside.

It's completely different when something is related to treating a pt... if a pt tells you they just shot up, are you going to have them arrested?

Well I guess I am in the minority. Absolutely I report this to the police. Absolutely I note it in my report. I am a public servant and I am here to protect the whole public I serve not just the one seizing individual. Who is he selling this stuff to, what other activities is he involved in? Who knows? Not me. But, what I do know is that these activities are illegal and that these activities can put other peoples lives in danger. The neighbors, the kids down the street, my family as they drive by this apartment when a looped up guy pulls out of the lot and hits someone. If a patient does not want to trust me and tell me of their drug use that is fine. That is a decision that is to their detriment. Again I am concerned with the whole community not just one individual.

If a pt admits to using heroin to you, are you going to tell the police also?

I sure hope not...

Right, but the reverse of that is do you never report anything? License plates of injury hit-and-runs, a house down your block dealing drugs to neighborhood kids, someone breaking into your neighbor's car, recognizing a murder suspect from a wanted poster. Some you might, some you might not. So, even if you're in EMS, I think there's still a sliding scale.

I'm not saying to necessarily report it in this scenario, but whatever your decision, it should be based on a personal sliding scale. I don't think it's best for the community to refuse to report simply because you're not required.

It's different when it's something you find out from access you had while treating a pt

A friend of mine told me of a situation in which he was off duty and gave cpr, the man later died, he worried that he would be responsible for his death, is this an accurate fear .

Assuming your friend was giving CPR for the right reasons, the pt was dead already :wink:

I guess you can be sued for anything, but I would not be too concerned as long as he did not screw something up or try to do a skill he isn't certified to do. Just doing CPR and having the pt die when off duty I wouldn't be too worried about.

I'm just a PCP student, but in lab the way we seem to do it is:

- KED for stable pts only, which means basically no one who has been in a car accident (unless it is extremely minor but they are complaining of head/neck pain with no other injuries)

- for pts who are not stable but do not have an ABC problem, we usually collar and then try to slide the board under them (or usually part of their butt) and then turn them onto the board and lie them down

- rapid extrication (meaning hold C-spine and try to move along the long axis of the body but just get them out fast) for pts who have problems with ABCs or if the car becomes unsafe

I'm also a Semester 2 PCP student and am not happy at all about the strike (in fact, some would say I'm a bit pissed)

I really don't care how horrible management is being (although a 12.6% pay increase over 4 years with no increase in workload sounds pretty good)

No matter what management did, I highly doubt that any of our instructors are having trouble getting food on the table and it was the union's decision to strike

If they really cared about the students they would not be on strike

I study a lot and while I may spaz out at first when I'm working as a medic, I won't be alone. EMS is not an individual "sport" and it's not like when I get a job as a medic I will be thrown out there to sink or swim. That is why services have orientation and let newbies ride as 3rd rides for a period of time. You do NOT need to know how to talk to patients, etc etc to get through medic school, plain and simple. Whether that learning comes before or after school is irrelevant in my opinion.

I would not see as much of a problem if you were going to graduate as an EMT-B and spaz out at first and not know how to talk to patients since EMT-B is Basic and you aren't expected to be the most trained provider.

But...

When you're an EMT-P, you're the highest trained and I think that because of that you should at least know how to talk to a patient before you graduate. I also feel that you should not need to be treated like a newbie when you're an EMT-P. If you put some field time in as a Basic then when you're a Medic you won't be new to the field, or talking to patients, or critical decision making. The only thing new will be a few extra skills and drugs.

I guess now I'll ask the second part of my question or explain why I asked it in the first place. I'm a first year Paramedic student in Ontario now... I've been looking at various options of things to do in the summer and this seems like a potential way to get out of the province while still making money (as opposed to just traveling or just doing pt transfer here in Ontario). The plan would be to come back to Toronto in September to continue my PCP education.

Does anyone have any thoughts on that? I guess it will be a bit of a waste to need to take an EMR class when I should already know most of the stuff... but it still seems like a good opportunity to make some money and see a different part of Canada.

What is an EMR? I'm to lazy to look it up and I'm from Texas.

Emergency Medical Responder

Just curious as to what employment opportunities for EMRs in BC and Alberta are like (in terms of how easy it is to find a job and what most jobs actually consist of).

I thought I read somewhere about EMRs in Alberta working in the oil fields... if this is correct, has anyone done this or know anything about it?

Should certified first responders be permitted to function as a primary member of a non-emergency transfer ambulance crew?

Why or why not?

In Ontario I'd have to say yes.

Our lowest level after First Responder is PCP and there's no reason to put someone with at least two years of education on a truck that just does stable transfers.

I don't know how big your school is and if there would be a need, but have you considered forming a campus response team? By this I mean running 24/7 and responding to 911 calls (in addition to the normal EMS provider) on campus rather than just standby medical coverage. This may be a good way for you to help the college community, while doing something that is fun and will hopefully look good when you try to get a job after school.

Many universities here in Ontario have these teams... I'm on duty right now here in Toronto.