mobey

but do we want BLS to call ALS just because or do we want them to know why they are calling them?

I believe you are on the same side as everyone else on this forum, you are talking about higher education standards at the basic level, however somehow you have turned it into a Paramedic bashing suasion. I agree with what you are saying just not how you are saying it.

We as BLS need to do everything for a reason, unfortunately not all BLS providers do...therefore we end up with impatient paramedics at times. Obviously you have experienced this.

First step towards being taken seriously as a BLS provider: DON'T PI$$ OFF ALS WITH UNNECESSARY INTERCEPTS

Second step: Apply to paramedic school

Third step: Do not point out ALS spelling mistakes

Fourth and most important step: Check your "Better than thou" attitude at the door! There are alot of people to learn from in this community and many intelligent discussions are held, don't try and bring us down to your petty arguments and insults.

And come on Master patient packaging...your embarrassing us :roll:

(Passed spellcheck + 1 for BLS :wink: )

Mobey

Education holds back the EMS profession?

That's a novel theory.

Care to expand on that for us?

Sorry I apparently worded that poorly

It seems pretty degrading to me to be calling BLS emergency service professionals "ambulance drivers" (unless that's all your basics do like our EMR's).

I dont think its a good idea to give ambulance drivers Combitubes. ambulance drivers need to go to Paramedic school if that want to be educated in airway management beyond the BASIC level.

Somedic Sends

Do all the basics just drive in your area, or are you just degrading them for sport and to assist the general public in holding back EMS as a profession?

2% - I have a class T-Shirt from PCP school. (but I don't think that should count).

Had a great anaphylaxis call late last night and wanted some opinions from you folks.

25 y/o female on an excersise run. Started to get what she thought were multiple mosquito bites on her chest and arms, ran back to house and jumped in shower, approx 5 min later called ambulance d/t difficulty breathing. O/A Classic anaphylaxis.... Choking shallow resps, edema in face hands etc, hives everywhere yada yada yada. She has never had a reaction before to anything. No bites (besides mosquitos) on her run, no plant contact, NPO for 3hrs previous to reaction. The only thing "new" that day was a new spandex sports bra worn for the first time for the run.

I have looked this up and info is sparce but it looks like some brands of Spandex contains latex. Anyone have any experience with this??

Onset (time, sudden/slow onset)?

SPO2?

Associated symptoms? (chest pain)

Has this happened before?

BGL?

Has she taken her MDI for this event?

Are the MDI's empty or expired?

Air entry sounds?

Smoker?

Is home O2 on and working to cannula?

K thats enough for now!

My school study buddy took the Salt Lake course last year, it was in Red Deer. She was going to work for Saskatoon which is the only accredited dispatch in sask. For that service you needed that particular EMD prior to applying, and EFD within one year of getting hired. It was a fairly intense 3 day course.

See...now that's just funny right there.

Dwayne

Acknowledge...... ](*,)

I am also registered with my gov't as an EMT. However my education level is Primary Care Paramedic, could we at least call each other paramedics in hopes that some day our gov't will recognize we are no longer EMT's.

I don't know Alta education standards very well but here is Sask there is a huge difference between EMT & PCP.

I'm not familiar with this abbreviation...at least not in this context.

Conscious... I may have made that one up :-k

What did you do with the unopened beer??

Sounds like you did the right thing, I had a simmilar call. The guy was Cx on arrival but as soon as he hit my stretcher he quit breathing. We bagged him all the way to the hospital where he awoke and abruptly jumped off my cot and climbed onto the hospital bed under his own power. A few minutes later he passed out again and quit breathing a second time. The doc shot him with Narcan, but it made no difference, so we brought in the guys girlfriend to keep him awake so he would keep breathing...Worked like a charm.

CNS depressant indeed. :shock:

I'm just looking for a basic idea. Obviously, it's not a M-F 9-5 job..

First off there is no such thing as an EMT in Canada, The bar has been raised please agnowledge that.

Secondly what these guys are trying to say is Paramedics for most part have no "standard schedule". I work rural 5 days a week 24 hours a day paid on call. In the urban service I am involved with you give your availability for the following month and they will schedule you where you fit.

Look for the service that serves the area you want to live in and ask them how thier schedule is formatted, that is the best way.

Mobey

Just the simple fact that you had to ask the question is an indicator that you need the experience. I also work for a very rural service with a fairly low call volume. Therefore I go to an urban service every couple of months for a few days and take call to make sure I am retaining my skills and knowledgebase. The thing us rural peple have to remember is our calls may not come in as often but they are just as real. You should take the job for the experience even if it you are not sure it will be a career path.

Hey all I had an interesting experience I thought I would get your opinions on.

I was paged to a 56 y/o male Cx & Alert c/o L sided numbness & chest pain. Came across pager as "Possible CVA/MI".

Upon arrival it was clear this was indeed a CVA but no chest pain present (just numbness). When I asked about Meds pt. stated he had chewed 1 adult Asprin as per 911 calltakers instruction.

It took us about 35min to get to pt. side and his BP was quite elevated, (can't remember exactly but the systolic was over 220). All I could think is oh sure just because he had ASA this will be hemmoragic.

Anyway it was ischemic, and no cardiac event occured, he is now being treated for high BP.

So what do you think should dispatch be giving ASA to chest pain when CVA s&s are present?

Should they be instructing the pt. to take the ASA at any time?

My job is kind of unique. I work for a small town in the utility department, gas-water-sewer-streets-dog catcher-etc.

The town board also oversees the local municipal volunteer ambulance service in which I am also the coordinator/manager for.

(We are considered paid per call) Most of the time I am able to run ems calls as needed so it really helps the manpower situation for a small service.

Take Care

I think this is the future for volley services, It is good that a town can create such a position. Now if the emphasis could be put on the EMS side. Things like you must keep a current BTLS,

Bi-Monthly ride alongs in a busy service, maybe ER rotations, just to keep it sharp.

Then maybe some on-call pay could be worked into the equasion.

How far apart were the P-Waves?? What was the rate? Maybe a rapid Classic type 2, Maybe Flutter waves? It could be an Atrial focused ectopic with a 2:1 Block, Check out this article.

Do you have anymore specifics?

http://www.medscape.com/viewarticle/433023

Mobey

... and as for the keds... well i've more often seen the words "found ambulatory prior to ems arrival" then i've ever seen a ked used...

....Does that mean you don't immobilize patients found ambulatory? or are you just refering to the KED in preticular?

Why would that not make sense?

Are all of your MVAs single car, single occupant collisions?

And does it really "make sence" to be out-of-service until you get your one KED back from the ER?

:?

Sorry should have been more specific..

Make sence to our service.

1) we would never leave the ER without our KED because our ER is 2.5 hrs away... we will wait.

2) In our service we have such a long transport time I coulden't imagine sitting on scene for X amount of time putting 2 KED's on.

3) Yes ALL of our calls are single occupant single vehicle!! :roll:

We are required to carry either 2 KED or 1 KED & 1 SSB. Since 2 KEDs don't make sence we do have 1 SSB. I would only use it if someone coded on my stretcher to add rigidity for compressions. But I don't think it would come out under any other circumstances.

However, I, and the others you speak of, have seen the ugly side of volunteering and do not pull any punches about it. Typically speaking, volunteer EMS attracts many of the wrong people, into doing the wrong things for the wrong reason. For every volunteer service out there who provides professional level service, there are 10 others that the term hit and miss is far from appropriate.

So, when someone comes along stating "Fighting to keep it volunteer!", you'll have to excuse it when people assume its yet another starry eyed hero with a star of life T-shirt, three missing teeth and a couple of tattoos, which unfortunately, compromise a good bulk of volunteer services today.

That is exactly what I am trying to say..Thanks Asys.

The reason I say such statements as the one that started this whole thread is because of experiences I have been involved in.

Example:

At a T-Bone in Alberta - "Sir try not to move your head, now carefully step out of your car and lye down on this board for us." (Then procede to spinal immobilize)

Example 2:

15yr veteran volley EMT sandwiches a kid face down, helmet on, between 2 spine boards after hitting the wall with his head at a hockey game. I spoke with her facilitator and she said "there is not much we can do, if I give her sh*t and she quits the health region will pull our ambulance. (BTW that EMT quit a few months later for perssonal reasons unrelated).

Money is just salt on the open wound, it is all about pt. care to me.

I stand by my original statement.

Fighting to keep it all volunteer. Thanks for lowering all of our salaries. You're such a hero.

=D>

From Canada...I agree!

Not only just the money issue, but volleys are held to a lower standard of education *prepares to be attacked*. Ya Ya argue all you want, I am sure "your" dept. is different.

I am surrounded by volleys, great people... poor professionals. We just started getting paid decent on-call wages in our EMS system so we can attract people to our remote area instead of forcing locals to be volunteers or our ambulances will be pulled. Fire should take notes.

So far EMS has taught me:

Don't be so judgemental, some things aren't as they appear.

Charish your family and close friends they can be gone in a blink of an eye.

Death is not the worst thing that can happen.

The people who say thier hero's aren't, real hero's don't realize they are.

When you think your life has gone for $hit, take inventory on your surroundings.

Before EMS I was the opposite of these!!

(I actually thought the off duty EMT who wore a flashy EMS jacket was a real hero)

Please keep in mind I am not claiming to be testing all 12!! Please add as you see fit.

PCP/EMT school taught to assess:

PERRL

Facial droop

Equality of smile

Grip strengths

Arm drift

I have added:

Directions of gaze. left, right, up, down.

Have the patient recite "you can't teach an old dog new tricks"

Raise both eyebrows

Ask the Pt. to swallow and assess if extra effort was needed

Stick out tongue

Shrug shoulders

I also do strength tests on Ext. and draw a number on the ankle and ask the patient to tell me what it is. Keep in mind I have an exceptionally long transport time so I can assess all I want.

I was also shown how to test some reflexes and have tried it a few times to pass the time.

I am still building on my assesments and any imput is appreciated.

Mobey

This is why it is so essential we become more educated in advance neuro assessments than the PEARL bull sh*t , that is being taught..Which means nothing! Once we start educating EMT's on neuro assessments such cranial nerves, nystgmus, and brain perfusion and cerebral resuscitation.

R/r 911

I totally agree!!

I had a hemmoragic stroke not long ago and was presenting with nystgmus. I was pissed that I didn't know what it was when I saw it. I called up one of my paramedic buddies and he showed me how to quickly test most of the 12 nerves and some other tips. This should be a standard neuro exam as far as I am concerned.

The biggest complaint I've been hearing is students being preoccupied.

Keep your cell phone off (no text messaging)

If your reading make sure it is something medical

Don't talk to your preceptor about personal issues, he's/she's a teacher ur a student.

No games on the palm.

Just act like your a guest (which you are) eg, no swearing even if they do, manners matter, etc.

Dust & Bushy: You are right I worded that poorly, I meant that a BLS is all that is practicle. I do agree that every service should be staffed ALS, unfortunatly some communities such as mine can't afford it. I did not mean to turn this into BLS vs ALS, there is no question.

Every ambulance should be ALS staffed, every hospital should have competent RN's, unfortunatly in a province with a Population of 1 mil (approx same Pop as Calgary) we do what we can with the little funds available.

Hopefully I have been more clear in this post.

BTW you will notice I am upgrading to ALS... :wink: