ukcanuck

Mattie457 If you want to PM me I made the move from the UK to Canada and managed to get ACP reg over here. I could give you some pointers and direction. Cheers

@basejump - sorry don't get it maybe your brand of humour/sarcasm is too urbane for me but no matter which way I look at that equation I don't see the punch line. @rock shoes - good job keep up the work and get that degree, nowadays you need pieces of paper to get ahead and thats a good one to get @tnuiqs - yeah I will end up taking the course when it expires that way I am seen to be up to date as much as I can be just look at it as a tax on keeping my registration. @ mobey - thanks for the offer and just how far east are we taking?? remember on my map anything east of the rockies is just labeled "there be dragons" thanks for the offer and if I am out that way I will drop you a line - what other courses do you run as I might do a week of collecting the alphbet courses cheers Thanks everyone for the thoughts

Ahhhhh, thats where it starts to unravel a bit as if you are a remote medic such as I, I have to do an ACLS every four years but a MCP trained EMT P doesn't have to do anything. The AHA/CHSF still put a expiry date of two years on the card so to stay "legal" I have to do a course every two years. According to ACoP I ahve to do it every four years? Very confusing but hey didn't expect anything different......... guess I get to do the ACLS refresher every two years. Do you know if the MCP training is available for outside AHS paramedics?? That would be great as finding courses etc for outside of AHS and BCAS is proving challenging. Cheers

Very true - as a member in good standing you can provide all the skills and drug therapy that is covered by ACLS and without a current ITLS/PHTLS you still do the surgical cric/needle decomp. I am doing it early after two years for educational credits for my BC reg and for my four year plan for ACoP. It is a grey area as I see it as the recommended renewal by the owners of the course is two years so if you are behind the trend in care or do something slightly wrong then I suppose technically you don't have the ACLS to fall back on as it is out of date. Hows the course going over in AB?

Just a quick question for the members here. The listed expiry on my card is two years but ACoP have confirmed that it is good for four years. So the question is when do I actually have to re do it? And if I let it go to four years am I liable as I have knowingly let it lapse? Just wondering what everyone else is doing. Cheers

Hey Rock Shoes Just read the last bit of your reply, does your friend still need help with UK?

When you can PM me and I will try to help. I did 15 yrs NHS then moved back to Canada. Biggest problem will be the work visaeven before the qualifications also everything depends on where you want to move to. Each Prov is slightly different - not like UK where the ticket is good for everywhere. Drop me a line

B.C. Registered Advanced Care Paramedics (ACP) Frontier Medical Canada Ltd. provides advanced medical support to remote work environments both in Canada and abroad, offering clients a complete medical care package with full management and 24/7 clinical support. We have an immediate need for ACP’s registered in B.C for several summer projects. Offering $550/day plus flights and travel days, employees will be eligible for benefits and continued work throughout the year. Qualifications: • ACP Registered (B.C) • ITLS • ACLS • H2S Alive • OFA III or PII • Current CPR Frontier Medical Canada Ltd. will be willing to help support medics in completing certain certifications. All applications will be considered. Applicants can forward their resume to: Jillian VanEngen, Human Resources Manager at jillian.vanengen@exlogs.com or fax their application to: (403) 291-3152

No particular order just coming off the top of my head as I stare at the screen. If you are worried about plastic blades have a look at "Timesco" website, they are UK based but provide metal single use blades and handles. Only thing you keep after a call is the batteries. Better than the plastic ones no sterilisation issues.If they have them over there they should have them here. GUM bougies are available in at least three sizes right down to peds try to get all of them for the dif airway. If you do lots of peds calls consider the LMA as they have peds sizes. Think about a lockable fridge to extend the shelf life of perishable drugs. A transport syringe pump driver and/or IV pump for meds EZIO over the FAST as it has a wider age range and multiple sites to use. It even comes with a sternal screw adapter now. CPAP - reduce the number of tubes you have to do and increase care. sidestream ETCO2 for both the intubated and non intubated patients transport vent is a must and will come down to what you/med dir prefer it to do but try to keep it simple to use. thats all for now sure there is more but the camp cook has just served supper Congrats on going ALS I hope the transition goes well

Barriers are both practical and financial as some people just don't have the time to keep up all the little tickets that you have to travel for to have a shot at a job for some services. You almost have to give up your job and move on spec to where you want to be then hope that a spot comes up before you go broke/crazy. That doesn't even start to touch on what you have to do to come over as a international paramedic. A friend of mine has just got his AB registration and one of the courses he had to do was a CPR C ticket dispite being ALS provider and able to prove a UK CPR ticket???? He has jumped the hoops cause he, like me, thinks in the long run it will be worth it. I didn't even think about trying to get my credentials done via the B. institute....... kinda figured that having UK tickets I wouldn't get past the front door. I love the fact that the government is training and assisting people to get qualifications for a job that currently has very little job opportunity..... that is so govt like As for spots in AB for ACPs, every service I have talked to says that they need or will need ACPs esp with experience. Active recruiting is another matter with the odd one popping up here and there and then it has some small course as a requirement for selection that most people from outside the prov will not have. Mobility between provinces FAIL We currently have an illusion of mobility between provinces. You can get the registration but getting the job is another matter. Services set different requirements for selection/interview/employment that make it difficult for applicants to attain and maintain for possible vacancies. But as you say, taking foreign trained doc make them ACPs to fill spots that aren't there when there are doc spots to be filled????? makes sense to me?????? Or are they planning to use them as advanced paramedics kinda like an Emergency Care Practitioner role in the rural communities and they don't have to pay them as docs cause they aren't?????? Nah thats takes planning and forethought........... Apology accepted gratefully and I will keep on slugging away at the pitches and one of them will be a home run - I hope Be safe with that OFA first aid kit - its dangerous you know

Been chatting with WCB just recently about the paramedic in industry course and it appears that an ACP does not have to do the course but only if they are operating as an ACP and NOT the designated first aider??????????????? So if an ACP is to be the "first aider" as well they have to do the course which is known to be of a lower level and lower treatment/care levels. That is excellent in my book <sarcasm> I'm off to the NWT for the summer season! Talking about barriers to Labour Mobility in Canada there are several even once you get your prov lic. Services that will not offer you an interview as you don't have that provinces drivers licence but you can't get one without moving there and you don't want to move there without said job?? Services that want you to be base hospital certified but you can only get BH certified if you work for a service that the BH covers. Provincially mandatory training for equivalency candidates before you can get hired.$$$$$ Small day long courses for differing topics that become requirements for employment/interview but they are only available in that area so you have to fork out cash to go do it.$$$$$$$ and they are not required by other services in that area or province. Differing requirements for pre interview medical/physical testing and even then the certificates are only good for a few months at best so you end up having to go back again and again forking out more cash even before you have an interview let alone a job. Ridiculously short time frames from advert to interview to selection to start date. Multiple and separated dates for the different elements to the selection procedure. I don't mind doing all of that but I don't think it right to make prospective candidates to do it all even before an interview. I'll jump through whatever hoops an employer wants after they have at least offered me an interview. I don't mind that the local applicant will have it easier hell he's the local it is always going to be easier for them but how about at least giving some of us that are a little further away a bit of a chance? The only area that I can see is anywhere close to mobile is industry. The courses I have taken are nationally recognised and apart from working as a "designated first aider" in BC I can apply for registration in a province then start working in industry. Just my take on it

Or you can fill out several forms with a photo and send off more forms to registration bodies for verification when EMALB can look on the web. Then wait for permission to sit the online open book e mail a buddy exam of 24 yes folks 24 questions then wait several more weeks to get your BC licence, this I can handle as almost all the provinces do similiar things and means you can move provinces but have to pre plan it so maybe a temp inter provincial registration should be introduced?? Just an idea?? Thats when you get to communicate with worksafe BC aka WCB...... after proving to the province once that you can operate at the PCP/ACP levelyou then get to do it again and you then have to do some modules at home which of course tax your skills and brain ??? and sit a 4 hour course after which you will magically be skilled and educated to look after industrial type people. Are they different to the people who dial 911. If they dial 911 at work does BCAS have to find someone who has done the extra endorsement?? I personally can't see how anyone could say that this is a barrier to the free movement of labor Freakin unreal is what it is!!!!!!!! OFA is not under the EMALB and so is not mandated by AIT as far as I can tell. Two separate entities who do not talk to each other as I can't get an answer out of either as to what a PCP/ACP needs to do to be "allowed" to work for industry. Great...........

Hello there Just wanted to ask the BCAS guys and gals out there if they have any information about current hiring (or non hiring as the case may be) of ACPs. I am living in BC again and just finished the AIT process for BC and am waiting for my lic from EMALB. Used to work for BC many many years ago as EMA1 and now trying to move back. Not the best of timings I know but looking across the country now is not a great time to move back into canadian EMS it seems. I am in contact with ACP recruiting in Victoria and just looking for the view from the street. I actually oddly want to work Vancouver so that is not an issue but would be willing to post to any ALS station. Any info, tips, hints, or warnings would be greatly appreciated. Either on the board or PM me. Cheers Ukcanuck

Too damn right So back to the actual thread - anyone heard of any jobs going in the Calgary area for EMT/EMT-P? there is also SSSD - same s**t same day for those really good days

Yep, had partners of ALL levels freeze, including pre hospital doctors, on calls and some even needed a slight gentle nudge across the back of the head to get them moving. That is not a ALS/BLS issue that is a person to person issue. What I am saying is that the ambulance crew should be just that - a crew - not two individuals working the same truck. Maybe it is just me expecting too much from my partner and maybe it is a good reason to ahve two paramedics on each truck???

Have a safe one

There is a team leader but they should be just that - a team leader - not the whole team and the minions around him do his bidding. Being a team leader is about getting the best from your team using the resources/skills/experience/knowledge available regardless of who has them. If the 747 Captain doesn't see the 777 about to hit them the first officer will speak up and the Captain will listen (well....should)if the cabin crew notice that an engine is on fire the Captain will be very interested in their opinion. I think we agree on the subjects dicussed just attacking from different angles Someone always carries the can at some stage and the way I look at it is that it is one of the reasons we get extra pay. That does not mean we have to take over when the BLS is perfectly capable and that includes some sick pts. Personally I am watching this thread as I have just got my EMT-P in Alberta and will be looking for work in the Calgary area after mid Jan but will not be adverse to working ANYWHERE else. Patients are patients and pay is pay. I am looking for 911 over industry just for the family time at home. I have found it particularly nice that there are the same issues in EMS in Canada even after leaving BCAS some 15 years ago and that they are still the same as here in the UK. SSDD be safe

I was really slow but I had better communication skills then those who had been urban the whole time. (This generally comes from having that extra pt contact time in a slower, rural setting) totally agree What we have to do is stop thinking ALS/BLS and start thinking TEAM. (True, but if one member frequently cannot function due to lack of life or road experience ...) agreed but the idea is that one complements the other not fight or take over from the othere when a certain pt population presents You are an ALS skilled team not individuals providing care at our level. (Each team member has a certain set of skills; if one cannot provide those skills ... see above) I work on the premise that my BLS partner can and will do his/her job when required. (Again, see above)If they can;t do the job then something is fundamentally wrong with the schools/induction/Q&A/preceptorships/ etc that get the crew member where they are I also know that you can learn a lot from those old time EMRs and EMTs who have worked the same patch for the last twenty years. (You don't mean the oil patch, do you?)No def not - sorry but if you graduate then go out to the oil patch w/o 911 experience then IMHO that is asking for problems, controversial I know but its what I think - no reasearch at all behind it just my opinion And to those ALS paramedics who think they know it all been there done that got the t shirt worn the t shirt out..... after nearly twenty years I have not seen it all. Seen most of it but I know that there will be a call sometime somewhere that will trip me up. The guy who will get me out of that mess will be my partner whether he is BLS or ALS. Its about pt care not who gives it. (I can't say I know one medic who feels they know it all; I work with several with 30+ years, however I know there are many out there who are narrow minded. As for 'getting out of a mess', I've seen the brand new EMT malfunction in a super busy situation and CANNOT do this, never mind start their partner's IV or differentiate between a canula and end tidal CO2.)I have seen and met new paramedics who think they know it all and dismiss the "dinausors" if you have been around EMS awhile you realise to listen to everyone and ignore the crap advice but to learn from others mistakes and successes. I too have seen a brand new EMT "malfunction" but why is this? Not enough support from their preceptor, not enough time, sacred to say or do anything cause of the ALS/BLS battle - we need to start talkinh about crew resource management and these principles need to be added to the paramedic courses as we need to act as a team not the dictatorship some crews come to be. this has been proven in aviation for years

I think that there are many elements at play here. I have worked rural, remote, semi rural, semi urban, and urban and each has it's own advantages and disadvantages. You might get to look after your pt for longer when you are rural but you get A LOT less pts so your exposure to the different types is limited. In Urban you see more pts but have them for less time so you will do less interventions and the ones you do do are done at the speed of light as you are trying to do them before you hit the ER. The list goes on and you have to benefit where and when you can. I do not believe that any one type of exposure makes you a better practitioner but rather a blend of everything. I felt that I was OK when I transferred to urban but quickly realised that I was really slow but I had better communication skills then those who had been urban the whole time. etc ad nauseum What we have to do is stop thinking ALS/BLS and start thinking TEAM. You are an ALS skilled team not individuals providing care at our level. I work on the premise that my BLS partner can and will do his/her job when required. If the pt does not require ALS intervention it is not an ALS call so effectively I am a BLS paramedic. If the skills ain't needed then they stay in the box till they are needed. I do not "take over" pts but rather provide a higher level of care then my partner can. If that means I have to stay in the back then so be it but if my partner can stay in the back then that is the way it is. A lot comes done to the confidence the ALS provider has in their own skills and abilities and the confidence and trust they have in their BLS partner. If the ALS guy is looking for skills to build their portfolio or is a skills hound then the BLS guy might as well be just a driver. But those guys would be the first to complain if his partner was downgraded to driver. You can't have it both ways. They are either your PARTNER or your driver. One of the responsibilities paramedics have is to develope the skills of students and those less experienced/skilled than ourselves. That includes the BLS guy you work with everyday. Let them have responsibility when it is safe and legal to do so and your day gets easier. Not every pt is a ALS skills dummy. you might even help develope one of the paramedics of the future. I also know that you can learn a lot from those old time EMRs and EMTs who have worked the same patch for the last twenty years. As a practitiooner you are supposed to learn from ALL sources and that includes your partner. If he is doing something wrong then work to get it right. You can learn tricks and tips on ways to get pts out of spots and little things that make a call go smoother. And to those ALS paramedics who think they know it all been there done that got the t shirt worn the t shirt out..... after nearly twenty years I have not seen it all. Seen most of it but I know that there will be a call sometime somewhere that will trip me up. The guy who will get me out of that mess will be my partner whether he is BLS or ALS. Its about pt care not who gives it.

I too agree with the if it ain't broke don't go fixing it cause you might break it school. It could well be that the WCT that you are seeing is a reperfusion rhythm. The myocardium will be hypoxic and there fore VERY irritable even with good airway and ventilation. Let the heart try to get back to normal before doing anything heroic. Don't get me wrong - I would still be ready for this guy to arrest again but just would not be too agressive with hitting him with anything as his heart is very fragile post ROSC. If the patient is perfusing adequately I would be tempted to get the meds ready that would be indicated for WCT ie Amio/Procainamide/Lido and administer after you have given the heart time to stop doing whatever it is doing. That will be be just after you think it has been long enough and your sphincter starts to tighten If it looked like he was going south with a symptomatic WCT then cardiovert. I would get a 12 lead ASAP to try to look at whether it is actually a WCT or a NCT with aberrant conduction which could be a possible as someone said something put him into arrest. Was that an AMI that has now stuffed a conduction pathway? If the pt is tubed paralysed and sedated I would watch my meds carefully so as not to cause a hypotensive event. I would also watch his tidal volume to not put too much pressure on his heart by blowing his chest up like a balloon. I am reliably informed that is bad....... Any way you choose - meds or energy or leave alone - its a bit of a crap shoot as these pts tend to do what ever they want despite what we do. You did well going from PEA to a ROSC big pat on back!!!!

Thats what I am doing - getting out of the UK like many NHS staff that are fleeing to Oz/NZ/USA/Canada/insert name of country........ stay safe

tnuiqs I was in the process of a lengthy answer to your reply about how the UK is responding to H1N1 when a crew mate called for a chat and mentioned that someone we know is being disciplined for comments deemed by our trust to be unbecoming of a paramedic and have reported them to our professional body. I have deleted the text I had typed. I will also be curtailing my activity on boards like this one. I do know people who know Stephen and the beer over here is one of the things I will miss when I move back to Canada. I am not part of Planet London though. I will say that here in the NHS we do not take infection control seriously enough and the main point to my post was that there are several other things that I am worried about catching from patients. We seem to be overly worying about one virus when as you pointed out there are many out there and god help us if they mutate or become resistent to treatment. D&V is diarrhea and vomiting. The UK has caused mass panic about the H1N1 but not supplied the vaccine fast enough and not made it mandatory. They have issued some kit to front line staff but then we get in the house before we find out what we are going to and what PPE to put on.It is dying down here but I stand by what I feel. The vaccine has not been properly tested and has been rushed through. There are too many dissenting voices to ignore it just yet. I take precautions when I can which does include wearing masks with kids esp for suspected cases of TB. I wear gloves, gowns, eye protection and wash my hands incl the use of alcohol rubs. If you want to discuss anymore PM me so it becomes a private conversation and so the trust can't ding me for anything I say on here. Stay safe and stay well everyone UKCANUCK

Here in the UK we are "encouraged" to get both the seasonal flu and the H1N1 vaccination. We have been issued special masks with removalable filters but only been issued two sets and have to re use them for several patients, makes sense to me - not! We look like something from a movie like Outbreak!!! Freaks the kids out really well!!!! We do have the problem that the bosses are so fixated on response times that the solo paramedic responders are usually in the house and assessing the patient when dispatch calls to advise them to take precautions. The calls will come in as SOB/unwell/chest pain/or pretty much anything else. We are also exposed to people from all over the world including areas that have no or little health care. The problem that the UK has is that they got so worked up about H1N1 that patients could get tamiflu over the phone using a hotline. So those patients have had H1N1 right???? So they don't need the Vaccination??? Or did they have H1N1 or just a bit of cold/flu?? As I understand the seasonal flu shot is the strain that the experts have worked out will be most prevalent in your area. So I will still get exposed to the variants/strains from all over Europe/the world and stand as much chance of getting that. I have no underlaying health issues so will NOT be getting the H1N1 as I am not happy that it has been pushed through. Just like if I or my family get it we will not be taking anti virals unless we get actually really sick (ITU kinda sick) as they have some great S/E. As for the excuse of thinking about my patients and should get the shot then please tell me - these patients will NOT EVER be exposed to someone who is H1N1 positive in everyday life by going out to the shops, their carers and family etc I take precautions when I should and can and try to keep my patients clean from anything I have. I stay away from work when I am sick use gloves and wash my hands very often. I change my uniform every shift and monitor my health. I am more worried about catching and bringing home a D&V bug or something like hep C

Did you manage to get a job in the states or just for a holiday?? Either way have a great time as I think that the states gets too much bad press and I think the vast majority of them are good people just like anywhere. safe trip

Would you guys say that the Theriault text would be a good book to get to study medic/legal aspects for the Ontario MOHLTC exam? I am looking for a text to study from and coming up empty at the moment hoping someone here could point me in right direction. Thanks