p3sibley

1. Unit 424, you are being dispatched to a report of male patient who was punched in the face by someone who used to be his friend!!! 2. Was dispatched to a report of a motor vehicle collision, only to arrive at a house to find that the actual emergency was a 10-11 year old girl who was home alone and was playing with a plastic self locking twist tie. She got it stuck over her wrist and tried to pull it off, but each time she pulled it just got tighter and tighter until the circulation started to get cut off. It was a good thing she called 911.

Connie I have never had any issues with you personally. In fact, you are right, we did get along. But when I heard that prior to you leaving you sent an e-mail to the Stn 23 firefighters detailing how awful we all are, of course that is going to be hurtful. Perhaps you can clarify on that. p3sibley

Connie, all I have to say is, I wish you good luck in your new station, because you burned the bridge and there is no coming back.

Just to kind of move another direction with this. In Nova Scotia we too have the same constraints with on scene time. !5 minutes for chest pain, SOB, major trauma, stroke, etc. and 20 minutes for all others. Obviously treating cardiac arrest and hypoglycemics and the like will take longer. Often we end up transporting within the required time only to arrive quickly at the hospital and end up treating the patient in the hallway for a long time due to ER overcrowding. The record for me so far was 5 hours. So I guess the question is, why rush at the house when the patient will end up waiting at the hospital anyways. Obviously if the patient is CTAS 1 or 2, they should get in the ER right away. But patients with CTAS 3, 4, and 5 tend to sit on our stretcher for a very long time. Just wondering if other medics experience the same problem with rapid transport only to have to wait a long time at the ER. p3sibley

I know I am late getting into this discussion, but why do so many people believe that EMTs or primary care paramedics are incapable of administering glucagon. In Nova Scotia anyways, all PCPs have a thorough knowledge of A+P and the pathophysiology of diabetes. PCPs can also measure blood glucose and administer IM injections, both BLS skills. Complications of glucagon are rare and the benefit when given to a hypoglycemic patient is significant. Why in the world would this drug be limited to Advanced Care Paramedics? That is ludicrous. And the inappropriate administration of glucagon is essentially impossible with a proper history and physical exam. Last, someone commented that the EMT couldn't do anything if there was an adverse effect to the glucagon, such as if the patient had the rare condition pheochromocytoma. Well what would an ACP do? We don't carry any glucagon antagonists. Long story short. Obviously D50 is the standard of care, but an IM injection of glucagon is not rocket science. It can easily be performed by all levels of EMT and paramedics. Good lord, EMTs and PCPs are not stupid like some people in this thread think. They are trained medical professionals capable of making decisions are performing skills and treatments, treat them as such. Second, someone mentioned about waiting until you get a hypoglycemic patient into the ambulance before you administer the D50. Why in the world would you do that? Start the IV in the house, give the D50, wake them up, get them something to eat, ensure there is a friend or family member to watch them and call back if any problems develop, fill out the treat and release form, say goodbye and leave. Obviously if you can't explain the reason for the episode, or they don't respond appropriately you need to transport. Otherwise, you've just saved that person a trip to the hospital and an ambulance bill, that is one less patient in the ER who will be seen by a doc who says check a glucose, give them something to eat, and then discharge them, and last, your ambulance is returned to service quicker. It's win-win for everyone. p3sibley, Advanced Care Paramedic

The Halifax Fire and Emergency Service in Nova Scotia, Canada is a composite department with around 250 career staff and 800 volunteers. Station 1 - administration Stations 2-18, core stations, staffed 24/7 by career firefighters, some volunteers on second call out if needed. Stations 19-63, rural stations, run primarily by the volunteers. Some stations have 2 career staff Monday to Friday to support the volunteers during peak hours, but during nights, weekends, and holidays, it's 100% volunteer. Volunteers receive a point for each call, training session, meeting, or fire prevention activity. The point value changes each year depending on the total number of points awarded, but last year, the value was around $5. The point of the honourarium is to just give a little bit of money back to cover the expense of gas, etc. My station runs approximately 150-200 emergency calls per year. Fires are way down. The most common call is medical emergencies.