tniuqs

Dwayne: Ah water off a ducks back mate, just remember that without those that fought for our rights and our freedom's no one could voice their opinion's without fear of serious imprisonment or worse.

basejump I took your advice and I toasted a few last night myself and curiously enough my head hurts, off to find my suit and my poppy one can't me late to the ceremonies in my little town.

Nypaemt39 .. that was the first poem I ever memorized.

This without doubt to myself is one of the most important days of my year to honour those that have fallen, please look back to years prior, especially Lone Star of whom my very dear friend assisted me with the post last year A Pittance of Time .

http://www.emtcity.com/topic/19112-11-1111-2010/page__st__10__p__249505__hl__+rememberance%20+day__fromsearch__1#entry249505

This year I submit, as I am a proud Scot to the very bone, a theme song that I would like to share, yes its a movie theme, nevertheless tis fitting this year with the loss of our Dustdevil131 aka Rob Davis.

Lest we forget those that laid down their lives so that we could have the right to the vote and free speech as we enjoy on EMT City daily.

and WW 2

http://www.youtube.com/watch?v=8t7WFprdSIc&feature=related

That's the thing, there are so many BS calls in the city along with the occasional 'real' call. Resources 'per capita' if you will are just as stretched. Mind you, we have maybe 25 on the road and that's less than minimum staffing requirements. Still, a larger city with more units on the road does more bullshit.

More People = More Bullshit .. its a linear equation, dough (see Homer Simpson)

Anyhow, flamingemt ... what about the woman who bends down to pet a kitten while walking near her apartment at night; gets scratched by said kitten and phones 911 because she has no bandaids? That's bullshit.

Provide a bandaid, does AHS not carry them any more ? Written cancellation but caution about cat scratch fever s/s. cat scratch fever is not BS .. just duly diligent.

What about the chronic narcotic abuser who is new to the city, who 'heard from a friend' that calling 911 and telling the ambulance that their doc in another province said to call 911 if they ran out of morphine and that the ambulance would give them morphine?

A druggy .. no kidding, those with great rational thought process, possibly going through withdraw .. yeah cancel don't get him help then get called back for a seizure or an OD ?

What about the ever helpful drive-by caller who phones 911 in the middle of summer for a person lying on a bench near a busy street, who doesn't have time to stop to see if this person is breathing? Only to have the ambulance get there for the typical drunk guy sleeping on a bench because he's homeless and has nowhere else to sleep?

Night or Day .. Suntan or Moontan ? a little old lady 82 y/o calls in because she is afraid to get out of her car in a bad hood and she an abuser I see, no G. Spady centre in EDM any-more ?

What about the person who phones 911 in the middle of the night living RIGHT BESIDE A DRUG STORE because they can't sleep and their Imovane isn't working?

Dispatch FAIL AGAIN !

What about the 18 year old male who vomitted 2 days prior to calling the ambulance, who only called because their abdomen is still "just a little bit sore" from wretching?

And he wasn't Drinking Ok right then and No such thing as Pancreatitis, GI Bleed ? ps one of the biggest admissions in ICU btw I had one of those 5 days ago lipase was 650 on admission to ER, one of his complaints was he thought he was constipated.

What about the person who calls 911 because the medication they were given is "working too well" and all their symptoms disappeared and they thought they should see a doctor about it?

First off I wish ... Then book an appointment to pshycologist STAT, or call the AHS help line .. the RNs can answer those questions.

What about the girl who gets a flu shot, then phones 911 because her arm is a "little bit sore" the next day? No other side effects. Just a sore arm.

Fail in delivery of Public Health Nursing system and dispatch .. read the farking hand out provided with every vaccination ... I DO and I hand them out and clearly explain the side effects <sheesh> !

I could go on for hours ... There certainly ARE bullshit calls out there. It's even more frustrating when you're sitting there on one of them hearing a cardiac arrest getting dispatched to a PRU (single member) because there are no units available. To deny that there are these types of calls is like denying one's shit doesn't stink.

I could go on for days ... but then again I have rhum and coke to take off the edge, but you never call anymore <sniff>

Here is the bottom line, if we wish to move forward as a Profession, WE have to deal with primary health care, stop being cocky pricks and do though workups, do non judgemental clinical evaluations before we will ever be called a "profession" otherwise your just a whiner.

Oh and drink to excess on days off, I do and it works

cheers

Whoa nelly .. lets all back up dah short bus. I leave for a minute and I come back to see some very jaded responses

Yikes kiddies this is supposed to a caring profession not a judge, jury and trial WTF .

So for shits and giggles lets do an actual intelligent post mortum on the initial post before slamming poor flaming medic for his opinion, shall we ? Perhaps remove heads from the dark place first, would be a great start, Is their calls that are a waste of resources, hell yes some ludicris some worth a good laugh remember stupid is a disease we cannot cure.

Your on scene its your responsibility to respond when summoned, when you book location your a problem solver quoting HammerACP .. where the hell did she go anyway ?

Had a call on my last shift where I felt it was a bit of a BS call but who I am to judge.

Your NOT a judge, precisely .

My partner and I where dispatched out for a cold 14 year old male.

That's all the info you received ? really come on........

When we arrived my partner asked the guy what was going on and the patient's response was " I am on my way home from a friends house and I am cold."

Ok 14, is this individual an adult ? nope, is this adolescent confused ? what is his body posture? what is he wearing? is he impaired ? what is the ambient temperature? What is he wearing ? Why did he leave his friends home, what was his destination ?

My partner asked if he called 911 because he was cold and wanted a ride home? The patient's response was " yes ".

That's it for history ? a one word answer .. come on again really ? No vital signs, no investigation of possible psych related problems ? Have you looked at the incidence of teen age suicide ? Your missing the big picture here

My partner explained to him that 911 is not used for this type of situation but we would give him a ride home this time. We drove for about 5 minutes when the patient said we could drop him off now as he was only about five minutes from home.

Abandonment plain and simple, that of an adolescent, do you have good insurance ? ... does your medical director know of your actions WTF are you thinking ?

I sure would like to audit that Patient Care Report ....EPIC FAIL.

Curious to know what kind of BS calls the rest of you get.

Remind me again of how long you have been riding on car PCP, their is no "honour" in becoming a jaded hardened medic ! am calling you out brother ...

At the risk of pissing off Happy aka or the wrath of Khanette pfft !

So you dont concider a False call a BS call. Have you ever been in a situation where your dealing with an ass that abuses the system for a ride up town and the real pt dies because of it..... I have and it sucks the big one.

Another EPIC FAIL, in a system with limited resources easy peasy .. here is how you do it .. btw you know I have the T shirt and I wear it proudly for doing the right thing and btw shit does wash off.

Dispatch this is Squad 51 we have a stable patient sitting seat belted in, we a ready, willing, closer and capable to respond .. what are your directions. PUNT !

Lard Thunderen jes sus, where U 2, I'll come to where urine at.

or is that the Screech Talk ?

Don't worry our army is getting stronger!

thanks Mobster ! and Happy, gentlemen don't kiss and tell LMFAO !

Lets call it the Dustdevil Army, and my motivation to keep recruiting, so lets NOT let ROB down, sorry all been a bit screwed up over that, been a bit of a slacker lately .. sorry to Dwayne , haven't had an "intercourse" with yall lately, and no worries about the "spy talk" its verbotten !

motto: As a team we will overcome any and all adversity, we will reload and we will answer. - Quote WFM

Pffft .. jump in the water get your feet wet ... do a scenario revive an old thread from a "stubble jumper" perspective . LOL.

ps Kiwi does not have a personality .. he's a just funny looking little bird ! sheesh .

AND never underestimate those that call themselves EMT-B there is no rank here, unless you earn it.

cheers

Where is that "rigger" partner you cross shift with ... ?

Triage by a lower level of care is a recipe for a disaster, we clearly observed this in Edmonton AB (back in the day) when 2 EMTs on one truck and 2 Paramedics on another .. but having FF "check out the scene first to see if an Ambulance even dumber, besides the liability in delay of dispatch (as if ALS) cannot cancel. This is one again excessive cost to send a Crash Rescue or Pumper and IAFF justification for thier budget concerns.

ErDoc .. one has to ask oneself if the "radius" of efficacy of HEMS was looked at too .. but ALS intervention 4 minutes earlier and lock and load with under 20 minutes ground transport time ... just saying a big show for one dead kid .. that said as always this IS a news report .

"yes send that ALS ambulance to the house to see if it is alight and decide if a fire applialce will be required...."

stay safe

Zactly !

Ahem You mean the Queens English, do you not ?

cheers

Ah another fresh one .. with good advice too .

Welcome Medisaun have we met ?

cheers

Bloody hell turnip i thought you were recruiting me eh

Welcome

Funny lil bird We cant get you to shut UP !

ROFLMAO!

Turnip eh your reading these treads ... game on lil bro !

Thanks guys for the great welcome Whiskey is going to be a rockstar Para .. just like his back to back, great attitudes and wicked smart.

In honour of Rob's memory I am making request to admin and Ak for their review, that we could start a Topic Site to be entitled:

The Dustdevil Memorial Remote Medic Topics ... am just throwing that out there, but with Robs passion for development it would be rather fitting ... what say you guys and gals ?

Dear WhiskeyTangoFoxtrot:

Firstly the traditional welcome to EMT CITY, very pleased you have jumped on board, er got off your bloody backside and signed in ... seriously we need more with the gusto you have, for Pre Hospital Medicine,

this is the start of journey that you will never regret .. lots of talent and a world wide perspective of EMS here and some bite.

I certainly hope your "back to back" i.e an offshore term will join this party of dysfunctional yet mildly demented group.

Should I point out your not in a forest your in the "SKEG !" young grasshopper, for those reading Whiskey is one of "those" I am attempting to recruit to the dark side, he's just the first of a few that will be joining the "festivities"

I look forward to your first post and don't think for one minute I will be nice to you

cheers

Just to go off topic a tad .. I believe I have attracted a small group of remote type paramedics in AB to join EMT city .. perhaps we could start an interest group ? I learned a lot in this scenario as in the Great White North we just don't see a lot of this type of pathology ... lots of skitters but they only carry West Nile .. although the cases of reported cases of malaria are increasing exponentially in the immigrate and holiday travelling public in Canada.

so a query gods of the nasty tropical stuff .. what medications are used to be profalaxis when travelling, I use Doxy but have heard that malerone is another ? Although side effects for women long term doxy can be a "concern" and some adverse effects to malerone

I will be presenting an interesting case ..ok 2 when I get paperwork completed on a possible perforation to anus NYD and a presentation on onset of pancreatitis NYD..it appears I am a shyte magnet theses last 3 days.

Is that the real pic or an Internet sample ... hell I am so envious if you have that capability in gram staining AND Micro photography .. Nice !

Ok a stab in the dark ... gram positive somethings ?

Do we have good evidence to begin anti microbial therapy however?

Its looking like that now.

APAP BTW what is this abbreviation ?

A new chest X-ray shows the development of a small right sided pleural effusion.

Great thread ... I had a similar patient x 4 days ago but no Cxray capabilities, bummer ! ... is their any other abnormal observations on Cxray ?

I would be hesitant to start throwing broad spectrum's / i.e .. the shotgun approach at this patient, the effusion could be a result of bacterial infection likely and compounded by a malignancy, CHF, pancreatic or TB ++

Are C + S available in 'this" clinic although that said sitting around for a couple of days not the best option, in remote of rural I suspect I would be looking for a ride to a real hospital at this juncture, he could become a threat to the entire operation if he is a community acquired Pneumonia .

cheers got to go do that safety meeting thang.

What about Sputum ? color, volume, consistency ?

... assuming people actually pay ambulance bills

How about we go back to the days of F&B Ambulance, only 'millenium style'? Each ambulance could be outfitted with credit/debit card readers by each patient entrance and include the option of leaving a tip. No change provided with a cash payment. All drunks etc, people arguing for a specific hospital and criminals under arrest with a police escort in the ambulance pay an automatic surcharge.

Heh ...

A Great idea .. but if one is using the Z card (welfare for those not in the great white north) or the DIA Gold Card, (you know the with one airmile rewards plan) you could start a small war over that "little" social / pc / human rights issue .. but good luck with that, not disagreeing with user fees for that target group of abusers but the fact remains its just not ever going to become a reality.

As for a tip .. accepting one is a breach of the code of conduct with ACoP, just saying.

cheers

Let me start by saying that I don't have recent experience in this system. I don't want to post my identity on the forum, but if anyone wants to pm me, I'll be happy to chat more candidly.

A very eloquent post for a said trunkmonkey .

Well quite an entertaining thread, especially concerning the AB the Rural vs Metro, and replying out of a personal request

Just may have a little experience in: rural, remote, urban, suburban, turban and tepee, both ground and air in AB but that is not the point at all, moreover the historical perspective in the development of EMS in Alberta and just attempting to establish I have seen many sides of these fences, but now I am observing some concertina wire getting strung up <sheesh guys>

One point is they are all very unique in their own ways and all challenging providing care. If was asked and the amount of ass time, comparableness and one to another it would be that of comparing apples to oranges meh a waste of breath quite literally.

One should be paid for what you KNOW, as opposed to what type of service one chooses to work in. The entire concept of pay based on call volume or types of calls or length of shifts is way counter productive, it is a blue shirt mentality, quite frankly.

Secondly the point is when there is any controversy or any "in" fighting about job equity, pay checks or work conditions (whatever) The Prime "employer" is very pleased and happy when that situation occurs, as without solidarity in any union or association your hooped for any success in negotiations even before one sits down at the big round table.

In fact this is a prime example of the Divide and Conquer Technique applied to labour negotiations. Its far more systematic related in the bigger political picture of folks living in Urban AB to Rural, just the area of Health Care to start scraping the surface, and will I predict with the "super board" type controversies will be a topic for discussion with the upcoming election, Wild Rose go get em I say !

Now facts as I perceive them of the pay equalization are a direct result of when the Conservatives in the "take over to perfection and bigger is better er unmanageable phylosophy' and taking over a entire system (that actually worked fairly well before) so if at the municipality level funding had increased this entire cluster would have been nipped in the bud. Without any actual tangible plan, just a concept applied and lets just see how many migraines we can generate and reinvent the wagon wheel .

Yes one can see the huge improvement LMFAO ! New chezzy uniforms made in Thailand by child labour and new generic paint jobs on the sides of the most of trucks, then generating protocols that DO NOT address the very different needs of the communities, not purely evidence based just "expert opinions' of the government chosen trio, the good the bad and the fossil I call them. Protocols established but no new drugs or equipment on the truck to acually follow them ..epic failure.

From the initial budget of 110 million for "take over" well its closer to 480 million now and its not yet anywhere completed, any government involvement results in exorbitant costs with VERY little change to the quality of actual delivery of said services.

Thirdly: AB Employment Standards dictating what Union (the lesser of 2 evils CUPE vs HSAA for the government perspective) to represent that entire "group of labours" oddly enough because your actual rights in Canada to "organize labour" were stomped on.. plain and simple. We got "controlled" by big brother Alberta Conservatives ... that move was fundamentally a blatant contravention of the Canadian Constitution .. if that happened with our brother and sisters south of us it would have become a civil war.

Remember that the entire reason for this was because Calgary took a Strike Vote in 2008 and at that time, the Minister of Health dodged a bullet and claimed that EMS in Calgary was not an essential service but a lockout would result in a "local emergency" .. then curiously within a year the Essential Services Act forced through the legislature .... hmmmm .

Siff:

In fact, I've give you my next paycheque if you walk up to one of the STARS medics and tell them their critical care skills are shit. You appear to know it all so it shouldn't be an issue for you.

My Dearest Siffalass:

Can I take you up on that offer ? PLEASE .. and just which rock STARs Paramedic would you like me to do a snap quiz with first ? LOL. Although I would prefer a few home made bottles of wine and hand delivered in lou of your pay-check that is. <insert wink>

Just to be very clear there is no Critical Care Level established in Alberta, yet the starboys have developed their own independent in house standards of supreme excellence better than all the rest of we lowly grunts in the ditches, but awesome PR once again.

If ANYONE "represents oneself" as a CCP-Flight in AB no matter what their real credentials may be, they could be subject to investigation for unauthorised use of that title by the College ... just saying it there was a release of that to the registered members on a group email a year ago.

cheers

multiple edits due the fact I was abducted by aliens in a limo last pm and was forced against my will to go bar hopping and getting asked to leave 3 bars .. a personal best for this group of aliens but unfortunate still feeling the after effects ... oh my aching head

Might want to look up PH and then look on the IV bags themselves.

Just to be clear "passing" an ACLS course is every 4 years according to the Health Disciplines Act under EMT regulations .. who knows what the queen pins will do when they ever get accepted under Health Professions Act.

This AHS deal is interesting is AHS except from the Acts and legislation now are they now the regulatory body for AB ?

Personally I take an ACLS course every time the standards change, so that's about 8 times I have donated ca$h to the Heart Foundation ... then then their is PALs too.

Frankly ACLS is beginning to be a joke its so watered down over the years so that a janitor can pass it.

9-4=1........Just take it again.

Just curious basejump as an EMR have you taken an ACLS course ? and what is the EMR "R" part are you in "remote" practice ?

FYI:

Please pass this on to as many of Rob's friends as possible. I was not consulted as to the dates, it is quick notice, and none of them fall on my day off, so I don't know if I will be able to visit much. Dutch, can you send on to Mark and Danny and the other truckers. I am a lousy secretary and forget where I write down e-mail addresses.

Chooper Copper

To those that wish to celebrate the life of Rob aka Dustdevil:

Please come by and join us in the Celebration of Robert S. Davis and his family and friends that will be held at his mother and stepfathers home from 10am to 8pm on October 22, (Saturday) 23, (Sunday),24 Monday. At Rob mother's home they will have room for 12 persons to stay at the home, not in rooms but open areas, and approximately 30 or more campers in the back wood area of the home. Robbie states she has plenty of wine for this celebration and beer, if you prefer something else BYOB. This will also be a pot luck situation, bring what you can. Any questions contact me at p31@evermantx.net.

He is out of pain and with God

Frank