I couldn't help myself....sorry!!

[WendyT]

Richard B said

Treat the patients, UPGRADE the machines, read the maps, and trust dispatch, just not totally.

[tniuqs]

As for Dispatch making address errors. I as alot know live on the Queen Charlotte Islands and out dispatch is out of Kamloops. I have been dispatched to Queen Charlotte City from my home town of Masset and it is a 1.5 hr trip

OK: I am really wondering if ANYONE read this Part ? or really understands where the Charlottes even are for that matter .....

JMHO but this is the "first" biggest hurdle to ovecome in the British Columbia System, it is absolutley insane that a dispatch center is so far away from reality. Sorry for going off topic but this "regionalization concept" is huge folly and a abismal failure for ground dispatch, in passing having dealt with the Air Side .... many concerns there too.

Just to put the time space continum in realistic pespective, It is akin to being dispatched for a call in Seattle Washington and having Dispatch in Boise Idaho, bit fewer calls though, but yes really really, it is that radical of a difference. :roll:

Also note another huge problem is that every ambulance driver in BC is called a Paramedic when in fact only about 7 major communities in BC actually have ACP's. I have just reviewed the new proposed protocols as well, in passing and there is MUCH to do to bring BC ACP standards up to the national average.

No offence implyed or intended as I am quite positive that if 'Happiness" was given any opportunity to upgrade to provide ALS services to her community AND be appropriately reimbursed she would be way ..... HAPPIER

And so would I ! And someday I WILL get there .... it is the most pristine temperate rain forest left on the planet.

cheers

[tniuqs]

Precisely. Unfortunately in some of the far flung regions of my home province "better than nothing" is the best that is provided. Remote stations in BC are so close to volunteer it hurts. Responders are on pager and paid a 4 hour "call-out" when an ambulance is called in their area. Many of them are driver only/EMR crews (EMR is roughly equivalent to EMT-. BC Ambulance is simply unwilling to provide a higher level of care when the call volume is 30-40 a year. In reality these outlying areas need some kind of "paramedic exchange program". Send medics from the busier centres out to these low volume places for a block every so often (Full timers in BC work a 4 days on 4 days off rotation). Think of it like a working vacation. Most likely these medics will get some time to de-stress but if something does happen the people in these outlying communities will get the experienced crews they deserve.

Most Excellent Idea with Exchange !

Kudos would love to get on-board with that excellent idea, pick me first.

Unfortunatly I have reciently contacted BCAS in order to investigate reciprocity, so here is the lastest from union run/ dominated position.

Even though I have active practice permit Alberta ACP/CCP level + other areas of Health Care AND have done many Medivacs OUT of BC, for years Flying. I have to still have write a $500.00 exam based on protocols that are about 10 years behind Alberta, I have current ACLS, PALS whatever.

Then I have to do a 3 month "mentorship" before I will be allowed to practice on the ground and restricted to a only major community ie VAN, VIC, Killona (lol) or the LOOPs ...I have no choice of where I wish to work.... ah canadian democracy in action.... MEH!

Well you get the black and white picture, from a kodiac brownie camera :twisted: I use a new fangled digital .... if your following my ramblings .

The biggest problem in BC is "top heavy" organized Labour, odd that Alberta ACPs are providing care to MANY industrial site's on the sly, as there are NO government regs in Private Delivery of Health Care and odd that Oilpatch DEMANDS that Level of care .... WCB should be burned to the ground and start again. Maybe perhaps time to consider a change for the public at large TOO?

GETHERDONE!

Personally: I would relish the idea of a court challenge, in reciprocity, it could just open up a door really wide and very pretty scarry to those white shirts in the Justice Institue sitting on their union asses... is my BET :evil:

So who would be the winner's with this you say .... the sick/injured taxpayers of BC perhaps ?

cheers

Honestly some Volly sytems DO work more effectively than overbearing Union Shows, just saying ......................... ALWAYS other options to consider.

[rock_shoes]

Even though I have active practice permit Alberta ACP/CCP level + other areas of Health Care AND have done many Medivacs OUT of BC, for years Flying. I have to still have write a $500.00 exam based on protocols that are about 10 years behind Alberta, I have current ACLS, PALS whatever.

I agree with you on the poor system of reciprocity. Credit should be given for experience. Unfortunately reciprocity sucks in both directions. If I want to work in Alta. once I finish my upcoming PCP course I will have to go through their also nightmarish reciprocity process. The only way to get around those issues is a national standard of practice with a self regulated national licensing/registration body. Just don’t be too quick to judge ACP practice in BC. The ACP’s we do have are excellent. We just don’t have nearly enough of them. A team of three women from BC did just take home the national title not too long ago. What are antiquated in BC are our licensing protocols. Fortunately they aren’t really used in practice. The switch has been initiated to “Treatment Guidelines”. Under treatment guidelines any procedure or medication that falls under your scope of practice is available for your use at any time without having to fit it to a rigid protocol. A good example would be giving someone with a severe allergy the benadryl before they go anaphylactic as opposed to waiting until you have to give epinephrine first (protocol is epinephrine then benadryl). You just have to be able to provide sound reasoning for your decision.

Then I have to do a 3 month "mentorship" before I will be allowed to practice on the ground and restricted to a only major community ie VAN, VIC, Killona (lol) or the LOOPs ...I have no choice of where I wish to work.... ah canadian democracy in action.... MEH!

I think you already know we disagree on this one so I’ll leave it at that. Personally I don’t see what the problem is as you would be paid your full ACP rate during this period anyway.

The biggest problem in BC is "top heavy" organized Labour, odd that Alberta ACPs are providing care to MANY industrial site's on the sly, as there are NO government regs in Private Delivery of Health Care and odd that Oilpatch DEMANDS that Level of care .... WCB should be burned to the ground and start again. Maybe perhaps time to consider a change for the public at large TOO?

No disagreement from me on this one. WCB will only recognize an OFA ticket or an EMR license currently. Join the 21st century for crying out loud. To work in the patch in BC as a PCP or ACP you need to do a 1 day “Bridge to OFA” course to be recognized. Then you can work to full scope if you have a medical director willing to sign off on you.

[tniuqs]

I agree with you on the poor system of reciprocity. Credit should be given for experience. Unfortunately reciprocity sucks in both directions. If I want to work in Alta. once I finish my upcoming PCP course I will have to go through their also nightmarish reciprocity process. The only way to get around those issues is a national standard of practice with a self regulated national licensing/registration body. Just don’t be too quick to judge ACP practice in BC. The ACP’s we do have are excellent. We just don’t have nearly enough of them. A team of three women from BC did just take home the national title not too long ago. What are antiquated in BC are our licensing protocols. Fortunately they aren’t really used in practice. The switch has been initiated to “Treatment Guidelines”. Under treatment guidelines any procedure or medication that falls under your scope of practice is available for your use at any time without having to fit it to a rigid protocol. A good example would be giving someone with a severe allergy the benadryl before they go anaphylactic as opposed to waiting until you have to give epinephrine first (protocol is epinephrine then benadryl). You just have to be able to provide sound reasoning for your decision.

Firstly and MOST Importantly agreed lots of bilateral heads up butts, the only fast tracking I can see is a serious court challenge (from either side of the rockies, I could really care less who funds this challenge from BC or AB really) get sleepy government officials moving, use solidarity for Paramedicine as the rationalle.

Never even suggested anything negative re: Quality of ACPs ... ever. Yes, Quite aware of the Durham finals and kudos, thing is place these all these folks in a sim @ the RAH or Uof A with ABGs, XRAYs, Labs plus ER MDS running the model's and one may find some very different outcome's and not sour grapes at all just a frank reality, heck Parkland won it last year. My counterpoint is that this just rationalization, and I see some pride as well, all awesome PR never the less, congrads to all the teams that recieved funding for this event.

On to Protocols: YOU are trying to defend the new ones, I am not being to quick at all so read on my friend, if you believe that BC ACPs are practicing on the same level as others in the country.

Then I have to do a 3 month "mentorship" before I will be allowed to practice on the ground and restricted to a only major community ie VAN, VIC, Killona (lol) or the LOOPs ...I have no choice of where I wish to work.... ah canadian democracy in action.... MEH!

I think you already know we disagree on this one so I’ll leave it at that. Personally I don’t see what the problem is as you would be paid your full ACP rate during this period anyway.

YES WE DO !

Credit should be given for experience

Here is the "problem" I have > than 20 years on the Road and Air, so just where is this credit thing factor in ?

Just how does your idea factor into this statement :3 months of paid or not. This does is addresses lack of ALS providers nor is it anywhere near cost effective. This 3 month deal is a union dictated "ideal" dude. I can work without supervision in the US and the majority of provinces and territories across Canada but have to have my hand held it is nonsense!

I dare say YOUR opinion will change when you get YOUR ACP ticket.

The very concept that YOU brought to light here, that being 'locums in more remote areas where ALS is needed" agreed an orientation period always is required .... but 3 months ? come on is that realistic time frame to follow through with your suggestion or maybe I am confused ?

Do the Math and by 2020 you may have enough to initiate this "locum idea" with the advancing age demographic a very serious consideration.

<snip my quote>

No disagreement from me on this one. WCB will only recognize an OFA ticket or an EMR license currently. Join the 21st century for crying out loud. To work in the patch in BC as a PCP or ACP you need to do a 1 day “Bridge to OFA” course to be recognized. Then you can work to full scope if you have a medical director willing to sign off on you.

Yes quite aware, its the lobotomy part I have some difficulty with is all, sheesh workplace BC affecting the provision of advanced health care ? Since when did they have input affecting Health Care, it is simply not within their juristiction or mandate.

BUT Hey were have a similar "stupid" affect with OH + S here, as they dictate ACP but can't identify that the "Level 3" FA Kits do not include IVs or even a Monitor .... ? WTF!

All in All its a bloody mess !

cheers

[rock_shoes]

Firstly and MOST Importantly agreed lots of bilateral heads up butts, the only fast tracking I can see is a serious court challenge (from either side of the rockies, I could really care less who funds this challenge from BC or AB really) get sleepy government officials moving, use solidarity for Paramedicine as the rationalle.

No question that BC and AB are the two biggest proverbial “sticks in the mud” when it comes to the formation of a national registry.

Never even suggested anything negative re: Quality of ACPs ... ever. Yes, Quite aware of the Durham finals and kudos, thing is place these all these folks in a sim @ the RAH or Uof A with ABGs, XRAYs, Labs plus ER MDS running the model's and one may find some very different outcome's and not sour grapes at all just a frank reality, heck Parkland won it last year. My counterpoint is that this just rationalization, and I see some pride as well, all awesome PR never the less, congrads to all the teams that recieved funding for this event.

That being the case we would have to send you a Critical Care team rather than an Advanced Care team. :wink:

I have DO have the new improved BC version,

BC ACPs have to patch for Narcotics.

No information on Pacing.

No mention of Amnio, or Vasopressin.

No Paralytics.

No Beta Blockers.

What is with your Hypoglycemic guidelines D 25 why ?

heck your still carrying Fluazamils, why? for mixed ODs. maybe best avoid that item.

Come on man I have all these options in Industry in AB, like today! Perhaps best keep to your skill set.

AND I do to have very serious issue with ANY PCP in administering ANY IV meds... Narcan is NOT without complications.

Like I mentioned before current licensing protocols don’t accurately reflect the state of practice. I do recognize that. Even by licensing protocols though morphine is not a patch it’s part of the standard drug list. So is D50. There are also allowances made for use of chemical restraint.

Here is the "problem" I have > than 20 years on the Road and Air, so just where is this credit thing factor in ?

Just how does your idea factor into this statement :3 months of paid or not. This does is addresses lack of ALS providers nor is it anywhere near cost effective. This 3 month deal is a union dictated "ideal" dude. I can work without supervision in the US and the majority of provinces and territories across Canada but have to have my hand held it is nonsense!

It isn’t really designed for the experienced ALS provider. It’s designed for the “fresh out of school” ALS provider (For whom I think it’s actually 6 months). For someone just out of school I still think it’s a great idea. Yes 3 months is long for someone who has been in the game for a while. There should probably be a competency based method of shortening it up for the experienced out of province providers. Just remember the amount of beurocracy we have to deal with here.

I dare say YOUR opinion will change when you get YOUR ACP ticket.

You may very well be correct on that. We shall see when the time comes.

Yes quite aware, its the lobotomy part I have some difficulty with is all, sheesh workplace BC affecting the provision of advanced health care ? Since when did they have input affecting Health Care, it is simply not within their juristiction or mandate.

WCB has a habit of sticking their nose into things they shouldn’t while ignoring some things they should be taking care of. I don’t like it either. I’m sure the other provincial equivalents can be just as much of a pain in the rear.

[tniuqs]

tniuqs wrote:

Never even suggested anything negative <snip> congrads to all the teams that recieved funding for this event.

That being the case we would have to send you a Critical Care team rather than an Advanced Care team.

With this statement it brings to mind one of the reasons that AB & BC do have issues at the ACP level, So does AB drop the standard or BC raise the high bar ? Don't get me wrong the majority of ACPs in AB need a palm pilot program for the ABG thang. The real point (s) are this Competition is a good social gathering for "national team building" and does open dialog on a national level that is the real success of this great learning opportunity! but why set the standards so low ? ... reach for the CCP level ! Maybe 1 CCP, 1 ACP, 1 PCP per team, just saying.

Sadly, this type of competition persay is only available to services than can financially support these teams. I dare say if had a spare 5 G I would love to bring a team as well, but my wallet ain't that phat.

Like I mentioned before current licensing protocols don’t accurately reflect the state of practice. I do recognize that. Even by licensing protocols though morphine is not a patch it’s part of the standard drug list. So is D50. There are also allowances made for use of chemical restraint

But no mention of this in this protocols ? So without a CLEAR CRITERIA for a written examination, can't you see that this is a setup for a big fat FAIL ? This is one problem that examiners in ACoP do not have (although a bit dated) the testing criteria is very clearly laid out.

It isn’t really designed for the experienced ALS provider. It’s designed for the “fresh out of school” ALS provider (For whom I think it’s actually 6 months). For someone just out of school I still think it’s a great idea. Yes 3 months is long for someone who has been in the game for a while. There should probably be a competency based method of shortening it up for the experienced out of province providers. Just remember the amount of beurocracy we have to deal with here.

Firstly make the system more efficiant and get rid of some of the dogmatic beurocracy first thats the biggest problem, doubt anyone would disagree on that in BC?. (HEY, do write a letter to your MLA as it could not hurt at all to educate the officials that pay the bills)

That said I think perhaps this maybe a goal of your government, as many of out of scope managers are coming from more progressive "places" the "change from within concept applied" ... just a bit sneaker is all.

The "recruit the rookie" concept is folly and destined to fail if the goal is to prudently improve ACLS care in your province, this idea for recruitment as it is just not a good representation of the best possible candidates and seriously it is also NOT cost effective either your having to pay for training "everyone/ ps taxpayers" bitch about the high costs of health care .... don't they? BTW .. when ACLS was initiated in Edmonton, they reqruited 4 of the best experianced REMT-Ps that they could find: 1 from NYC, 1 from Chicago, 1 from Tuson, and 1 from LA .... it was a HUGE success. Don't reinvent the Wheel when its working well in many other places. (just an idea is all)

Senario:

So I am a guy with a home and family, move all my stuff/kids/wife to say VAN or VIC for 3 months and then and only then and IF I get a good evaluation ... then where am I going next ? Do you see where I am going with this ? Just what would an experianced Practitioner PCP or ACP have to gain to just uproot from a decient paying job and relocate with no guarantee where they would even geographically end up? Yea, BC is beautiful but we can go there on holidays .... With this attitude based on the placement practices, and primarily UNION influenced this a good explanation of why the BEST candidates never even bothered to even investigate 3 years ago when the drive was in full swing.

WCB has a habit of sticking their nose into things they shouldn’t while ignoring some things they should be taking care of. I don’t like it either. I’m sure the other provincial equivalents can be just as much of a pain in the rear

Medical translation of WCB = Geriatric Rectal Cranial Inversion ?

WCB and OH+S are NOT friends of Paramedicine .... PERIOD!

cheers

ps rockshoes, I know I am preaching to the choir, sure hope that some lurkers read my missive is all. :wink:

[spenac]

We've gone from bashing vollys, bashing dispatchers, bashing software, to canadians bashing canadians. This canadian on canadian violence must end.

[JPINFV]

[s:4f9e4c3605]We've gone from bashing vollys, bashing dispatchers, bashing software, to canadians bashing canadians. This[/s:4f9e4c3605] canadian on canadian [s:4f9e4c3605]violence must end. [/s:4f9e4c3605]

I'm sorry, were you saying something? I kinda of zoned out...

[tniuqs]

dear spenac:

Just following this thread's posted topic is all.

I couldn't help myself ...... sorry ! :wink: