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Advising family of a deceased relative is part of what we do. Do you remember the first time you had to speak to a family about this? Would you change any part of your communication if you could?

I guess it's different everywhere. I've worked small town where VSU was very close at hand, and I currently work in a large urban area where it takes a bit longer to mobilize VSU. If we are called for an unconscious/man down sort of thing and the person hasn't been seen in a couple or few days and we find them, if family is on scene and I'm their first contact, yes I will tell them. If family is nowhere to be found, the police end up making notification when family is contacted. The first notification I ever made was to someone who was soon after charged with the murder of their mother. It was not my place to give my opinion of them when they asked if there was anything we could do for her. I removed the whole homicide aspect, put myself in the position of someone who was about to learn of their mother's death and said what I needed to say.

Who are these 'experts' you talk of? Where are the studies behind what you're talking about? What book and what book company? What reason? You can sit in the middle of a busy intersection doing chest compressions 3 minutes away from hospital. I'll continue on as originally planned with perfectly good CPR and meds

Thanks for the clarification, it sounded different. I have however seen and myself performed quality CPR while the ambulance is in motion, even in an urban setting with retarded traffic all over the place. It's not difficult.

Thank you AK, well said. (Still waiting for an answer from spenac about why they stop the ambulance to do CPR)

Exactly ... That would be nice ...

Sure, we'll make helmets legal too for everyone in their cars. As for your idea on CPR ... I guess you've never had someone you've gotten ROSC on who yet again coded after transport was initiated. Are you going to stop the ambulance in the middle of nowhere to bang on some guy's chest for a while? Perhaps it's lack of resources, because I can't see you being serious ... And as for this thread, seems to be a revival of something from February 2006 ...

Yeah, seatbelts are a given. Unless you're working a code, kind of hard to do CPR when you're belted into the CPR chair. As for helmets, jeez why not make everyone in their cars wear them? I think it's going a bit too far personally.

Here's how this comes across to me ... "I want people to wear a helmet while travelling in the ambulance." Am I correct? Or are you asking to have them on car for use only in situations that would require a helmet?

Quite interesting that MOT regulations state that due to safety Pilots and Flight Attendants subjected to the stressors of flight and are limited to a 14 hour duty day ... all I will say on this topic its about DAMN time Flight Medics health and the safety of those that fall under their care are in placed in jeopardy. GO get em HSAA its way and in passing both the regulatory body and Employment standards Alberta and Federally are aware of this situation since 2004 (practice beyond safety for rest periods) ... Where was the regulatory body in this protecting the public safety with this very serious situation once again ? Alberta Labour get your head out of your sphincter do whats SAFE for Albertans that are sick or injured.

I have been watching this thread for some time, and am finally going to interject with some of my observations and comments. Jamie asked Personally, I am happy that a paramedic-based association is working on this. The discussion of why ACoP was chosen aside, would you rather it be a non-paramedic based association addressing this issue? After all if we (paramedics) can't get this right, then who can? I have a number of issues with a certain regulatory body taking on the role of determining the national standard. - the organization in question is not a democratic organization, regardless of what they try to tell their members. The paramedics who are members do not get input into the decisions made by this regulatory body. Oh, they talks a good line, and has an AGM every May, but it doesnt matter what the members vote, the board can overturn each and every vote that the members make. So, Jamie, IMHO, we dont get input, so we wont get it right. - this regulatory body began the process of computer-based testing several years ago, and after spending several hundred thousand dollars on it, shelved it, and most members do not know that this was shelved. On top of the money spent, I am still not sure why they were trying to re-invent the wheel, when it would have been much more efficient and cost effective to involve a group who had already designed EMS computer-based testing. Is this going to be another situation where this group starts a project and does not finish it? - this regulatory body has obvious management issues, given the number of board and committee members who have resigned in the past 2 years. I would have to look back through the paperwork, but off the top of my head, I think it has been over 50% turnover on the board. This tells me that there are internal issues that are not being resolved, and members are unable to work with each other to solve the issues. - I know of specific circumstances where the ethics of this regulatory body are in question. I will not divulge complete details here, as I do not think that is appropriate, but I know of events at exams where neutrality has been questioned. I question the ethics when it comes to determining what organization is qualified to provide education and instruction, when there are providers who have had classes with 100% failure rates at exam writings with no investigation, and other providers who have had almost 100% pass rates and yet have had their authorization to provide classes revoked. Given what I have seen, and my questioning of the ability of the regulatory body to provide a quality product, and their lack of allowing practicing members to provide quality input, my faith in their being able to build a national standard is almost non-existent. Now, to my comments about the Alberta situation: - AHS took over all EMS operations; however, they negotiated contracts with a number of services, and specifically amalgamated services, so really, they did not take over the operations. - Before provincialization of EMS, there were 2 pilot projects Peace Region, and Palliser region. I work in the area formerly known as Palliser (why does the artist formerly known as Prince come to mind). In 4+ years, the powers that be were never able to completely integrate services and amalgamate operations so that it was truly a unified region. There were a number of areas that were never addressed, including renumeration and equipment standardization, and problems that were never solved. I am aware of similar issues in Peace region. If those powers that be couldnt consolidate a region, how can they possibly think they can consolidate an entire province? I will comment a little on tniuqss rant on immigrant staffing (and tniuqs, please correct me if my interpretation is wrong): - as an instructor, I am well aware on the limitations we put on class sizes and how hard it is for students to get into programs. The Alberta regulatory body and CMA puts limitations on instructor:student ratios, and there are limitations due to availability of practicum sites as well. - it is frustrating to see allowances for workers to come in from other regions, and offer training with decreased cost and hours to those workers, when we are limiting training of our local staff for example, EMTs who want to get into medic programs, but due to cost and limited spaces, cannot get in; however, if they were from out of country, they would be allowed training at a reduced rate. What is the advantage to this system? Isnt it better to train local, so that those students will remain local, instead of training someone who is more likely to leave? As an employer I want an employee who will stay with me the costs of staff turnover are huge, and I want to avoid that (hmmmm… back to the regulatory body board member vacancy rate… oh never mind), and by bringing in employees from out of region, it also increases the probability that those same employees will not stay here as long. - I am not saying that we have to have protectionist policies. I am saying that we need to improve our current system for our own population first, and build off the resources we have currently, rather than continue to limit access for our own population. We need to open the doors for more providers to allow for more students, rather than grant one time fast track programs for foreign students the fast track programs are a short term, short-sighted solution, not a long term improvement to EMS. Instead, they have done the opposite they have recently implemented a 1 year moratorium on applications to provide EMS instruction, so that those that are currently under review are being put on hold, and new applications from educational services will not be considered. Now, I have a couple other questions… Jamie Hershey, I am curious as to what your background is and where you work, and what you do. Unless I have missed it, and if I have, I apologise, but where do you live and work, and what is your certification? How many years of EMS experience do you have? I know you are not ACoP registered, so where are you certified to work? If I have missed it, please re-post it for me. Because of my generally pessimistic nature, I am curious what your background truly is.

In view of how many agencies are being duped by people who are untrained/unlicensed working as EMS practitioners, and the notoriety that these cases get (at least within the EMS community), one must ask what's being done to the agencies that are hiring these imposters without fully vetting their credentials? There are many avenues to verify credentials, (state websites, NREMT website, etc); there is no reason that the policy of "Trust, but verify" cannot be followed. With the glut of 'practitioners' being churned out by the 'patch factories', are these agencies THAT short handed, that they will just take anyone off the street that claims to have all the proper credentials without verification? Even if documentation is presented during the application/interview phase, it's not terribly difficult to verify with a few clicks on the World Wide Web or a quick phone call to the Department of Health (or whatever agency in your state is the governing body of EMS). Having been involved in the hiring process (in another service industry), I verified ALL credentials that the prospective applicant provided during the application/interview process. Failure to perform due dilligence not only shows dereliction of duty on the part of H.R. (or whomever is handling those duties), but it also opens the company to possible litigation.

If you are asking me if you should live in Alberta and work elsewhere, my answer is yes. It is a free country so do what you want. I suspect that people might be doing that very thing right now. If you need any contact information to help with job prospects let me know. As for the labour minister's response, could you share it with the group? I would be surprised to find a willingness to discuss barriers, such as 'provincial' residency status especially when you consider the AIT is aimed at knocking down barriers. Also, as you know finding quality staff can be a difficult prospect and manpower (staff) is needed to drive economic growth. What a US NREMT-P going to BC, getting registered, then coming to Alberta to work… after failing the exam 3 times? Hmm, I think I picked up on your subtle undertones there. What you are saying is that somehow this individual is not qualified hence the backdoor comment. Let's break this down shall we? First, if the person is legally able to work in Canada then where they came from is not an issue. Secondly, you are confusing professional practice with a career again. Simply put, if EMALB says this individual can work as a medic, and ACoP says they can work as a medic, well then they can work as a medic. A professional association dictates professional practice not an individual's career choices. If they don't want to work in a public system, or they just want to work in the oilpatch so be it. It is their choice to do so. Even if you don't agree with it. How they get taxed and where that money goes is a question of tax law, not professional practice. As for the question at the end, is this the professionalism I am referring to, my answer would be yes. Look at it this way, how 'professional' would a paramedic association look if they excluded people based on non-clinical/training related issues? You can't start a paragraph talking about the highest common denominator, then end with saying that there are no artificial barriers. What is it? Personally, I am happy that a paramedic-based association is working on this. The discussion of why ACoP was chosen aside, would you rather it be a non-paramedic based association addressing this issue? After all if we (paramedics) can't get this right, then who can? How about a nursing association, or how about (insert profession here)? See my point? A paramedic association needs to be directed by paramedics. What level of care or training shall we train those paramedics at? How exactly would this economic grant favor non-citizens exactly? I don't follow your logic. Canada supports the rest of the world? Really? When did this become a discussion regarding us green cards, or Canadian residency? Here is a question for you: why do you think governments hand out green cards, and have immigration? Growth is the answer. When a population grows, so does the economy. People work, make money, spend that money, and demand services. I know I promised to not dive into economics but next time you are in a town with declining growth (decreased population) take a look around. What do you see? Next take a look at a boomtown (increased population). What do you see? This also applies to countries. Where do you want to live? Delinquent? I pay my taxes every year! J Sorry, I always thought my federal income tax, well, went to the federal government… If it doesn't go there where does it go then? Oh no, here comes the Alberta advantage/rest of Canada is ripping us off discussion. If you want to talk economics, Ontario pays the most into the federal system and until last year they didn't receive a single transfer payment. I could go on here; however, I don't want to turn this thread into a flame war on taxes, and transfer payments. Perhaps I might already have. Regardless of who pays into the system, stability is the key. A country with solid banking laws, strong government, and all that is a place I want to live, and a place that people want to invest in. Someone has to pay the bill, but then you can't turn around and beat up the system that provides that very stability. If you disagree I have some stock in a nice Liberian mining company for sale!

I have stated before tha whole US system needs a complete review. The notion of an EMT-B (sorry guys) really should no longer exist. There is evidence (we do work on evidence based parctice these days) for early cardiac reperfusion through the use of ASA nitro & O2, this is just 1 example. We need a medical director, there is no dispute about that, but they should be an advisor only, sign off on a protocol & pharmacology & then start a new review, looking at current evidence based practice. Other than this there should be complete autonomy with the officers on scene & with the patient. I do, however, have 1 exception to this rule. There are services worldwide that have conducted, are conducting or have introdced thrombolyasis for STEMI. To the best of my knowledge these are all done with the approval of a doctor. This should continue as this means that all personnel who can start a line can use these drugs. This will lead to improved patient outcomes. I fail to see why I should have to ask how much pain relief to give to someone. Knowledge & experience will tell me. Get rid of med control, overhaul the system to remove a EMT _ B's (an upgrade would be the best option) & provide better overall care to your patients.

I hadn't seen the show before, so I asked Babs to record it for me. She said, "I watched a little bit of it..I think you're going to hate it." But you know what? I didn't. Did I see a lot of inaccuracies? Sure, but I see just as many in House, and I love that show. Why didn't I hate it? The folks were dressed decent and were actually able to to speak in full sentences. It showed the fact that some of EMSers believe that intelligence is held in higher esteem than bravado. The pilot guys is all screwed up, and we see those folks, but he's also a cowboy (guessing from peoples' comments towards him) and for a change no one was in awe of the 'cowboy' but held him in disdain. They showed an inexperienced provider, I don't know if he's a new medic or basic, screw up, and actually explained that that is part of EMS. He had to make some decisions, as he'd asked for help and been told to "deal with it", made some poor decisions when he had to, without guidance, and now has to live with it. Often we (at least me) have to make decisions and hope that they are the right ones. Most times they are, sometimes they aren't, but the possibility of really screwing the pooch is there. Can I say it was a bad idea to split the crew from the allergic reaction and the chest pain guy? Sure, I would have managed them both on the lawn. But then the kid wouldn't have been alone, wouldn't have screwed up, and the point wouldn't have been made. They gave us, as professional providers, plenty to bitch about, but I think they also made some effort to give us some things to like if we look for them. Do kids believe that all firemen are heros because they've watched a lifetime of shows that explain the exact angle of attack for a fire? Or because they've watched years of them spending half an hour defining the optimum number of personnel and equipment necessary to fight a structure fire before running in to save the baby? No man, they showed them doing a bunch of nerve wracking, exciting stuff. You all seem to want EMS explained to the masses in these shows. How about being happy that they were presented in professional, intelligent manner when viewed from the uneducated point of view? I was actually shocked after all the comments I've read here to actually see it. We can pick apart the fact that the chick in the backyard was bagging without making a mask seal, that the kid gave three shots of nitro, that some of us would or wouldn't actually work a trauma COR or afterwards be fucked up by it, but all in all it appeared that they tried, from the outside looking in, to present EMS as having an overworked, kind, decent spirit...and for me that's a good thing. Let's watch what they do with the macro impressions and work backwards from there to the micro and see if that isn't a better approach? I look forward to seeing how the show progresses. Dwayne

This is my take on it. This is not my run so I really don't care but...............EMT-b training does not teach these guys how sensitive a job they hold. Just the possession of Vicodin and Pot are out side the fence. It is still the south, so.....I will raise an eyebrow to the cousin issue. It have heard of several Sex Offenses in that area. Someone might ask what is going on. This type of issue is very complex and other EMS Providers passing judgment does not help. Remember this...... put a firefighter in a room with 2 steel balls, he will brake one and loose the other. I know I have done it myself. Guy should have asked for help before his addictions got out of hand. BUMMER FOR EVERYONE.

No idea. It was in Jan/Feb, I wasn't here for a few days, opened up the site and was sitting at 70 something. 2 days later it was over 100. I can't find any of my posts with that many +'s. I wouldn't complain if the whole ratings thing was dropped.

Not if they're less than 20 feet away in the other room and it takes a full day for VSU ... I mean working a code etc etc ... EMS doesn't usually go to doors making notification if that's what you thought I meant.

Pretty much says it all, doesn't it?

During the campaign, I really like Obama. Now I have discovered he is a lair, a hoax, a fraud and a puppet to the criminal elite who run the world. Before you dismiss me as a nutter like the TV has trained you to; I encourage you to watch this

Obama like his predecessor is a liar, you can tell cause his lips are moving. The real shame is you thought it would be different.