Leaderboard

Holy Crap batman!! 15 weeks.... no wonder they call it a Paramedic SPECIALIST.... Special indeed! Let me put it in perspective, and you can make your own choice (OP)... I recently graduated from a 2yr Diploma course at the University of Alberta. That was, however, after doing a 1yr EMT course, 10mon Intermediate course, then 1yr of pre-requisites. Yup... 4-5 years of education. So the question you gotta ask yourself is this: What is most important to me, getting through school fast, or providing my patients with the best possible care I can by ensuring I am highly educated for my position? Only then can you look at schools IMHO

The problem with patients with psychiatric disorders is that it's all dependent on the patient, the disease, and recent history. Just the presence alone of a psychiatric disorder shouldn't ever be enough to demand, dictate, or provide any form of restraints (To show the, erm, insanity of that extreme, would you sedate a patient diagnosed with alcoholism or someone with a phobia and nothing else? Both are in the DSM). I think another issue with EMS and patients with psychiatric disorders is that the EMS training seems to be confined to no restraints, 4 point restraints, and chemical restraints. While this is fine for the acutely ill 911 patient exhibiting active threats to themself or others, it's a completely inappropriate mindset for interfacility transports. For the "might become violent" (especially the ones who are compliant and cooperative at time of transport), did you consider alternative restraint methods? Maybe a vest style restraint (i.e. poesy vest) might have been appropriate. Another thing to think to consider is what are the trigger points (if any are known) and the patient's recent history. A patient who was combative a week ago prior to starting (or restarting if non-complaint) medications might not be a likely threat today because of the medications. Similarly, a patient who is being restrained 'just because' might view the application of restraints as a threat against themselves, and respond in an appropriate manner.

I thought it would be fun to post whacker gear. Things we run across that are funny etc... Here is something I found on craigslist looking for some work pants. http://denver.craigslist.org/tag/1842515430.html

This CTV story is a bit misleading. At least for the time being, many Ontario PCPs (outside of Ottawa) are still doing IVs.

I agree with this as long as the crew isn't making the jump of 'positive psychiatric history means the patient is de facto a danger regardless of what an actual assessment shows.' A patient who is an immediate threat to themselves or others due to disease or disorder, including psychiatric illness lacks capacity, including the capacity to refuse medication needed to stabilize their condition. A patient who is violent while off their medication but is currently is medicated is not a de facto threat who lacks capacity though.

I think what we need to remember here is that there are a number of factors involved. Firstly the assessment must be made of the patient & the possibility (probability) of them causing actual harm to people. Whats to say that a normally sane person, with no mental health history doesnt freak on a helo or aircraft? Secondly we need to remember that they have a diagnosed illness. Just as a person with Cardiac Illness, Respiritory illness etc. They still deserve to be treated with respect. We need to ask is chemical restraint the most appropriate first action for mentally ill patients, or would a mechanical restraint be more appropriate. Mentally ill patients have the right to refuse medication, they also have the right to refuse an injection, or any meds we want them to have, just like any other patient. Coupled with the fact that a proper psych examination cannot be done until the effects of any drug have worn off, therby delaying proper assessment. Surley this is not in the best interest of the patient. Mechanical restraint can have a calming effect on the patient, allow for an earlier assessment & for appropriate treatments to begin. They also offer suitable protection to staff & if necesarry, lower doses of chemicals for further restraint.