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Please stop mutilating the English language! The occasional spelling or grammatical error is one thing but treating the forums like a text message is something else altogether. I think you'll find other forum members will be much more receptive to you and your ideas if you clean up this aspect of your posts.

Ya I feel like I don't have enough info here. Were it a basic 911 call and I was starting my ACS protocol then ya, I'd upgrade to L&S (called code 4 here). Were my 12 lead to show a STEMI we'd bypass, otherwise L&S into the hospital since that Pt. will be getting stat bloodwork as well as follow-up 12 leads and in the event a non-STEMI is found may still end up heading to the cath lab or being thrombolyzed. However, as a CCU to CCU transport, what's the Pt.'s Hx? Course of tx in the sending facility? Mainly my question when deciding to go L&S is, is there a time sensitive treatment that will be done for my Pt. immediately upon arriving? Is my Pt. decompensating or critical and in need of resourced beyond what I can provide immediately? Generally I am very reluctant to proceed L&S to the hospital without compelling reason. The increased risk is not worth the time saved.

Correct (mostly, as Alberta uses the title "Paramedic" exclusively in reference to ALS). An Alberta EMT-A is equivalent to Primary Care Paramedic or PCP to use the nationally accepted titles. In general education to the PCP level in Canada involves 1-2 years of university level education (some provinces compress 2 semesters of material/credits into a single semester as in British Columbia). The PCP SOP typically falls somewhere within the EMT-I realm. A Canadian provider functioning at the Advanced Care Paramedic (ACP) level will have completed 3 years of education in out of hospital care with a SOP similar to that of a US EMT-P. As to the topic at hand. I prefer paired units myself. I have worked on both in a ILS capacity & in my own personal experience found it to be best practice for patient care. If a patient requires basic care that falls within a lower level providers SOP does it really make sense to tie up an ALS resource in most cases? If a patient requires higher level care would it not be in that patient's best interest to have two ALS providers working on them as required?

Just to re-iterate a particularly important point within this thread. Canadian Advanced Care Paramedics (ACPs) are no less educated than RN’s with regard to emergency care of the sick and injured. In some respects they are better educated and in fact able to perform a greater number of advanced procedures with less direct oversight. I have a great deal of respect for what many nurses do but starting a pissing match with their emergency service colleagues is poor judgement on their part. There is a lot both sides could be doing to help round out the other. Paramedic knowledge of long-term and continuing care is minimal at best in most cases, while (with the exception of nurse practitioners) nurses have very little in terms of independent care ability (almost nothing for independent scope of practice (SOP)). It is possible for the two to work together in the best interest of patients as a whole.

Perhaps you can look into your english language and learn correct grammar in your spare time. I am not to fond of abbreviations or slang such as "gr8t", is typing great out really that difficult? This is another way to write the above statements and make it look as it were written by an instructor. I want to encourage each and everyone of you here to look into becoming an instructor for the American Heart Association. It is a great way to spend your free time and it allows you to build lasting relationships with other healthcare providers. It can really make a difference on your resume. I know it has helped me to build my confidence, leadership and teaching skills. And above all it gives me a great feeling of accomplishment and pride in all I do.

Touche my friend. However, if your house burns down the fire department will come and put it out free of charge, the police don't send you a bill for helping you out if you need it, most local libraries are free, you don't have to pay to get US mail and so on and so on .... all of these things are regardless of income or how much you have "put into" the pot. Why is it that healthcare, one of if not the most basic and essential human services is not seen as so in your parts?

I tho tis wuz a blog... Didn't kno I had 2 use proper grammar. Sorry... Instructor not a professor.... But ur rite.... Betta? U hav 2 reelax..... Plus otha than tha gr8t; your point not taken.... I'm talkin bout becoming an BCLS, ACLS, PALS Instructor not a Teacher or Professor... Plus bein Asian, maff is mi forte... Lol.

I am petitoning for change in NYC; I've sent emails and letters to NYCREMSCO, the governing body for the 5 Boro's of NYC EMS. I'm asking for several revisons of our ACS, APE, Asthma/COPD, Seizures, & AMS Protocols. I want vast changes but baby steps first. I've been reaching deaf ears when it comes to EMS change. I'm asking for continued (ACS/APE) SL NTG w/o calling Med Control; we can give 3 SL in S.O.. (Asthma/COPD) Continued Albuterol/Atrovent w/o calling; we can give 3 Combi in S.O.. (Sz) Continued Benzo's w/o calling Med Control; we can given 2 doses in S.O.. (AMS) Putting back Thiamine; it was taken out over 1 year ago. What are ur S.O. & Med Control. I want to know the limit on Benzo's, NTG, Neb, & do u have Vit B1? Thanks in advance....