HellsBells

Yeah, in the Calgary we haven't used antidysrythmics in routine practice for quite some time, I wonder if an argument could be made to remove even Epi from codes, as it doesn't seem to translate to an increase in pts getting out of the hospital alive.

I just bought a house, most of my money is tired up in the downpayment. However, as soon as I can I'll be donating some money. This is completely ridiculous. These bastards are out for a payday, plain and simple. I wonder if this company doesn't have some mob connections, as this is a shakedown, right out of the gangster playbook. Good on EMT city for fighting this injustice.

When I was an EMT working for a BLS service, we had a similiar situation involving a truamatic arrest MVC, the pt had agonal resps on scene, and by the time we'd moved him into the ambulance he coded. After approx. 30mins transport time to the hosp he was treated with ACLS drugs and an AED, after which he regained a pulse and lived for approx. 24 hours. I agree completely that it is of benefit to the family to be able to say goodbye to their loved one. However, I disagree that it was the AED that specifically brought the pulse back to these pts, but the combination of ACLS drugs and defibrillation.

...Having recently wrote (and passed, woot!) ACP's paramedic exam I have to stay that it was a fair testing process. The written seemed to ask fair and straight forward questions, and the practical scenarios were not too difficult. There were not many of the obtuse and unanwerable questions that so many often complain of. Now, of course I still have a huge beef with the cost of the exam, $750 still seems excessive to me. Additionally, some of the material left off the test was simply stunning to me; no questions on 12 lead ECG's at all, very few questions pertaining to ACS, and only a handful of pharmocology questions. Ironically, there were numerous questions, perhaps 10-15 on the application of NG tubes. However, despite my numerous issues with ACP as a whole, I was quite pleased with the testing process.

I have to agree that zzyzx's Dx of sepsis sounds like the most appropriate: - fever, flushed dry skin - pulmonary edema - altered LOC, apneic spells- due to increased ICP from cerebral edema? - Bulging Eyes- occular edema I would also be keeping a high level of suspician for menningitis.

Ok, after my little rant, I noticed that ACP has, in fact, posted the financials on their website.

I completely agree, in regards to AHA. Before taking an ACLS course, I had a valid CPR cert from red cross, but had to retake my CPR from AHA in order for them to consider it valid. As for the original topic, I can't really comment, as I don't know the specifics.

Hey thrutheashes, if you could pm me about the financial statement, I'd like to see a copy of it as well. The fact that they wont release any financial statements other than at the AGM is complete rubbish. It seems like an excuse for them to avoid accountability. It is hard to go over an entire document while sitting at the meeting, then have to formulate solid, probing questions in the few mintues to hours while other college business is taking place. If they were truly interested in tranparency, they would release the documents for review prior to the meeting. Does the document make any mention of the total dollar fiqure spent on the CBT boondoggle specifically?

Wonderful, gald to see that our college is making good use of our ever increasing membership dues. Any explanation as to why it was cancelled?

FL medic, can you share the source of that data? I'd be interested in reading it.

Based on the fact that Lifeguard mentions PCP training, an EMR scope, and a strike, I'd say that he is from British Columbia. I don't really understand the problem with the scenario he is posting here. If the OP would be so kind as to clear things up a little, I'd like to ask a few questions. First off, did you actually need 3 people to be present in the testing area to perform this task? Or did you have to mention that, theoretically, you'd use 3 people? Secondly, I don't understand the positioning you're speaking of, why would you hold the pt in a lateral position, manage the airway, then place him back into a prone position? Would it not be feasible to roll the pt directly onto a backboard and manage the airway from there? Finally, what part of this procedure did the instructor not teach? How much instruction on airway management were you given?

So, I didn't have a chance to make it to the AGM this year. For those of you who did, anything interesting happen? Tniuqs, Mobey, whats the gossip?

It seems like this is more of a cultural problem, as the citizens of Alberta drink copious amounts of booze, both beer and "sickly sweet" rum, and I can think of maybe 1 incident in the last 5 years where EMS was attacked by revelers at a pub or nightclub in this province.

The Flock of Seagulls song comes to mind... "and I ran, ran so far away" Seriously, If your planning on going to EMT school in Edmonton, I'd suggest NAIT. They are a solid school with a good reputation. I don't know when their program starts, however. So, if you really, really want to start in July, then maybe CC of EMS is your only choice. They are still CMA approved for the EMT program, but recently lost approval for their paramedic program, so obviously there are some problems with the school. They have had a bad reputation in the past, but perhaps, as you say they have made some changes, and a bad rep is hard to shake. However, I'd be very careful going to this school, and you may want to ask them specifically what changes they have made to make the program better. Good Luck.

I think that this applies more towards football helmets, where one can unscrew or pop off the mask. Most motorcycle helmets, with the exception of the skull cap variety, have visors or face sheilds that make it difficult to access the airway. Although I will admit, with the snug fit motorcycle helmets can be a challenge to remove while maintaining C-spine. However, it seems that he wasn't wearing a helmet, so no worries. So... In light of the new information, lets alter my Tx somewhat: - Bleeding Lac on skull- have a co-worker apply direct pressure, unless there happens to be a skull fracture, then an absorbant bandage should stop the bleeding, as its unlikely to be arterial. If worst comes to worst, some quikclot could be used I guess. - Trismus- start with an NPA, Bag through there if possible. Seeing as how the dude is a little blue we should consider an RSI- right there on scene. - Agents would preferably be Ketamine and Succ. Or Fent/Succ - Depending on the pts, Airway and LOC status, this may be one case where we go directly to SUCC and intubate

- Have a co-worker/FF take C-spine control - Make sure someone grabs the Longboard, c-pine eqiupment - If helemt allows access, open airway, insert OPA - Quickly check back for trauma, wounds and roll pt onto board - Remove helmet while maintaining C-spine - Assess LOC, ABC's, Vitals - support ventilations with BVM 8-10/min 15LPM - Secure on board, Move pt into ambulance - Alert Air Medivac- Dependent on duration of trip - Repeat Vitals, assess LOC cut away clothing - Bilateral IV @ AC, as large bore as possible, fluid bolus to 90 systolic- as needed - BGL, Temp, Monitor, End Tidal C02 - Rapid Tranport- or air transport as warranted - Bilateral traction splints to femurs - Consider intubation - Patch level 1 trauma center I'm probably getting ahead of myself, as all the details of the pts condition have not been revealed yet.

The bottom line here, I think, is that a service should have a reliable system in place to find an address. Whether it be GPS or map books is irrlevent, I personally like the CAD/GPS system we have, it is a lot easier to use than a map book, but it is computer tecnology, and technology can fail. When that happens, our units have map books as back up.

Well Mobey, you and I are out on the other side of this program now, any closing thoughts on the program? Would you still recomend it to prospective paramedic students?

I think there are distinct advantages and disadvantages to GPS. For the past 3 years I've worked in a city of a million where we use GPS. In that time, I can think of about 3 occasions where it has gone down. The system is very reliable and very precise. I agree that area familiarization is a great advantage to crews, its not always possible in larger urban areas. Our system has become increasingly busy, and often we travel out of our zone to cover far flung parts of the city. I personally have a good sense of all the major routes and roadways in the city, but it would be impossible to have an intimate knowledge of all the smaller neighbourhoods within the city. Wirh respect to the Fire Dept., they typically do not leave their service area, so there is no excuse for them not to be familiar with the area. However, it comes as quite a suprise to me that FDNY doesn't use GPS in their ambulances, particularly because they are facing much larger call volumes than my city, for instance.

Looks like the ST elevation is nearly global, so perhaps pericarditis is the culprit. Any increase in SOB when he lies back, as opposed to sitting? Temp? What does auscaltation of the chest reveal? Perhaps a chest x-ray is in order? Med Hx? Allergies? Meds? Oh, and for the moment lets also put the kid on a nasal cannula @ 4LPM and gain IV access, get a BGL and draw blood.

Perhaps this topic should be brought up at the next AGM?

I'm afraid that the crew here did the hatchet job on themselves They put themselves in harms way by parking within line of sight of the scene, then made themselves look foolish by not treating the pt when he was brought to them. If the unit had been parked four blocks away and out of direct line of sight, then there would have been no story for Fox to do a "hatchet job" on.

Not sure what this story has to do with sexual harrassment. As to the originial question, what is the sense in reporting this guy? He told a joke to a coworker, who admitted he wasnt offened. Where is the harm? Some people have far too delicate of sensabilities these days. That said, I don't think anyone can be held responsible for his death, as there would be no reasonable expectation that the compliant would lead to suicide.

They do, Just looking for additional material. if any is out there.

CJA brings up a good point, I also find the search function here to be terribly difficult to navigate through. It seems to be far to inclusive, and returns way too many results. There have been a few occasions where I've given up in frustration after sifting through results that have seemingly no relation to my search query. Is there anyone else who has encountered this issue? Is there a way to narrow the search I'm not aware of?