HellsBells

My real problem with these LTC facilities are the facility Doctors that seem to be chronically absent, or advise that a patient be sent to the ER after a phone "consultation." Otherwise, the video is really funny, even if the lego guy is a fire fighter.

We have two main bags that we carry: Our main bag/jump kit contains: Main Compartment: - Oxygen Masks: cannulas, NRB's, NEB's, simple face masks - Meds: all ampules and vials, RSI meds, and preloads Front Compartment - IV kit - Saline bags: 1 100ml, 4 50ml, drip sets Rear Compartment: - Trauma dressings - BGL kit - Thermometer - pen light, gloves, cold packs side compartments: - various BP cuffs - Sharps container The advanced Airway kit: - Intubation Kit - Cric Kit, PTTV kit - 1 adult, 1 ped BVM with inline filter and various sizes of masks - set of 7 OPA's - LMA's - second set of airway masks - Ventolin MDI's, PEEP valve - Battery powered suction Personally, I don't like the layout of our advanced airway kit, it is so full of eqiupment that it barely zips closed, and its often a pain to dig through all the stuff inside it when on a call. We also carry a D size O2 tank in by hand, and use the LP12 monitor.

Good, Its about time, its just too bad that it took large budget cuts to get an ambulance service out of the Taxi industry.

I agree with Phil, why are the FF bitching to the paper about this? This is something that should go up the ladder through management. The most ridiculous part of this story is that the FF's have no numbers to back up their claims. Maybe if they could make a case stating the number of calls EMS is dispatched first, how requently it actually occurs, how long the average delay is, and how much property damage is estimated to have occured due to delays. Furthermore, if it took EMS 90 days in 2004 to realize that this dispatch software sucks, why is Fire still using it six years later?

The issue of administering free needles to drug users stirs up quite a bit of controversy wherever its tried. There is a lot of debate over the issue in Vancouver right now as to whether free injection sites should continue or not. Personally I'm torn on the issue. On one hand, I think that the idea of providing a safe and clean space for junkies to use should reduce morbidity and mortality amoung them. It also allows health care workers to monitor these people and provide information about rehab programs that they may not have access to out on the street. As far as the pamphlets go, I think that $32,000 is a small price to pay, as even a single person admited to the hospital for treatment of chronic diseases such as HIV or HEP C could cost hundreds of thousands of dollars. However, I think that Herbie (no flaming from me, I promise) has a good point. What is the point of having laws against drugs, if we are going to look the other way, and offer a kind of backhanded support to illegal drug use with things like safe drug injection sites and informative pamphlets? If that is the case it would be much more ethical, not to mention logical, to just decriminalize the whole mess and have done with it. But... the chances of that are slim to none, as long as America has its death grip on "The War on Drugs" even the mention of decriminalization is political suicide. Even up here in liberal Canada, we couldn't even get weed decriminalized (although we came close).

There is no doubt the underlying issue needs to be fixed. The same can be said for almost any pt we transport with oxygen; 02 is not going to fix the underlying problem in an MI, GI bleed, or hypovolemic trauma pt either. Yet, it is still good practice to provide oxygen to these pts

This might be a little off topic here, but I'd just like to make a comment on the olympics in general. I have found that the olympic games exist soley to enhance the glory and profile of the IOC and in this case COC, and VANOC members. Its certainly not about the world class athletes that participte in the games. Not only has this nonsense with BC ambulance left a bad taste in my mouth, but the corporate ties also seem endless and in my opinion inappropriate. The most ridiculous being Mcdonalds and Coca cola. I know that there is a long standing connection between these brands and the Olympics, but I find it ironic that two junk food companies are the official sponsers of a world class athletic event. Then are is the controversy with the new design of Team Canada hockey jerseys. The IOC says that the hockey federation logo can not appear on olympic jerseys, so now the new jerseys are selling like hotcakes @ $130 each for replicas. Ten percent of that goes to Hockey Canada, the rest? Back into Olympic coffers, not a bad payday. I know that it costs a lot of money to run the games, but the corporate sponsorship seems overwhelming and in my opinion, sucks all the fun out of the event. So this latest scandal with BC ambulance just takes the games one step closer to complete irrelevance.

Fair enough... but with all due respect, its not scientific, not at all.

Care to share with us? don't really know what it could be it seems as though the following have been ruled out - asthma, no wheezes, no Hx of same - Allergy, no previous Hx, no other signs/symptoms - Epiglottitis- Seems to be ruled out after Mobey asked about drooling So... what are you getting at? a foreign airway obstruction, as chbare mentioned?

Well Sifaliss, I do agree that a rural BLS service gives more of a leadership role to the new EMT, obviously there are certain limitations, as I've mentioned above. I don't know that one system as particularly superior to another, as all we have to go on are personal opinions. However, it would be interesting to do a scientific study on practitioners in the rural vs urban setting. Criteria could follow green EMTs at certain times into their career, i.e. 3 months, 6 months, 1 year, 2 years etc. We could gauge their ability to run a call, perform certain procedures, such as IV skills, BVM ability, medical knowledge, communication, and so forth. Of course there would have to be some strict control procedures to follow, but it might help to move the discussion further then individual exeriences and opinion.

I happen to work in Calgary at the moment, as far as hiring goes, I have no idea what is going on with recruiting, but they just released a new batch onto the streets. So I imagine there will be another posting fairly soon. Hrm... Ive heard the idea that the rural area is the best training ground for new EMTs many times before. I'm not sure that I believe it. A green EMT is a green EMT, no matter where he starts. Calgary seems to be chronicly understaffed, and many brand new EMTs are hired here right off their practicums. Some do well, and learn fast, others don't. A previous poster said that an EMT learns to communicate better in the rural setting. Would you care to explain the reasoning behind that? Please don't tell me its because they get to spend hours on transfers chatting up old ladies. I think the multiple patient interactions, frequent reports to nurses, increased exposure to doctors that occurs in an urban setting is a great way to improve communication skills. I'm not attempted to bash rural services here. I started out in one, and have very fond memories of my time there. However, I think that Mobey brings up a very good point when he mentions the low call volume in certain areas. How is it an advantage to a new practitioner when they do maybe 4 calls per tour? I will admit that there are certain skills to be learned when tranports are longer and back-up is limited, but that has to be weighed the actual number of calls as well. As for this idea that an urban EMT simply rests on his laurels, letting the Paramedic take the weight of the calls? I can assure you that is not the case, at least in the service I work for. All new employees of the city are expected to learn to SOP and protocols for the city, including the medications, and ALS procedures. So, I think it safe to say there are a different subset of skills one can learn in urban vs rural setting, one can learn what they need to learn in either setting. But to say an EMT learns to communicate better in a rural setting? That is utter nonsense.

...Versed is sooo Gay. Anyway, Versed is the only benzo we carry in Calgary. It seems to work just fine for seizures, and of course we use it for RSI, and sedation as well. It really seems that many systems in this neck of the woods are going away from valium use. However, I would love to see Ativan SL tabs in our service to settle some agitated pts. ...Oh and one more point about Versed, we currently have a Paramedic student from Nova Scotia who says the only drug they use in their RSS protocol is Versed, no analgesic at all.

Hey Mobey, how are ya? I'm curious, are you aware of any services in Alberta that use ETC02 in non-intubated pts?

YES, that is an example of better care. Not waiting endless hours to see a doc, is better care than waiting hours to see a doc.

This is a ridiculous argument, and I think you know it. There is a difference between getting good health care and having luxuries in life. Health care is not a luxury, its a basic human right. If you're driving a Ford Focus you still get decent safety features, and have reliable transportation. Eating Ramen Noodles may not be the healthy choice, but it is still possible to eat decent food on a budget without going out to restaurants multiple times a week. However, if it costs extra to see a good doc and receive competent, timely care that the poor don't have access too, then we are talking about a different matter altogether. To answer your question, yes that is elitist. Oh, and by the way, you know those people who can afford the Lexus and that go out to eat the fancy dinners? They are elistist too. The difference is, buying an expensive car doesn't affect the quality of the Ford Focus.

I sincerely doubt that the volume of the siren is the only reason for the number of accidents in the state. In reality the number of accidents from one year to the next doesn't really provide enough information, it may just be a statistical anomoly. Data from the last five or ten years may paint a clearer picture.

I wont rain on patch your business, if you cut me in for 20%

Good for them, hopfully more pickets of this nature will shame the government into bargining in good faith.

Honestly, so fucking what? I'm sure we have all been exposed to MRSA+ patients and even known it. It would be interesting to do swabs on all persons who have been in health care for 5+ years and see just how many are MRSA+

I think I have had this debate with you in the past as well Mobey, and I have to side with tniugs on this one. The change of title in this province is a bad idea. Its not a problem from my perspective, I could give a flying funk if we are called ACP or just good old paramedic. The thing that worries me, and worries me a lot is the reason behind the title change. I beleive that the public does know the difference between EMT and Paramedic, and that is an important distinction, because although he doesn't know exactly what the difference is he is aware that a paramedic can provide a higher level of care. So, when his loved ones are sick John Q Public feels secure knowing a Paramedic is in his community and will respond to his home when needed. Now, it is unlikely that he will pay enough attention to the certification of EMS to learn the distinction between Primary care and Advanced care paramedic. The magic in the title "paramedic" alone will soothe him and bask him in the light of its warm glow. He may even think Primary care Paramedic? What a great idea, the patient is their "primary care," in other words, the paramedic's "number one concern." Now, imagine a government run health service, taxed with the burden of finding creative ways to cut funding. They have promised not to degrade the level of service in EMS and maintain Paramedics throughout the province. How can they cut costs, but maintain paramedics? Simple, with a quick title change, they can hire more PCP's, pay them less, and guess what? Overnight, every single EMS attendent in Alberta is a paramedic! What a great and benevolent leader AHS will be. Of course there will be some bleating from the unions about the scam the govnt is playing on the people, warnings that people will die, facts and fiqures that show the difference between the two levels. AHS will respond by acusing the unions of greed and hypocracy, paint them as villians angling for a raise in a recessian. Some people may listen, but eventually the fighting will die down and the new titles will remain. Here is a good example of the publics perception of EMS in B.C. I was having dinner at the home of a colleauge who is a registered Alberta Paramedic (ACP). His father in law was visiting from B.C. and asked why we had such a backward EMS system where only some personell are paramedics and the rest are EMTS, because in B.C. everyone is a paramedic. My partner did his best to explain the difference between the PCP/ACP for about ten minutes, was met with a blank stare and the statement, "OK, but I think care is better in B.C. because we only have paramedics."

I had the same response as tniuqs, where is the evidence? I would seriously be interested in reading about harm caused by vaccines. Or is this the knee jerk "the flu vaccine made me sick" or "vaccines cause autism" reaction?

If you have worked in research for 25 years, then surely you know that sound medicine is based on dispassionate scientific study, not an overly emotional response. Certainly you must realize that the link you provided has no scientific merit, its an opinion piece that states only a hypothesis- the "cytokine storm" theory- is the cause for mortality amoung the young. In fact, it states numerous times that more research is needed, and the only tangible evidence stated is the rather underwhelming fact that "proinflammatory cytokines are elevated in the presence of influenza infection," basicly informing us that the immune system responds to infection. Although an interesting, and possibly correct hypothesis, your "example" falls far short of answering your rather haughty query of how the virus works and how it effects the immune system. I'm afraid that with your lack of compeling evidence, tnuigs will not, in fact, back off. Lastly, I believe that Health Canada has been quite dilligent about ensuring that this vaccine is safe, which is one of the reasons it took longer to be released here than in the USA.