MedicMal

Tell that to the transfer company I work for LOL

agreed

Definitely you would resuscitate. What would be your reasoning for not resuscitating?

This question is for medics from Ontario. A friend told me she heard that if you don't work in Ontario within 5 years of getting your AEMCA that you have to write it again. Does anyone know any truth to this? I always heard that once you got it you had it for good. Thanks in advance, Mallory

vs-eh you bring up a very good point. You're absolutely right, we're not paid to assess patients. Sometimes hospitals (this is from personal experience and from hearing stories from co-workers) will send patients home who are not ready to go. I'll try to explain that better. What I mean is if we were to take them home chances are the RN/RPNs of the NH or family members would be too uncomfortable with the patient's condition and end up calling EMS to bring them back to the hospital. Or there have been situations where myself or a co-worker just felt uncomfortable transferring a patient (i.e. we were questioning whether or not the patient was "circling the drain"). More so, and I guess this is because I have the education and training, I don't want to take the patient because I know I don't have supplies and equipment to render the care needed if something were to go wrong en-route. Does this make sense? You're right transfer services are not bound legally under the MoH or their basehospital to use discretion when transferring patients and I agree it is more of a moral thing or common sense that transfer services' employees need more of. I guess that's more of the point I was trying to make. As for my situations I can think of 2 off the top of my head. 1. Hospital was sending elderly female back to nursing home. She had been in the hospital with pneumonia. My partner was "attending" who had also taken the paramedic program. She was looking at the hospital notes for hx and the most recent vitals. When she took a look at the patient she noticed her breathing was pretty fast. According to the notes the last set of vitals were taken an hour earlier and her breathing rate was 20 breaths per minute. My partner calculated 48 breaths a minute and then asked me to confirm, I got 44 breaths per minute. We then went to the staff to inform them of the increase in breathing rate. They still insisted we transfer her, so my partner called our dispatch and informed them we were uncomfortable transferring this patient. Our dispatch gave us permission to cancel. 2. This situation is different as we were picking up a patient from a residence to go to an appointment. Patient had a hx of lung cancer and was scheduled to get his lungs drained (what the family told us). Right away I noticed the patient was very pale and cyanotic. His breathing was very fast and laboured, 2 word dyspnea and his extremities were very cold to touch. I felt this patient was too unstable to come with us and should go to an ER so I convinced the family to call 911. I directed my partner to apply oxygen, and I gathered a complete history and whatever vitals I could get and relayed it to EMS when they got there.

I completely agree with vs-eh on the topic of the MoH taking over the province's system and standardizing everything. One big issue that I have with these companies employing people that only have their first aid or EMR is that they generally don't know how to recognize and evaluate a pt that isn't stable. I don't mean that ones that are obviously unstable. They're sent to pick up a pt and transfer them somewhere so that's what they do, they don't really get a history or actually evaluate if the pt is stable enough to be transfered somewhere. I've had pts more then once that were breathing greater then 40 breaths a minute, that the hospital wanted transfered home. The sprinters can work if companies put the extra money into better suspension and only equipping them with ONE stretcher. I hate the 2-stretcher trucks, its not safe, especially when you have only one person operating a stretcher. That's VERY unsafe. Just a side note: F class isn't required for transfer services because they aren't covered under the Ambulance Act.

Well I have finished the paramedic program and have my AEMCA, but I have not worked as a paramedic yet. I have however worked for one of the GTA transfer company's you're referring to. I do get and what you're saying and somewhat agree with it as well, but I would like to add some points. Ambulance Style vehicles- as I was working for a company that utilizes the dodge sprinters, I have to say they're not very good. They do have lots of room, that is if you don't put 2 stretchers in them. Cuz with 2 stretchers there is about 7 inches of room between them, and doesn't make a pretty picture if you have to attend to one of the pts (because they coded or vomited, etc). Not to mention they have next to no suspension brand new that wear out altogether after about 50,000 kms, which makes for a VERY UNCOMFORTABLE ride for pts. Maybe if the company spent a little bit more to add the proper suspension and only had 1 stretcher then it wouldn't be so bad, but at the company I worked for I didn't like them. I do not have a problem with them using the ambulance style trucks, I actually prefer them. After all they are transporting pts and are classified as healthcare professionals. I do have a problem with them making themselves look like EMS ambulances and having words like "paramedics" or "critical care patient transport" written on them, because like what was stated its a misrepresentation. Especially when you only need standard first aid and cpr certificate to work for the company. I think they should just clearly state "Non-emergency Patient Transportation" (some do). As for the lights- It's illegal for them to have forward facing red lights. I don't disagree with them having the lights, but I do disagree with the forward facing reds that some companies don't bother to remove/change. At the company I worked for we sometimes had to pick up pts at the Airport that had to be transfered to a hospital, and to enter the runway area we had to have our emergency lights on. Not just our 4-way flashers, they wanted everything on. So having the lights on the trucks are sometimes necessary. Uniforms- I disagree with them looking exactly like paramedics, but I don't disagree with the reflective striping. It comes in handy when you're working at night, for safety reasons (in driveways, parking lots, if you've come across an accident and you render care until EMS arrives, assisting EMS, etc). I think tac pants and a golf shirt would work good. If you've done the paramedic program and work for a transfer company and choose to wear your utility belt and stethescope, I see no problem with this, after all they know what they're doing with them (usually lol). I do have a problem with the people who only have their first aid or EMR (remember Ontario, EMR here is a weekend course) and chose to wear these items, which most of the time is simply because they want people to think they are paramedics. I personally didn't wear my utility belt or stetchescope, but I had them in my bag in the truck just in case. My issues with transfer services: - the people who work for them who only have their first aid or EMR and call themselves paramedics - trucks not being properly stocked. You want the public to view you as healthcare professionals, then you should have the supplies and equipment to back that up - the fact that you only need first aid and cpr to get hired on with these companies. You should have at least your EMR. My true feelings are with the topics that have been discussed before about the MoH taking over transfers, almost like a sublet of EMS. Especially these days when its so difficult to get a job in EMS, pay $10 less and hire these grads to work transfers until they get a job. Not to mention regulating the system, and I could go on, but it's off topic. Anyways, thats all I can think of for now.

I highly recommend competing, if for nothing else, a good time!! I volunteered at this event for the 2 years I was a student at Durham and its a fun time.... the scenarios are usually pretty wild too! MedicMal

I was taught the 4 F's for cholecystitis as well. Just one difference: Fat Forty Female Fertile MedicMal

Be safe AK MedicMal

Oh geez, I didn't even know there was a Canadian EMS mag :roll: LOL MedicMal

code

Yeah I have no clue what is going on either LOL MedicMal

Well said Rid!!! MedicMal

I think enough has been said here. I can see that this is going to be a big he said/she said game and finger pointing. This issue is dead and in the past, just leave it be. All that is going to happen is people attacking each other, and there is already enough of that on this board. Please just let this issue rest in peace. MedicMal