Arctickat

In that case the fetus is already dead long before I arrive, so I might as well try to save the mother. As to the previous post about the medic who did the C-Section in the field. Lucky for him the baby lived. Had it not no doubt that medic would be penniless from all of the court cases for conducting a procedure out of his scope of practice. Not even medical control can authorize something like that. If loading and running like hell was the best practice for cardiac arrest we would be doing that every time rather than sitting on scene running a code. I stand by my treatment

Congratulations, you just described every hospital emerg within a 60 mile drive for me. I stick by my answer because anything we do will be done at the hospital, we will just be able to have it done sooner and arrive at the hospital in time for them to consider alternatives.

The best chance of survival for mother and baby is for me to stay on scene and work her. The time my patient loses by running BLS to out local hospital will be wasted. The nearest facility capable of a c-section is over an hour from me and the nearest NICU is over 2 hours. There is no helicopter service available at all. More than likely, they are both dead.

Interesting...one wonders, what would have happened if this had been a male social teacher and two female students? I know, it's a "what if' but I have a feeling it would have been a far louder outcry. Or, "What if" the two students had been white instead? The black community is still quite acutely aware of what slavery did to their ancestors, but do that to a couple of white kids and see how they perceive it.

All good points tniuqs, but here's how I see it. Over the past five decades, EMS has progressed from the meatwagon system to one of highly trained professionals who are able to provide advanced medical skills to the patient to save lives. Treatments commonly performed in hospital have trickled down over time to be done in the ambulance. As technology becomes available, smaller, and more portable it tends to make its way to the ambulance. Defibrillators, IV punps, and transport ventilators are all such examples. As technology continues to evolve into the EMS field, so to do the treatments a medic is able to provide. What did we do with hypoglycemics before we could do a blood glucose check in the field? Many EMS jurisdictions want to use thrombolytics in the field but the powers that be are still reticent because they don't feel a medic has the adequate training to interpret a 12 lead and if one should be sent to the cardiologist for confirmation, the cardiologist still doesn't get the whole picture; also, consider the time this takes to complete. Fax 12 lead, hospital tracks down doc, he reads the 12 lead and gets back to you. Having the ability to conduct a prehospital lab test, whether by ISTAT or the less expensive IVDDs provides one more weapon in the medics arsenal to confirm or disprove the presence of a myocardial infarct. It may even be considered that the medic will then have enough information to be able to determine if thrombolytics are appropriate and have them added to the protocol without having to consult a cardiologist...med control of course, but not the specialist. The problems with the ISTAT is the cost, that the cartridges have to be refrigerated, and it can only do one test at a time. 10 minutes for trops, another 10 for CK-MB, and so on. The IVDDs can do all three in 5 minutes, can be stored at room temp, and have a 2 year shelf life. Studies listed at AHA and medscape confirm that giving thrombolytics sooner is better than later, the Assent III plus is one example. ExTRACT-TIMI 25 is another. To have the added tool to confirm that it is being used properly is just one more piece of technology that will advance prehospital care.

About 6 bucks for the TnI test and 25 bucks for the combined TnI, CK-MB, and Myoglobin

Canada doesn't have a federally operated healthcare program like Medicare. Healthcare is the responsibility of each province. As far as your rates go, we do have a billing policy in place if multiple units are required for a single patient.

I was admiring the planetary alignment last night. Pretty cool. No Northern Lights here so far, still waiting to see them.

Crotchity, you're in Canada aren't you? Since when do we need to lobby a United States health care compensation program?

Yup, we call it the "Code Two Club" Considering I'm on duty 24 hours a day but get to sleep in my own bed, i have to say yes. Also, since my wife became an EMT after we got married one could say I am sleeping with a co-worker. You trolling for a date crotchitymedic1986? What about gay medics? Why can't gay medics be included in your poll?

Holy, if you're this antagonistic towards someone who agrees with you I'd love so see what happens to those who dare to disagree. I'll go make some popcorn. I know perfectly well who appointed the Puppet General, perhaps you need a reading lesson there tniuqs, I said I was hoping, she would, not that I said she would. She is also married to a Quebec separatist who has close ties to the Parti Quebecois. Once she's appointed to the Puppet General office, she can't be "unappointed", so she doesn't have to do the bidding of the Liberals, but I'll bet her hubby will be hell to sleep with if she crosses his party. History door swings both ways, don't let it hit you in the ass on the way out.

The only problem I have with people on soap boxes is that they THINK they know all the facts. For example, the Toronto Stock Exchange hasn't been known as the TSE for years. It was changed to the TSX, as for the lowest level in history? pfft, Even I remember it being below 6,000. What do these have to do with the political agenda of the writer? Nothing, but it does speak to the reliability of his "FACTS" I'm surprised that message didn't come with a note claiming you will have bad luck if you don't pass it on to 10 friends in 5 minutes. Politicians are of a breed alone, backstabbers and backroom dealers. No, I don't like what the Liberals and NDP are doing either, then again, I didn't vote for Harper. One wonders though....is the Liberal leadership race still going to happen if Dion becomes PM? I'm hoping the Gov Gen dissolves parliament, either way, it's a no win for the Liberals.

I scored 156, I am smarter than a Stephen Harper. Thank you Mr. Foxworthy.

Exhaust fans too

http://www.news.com.au/couriermail/story/0...from=public_rss AMBULANCE officers are being called out to treat sunburn and shaving rashes - despite a $400,000 awareness campaign about the correct use of 000. Fed-up paramedics have told The Courier-Mail they have seen little change in the attitudes of patients about the appropriate use of the emergency number.

I don't think it will replace the blood tests in the hospital at any time in the foreseeable future. These tests are qualitative, not quantitative, but I can see them being used in the field as regularly as an ECG. The most comprehensive test I have provides positive readings if: Cardiac Troponin I exceeds 1.5ng/ml CK-MB exceeds 5ng/ml Myoglobin exceeds 50ng/ml A positive reading is indicated by the simple appearance of a line for the control and one for each marker, a negative reading by the appearance of only the control line. My understandings of cardiac markers is that they take some time to appear and return to normal. I believe I have a previous post in here regarding the time it takes for this to occur. These tests will provide positive results only if each of these markers is present in the blood stream at sufficient levels as noted above. Any of these levels indicates muscle damage, especially the troponins. PM me if you'd like further information, I can send you to the website of my supplier.

The tests that I use actually give results in about 5 minutes and should not be used as a reference after 20 minutes, but as I have stated before, they are blood tests, not saliva. I never wait around to make a transport decision based on this blood test, but it is always ready by the time I radio into the ER with my report. Usually what I do is a small blood draw off the IV start. If the patient doesn't warrant an IV start, then I don't do the blood test.

Thanks Doc, I knew something didn't look quite right with those x-rays, but I couldn't quite put a finger on it. A little slow this morning.

Fortunately for those without insurance there are no EMS operators with the courage to try it. Not many people can afford a $5000.00 ambulance trip to the tertiary centre. It's moot anyways, the rates for ambulance services are determined by the Ministry of Health, not the individual operator. A private operator out here couldn't raise his rates even if he wanted to. Besides, how would you like to go to work for your four 12 hour shifts and do about 4 calls a month? Pretty boring job if you ask me.

Because to properly staff the ambulances they would need to pay 300% and that kind of money just isn't realistic unless user fees are also tripled. then no one would call the ambulance, call volume would drop off, and the service would be shut down because of a lack of calls. Your part time job sounds pretty much exactly what we deal with. 350 - 400 calls a year. Roughly half of which are transfers to a tertiary centre lasting anywhere from 7 - 10 hours on average depending which centre we go to.

Actually, we are only required to report for duty at 0930 every morning to ensure the ambulances are properly equipped and cleaned. Typically, we sit around and drink coffee for a couple of hours, maybe do some con-ed. By noon we are all at home waiting for a call to come in until 0930 the next morning. Do you get paid full time hours to go home and sit around? Maybe even work a second part-time job that permits you to leave for a call? We're still required to be on air within 7 minutes of being dispatched, but in a town of 1000 people, it's a short drive back to the office. To be able to have a unit staffed with people at the base 24 hours a day would cost about triple the current gross annual income of the company and be a waste of money. As things stand now, I make about $85,000 per year, the basics are making over $62,000.

I'm a pilot, although not rotary wing, I do have some insight. This http://www.tc.gc.ca/CivilAviation/commerce...39/section9.htm is the Transport Canada Guide to Air Ambulance Operations for helicopters. I will see what else I can find, I'm looking through the CARs for more information. Waht i do know is that they must still follow the weather minima for VFR flight. At night, that can be difficult.

Then there is mine, paid $21.61/hr for 8 hour days $2.19/hr for 16 hours standby, any calls taking place in that 16 hours is paid at $32.46/hr

Exchange rates cannot factor cost of living and are not reflective of living costs as money is bought on the exchange based on desirability. An oil change costing $40 CAD a few years ago at the exchange rate of .65 still costs $40 CAD while instead of costing $27 US at the old exchange rate cost $33 at the US current exchange rate. The only relevance the exchange rate might have is if someone from the U.S. decided to work in Canada but live in the U.S. As to the previous poster, he makes a good point. Annual wage is not as relevant as the hourly wage. Fresh out of school new EMTs make $21.611/hr new medics make $26.413/hr. I guess it depends on what the shifts in Atlanta are like and how many hours are required to work to make that wage.

My medics start at about $52,000 a year but they also get at least 20 hours a month in overtime which equates to another $10,000 or so. Basics start at about $43,500. As well as a cost shared benefits and retirement package.