Dustdevil

Why are you so hung up on dodging the question? And every other question we have asked so far. [stream:52e6609944]http://www.destgulch.com/movies/luke/luke18.wav[/stream:52e6609944]

Me neither. I am wondering who is being called an EMSA hater here. I said nothing disparaging about EMSA. :?

Haha! You took the words right out of my mouth! :thumbleft: Seriously, you're just joking with us, right?

I think it *might* be a factor in your favour when applying for a position to already be an ACP. It sort of complicates matters though. If you apply as an ACP, you're probably not going to get hired by the big boys if you have no street experience. If you apply through centralised testing as a PCP, then the ACP creds may well be that little something extra that gets you hired over the next guy. But you'll still just be a PCP. And let me tell you, bro. Working below your educational level is an extremely frustrating experience that most people can't handle for very long. You'd be miserable. On the other hand, you're one of the smartest guys in your class. You're going to come out of school with good marks, good understanding, and a high score on the AEMCA. You're more than likely going to find a PCP job pretty soon anyhow. Certainly sooner than you could finish ACP school. So, all the way around, you are probably much better off going straight to work after PCP school. Very dependent upon where you are looking. In the GTA, the application process is definitely a LOT easier for ACP's than PCP's. But beyond that point, the selection process probably isn't a lot easier. Especially with no experience. Look at it from the agency's point of view. They are going to have to invest just as much time and effort into training you as they would a new PCP, yet pay you more. Why would they want to do that? If you move out of the GTA to a service a little farther away from the glut of schools, then yes, you will probably find it easier to find an ACP job than a PCP job. But the short answer is, you probably won't find yourself a whole lot more marketable as an ACP with no experience than as a PCP with no experience. In most cases, this theory is very overstated. The belief that rural medics are usually less experienced is one of the biggest myths in EMS. Do county services make fewer runs than urban services? Sure. But they also have proportionately fewer ambulances, and consequently, proportionately fewer medics. That means that things come very close to evening out, and you as a medic are still going to be making a good share of runs. You are also going to be caring for patients for much longer periods of time because of the increased transport times. Any difference in run volume is more than made up for by the length of patient contact and treatment times.

It sounds like some idiots set out to produce a document that discouraged FD's from training their monkeys to be paramedics in order to protect their EMS turf. While that is a very admirable premise, the way they have gone about it was stupid. Predictably, it is backfiring on them. Instead of proving that we don't need ALS firemonkeys, people are seeing it as an indication that we don't need ALS at all. So yeah... this has Stout's stench all over it. And the fact that EMSA was the primary source only solidifies that impression.

Well, as with the rest of this entire thread, I still have not the slightest idea what you are talking about. :? I am neither criticising you, bashing you, nor attempting to discredit you. Nobody has criticised or bashed you yet. How could they? So far, none of us have figured out what it was you even did. I keep asking the same questions over and over -- as are others -- because, as VS and JP also pointed out, you are simply not making yourself clear. The story keeps changing. He's prone. He's supine. He's being bagged. He's not being bagged. He has an airway inserted. He doesn't have an airway inserted. I honestly cannot imagine that you don't understand why we are all confused here. I'm very sorry that you feel that myself or anybody else here is being unreasonably antagonistic towards you. That is certainly not the case. We're just trying to figure out what you are saying so we can play along. I have read your original post multiple times. My reading comprehension skills are exceptional, yet it still is not clear to me. Or anybody else, for that matter. For some reason, we remain optimistic that if we just ask one more question, you'll come back with a reply that clears it all up for us. Several of us have tried. But so far, it just gets muddier everytime you try to explain. MedicMal was thinking along the same lines as me and beat me to the point. Are you sure you know the difference between supine and prone? It does indeed sound like you are reversing the terms. If so, that would go a long ways towards starting to clear up the scenario for us, because the patient's position is one of those things that we just can't move past in order to resolve the rest of the scenario. This whole situation seems very clear in your mind because you were there. But remember, we were not there. All we have to go on are your words. And to this point, your words make no sense.

Exactly. If you want to be a fireman, go for it. But don't think for a moment it will get you anywhere within EMS. EMS administrators with any sense at all will hold it against you. Why would I hire somebody who obviously isn't interested in EMS as a career? Why would I hire somebody who is just using me as a stepping stone to something else? Why would I hire somebody who will be gone, probably without notice, the moment they get called by a fire department? And minus 5 for posting in the wrong forum. :wink:

I am trying to stay out of this because you specifically asked for an Ontario perspective. However, I just want to say that I pretty well agree with VS here. Ontario education is completely different from the so-called "education" in the US. And, because of that, I agree that some practise time is indeed very beneficial to a PCP before continuing to ACP school. I might even go so far as to require it, although I am not sure. Again, Neesie, I am disappointed with your continued focus on skills. What "skills" did you learn in ACP school? How hard is it to splint somebody or stick a puffer in somebody's mouth? How much practise does one need to perfect that? And how often does a PCP even use any of that stuff anyhow? This is the practice of medicine. It is about scientific knowledge and understanding. The ability to examine a patient, evaluate the information, and arrive at a prudent clinical impression and plan of action is what it is all about. That is what you need a year or two to validate and sharpen with practise. And that is what a PCP receives a significant education in, whereas an EMT receives next to none.

I dunno. For clarification, I was referring specifically to the idea of mimicing body language that Anthony and Rid focused upon. Ever spent five minutes with a used car salesman?

That is definitely a problem. I agree with you on that point. I would be very disappointed in anybody doing that. However, it is pretty darn common here in the US. Lots of EMT's run around telling the public that they are a paramedic. Heck, we have wannabe's here on this board that are unexperienced and/or unemployed basics who try to thrill us with their tales of heroism and ALS skills, so you know they are bullshitting the people who don't know anything about EMS too. But, as much as I am keenly aware of the differences between an ACP and a PCP (or an EMT and a Paramedic), I agree with the conventional wisdom in Canada which believes that the greater good is served by identifying all pre-hospital EMS care providers as a single group with a single, easily recognisable and understandable moniker. Sure, they are different levels of providers, just as there are also different levels of physicians and nurses and respiratory therapists. But all of those professions have also recognised and embraced the benefits of representation under one umbrella. We should too. Of course, in the US at least, the first step is to make EMT's actually EARN that identification, as has been done in Canada.

While that may be true in a great many cases, it is also exactly what we are trying to change. Therefore, I wouldn't simply accept that as it is.

I wouldn't be surprised to find that Jack Stout and Jay Fitch were behind this nonsense. They are the masters of rehashing the same old, worn out, disproven theories every few years in hopes of making another buck. Just like the CISD charlatans, they trot out the same pig wearing a different dress every now and then, knowing that there is a sucker born every minute who doesn't know the history and is too stupid to figure it out.

I could rip this entire article to shreds in an embarrassingly brutal manner, as was done to the so-called earthshaking "news" they printed a few years ago when some retards concluded in a study that those who arrive at the ER by ambulance were more likely to die than those who arrive by POV. Well, no $hit! Any moron could have figured that out without a half-million dollar federal grant. But then, just like this time, McPaper (aka USA Today), presents the study as meaning something that it does not. And the dolts who read that rag are just stupid enough to believe the slant. Of course, that may well have been the slant of the study too. We don't know until we see it. So I agree with ERDoc that we have to see the actual paper before we pass judgement on the conclusions. But I have to disagree with ERDoc that there were "no statistics" presented. Sure, there were no specific numbers presented. But when words like "fewer," "more," "higher," "lower," "smaller," "less," "measure," "numbers," and "rates" are thrown around in every sentence, they are very clearly talking about statistics.

I agree with Dude and VS. PCP is not a misnomer. Unlike an EMT in the US, they are not merely technicians. They are not trained. They are educated. And utilising that education, they conduct in-depth physical assessments of patients in order to come to an advanced clinical impression and make subsequent medical decisions. If you have not spent any time in the US system -- where EMT school can be completed in as little as two weeks -- you simply have no idea what a HUGE difference there is between an EMT and a PCP. In fact, EMT's in the country should probably be renamed to FAT, or "first aid technician," because they are not given the education necessary to actually make medical decisions. They are only given a cookbook of techniques, which they very rarely use anyhow. Neesie, I am very, very disappointed that you don't seem to recognise the difference between education and scope of practise. The way to measure medical professionalism is not by asking, "what can you do?" The way to measure medical professionalism is by asking, "what do you know?"

The whole process is condescending and patronising. It assumes your patient is a mindless idiot. Many of your patients are smart enough to know when they are being manipulated and sold a bill of psychobabble goods. If you use these techniques, you had better not underestimate your patient or you're going to alienate him and lose his trust. Then you have nothing.

I don't think that would even be legal. :? As a mobile hospital, sure. As a transport vehicle, I doubt it.

Every patient has a pulse... right up to the point they lose it. It's mere presence tells you very little of value. And the old theory of estimating BP by palpating a pulse was disproven quite awhile back. It's old school and is being thrown out of ATLS.

You didn't? Then what was this all about about? You said the patient had an "patten" airway, and went on to describe it as thus: And how were you bagging a prone patient? This just isn't adding up at all. [stream:d8727bcce0]http://www.destgulch.com/movies/luke/luke18.wav[/stream:d8727bcce0]

I still want to know what a Patten airway is. Who inserted it? And how did they do it with him conscious, alert, and in the prone position? And yes, I have searched here and Google. Nothing. [stream:dc2d51f6a6]http://www.destgulch.com/movies/luke/luke18.wav[/stream:dc2d51f6a6]

LOL! I feel you on this issue, bro. But you're way off on that one. Ever been to Toronto? Ever been in an ER there? You'd be surprised how non-Caucasian it is. But then again, compared to Atlanta, pretty much anyplace but New Orleans is more Caucasian.

It's twice as bad in Houston since it filled with Katrina refugees, Jake.

Driving is just like practising medicine. Just because you have the knowledge to do the job does not necessarily mean you have the intelligence, maturity, or self-control to actually do it properly. In accident investigation, we call this the human factor. EVOC would have had no bearing on this accident. In fact, I am pretty sure Rural/Metro requires EVOC. This guy knew he was driving too fast and following too closely. He simply didn't care. He was an immature wanker hot-dogging like an sixteen-year-old with a new Mustang. Interesting that no reports I have read have yet said if they were running hot.

What exactly is a Patten airway? Is that the new quadra-lumen thing? :? Unless I was a very long way from the trauma centre, I see no reason for aeromedical transport. How long is it going to take to get this guy down? Will it require special resources that you do not currently have on scene? [stream:071694444c]http://www.destgulch.com/movies/luke/luke18.wav[/stream:071694444c]

Wouldn't be the first woman I've known to give birth without knowing she was pregnant. Doesn't sound exceptionally probable with this broad, but for them to put a specific gestational age on her, there must be some pretty significant evidence. Or else the doctor is a dork. It might be a tumour. What was her temp? P.S. I only understand about half of your abbreviations.

The search function is your friend. This topic qualifies as a Frequently Asked Question. http://www.emtcity.com/phpBB2/viewtopic.php?t=4415 http://www.emtcity.com/phpBB2/viewtopic.php?t=1129 http://www.emtcity.com/phpBB2/viewtopic.php?t=2763