PCP

On our car, we have one pillow on the cot at all times, which gets switched out after every call or at least a new pillow case, as well as we have one extra pillow or two in our cabinets. Also we have a pillow with a trauma strap wrapped around it with a ice pack in it to be used as a pillow splint. In many cases I have used two pillows for my patient, so they are comfortable, especially on those long transfers.

Hey no problem As mentioned before good luck and don't be shy, jump into discussions on the forum or post more questions. There alot of people on this site that can be very helpful.

Welocme to the City! IMO having management experience and staying with a job or having people screaming at you every day is not the reason you should do the job. I may be worng, but I feel with your work experience as well that it will not help you find employment in EMS. I can say for sure what each company is looking for when they are hiring somebody, but for the most part I would say it would be based on personality, how you answer their questions, and how well you do on their scenario based examination if they have one that is part of their hiring process. You have to be able to enjoy what you do and have the PASSION for the job and want to help people and treat them with respect and compassion. Sorry I can not answer your question if 12 dollars an hour is good for a starting wage for a Basic at a private company. The service I work for, the starting wage is 18 an hour for a driver only and that is someone who does not have an EMR, PCP, or an ALS license, so all they can do is drive. The pay goes up from there depending on what license you hold and how many years you have been in the service. Now with that being said, we are a union service so that does make a big difference. I would maybe try and do some more ride alongs if possible and talk with the medics and find out what they enjoy about the job, as well as what they don't like about the job. It will give you more of an idea of what a day and a life of a medic really is like. In my experience, working as a medic, there are very few days where you are dealing with people vomiting, yelling at you, or even very little trauma. Most of the time you are dealing with sick people, so you need to have a good understanding of Anatomy and physiology . Possibly take a first aid course first before jumping into the EMT-B course, just because IMO the course can be very intense and there is lots to learn in such a short period of time, so having some basic skills will help you in the course. It does not matter what people tell you, just remember it is your life so it is your decision! That statment comes from my own experience from people trying to talk me out of becoming a paramedic due to such low wages. I would not change a thing as I love going to work and helping people and learning every day. Good Luck to you! Brian

The service I work for I believe starting in June of 2011 are going to a dark blue dress shirts but no more buttons, but a zipper in the front. We currently wear a white dress shirt and have been since the service started back in the 70's. Not sure why the change, but I like the look of the new dark blue dress shirt. I feel wearing a t-shirt would be nice during the summer time as it might be a little cooler. When it comes to a uniform looking professional I feel that as long as the dress shirt is ironed and tucked in, pants are pressed, and boots shined that is professional or if wearing a t shirt it should be not wrinkled and tucked in. As mentioned we wear white dress shirts (soon to change) and if we spill anything on it or if it is wrinkled before your shift. Our Unit Chief requires that we iron our shirt or change it if it has a stain on it. He will even shut the car down until we change our shirt. That even goes for students if they show up with a messy looking uniform, he will make them iron their shirt, polish their boots, iron their pants or change their their clothes before going out on a ambulance call with their preceptor. Sounds anal, but in our profession I feel we need to dress and look professional at all times, that even goes when wearing a t-shirt in those hot summer days!

Welcome to the City! You will find some great discussions on this site, so don't be shy and jump in and put your two cents worth in. Happy New Year!

LS first of all Happy New Year to you sir! Hope you had a great New Years Eve and the hang over was not too bad. I am working unitl 1800 on New Years day, then I am heading home to see the wife and kids. Looking forward to spending a couple days at home with them before heading to work to my second job which is on the Ambulance. I am working the transfer car again and looking forward to hopefully doing a another transfer with a Nurse escort so that I can use the knowledge I have gained from this post. Yourself and Dwayne both have mentioned that I have taken some personal attacks on this post, and I am blind I guess as I don't see that at all. All I see are comments towards me that I can either agree with or not. Life is all about learning and sharing information with others. I figure if I am going to be working in the EMS I best gain as much knowledge as I can by asking questions and learning from the mistakes I make out in the field. The more I get to know certain memebers in the City, the more respect I have towards them and their comments either good or bad. . So thank you for your all your comments in any of my posts as you are one of the members I respect and always look forward to learning from. Happy New Year! Dwayne, The comments that are made by you in the post above about being banged on needlessly don't bother me one bit. Everybody has the right to share their opinion. I am not going anywhere and I am going to keep posting questions or jumping in on discussions that I feel comfortable posting on, even if I am wrong with what I feel may be the answer to the question and may get as you put it "banged on needlessly" I fully respect what you have to say and how you are willing to help and answer questions from new medics and posters on the City! I am looking forward to 2011 as well and hope to learn lots from the City and while working on car. Happy New Year!

Happiness, NO need to apologize for your post. I did not take it as being snotty at all. You were just pointing out a few facts that need to be addressed. Any comment or suggestion comming from a veteran like yourself especially from a fellow BCAS employee is alway welcomed by me. If it was not for this website and the discussions I have had and the few friends I have made by joining this site, I would not have learned what I have learned in the past month which has helped me in my career as a BCAS employee, as well as helping me become a better paramedic which will help me give my patient the best patient care they deserve. So, as mentioned NO need to apologize for your reply. I understand what you have said about the back of the ambulance is my work space, and for now on I am going to treat it as so when doing transfers with a nurse escort or any time I am attending. Hope you are feeling better soon P.S. I received an email from my UC the other day, explaining that the local fire dept. and the wife of the patient I had last week that had a cardiac arrest contacted him and expressed how good of a job my partner and I did and that how respectful I was, and how I showed great empathy for her and how I showed great dignity towards her husband. The fire dept. said they were happy the way my partner and handled the call and they were impressed how I handled myself for doing my first cardiac arrest. For me that made me feel proud to be part of the BCAS and that helped me know that I did everything that I could for my patient. As well as when I took some time to talk to the wife while at the hospital that my words did mean so much more than one can imagine to a loved one that was going through what she had to go through. HAPPY NEW YEAR and STAY SAFE!

Lone Star, Thanks for your post and I do agree we all need to check the truck before leaving the station and I do that every time. You must have missed the part of the post to as where I mentioned that the monitor is not part of our ambulance and belongs to the hospital. I did learn from the experience and from talking to yourself and the others what could have been done better. For example, next time I am doing a transport with a nurse I am going to ask and confirm that they have fully charged batteries. I don't feel that I am being blasted here or being knocked down at all. I was just making a point that I feel as a new medic that I made some mistakes and that I need to learn from them. In now way do I feel I am or need to play the "Poor Me Card" that is not my style and it never will be. I appreciate your comments and suggestions as I take every comment and suggestion from everyone who posts on a subject that I may have posted and I feel it is a good point I try to incorporate it into my assessment or treatment, as well as I attempt to gain more knowledge by reading others posts or comments to me. Please don't take this post as if I am upset or pissed that you said I need to stop my poor me attitude. It is hard to tell how a person is feeling by just reading a post they typed out. Thanks again for you comments and encourgments! Brian

Well done Herbie1 It must have been a great feeling!

tniuqs, Thank you again for your comments on my post. In no way did I take them personally. I admit at first I was a little shocked, but then I took some time and read your comments again and it made sense to me. As to me coming back and explaining myself to where I am in my career I guess I was just trying to explain myself a little better as to my level of experience in the EMS system and that I do have the passion to learn and as well as very little experience when it came to doing a transfer with a nurse on board or doing a call period. I honestly love the job and really want to be the best paramedic that I can, which I feel will make me a better patient advocate. Any how, thank you again tniuqs for your comments and your advice p.s. I am open for any advice anytime from anybody! HAPPY NEW YEAR EVERYBODY!

Happiness, I now realize after reading your post and the one from Richard that there are things that should have been done and asked by me as the attending paramedic even when there is a nurse going on the tranport. I am not sure why the patient was not on O2 from the beginning. It is my dumb mistake for not asking if and why the patient was not on O2 from the beginning and it was also my dumb mistake for not doing a better job at jumping in when the patient stated to the nurse she was having chest pain (angina). The nurse was taking care of the patient and I did what she asked me to do. I do know that giving Nitro is in my scope of practice and I would have administered it myself, but as mentioned the patient was being transfered with a nurse and she was in charge of the patient. SO I THOUGHT! I now know for next time that any time a nurse is along for the ride that I will do a better job of asking questions and making sure their equipment is in good working order, as well as if the patient develops any problems while in the back of the car I will not just let the nurse take care of it. I will do what I would normally do as if there was not a nurse escort. I have only been working in a busier station now for 4 weeks and previous to the that I was in a station where I never did transfers and very little patient contact as I was a driver only for 2 half years and did only about 20 calls in that time.I am learning very quickly how things should be done.

Well, I am sorry I posted this question as I was just curious to know if we should have upgraded to code 3 that was all. I am not sure where you took your PCP training, but where I took mine part time course we where not instructed how to read the different rythms or placement of leads, sure we read about it, but it is alot different when a person spends a two weeks just on cardiac stuff compared a few hours reading a section on Cardiac. Being a NEW PCP I learn something new every day and by reading your post it has made me realize that even though the patient was in the Nurses care I need to ask more questions before taking a patient. Also I did do a PCR including vitals before we transported. Thanks for pointing out that chest pain is called angina I did not see anything wrong with saying chest pain guess I should have said angina. On another note I did ask the nurse if she wanted L/S and she said no. Seems as though I have let you down with my posts and here I thought this site was for learning and that is what I am attempting to do. Thank you again for giving being so hard on me and pointing out where I have FAILED as a PCP and where I have failed by asking a simple question. I do read my books still and try to learn on every call and while sitting in my first aid office Yes OFA level 3 that does not mean I don't have the smarts to be a Primary Care Paramedic. Any how, I don't want to say something that I don't mean, so I am just going to leave it at this as I am taking your post towards me as a learning tool. SORRY FOR MAKING YOU SOO UPSET THAT WAS NOT MY INTENTION AT ALL!! OH, VITALS SIGNS BEFORE TRANSPORTING BP 110/75 R-18 EASY P-72 REGULAR-SPO2 97 RA If I had known that this post would have turned out like this I guess I would have mentioned as well that I did attempt to take a set of vitals while on route, but the attending nurse told me not to worry about at as she is stable and that the patient is in HER CARE.

The EKG machine belonged to the sending facility, as we don't carry EKG's on our BLS cars. Yes the patient was under the nurses care so she had the authority to upgrade to code 3 at any time and she felt it was necessary. Not sure of the outcome, all I know is we got our patient to the other facility safely and she was scheduled for surgery later that day or early next morning. Yes this event did take place in Canada eh! LOL, I know it is hard to not make fun of us Canadians as we seem to say eh after every word!!

Here in BC at the PCP level we are NOT trained on how to read a 3 lead. I have done some of my own research, but no way I am able to diagnose anything or do I fully understand the different rythms. Patient hx was the night before she woke up for a bowl movement and she developed chest pain. After the bowel movement the pain got worse and called EHS. She was transported to the hospital and was sent to the CCU due to having a first degree heart blockage. No previous hx of any cardica issue. pack a day smoker and chronic fatigue was the only other medical hx we had. She was being transported by us along with the nurse due to having a STEMI which I just looked up to understand what STEMI stands for now. The patient was given a thrombolytic medication two hours before our transport time which was at 0600 am. Not sure the name of the Thrombolytic (sorry) That is all the information I received from the attending nurse. When asked, the nurse stated that her vitals where all within normal range before we did the transport. I am not sure what the vitals where when the patient experienced the onset of chest pain while enroute, as the patient was under the nurses care at this time. I over heard the nurse talking to the attending dr. at the receiving hospital that the patient had elevated Traponine levels. When I asked, I was told that by having elevated Traponine levels it indicates the patient has suffered damage to the heart due to her having a STEMI. That is all the information and hx I had on the patient. All and all it went well and we did not go code 3 and the patients pain went away after the squirt of Nitro and the pain never came back. My feeling is, if we did not have the nurse on board and since we do not have the capability of using a 3 lead we would have upgraded to code 3.

Okay, yesterday I was working on the transfer car and we were transporting a patient from the CCU down to the CCU in Victoria which is about an hour and half away from Nanaimo. I had a nurse on board with me in the back, the lady was hooked up to a 12 lead monitor, along with two 18g IVs one in the ACF and the other one in the right hand. No IV solution running at this time. The lady was diagnosed with a 1degree heart blockage. I am the first one to admit that I do not understand the difference between a 1 degree and a 3rd degree heart blockage. But I can learn about that over time. Any how, when we were about 40 minutes from the hospital my patient started to experience chest pain again, the nurse gave the patient some nitro and asked me to put her on 3 lpm of O2 by nasal cann. Also the monitor's battery was running on a low battery, when it died the nurse switched over to the back up battery which was reading low battery as well. My question is would you have upgraded to Code 3 due to being about 40 minutes from the hospital due to the patient experiencing chest pain? The nurse in this scenario did not, so I was just curious to know if we should have possibly upgraded to code 3? Thanks, Brian

I have to say that is one for the books for sure! I can not believe some chick crashes her car just so she can see you I just don't understand why some people wait so long to call for an ambulance when they have been injured??? Hopefully you are not on shift tonight and you can get much needed and deserved rest!! All you can say sometimes after a shift is

Thank you everyone for your kind words and thoughts. The fact that I was unable to bring this patient back from his arrest does suck, but what sucks evern more is, that I can't help to think if he had just gone to the hospital earlier in the day when he was complaining of indigestion to his wife. The fire captain was on scene as well and was feeling the radial pulse while I was doing chest compressions and he said I was doing good. So my only thought was I must be performing the compressions properly. I am a BLS provider, so I don't have access to the tools that the ALS crews have, and as mentioned in other posts we do not have ALS in our community which would have been nice to have. It MAYBE could have made the difference in this call. I feel that for my first arrest that I did everything in my power to attempt to bring my patient back. I feel for the family more than anything being so close to Christmas and also having another family member pass away just three weeks prior. I wanted to stay with the wife longer while they were working on her husband, but duty called. I attempted to get a line on the guy as well in the back of the ambulance while the fire guys where doing CPR, but was not able to start the line. Not sure if that would have made a difference or not? I guess there is not much more I can say, besides I did my best and unfortunatley it was this guy's time to go and hopefully next time there is a better outcome. Thanks again everybody for your kind words, thoughts, and sharing your stories. It is nice to know that I can share my stories here on the City knowing I can get feed back and support. MERRY CHRISTMAS TO EVERYBODY!! Brian

Hey Sean, Thanks for your reply and sharing your thoughts and story as well. This guy had just turned 60. While at the home we received gave the patient 4 shocks and after the fourth one we loaded and transported with giving two more shocks in the back of the car. At the hospital the patient recevied three more shocks before the Dr. called it. I was hopeful that we may save this guy, due to having a shockable rythm. I do find it hard to believe that it gets easier as you do more arrests, due to the nature of the call and knowing that the person you are working on is someones father, mother, husband, wife, dad, mom, or grandmother, or grandfather. As mentioned in my original post, I don't seem bothered by the call, as I am not having trouble sleeping. I am thinking about it pretty much 24-7 about how the call went and if there was anything else could have done? I agree that when it comes to the family members that they also are experiencing a huge tragedy in their life at that moment and they are the ones who will need to be taken care of. While I was working on my patient I could not help but to wonder how the wife was making out and hoping my partner was talking with her and doing what ever she could do to comfort her. Thanks again for your thoughts and comments. I am sure there will many more posts like this one in my near future. Brian

Welcome to the City!! No question is a dumb question. trust me I have probably asked a few quesitons that seem dumb to some members, but we all start off not knowing stuff and at the end we all still have to ask questions as we don't know everything!! There are some great members on this site who are very helpful and will answer any question you may have the best they can. Welcome again and have fun! Brian

Welcome to the City. Good for you for not giving up and wanting to give more to your child Enjoy the City, ask questions and learn lots Brian

Well, I did my first cardiac arrest the other night and my patient did not make it. On the way to the call I was running through my CPR protocol in my head and what I would do when I arrived on scene. For the most part it went the way I thought it would go. When my partner and I arrived on scene and walked in the house there were no lights on inside except for one. So I called out " its the paramedics " I never got a response, so I went towards the light and the first thing I see in the bedroom is a woman performing CPR while holding the phone between her ear and her shoulder talking to whom I assumed was dispatch. I was taken back by what I was seeing as I pictured a person laying on the floor unconscious, not seeing the patients wife performing CPR on her husband in their bed talking to dispatch. My insticts took over and I told the woman I will take over, and I started chest compressions while I waited for my partner to arrive in the bedroom to help me move the patient to the floor. From there we ran our protocol and transported the patient performing CPR in the back of the ambulance. Unfortunatley my patient did not make it. Once we transfered care over to the attending physician I went out and spoke with the wife to see if there was anybody we could call for her, but she said no. That was the hardest part to take, as I felt she needed someone there to comfort her while she was waiting to find out if her husband will make it or not. Fire stayed with her for a bit, but had to leave. After the call I had took some time to think about the call and I could not help, but to think if there was ANYTHING else I could have done that may have resulted in a better outcome? After I was finished thinking to myself, I went back into the hospital to complete my PCR form and I had a chance to speak to one of the nurses and she told me I had done a good job and when I arrived that I was very calm for someone who had just done their first cardiac arrest. She also said try not to think about the call too much and sometimes things just don't work out the way we think they should. She said it gets easier as you do more cardiac arrests. Does it? It has been two days since the call and I can still picture the wife performing CPR on the bed, as well as I keep picturing the guy's face as well. I am not sure if that is normal after doing a cardiac arrest, but I sure hope that I blank it out of my mind soon. I am not upset about the call, as I have had no problems sleeping, but for some reason I just can't get the call out of me HEAD!! It could be because it is so close to Christmas and that it was my first cardiac arrest. We had a hard time finding the house so I think what if we had gotten there sooner could we have saved him? Was I performing chest compressions well enough? Well that was my first experience attending a cardiac arrest and I have to say it is alot different then how they make it out to be in the class room. Well, once that call was over off I went to go do my very first seizure call..Man what a night