WolfmanHarris

We already have this in Ontario, they're called private transfer services. They have poorly trained staff, in old decommissioned ambulances in an entirely unregulated indsutry. No room for them in EMS though as the minimum level to work on an Ambulance in Ontario is PCP. So if those unemployed people would like to go to college for two years... It's not hard to get to a Basic cert and it doesn't take long. Heck with how Basics are paid in many places I'm not sure how much smaller payroll could get.

Because education in EMS shouldn't be the sort of thing you can get on the side and because we shouldn't be relying on other agencies and jobs as stop gap band-aid solutions to hide the failures in EMS funding. Like I said, give me a fire fighter or two on a bad call to help carry a bag, lift a patient or bag on route. Great it will keep another Ambulance free to respond and not tie up a Paramedic or two doing basic skills or manual labour in the back. But why are we relying on any agency for "first response" to all these calls and accepting this as a solution? If we can't get Paramedics to their calls fast enough, we need more ambulances and paramedics, not a fire truck or a cop car. In terms of PD vs. FD taking part in EMS. Neither should beyond what I've described above. (I'll gladly have PD help me lift the 400lb'er) If you review the article you'll see the reason it's consistently FD, is they have less to do. I don't know too many cops with alot of down time on their shift and their presence on patrol between calls is supposed to be a deterrent to crime. So far we've only ever dealt with system where Fire is the primary job and EMS tacked on. For those out there who consider themselves primarily as FF's who are also EMT's or Paramedics I have a question for you. With some of the ways services out there divide their training between the Fire and EMS roles, would you be comfortable going into a fire with someone if their training were reversed. If they studying and practiced medicine constantly and once in awhile completed Fire CME, maybe online, would you want them as your back-up? Would you be comfortable that they could do every part of Firefighting without hesitation or critical mistake? If that level of commitment is not good enough for you, then why would you wish something similar on every one of your patient's? I've still got no problem with Fire and if someone wants to be a Firefighter and a Paramedic, get two jobs. Just make sure that you can do both as well as they deserve. I couldn't do it and from I've seen on the news sites, neither can a lot who try. But there's Physicians out their with double specialties... Don't force people to be a jack of all trades and master of none who have little to no interest in it. And please please don't try to blow smoke up their ass and convince them they've mastered something when they've barely scratched the surface. It may be good for their self-esteem but it's hurting patient's. Honestly if you're reading this and still not getting why trying to dual role vastly different jobs is a problem, you either haven't been on the board long, are far smarter and capable then I am and can master and stay current on both with equal passion or have had far to many instructors tell you how great you're doing and how many lives you'll save as they slapped the patch in your hand that you're believing your own hype. Either way, I starting to understand the frustration of some of the senior members more and more with each passing day.

Maybe I wasn't entirely clear, but I don't care who anyone hates or doesn't hate. I'd prefer to see less hate in the world, but that's neither here nor there. My point was regardless of who you hate, who you fuck, who you pray to (or don't) how much melanin is in your skin, or what you've got between your legs, when you get to work, the person who has the onus to shape up or ship out is not the person who hates/dislikes/feels uneasy or the person who is the source of those feelings, but the one who allows it to spill over from their personal life to the job. How I or you feel about someone's sexuality in and of itself is, and should be treated as, irrelevant to the field of EMS.

Quoting myself from the article on EMSresponder.com.

I know we can't be entirely responsible for our likes, dislikes, fears and unease in any situation. Whether it be a person we work with, a patient or even a type of call, in a professional setting we need to put these aside as much possible in order to do our jobs. Anything less would be unacceptable. If you don't like Black people and treat one with an MI and allow your racism to affect your treatment of the patient, regardless of how much that person may fit any stereotype is the problem not yours? If you are a woman Paramedic who was raped and have an understandable unease around men fitting a similar description and this experience makes you unable to do your job properly, is this your problem or the patient's? If you are a Paramedic with a problem with Homosexuals and are assigned a homosexual partner who has committed no wrong against you, the company, the profession or a patient yet despite this you are ill at ease and it effects your performance on the job, is this your problem or your partners? My point here is that regardless or any personal issues we have on the job, it is our responsibility to control them to ensure they don't affect things on the job. It's been said a few times "I don't care as long as they don't hit on me." or similar remarks. For this, all I can say is that responsibility goes both ways and that were that person, gay or straight to sexually harass their partner, it would then be their problem. Until that happens, your unease is yours, and the responsibility to deal with it and do your job, or to be frank, get out, is also yours.

A driver's license? Usually I but the first round, but Echo's a few years off yet. Happy B-day Echo!

Tamaith, please consider that on an online forum the only way in which we can and do get to know you is through your ability to communicate in writing. So while you may be an intelligent, insightful person, how can we know that when your writing is poor? It is in your best interest to take the time to proofread your posts so as not to undermine your own opinion or argument. No one is asking for or expecting grammatical perfection, but some basic notice to proper English is in order. Best regards and welcome to the forum, - Matt

The elderly woman. I give $50 to my best friend and ask that he call a cab and ensure that the woman of my dreams gets home safely and that he gets to my place where I'll join him for a beer (on me) after my shift. If she's the woman of my dreams we'll meet up again and hopefully she'll remember this; if not I'd rather have a friend to help me through it all and since it's my best friend, he'll understand why I need to make sure that this sick elderly lady gets the care she needs before I can kick back and hang out. If he and the woman of my dreams end up hooking up, well good for him. I must of been mistaken as to who's dream I was seeing in the first place.

Mobey you know I've got nothing but love for ya (not in a homosexual way of course ), but in this I've gotta disagree. Despite a rocky start, I think Crotchity has backed off of the devil's advocate, poorly argued positions and is starting to post some good threads and input. Previously I was with you in my issues with him, but at this point I have none. We don't agree on many points, but as it stands now I don't have an issue with they way these arguments are presented. I have no problem calling bulls**t on someone, but in this case I don't see the cause.

My concerns aren't province specific. They're provider specific. Though sometimes I wonder about this guy named Mobey...

The Ontario "F" class driver's license is required to drive an Ambulance and a small van or bus holding no more than 24 people and not used for school purposes. While it's a commercial license, there is no requirement in the driving test that covers the emergency operations part, making the special license next to useless in terms of EVOC. That brings me back to the training we receive in school. In two years of school we spend half a day in car doing "advanced driving" with a high performance instructor and a single semester class on the operational side of the job. This includes the Ambulance, radios, CANUTEC and many other subjects. This is not enough focus on what is still a very large portion of our job and arguably the most dangerous part. Might be time to add CDE on top of our CME requirements.

I already wonder if some ALS EMS providers should be doing some of their skills with the education they currently have, why the heck would I support more skills with less education? Let's be clear folks, as tempting as it is as a BLS provider to be able to do more without going through the education, do NOT consider it a plus for you as a provider. You are being done a disservice and are being insulted (whether you realize it or not), but the administration (hypothetical as it may be) pushing for this. They are not saying "you're such a great basic we think you can intubate." They're saying "we don't care to send you for a proper education or to pay for Paramedic's, so we're going to toss you a one day CME and have you do these ALS skills without being an ALS provider. This isn't worth our time, effort or money to do right." I wonder how common this is in the United States? Here as a PCP I have to take a seperate base hospital certification in SAED and Symptom Relief, despite the fact that I have an entire semester devoted just to this component of my scope. This is a hold over from when PCP was a much shorter program and SAED and SR were add-on's to our scope requiring a separate certification. As a result we need to be tested by our base hospital on these skills and be certified by them (as these are our delegated medical acts) when we start at a service and whenever we work under a different base hospital. It seems redundant, but like a lot of things in government, the rules have not caught up to reality yet.

I was worried for a second when I saw this thread surface again, but was pleasantly surprised to read this addition. Confirmed what I said earlier Crotch, despite an incredibly rocky start this is an important addition to the discussion. It is very unfortunate that the EEOC does not cover sexual orientation but the comment that drew my attention most was the part that said: "Sexual preference is not governed by EEOC but may be under local or state laws." My first question is whether that quote is their wording or yours Crotch? I'm not usually a fan of semantics, but I'd consider sexual preference a misnomer that implies a choice that to my understanding is not supported in literature. (Though I'll admit this isn't first hand reading) My close relationship with LGBT friends and family means that I'm closer to the LGBT community than many others might be, so it may be my experience that's colouring this, but sexual orientation is considered the correct term in recognition of this. For an organization that practically screams politically correct (Equal Employment Opportunity Commission), in the area of sexual orientation they seem behind curve on issues of sexual orientation in employment and not just in the letter of the law. My second question is, is anyone state or local laws that cover sexual orientation in either specific or blanket terms? The Ontario Human Rights Code provides protection for sexual orientation, same-sex partnerships and gender identity. Information can be found here on the Ontario Human Rights Commission website. On a federal level the following link to the library of the Canadian Parliament has a great deal of information on sexual orientation and the law. Specifically refer to section A, where is specifies that despite the ommission of sexual orientation from Section 15 of the Charter of Rights and Freedoms, the open-ended language allowed for precedent to flush out the scope of this protection. Under Andrews v. the Law Society of BC (1995) S15 was found to include sexual orientation. Note that the Charter of Rights and Freedoms supersedes all law Federal and Provincial unless explicitly excluded under S33 ("The Notwithstanding Clause") and therefore any law that would seem to exclude sexual orientation would be of no force and effect. As something of an armchair jurist, I'd appreciate any other laws that exist at a Federal, State or Local level that address sexual orientation in terms of employment.

Ohhhhhhhh...You just got DSM'ed bi-atch!

You caught me in an oversimplification Michael. I should have considered the role of Government Sponsored Enterprises Fannie-Mae and Freddy-Mac and the momentum given to the situation by increasing government pressure to provide shaky mortgages. I also should have placed that in context with a climate of ever decreasing regulation of the market by lobbyists and an SEC with little to no interest in finding problems with business practice as long as the money was being raked in. Of course I'm still oversimplifying this as we haven't even considered how a starting premise that an entirely unregulated free market best underpins western society provides the perspective from which so much of this was viewed. The economy is far from my strong suit, but I'm comfortable in saying that a whole bunch of people making way more money than any of us will in EMS, with little to no restriction on how they do things (whether in the private sector or government) are responsible for the mess we're in. I have a social left bias and I'm comfortable with that and maybe it is that bias that's leading me here, but how can a profit-driven model ever by it's nature consistently work in the best interests of the patient and still maximize profits? I just don't see it.

I regret to inform you all the member DocHarris was killed by a stampede of caribou down Highway 401 brought on by a massive polar bear attack. DocHarris, 24 was dog-sled lifted to Sunnybrook Hospital where he was pronounced dead. Please send donations to... Crap. Forgot to use my alias. We'll try this again later.

I do have the right to vote under the Charter of Rights and Freedoms of Canada. Democratic Rights 3. Every citizen of Canada has the right to vote in an election of members of the House of Commons or of a legislative assembly and to be qualified for membership therein.

I think Spen's on to something here. I mean big business did such a bang-up job on the mortgage industry and deciding who can afford what house regardless of their income, why not have them decide what medical treatment someone should receive regardless of their clinical condition. I'm sure alot of people will make a lot of money before the bottom falls out entirely.

"If X then Y. If Y than do Z." What are the chances that Z will always be a pharmaceutical or other product endorsed by some lobbyist somewhere? I'd imagine pretty good.

Hey Crotch. Just wanted to echo much of what Spenac said. I've had my share of issues with you in the past and didn't hesitate to take you on, on them, publicly. I'll also admit to venting on chat once of twice. Past frustrations aside, I'm glad we've moved past that. I doubt we'll find ourselves on the same side on much of the discussions and you'll probably still manage to annoy and frustrate me, but that's the way I prefer it. No good discussion's going to come from a bunch of sycophants mentally mutually masturbating each other. Without discourse and dissent how do we ever challenge what we know. (I'll try to remember that next time I get the urge to smack my head into my desk over a debate ) Though the internet makes it exceedingly easy sometimes, there's really no reason to go digging up someone's personal life over an internet forum. I noticed one day awhile back that events occuring online were nagging me during another part of my day and realized something had gone horribly wrong. It was a good chance to give my head a shake and take a break for a few days. I'd suggest it to anyone that finds themselves obsessing over the City, or Facebook, or Twitter.

From their latest ads, Crestline is building ones similar to that Calgary Ambulance. They're awful at updating their site though so I have no pictures of it. I'd be interested in getting a closer look at that design and see how well it works.

Pfft. What's the big deal? Almost anyone can do it. Kidding of course. Congrats again. I wish you nothing but nights full of sleep and empty diapers.

I found this article while reading the news today. Once again I feel like EMS could learn a few things in terms from the aviation industry. CBC News Article NEJM Abstract There's a pre-hospital researcher up here that I read an article about, who's conducting research on the role of checklists in EMS. I'll go diving into my stack of magazines later to find his name and more info. When I think about things like intubation (esp. RSI) and some of the other high-risk, high acuity, low instance skills/calls we do I think that a checklist might be an excellent idea and this research seems to support this. I'm not advocating cheat sheets for everything we do, but perhaps there might room for this sort of resource?

Looks like this is going to be the second EMT City Event I'll be kicking myself for missing this year. With any luck I will be starting my first EMS job around then, or with less luck, unemployed and facing crippling debt. Either way, I'm afraid I will be unable to attend in any way other than projecting my seething bitterness onto all of you. Hope you guys all have fun!

But Richard, the rest of us don't work in NYC. The rest of might consider it a good idea to wall up NYC and you can be Snake Plisken. Kidding of course. I've been to New York twice and found the muggers to among the world's finest.