WolfmanHarris

A few of the services have started changing their names in this Province from EMS to "_________ Paramedic Services." Ottawa EMS is now Ottawa Paramedic Services. This was based on ease of translation (looks similar in English and French) and to recognize the Paramedics specifically. Also it brought them in line with Ottawa Police Services, and Ottawa Fire Services in the nomenclature. Peel Regional EMS also recently switched to Peel Regional Paramedic Services. These are two of the biggest services in Ontario. I'd agree with Michael, Essential seems more broad than Emergency. As for the state trooper, that's just a fault in the legal system that doesn't recognize EMS (and I'd assume other Healthcare workers) as essential. I hope too many ER doc's and nurses weren't turned back too.

And I think you're projecting your homophobia onto everyone else. I'll admit that there are homophobic providers out there, just as there are racist providers, those that beat their wives, those that drive drunk and those that are medically incompetent. You know what they all have in common, none should have a place in EMS or any other part of Healthcare. If management is allowing discrimination is hiring process this is a system problem and that system needs to be overhauled ASAP. If the individual providers are making a hostile work environment for a homosexual provider, than that problem is easy to solve. Fire them. Same goes for race, sex, age and all the other things covered under discrimination.

Not always. Type III's in Ontario do not have walk-throughs as per provincial regulations which do not allow it. (So I've been told. I didn't bother to verify this.) Point is no Type III I've been in has a walkthrough.

And perhaps this is why this should be one thread. Since Crotchity is going to make the same faulty argument in both. Not sure how you can be so well versed if you don't even know the right terminology. Not hiring someone for any reason is called discrimination. Not hiring them based on sexual orientation would be discrimination not sexual harassment.

Discrimination does not equal harassment. They are different terms they do not mean the same thing. What exactly are you trying to argue here Crotch? Edit: I was going to add more but Chris' last edit said exactly what I was going to.

Legal protections for LGBT people in Canada - Section 15 Canadian Charter of Rights and Freedoms - Reinforced by Egan v. Canada, Supreme Court 1995 - Every provincial Human Rights Acts explicitly recognizes sexual orientation beginning with Quebec in 1977. Alberta does not specifically mention it as Vriend v. Alberta found that the omission of it did not mean it wasn't covered. (I think, I only skimmed this one)

But Michael, aren't those jokes more inclusive usually. I mean if a Priest, a minister, a rabbi and and Imam walk into a coffee shop... (almost said bar)

So it seems like every discussion now starts with a poll to keep score on what people think. So let's have a poll on polls? What do you think? Should we poll what you think about each option?

Being honest is a really good idea Crotch. Honestly, your homophobia is something you need to come to terms with. Both the wording of your question and your own words show that you have a problem you have not come to terms with, with regards to homosexuals. Worse, you think that everyone must share this. Not true. I have absolutely no problem. My Aunt is a lesbian and her Wife is great. Two of my best friends are Gay and getting married in the fall (to each other). I introduced them to each other through my campus' first aid team. My mom's former business partner is Gay and an total jerk who I can't stand. One of the people within EMS that I can't stand; refuse to talk to unless its professional and have no time for is also Gay. They're people and aside from one aspect of their lives. You know who I would have a problem being partnered with. The ignorant. In any form.

Here's my problem Crotch. Reading your posts it seems like you want to discuss the real issue of discrimination with regards to homosexuality. Great. But you've prefaced it with one of your bullshit polls again and that just pisses me off. Ask yourself this, if the poll question asked if someone had a problem with a black partner, or latino would it still be an appropriate way to start this discussion?

I just reviewed Bledsoe and there was nothing in the text. Nothing about taking bilat BP's either (just a quick mention of pulse deficits). I must have gotten that one from an instructor during lecture, though a physician asked me if I'd taken bilateral BP's on a CP Pt. during clinical.

Now I was under the impression that a deficit in blood pressures between the two arms is a hallmark symptom of aortic aneurysm? That's why I try to take my first manual BP on one arm and when I toss on the lifepack I put it on the other arm. I'd appreciate some insight into this too. - Matt

What Dust said, that's what I'm hoping for from my preceptor. Somebody who sets the bar right where it should be. No picking up bad habits before I even start working. I don't consider that being a jerk. Now if cleaning the entire truck was just my job as the student, and I was given only a toothbrush, and the crew threw things at me while I did it... that would make them jerks.

I think that's an excellent idea ruff, in principle. This is an area outside my expertise, but I wonder how much training is necessary to adequately prepare someone for that situation and how much of that is practical in EMS education? For example in fourth semester we take a course called "Crisis Management." Part of the course includes abuse and sexual assault, but this is only 2 hours of lecture and a few hours of reading and prep on this in a course that covers topics from critical incident stress to nonviolent crisis intervention. This is obviously not enough to be any sort of expert in this, but I wonder how much is adequate. The problem I see with doing more than familiarization is that it could be enough to be dangerous. Could a provider be given enough training that they get in over their head's by attempting too much "counseling" (that they're not qualified to do) and they can potentially make it worse? A close friend of mine is a sexual assault crisis counselor. She underwent more than a hundred hours of training just to be a volunteer that answers the phone and provides a compassionate ear as well as to help facilitate and encourage access to resources. Her role isn't to provide counseling in any definitive or long term way and she says she sometimes finds herself over her head. I'm not saying we get enough training, I'm just wondering what the best way to approach this might be to ensure that we as health care providers are doing the best for our patients? It's my lack of knowledge about how best to handle these situations (along with my lack of experience) that worries me about treating these patients when/if it happens.

Bushy... I have never wanted to come to Australia as much as I do right now. I don't really want to do another 6 years of school on top of the six I've done, but wow, it sounds like it would be worthwhile. I want that education. Edit: So I asked the fiancee what she thought of heading to Australia so I can go to school again. She was not so impressed with the prospect of being to only breadwinner for any more than the five months left of school here. Moving would likely cost me a marriage. So you can see it would be a pickle of a decision.

Hmm... they all are garage stored here. Provincial mandate requires all Ambulances be stored inside (one of the reasons they needed a new base). So maybe it's not about charging as much as keeping the charge on the battery up if the engine's off and the lights and the like are on?

Okay thanks for explaining. I don't agree. I will admit that knowing that a injured child was jumped rather than bit may increase my index of suspicion about other injuries, but not by much if I'm already thinking the patient is a poor historian. The same with knowing that a pt. has a history of faking seizures (though I'm yet to see a convincing fake). However, I honestly think you're confusing common sense with clinical judgement. Knowing that a patient's presentation does not fit and exploring alternative causes is clinical judgement based on medical knowledge. Common sense on the other hand refers usually to an understanding of something that is generally innate in a group. The reason why we also bemoan the loss of common sense is that we sometimes forget that our shared experiences are growing further and further apart. For example, when more people within our population were employed in industry and agriculture they had a greater familarity with machines and the maintenance. From this familarity they would be more comfortable repairing their own house as they are used to working with their hands. However as people have more diverse jobs than we once did and less exposure to these concepts, it is no longer common sense to know how to wire a light switch or troubleshoot a small engine. The common sense you're referring to could only come from the shared experiences of others within EMS and once again what you're referring to sounds more like knowledge than sense to me. Common sense in my understanding would be more about the techniques we pick up for prepping tape for an IV start, or keeping that k-basin handy after giving the glucagon. These things may or may not be taught in school but along the way we pick up these shared experiences and establish a common sense. To rule out who's full of crap you need a thorough understanding of the medicine to accurately judge someone's condition. I think you're not giving your education enough credit as you don't realize how much you rely on it in these judgments. Experience is incredibly important; I'm not doubting that at all, but I don't think you get from experience what you seem to be arguing for. I think experience builds relevance, provides real world exposure to what was previously theory and places things is context. I don't believe it does (or should anyways) be providing critical theory. If it is than the classroom part of the education has failed to lay down the fundamentals.

I'm not actually familiar with this term. Is it supposed to refer to where the medic works or to their quality as a provider or both?

Didn't realize the other parts were up. The Large Hadrian Collider is really quite beautiful and exciting. I'm excited to see what we learn from it in 2009.

But doesn't that hands on need to be based on a strong foundation of knowledge in order for that hands on to be relevant, adaptable and more than rote physical skills?

Forgive as I'm grass green new, but that's not what I believe this job is about at all. We're not cops looking at someone trying to figure out if they're lying or not so in most medical cases I don't see where street smarts comes into it as far as treatment goes. There are times for it sure, but not in field diagnosis. As for common sense? What assessment relies on that. Should we not be basing our practice on sound clinical judgement? And from that should the "smarts" we develop not be about familiarity with medicine that allows us to come quicker and more confidently to our clinical judgment? Maybe I'm missing something you're trying to say.

Thanks Michael. For all the tragic photos, there are some really breathtaking one's that remind us how wondrous the world is too. Looking forward to parts 2 and 3.

Here call volume seems consistently broken down by code: Code 1 (deferrable) Code 2 (scheduled) Code 3 (prompt) Code 4 (urgent) Code 8 (standby) Codes 5,6 and 7 are not counted and aren't really used in record keeping anymore. (From what I was told during dispatch rotation)

I don't know about California specifically, but I was always under the impression that to work flight generally called for an experienced provider. Up here getting on rotary wing involves being an ACP getting a flight course with ORNGE and working in the middle of nowhere for awhile before getting a spot in CCP school and potentially snagging a job in a more urban centre. Not something you do right out of school usually. But I could be wrong.

Careful with the generalization there Crotch. I know I've made a concerted effort not to call you or anyone else names and a quick look through previous posts and threads readily showed a pattern of increasing frustration with your unwillingness to ever concede a point or provide support to your arguments that were not just hypothetical constructs. I will grant you this in a few cases. Just as you prefer to argue from hypotheticals others prefer to argue from experience. Both have limited use in a discussion which is hoping to make sweeping claims/suggestions on an entire industry. I mean you talk just as freely in the LA or DC or Florida or NJ news threads to see how vastly different EMS is within throughout the United States, let alone the world. See above. EMS is different everywhere, so unless we're going to make every discussion about how something would work for an individual service or county we need facts. Arguing from experience, analogy, straw man arguments or slippery slopes are the easy way out. Use them to lay out your question, your concerns and establish the argument, but when it's all laid out if you're going to convince anyone, you must be able to back it up. Otherwise it's just your opinion and there's no reason we should be convinced to agree. I don't know when "sticking to one's guns" regardless of anything else became a commendable attribute in a person. Sticking to a principle is noble. Sticking stubbornly to a viewpoint regardless of what is presented to you in terms of other opinions is ignorant. It is important to be able to accept and analyze new information and be willing to allow that information to adjust your viewpoint. Sometimes you will and should reject that information, but never just because it doesn't fit with what you already "know." The wonderful thing about a really good discussion is it takes on a life of its own. It goes places you don't expect and the outcome is never predetermined. So yes, this was intended to be funny, but we realized quickly just how varied our views on what was appropriate humour is. Personally I would rather this exploration of the topic as I learned not only what other's thought but was forced to examine something I had never considered before. This is a good thing. So Crotch, I implore you to consider being a bigger person. Know that many times you will not agree with others or anyone of this forum. Accept it and stop trying to convince at all costs. Make an effort to listen, not just to decide your counter argument, but to examine your own thoughts. You likely have a great deal of experience that myself and other new providers could learn from, but it's difficult to find among the crap. It's my intent that this will be the last time I try to point out the problems I see with your approach, but like your last words it can be difficult to walk away. I hate preaching, especially towards those more senior to me; not what I came here for and I hope this isn't what brought you here. I'm going to head over to the scenarios section and see if I can learn something about medicine. Kind regards, - Matt