WolfmanHarris

What we need is to make the CPR recert more health care specific (and I don't mean AHA's or CRC or anyone's CPR-HCP) course such that it makes good CME. So rather than spending hours on the how boring everyone to death, spend the recert on the latest from ILCOR and the why. That would be a recert worth the few hours. Though I just sign my friend's card and he signs mine each year, since we're both instructors.

Do you not see the potential problem in an entirely insular debate? If all the input comes from a single perspective, how much understanding can be obtained? For example, if I have a problem at work I can go to the rest of the co-workers for commiseration and hear their opinions, which will likely parallel my own or I can go home talk to my friends who don't work with me and get some actual input from outside the situation. I have no problem (how could I) with banding together for mutual support. But if its a debate on the issue, failure to consider different perspectives is a losing proposition from the get go. That being said, I don't necessarily expect us to agree on this point, nor do we need to. As a forum, any and all who wish to add their two cents will (and then some). So let's move past the debate over whether or not any of us should offer our input into this thread, accept that it will happen regardless and discuss the OP's original point. - Matt

Go for it! Could be interesting.

Hardly. I'm denying that any meaningful discourse is generated by prefacing the debate first with a list of approved and not approved operational definitions. Rather those debating should accept, that while the semantics may vary if there is no intent to offend and if the language is not obviously inflammatory (as per, let's say in this case, a reasonable persons test). Further I'm denying that any reasonable understanding or progress can be reached when the debate becomes immediately exclusionary and focus on fault and on punitive language. This is neither progressive, nor impowering to those seeking redress as the stigma of victimization continues internally. I don't seek to invalidate your point of view, only your perceived privilege to exclude mine.

I'd argue that semantics are a smokescreen that people hide behind rather than address the issues at their core. Intent is paramount.

Heck I'm documented when I take vitals in hospital clinical and have to sign the ACR as 3rd crew when I rideout, even if I only observed.

We all share in the fault here. We engaged in it in the first place. Maybe I can start a trend: I, Matthew Harris, do solemnly swear that I will give my best effort in ignoring pointless threads whose main purpose is inflammatory. If I feel the need to engage may I limit myself to posting a link directing the poster to one of the umpteenth other similar threads. Fail not in this pledge at my own peril. May I be kicked along with the dead horse.

I'm sorry but I don't follow most of what you were attempting to say. What was your point exactly and how was it related to the original poster and his novel suggestion that rather than Fire taking on EMS, EMS could take on fire?

A guy I went to school with was awful for filtering everything that happened to him day to day as homophobic with the one that comes to mind most being when he was not allowed on the bus with his dog (little ratty, nippy thing). He argued with the guy and the driver eventually just closed the doors and drove away. He came into the team office and started going off about how he was goinf to file a discrimination claim and a friend of mine (also gay) just put down his book, looked at him from the couch and said, "Michael, it's not cause you're gay. It's cause you're a f***ing a**hole." Didn't make a difference I'm afraid. Recognizing and attempting to eliminate true discrimination is an excellent goal and should be not only the concern of HR, but every provider. But it shouldn't be used as a crutch or shield by anyone against their own limitations or failures that exist seperate from that. My maternal grandfather grew up on a native reserve, with all the troubles that entails. He had to overcome alot to leave, maintain a steady occupation and raise a family. Those were his troubles though, not mine. I've lead a blessed life free from that. I don't pursue status benefits or land claims because I do not need to be propped up. I stand just fine on my own. But I don't diminish those who do.

No nighttime scene response means just that. They get taken to the local ER, airport, etc. Usually the local ER and are transported from there by air. In the event someone is very remote and it could be considered a SAR response, the military is called in. The bread and butter for Air Ambulance in Ontario is Critical Care Transfer from one facility to another with scene response being only a small part. I'll see if I can dig up my utilization standards later. Here are the guidelines for interfacility transport ORNGE

So... do you just not read the content of posts about Fire-based EMS? Or have you chose to ignore them to create a post to stir the pot (as per your avatar)? Admittedly more than a few members here are not only anti-Fire Based EMS, but as an extension are not big fans of fire. What you might have missed is that no one wants control of Fire either. They want EMS to be on its own as a separate agency and profession not held back by split commitments. If you'd like to know more, use search and read. I'm not rehashing this one any further and to be honest, with posts like this I'm rapidly understanding the less patient views of some of my colleagues on here with regards to these threads.

I don't know if the counter billing argument would work as I imagine there's less need for EMS on standby for structural fires than there is fire on standby at MVC's without extrication/fire. A large part of me is tempted to say F'em, but I honestly believe that FD should be at any MVC with injuries until absolutely sure they're not needed. Dispatch info, as we all know, cannot be considered reliable to the extent that they shouldn't be dispatched based on it. So you're left in an awkward spot where FD isn't willing to step up to what seems to be their duties (standby for fire/extrication duties at an MVC) without some money being shelled out and telling them where to go with it starts a pissing match where only the public are put at risk. I'd argue that a reasoned argument that says that they are there for the same reasons EMS is at fire scenes under NFPA might convince if that was the actual reason for the problem in the first place. But as Doczilla said, it's about money and the FD wanting EMS for themselves as a funding source. Since their argument doesn't reflect their actual wishes or agenda it's damned near impossible, I'd imagine, to reach an understanding. Let's approach this from another angle then. Has anyone crunched the numbers to see just how much of a budget hit this would be and then combined that with the potential revenue if they were charged for every standby. Multiply that by all the FD's in the catchment (since if one get's it...) and see what the potential hit might be. It's a sour pill, but can it potentially be swallowed in the name of taking the high road? And if so can you cement the role of EMS in your community even more by making a public deal of taking the high road? To be honest, I'm reaching for ideas as this one feels like a fight that's less about the money and more about the FD securing a position of poverty in time for the next year's budget. If they're so broke they need to cut back responses are charge from them and since EMS won't pony up, them obviously the city MUST find a way to increase their funding. Gotta love municipal politics.

Sounds like fire is going to "not our job" themselves out of a job. If they don't do medical, and say the gas company gets sent to CO alarm calls and the city building inspectors take over fire inspection... I don't think there's a good way to convince them. It seems less that they don't want to do the job as much as they don't want to do the job for free. Short of calling their bluff. Question: if both EMS and Fire are municipal isn't this just a matter of the municipality approving money being shuffled from one department to another? I'm not sure where, other than fuel costs, the demand for money would come from. FF's are paid regardless right? Equipment costs are lower if they're not needed since they don't use anything right? For medical calls the cost could be decreased by having EMS supply and stock the kits they use for these calls (O2 tank replacement, C-collars, etc). I don't quite buy a wear and tear argument because any paid department I've ever seen swaps out their trucks long before the end of the chassis serviceable life and they end up with a cash strapped VFD.

You know that's something I hadn't considered. Up here, the downturn in the economy means there might be some hiring freezes and a halt to capital development projects for some services, but I'd looked at EMS as being a quite stable spot for me in a tanking economy. Good pay cheque and falling house prices? I didn't consider the effects on privates. From what I understand, collection rates can be quite low in a lot of systems making profit margins razor thin. Is this the case? And if so, we'll private 911 run into the problem of people losing their jobs, relying on 911 and Emerg for their primary healthcare even more and since you have to respond but they won't be able to pay, will these be losing propositions? How was it during the last recession? I remain a proponent of public EMS, but I'd hate to see any of you folks lose your jobs.

What is the saying about knowing enough to know how much you don't know? I'm afraid you don't even know that much my friend. It's natural to not want to look at the system you work and find significant problems. It's natural to look at the hard working, decent folks within your department and not want to admit that despite the commitment and hard work that your department is not providing the best care possible for your community. It's even harder to look at the work you put into your training and admit that while you worked your hardest and learned your stuff, that despite your best efforts, your education was deficient and failed you and your efforts. These are incredibly hard things to face but there's an important distinction to be made. No one is saying that you as individual providers are not doing the best you can within your system; we're saying that as a system there are problems that should not be ignored. If you can see within yourself to separate these concepts and not take them personally, than you can look past your backyard and see the areas where your system can learn, improve and provide the service I'm sure you would agree your community deserves. I don't know a tonne about your department and a quick look on its website told me very little. Therefore I will only address one thing that you have mentioned and that is relevant to this discussion. Crewing. In terms of general crew requirements, I would argue that a single ALS provider should be on every unit; at least until that hallowed day when we have one level of care. In Ontario, education is very much geared to, this is the first step towards ALS. We are taught to work with ALS (in terms of equipment familiarization and background information) and the tone of the instruction is that most of us will go onto ACP within a few years (backed up by stats that say 80% will go ACP; sorry no source). I plan on being ACP within 5 years of graduating max; 2 preferably. It sounds like on staffing LA Co has a great start. Two ALS providers in a unit. Now go the rest of the way and lose the squad and enter the 21t century with the rest of the world. Treat and release is a great direction for EMS, but in the end transport medicine is still the cornerstone; a cornerstone you don't even touch.

Not to mention on a roadway I want that engine as a blocker vehicle for me and everyone else on scene.

Gets gripes for way more contact?! I wish we had even more than we do and I get about 700hrs rideout and 100 in hospital. We do hospital every other friday and I wish we did it every friday. The fact that this politician would rather have an experienced first aider than a new EMT is kinda scary. I don't know how first aid is taught down there, but up here they aren't even familiarized with any of the equipment they'd be helping an EMT with. So would I want an experienced first aider whose picked up anything he does know along the way and may have been taught wrong, or would I want an EMT who was unsure of themselves but atleast spoke the same language as me and knew the equipment? I'd take the EMT any day.

I can't confirm this one for sure as it's the product of the EMS rumour mill, but recently one of the town's in Durham region approached country council wanting to be paid for responding to EMS calls. Durham Region EMS (3rd service Regional Municipality) told them thank-you but in that case your presence will no longer be required at anything other than VSA's and MVC's. So far FD is apparently happy with the arrangement, but budget time hasn't come around yet and their decreased call volume hasn't been an issue. I do not know of any area within my part of Ontario where FD is paid for their first responding by EMS. The cost comes out of their annual budget, which like any municipality, there's no bonus for having a surplus of at the end of the year.

Want to always remember 2nd degree type 1? Watch this. Diagnosis Wenkeback Wanna get a laugh about the others? Watch this. Everybody dance now!

That an Ambulance is still required to carry a first aid kit, and no, the equipment in the back doesn't count.

I don't believe in Fire Based EMS as the best option but in this case, nothing here seems to be the doing of or problem of the Fire Service. A private company dropped the ball huge at the expense of the public (by the way, not a private EMS fan either) and the Fire Department is picking up the slack. Yes this means more fire based EMS, yes this is good for LVFD; but I don't fault them at all for it.

Welp when I talked to my coordinator to get excused from class I was told that there will be a test that day and given that it's the end of the semester I must reluctantly miss out. I'll be kicking myself all year on this. Doczilla, any chance this is an annual thing? I'm so impressed by the commitment to education by you and your folks. Thanks for the opportunity, I appreciate it, even if I can't make it! - Matt

I lasted 30 f'ing seconds before I had to shut it off. If only we could do that in real life.

I'll save you a trip. Find a local street full of big box stores and then find a cookie cutter generic suburban street. Repeat until you reach a population of 80000 and you've got Newmarket.

I grew up in Newmarket but don't live there anymore. I've got a very nice aunt and uncle there though. If you're really in a pinch PM me and I can give them a call. (No promises I'm afraid)