hammerpcp

Ummm......abdo. pain? to put it delicately.

If you impressed Marty that's saying something.........and yes everything I say is personal. :wink: Go team! (Just a useless post getting us one step closer to busting that record)

Assist ventilation's. Apply monitor and SPo2. BG. Vitals? Any other PMHx? Duration of current condition? And what do you mean she "thought they were seizures"? if i am skeptical about her ability to recognize a seizure i would ask her to describe the Pt's presentation in detail. Incontinence?

That sounds like a great idea! I would love to not have to transport every abdo pain call. We could do in house surgery and It would probably take less time then the offload delay at the ER. Now that is using your resources efficiently!

Steel mill flava anyone?

:oops:

Great handle. What is TEMS? Toronto EMS? tactical EMS? testacular EMS?

I mean clearly, Jonathan was gay. If it wasn't for eleven year old Alissa, that show would have been cancelled after its first season. And Tony and Angela? Please! we all know that Tony was secretly with Mona the whole time. Eh OH, Oh Eh.

Like I said, what the hell is an intermediate? The point I'm trying to get at, is that level of training and procedures, and scope of practice is all relative, and it is also progressive. So there are no absolutes. At some point, some one decided that you had enough training as a paramedic to do whatever you are allowed to do. And at the time this was a fairly arbitrary decision and i am sure many people argued about the education levels of paramedics and if they knew enough to safely administer the next drug, or use the next airway adjunct. The potential benefits of each new procedure are weighed against the potential risks by the powers that be. And both are constantly being reevaluated, as they should be, when new research is done.

I'm going with abdo pn.

Well said. =D> Let me dumb it down some more for those of you who still don't get it. Medicine is a constant balancing act of harm vs benefit of any given treatment or procedure, be it medication, intubation, IV starts, etc. For any of you to say that any particular procedure or treatment is absolutely not acceptable for any particular level because "that is how it's always been" is sooooo ignorant. (Can you say paragod complex?) Let's aim for progress in this field here people, not stagnation. As of yet no one has given a good reason why sufficiently trained (or educated whatever you want to call it since the two words are really interchangeable) individuals should not be allowed to administer Narcan. On the other hand several very good reasons have been given supporting appropriate administration of this drug.

Lithium, "2 mg isn't enough, I'll just call for more" is not my thinking. I hate to repeat myself, so please reread my previous post. And no, you are not making yourself clear. You are in fact contradicting yourself by saying in your original example scenario that the pt did respond to narcan and then later that they did not. OH..there i go repeating myself. Anyway, to state that BLS providers should not have access to ALS meds is quite a broad and self important statement to make. Especially since up until now you have not been able to substantiate it.

um...I thought your example was trying to point out that narcan has a shorter half life then some opiates? Not that the pt had no response........?So why wouldnt you call for more narcan?

I say get rid of all the ex-paramedics.

Ya 99..LOL. Or muscular skeletal trauma or whatever it is. But if you don't think it is ischemia don't use 51. You'll have a lot of 'splainin' to do when you don't administer symptom relief.

Again, its a monetary issue. Ideally we would all be doctor-medics riding around on the ambulances. I'm not sure how intubation made its way into this discussion, and we weren't talking about Valium either. As far as anticipating side effects of medications you administer that applies to everyone and all medications. Did you administer NTG as a PCP without knowing the potential adverse reactions? I hope not, since that is part of the PCP skill set. Also, many PCP's have LMA's and combitubes in there repertoire. And surgical crics? Have you ever done one? Never mind, that is off topic. You wouldn't contact BH for orders? Airway management without intubation is not ideal, I don't dispute that. What the hell are we talking about here anyway? Narcan is good, and so is IV access. It's good to be convinced and unwavering about something that is untrue. :roll: I say morphine for everyone!

I thought we were talking Canada here. Ayway, I am obviously missing your point because from what I understand you to be saying is that IVs are pretty much useless except for drug administration . I mean, if a PCP is giving a drug that requires IV access what is the difference between that and an ACP?

You've retired the old G-string? Thats a shame

Who are you calling a "sub-paramedic provider"?

OK folks lets do a reality check here. We have basics or EMTs or whatever because of the bottom line. You educate people more you have to pay them more. Lithium, stop laughing at us Hammertonians. Don't judge us because we have mullets and no teeth and really like Tim's. Anyway, if I understand you correctly you are saying that PCP's should not give Narcan because they do not have the capabilities to deal with potential side effects. (It just occurred to me that you could administer morphine to someone experiencing seizure from acute opiate withdrawal and it would probably be much more effective then just suppressing the seizure with valium. But I guess you would then, technically, be a drug dealer.) The problem with your logic is two things 1) there is always a higher level of care, I'll borrow something that is already mentioned....ALS medics have Valium but do not carry romazicon. Same situation, no? And 2) As I stated earlier, as far as drugs go Narcan is pretty benign and the chances of actually inducing life threatening adverse reactions is actually low. (If administered properly) 8)

Well..............Since we are going to debate this over and over again I thought that you all are entitled to my opinion. Ontario PCP's (sorry Neesie I can't speak for the other provinces because i just don't know enough about their education, although I will take your word that it is sufficient, since your medical director and provincial government seems to think so) are trained in IV skills, initiation, indications, precautions, etc, etc. In fact I damn near perfected the skill while in school only to graduate and not be allowed to use any of those skills or knowledge. If my education is not sufficient to have IVs within my scope of practice then American paramedics should no be allowed to either. *Hiding under the desk* And nsmedic393 are you beating your chest and saying "I'm the boss" again? Whats the problem? I don't see it. BLS or ALS skill, whatever you want to call it doesn't really matter. IVs are quickly becoming a standard skill set for PCP's in Ontario, as well they should be. If you don't want to call us BLS medics anymore that is fine. We change our title every few years anyway.....and the public continues to call us ambulance drivers so who really cares. BTW, D50 is a much safer drug then Glucagon, and we give that out freely.

Meh.............. :dontknow:

Where do you work? I'm comming over. :wink: