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Well this is a awesome concept ... ! Honestly .... have been pounding this idea for over 12 years, not just war vets but down town city boys that want to go to outlying rural areas in Alberta / BC / Sask/ Toba (hey maybe work out of Rural ER too ?) I would bet money that Dr. Wesley is behind this the wings whispering in ears ! CHEERS for a move in the right direction

My first question would be how was this Temp measured @ 91F (~32.7 C) point being is it core ? So I am assuming that it is, 10 cm up the (fill in blank) Hypothermia may the most serious consideration here and I would be skeptical of pulse ox readings due to decreased perfusion, that said > 35 C the patients LOC may be also decreased, shivering may likely not be observed, active extermal rewarming teqniques and gentle handling advised. If one can't pop a line in perferal then consider IO. (PMHX Allergies and History of event may be difficult to obtain)any Medic Alert Bracelet? And we a certain no red inflamed "whip like papules/ blisters" ? The CC of "pain all over my body" could be indicative of the bends / chokes (pick your term) or in fact hypothermia .... Chest sounding "WET" BI basilar lung sounds could be from numerous causes, from aspiration pneumonia or a near drowning event, if SPO2 is 100 and patient not bradycardic or tachycardic. What other questions should we ask? So G/F is present whats the PMHX from her or is she a typical "I dunno he picked me up in a bar last week type?" thinking was patient drinking last evening ? Who should we contact during transport for the most reliable information? Information on what the patient or the situation ... personally if I asked Medical Director for advice in this patient he would have a chat in the back room later . Any other sources we can call for dive emergencies? Where will we take this patient and how will he go? Thing is with a 7 minute transport, flight altitude considerations "tree tops" if possible and get to a facility ASAP, why contact medical control when patient is stable, well, except for information patch. And where I live there is no open water (it solid state) this time of year and no "dive emergency phone numbers" cheers <late edit> is the Dive record on his computer and take that with you to hospital.

What about a White Trash Christmas song ? http://www.funny-games.biz/cartoon/whitetrashxmas.html cheers

A109 E SWEET ! So we have room to move and work and no turbulence ... I wish I would be thinking: 1: Drowning/ Near Drowning. 2: Box Jellyfish, Stone Fish, Irukandji,(sp) Portuguese Man o War ? 3: Bent or Pulmonary Emboli, as not a professional diver. 4: Hypothermia ? Have WE made contact with patient and are we prepared with PPE if the case of the marine critters are still on the patient? Any history to to event: Like lhat is being done in the back of the truck ... is patient awake, is the pt intubated, wearing a scuba or sting resistant suit, whats being done for this patient ? cheers

No say it isnt So ? Whats the death toll now that could have been cut in half by simple but early vaccination and in passing the HUGE health care costs ? http://news.sympatico.cbc.ca/Local/AB/ContentPosting?newsitemid=edm-calgary-death-teenager-h1n1&feedname=CBC_LOCALNEWS&show=False&number=0&showbyline=True&subtitle=&detect See link : http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm US body count ~7,070 to ~13,930 Dead Think you and your family are immune ? http://www.cdc.gov/H1N1flu/qa.htm Canada body count = 390 http://www.phac-aspc.gc.ca/alert-alerte/h1n1/surveillance-eng.php

Not to forget that the "removal" of Acute Care Capabilities and down grading the Hospital in Nelson or Castlegar sewered the possible development of a retirement destination, as the potential retirees need Health Care ... go figure eh ? What an excellent way to destroy the potential of community, meanwhile in Nelson the Drug Trade grow ops / co-ops has BOOMED ! A letter to Nelson Express in 2001 may have assisted to actually have a CCT Team to cover the needs due to the loss of services. Funny, that 20 years ago RNs could care less that some patient showed up to ER in a wheelbarrow or horse drawn buggy but with the advancement in Pre-Hospital Care this is now a huge issue. Even though its a rarity to see an RN in Alberta Health Air Ambulance, in Toba I got paged (in Hospital) as a Flight Nurse on a medivac a year ago and they wondered why I didn pick up a phone ... ? Also with the wide open positions in dang near every Hospital in Western Canada, one would think that RNs would be best utilized (generally speaking) in Hospitals ? I have had most excellent RN F) on some teams and mandatory in AB that the RN have registration as EMT or Medic if working on car. It does add depth of field in care but not being able to get behind a wheel or work in the field is absolutely a waste of recourses. cheers <late edit> way to go rock_slippers to get me WAY off topic The thread and link should be reviewed (perhaps leave a comment on the MacLeans internet site regarding this IAFF move to further stupidity?)

Ok a Diver "sick" ALS requesting transport. I must assume that this is a small bird, A-Star, Jetbox or BK 105 (a big if transitional lift is a consideration) but ruled out to be a concern, I am thinking that space is a consideration and what invasive procedures MUST be performed prior to skids up. So single pilot ? Single Paramedic ? LZ Safe and Secure are LEO of FF on scene (ie appoint safety officer) So a little more background info svp: Is Arkorgania Salt or Fresh water state ? Transport Time estimation for transit en route? Closest Hyperbaric Chamber availability ? chbare have we made contact with patient or ALS ground crew updates ?

I purchased the hat from eBay for a great price and the information provided stated clearly it was only used once and the blood was easy to wash off.

Ok so what just what would be considered "obscene" on a condom wrapper ? And in passing why exclude less that 17 y/o (s) isn't that a target group, yeah know because there is no teen age pregnancy. cheers

Well thats all well and good (in NZ or OZ) but the "terms" of reference and titles are used in legislation and clearly define scope of practice in Canada. In many cases government or the whom ever is funding pastes labels on the trucks and the level of care under the term now as "Emergency Paramedic" this blurs the lines to the extent of bamboozling the public, the term PARAMEDIC includes variances in education from an EMR to Critical Care ( from an 120 hour F.A. Course to 4 years) is this the way to go ? ... Not my idea of standardization, then throw in the concept that FF/ALS is even near to possible instead of funding more ambulances (the Winnipeg Fire Service believes that the Ambulances should be staffed with just drivers only) at there beckoned call ... then quite shocking that the FF "medic" is by break down only EMT level ... The biggest trap that EMS runs into to divide and conquer btw and continual change in the alphabet soup is IMHO shooting us ALL in the foot, besides it costs tons of funding to change the terms, and amendments to legislative documents and if I have to go into the "timeliness" of politicians to address real issues well no point me going on a <rant> again. In the case of the EMT / PCP this is a technical provider ONLY ... I see A ... I do B as after all this IS the truth. Confusing this with the Primary Care Paramedic (well look to the REAL definition of Primary Care by the World Health organization) you may be "shocked" as by definition : http://www.who.int/topics/primary_health_care/en/ so this is a mis namer. In passing only has the "PCP" level or term accepted in "some" provinces one does not see this world wide but it does seriously complicate issues when one throws the Fire service banging on the hero, life saver chests (as in the article) The 'I' in Canada does NOT indicate Intensive Care its Intermediate the EMT with IV skills. On that note is there a true ICU truck out there in the real world ... come on really, chest tube inserion, doing invasive procedures like Central lines, xray capabilities, Swan, Real Transport Ventilators, ABG machines. The term of ICU is clearly understood by the public as in "damn sick" anyway the myth in most cases as soon as the patient arrives in ICU the "medics" drop back behind the curtains, the rare individual that can go from street level and actually assist in an ICU is like having an ER specialist MD work in ICU as an attending intensivist. Advanced Care Paramedic providing ACLS is pretty clear and should become the STANDARD on all trucks in Canada (I can only hope in my life time)that said in a duel role and part of every "urban" Pumper mixing Pre Hospital Health Care and Public Safety is asking a but much and then forget the rest of Canada with this model, is beyond cost effective and or realistic as besides the densely populated urban centers there does exist the "ROW" the rest of the world where ALS rural does make a huge difference in positive outcomes, ie volume expanders, chest decompression, clot busting drugs, 12 lead, anti arrhythmic's, pain relief medication and at least 40 other true life saving drugs and procedures, so throw that individual on a Pumper and you put the pumper out of service if the medic has to transport Laws here are quite clear any medication or invasive procedure and one CAN NOT hand off to subordinate level of care hence the model proposed by IAFF is way expensive. True Critical Care Paramedics are still a rare breed,(the CCP program is not done in 3 weeks as in other countries) typically this pertains to Flight side and required for long distance critical care transports, we do have quite a few of those types of inter facility transports in Canada. In this article the IAFF in Toronto, Winnipeg and Prince George Fire Dept's (and 3 different provinces and all with their provincial statutes) where the training for medical varies greatly. Point being without having the capability of transport, the basis of debate by IAFF by many is the "fastest response time" and the focus arrest situations ONLY, biggest point being the clock STOPS upon arrival HUH ? but very typical Modus operandi of Fire departments justifying budgets ONLY ! Point being again if the statistic's show conclusively that more EMS is needed to meet with medical calls and fires are markedly down why the hell would one provide funding to the Fire Service "to fill the gaps" when the clear problem is medical. An analogy would be going to the store to make an Apple Pie and purchasing Potatoes or in my case Turnips. The OPALs studies (use search engine) besides being very dated, quite flawed (it compares apples to kumquat's) and the funding provided by those that were anti ALS.(they believed the cost outweighed level of care/ proper assessment) Many of the commentators in this article are seriously mislead and in vast majority of cases the only study "conclusions" Hence the drive for IAFF to use this as an impetus or push to fund their departments do they really care about an improved model of delivery of care ... not a hope. The concept of ALS Fly cars, Treat and Release,(increasing scope as done in London UK) Triage by a Higher level of education, redirection to facilities to clinic or available Family Practice MDs, then have the Paramedics actually work in the ERs ... but that becomes a "turf war too" with Nursing staff. This throw a FF/Medic on red trucks is simply a band aid fix and short term and totally forget about the real issue, improved Pre Hospital Health care. That all said IF one can be a FF/MEDIC ... why not train the MEDIC (staffing an Ambulance) to go to FIRE, in the rare case where more staff is needed to pull hose, just saying this is not a 2 way street. Oh and read the comments in the article. cheers

Dear Meghan Shannon: You may find this link helpful, knowing you material is the best way to avoid the jitters. http://www.templejc.edu/dept/ems/Pages/PowerPoint.html In scenario testing when I come to "duh" spot .... I just imagine all the examiners naked. It doesn't help recalling information but it keeps them guessing why you are smiling ... best not verbalize THAT btw. cheers

Oddly enough my ex sent me a note to send me on a trip too (one way) the suggestion was a place a bit warmer than Jamaica and common decency does not allow provision for "destination details" Oh yes still awaiting the autygraff, and I do accept Visa or direct deposit .... te he. cheers

Dear Jon: Which organization are you speaking about, the Conservative government ? They are the ones that have fielded this new bill 60 in order to comply with the reciprocity agreement(s). Will EMTs in AB be called PCP well after chatting with ACoP, I really don't think so any time soon. Dang there goes my business opportunities down the drain AGAIN The concern of ACoP "running free" is moreover being TOLD what to do, self regulation is now a myth because of an epic fail buy the membership to participate in annual general meetings or even bothering to sign a proxy, last AGM was 100 our of a possible 7000 ... we have essentially shot ourselves in the foot due appothy. I am hopeful things can and will improve with a change of government (and send Dr. Drunk Man back to where he came from) presently in AB the Stelmach Conservatives would fail miserably (the latest polls) with the Wild Rose Party knocking on the door. http://www.wildrosealliance.ca/

Did anyone actually read the link to the news article in MacLeans magazine ? It is about upgrading Hose Monkeys on Big Red Trucks to the EMR or PCP level then calling them FF/Paramedics (because the Firemen have better response times in Toronto and Winnipeg )and the propaganda by the IAFF not only is this very misleading but very obviously a budget grab for the cash, no brains just chest pounding that this "model" is innovative in some way. Besides the fact that this is not even close to a solution for rural Canada as most Fire Halls are volunteers. (Funny thing I live in a community of 2500 closest Hospital about 30 mines (direct) we have a 3 million dollar Fire Hall averaging 30 calls a year and NO ambulance ? ... weird EH, 3 24/7 Ambulances in this area and over 12 Fire Apparatus staffed 24/7. My points are quite elemental: If the wait for Ambulance (Toronto and Winnipeg or Prince George the only services reviewed) Response Times unacceptable for a medical call then why the hell not fund more Ambulances to reduce response times, well if thats the real goal besides decrease operating costs over all. One ambulance is far less expensive than a Crash/Rescue or a Pumper with minimum of 4 men and still not have the capability to transport the patient to a definitive health care facility. If you do pull a PCP/EMT off that Pumper is 3 men safe to respond to a fire no your putting that Pumper out of service bottom line, ps I know that some FF services do run 3 men on a Pumper ... so one would be down to 2 men ... sheesh. Then the "other" options in delivery of Emergency Health Care, ALS Fly cars, Treat and Release, Triage by a "Paramedic Practitioner" and/or all level's PCP up to be trained to work in the ER departments whats so wrong with that cross training idea ? (oh yea that would be RN "turf wars" what was I thinking) I was lambasted <insert gasp, sniff, ha ha> for suggesting that EMS providers become cross trained to Fire Fighters WHEN the need arises to "assist" with fire call's. (It appears this is not a 2 way street either .... rather curious NOT!) Fact of the matter the call volume "actual fires" is way down (as legislation building codes +++, heck I say put sprinklers in every new structure) and medical calls way, way up? This FF/Paramedic integrated service sadly ignores the real issues and is a band aid short term fix with ageing population, over crowded in walk-in clinics and Family Practice MDS retiring (mine is) there are better ways, really. Then there is the battle of the sexes ... their remains in the Fire Hall macho "hero" mentality that women can not do the job and the last bastion of male dominance in the work place, tell me it isn't so and I will eat my fur lined hat! cheers

Freaking ... yikes Squint runs and hides, ducking and weaving looking for a bunker.

Gypsy: 2 thoughts cross my mind with this: 1- I would be very pleased to have a preschool care provider to have this medication in their hands over the standard run of the mill "preschool teacher" as any seizure activity can be quite disconserting to observe to say the least. As an EMT as you would know how to maintain an open airway without/with a benzodiazepine in a child in Status Epilepticus until an Ambulance was summoned and arrived of course. If you are permitted by the parents of the child then really I can not see a legal issue, just who would take legal action against you ? Here in Alberta there are provisions in law to allow and care for these kids with serious medical conditions to go to schools with the previso that that they caregivers were educated to administer that drug. (I can understand that you would feel uncomfortable) That said you could if your clever to ask for additional training and flip this into a positive for both the preschool program, yourself and last but not least allow this child to attend school / preschool. 2- The legal issue oddly enough is that your EMT training this becomes an "out of scope practice issue" instead of what is the best moral and ethical manner to care for a child with a known medical condition and to attend school. This could become a really bigger deal by far as the parents (here) could bring a human rights complaint against the school, just saying. cheers

Ever hear of a palm OS based electronic PCR called "E RUN" ?

LIKE WOW ! I guess the photo copy machine is a cost effective alternative, then fax copies too ? Ghetto mentality fer sure.

Ok so have you heard word one from this group in the last 2 years, the forums are deceased the list server is a means to discuss issues is an epic fail, cant get a discussion going even with a BOMB. I had 5 replys for the same poll in are you assisting for H1N1 vaccines ... pitiful really. Chop the funding off and thats what one gets I guess ?

ABSOLUTELY, just put it on a cheque for $1000.00 first .... Arctickat: You must feel very disappointed but this is VANOC and Campbell's doing, I have to take my hat off to you having a set of balls, just ME but this put a spending cap on supporting any Olympics "gack" in anyway way ! There is no red mitts on my Christmas lists now of that you can be guaranteed ! Seriously if we could stand together across Canada to protest the treatment of our brothers and sisters as an Association of Paramedical Professionals It could sent a very serious message to other provincial government's considering these underhanded tactic/s as well this is an abomination and bargaining in very bad faith and will not be tolerated, BCAS management should be sacked. ps I too look very svelt in "Salmon" too and looking for my ice axe and crampons (era 1980)

So whats Wrong with retro you like shag rugs ! Following a logical progression of the Queens English: Should it NOT be called FEET ball ? Agreed "Available" Caribou Please Apply to PM cheers

Good Points ALL: And/Or a pyrotechnic device and does one cut on the top of A post or bottom ? The higher end Caddies or Beamers have been known to kill the uninformed, but Cutting the Battery Cable when the vehicle is on the roof in the snow maybe quite a feat in itself ! Then there is the stupid Hybrid's ..... ? There is a PDA program available for exactly these Extrication issues and is updated almost weekly not a bad investment for Fire Departments (the locals in my Hood use one) cheers

I feel a compelling need to sharpen my AXE ! WTF were these 2 thinking (even to admit guilt is dumb too) AND Isn't ARSON huge Jail Time ?