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I would not jump up and down and say this will not become a reality ... in 1993 the groundwork was laid by Nancy .... whatever the hell her name was, the Minister of Health ... oh yea Betkowski the turncoat. Just where did she go anyway ? NO CHEER. Heck, next thing you know there will be a 24 week course for foreign trained immigrent MDS to be fast tracked on the taxpayers dollar ie. FREE ..... to become REMT-P and fill the gaps ...<give me stength> WTF is the Brendan Institute anyway ? If my fellow Albertans do not believe this is far more a concern .... sheesh. ps A letter recieved from MY M.P. stated a "review" in the next budget this will be forthcoming and thanks for bringing this to my attention .... hmmm, damn good thing I say, if their credentials ie FTMDs and level of English comprehension and credentials are not accepted for medicine, then why sould they be accepted for Paramedicine ? cheers ps If it came down to it, I would rather work with an AB registered EMR (on car) than the possible alternative.

On the same page ! but what the heck with paracetomol IV ?

The EMT/ PCP level in Alberta does have Entonox (the vast majority of sevices) in passing. The question that must be raised and with the multiple "handles" are used nationally, and PCP this is really not standardized across the many provinces as of yet. I have very serious reservations in allowing IV MS for the PCP level, well with one previso... unless the patient is on a self admin pump. It was mentioned that the BC PCP maybe giving this on LDTs .... yeah know thats scarry to me. Question raised is what level is educated "enough" to provide Narcotic Pain relief ? I have serious concerns that just any PCP/EMT could give any IV drugs, just not the background in the vast majority of Canadian programs that I have reviewed, (there is a stong reason to push for all to become ACP) as without background and the other essential tools in place to protect airway and effectively deal with complications ie anaphlaxis and reversal .... these are very serious considerations to my way of thinking, it is Paramedical history if one screws up ALL will be restricted ... sad but true. Must agree With WelshMedic .... we are not doing as good a servive to our patients as we could be, btw I have never heard of paracetamol IV ? I believe thats what we call Acetaminophen here. One will find this situation more the norm than exception, I have made it my personal policy to "top up" for breakthrough pain relief in the last block before the ER ... especially when I know it is busy. Another good trick is using what would be the normally the waste from IV ... say 3 to 5 IV MS as an example (for movement and transport and to effect) the rest IM ... no point in squirting 38 cents of MS down the drain, maybe it's the Scot in me I guess ? <G> Waste not Want not. cheers

Thanks but I will pass on the offer for dinner of Frogs Legs :shock: cheers and now back to regular sheduled programing.

Very Harsh Ok so have you ever thought of using Blow Darts :shock: http://en.wikipedia.org/wiki/Curari

Agreed 1000% this is a recipe for legal disaster. Unless one can: 1- Evaluate the ETOH level on scene? 2- Counteract with some new magic drug the effects of an ETOH OD ? 3- Until that time ... this is not practicing medicine at all, its practicing CSI. I suspect a very negative PR result with the general public as well. Will they even call an ambulance if they are at all intoxcated and ill ? .... silly silly silly .... tisk tisk tisk .... dumb dumb dumb. cheers ps love the new look AK, did you finally shave ?

Quake mind if I use that ? te he

Curse: Well please accept my personal apologies for the spelling error, some how my point was lost as a result, i guess its true some people cannot see the forest for the trees. Shockable rhythms get shocked rhetorical question's hey, I can even do it on the cot and my monitor fits on it. EMT-B, EMT-I, EMT-P = Eds Moving and Transport is bottom line in my books. Most pleased to respond and thank you for providing yet another "circle talk" example : Non committal, with purpose, to point out, you disagree with Phil and others GET to more of your opinion ? Sorry, with all the flowers something got lost me in the presentation, I am quite simple minded that way. I agree with Phil as stated prior, his opinion is in my mind far more realistic and in my world good educators lead through encouragement, provide tangible realistic examples, and be supportive. Look to Timmys senario re: Cowgirls .... a very nice presentation to amplify my point, very clear, consise, truely just asking for advice. These "what if" situations rarely lead to anything positive and lead to guessing games only. As IF any experianced provider respected on this forum site has never had an arrest on the ramp. My last one of note was a ruptured ectopic pregnacy and no possible way one can treat that in the back of a gut wagon nor even the ER, fortunatly we had a surgical resident with balls on that night, and she popped in a sub clavian line and we were pressure infusing blood asap, 2 large bores didnt hurt either en route. ps she lived, a good history taking was what really saved her. Curse but you have now hijacked this thread and completely lost MY point and you failed to address proactive vs reactive Paramedicine, but then again how could you without proper information with such just a genaric query. cheers

Mind if I say a few things in this dubious "senario" to start with... no mention of what even type of call Cardiac, Trauma, Maternity, Siezure, GI Bleed, Respiratory, Stuck Fart .... HUH ? No mention of the recieving facility capabilitys rural vs urban ..... ? Then throw in no exact patient rythum ... arrest only ? shock or not shockable ? Is even if this ALS or BLS ? The really a simple answer go back the basics .... call for HELP .... duh. Agreed. But no not good enough for some ... so then lets introduce RNs are idiots and so are MDs and Paramedics are Gods because they know ACLS, why am I laughing again and who said this ? .... well who cares really and they are not a team player, I dont want them on my gut wagon. SO we somehow manage ROSC ... and are our rates in EMS alone are abismal to start btw and with a 2 man team we can not appropriately provide post resus management in comparison to ANY facility not 3 days but immediate .... the smoke is tickling me butt right now. Tell me of one facility when the Driver hollers "HELP' From the bay no one will come out of the building ? Genaric questions get Genaric answers, yours is circle talk only. But heres even a more challenging point for those that are really cocky .... put the egg before the chicken So if this patient is so close to arrest why have you not taken preemtive action ie RSI to start with and take the WOB (work of breathing) away, oxygenate and ventilate ... before that Patient Arrests ! This is proactive medicine not reactive medicine when will we learn ........ cheers

Maybe contact Autovent, they do make training VHS and CDs of this I do know. I do not have one handy sorry:>( cheers

This is an acute issue, bottom line ANY narrowing of Pulse Presures and resulting in EMD ... your a fool not to try this, granted with a PMHX of so whats to lose ? ps try search Pericardiocentesis on this website ... maybe ? cheers

Well I DO stand corrected and quite pleased too (I guess you just can't believe remote support office people, because it takes the profit away) .... thanks for the link, I had never persued this but will now. The only issue I had with the vac matteress was that in rough terrain (ie volcanic rock) you don't really want to get a rip in it, it really wasnt that robust. On the other hand using a SKED in conjuction best of both worlds tad heavy for rescue work packing it in. When on air transports with the vac thingy one has to be quite vigilant as Boyles Law as this can complicate issues ... on assent keep the vac pump handy, just saying. :oops: In a ancient northern deployment we glued 'closed cell foam' (old camping type style) on the clamshell/scoop aluminum so the patient would not freeze to the device ... it turned out to be very difficult to clean, even with a pressure washer btw this memory foam is open cell therfore once contaminated ... its time for the garbage, unless one could develop a puke proof cover could enclose the pad. Now if my server was a bit faster back to checking scuba's links ... I don't believe the complications of stress ilieus has been mentioned and even higher risk factors for the trauma geriatric population plus the need fror additional benzos and narcs to keep the patient comfortable on long trips on LSB. Oh yes I am aware of lack of evidence for efficacy or data to prove the LSB prevents further injury, and a huge undertaking to prove otherwise, but this LSB still is "Standard of Care" becomes a legal issue if one opts to use another device only. ie OSS. or KED. have recieved a few finger waggings from recieving ER docs. Cheers

Well gotta say, I sure enjoyed Texas .... kind of Southern Alberta only really farking hot .... Cattle and Oil speak ..... just too bad they threw me out of Ft. Worth, I wonder what that was all a boot or what gave me away Eh? dang

I was going to get ballist myself then I saw this post ... rock_shoes making blanket statements are folly, thank you AK, for saving an internet life. SAR work I carry, Polar Bears, Grizzlys, Black Bears and Cougars do not require a silly ass pistol you need a cannon, ever work extreme remote or at a forest fire ? .... I was at Katrina as well but was not permitted. Ever worked in a northern reserve when RCMP are 50 kms away ... hey sometimes I wish could shoot back, as for those that have been shot at or walk across a kill site have kinda different perspective, it kinda makes it clear who and who not been shot at. I carry rubber too as I would rather haze the bears, than shoot them, but sometimes that too can causes a charge ... then you knees knock together big time.

Have used Vacume Spinal Imobilizers ... but they are NOT inexpensive and cant even remember who makes them, I think like 10 G a piece ???? One can fall asleep in one of those, like an old bean bag chair concept with the air pumped out ... very sweet kit. In the boonies I pack a SKED and OSS an only 24 pounds, raises, lowers the works. I like this idea DocHarris got a picture ?

I believe he is "undercover" somewhere, good news is I believe he was part of this study, see under special ops. cheers

OK so I am going to spoil all the fun, jokes and games. Ever see the Movie called "The Worlds Fastest Indian" btw nothing to do with aboriginal cultures, unless your from Springfield. If you have not seen it I recomend it highly, I will leave it at that. cheers ps I always win :twisted:

Yes thats why I was considering dumping Toradol, GI PMHX maybe when it expires but the old boys say its the way to go with renal colic, btw Diclofenac is killing the worlds vultures .... hmmm ? I get a lot of wood chips with the chainsaw gangs , Pontocaine great for one or 2 doses to inspect, makes life easier all the way around, yes it can if used excessivly delay healing for arc flash conjuntivitis, funny it was OTC here until just lately .... damn welders ! Morgan lenses and a Marcaine drip the best for longer term relief, saves the opiates, and chopper time. Taking care is my job .

Any one use Toradol aka Ketorolac ? I was going to dump it from my remote stuff but have learned that it is very effective for renal colic patients, where in past, I would go straight to Fent or MS, live and learn from others. Thanks to Larry, Donn and Dust. No one has said anything about eyes ... any Pontocaine or Marcaine out there in upside down world ? cheers

Some days I just have no control over my fingers . cheers

Maybe something lost in the translation to Canukistanian .... and a boot time, eh? cheers

Good query, dopamine is a precurser and dependant on dosage has numerous effects, around 5 is renal and mesentaric artery effects ... is this needed in the neonatal? then positive chronotropic over 10 mcs/kg /min.. yes neonatals respond with increased rates to compensate, unlike adults witch is positive inotrophy ... ie starlings laws so alpha and vaso constriction becomes quite a factor. Vent will most likely deal with sepsis as neonates respond with odd coagualopathys quite typical in sepsis and epi will increase PVR and your ahead of the issues, BUT when your kid is not responding to fliuids you have major concerns like death. cheers looking forward to ventmedics comments.

What Country ? You boast Canadian Flag ... world wide or more bs polls ? cheers

Why go Dopamine in the first place ... I would go Epi.