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Its Not a matter of opinion, it is legislated they can not work if the company does not have a minimum level on site, that's a minimal level again, Did you actually read my previous post ? The big concern I have is that in most areas in Alberta there is more EMRs per capita of oilworkers than need be, its simple overkill. Put a Clinic in a remote area centralized say like Twin Lakes Road/ Willow Creek road/ say just south of Mariannas lake? Staffed with an RN and a EMT-P and half the # of EMTs (getting rarer) and a bunch of EMRS, strategically deployed to cover not just that "one" company but everyone in the area. This concept is an absolute total win win for the workers and if done right could hugely lower costs to the Oil companies AND provide Superior CARE for all, with a decent pharmacy so that "buddy" doesn't have to travel 12 hours round trip for 10 bucks worth of anti biotics for a bad tooth, (ps or wait in the already overcrowded ER waiting room for hours) As for EMRs having a larger scope of practice than a OFA level 3 could you be more specfic ? Perhaps an example or 2 where an EMR has a broader capabilities or scope ? After all, come on, man it is just an 80 hour course. There is no professional snobbery here just facts and legal regs, I am hoping once again a level that believes with this extensive education can evaluate whether or not ALS is required. A point in passing I an treating more and more "medical" and a mixed bag of COPD, cardiac history with a super imposed pnemonia these are complex patients. and current regulations like in your MTC is set up for trauma only (hell the OH+S doesn't even require a cot to sit someone up) the demographic of the oilfield worker is changing ... cause the boys are getting older, so lets not get silly please, this is the Canadian forum. cheers Yea I hope that those CCPs from NS are registered out here, if there not they stand serious risk of legal action, that said: We have lots to learn from the community outreach concept that appears to be gaining excellent momentum out east. In closing I agree one can not take a Paramedic off the streets of Cow Town, and expect them to provide remote care ... its just not in their education process, offshore and remote are very specalised areas.

Ok if I am picking up what you are laying down : "So easy A CAVEMAN CAN DO IT ?" Thats odd, I thought Neanderthals died off quite some time ago, or are they all just in counselling ? late edit: ie Notifications: Anyone a Monty Pythons fan ? "BRING IN YOUR DEAD " ? now thats sarcasm

well tanks "priase dog" dat da fat heart dood gots awl dem funy lokin beats gosh sur dang happy had me trusty bic pen ta cut him a new troat wit me on my heavy duty belt bat belt translation: Pointed humour, no disrespect intended to the 'open minded' EMTs.

Just saying ..... love that Dwayne and I commend you for defender of the I hope "open minded noobs" like Miz Black Crow but please implement some triage techniques, thanks in advance. I too like to encourage and try to support the new comers to this professional site, but when the topic of discussion is so obviously NOT a BLS subject. ie Using a 12 lead to rule to out MI, is there not enough threads already active for blowing smoke up ones own ass ? Then why, oh why would a such a silly and I do mean bloody silly post based on a very nothing other than "hey we are faster theorem" I have no guilt feelings to advocate a most serious mental thumping be implemented and should be the order of the day, this "poser" I have no doubt will only continue to be a disruption ONLY. Respecting the others that take a great deal of time to post intelligently and positive input, after all this site is BASED on VOLUNTEERS time and serious efforts for an informed debate and issues that may positively affect advancement for EMS. Commenting in this manner, and completely off topic is comparable to a Paramedic walking into trauma/ cardiac/ neurosurgical rounds and telling the surgeons and inform them that s/he delivered a baby ... sheesh, give me strength to be the good Shepard, oddly every thread of my soul wants to put a cap into this guys arse, are you getting the drift here door knob, ps door knobs are used to open the door and are useless after the door is open, looks like total lack of "situational awareness" quoting "zilla" becomes apparent once again. Bottom line is this Jinketsu is walking into an "unsafe" or "unsecured scene" .... bang bang You FAIL, Your DEAD ! simple. So just when will the day come that the media stops reporting "The victim was rushed to the Hospital" instead of "The Paramedics rush to the scene where the Victim was Stabilized and Transported" ? I am beginning to believe that it will not happen in my life time very sadly, no matter what we try do and very disappointing. Well at least we have Miz Black Crow, thumbs up little lady :!: tOTALLY oFF tOpic YEA dOOD jus LIK aGiN .... (bit of a subliminal message think anyone will pick up what I am laying down, this isn't my 12 y/o kid TEXT messaging ! blimy) I do enjoy the EMT/Paramedic team model as it fosters a positive a collaboration model for a positive future, yet very obviously NOT the case here in that regard. It is quite obvious that this is not the situation at hand, asa can't hurt you ?????????.... just 2 weeks ago I had a patient that reacted adversely to ASA and very seriously complicated his outcome, (yes, quite rare) but this was treated effectively and just WHY, yes because I can as a ALS provider recognise and take appropriate action ..... that said ASA is NOT the frigging TOPIC ! So I leave you with this: If you continue to think the way you have always though, you will continue to get what you have always got. IS IT ENOUGH :?: ps Admin PLEASE could you add a "vaporize" button next to "report" post sure would save a lot of My time ! :evil:

:arrow: AGREED Scara I know this is off topic but I simply LOVE your new look, let me think it its so umm .... SCAREE ! :shock: Its a very intimidating tactic ... but It will not WORK :twisted: LMAO

Have you got a link, PLEASE , cause I do not make the big bucks like AK / Dust to afford this JEMS thing Don't you mean good observational and clinical skills ? Yes, agreed we have established clearly that relying on an EKG for dx of MI stemi or non, this can be a late finding, serial labs are the gold standard. That said: Oxygenation Evaluation = The diagnostic tool "Pulse Ox" presently available to determine Hypoxia. vs Ventilation = ETCO2 which is the tool for an indirect and "somewhat controversial" acid base imbalances and often complicated by V/Q mismatch. Nuff said these are clearly distinct diagnostic evaluations. So I ask a polite Question: What is the first (correctable) cause of an possible imminent arrest .... Hypoxia or Acidosis ? BTW there are many ways to improve oxygenation in the ventilated and spontaneously breathing patients. Already KNOWN or assumed, sorry ? Once again You are the master of evidence based medical studies, did you throw that philosophy aside on this one or are you just teasing me? :twisted: Ok 45 seconds is this the average time? or your time, man it takes me way longer to do a 12 and R sided than that, and I think I can do it faster with a 4 lead EKG, to obtain a working DX. Now lets be reasonable this is simply bunkola, with the proviso being that a serious relationship has already been established with the attending Cardiologist and the Paramedic, in most situations they have never met, come on R/r this is not reality here. Yes even the Fly boy, as most Cardiac patients prior to an arrival to ER are dang lucky just having a Fellow or Chief resident saunter down to ER to take a gander before the attending is even called in and the team is gloved up and ready to blast ! Thing is that my system it may be very different, I would tend to believe in most situations I suspect the ER doc calls in the troops not the Paraidiot. We are not THAT well generally accepted just yet, hey, maybe some day down the road. 8) zactly !

Positively and Absolutely I whole Heartedly DISAGREE ! Pulse oximetry is a Vital Sign..... everywhere ! If one looks to the studies it is abundantly clear (ps these studies were done in the US btw!) and by experianced flight Medics and RNS, yes clinical judgement is clearly a guideline when Dyspnea or SOB c/o but when the flyboys/girls and can't identify Cyanosis until those that are truely hypoxic and cyanosed until they are a life threatning < 77%. Its a proven fact JACK, the reliability factor is wholy based on perfusion and the complete understanding of the device, its only as good and reliable as the practitioner that is using it ! say JUST like the 12 lead EKG ..... But this TOO is a side bar and excuse me for getting off track, the topic is 12 leads ! sheesh.

[align=center:65ea16d291]HELLOOO, think we could get back on thread ...?[/align:65ea16d291] [align=center:65ea16d291]I DOUBLE DAWG DARE ANYONE TO DEBATE WITH ME HERE, YOUR DELAYING TRANSPORT AND HURTING YOUR PATIENTS ![/align:65ea16d291] ps I always tell my kids, cursing is for those that have a very poor vocabulary.

Good golly that guy (my evil twin) is long winded....OMG! The really sad part is that In Alberta is huge majority government of Government dictates these levels to the Industrial shows and scares the crap out of them with a little Bill called Due Diligence Laws. POINT BEING there is 10 times more injuries in the home as compared to Industry and The Alberta Government simply underfunds the vast majority of communities other than major centers, a double standard in my humble opinion. Simply put, the municipalities cannot afford to pay and retain GOOD EMTs and PARAMEDICS with equal wages to Industry, a very sad state of affairs. Thing Is THEY ARE WORTH IT! cheers

Ok just to play the devils advocate, and for entertainment sake as well. 1- If you do not carry any Thrombolytics on car, nor bedside troponin for that matter. 2- It has been established that 12 lead can not rule out MI. 3- You have the capability of doing a R sided lead to rule out R sided infarct, talking Nitro here. (besides you can do with a LP 10 or equivalent) 4- One other exclusions.. yes, its a cleaner picture of an BBB, a possible pseudo VT. (but one still can rely on clinical observation for that can't you ?) So why then would you delay transport to a definitive care center? We know that patient is progressively infarcting as we speak and any "delay" does cost's more tissue damage? Are we playing ERdoc ? cheers :oops: :twisted:

Good advice ! It is break up this time of the year, things have really slowed down on the "gas" side of things due to prices, meanwhile back in Ft. Mac its busness as usual, stupid crazy just A word of caution if an Employer will hire you without ACoP registry be very very aware, you may be on the sharp portion of the learning curve. There is presently over 180 "bandaid" shows in the province many ma and pa ops that are ummm sub theraputic ... ! Heres a good question to ask any and all, can I have the phone # of the medical director you may be amazed by some of the replys in that regard, ps its Alberta Law to have a Medical Director on staff .... good luck with that. Bottom line: Industrial EMS is not EMS, if you have worked on an offshore platform in NFL that would be "similar" :shock: Best search this site on a variety of topics, try ACP/Industrial EMS/Oilpatch +++ first, some very interesting advice and insights by many experianced members, yes, it can be boring as hell. Thing is if your way out in the boonies on your own/ with a poor medical operator and you take a good hit you may find your over your head in a blink of an eye, perhaps google up some due diligence laws as well, just CYA. Immediate Reciprocity is an ... hmmm interesting issue to say the least. cheers

I have done follow up, thanks for the heads up ! I am so pumped about this Study anyone/everyone in EMS should read the complete pfd, a quick google. A CAF link, fyi. http://www.google.ca/search?hl=en&q=RO...trial&meta= I do have a few queries in regard to the ARDS outcomes, it does not appear from first review that any "guidelines" in so far as the means of ventilation for the patients in this study .... as we have so much research data in that area, ie Small VT (5 to 7ml/kg ideal body wt) as opposed to Conventional VT, (10 to 15) the outcome studies in this multicenter study were very conclusive. Question remains are set Ventilator parameters or Manuel ventilation guidelines part of the BC study, if ARDS is to become an outcome indicator? cheers, and I believe I am getting sexually aroused ....;~) j/k Sure would be lighter to carry in my remote kits ... just in passing.

Don't mean to be too adversarial here zilla and in your post and I make note: You are not commenting on bicyclic type drugs as Effexor/Venlafaxine, which in my personal opinion is a lemon, many documented cases of extreme difficulties in discontunuation of this drug. Wendy T try google please, you may need a support group. I have asked many exactly the mechanism of action other than just reuptake and some very informed individuals can not explain how exactly this or other rx works, point being do we actually know enough enough about the human brain as far as the very complex chemical/ pharmo reactions that take place? I do not believe that we do quite yet. Absolutely there are treatable organic causes but it is a sad commentary on our North American Culture when "meds for your head" are prescribed in such huge numbers. Just take this pill and troubles will be tolerated, sadly more often true than not, I believe that there is a lack of funding for mental health councilors and this could partially be to blame in some cases. Perhaps even a reflection on our fast paced, chase the buck society, could be a direct result of media and marketing and that hollywood movie ideal, dictating what success in life is really is supposed to be. This instant society, with instant food, instant communications, instant gratification, instant fixes, and instant whatevers. It always floors me when an "ex" father in law goes to hospital for his "ticker" and looking for the instant fix of a pill, despite a heavy smoker, hard boozer, overweight, saturated fat eating and depressed fellow and somehow the MD is supposed to instantly solve his problems... ? cheers ps I could not agree more with asytole in 2 leads !

I am a true believer in aerial spraying of prozac, just think, if all medivac aircraft sprayed before they landed it would be preventative EMS medicine ! :twisted: j/k

Yikes: I thought CCEMS was CMA accredited ? You sound bitter or something did you go to that school ?/

NOT IF YOU WERE THE OWNER Ok oxygen and bar in the same sentence .... I like it! Late edit: correction CO-OWNER duh ! Hey what a opportunity I can see it all now,and sorry folks for RRTs ONLY, :shock: I am thinking more of a retirement job on a beach somewhere hot ? Hey the Hollywood crowd would eat it up HUGE ! So with 1 oz of orange flavoured Vodka via S/S neb, at 8 lpm @ $ 1.00 per liter. Hey the medical grad stuff is not cheap, so just how did you want to pay for that $50.00 tab sir ? We do take Cash or Visa. Check your pulse oximetry ? ..... sure but that IS extra :twisted: :wink: OMG your ONLY 98% ..... another round then ? :wink: Hey we do have that new STAR WARS mask too .... LMAO!

No intention to make light of a very serious (with my prior post) Not only the actual physical disability itself but ALL the personal emotional that seam to well up during these difficult times. Very unfortunately, a rather rare infectious pneumonia hammered me ... and bloody hard! I was slammed into an IC and where I worked in fact. To further add insult to injury, was thought to be a mycoplasmic pneumonia, I wonder where I picked that up ? Not only was it very difficult for me, as it was hard on my co-workers as well watching me circle the drain. I even had one crying at my bedside one day while pulling an ABG from my art line, odd because I felt for her more than me at the time and weird because I felt guilty in some way. High dose "Roids" and Hypoxia do fark up ones thought processes just a tad, feelings of sadness overwhelm me even to this day over that. Ah there's no such thing a PTSD, thats just lot of wimpy pschyco babble :roll: Workmans Comp was never a consideration as my MD stated "a waste of his time" filling the papers. (would be rejected he stated) The rationale being: it was a "possible" I contracted an infectious community acquired disease, one genius resident even proposed I was SARS ... HUH ? :evil: if that test was positive at least then I would have had coverage! I was forced to fall back on EI/ unemployment insurance (in my neck of the woods) our national social service net and that pays even less than WCB and apparently one is only ill for/or have coverage for 16 weeks ? wtf over ? So: After that its the welfare line, can't tell you really how hard that was to deal with, that rather devastating to ones self esteem a very negative effects for my now defunked marriage as well. When you have one infant and a pregnant wife, with a house payments one has absolutely no choice at all. Seriously when your up against the live on the street, I would have happily opened a roadside Kool-aid stand to help with the bills, it took years to recover ... . Yes, I have been there, got the welfare recipient "T" shirt, so hang in guys/gals things do get better. :wink: I now have a more tempered view of those that are on the government dole. To: Richard, could wearing your duty jacket off work have been a mitigating complication ? not that I haven't done that myself, now I only wear EMS shirts and stuff but never uniform issue kit, mostly free ones :shock: Sooo if you have to play "catch buddy" if he falls there is less of an public expectation because anyone can purchase an EMS T shirt. OR one can use the excuse I JUST WORK IN THE OFFICE ..... cheers

Are we talking Taxicab Confessions here? Dust I saw the episode you and that hot chicky were featured on .... hey SHEEP have feelings TOO ! :oops: cheers .Speaking of sheep/puppys it looks like you may have one of the new flock following closely on your heals ? lmfao !

Dang .... wrong thread ..... I thought it said BEING LAID .... mybad? :oops: Side note to firedoc if I were screwed up in a wreck, would be gosh darn happy some one stopped ..... THAT IS the ticket ! cheers

YES: I do in fact from prior posts YOU were an advocate of improved diagnostic abilities to lighten up the load for ALS providers, or am I missing something ? I the majority of communities across north america there is no fully ALS system to give a comparison so your asking a subordinate level to triage patients without anything but the basic diagnistic kit .... this in itself is flawed arguement, just how to you propose a study be be even considered ... ? ALL chest pain calls require ALS a little thing called a 12 lead and early intevention does make a difference we just have to prove it,yet again how would YOU know the difference between a surgical belly and a stuck fart , are we following here ? The futher education level is quite clear called REMT-P, step up to the plate, its were the rock stars get separated from the groupies .... ps heard that on TV somewhere ? The tread was derailed by someone perhaps do get back on tracks shall we ? Its called EMS RESEARCH and it almost appears that your trying .... So just how many EMT-B out there would do not want more education? an improved skill set to provide better care? and a better paycheck ? .... I dare say NONE on EMT city thats why I dare to believe they ARE HERE, so shoot me for believing in this membership....ps better have an elephant gun. I propose a study based on treatment to door outcomes, BLS compared to ALS ... lets say rural with greater than 40 minute transport times, better yet HEY the response time TO the patient, call to patient contact time should be the determining factor, not cost effective, is it your Mom their coming to treat ? Inclusion criteria proposed "Medical calls only" R/r has provided excellent documentation in previous threads on the poly trauma patient, so exclude those for now. Just for giggles include this question to the survivors in the study: Did you feel confident in the providers care and knowledge ..... hmmm interesting spin is it not? What call volume ? huh... numbers svp, 62 % of 5 or 5000 calls ? Ok again Triage by a subordinate level....pointless, and again what call volume are we basing this on ... a year, a week or a day in downtown NYC, out of the bronx burrough (sp) sorry guys never understood that ? cheers

Yes you make a good point in regards to retention of staff, the stats here indicate a 3 year purge, as everyone believes the grass is greener on the other side .... meh. In regards to every dog and cat wanting too and few graduating, first off not that many positions available I would speculate and I believe their is field evaluations done on a very routine basis for the EMT-B that I worked with, and prior to any agreement for them to access further education, many many exams. Sadly (was kinda busy) I did not have an opportunity to do trips with an REMT-P's, just many interactions that were very positive. No matter what, at least this Company has made strides to provide futher educatuion opportunities for their staff and address the needs of the community that they serve, very commited bunch of men and hot chicks during the Katrina/Rita nightmare got to take your hat off to them for their commitment, you know sometimes a good heart makes up for many other things. And don't think for one second I am just blowing smoke, there's problems in every system but lots of ways to skin a possum.... whatever the heck that is they eat ....eewwuuu I will pass thanks. cheers

Firstly: Thanks so much for providing me the oportunity to wash my screen with coffee ! I must incude for your review: