BLS vs ALS

[tniuqs]

Dustdevil, on 14 February 2010 - 06:58 AM, said:

I have no problem with that. None at all. So long as those providing the care are competently specialised in emergency care, I believe it is the best possible solution. I just don't think this country would ever pay for that because, unlike Europeans, we like to keep at least half of the wages we make, rather than paying them in taxes.

In a Perfect World, but dust what can an MD/ RN do like realistically in the back of a gut wagon and beyond in Canadian CCP present scope of practice, like above and beyond ?

http://www.paramedic.ca/Content.aspx?ContentID=4&ContentTypeID=2

Well that is a point worth considering... as I said, the cost effectivness of such a solution is highly dependent on the type of healthcare and welfare system that a country has... it will come easier to those that already have some sort of public funded healthcare.

Well just speaking for my hood in Kanukistan this just is not going to happen in my lifetime or ever. WE ARE Publicly Funded Health Care. We are presently in the throws of establishing standards nationally for Paramedics BLS and ALS ok more like reinventing the wheel. Somehow we manage to train Canadian MDs/ER and multiple specialists and send them directly southbound, want a Canadian trained Family Practice/ GP try the Arizona directory.

Hell we can't even fill Family Practice MDs alone or least of all retain them.

Consider an MD on an Ambulance so just who does routine like 90 % of call volume transfers in Spain an MD/RN team ? Doesn't sound, well if thats the truth, to be very cost effective. That said my knowledge of Spains system is really an empty void, so just how does that work ?

JackMagna ... please I would enjoy your input in the thread: http://www.emtcity.com/index.php/topic/17630-significant-interprovincial-project-will-benefit-the-profession-of-paramedicine/

Question:

Would you like to relocate to Canada ?

Looks like the flood gates are opening up, ps bring snow shoes and "Stanfields"

http://en.wikipedia.org/wiki/Long_underwear

And can you operate a sled ?

Hey sex sells !

cheers

<edit I have no idea how that happened ... but twins is not a bad thing is it ?>

Edited February 14, 2010 by tniuqs

[daedalus]

"Extend physician like care" makes ambo's sound like a doctor's bitch, hence, being subserviant to the house of medicine!

What about the other 90% of patients who do not have some emergent life threat?

Have you not been listening to me scream for pages now about how we need to get away from proving "life support" and do something about the other 90% of people that all the ambulance can do is take them to the hospital?

Look at ECPs in the UK (dubiously, no press please Professor Malcolm Wollard), CARE/ECP in New South Wales, ECP (urgent community care) here in Wellington, CREMS (community referrals by EMS) in Toronto.

Until EMS gets its thumb out its arse, away from the 10% of jobs that are "exciting" and takes the 90% of its workload which is not glamorous and exciting SERIOUSLY and develops appropriate linkages into the healthcare systems for these patients then I dont think it's going to get very far.

So ... a Paramedic should be defined as at the VERY MINIMUM a "health professional who provides emergent community based health assesment, treatment, referral and transport as appropriate to the to enable them to recieve the most appropriate healthcare for thier needs" or something VERY SIMMILAR

To clear up a few things, I do not mean that the ideal paramedic is just the eyes and ears of a doctor on scene. What I mean by extending physician like care to the field is just that, extending good evidence based medicine into the non clinical environment. I support the idea that Bledose has been pushing recently, that online medical control is a waste of time and has no place in a modern EMS system. Paramedics should not be calling for orders for adenosine only to be told to just bring the patient in. They should have the authority to start their own treatments in the field based on the scope of their education.

[Kiwiology]

To clear up a few things, I do not mean that the ideal paramedic is just the eyes and ears of a doctor on scene. What I mean by extending physician like care to the field is just that, extending good evidence based medicine into the non clinical environment. I support the idea that Bledose has been pushing recently, that online medical control is a waste of time and has no place in a modern EMS system. Paramedics should not be calling for orders for adenosine only to be told to just bring the patient in. They should have the authority to start their own treatments in the field based on the scope of their education.

While that is true, do you think ambos should get involved in doing something other than just treating and transporting?

[JackMaga]

Well just speaking for my hood in Kanukistan this just is not going to happen in my lifetime or ever. WE ARE Publicly Funded Health Care. We are presently in the throws of establishing standards nationally for Paramedics BLS and ALS ok more like reinventing the wheel. Somehow we manage to train Canadian MDs/ER and multiple specialists and send them directly southbound, want a Canadian trained Family Practice/ GP try the Arizona directory.

Hell we can't even fill Family Practice MDs alone or least of all retain them.

Question:

Would you like to relocate to Canada ?

Looks like the flood gates are opening up, ps bring snow shoes and "Stanfields"

http://en.wikipedia.org/wiki/Long_underwear

I'm sorry to hear it's so difficult to retain your physicians... I'm curious as to the why of it: not enough pay? Career opportunities?

I'd like to see Canada, but to work there? No thanks...I don't mind the cold but one of the reasons I chose Emergency Medicine is to work EMS... you won't drag me out of my ambulance alive!

Consider an MD on an Ambulance so just who does routine like 90 % of call volume transfers in Spain an MD/RN team ? Doesn't sound, well if thats the truth, to be very cost effective. That said my knowledge of Spains system is really an empty void, so just how does that work ?

I don't know much of the spanish system, but in Italy non critical calls are usually trasported by an ambulance staffed by an EMT/RN; in some systems that use a tiered response sistem (EMT staffed ambulance with MD/RN rapid response vehicle) non critical patients may be transported by a BLS crew of 2 EMTs.

Edited February 21, 2010 by JackMaga