Paramedical Skills in Canada

[Mattie457]

Good Morning to you all!

I have been reading throught the various thread/topics and was wondering what different skill levels there are in Canada and what different types of Paramedics there are.

In the UK the structure is:

Emergency Care Assistant = There to assist the Paramedic not actually able to do much apart from BLS Entonox and oxygen

EMT = Can give certain types of meds off there own back like

GTN

Asprin

Adrenaline 1:1000

Narcan

Glucagon

Salbutimol

Atrovent

Able to do BLS with manual Defib

Paramedic:

Full ALS Including intubation although there is talk of that being taken away for the newly qualified Para's

Full range of drugs:

BenPen

Sodium Chloride 0.9%

10% Dextrose

Furosimide

Hydrocortisone

Oromorph

Tenectaplaise

Morphine

Diazamuls

Diazapan (pr)

ALS Drugs

Syntrometrine

Chlorphenamine

Plus all the EMT drugs

Then we have Critical Care Paramedics

Work along side Doctors able to assist with RSI but not actually RSI

Able to give some drugs off there own back such as Ketamine/Midazolam

They have various other skills but alot of the time have to have a doc with them to carry these out.

I hav spoken to various people that work out in Canada or know people that do and it is the general opinon that UK Para's would come out as a EMT intermediate in Canada is that right?

Sorry if there is typo's or this doesnt make sense been a long old shift!

Thanks in advance!

Matt

[systemet]

So, the problem with making a comparison like this, is that health care is provincially regulated in Canada. So each province has its own licensing / regulatory bodies, and legislation governing scope of practice. There's no central organisation, so there's a lot of variation within the country.

There's a slow movement towards national standards, and a national registry / registry exam, but this is probably a few years away. On the upside, if you can get registered in one region, you can often transfer that registration / licence to another. This can get a little complicated, but from what I here it's become easier in the last couple of years.

The skills you describe seem to put you at about the Primary Care Paramedic level. This course varies from around 6 months, to as long as two years, depending on location. As I understand it, it usually includes IV initiation, basic ECG monitoring and nonvisualised airways, e.g. King LTD, combitube, etc. In Alberta, this would be the EMT level.

For a UK paramedic, it's hard to know where they'd fit in. Obviously they have 12-lead skills, they have TNK, which is used in Canada, and has been for over 10 years, but only in some regions. I know a lot of these guys also have BSc degrees now, in which case they've had more education than most Canadian Advanced Care Paramedics. On the other hand, the ACP scope at a national level includes more second-line ACLS drugs, and sedation-based intubation.

There's also a critical care paramedic level in Canada. These guys have an ability to start central lines, RSI, monitor balloon pumps independently, initiate arterial lines, interpret chest X-rays, etc.

The problem is, not all of the provinces scopes really align. For example the Alberta Paramedic level is recognised national as an "Advanced Care Paramedic", but encompasses a lot of skills that are found in the "Critical Care Paramedic" level in other provinces. AB, for example, doesn't have a separate Critical Care level yet.

Here's a couple of links that might be helpful:

Take a look here for the proposed (and fairly old / out-of-date) national levels:

http://paramedic.ca/nocp/

And here's the AB levels for comparison:

http://collegeofparamedics.org/pages/Practitioner_Resources/Scopeofpractice.aspx

Are you thinking about moving to Canada? Do you know where you'd like to move to? Because if you can narrow it down a bit, there might be someone from that region who can give you specifics.

[Mattie457]

Cheers for taking the time to reply!

We are thinking of moving to canada but not for a while as have to wait until my step daughter is slightly older. My wife has relatives in saltspring island just off vancover island so probably into the BC area if thats right?

I have heard through friends that work in Calgary that the BC system is slightly different as you have to be part time rural before you can go full time in the urban area? I dont know how true that is?

It all sounds slightly confusing as things are very different when you compare provinces?

The job I am currently doing at the moment is geared towards CBRN terrorism and mass casualties and taking paramedical care to the patients in that enviroment so i am trained in Breathing apparatus, Confined space medicine, Working at height, swift water rescue, tactical medicine, public order situations etc. Do you have those sort of teams working in Canada or is that more a fire/police thing?

Sorry for all the questions!

Thanks in advance,

Matt

[systemet]

Cheers for taking the time to reply!

No problem!

We are thinking of moving to canada but not for a while as have to wait until my step daughter is slightly older. My wife has relatives in saltspring island just off vancover island so probably into the BC area if thats right?

That would be BC, yep.

I have heard through friends that work in Calgary that the BC system is slightly different as you have to be part time rural before you can go full time in the urban area? I dont know how true that is?

Both systems have changed a lot in recent years. I think that there are probably other people that can give you better information here than me. It used to be that you were trained by BCAS after you applied (I think the NHS used to do this / still does?), and bid on postings and further training based on seniority. This resulted in a lot of junior people being exploited. I hope this is one of the things that changed. But rather than me giving you a bunch of out-of-date information, maybe we'll let someone else comment on this, who has more recent knowledge.

It all sounds slightly confusing as things are very different when you compare provinces?

Very much so. But, as I understand it, this is less of a problem than it was in the past.

The job I am currently doing at the moment is geared towards CBRN terrorism and mass casualties and taking paramedical care to the patients in that enviroment so i am trained in Breathing apparatus, Confined space medicine, Working at height, swift water rescue, tactical medicine, public order situations etc. Do you have those sort of teams working in Canada or is that more a fire/police thing?

This also varies a lot with location. In some areas there are combined fire-EMS systems, where you may be expected to do fire suppression, extrication, etc. in addition to EMS duties. Some stand-alone EMS systems have specialty teams that would with fire department hazardous material teams, or HUSAR, or are attached to SWAT / tactial teams. I don't have any specifics on BC.

If working as a firefighter is an interest of your, firefighter training is very short in Canada. There are also fire-based services that need paramedics very badly, but can't afford / aren't willing to spend a couple of years training their own. They often hire qualified paramedics (the ACP or level III, or whatever, fully-qualified medic), and then provide this training, paid. However, I'm unaware of any fire department-based serviecs in BC.

Sorry for all the questions!

Thanks in advance,

Matt

No problem.

[Happiness]

http://www.bcas.ca/EN/main/careers.html Here is some information. The system has changed alot since I joined many moons ago. Salt spring island Im thinking is a part time station but not really to sure. Most new paramedics do try to go to the rual or isolated areas to get their foot in the door and then as they get more experience and senority in the ranks they transfer closer to where they eventually want to be.

I am lucky as I am high in the senority and I could work anywhere if I so choosed to do so, but it has taken alot of years to achive that. I would say you should have a 2-5 year plan before you take a position.

Maybe Asysin2leads will answer this thread as he is from outside BC and working on getting into BCAS.

Good luck

Happi

[ukcanuck]

Mattie457

If you want to PM me I made the move from the UK to Canada and managed to get ACP reg over here.

I could give you some pointers and direction.

Cheers

[Mattie457]

Hi Mate,

I have PM'd you but head nothing back did you get it?

Cheers,

Matt

[Siffaliss]

Cheers for taking the time to reply!

We are thinking of moving to canada but not for a while as have to wait until my step daughter is slightly older. My wife has relatives in saltspring island just off vancover island so probably into the BC area if thats right?

I have heard through friends that work in Calgary that the BC system is slightly different as you have to be part time rural before you can go full time in the urban area? I dont know how true that is?

It all sounds slightly confusing as things are very different when you compare provinces?

The job I am currently doing at the moment is geared towards CBRN terrorism and mass casualties and taking paramedical care to the patients in that enviroment so i am trained in Breathing apparatus, Confined space medicine, Working at height, swift water rescue, tactical medicine, public order situations etc. Do you have those sort of teams working in Canada or is that more a fire/police thing?

Sorry for all the questions!

Thanks in advance,

Matt

Hi Matt,

In Edmonton we do have CBRN, TEMS (tactical). I think it's mostly fire and some rural services that would have confined space, etc. Fire and EMS are not amalgamated in this city.

A few years ago when I was first starting out in EMS, it would seem that working rural was like a right of passage for newbs coming into the field. They'd have to get experience on car rurally, then MIGHT be considered for urban ALS. Things change however and it seems as though potential applicants are getting younger and younger, and are barely out of the house never mind having any actual field experience for a couple years ...

Edited December 22, 2011 by Siffaliss