# British Columbia (Canada) EMS



## blindsideflank (Nov 20, 2014)

I've wanted to clarify some stuff regarding EMS here in BC. I won't get much into the EMR and PCP role and the poor staffing and odd pay structure of rural EMS here. What I would like to share is what I believe is the best EMS education in Canada and I  sometimes ponder how it stacks up worldwide.

Here is the progression.
EMR-4 weeks of class
PCP-4 months of "accelerated" school and a short practicum
ACP- (required experience as a PCP) prerequisite courses offered through the JIBC or TRU) 2 years of school and a one year internal mentorship program that is absolutely vital to the development of a good ACP. Our system is tiered so that you are only attending to the sickest patients.
I'm going to ignore the infant transport team as they are their own little world
CCP-challenge/complete the BCIT critical care nursing program and complete
Two years of training. These practitioners are so far beyond anything in any other province that when people try to compare it is absolutely laughable.

Below are the TRU courses link and the BCIT link
http://www.tru.ca/distance/programs/health-science/pre-health-science-certificate.html
http://www.bcit.ca/study/programs/680dascert#courses




I wish degrees were awarded here and I wish we received the recognition for our system. I recently heard a term called a HALO event. A High Acuity Low Occurrence event. It was funny because that is our bread and butter.

PS... Come at me Albertans 
(I used to work there and of course you have many great practitioners but your system is becoming horribly watered down with young, inexperienced paramedics)


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## cprted (Nov 20, 2014)

EMR is three weeks not four ... not sure why we accept someone with 100 hours of training to work on an ambulance in this province ... in some cases with another EMR or a Driver Only as a partner ... and they're working the farthest away from higher levels of care ...

I also think having the shortest PCP program in the country is nothing we should be bragging about ...

There is a lot of good to be said about the paired, targeted ALS system, however, think about all those BLS-3 or BLS-2 calls where the patient would benefit from an ALS assessment or treatment.  What about the great swaths of this province where there is no ALS available at all.  Why are the people of Salmon Arm less deserving of ALS care than the people a hour down the road in Kamloops?

You actually can get a degree here.  TRU will accept the JI's ACP program as 60 credits towards their Bachelor of Health Science degree.


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## blindsideflank (Nov 20, 2014)

I think emr is 1 week ore read then 3 weeks class but whatever.

Why don't small communities have ALS? Well I can't speak to salmon arm in particular but staffing ALS in small communities  creates the alberta problem... Practitioners pushing paralytics in patients when they probably only intubate 2 people a year. It's a recipe for a disaster. If you aren't using it you are losing it.
I'd like to see an ICP so these communities could have more care but some things need to be withheld because there is a problem with retaining skills and keeping that knowledge fresh. Obviously we need full time spots there too.
And BLS code 3's requiring an ALS assessment? I acknowledge that but don't know how much value there really is.  Maybe, if these patients benefit from ALS then the reporting (and resulting stats) should be pushing dispatching policies towards utilizing ALS (perhaps that's too idealistic to say)


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## cprted (Nov 20, 2014)

I'm not coming down on one side or the other (lots of pros and cons in the All ALS vs Tiered ALS debate), but when you say "the Alberta problem," it is actually a "North America problem," as BC is rather unique not having an all-ALS system with d-paired cars serving rural communities.  Skill and knowledge is obviously a significant issue, but you have to weigh risk vs reward.  If you have a patient an hour from hospital who needs to be intubated, is it better to have a practitioner with a 75% first attempt success rate vs not having ALS at all?  I kind of lean towards having the slightly less sharp ACP over not ... Just a bit of devil's advocate.


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## jcroteau (Nov 20, 2014)

Having worked in BC for years and now doing my ALS in Alberta I have seen both sides of the fence. I'm uncomfortable with how you describe comparing alberta and bc "laughable"

Bc has some very good practitioners as does alberta......it is a complete slap in the face to the citizens of BC to have what? 10 communities served by ALS?

Don't even get me started on working conditions between the two provincial agencies.

Like I said, having seen both sides of the fence BC is in the Stone Age.....getting better...but still in the Stone Age.


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## blindsideflank (Nov 20, 2014)

You were a PCP in bc and now training as ALS in Alberta? Believe me, your eyes will be opened if you ever come back to BC. 
I was referring to comparing alberta ALS education to BC CCP (which happens often because Alberta is so proud of their extremely dangerous scope) and I'll stand by in saying that that comparison is laughable. I was trained in Alberta and when my classmates said things like "I'm trained to use a vent" I knew that meant "we spent 4 hours chatting about vents and got 2 handouts to take home"

I'll admit that we are missing tools. All I meant to say in this thread is that our training philosophies in the upper licence levels are top notch


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## gnosis (Nov 22, 2014)

The PCP program at the JIBC is more of a study guide for the licensing exams. They do very little to actually train good paramedics. It seems to me that BC is trying to counter the constant flow of paramedics out of the province my throwing people through the certification process as quickly as possible. (those would be the young inexperienced paramedics flooding the market in Alberta as they flee the BCAS)

I've heard people suggest that we rotate ALS medics through rural areas to provide wider coverage and keep skills current. However, I'm not sure how many people would be willing to do such a thing. Maybe work out a live in rotation gig somewhat like industrial medics do.


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## irishboxer384 (Nov 22, 2014)

what about this:

http://www.cput.ac.za/academic/facu...tus/course?i=323&seo=TkM6IEVNRVJHRU5DWSBDQVJF

I believe they have a few fitness tests to do the university course also....with the amount of morbidly obese practitioners I've seen (in the US at least), some stringent physical tests would sort the men/ladies from the boys/girls!


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## jcroteau (Mar 12, 2015)

I would love for BCAS to put me in a Tahoe with als gear and throw me into a rural area


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