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I'm torn with what I want to do long term in my career. I work for a fantastic service that is both clinically progressive and embracing Community Paramedicine through an evidence driven approach (every program we have in this area is part of a study). On one hand I'm drawn to the clinical...

It's provincial jurisdiction for things like that, problem is, the Territories don't have their own regulators for Paramedics (I think). Best bet if actually interested would be to talk to the company directly. Based on their website they're not particular over which province you're certified in...

The company is hiring Flight Nurses and Flight Paramedics at the moment according to their site. Fly in/out from any Canadian airport with crew housing if anyone's interested in seeing those views in person.

Here have to have IV access prior to admin if the Pt hasn't taken NTG before AND regardless of previous use we must have a 12/15 to r/o RVI. When possible for the cath lab access should be left side, AC preferred as our PCI lab uses groin primarily and R-arm as their secondary site. If I'm...

I ask staff not in the circle of care to leave. They have no role in my patient care and no responsibility for decision making. As I have told many a nursing home or retirement home, "I am not beholden to your policy." Coercion is medically unethical and I have no issue telling school staff...

Zero shortage in Ontario. Hiring for PCP's is extremely competitive with more than 1000 applicants for the 30 spots in our last hire and those numbers are typical for large services. ACP shortages are more common only because they generally have built up seniority by the time they complete their...

I've had a few breakdowns over the years (nothing major, our fleet guys are pretty good and the trucks are on an aggressive preventative maintenance schedule) but nothing that would cause such a catastrophic failure I couldn't still draw electrical or even keep the truck idling. The most...

If you're rotating start times why have a shift that ends midday, in what I imagine is a peak time in most places. Have you run the numbers too see how that reflects demand? I imagine that truck is going to get hit with lots of shift overrun. In my system our peak demand trucks come on at 1200...

SCA call a few years back: 55y/o M, just dx w/ lung CA w/ extensive mets the week before. No advance directed or DNR in place as yet. Ask family about his wishes. "Only if he'll be okay. He wouldn't want to be a vegetable." Ummm.... Wasn't too sure how to address that one at first. Started...

I'd really love to know what programming decision had autocorrect decide that bloodworm was more likely than bloodwork. Especially since the rest of autocorrect seems to be learning to stop highlighting my medical words. Anyways, unfortunately when I made it back into the hospital today, the...

Had a call today that I'd like to work through the patho on. First the call, then some questions. Responded for a 22y/o M, query seizure following a weekend of binge drinking. Arrived to find Pt. lying supine on the floor, conscious, alert and oriented, in moderate distress. Pt. pale/ashen...

Also consider that a week is still a very short period of time to process a difficult experience, unless you're seeing some significant red flags just be supportive and give it time.

We had a marine unit in my service for a number of years. A single medic was deployed on PD's boat. Was a great opportunity for the medics, they ended up getting sent off for their coxswain's course and some other certifications, but when the unit was reviewed they realized that they weren't...

There's arse-holes in every profession, perhaps a few more attracted to ours, some created in ours too but I can't say this is an issue I've had from retired medics, RN's or Docs. If anything I enjoy meeting these folks and have found that when engaged in conversation they seem to enjoy...

Nope. Despite education standards Ontario is only just starting to change our regulatory framework to reflect the reality of 911. Soon we should start to see assess treat and refer programs (treat and release) and transport to alternate destinations (including non-transport w/ referral to...

No reimbursement: Ontario. We're funded entirely from the public purse. 50% of operational expenses come from the province, 50% from the Upper Tier Municipality (County, Region or City). Capital expenses come from the municipality though province may provide grants. A $45 co-pay is collected for...

Interestingly, the pay difference isn't huge between Primary Care Paramedics (PCP), our BLS and Advanced Care Paramedics (ACP) our ALS. As a result many medics here stay BLS throughout their careers. My service pays for ACP and I'm entering the upcoming class where with only 8years on the job...

I love our schedule. PD is on the 2D-2N-4Off and they always look wiped by the end. We're on 4N-4Off-3D-3N-4off-4D-6off. The split can be a challenge, but the 6 in a row off each month and the predictability of having two out of every four weekends off is nice. Plus using 48hrs vacation or lieu...

I think checklists are a fantastic idea for any high risk, low incidence procedure. I haven't reviewed the research in a long time, but I think when it comes to procedures designed to limit error during high stress, can't do wrong taking cues from NASA.

Yep. We staff 5 from 0600 to 1800 and another 4 that come on from 1200-2400. They cover an area of a few square kilometres in areas that are both high density for calls and due to traffic have higher than average response times. Single Primary Care Paramedic (BLS) that stay mobile in their zone...