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First we need to differentiate between ethical and problematic. Treating an ex and dealing with the personal stress and drama that may surround that even with the best outcome is problematic at rest and I wouldn't wish anyone to have to face that situation. Ethics, however, has very little to do...

There is. For example, Answering question: I'm not sure, you probably know you're sleep style best. If you're hard to wake up I'd keep it cranked and deal with the sympathetic response that jars you awake. Otherwise you'll probably be fine, back when we kept trucks numbers consistent I could...

Keep in mind too that with jobs being competitive services can pick and choose and often put preference to those who are from or live in the area, went to school in the area, precepted there, etc. In Ontario IFT is largely done by unregulated patient transfer companies which pay poorly since...

My service pays under a dollar per NTG spray. I was discussing it with a Sup and we were trying to figure out how you can even make a glass bottle and pump that sells that cheap even before the drug is added.

My service (York Region Paramedic Services) contracts ACP training to one of the colleges who run the didactic portions at our HQ. Students are pulled off the road and assigned to school as their FT job for the year.

Most of Ontario does a hybrid system where vehicles have a station but they may be moved from station to station as coverage changes. Some have more complicated plans. For instance by service has 15 different deployment plans based on day/time which prioritize station coverage differently. Once...

I love my big shears and have had other medics, RN's and Docs comment on them. Most notable cut I've had with them is through a sari with lots of bundled layers in one very crumpled car. Actually had another medic from my station stop and say "these shears are friggin awesome!" They're a little...

This is going to be dependent on both local laws and Hospitals. Due to a few high profile cases I recall reading about Hospitals making policy changes to cover their entire property in addition to 911 rather than calling 911 and ignoring the call. One of my favourite "Duh" moments is the odd...

If my region cardiac arrest gets two units (1 transport and 1 RRU or 2 transport) for a minimum of 3 medics on scene with at least one ACP as well as FD. There has been a big push from medical direction and the service for out crew approach emphasizing minimal interruptions and delayed...

Meningitis? Could present with similar recent Hx to febrile seizure and difficult to distinguish in a 15mth old.

Now with all our trucks having Stryker Power Load we don't have dedicated bariatric units. Our Special Response Units carry the wide body version of the Stryker power cot and the motorized stair chair as well as lifting air bags. SRU responds to our bariatric calls along with the transport unit.

Not uncommon at all. Essentially all of Ontario is Municipal EMS, just at the Upper Tier Municipal Level (Counties or Regions). Large cities like Ottawa, Toronto or Hamilton are not part of a greater upper tier and thus have there own service. I don't work in Ottawa, but I'm familiar with the...

If your fleet has no trucks with more than 200 000km and no truck more than four years old. Your equipment is new and top of the line. Includes power cots and power loads on all trucks. You have sufficient capacity for back-up when needed and for large calls including response cars and...

Standards are only getting worse with the standardized protocols. Thankfully I'm under one of the better base hospitals, but the way some of the other BH's are holding everyone back in ridiculous. Don't even get me starting on MOH EHS branch.

Are the increasing the didactic time for BC as well? Anti-emetics and benadryl were added to the PCP scope in Ontario recently. IM/IV toradol is currently an auxiliary directive and my Base Hospital has chosen not to implement it yet since the directive is going to be adjusted significantly...

If this medic did a poor, extremely brief physical assessment I can see trismus being confused with rigor mortis. If the Pt. died of a closed head injury it is certainly a possibility. Doesn't excuse it, but does help lead to a root cause identification for how this critical error was made.

EMS is 100% unionized in Ontario and probably quite close to that across the country. (BC, NS, NB, PEI and most if not all of Alberta I'm sure about). The nature of our job makes our working conditions ripe for abuse. No breaks, forced OT, health and safety, etc. Using my service (3rd service...

We did a limited trial of Powerload two years ago and did a service wide (40 vehicles) roll out this year. The power load has been universally loved by crews. To the extent that they've had issues with vehicle deficiencies not being reported because crews didn't want to switch into a spare which...

The service where I live and where a few friends of mine work use that schedule. He likes not switching back from Day and Night very often and the short sets but finds the short time off means he never really settles. I love our schedule. 12 hr shifts, 4 week rotation. 4 nights, 4 off, 3...

I've read in a few consultants reports that Unit Hour Utilization (UHU) above 0.6 is considered too high to ensure response time targets. In other words if your units are occupied for more than 60% of their service time than coverage and response time targets will suffer. I think UHU regardless...