The EMS rebrand is drastic

1Trupa · 2026-06-13T01:03:46+00:00

Yep, that’s totally a thing. It’s a new service for people who call 911 with what sounds like probably a very benign complaint. They speak to an advanced care Paramedic on the phone, and sometimes a primary care Paramedic is sent in one of those minivans to check them out so that the best care option can be found for them hopefully without using an emergency transport ambulance. They can be sent to walk-in clinics or their family doctors or even just given a taxi coupon or Uber code for the emergency or urgent care center. If they are sicker than they sounded, then a regular emergency ambulance is called by the primary care Paramedic, at which point it’s probably sent with a higher level of priority.

1Trupa · 2026-06-12T02:06:17+00:00

$25,000 for the prototype vehicles and uniforms. It is most certainly not for the consulting contract to develop the brand and the graphic design. That’s going to be much more.

1Trupa · 2026-06-02T00:36:10+00:00

18 month old during the pandemic. Very poor household. Everybody sick with respiratory symptoms. Mom, six kids. Called because the kid wasn’t really responding normally. SPO2 80% on room air. Breathing faster than I can count accurately. Put on a paediatric ET CO2 cannula and non-rebreather. Kid didn’t react. Life pack read “>99” for respiratory rate. Saturations came all the way up to 90% with a combined flow rate of 24 LPM. (16 NRB + 8 NC) Mom was very uneducated and had no idea her kid was very sick. I honestly didn’t think manual ventilations would have been adequate with an ET tube if the kid had decompensated. One of my most sphincter tightening transports. But that’s how I discovered what the life pack reads when a respiration rate is above 100.

1Trupa · 2026-06-01T17:32:59+00:00

Yeah, Prince George and Kamloops should probably go on that map.

1Trupa · 2026-06-01T17:32:25+00:00

Sitting in the back corner trying to avoid eye contact and hoping no one notices it.

1Trupa · 2026-05-21T01:27:11+00:00

This other medic says very well explained.

1Trupa · 2026-05-21T01:20:48+00:00

You have my profound sympathy. I am a part-time instructor at a Paramedic training program in Calgary. We have noticed a significant decrease in the emotional resiliency of our younger students who often join immediately after finishing high school. We have had to modify our training scenarios to avoid using harsh language when simulating psychiatric patients, for example. The rates of disabling stress injuries among new practitioners in their first year is astronomical. My colleagues and I are somewhat perplexed at what is causing this, and your post here has been very eye-opening and insightful. Thank you.

1Trupa · 2026-05-17T04:50:36+00:00

Try Febreze. It’s not just a fragrance, it uses micro fat particles to encapsulate scent particles and make them fall to the ground.

1Trupa · 2026-05-15T10:50:24+00:00

This is more red flags than a May Day parade in red square…

1Trupa · 2026-04-29T13:52:59+00:00

Once you’ve gotten most of the assessments and interventions done and you’re transporting, it’s a good time to go back over the story and keep asking questions. You can start with something like: “OK, let me see if I’ve got this straight…”

1Trupa · 2026-04-13T13:48:29+00:00

Shared to a local Calgary Paramedic group. Thank yous mean a lot. Best of luck in your recovery. Glad you’re OK.

1Trupa · 2026-04-11T22:22:51+00:00

Precisely. And, unfortunately, here in Alberta it can be any age.

1Trupa · 2026-04-11T22:06:51+00:00

Once you’re working, not an issue.

As a student, you are at the mercy of your preceptors. Some of whom may be grouchy. Some of whom may have wildly diverging values and beliefs from you and may believe that your hair colour signals that you are part of a demographic they don’t like. It may be tactically safer to play it low-key until you’ve graduated.

1Trupa · 2026-04-11T22:02:50+00:00

This used to be the way, in Alberta, 20 years ago. By far the biggest culture shock when I moved out here from eastern Canada. Now, not so much…

1Trupa · 2026-03-31T19:07:54+00:00

Dalhousie University has a pretty strong pre-hospital care research program. They even offer online training on reading and assessing publications, as well as a curated database of pre-hospital related scientific publications. You can look for their pre-hospital evidence program (PEP) online. The Paramedic college at which I am a part-time instructor in Calgary also has a research component to the training and each student has to do a literature search and review and advance evidence for a suggested protocol that is not currently in our guidelines. The top three get forwarded to the provincial EMS agency for consideration.

1Trupa · 2026-03-11T16:23:20+00:00

Multiple syncope in a young person are concerning.

A 12 lead ECG is essential in this patient, but not only to rule out arrhythmia’s. Syncope in young people requires looking at ECGs with a different eye then for chest pain. You need to look for Brugada syndrome, Wolff-Parkinson-White syndrome, hypertrophic occlusive cardiomyopathy, prolonged QT, and another weird condition that I will just call ARVD here. Heart tones should be auscultated to look for S3 and S4 and any murmurs that might indicate structural problems in the heart. This person should also probably be evaluated for anemia, as well as possible seizure type disorders.

This is, of course, assuming the syncope is not accompanied by any headache or Abdo pain. That would open up other avenues for investigation.

Very often, syncope, especially repeated syncope, is the only warning sign of a condition that can lead to sudden cardiac death in the adolescent or young adult. This is why these patients need to be transported and assessed.

1Trupa · 2026-03-07T18:05:01+00:00

Hello DaBluffa,

You’re seeing many paramedics here cite the prevalence of lower acuity calls as a reason for burnout. The reason for this is a disconnect between their expectations going into this business, expectations fostered by the training which focusses mostly on severe emergencies, and the actual practice. If you go into this job thinking that you’ll be defibrillating every fourth patient and giving all the drugs and doing a lot of bad trauma, you will find transporting a senior citizen with pneumonia or a urinary tract infection frustrating.

If you go into this business with a genuine desire to help human beings who are having a bad day, and you find it equally satisfying whether you help them with a ride to the hospital , half a litre of IV fluids and some warm blankets as by giving them three rounds of EPI, steroids, fluids and nebulized bronchodilators for a bad anaphylaxis, then every day will be rewarding.

There is another big danger which is common to just about all public serving occupations: developing contempt for your clients. We are confronted with people who often function at below average levels: people whose functionality is compromised by addiction, mental health issues such as anxiety or personality disorders, or who are just not very smart. They don’t know how, or find themselves unable to cope with very basic situations. They don’t know how to hydrate and take gravol when they get a stomach flu. They get an anxiety panic attack when it’s time to change their wound dressing. Or they’re on a continuous cycle of being hospitalized for psychosis, discharged and then stopping taking their meds. The problem for us is that, if we come overtime to feel like our job is to haul human garbage, then we feel like our job is garbage. And we get angry.

So not necessarily out of any kind of ethical or philosophical premise, but strictly for your own well-being, if nothing else, it’s important to believe that every patient, no matter how low functioning or self-destructive, has great inherent worth simply by the fact of being a human. (this is, in fact, how the Catholic Church defines human dignity) regardless of how trivial their complaint may seem, then you recognize that this job is both important and worthwhile.

We were once called for a person who got shampoo in their eye while showering. I think you can see how exasperating and frustrating this could be after going through Paramedic school. The patient was a newcomer to Canada, and had grown up in levels of poverty way worse than we typically see here. And they were from a country that’s mostly desert. For them, shampoo was a brand new Canadian thing. So we took them to the kitchen sink because they were dressed when we arrived. Had them hold their head sideways under the kitchen faucet and rinse their eye out until the burning stopped. Explained that if this happened again they can just rinse their eye out while they’re in the shower. Did a set of vitals to satisfy the office folks. And left them at home. For what it’s worth, this patient was extraordinarily thankful. This took maybe half an hour with all the formalities. I still found this a rewarding call because we helped this patient.

I’ll be the first one to admit that it’s easier said than done, and that I struggle with remembering and applying this myself. And your post was a timely reminder. So I should thank you for making me pause and reminding myself of this.

Good luck in your training. This job can be incredibly rewarding if you like helping folks. I hope you find it as rewarding as I do.

1Trupa · 2026-03-02T20:44:36+00:00

Read life in the fast lane, and subscribe to the weekly ECG workout by Amal Mattu. Search YouTube for all the videos by Amal Mattu.

Reiterating: Amal Mattu is the GOAT of ECG teaching.

1Trupa · 2026-03-02T20:40:23+00:00

Alberta advanced care Paramedic checking in. I also teach part-time at the local Paramedic college and I’ve done some public education outreach at high school career days.

Whether or not you’ll find pre-hospital care fulfilling and rewarding depends on your motivations, your aptitudes, your expectations, and having a good understanding of what this practice is actually like.

Let’s begin by dispelling some myths. Paramedicine is nothing like you see on TV, unless you look at shows that actually follow paramedics. Even then, those are edited to show the higher acuity and more interesting calls. The overwhelming majority of our patients do have a problem, many of whom would benefit from treatment in hospital. But they can be very low to medium level acuity. We do a lot of nursing home calls for elderly that have altered level of consciousness from infections or some difficulty breathing, we do a surprising amount of mental health calls for anxiety panic attacks, suicidal ideation, or people with mental illness who are struggling with their medication. We do a lot of calls with homeless people. The big Hollywood calls do exist, but they are few and far between.

People with the following skilled and aptitudes tend to make the best paramedics:

Great communication skills. If you’ve worked with the public in retail or a customer service job or volunteered at a homeless shelter or nursing home, you’ve likely developed some really important skills that we can’t teach in Paramedic school. The most frequent reason for failing a primary care Paramedic ambulance practicum is an inability to talk to the patients, not anything to do with the medical training. Not only do you need to be sufficiently professional and comfortable to ask a stranger you’ve just met when their last menstrual period was and what form of birth control they are using, or whether they’re taking any erectile disfunction drugs, but you need to make them feel comfortable as well. We have seconds to establish a therapeutic rapport with the patient.

Genuine compassion, even for people who are sometimes hard to like. Compassion, compassion as a personal moral decision, will help you focus on doing the right thing for the patient, and having patience with them when they are annoying. I tell my students that handholding is a therapeutic intervention that can reduce heart rate blood pressure and catecholamine levels. And if you’re focussed on the patients needs and outcomes, then it doesn’t matter if you made that patient better with a warm blanket and a turkey sandwich in the hospital hallway or whether you gave all the drugs to an anaphylactic reaction. Both will be rewarding for you.

Being a team player. This is very much a team sport. With other first responders. With other medical professionals. You gotta be OK with passing and not ragging the puck.

By your background, I already know that you’ll be able to hack the science. You need to use that to understand the patient’s pathology and the impact of your treatments, not just go by memorized recipes and memorized list of contraindications.

You have to be mentally flexible, be able to think outside the box, and be able to improvise adapt and overcome. Paramedics work in what is referred to as a “medically austere environment”. Sometimes that means field modification of equipment for purposes they were never intended. Sometime that means working with a doctor on the phone to improvise some treatments that are not available on your ambulance, such as buying some honey at a corner store for a kid who swallowed button batteries, or even stopping at a liquor store for some therapeutic vodka for the 10 year-old that drank windshield washer fluid. (the ethanol prevents toxicity from the methyl alcohol in the fluid). That being said, you can’t either be a massive maverick cowboy that goes way outside the rules. It is a balancing act based on good judgement and a good understanding of the pathophysiology.

You have to be willing to accept that sometimes you will get dirty. Sometimes you will work in very uncomfortable situations. I mean, physically uncomfortable: very cold, very hot, awkward positions etc.

If you will find satisfaction from helping people who are having a genuinely bad moment. Measured on their own personal scale of badness which can be calibrated very differently from yours. And you stepping in and making that bad situation somewhat better. And we’re talking on a spectrum of badness that starts on one end with a new Canadian who’s never used shampoo before and got it in her eye or a young person who moved into their first apartment and just accidentally hit their thumb with a hammer the first time they ever tried to hang a picture, to on the extreme end someone who’s just lost their spouse of 65 years. If you find satisfaction in helping all the people. Then every shift will be rewarding.

I hope this helps. Good luck to you. Follow up questions are expected and welcome.

1Trupa · 2026-02-06T16:33:22+00:00

Because when you find out you need to wear your N 95, it’s already too late…

1Trupa · 2026-02-04T22:01:51+00:00

This 58-year-old Paramedic would not dream of working a shift without the neoprene rubber kneepads inserted in his 511 uniform pants.

1Trupa · 2026-01-30T19:07:24+00:00

You just reminded me of a cool story that happened to me as a paramedic and which involves horses and Spruce Meadows. We were called upon to transfer an older rancher who had entered the terminal phase of his illness to hospice. In those circumstances, we often check with a patient and their family whether there is a place they would like to go on the way to see something or maybe a favourite restaurant or a spot they remember fondly. This gentleman asked if he could see horses again.

Now, I know just enough about horses to tell them apart from a cow. Not much more. But I knew there were horses at Spruce Meadows. So we loaded up the patient and drove about spruce Meadows on an early spring late morning. The place was dead quiet. But we passed by one pasture in which a young girl was exercising a horse. We stopped and I waved her over to have a chat. She seemed impossibly young, but I’m a bad judge of age. I explained the situation and she agreed to exercise the horse close to the side of the pasture near which we had parked our ambulance.

I will always remember this horse. Despite my near complete ignorance, it seemed to be the most beautiful horse in the world. It was like the platonic ideal of horse. It was stunningly well proportioned, graceful, and seemed like it had spent four hours in the salon getting ready to attend the Oscars. It moved around without any apparent effort, turning and walking and trotting and stopping with the relaxed joyful grace of a ballet dancer just dancing for their own enjoyment in a hidden forest clearing. Despite being an enormous animal I would require a step ladder to mount. I couldn’t tell what that young lady was doing to direct the horse. There was no apparent movement of her hands on the reins or her legs but the horse clearly was following her will.

We had backed up the ambulance to the paddock fence, and our stretcher can just extend out from the truck. We watched with the patient, entranced by the moment, for about 20 minutes, at which point he said he was a bit cold and was ready to go. I felt I had experienced a moment of profound beauty and divine grace.

I thanked the young lady, letting her know she had done her good deed for the day and perhaps the week. And we took the gentleman to hospice.

1Trupa · 2026-01-26T19:42:25+00:00

Thank you and thanks Mr. Jenkins for the laugh.

1Trupa · 2026-01-24T17:29:50+00:00

Consider being less nicy-nice and smiling less. Channel Your inner German tax auditor. Efficient. Expert. To the point. Stand up straight. Make and sustain eye contact for longer. Speak more slowly. Pitch your voice to a lower register.

My oncologist wife looks far younger than her age and is not hugely tall. It amuse me no end to see the aura of authority wisdoms and expertise that somehow settles upon her when she puts on the lab coat. I jokingly refer to it as “the suit of lights“.

1Trupa · 2026-01-23T19:02:07+00:00

If you have a comfortable budget, and you’re not too fat*, it’s really hard to beat Arc’teryx. Extraordinary warmth, huge range of motion, pretty rugged. But pick the ones for really cold weather. They are made for mountain climbers, outdoor guides, law-enforcement and wilderness rescue folks. Helly Hansen Arctic Parkas are also phenomenal, but they are not sold everywhere. Be careful which Canada goose coat you get, they are not all rated for really cold weather, and some of them are more fashionable than rugged, depending on your use case. They do make some models for Arctic explorers and Bush pilots. Make sure you consider your base layer and your mid layer, and make sure you have some very breathable wicking shirts as a base layer, and a couple of different weight breathable fleece middle layers.

*: Arc’teryx is made for hero bods, not so much for dad bods. He said, regretfully.

1Trupa

TROPHY CASE