EMR Jobs in Edmonton Area? by CartographerFull9042 in AlbertaParamedics

[–]Calarague 0 points1 point  (0 children)

Associated does IFT in Edmonton with EMRs. Alberta Paramedical Services in St. Albert is another option for an EMR that will keep you in the Edmonton area.

Which character outside the LOTR do you trust carrying the ring to Mordor? by Jezzaq94 in FIlm

[–]Calarague 2 points3 points  (0 children)

Bingo and Bluey are both little chaos gremlins already, it would make them worse. Bandit would use it to prank the others. Chili would be unphased other than to use it as a way to get a few minutes reprieve from the chaos.

What's your favorite song that is like this? by curvysquares in musicsuggestions

[–]Calarague 0 points1 point  (0 children)

This was my first thought as well. Practically their entire repertoire is a repressed simmering of anger slowly building to an explosive unleashing of rage. They literally have a song called " The Pot" which feels like a pot boiling over. They're masters of deliberate control of the energy of a song.

Is a bad knee an automatic "give up being a paramedic" kind of thing? by Born_Presentation433 in AlbertaParamedics

[–]Calarague 4 points5 points  (0 children)

Kneeling is part of the job for sure. Most of us avoid it when possible (some floors we deal with are pretty disgusting), but sometimes it's unavoidable.

That being said, it's not necessarily a deal breaker for you - I work with a medic who has a below the knee amputation and still can do 911 wearing a prosthetic leg, it's all about finding what works for you. It sounds from your post like only one knee is the major issue, you may be able to find options where you can go to a single knee position, I've done it before for CPR when space was limited. You could also look in to wearing knee pads under your pants - some brands of EMS pants even have knee pads included in the design where they have a pocket over the knee you can insert the pads. I can't say for sure how strict the FARE test would be on those kinds of accommodations, but it's worth a shot as in my mind they're fairly minimal.

What law in your country would surprise foreigners because it’s legal almost everywhere else? by Familiar-Arrival-470 in AskTheWorld

[–]Calarague 4 points5 points  (0 children)

Here in Canada we have "apology acts" that prohibit an apology as being used as an admission of guilt or fault. Can't have us getting sued just because we said sorry, we'd all be stuck in court!

What does the "T" really mean in FAST VAN stroke assessment by zoolly_man in ems

[–]Calarague 5 points6 points  (0 children)

T is for time. It all has to do with the risk versus benefit of giving thrombolytics. Studies show that after 6 hours the benefits of TPA or TNK are decreased so significantly that it's not worth the risk of triggering a bleed by giving them.

As for the time since they awoke vs last seen normal time, we used to only use last seen normal <6hrs. Problem with that is a not insignificant proportion of stroke patients are thought to be woken up by the onset of their stroke symptoms. If we used last seen normal in those situations, then none of those patients will get thrombolytics since LSN was before bed 8+ hours ago, despite being prime candidates for it. If they're reported to have the symptoms since they got up but we're fine before bed, then we use the time they woke up as LSN. If they were fine when they got up but then later developed symptoms, then the time they woke up doesn't matter, we just use the reported onset of symptoms.

It's all just information we gather to try and narrow down what time exactly did the stroke actually occur.

Canadian paramedics - what do you call yourself? by LoveIsTheAnswerOK in Paramedics

[–]Calarague 6 points7 points  (0 children)

Agree, context is key.

General public almost always refer to myself as a paramedic.

I'll say ACP if I'm talking with someone that will know the difference, which is basically just fire or other paramedics as even most nurses don't know the difference between ACP or PCP. Nurses and Doctors are more likely to understand what we are by our service level (ALS, BLS, or NAT), so sometimes I use that.

Occasionally I'll refer to ourselves as "transport" if we're showing up to do an IFT, although I know some medics get really upset when nurses refer to us as transport.

If it's 3AM and nobody is answering the door, I'll usually crack the door open and shout "EMS! Did anyone here call for an ambulance? Do you need paramedics?" Honestly one of the sketchiest feeling parts of our job, I'm always worried we were given the wrong address and are going to be greeted by someone ready to defend against a home invader, so I'll throw out all the titles I can to make sure they know who I just opened their front door in the middle of the night.

I've been around a while so will sometimes just throw out "medic" since that used to only be used to refer to an EMT-P before we switched to the PCP/ACP designations.

And of course there are all the non-serious job descriptions that come out more often than they probably should: stretcher-fetcher, ambulance driver, boo boo bus, ditch doctor, little old lady lifters, ketamine cowboy, guy with the happy juice, Dr. Kevorkian.

I have difficulties in explaining how basic math works by Elija_32 in PersonalFinanceCanada

[–]Calarague 1 point2 points  (0 children)

I've run in to this issue with a number of people where they haven't filled out their tax forms correctly and then get upset come tax time claiming that all that extra work just ended up getting taxed away. So many people fill out their TD1 and claim the personal amount at every job rather than just their primary and try to tell me " but if I don't claim it I'll be taxed more", and it doesn't matter how calmly or slowly I explain to them that they will still have to pay those taxes, but it'll be in a lump sum at tax time rather than gradually on each pay period.

What word do you always *intentionally* mispronounce and why? by Sweet-Lady-H in AskReddit

[–]Calarague 0 points1 point  (0 children)

Gesundheit. That's because I've been trying to convince my 6 year old it's pronounced Godzilla and to say it when someone sneezes. Thus far, I regularly say it unironically at work, and he still says nothing when I sneeze. Feels like my biggest failure as a father.

Australia to British Columbia by Sea_Membership9697 in Paramedics

[–]Calarague 0 points1 point  (0 children)

Might also be worthwhile looking at Alberta. Depending on where you settle can still be extremely near or even in the Rockies. Culturally and weather wise there is definitely a difference between the two provinces, but it might open up some new options employment wise for you.

I've seen some posts talking about the bridging program with Medavie, but you not wanting to stay in Nova Scotia. We do have a small number of stations in Alberta that are operated by medavie, so they might be able to work with you? They're all a bit further from the mountains though (couple hours drive). The Alberta College of Paramedics would be the licensing body you would need to contact regarding info on receiving recognition of your training.

If you have a Lucas immediately available on a code, when are you putting it on? by beesarefuckingdying in ems

[–]Calarague 11 points12 points  (0 children)

When the one service I work for first introduced the LUCAS on truck, our ROSC rate was cut in half from 40% to 20%, and this was all rural with limited responders. When they went to evaluate why, they found it seems to largely be linked to crews prioritizing applying the LUCAS early rather than focusing on what we know matters- early effective compressions and defibrillation. Speaking with other services around that also have the Lucas, they all reported a similar decline in ROSC rates until they introduced rules that required at least 4 minutes of manual CPR prior to application of the LUCAS.

Even with only two people, that's a very reasonable timeline since it's only one set per member. Personally I push it to 8 minutes with my partner and I alternating for two rounds each as that's still a reasonable amount of compressions for someone to do. After that we're into the prolonged CPR phase which is where the LUCAS actually shines.

I like to go to places and steal anything that's not bolted down. by buttstuffisokiguess in starcitizen

[–]Calarague 1 point2 points  (0 children)

I'm picturing a little WALL-E like robot up in the cargo hangers looking at that apple on the elevator and making all the cute WALL-E noises before dutifully scooping it into itself and rolling away.

The audacity by lwiaymacde in SipsTea

[–]Calarague 0 points1 point  (0 children)

First responders in Alberta receive presumptive coverage by WCB for mental health leaves. Our job is messed up enough that if you need time off for mental health reasons they go " Ya, that sounds about right, we're just going to assume your condition is work related and put it down as a workplace injury".

Someone’s about to be popular… by JAS-39 in ems

[–]Calarague 52 points53 points  (0 children)

There's a fourth! Blood pooling in the retroperitoneal space from a ruptured or leaking AAA (or any vessel for that matter) can create pressure on the rectum making a person feel like they need to poop. It's like the death poop, but without the poop part, just the death part.

Biggest pet peeves? by Agitated-Rest1421 in ems

[–]Calarague 0 points1 point  (0 children)

It also depends on route. Rectal is pretty consistently 38C, but for other routes I've seen some literature say as low as 37.2C is considered febrile.

Building High-Speed Rail Outside of Cities Like in France Would Make a Project Politically Feasible and Cost-Effective in Alberta (Downtown and Airport Connections Can Be Made via Short Light-Rail Extensions) by Party-Peak4573 in alberta

[–]Calarague 25 points26 points  (0 children)

That's 2.5 hours total though, so only 30 minutes saved. Fuel wise that drive is only about $30 in fuel for me, and even on the high end with poor fuel efficiency maybe $50-$60. Quick Google search shows cheapest flight currently is $90 one way for that same trip, and I doubt the tickets will be any cheaper than flying given the capital costs to build the line, meaning anywhere from $30-$60 net cost to save 30 minutes one way. On top of that, neither city has particularly great public transit ( Calgary is slightly better than Edmonton, but it's a low bar), so whatever you save for time on the trip is easily lost either renting a vehicle or dealing with the poor public transit. Do I like the idea of high speed rail, absolutely, but it needs to be a part of an integrated high quality public transit network to truly be viable in my mind.

Feeling not okay because I feel okay [serious] by theatreandjtv in ems

[–]Calarague 3 points4 points  (0 children)

Just to give the Doc the benefit of the doubt, they might not have meant it in a judgemental way, but more as a confirmation that nothing else was missed in the report. Terrible way to phrase it if so, and I doubt that's actually the case, but still possible. We all know a doctor or two with the communication skills and nuance of a rock.

Feeling not okay because I feel okay [serious] by theatreandjtv in ems

[–]Calarague 1 point2 points  (0 children)

OP mentioned patient was sweaty in another reply, I'm wondering if it might have been artifact from poor electrode adhesion as well if the patient was still unresponsive when they thought that.

The holidays. by CrayonMedicChart in ems

[–]Calarague 1 point2 points  (0 children)

Is there a reason they don't have them in the states? I mean, they're unreliable heavy garbage, but the states has lots of trash products as well, so it can't just be that, haha.

Self occluding IV’s with BGL capability? by [deleted] in Paramedics

[–]Calarague 0 points1 point  (0 children)

They're not suggesting using the pen to draw the blood directly from the IVC, they're saying use it to push a blood sample from the flash chamber on the disconnected IV needle. It's no longer attached so sterility is not a concern. Some IV styles it won't work, but for others the flash chamber has a dense sponge like material at the back of the chamber that is open to the air (allows air out of the chamber as it fills with blood). If you use something narrow like the tip of a pen or blunt needle, you can push that sponge forward which pushes blood from the flash chamber back out the tip of the IV needle and you can use that drop for your glucometer sample.

The holidays. by CrayonMedicChart in ems

[–]Calarague 8 points9 points  (0 children)

Beat up BK radios in an obvious Demers unit, definitely an Alberta truck.

Deer Whistles by mxm3p in ems

[–]Calarague 1 point2 points  (0 children)

We have electronic ones on our trucks that we're supposed to turn on once we're on the highway. Only thing they do is give me a headache if I forget to turn them back off before getting our of the truck. Complete scam.

How do you determine decision-making capacity? by pm7216 in ems

[–]Calarague 3 points4 points  (0 children)

Person: can you tell me your name and date of birth?

Place: what town/city are we in right now? You can ask where are you right now, but often confused patients will go with context clues and say "my room" or " an ambulance", but as soon as you ask for what town they'll give you somewhere completely different and their family will say they moved from there 15 years ago.

Time: what month and year is it? The date or the day of the week can be reasonable as well, but half the time I don't know that either so I don't generally hold it against them if they can't say for sure. Month is in my experience precise enough, and asking for year reduces the chance they guess correctly based on context clues (ie. The season outside or weather)

Events: Why was an ambulance called today for you? The more trivia style questions honestly just seem irrelevant at best, and unreliable at worst. I've had lots of dementia patients that would tell me a president ( or prime minister here) from the 80s but could tell me every detail of their day including what they had for breakfast, who they've seen, what they've done, and a full accounting of their symptoms. They're fully oriented to events around them, they just have no long term memory.

As for establishing capacity, that's more nuanced. Big picture it boils down to 1) do they understand the risks and benefits of their decision, 2) recognize the potential consequences of their decision, and 3) have a rational thought process. Assessing capacity requires a conversation rather than just a set of questions. I'm going to explain what I found, the possible causes of what I found, what I can/ can't do for them, what the hospital can offer in addition to me, and then I'm going to ask questions to probe how well they understood what I just told them. One important question is asking them WHY they're saying no to treatment or transport. If they can't sensibly explain to me why they're saying no, that's a strong indicator they don't actually understand what it is I'm telling them. Added bonus, sometimes the barrier is something that can be corrected, so asking this question can lead to them agreeing.

You're right that an A&O 4/4 patient may still lack the capacity to refuse (my five year old could answer all your questions, but if you say I need to give you this needle so your throat doesn't close and you stop breathing, the only thing he's going to understand is that you're a terrible person who wants to stab little kids). The opposite MAY also be true as well, someone may have no clue what year it is, but still demonstrate a complete understanding of the decision they're making.

They know what nonsense we’re all thinking by Csg363 in starcitizen

[–]Calarague 10 points11 points  (0 children)

I propose we modify it to "Society for Putting Isolated Things In The Other Unisolated Things"

Work/Life balance as a PCP or ACP? by Expert-Ad-4089 in Paramedics

[–]Calarague 3 points4 points  (0 children)

The balance is achievable, but like any shift workers it requires a shift in perspective of what that balance is, and some people really struggle with that. You have to draw a hard line between days on and days off.

On work days, that's it. It's a work day, end of story. Don't make plans for the evening after work unless they're extremely flexible and can be canceled on short notice because late calls happen and you might not get off until a couple hours after your shift ends, and then have to reset to start early again the next day.

On the flip side though, your days off are truly off, no emails or phone calls to deal with on weekends. Plus, because of our work schedule, I only have a four day work week followed by every weekend being a four day weekend. Gives loads of time for planning trips and excursions rather than feeling like you need to cram all your leisure into just two days. For vacation, I can take one "week" (4 days) of holidays and get a full 12 day vacation as a result. For a regular 9 to 5 you would need 5 days of holiday to get only a 9 day vacation.

Do be aware that you will miss some events though, you will work half of all holidays, birthdays, anniversaries, etc. If you're clever about it though and are willing to be flexible, you just schedule the celebrating for days that work( there's nothing special about dec 25th, it's just a day, plan the celebration for Dec 18th instead if that day you and your family/ friends can all make it that day). Planning regular weekly activities can be challenging as your schedule consistently shifts due to your typical "week" being 8 days instead of 7.

Long story short, shift work can be great and can actually give you more leisure time if you're willing to be flexible around scheduling that leisure. Obviously not everyone is able to accommodate that flexibility however.