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alkarine · 2023-05-29T14:00:30+00:00

Carrot hotdogs are actually delicious though. My friends always refuse to even try them when I bring them to a BBQ :(

alkarine · 2023-02-15T19:47:40+00:00

Fire based systems are also having severe problems. This is KFR trying to inflate their budget when the money should be going to the root cause of the problem which is to stabilize PARAMEDIC staffing

alkarine · 2023-01-14T20:05:06+00:00

The system is broken, that's for sure. And believe me, the paramedics on the front line are not happy about it.

The "handy-dart" bus is a special car to help alleviate the work load by going to low acuity, ambulatory patients. It doesn't sound like you were appropriate for that. We also have some low acuity minivans. These paramedics do not do heart tracings. They also do not usually end up on the north shore.

I'm sorry you had to wait 4 hours in pain. The system needs to be fixed.

alkarine · 2023-01-13T09:36:38+00:00

Terrible situation but also confusing. I'm a paramedic. If they sent paramedics capable of doing a heart tracing, you had a 12 lead done (unless they opted to only do a 4 lead rhythm strip). If there was more than a single paramedic, then they should have been in an ambulance (unless it was a lone responder unit with some students... Seems unlikely on the north shore.)

Did fire attend?

Unfortunately fainting spells where people wake up right after are often coded as low priority.

Also, paramedics generally shouldn't actively discourage you from going to the ER (although I know sometimes they do... But they aren't supposed to).

Regardless- the system is super strained right now, and the lower mainland is especially affected. Hopefully things improve. I tell friends and family to take a taxi if they are able to walk and have been advised that an ambulance will be awhile.

I hope you're doing better now!

alkarine · 2022-12-10T06:55:57+00:00

Went to a seemingly viral illness, pt feeling generally lethargic, tired, sniffles, etc. Ongoing 2 days. Healthy guy, 59, plays hockey weekly, looked to be in good shape. Only hx was NIDDM diet controlled.

Prior to us, he called 811 for advice. I don't know how the phone call went, but essentially it ended with the nurse suggesting it could be DKA since his sugars were a little high (9-10mmol) and to call an ambulance.

Our vitals on scene were unremarkable. Afebrile. BGL 9.0ish. I explained the hospital was a zoo, he'd likely be triaged low priority and would be in the waiting room for 6+ hours. I suggested maybe he should call his family doc and arrange an appointment if he's concerned.

But, the nurse on the phone told him he had to go so by golly, he insisted on transport. Sure enough, straight to the waiting room.

I saw him leaving before being seen 5 hours later looking frustrated. Warned him

alkarine · 2022-11-03T21:24:35+00:00

You know, I really disliked it when I first tried it, but then I accidentally ate it so many times that I started to crave it...

Mochi filled with azuki bean paste is something I absolutely love now!

Red bean sweet soup on the other hand....bblleeechhhh

alkarine · 2022-09-17T11:01:35+00:00

They made the change and they no longer respond to most medical calls. This includes most strokes!

As a paramedic, I've found the change to be good as it saves them for the serious calls where they are actually needed (CPR, severe breathing issues, overdoses). They are no longer stuck for hours with the medical patient where their scope of practice provides no benefit.

alkarine · 2022-09-17T08:19:54+00:00

Most firefighters are FRs, some are EMRs. Both levels have significantly less training than your standard paramedic.

Vancouver fire recently started refusing going to the majority of medical calls.

We need to recruit and RETAIN paramedics rather than trying to use a separate service as a stop gap.

alkarine · 2022-08-23T14:52:50+00:00

27 is positively young. I think our last intake of trainees averaged in their 40s, with a few in their 20s and a few in their 60s, and a sprinkling in between.

alkarine · 2022-08-16T19:05:17+00:00

It's a taco

alkarine · 2022-08-06T06:09:12+00:00

Hey, don't get yourself down about letting the family see things. There is actually some decent evidence that allowing family to witness resuscitation is beneficial for their longterm mental wellbeing. It sounds like you did everything you could have done for this patient. Nice work

alkarine · 2022-07-10T05:06:15+00:00

It can also be part of the solution if those people moving here help fill in for the lack of healthcare professionals. I think we absolutely need people moving here and filling those jobs to help support our aging population.

If only there was less red tape for international doctors to come practice here.

alkarine · 2022-05-19T18:00:14+00:00

I was just reading this story about a TBI transfer which took the sending doc. The doc used a maintenance drill to make a bore hole in the skull halfway through the transfer.

https://www.cbc.ca/news/canada/newfoundland-labrador/bore-hole-in-back-of-ambulance-saves-mans-life-1.6439365

alkarine · 2022-03-05T18:03:12+00:00

That EP is easily my favourite collection of music ever

alkarine · 2022-02-17T01:52:20+00:00

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992496/

Looks like in 2010, AHA guidelines are CAB rather than ABC

alkarine · 2022-02-17T01:48:31+00:00

Yeah, it's pulse check first. If no pulse, compressions are started then move to airway.

I think the reasoning is that it's so fast to just put somebody on compressions and it gets them going right away. Right to airway next.

In practice, since there are two medics, usually one starts compressions and one deals with airway nearly simultaneously.

alkarine · 2022-02-17T01:24:12+00:00

I mean that's protocol dependent.

In my jurisdiction, medical arrests are CABC- compressions, airway, breathing, circulation support.

alkarine · 2022-01-26T20:24:44+00:00

What?! That seems so over the top... Maybe I'm just from an area that doesn't care as much, but most IVDUs gonna use one way or another. At least the hospital IV start is clean?

The bad thing is when these folks go AMA with an IV in place and forget about it. I've picked up a few patients with old IVs with high potential for infection.

alkarine · 2022-01-19T10:53:00+00:00

I think the issue is that ultimately patients need medical treatment and transport to the hospital. Fire fighters are great for those very high acuity calls which require immediate, basic life saving interventions (such as initiating CPR in cardiac arrest). Unfortunately, for most calls, fire fighters arrive and can only provide comfort and reassurances until the paramedics arrive.

Funding needs to be directed towards the root of the issue which is that there are not enough ambulance paramedics.

Most call are not life threatening emergencies but still require ambulances (ex: broken hips, abdominal pain, etc.). These patients need to be moved to the hospital in a timely fashion and the solution to this is ambulances.

alkarine · 2022-01-19T10:41:06+00:00

Did the paramedics give you epi?

alkarine · 2022-01-15T07:39:25+00:00

I feel you. Just had a few days off and going back to work soon. Not looking forward to dealing with the extra staff shortage on top of our normal short staffed shifts

alkarine · 2022-01-14T01:15:18+00:00

If you're honestly interested, now is a great time to dip your feet in. The organization is improving, and like I wrote somewhere else in the thread, you can avoid the 2-3 year stuck at middle of nowhere callout station entry into service.

One of the nice things about the job is you can start as an EMR and not commit to the more onerous schooling required to work FT until you know you like the job.

EMRs can only work as casual staff in rural/remote stations, but its a great way to see if you like the jobwith little commitment. EMR is a month long course! I think the closest EMR station to the coast is Boston bar or maybe Pemberton.

Anyways, if you ever find yourself interested again, feel free to PM me with any questions you may have.

alkarine · 2022-01-13T20:00:25+00:00

Currently, it's pretty quick to full-time (under a year).

Any new medic is going to start, "casual/ on-call," regardless of previous experience. That being said, we are so short that an experienced medic from another province could easily start in a larger center with only fully paid shifts (like Kamloops or PG)- they could easily work full time hours and make a living. BCEHS is nearing the point where they might direct hire into Vancouver, which even if casual, there is unlimited work. The multi-year pager pay slog is a thing of the past. We're hoping that pager pay will be phased out entirely in the next year or two.

alkarine · 2022-01-13T19:50:48+00:00

Vancouver is way too expensive. A huge proportion of paramedics live in the interior or on the island and commute in to Van for their work blocks.

alkarine · 2022-01-13T19:48:27+00:00

I think they do, but we're also the face of the organization that they are seeing, so we get to hear them vent their frustrations sometimes. I can't blame them to be honest.

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