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New skills for rural and remote paramedics

All paramedics want an expanded scope of practice. Those of us on the frontlines see the deficiencies as measured by the unmet needs of our patients and their families. The needs of our communities and our medical system are not being met either as illustrated by continuing difficulties in recruitment and retention. Change is coming In Australia, the UK, the USA and Canada this change has been underway for quite some time now. Many communities have adopted an Expanded Scope … Read More

The Canadian Resuscitation Outcomes Consortium (CanROC) Paramedic Primer

By Nick Sajko & Judah Goldstein The out-of-hospital component of medical care begins with a 911 call and often ends on arrival to the Emergency Department. In this setting, a wide breadth of medical issues can be encountered, the most serious of which require out-of-hospital resuscitation (OHR). Although a broad category, OHR mainly involves two major conditions, both of which are associated with high mortality and morbidity rates. These conditions include: 1) out-of-hospital cardiac arrest (OHCA), and 2) major trauma. … Read More

Role of TXA in Management of Traumatic Hemorrhage in the Field

  Art Proust, MD, FACEP and Kyee Han, MBBS, FRCS, FRCEM   The guidelines and references contained in this document are current as of the date of publication and in no way replace physician medical oversight. Introduction Hemorrhagic shock remains a serious problem for the multiple trauma patient. It is the leading cause of preventable trauma deaths after loss of airway. Rapid and effective control of exsanguinating hemorrhage has been demonstrated to markedly improve survival and outcome, especially in the … Read More

Fanshawe Paramedic Student Research

Introduction As our paramedic profession grows throughout the world, so does our need to teach students the importance on research and the role we all play in growing and improving our knowledge. It is important to stimulate students and to teach them that research is not something to be feared, but rather embraced. It is universities, colleges, and programs, like Fanshawe, that have taken this to heart and are paving the way for our future paramedics to be more actively … Read More

Paramedic POCUS

BY CRISTINA D’ALESSANDRO, PCP, BA(HONS); IAN R. DRENNAN, ACP, PHD (C); JOSEPH NEWBIGGING, MD, CCFP (EM), FCFP; AMER M. JOHRI, MD, MSC, FRCPC, FASE  This article is a reprint from The Journal of Point of Care Ultrasound (POCUS) and was originally published on August 2018.  This work is licensed under a Creative Commons Attribution 4.0 International License. Background Portable ultrasound is a burgeoning technology with unrealized potential at a critical point in its evolution [1]. Francis Galton first generated ultrasound waves … Read More

Ketofol: A Sedation Alternative

We describe the experience of pain as “an unpleasant sensory and emotional experience” (1). As an essential facet of patient care, sedation and analgesia are of equal importance in the critical care setting for intubated and ventilated patients. The mismanagement of sedation and analgesia can lead to psychological and physiological consequences leading to an increased length of hospital admission and poor patient outcome resulting in long-term disability (1). When caring for patients who will ultimately require intubation and respiratory management … Read More

Transport of the ECMO-Dependent Patient: Introduction, Indications, and the Novel Role of Critical Care Paramedics

Introduction and Background Extracorporeal Life Support (ECLS) is an expanded scope of therapies offering heart and/or lung support. Such therapies include Ventricular Assist Devices (VAD), Impella heart pumps, Extracorporeal Carbon Dioxide Removal (ECCOR) and Extracorporeal Membrane Oxygenation (ECMO). These various therapies can assist in treating acute cardiorespiratory failure, which remains a leading cause of death, with mortality as high as 41% (1). Extracorporeal Membrane Oxygenation is the application of cardiopulmonary bypass to temporarily support cardiorespiratory function until the underlying cardiac … Read More

Paediatric Patient in Paramedicine

Whilst paramedics, emergency medical technicians (EMT) and students manage complex clinical cases as a part of their professional roles, many will find paediatric patients somewhat alarming and confronting. This is likely attributed to a deficiency of paediatric exposure for most crews. As a result the limiting exposure to paediatric patients, a somewhat deficient assessment is sometimes performed. This short article attempts to simplify this issue by providing two simple paediatric specific assessment tools for use by paramedics and students in … Read More

Practice Innovations: Rapid Deployment of Palliative Care

By James Downar, MDCM, MHSc;Amit Arya;Genevieve Lalumiere, BScN RN MN;Ghislain Bercier, Advanced Care Paramedic;Shannon Leduc;Valerie Charbonneau, MD, MSc, FRCPC Introduction  The greatest impact of the COVID-19 pandemic has been felt in long-term care (LTC) facilities. In Canada, approximately 80% of COVID-19 deaths have been linked to LTC facilities[1] and the strain of caring for so many acutely ill residents has been challenging. Even prior to COVID-19, some LTC facilities were struggling to care for a population that is increasingly elderly … Read More

Paramedic Educators as Subject Matter Experts: A Threat to Education Departments

In 2019, the Ontario provincial government announced a funding freeze for paramedic services[1]. At the time, I worked for Peel Regional Paramedic Services in the Greater Toronto Area. In response to this announcement, Peel’s paramedic leadership team swiftly chose to suspend programs such as driver training, autonomous intravenous access training for Primary Care Paramedics, and Advanced Care Paramedic training. I suspect similar decisions were made in other municipalities at the time and that many paramedic organizations across Canada have faced … Read More

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