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James William Lloyd Mahoney
New member
Username: Jmahoney

Post Number: 2
Registered: 02-2003
Posted on Monday, December 11, 2006 - 06:48 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

i've taken the new first aid and basic cpr course, can someone explain why theres alot of these changes. i mean theres alot of new things but theres alot of stuff that we were forced to know now its gone? whats up with that?
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Jake and Krystle
Junior Member
Username: Jakekrystle

Post Number: 10
Registered: 03-2006
Posted on Monday, December 11, 2006 - 11:58 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I think that is the same reason that the First Aid certificates are only good for 3 years."They" find out the procedures are not working as good as they should so new procedures are found and old ones aren't used anymore.i.e whacking someone on the back when they were choking or tilt head back to stop a nose bleed.These methods didn't work so they have revised the procedures to make treating them better.
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Jeff
Intermediate Member
Username: Trexer

Post Number: 20
Registered: 10-2002
Posted on Tuesday, December 12, 2006 - 12:23 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

There is truly solid research behind these new changes. Basically a lot of the changes have been down to simplify things. CPR-C is directed towards the lay rescuer someone who take a first aid course in weekend and may recert in a few years or maybe never. Thus keeping things simple is what research has indicated.

If you really what to know the reasons behind the changes I would suggest reading the following http://www.americanheart.org/downloadable/heart/113262184291 2Winter2005.pdf

It is a pretty good read and puts the changes in perspective.
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James William Lloyd Mahoney
New member
Username: Jmahoney

Post Number: 3
Registered: 02-2003
Posted on Tuesday, December 12, 2006 - 04:18 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

thank you,jake and jeff. jeff, im going to pass this on to other members of my division be a good read for all of us older ones.
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Johnson Lai
Senior Member
Username: Gundam

Post Number: 288
Registered: 11-2002
Posted on Monday, January 29, 2007 - 02:23 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

While I agree with having updates and changes, everything needs to be updated every now and then.

The thing I don't buy is, when they say "We have research to show this and that" because this is exactly the same reason they gave when they updated the CPR procedures last time (way back when).

So, I'm going to take these reasons for change with a grain of salt. In a few years, they will use the same reasons again and change it another time.
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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 58
Registered: 02-2003
Posted on Monday, January 29, 2007 - 10:24 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

If you are really interested you could always download the journal article with all of the guidelines and look up the studies listed to find the actual data.

I can understand what you're saying, the "reasons" they give for the changes seem to always be the same. One thing to keep in mind is that usually with protocol changes it doesn't necessarily mean the old way is bad, just that the new way is better.

Gathering definitive data with respect to resuscitation is a difficult process. It is difficult to accurately measure the success rate of different CPR ratios and very difficult to compare them. I doubt that the "BEST" way to do all this has been found yet, and I am sure there will be more changes in another five years. Again it doesn't mean what we're doing now is bad, just that the new way will be "better". Each time they release new guidelines they base it on the best research they have at the time. Over the next five years more studies will be done based on the new protocols to see where they can be improved.
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Lana H
Senior Member
Username: Ldh

Post Number: 138
Registered: 11-2003
Posted on Tuesday, January 30, 2007 - 11:55 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Let's face it - the best way to do CPR is not to HAVE to do it but if you do having an AED on hand at all times would sure be nice too.
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Lana H
Senior Member
Username: Ldh

Post Number: 139
Registered: 11-2003
Posted on Tuesday, January 30, 2007 - 12:00 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

James there is also an "upgrade" if you want to call it that, that mixes some of the old skills with the new protocols (pulse checks, AR etc.) which is designed for Health Care Providers which would include members of Patient Care Divisions if it is available in your area you could look into it. Also, keep in mind your CPR certs don't actually have an expiry date on them as annual retraining is strongly recommended as these are skills (changed or not) that are quickly forgotten if not used. Bottom line is doing CPR with old or new protocols is not as important as actually DOING CPR when it's required. Just my 2 cents worth.
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Johnson Lai
Senior Member
Username: Gundam

Post Number: 289
Registered: 11-2002
Posted on Tuesday, January 30, 2007 - 04:26 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Agree with Lana. The best method is also prevention. A lot of heart attacks can be prevented if only we led healthier lives.
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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 59
Registered: 02-2003
Posted on Tuesday, February 06, 2007 - 07:56 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana and James:

The HCP level of CPR is not an "upgrade" but rather an additional level that is in place for Health Care Providers. Heart and Stroke/AHA has always had this upper level, but there have not been many differences between Targeted Responder (which is what they used to call it) and regular CPR-C.

I don't know for certain why SJA has now decided to have an HCP level course, but I imagine it has to do with the fact that regular CPR course have now eliminated pulse checks and AR.

If I recall correctly HCP level CPR is the level of CPR that Patient Care divisions are required to take, as it is consistent with what is required in the MFR program (HCP CPR includes use of the BVM).
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Lana H
Senior Member
Username: Ldh

Post Number: 140
Registered: 11-2003
Posted on Tuesday, February 06, 2007 - 01:27 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

There are a few other subtle differences but yes that's basically it. The reason I referred to it as an "upgrade" is because there are still those subtle differences that are now offered to the public in the Level C CPR
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Martin
Intermediate Member
Username: Marty

Post Number: 25
Registered: 06-2005
Posted on Wednesday, February 07, 2007 - 11:18 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Gee, as our training gets more and more intense I have to wonder when we are all going to be Paramedic Level 1s? We sometimes joke and say we are Paramedic Level 0.5, which as a Medical First Responder (us, firefighters, etc) basically are. We just don't get the elite title of paramedic (works for me). What I would like to know is that with all the strict "rules" on the MFR, what about crusaders? I would love for them to take the course, but most of them work weekends and to ask them to book TWO WHOLE WEEKENDS off and lose that money... some of them can't afford it. Am I the only one who has come up against this hurdle, or is anyone else "feeling the pain?"
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Adam Prieur
Senior Member
Username: Beanmedic

Post Number: 60
Registered: 01-2003
Posted on Thursday, February 08, 2007 - 12:02 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

AMFR-1 is a 2 weekend course.
Paramedic 'level 1' is a 2 year course.
Lets not get carried away - it's not even close.
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Lana H
Senior Member
Username: Ldh

Post Number: 141
Registered: 11-2003
Posted on Thursday, February 08, 2007 - 12:53 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Martin, many branches offer these courses during the week too and sometimes 5 days in a row like over Christmas or March Breaks (which might also pose a problem where student jobs are involved but just and FYI) - or there is always the option of "borrowing" an AMFR instructor from another area - assuming your branch is willing to pay for their expenses of course
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Johnson Lai
Senior Member
Username: Gundam

Post Number: 292
Registered: 11-2002
Posted on Friday, February 09, 2007 - 04:48 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

We hear ya Martin. Its all because of increased competition for first aid services.

There are other companies out there that compete directly with SJA for clients. So if they are trained to AMFR-1, shouldn't SJA volunteers also get to that level (or beyond)? If we are still stuck at BTS-1 to 4, we will lose more clients.

Its about coping with change. SJA is a great place to teach us how to handle change. Change happens at school and work (the real life), so its not bad to get more practice at it through SJA.
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Michael Lawrence, RN
Senior Member
Username: Spud

Post Number: 69
Registered: 10-2002
Posted on Friday, February 09, 2007 - 09:54 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Johnson, I have to disagree with you... I don't think it is about competition for first aid services specifically. It is more about standardizing a programme nationally so that no matter where you are in Canada, you receive essentially the same training for AMFR. Certainly, there will always be differences between instructors and quality of instruction, but essentially the core content is consistent.

Also, it does raise the bar for the organization and makes us more modern as you alluded to. However, it also addressed the issue of members uniformed and looking a lot like paramedics but without the equipment or training. The public does not know what we can and cannot do, but with AMFR we are at least better equipped to respond to medical problems with a better foundation to provide care to our patients.

I have always been in favour with the MFR program and was very happy to implement it and move away from a BTS system that although was well intentioned, was not exactly executed well at an organizational level. That being said, we do need to update the MFR materials and incorporate the changes in CPR/AED 2005 protocol updates before the next round of updates occur in 2010!

Just my thoughts.

Cheers,
Michael L.
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Martin
Intermediate Member
Username: Marty

Post Number: 27
Registered: 06-2005
Posted on Sunday, February 11, 2007 - 11:10 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I actually have to agree with both of you. Change can be a good thing. While I do not think we will lose clients because of what we name our training system within St. John, we need to be more competitive out there. Very few organizations, including those we work for professionally, recognize the old BTS system. AMFR, or MFR whichever you call it is more "civilian." And, seeing as we have "civilians" running the show now, we may as well have a civilian name for our training program. And yes, the quality of instruction does somewhat hinge on the instructor's ability to relay the content, it's based on the volunteer's ability to process the information. All in all, the MFR program is a good thing, and while the rollout was mediocre at best I am glad we have it.
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Martin
Intermediate Member
Username: Marty

Post Number: 29
Registered: 06-2005
Posted on Sunday, February 11, 2007 - 11:27 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana, I am looking into different options right now and we MAY have a few different things we can try. One thing I have to realize is that there is always a way. As they say in the Army: "Adapt and Overcome". And that I shall! As for our branch willing to pay for the course... we'll see but I have my doubts.
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Martin
Intermediate Member
Username: Marty

Post Number: 30
Registered: 06-2005
Posted on Sunday, February 11, 2007 - 11:37 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Adam, yes the paramedic level 1 is a longer course, however if you look closer you will realize that it is not two years, in can be done in 10 months (or less if you are willing to pay big bucks). A friend of mine is looking at doing just that. But what can a P-1 do that we can't? Administer drugs. And they do spend a lot more time on theory stuff then we do. BUT, we also (or are supposed to anyway) train once a week. A paramedic takes "refresher" course, and more advance course like administering more drugs, starting IVs etc. St. John couldn't AFFORD for us to do that, but it has been suggested to me a couple of times by paramedics that we should learn how to take and read ECGs (I had to point out that we can't afford the $5,000 or so for the machine). And we are not paramedics, but the public doesn't know that! I try to explain the difference but I think I lose most of them!
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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 60
Registered: 02-2003
Posted on Monday, February 12, 2007 - 06:12 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Martin:

I think you need things put into perspective for you. The Primary Care Paramedic program is a two year college program (which means 4 terms with roughly the "normal" number of hours per week for a college program). You are correct there are some programs that don't take breaks and there are some programs that run more hours per week to shorten the program, but that does not change the total amount of education the candidate receives, it's still for all intents and purposes a "two year" college program.

I don't really think a 40 hour AMFR-1 program does anything more than barely scratch the surface. Paramedics can administer drugs, you are correct and yes, they do learn much more in the way of theory. This theory you refer to, education in anatomy and physiology, is necessary to understand and safely be able to make a field diagnosis and administer medications safely. Paramedics do participate in Continuing Medical Education regularly. They do not train once a week as SJA members do because they are doing better - actually using the skills and knowledge.

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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 61
Registered: 02-2003
Posted on Monday, February 12, 2007 - 07:33 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Martin: with respect to the above comment from Lana about paying for an instructor - I believe she said pay their expenses.

I don't know where your branch is but if it is within an hour of where there is a Community Services MFR instructor you can probably get one to come as long as their expenses (gas and possibly meals while they are there) are covered. If you are a significant distance from any other instructors they might need to pay for accomodations. It's worth looking into.
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Lana H
Senior Member
Username: Ldh

Post Number: 143
Registered: 11-2003
Posted on Monday, February 12, 2007 - 01:59 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Thanks Kevin, I did say EXPENSES and yes, they are usually pretty minimal - many instructors won't even charge you anything unless they are going to be significantly out of pocket. If Branch funding is a potential issue go to your membership - if every participant was able to chip in $5-10 you've probably got it covered yourself. If accomodations are an issue see if someone will bilet the instructor. The actual cash outlay might even be less if you bring in lunch and everyone contributes an extra buck or two towards the instructor - any left over cash could be given to them as a "gratuity" for the little costs they might have incurred but discounted - you will learn, if you haven't already done so - that in SJA as in most volunteer organizations, if you want it bad enough you will find a way to get it done. Good Luck!
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Martin
Advanced Member
Username: Marty

Post Number: 32
Registered: 06-2005
Posted on Monday, February 12, 2007 - 11:03 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Kevin: You are quite right. While paramedic training is more advanced, ours is getting more and more advanced as well. Personally if I were to become a paramedic I woul=d actually join the military... they can do all a paramedic can do plus plus plus! A good friend of mine was a medic in the service and some of my friends are paramedics now (civvy side) so I get a nice prespective from both. But don't knock our own experience and training.. I have seen first aid competitions where OUR people actually beat experienced paramedics. I have also seen the textbook (also known as the bible). Very neat stuff!
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Martin
Advanced Member
Username: Marty

Post Number: 33
Registered: 06-2005
Posted on Monday, February 12, 2007 - 11:09 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana: NOW I see what you mean. Our admin centre is right here in London so expenses WOULD be minor. Getting an instructor to GIVE two weekends... we only have a few instructors for AMFR-1, at least two are brigade members as well. Not quite ready for my crusaders to take it, I would like them to be in a minimum of 1 year first, plus I want hours of them sitting in the truck like me! lol!
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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 62
Registered: 02-2003
Posted on Monday, February 12, 2007 - 11:51 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Martin:

I'm glad you finally agree but you still seem to be missing the point. Our training certainly is becoming more advanced, as is that of PCPs, ACPs and CCPs. It is logical that as advancements are made at the higher levels the lower levels follow.

Comparatively speaking, approximately 20 years ago Ambulance attendants practiced at a level similar to our MFR, while our members were basic or standard level first aid. As the "higher" levels progressed, the lower levels followed.

Also, I wouldn't say a military medic is all "plus plus plus". They really can't do all that much more, and what they can do is really situational or occupationally specific (eg administering antidotes/treatment for chemical warfare). Likewis e some EMS carry additional drugs/treatments for things prevalent in their area (like an antivenom for a snakebite).

I wouldn't hold my breath waiting for the St. John Ambulance MFR Program to start bridging the gap between the First Responder Level and the PCP level.

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James William Lloyd Mahoney
New member
Username: Jmahoney

Post Number: 4
Registered: 02-2003
Posted on Monday, February 12, 2007 - 11:58 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

SJA would doubtfully, bridge the cap between the MFR and the PCP level, for one it'd be too much and for two there's no need to go that far unless your planning on getting into the paramedic career.
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Martin
Advanced Member
Username: Marty

Post Number: 34
Registered: 06-2005
Posted on Tuesday, February 13, 2007 - 12:03 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

True enough, but as a military medic you can also suture... no need to visit the doc! I think what really needs to happen is the whole medical training for PCPs (hate that term!) ACP and CCPs need to be looked at... what are they sitting in the hospital? 12 hour shift and only one transfer cuz two Toronto paramedics had to sit with their patient for 11 hours. Anyway, our training will only advance as community need requires it, or someone up top decides we need to do more. For now, I am happy with what we have. We are fully qualified to save lives and thats what really counts.
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James William Lloyd Mahoney
New member
Username: Jmahoney

Post Number: 5
Registered: 02-2003
Posted on Tuesday, February 13, 2007 - 12:08 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

as you said our training will advance as our community needs it. take a look at the st.john divisions over in the european countries, especially england, there's SJA members are pretty much their paramedics its well maintained over there and its highly respected. as we move into canada, that respect is still there but we arn't as needed i guess you could say because we do have the Paramedics, who go threw the extra training.
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Adam Prieur
Senior Member
Username: Beanmedic

Post Number: 63
Registered: 01-2003
Posted on Tuesday, February 13, 2007 - 12:09 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Martin, I' just wondering why you hate the term 'PCP'

I'm curious, that's all.
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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 63
Registered: 02-2003
Posted on Tuesday, February 13, 2007 - 12:29 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Anything extra military medics do is required by the nature of their posting. If there is a doctor around, the patient will still see the doctor over the medic. But really military medics aren't the focus of discussion here.

Can you elaborate on what you mean by the training "needs to be looked at". Yes, sometimes paramedics sit in the hospital for the majority of their shift due to offload delays, but I don't think this is a reflection of the level of training of the paramedic but rather a much larger systemic problem.
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 143
Registered: 02-2003
Posted on Tuesday, February 13, 2007 - 03:06 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

It should be noted how involved in Canada SJA is in primary and advanced care teaching for Paramedics. Some may not even be aware of this level of community involvement. http://msop.ca
;-)"Be Good All Day"
Paul
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Martin
Advanced Member
Username: Marty

Post Number: 36
Registered: 06-2005
Posted on Wednesday, February 14, 2007 - 11:38 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Adam: The reason why I hate the term PCP is because, growing up in a house where the people worked in federal drug enforcement, PCP is a nasty drug. Everytime I hear it, although I realize it also stands for Primary Care Paramedic still always reminds me of the drug thing. I have seen firsthand what is does to people. Not pretty.
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Martin
Advanced Member
Username: Marty

Post Number: 37
Registered: 06-2005
Posted on Wednesday, February 14, 2007 - 11:47 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Thanks, Paul, when I can keep my eyes open I will look at that link. St. John does much more then first aid in our communities, but the sad thing we are the only ones that know it. Why is that?
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Martin
Advanced Member
Username: Marty

Post Number: 38
Registered: 06-2005
Posted on Wednesday, February 14, 2007 - 11:58 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Kevin, you are quite right where the entire system needs to be almost re-built. Additional training for paramedics is only a small dent into the problem. But some of the smaller stuff I see going to hospital could be dealt with on scene (treat and release). Maybe provincial laws do not allow that, I dunno.
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Kevin Morgan
Senior Member
Username: Kmorgan

Post Number: 64
Registered: 02-2003
Posted on Thursday, February 15, 2007 - 09:52 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Martin:

While I would agree there are a few changes that should be made to the PCP skill set (such as IV starts being a standardized PCP skill across the board) I still say the problems lie further up.

Paramedics are supposed to transport patients to the hospital. In some cases they don't necessarily need to, but it is the patient's decision (if a patient wants to go, the paramedic cannot refuse to take them). Who's to say exactly what the problem is. I personally think if people had to foot the bill there would be a lot less ambulance abuse, but at the same time it would prevent people who need that care from calling an ambulance or seeking treatment.

One pilot project to alleviate the demand on the ER's I heard about was transporting lower priority patients to an Urgent Care. I think this is a great idea (I think it was in Peel, but I am really not sure on that one).

Perhaps we should be moving this to another thread . I think we have drifted away from "CPR Protocols"
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Martin
Advanced Member
Username: Marty

Post Number: 40
Registered: 06-2005
Posted on Thursday, February 15, 2007 - 11:08 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Kevin: Having visited the hospital today including emerg, I would say you are right, additional training is only a small thing, I deal with medical emergencies on a regular basis. My company's policy is to call an ambulance, then page our ERT team. Not always needed, so I completely agree with the abuse. As for Urgent Care we have one here in London, as far as I know it helps, but the 10pm closure is a bit of a drag. Once they have enough statistical data, I am sure they will open more and for longer hours. Whatever happened to the walk-in CLinic idea... what, no one likes these anymore? lol! Quite right, we need a new thread... Ideas to improve our health care system?
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William Woodstock
Senior Member
Username: Wwoodstock

Post Number: 222
Registered: 01-2004
Posted on Friday, February 16, 2007 - 10:00 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Don't you think your stepping out of your box a little Martin? I'm not trying to say you have bad ideas or anything, but ideas to improve out health care system? Don't you think thats a little bit bold of a "civilian" to do?
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Martin
Senior Member
Username: Marty

Post Number: 41
Registered: 06-2005
Posted on Friday, February 16, 2007 - 02:38 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I am not saying I will try to change the system, however anyone can offer and share idea with our MPPs. However my experiences the past few days of going from work to hospital to home has opened my eyes a little more. I have spent enough time in various hospitals over the past year to notice things. Anyway, I think we are getting off the topic of this thread!

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