March 1, 2020: Kara Thompson
Written by: Ronda Ryder
Ryder: “What area of paramedicine do you currently practice? What does a typical day look like for you?”
Thompson: “I am currently working for AHS as a community paramedic. A typical day is BUSY haha, I get to work, login to my computer, pick up my drugs, check my calls, do some research on netcare etc. and head to my first call. I then head from call to call and try to squeeze some food in.”
Ryder: “Did you enjoy your education experience for paramedicine? Can you give one suggestion to schools?”
Thompson: “I really enjoyed going to school, I love learning and found paramedicine especially interesting! Paramedic school (I went to SAIT) was an absolute blast – we had a really close class and therefore spent a lot of time together. I had really fantastic practicums and teachers and felt well prepared once I was on my own.
A suggestion for schools… I went to AHASTI for my EMT and I was put in Fort Macleod for my practicum. I was there for 2 weeks straight and did hardly any calls. I would suggest that all students go to a busy city center, even if that means waiting for a few weeks for placement. I felt very ill prepared for my first EMT job with AHS Calgary Metro as a result of this.”
Ryder: “Do you have a favourite call? Maybe one that made you grow as a practitioner?”
Thompson: “I actually did a call recently with CP, a lady had fallen and lacerated her scalp. We had gone and glue stitched her scalp however the next morning she had woken up with a blood soaked pillow as the glu had not held. By the time I got there her head was saturated with dried blood, so much so that I could not see the initial wound. I spent the next 2 hours washing this ladies hair, in the shower and the sink, just so that I could see the initial wound. She was the nicest elderly lady and was so cooperative. In the end I had to send her in to the hospital as we couldn’t stop the bleeding and were unable to stitch it due to the initial use of the glu stitch. I didn’t do much for her medically, but I was with her for around 4 hours and she was so thankful that I took the time to wash her hair and clean her up. She was so worried that the hospital would have shaved her head due to the amount of matting from the died blood. At the end of the call she gave me the biggest hug and asked if I could come visit her again – she said that she felt like I truly cared and she was so thankful that there were still people in the world who were kind. She said she was so incredibly thankful for our program and that it had made such a difference in her life. What she said made such an impact on me as a practitioner, I felt like I truly made a difference for her and I was so proud to be a community paramedic and a part of this amazing program.”
February 1, 2020: Glen Manser
Written by: Ronda Ryder
Ryder: “What area of paramedicine do you currently practice? What does a typical day look like for you?”
Manser: “I am currently working as a Community Paramedic in Calgary, specifically on the City Center Team working downtown with the homeless population. My typical day consists of visiting various shelters, harm reduction sites, and encampments to provide care to our clients where they live.
We provide a varied field of care, from wound care to antibiotics to managing complex cardiac illnesses, all under the direction of our specific physicians.”
Ryder: “Did you enjoy your education experience for paramedicine? Can you give one suggestion to schools?”
Manser: “I can’t say that I enjoyed my educational experiences. My paramedicine course was taken through Portage College, meaning most of the learning was self-directed. I struggled with this as I didn’t have a true understanding of my own learning style. I now know that I learn better under a structured, in-class setting as opposed to once a week on site every three months. I chose that method as it allowed me to work full time and raise my family, so it was my only option.”
Ryder: “Do you have a favourite call? Maybe one that made you grow as a practitioner?”
Manser: “I can’t think of a specific call that I would say was my “favourite”. Each call is different, and offers a learning opportunity if you open yourself to it. For me, I always took pride in the fact that people were allowing us in to their lives at some of the worst moments of their lives; there is a great responsibility that goes with that and I’ve always tried to keep that in mind.”
January 1, 2020: Jason Cattoni
Written by: Ronda Ryder
Ryder: “What area of paramedicine do you currently practice?”
Cattoni: “I am currently an EMR working IFT.”
Ryder: “What does a typical day look like for you?”
Cattoni: “My typical days starts at 16:30 hrs. I disinfect the Ambulance with Cavi wipes. Steering wheel door handles, etc. Then we sign in at 17:00 hrs and head to our first transfer. Most patients are move to a lower level of care. I also work for a Central Zone Ambulance Company that allows me to get experience on emergency calls as well.”
Ryder: “Did you enjoy your education experience for paramedicine?”
Cattoni: “I have the lowest level you can have to be working on an Ambulance. I’m looking forward to moving on to PCP and then ACP.”
Ryder: “Can you give one suggestion to schools?”
Cattoni: “From what I hear and what I know is smaller classes for more one on one time is the biggest complaint.”
Ryder: “Do you have a favourite call? Maybe one that made you grow as a practitioner?”
Cattoni: “Still new to the business, I do have a couple gross calls that stick in my mind but I can’t really say they were my favourite. I have a lot of fantastic people that I have met and have been amazingly helpful and supportive (including yourself) during my career change. It’s not easy changing careers when you have a family.”
December 1, 2019: Kaitlynn Dick
Written by: Ronda Ryder
Ryder: “What area of paramedicine do you currently practice? What does a typical day look like for you?”
Dick: “I currently practice three areas In Paramedicine within Alberta Health Services. So my day to day changes depending on which variation of Emergency Medicine I am working that day. I work Ground Ambulance, Air Ambulance, and Community Care Paramedicine. So my typical day is anything but that. Everyday brings on something new of which I can work and learn from and seems to be constantly changing. I find that everyday I am confronted with a new challenge which involves me referring to not only my base knowledge from post secondary school, but that of which my advanced training from Alberta Health Services which involves an array of tools from my Ground and Air Protocols, Online Medical Consultation, Equipment to Crew Partnerships. One day I can be working closely with our MIH physicians to devise a tx plan for patients that are wanting to be treated in the comfort in their home, to flying critical patients from one hospital to another, to working on Ground Ambulance and never knowing what to expect from the next call. I know that no matter what the typical day has me showing kindness, compassion and empathy within my treatments and towards my patients.”
Ryder: “Did you enjoy your education experience for paramedicine? Can you give one suggestion to schools?”
Dick: “I did! I loved my schooling. While it was hard and at times frustrating it taught me how to become more disciplined, and to have a higher level of respect for the health care profession. I was fortunate enough that through out my schooling not only did I meet new people and friends, but came out with relationships that have allowed me to remain resilient and strong within this profession, I would definitely say that not only did I come out with an education, but relationships with people that I would consider a second family. I went to the Medicine Hat College, and was fortunate to have amazing professors that were so knowledgeable and confident in themselves that they were able to teach us not only the knowledge and practical hands on, but the confidence to be amazing practitioners. A lot of our courses from the College are transferable to achieving a degree in Paramedicine as well as other things such as a general degree in health sciences, or kinesiology. But honestly It’s whatever school suits your needs at the time! If you’re needing to do your education by distance learning since you are working full time then there are schools well suited to you. It depends on the area of Alberta you would prefer to live in. But obviously I’m a little biased towards the Medicine Hat College.
Ryder: “Do you have a favourite call? Maybe one that made you grow as a practitioner?
Dick: “That’s a really hard question to answer actually. I appreciate every call because every single call has helped make me a better practitioner. One of my favourite parts of Paramedicine are palliative calls. I was fortunate enough to be around while my grandfather was dying from Pancreatic Cancer, My family and I all banded together to help and once he was moved into palliative care in our local hospital I saw the kindness, compassion and empathy a lot of those health care professionals had while helping with the comfort of my grandfather. I had an EMS call for a wonderful woman who was not feeling like herself. Her husband and herself had noticed a decline in her physicality, however our diagnostic vitals were showing within normal parameters. The patient initially did not want to go to the hospital but my partner and I were able to convince her that it was probably for the best if she were not ambulating as well. We treated and transported her to the hospital. However we crossed paths once again a week later, when she was being transported to our Local hospice for palliative care. Her husband and herself were so appreciative of having me be one of the practitioners to transport her to hospice as we already had a rapport with one another. I had asked her if there was anything she needed prior to us leaving the hospital, to which she said she was sad that she did not have her colouring books while she was in hospice as she did not want her husband to leave her side at the time, understandably. So I asked my partner to go take me to a store and bought the patient a colouring book, pencil crayons and flowers and took them back to her. I saw a light in her smile when I gave them to her that I knew was so genuine, it was such a small gesture that helped make a big difference for this patient and her family. Now that I have learned so much more about palliation through my continuous ems education as well as being able to be a Community Paramedic and be one of the first people to help in palliation of a patient,it has solidified my gratitude and appreciation for every single persons life that I get to be a part of, even if its for a little while.”
November 1, 2019: Leah Lavers
Written by: Ronda Ryder
Ryder: “What area of paramedicine do you currently practice? What does a typical day look like for you?”
Lavers: “I currently practice in an urban emerge setting in and around the core of Calgary. A typical day consists of arriving at my hall, going to one of the changing dorms and changing from my street clothes to my uniform. I then go out and wipe down the truck and check the bags for it’s contents and the back of the truck and take note of anything that needs to be restocked. I sign into the CAD and make sure the radios have adequate battery and grab extras as needed.
Generally at this point we are being dispatched on a call, especially if it’s an evening shift. I’m on a peak car which means I work 0700-1900 hrs and 1500-0300hrs . So in the mornings we might get some down time to eat breakfast or maybe catch a quick nap or work on continuing education. On the evening shift we are generally on a call right away or maybe sent for hallway relief for the day crews. That’s one of the unfortunate things about being on a peak car. If we aren’t doing hallway relief we are generally service the vulnerable populations of the downtown core. Overdose of fentanyl or alcohol or simply just picking them up and moving them to a less conspicuous area such as a shelter or their subsidized housing site. Shifts are generally 12 hrs. Most meals are eaten in the ambulance on the way to calls or while doing paperwork in a small dirty office in the ambulance bay.”
Ryder: “Did you enjoy your education experience for paramedicine? Can you give one suggestion to schools?”
Lavers: “I did enjoy the education experience . Though I wish we could have paid practicums as most of us are established adults with mortgages and families. Suggestions I would give the schools are instead of hospital practicums that we start integrating clinical time with the community care paramedics. Something I believe is more applicable than a hospital. I would also recommend that they start teaching self care and resilience in their programs to better prepare yourself for later on in your career when everything isn’t new and cool and now becomes that heavy burden as burnout and PTSD start to set in. Something employers can do is offer programs other than R2MR ; such as counselling services with psychologist, scheduled breaks that allow us to process and digest what we’ve just been through. I would also recommend that schools don’t allow students to go straight from EMR to advanced care paramedic without a few years in between to gain experience. All too often young kids coming through with no life experience and no being exposed to unimaginable things are freezing in the heat of the moment. Most people cannot process trauma until the brain development and plasticity has reached at least 26 years of age . I think that the minimum age to enter into paramedicine should be 25. That way social skills and brain development have had a chance to develop.”
Ryder: “Do you have a favourite call? Maybe one that made you grow as a practitioner?”
Lavers: “One of my favourite calls is probably on of my first cricothyroidotomy calls. She was a 30 something year old Phillopino lady with throat cancer. She was getting weekly endoscopic procedures to monitor the tumor growth. This particular day the family called because she was vomiting and coughing up blood. When we arrived she was in an apartment building on the 3rd floor with an additional walk up loft. As we walked up we could see the blood all over the wall and at least a litre in a garbage can and she was laying on a mattress on the floor in the upstairs room. It looked like a murder scene. At the time she had a faint pulse and was unresponsive and barely breathing. There was no place to work so we picked her up and carried her down the stairs to the main living area floor to work. As we carried her down the stairs blood just flowed freely out of her mouth soaking our uniforms. We tried to suction but our machine couldn’t keep up so we called for an additional unit for support. We tried to bag her but couldn’t get air in. I tried intubation but couldn’t pass the tube because of the tumor. I went in with the magill forceps to pull out clots the size of over cooked scallops. They were so hard yet viscous at the same time. And I kept pulling sooo many out. I had the suction in at the same time as the blade to tried to follow bubbles to find her trachea with no luck. This women had lost so much blood. We knew we needed to cric. Unfortunately we had just switched to a new system and it was awful. There were no scalpels provided in the kits and the trocar itself was not sharp enough to puncture the skin without the safety popping off releasing the tube down. It requires two of us to pierce the skin and finally get the cricothyrodemy in place . Finally we were able to get air in. At this point we knew that this lady had to be brain dead but now in cardiac arrest we would give her the proper 20 minutes of ACLS and give this women as chance or at least her family a chance to come from the Philippines to say goodbye. I was talking to some of her family when I could hear my partner and our backup unit charging the life pack.
I poked my head out of the private room the family was sequestered in and had a puzzled look and they said that they had a rhythm they could shock. So, we did and the most awful thing happened. She was so bloody and we could not keep her dry no matter what we did that when we shocked it arced and had burnt her chest where the pads lay. As we hopped back on the chest for CPR we carefully removed the pads and applied new ones this time anterior posterior. We shocked a few more times and to our surprise got ROSC. At this point we had been on scene for quite some time with all the calamity of errors and challenges we had faced. We decided that since there was no elevator we would disconnect everything and carry her down the stairs and hook everything back up at the bottom. Our fire crew was amazing and was done with precision. We strapped her down and to our surprise still had a pulse. We wheeled her outside (which was -30) and into our unit only to find that in that short amount of time that the cric tube had frozen, cracked and broke. We quickly replaced ALL of our equipment including the bvm and we were able to again ventilate our pt. We did a quick radio patch to the hospital who were not impressed at this time in the morning that they did not have time to prepare as we were sitting on their doorstep. But we made it! They saw what we were working with and how exhausted and soaked in blood we were. She ended up living a week in the ICU so family could come and discontinue care and let her pass.
Now this call happened 5 minutes to shift change on one of the coldest days of the year. I was a newer medic and it taught me to adapt and overcome and not be driven by protocol because not everyone fits into an algorithm. We needed to think quickly on our feet when everything was thrown at as to try and make this call unsuccessful but we macgivered and came out on top. We considered this a success because her family was able to give her the proper goodbye.”
October 4, 2019: Logan Straub
Written by: Ronda Ryder
Ryder: “What area of paramedicine do you currently practice? What does a typical day look like for
you?”
Straub: “I am currently practicing as a community paramedic in Medicine Hat and have been since October 2018. Generally, my day is scheduled ahead of time and varies greatly day-to-day. I do anything and everything, utilizing my full scope of practice; I am usually called to provide initial patient assessments where I’m required to consult with a physician – whether it’s the family doctor or my MCN – and initiate treatments. These treatments consist of blood draws, foley catheter insertions, IV hydrations, IV medications and prescribing medications in conjunction with the physician. I’m also utilized in providing wound care, which can be anything from wound cleaning/dressing all the way to providing sutures. Lastly, as a community paramedic, we can act as a bridge for patients who do not currently have a family physician; we can provide the resources and a baseline trust for these patients to seek further care for themselves.”
Ryder: “Did you enjoy your education experience for paramedicine? Can you give one suggestion to schools?”
Straub: “I thoroughly enjoyed my time at the Medicine Hat College studying paramedicine; the instructors were excellent and provided me with the appropriate tools to strive as a paramedic. The focus on true emergencies was superb and provided me with confidence on how to manage these cases. One suggestion I would make is to provide students with a more realistic approach to patient assessment and care instead of focusing on the ACP-scenario format. Secondly, I suggest that there is a more candid discussion on the 95% of EMS calls we truly go to as well as the out-of-town transfers.”
Ryder: “Do you have a favourite call? Maybe one that made you grow as a practitioner?”
Straub: “I met a patient during my time on senior practicum who I have not been able to forget to this day. I first met this patient while he was attempting to commit “suicide by police.” The patient stood 6’6 and weighed around 120kg and was previously known to police. We were able to talk this gentleman down and transport him to the nearest hospital without incident – during the transport, the patient was very candid about his current mental state and how he had previously attempted suicide in a variety of violent ways. The next day, after transporting another patient to the hospital, I saw this gentleman again in the ER in handcuffs as he had been placed under arrest for another attempt. I saw the patient once more in ER that same tour for the same complaint but did not come across him again. I think about this patient often, of course wondering if he found the help he needed or was “successful” in his attempt; I think at that time, I was too young to realize the impact he had on me but since then, I use him as a reminder that no matter what walk of life you are from, we all deserve the same respect and dignity. I’ve found myself in situations where patients are aggressive and violent towards my partner and I and it’s difficult to remain level headed; keeping that patient in the back of my mind reminds me that all most people need is someone to listen to them. All that the patient needed was someone to just listen and he was agreeable and cooperative.”