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Hi Bill,

Concur completely with 's comments. We offshore medics have a

lot of autonomy, given the isolation and inherent difficulties. That

being said, we also have communications with expert help onshore

24/7.

If your people are three hours from the nearest specialised care, I

expect this can become six hours through weather problems etc. Much

will be dictated by the emergency equipment you hold also. In my

experience, anything more than one hour availability of hospital

care will require top notch personnel and equipment. As this is a

Canadian outfit, I expect the consequences of litigation could loom

large. Better if they pay for the best now or pay huge if found not

providing " adequate care " to their employees. Its a situation I knew

well from American vessels running in the Caspian with no Medics at

all.

It sounds like you have a good case for the provision of very highly

qualified and experienced paramedics at this location. In the UK,

such things are formally dictated by a risk appraisal of the

situation - including worst case scenarios.

Good luck

Buck

Medic

Ninian Southern

In , " thomas greaber "

<tom5255@h...> wrote:

> Hi bill

> Most if not all of us whom work offhsore and on remote sites

function at a

> level above " paramedic " as it what a paramedic does ona ambulance

we all

> tend to have very liberal protocals and routinely provide primary

care to

> our patient load. such as antibodics, dental care, basicly the

same stuff

> that your aver GP sees in his office. We also dela with other

issues a

> paramedic never deals with...health and hygenie. occ heath issues

and a pile

> of other crap. Ranging form inventory to advisng the client on

equipment,

> training ERT teams etc;

> If I remenber correctly EMT 3 is basicly trauma related or should

I say

> orientated. So the issues of cardiac and the like are out of thier

scope.

> Would submit that any remote site needs staff at the very least

staff by

> paramedics ( or as in the case of some of our fellow providers on

the list)

> staff with ED, ICU nursing background) this is a profession where

paramedic

> is where your start.

>

> Regards

>

> Tom g

> Sakhalin island

>

> >From: Bill Witmer <billemtp2000@y...>

> >Reply-

> >

> >Subject: question for group

> >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> >

> >

> >

> >-I have a question I know this is not an American

> >group per SE but what is the level of care most of the

> >places you work at? Like I work at a remote Gold Mine

> >here in Alaska and it is currently a Paramedic level

> >care but they feel that EMT3 level care is good enough

> >so I am trying to put together a argument that

> >standard of care is Paramedic care or higher is

> >standard. But I need proof, this is a Canadian based

> >company that I work for and so maybe I am wrong. Is

> >Canada rated at Paramedic or do they have a different

> >system..

> >

> >

> >thanks

> >

> >Bill Witmer

> >NREMTP, RT

> > >

> >

> >

> >

> >

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Hi Bill

I agree with all the below comments, but how about asking your company

to send you on a remote medics course - the one we in the UK do for

offshore would be a benefit for you providing that you find the correct

course provider ...

just a thought!

best wishes

question for group

> >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> >

> >

> >

> >-I have a question I know this is not an American

> >group per SE but what is the level of care most of the places you

> >work at? Like I work at a remote Gold Mine here in Alaska and it is

> >currently a Paramedic level care but they feel that EMT3 level care

> >is good enough so I am trying to put together a argument that

> >standard of care is Paramedic care or higher is

> >standard. But I need proof, this is a Canadian based

> >company that I work for and so maybe I am wrong. Is

> >Canada rated at Paramedic or do they have a different

> >system..

> >

> >

> >thanks

> >

> >Bill Witmer

> >NREMTP, RT

> > >

> >

> >

> >

> >

Member Information:

List owner: Ian Sharpe Owner@...

Editor: Ross Boardman Editor@...

ALL list admin messages (subscriptions & unsubscriptions) should be sent

to the list owner.

Post message: egroups

Please visit our website http://www.remotemedics.co.uk

Regards

The Remote Medics Team

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Guest guest

Hello Buck ,

Are you still squishing about the higland roads on that motorbike?

You are quite correct in your comments below but I have often felt that many big

companies would rather take the gamble on their hard working medics saving the

day and not costing much against something bad happening, which could have been

prevented, and then calling in their lawyers and HSE to fight it and/or find a

scapegoat.

This was seen recently in Texas with BP who, following a fatal incident, held an

investigation and found the fault lay entirely with the employees and

supervisors on the spot. Fortunately in this case the US unions jumped in and

told BP that they would not accept this finding at all.

In the largest Saudi oil company it was not uncommon for medics to be

intimidated by supervisors or managers to change medical reports on incidents

that may have required investigations and a poor score on their department

safety points for the month.

An American drilling company in the Caspian which had medics did not have a

company medical department and was not willing to pay for a Topcover contract,

so despite having very good medics working for them it was not uncommon for

medical decisions to be overruled by the zone manager, the rig manager, the OIM

or the senior tool pusher, to save a dollar and avoid paying for treatment.

Investing in quality staff and equipment does pay off at the end of the day.

P.

<bxtaylor2@...> wrote:

Hi Bill,

Concur completely with 's comments. We offshore medics have a

lot of autonomy, given the isolation and inherent difficulties. That

being said, we also have communications with expert help onshore

24/7.

If your people are three hours from the nearest specialised care, I

expect this can become six hours through weather problems etc. Much

will be dictated by the emergency equipment you hold also. In my

experience, anything more than one hour availability of hospital

care will require top notch personnel and equipment. As this is a

Canadian outfit, I expect the consequences of litigation could loom

large. Better if they pay for the best now or pay huge if found not

providing " adequate care " to their employees. Its a situation I knew

well from American vessels running in the Caspian with no Medics at

all.

It sounds like you have a good case for the provision of very highly

qualified and experienced paramedics at this location. In the UK,

such things are formally dictated by a risk appraisal of the

situation - including worst case scenarios.

Good luck

Buck

Medic

Ninian Southern

In , " thomas greaber "

<tom5255@h...> wrote:

> Hi bill

> Most if not all of us whom work offhsore and on remote sites

function at a

> level above " paramedic " as it what a paramedic does ona ambulance

we all

> tend to have very liberal protocals and routinely provide primary

care to

> our patient load. such as antibodics, dental care, basicly the

same stuff

> that your aver GP sees in his office. We also dela with other

issues a

> paramedic never deals with...health and hygenie. occ heath issues

and a pile

> of other crap. Ranging form inventory to advisng the client on

equipment,

> training ERT teams etc;

> If I remenber correctly EMT 3 is basicly trauma related or should

I say

> orientated. So the issues of cardiac and the like are out of thier

scope.

> Would submit that any remote site needs staff at the very least

staff by

> paramedics ( or as in the case of some of our fellow providers on

the list)

> staff with ED, ICU nursing background) this is a profession where

paramedic

> is where your start.

>

> Regards

>

> Tom g

> Sakhalin island

>

> >From: Bill Witmer <billemtp2000@y...>

> >Reply-

> >

> >Subject: question for group

> >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> >

> >

> >

> >-I have a question I know this is not an American

> >group per SE but what is the level of care most of the

> >places you work at? Like I work at a remote Gold Mine

> >here in Alaska and it is currently a Paramedic level

> >care but they feel that EMT3 level care is good enough

> >so I am trying to put together a argument that

> >standard of care is Paramedic care or higher is

> >standard. But I need proof, this is a Canadian based

> >company that I work for and so maybe I am wrong. Is

> >Canada rated at Paramedic or do they have a different

> >system..

> >

> >

> >thanks

> >

> >Bill Witmer

> >NREMTP, RT

> > >

> >

> >

> >

> >

Member Information:

List owner: Ian Sharpe Owner@...

Editor: Ross Boardman Editor@...

ALL list admin messages (subscriptions & unsubscriptions) should be sent to the

list owner.

Post message: egroups

Please visit our website http://www.remotemedics.co.uk

Regards

The Remote Medics Team

---------------------------------

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--- Parkinson <gary.parkinson@...>

wrote:

> Hi Bill

> I agree with all the below comments, but how about asking

> your company to send you on a remote medics course - the

> one we in the UK do for offshore would be a benefit for

> you providing that you find the correct course

> provider ...

I think

The whole point od his message

Is that his company... paid already too much to have a

Medic

A first-aid kit and maybe a bottle of oxygen. They are

satisfier that they have a warm body with an EMT

certification. They do see the point of anymore expenditure

or of the usefulness of the Medic (since he his outside of

the revenue generating equation)

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Do you know if the remotemedic course is accepted in

the US. the Doctor out there has used my miltary

exsperience to cover for the procedures I do Outside

of the normal medic stuff.

Bill

--- Parkinson

<gary.parkinson@...> wrote:

> Hi Bill

> I agree with all the below comments, but how about

> asking your company

> to send you on a remote medics course - the one we

> in the UK do for

> offshore would be a benefit for you providing that

> you find the correct

> course provider ...

> just a thought!

> best wishes

>

>

> question for group

> > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > >

> > >

> > >

> > >-I have a question I know this is not an American

> > >group per SE but what is the level of care most

> of the places you

> > >work at? Like I work at a remote Gold Mine here

> in Alaska and it is

> > >currently a Paramedic level care but they feel

> that EMT3 level care

> > >is good enough so I am trying to put together a

> argument that

> > >standard of care is Paramedic care or higher is

> > >standard. But I need proof, this is a Canadian

> based

> > >company that I work for and so maybe I am wrong.

> Is

> > >Canada rated at Paramedic or do they have a

> different

> > >system..

> > >

> > >

> > >thanks

> > >

> > >Bill Witmer

> > >NREMTP, RT

> > > >

> > >

> > >

> > >

> > >

>

>

>

>

> Member Information:

>

> List owner: Ian Sharpe Owner@...

> Editor: Ross Boardman Editor@...

>

> ALL list admin messages (subscriptions &

> unsubscriptions) should be sent

> to the list owner.

>

> Post message: egroups

>

> Please visit our website

> http://www.remotemedics.co.uk

>

> Regards

>

> The Remote Medics Team

>

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Guest guest

Hi Bill,

I'm not sure but I bet that someone on the list will know - a while ago

I remember we had quite a few US medics going on the UK offshore medics

course as it has been seen as the 'gold standard' for the industry - it

was discussed on the group but I'm not sure when (maybe about 6 months

ago...?)

hope that helps

Best wishes

question for group

> > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > >

> > >

> > >

> > >-I have a question I know this is not an American

> > >group per SE but what is the level of care most

> of the places you

> > >work at? Like I work at a remote Gold Mine here

> in Alaska and it is

> > >currently a Paramedic level care but they feel

> that EMT3 level care

> > >is good enough so I am trying to put together a

> argument that

> > >standard of care is Paramedic care or higher is

> > >standard. But I need proof, this is a Canadian

> based

> > >company that I work for and so maybe I am wrong.

> Is

> > >Canada rated at Paramedic or do they have a

> different

> > >system..

> > >

> > >

> > >thanks

> > >

> > >Bill Witmer

> > >NREMTP, RT

> > > >

> > >

> > >

> > >

> > >

>

>

>

>

> Member Information:

>

> List owner: Ian Sharpe Owner@...

> Editor: Ross Boardman Editor@...

>

> ALL list admin messages (subscriptions &

> unsubscriptions) should be sent

> to the list owner.

>

> Post message: egroups

>

> Please visit our website

> http://www.remotemedics.co.uk

>

> Regards

>

> The Remote Medics Team

>

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Guest guest

Hi Bill,

I practiced in remote Western Alaska with many a fine

paramedic...I am worried that standards of practice in

Non US locations could get you in trouble in Alaska.

Be sure you don't run afoul of the Alaskan/USlaws and

" Standard of Care " by performing care beyond your

licensed " scope of care " . Alot of what you are

describing to us is what is licensed to the Nurse

Practioner or Physician Assistant level in US.It is a

common problem in the US( and of course elsewhere)that

competent and experiensed paramedics with former

military backgrounds are not used effectively.Many an

IDC( independent duty corpsman) has returned to the US

and been unable to practice at his competency level

also , rather they were relegated to the regulatory

level which currently has a gap..

Being land based has differant laws. A Forgein

physician WILL NOT cover you under these circumstances

I assure you.They cannot delegate to a licensed

medical provider tasks beyonf the scope of practice.If

you were unlicensed they could !!! And then they are

on the hook for the standard of performance.

Better check with the regional EMS and State Medical

board before you go further and wind up in hot water.

Sorry to be the yellow flag on your race.

Gerry Keenan PA-C, MMS

formerly at YKHC in Bethel,AK

now at an ER in Maine and

Principal Consultant, Partners in Practice,Physician

Extender Consulting Services

--- Parkinson

<gary.parkinson@...> wrote:

> Hi Bill,

> I'm not sure but I bet that someone on the list will

> know - a while ago

> I remember we had quite a few US medics going on the

> UK offshore medics

> course as it has been seen as the 'gold standard'

> for the industry - it

> was discussed on the group but I'm not sure when

> (maybe about 6 months

> ago...?)

> hope that helps

> Best wishes

>

>

> question for

> group

> > > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > > >

> > > >

> > > >

> > > >-I have a question I know this is not an

> American

> > > >group per SE but what is the level of care most

> > of the places you

> > > >work at? Like I work at a remote Gold Mine here

> > in Alaska and it is

> > > >currently a Paramedic level care but they feel

> > that EMT3 level care

> > > >is good enough so I am trying to put together a

> > argument that

> > > >standard of care is Paramedic care or higher is

> > > >standard. But I need proof, this is a Canadian

> > based

> > > >company that I work for and so maybe I am

> wrong.

> > Is

> > > >Canada rated at Paramedic or do they have a

> > different

> > > >system..

> > > >

> > > >

> > > >thanks

> > > >

> > > >Bill Witmer

> > > >NREMTP, RT

> > > > >

> > > >

> > > >

>

=== message truncated ===

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Guest guest

Bill;

Regardless of the head office is situated, the question remains what current

soil are you physically sitting on, different countries / states / provinces

/ commonwealths / republics have differing standards and regulations, it

becomes a mater of Jurisdiction. hits the head of the nail!

It is a bit personally disappointing to me that the individuals that you

have employed you are not heeding your expert advice... it will be just a

matter of time before precedent is set, unfortunately it usually it takes a

few lives ( and huge out of court settlements) before changes are

implemented.

Education may be the route to go http://www3.gov.ab.ca/hre/whs/law/ohs.asp

there is a power point presentation on that site it may be of value, and the

new increased in fines in place as well.........? Speaking from personal

experience if issues are pushed too hard, you are replaceable.

How far is the WALKING distance to that closest community?

I find it rather humerous that " that lazy band-aid " , is the usually the

lowest on the feeding chain, but if there's a wreck " Suddenly your Status

Changes! "

Where I live it gets tricky, here's why, OH+S/HSE dictates an RN or

Paramedic ALS level, if > 40 mins travel by ground and over 250 men plus

additional first aiders or EMT for additional men on site, on top of that is

Risk assessment. BUT the regulations for equipment quote First Aid level

supplies, very specific numbers of Band-Aids, pins, and the like. Is a

Paramedic a Paramedic without the Meds and Electronic Kit, Medical

Director, and Comms?

Some operations run by Lay people in the head offices don't understand, Ops

run by Paramedics at the helm usually have all the bells and whistles, they

understand the legal risk.

Canada generally speaking has quite high standards, I think the British

Offshore Training programs are way ahead, and if I could type faster I would

have said " The Gold Standard " but beat me to the punch!

By the way, I am accepting donations for Send Wilf to the U.K. fund, and I

prefer just a drop of Cream in my Tetley's.

Possibly a new thread here........ bit of a Catch -22.

The current trend is combining the HSE/Medic role to be more efficient.

Legally where the heck do you stand if you identify a Safety issue.....no

action is taken..... you have a wreck........ and the because you don't have

enough meds / fluids to resus............ a fatality results....... its not

a dream, its my nightmare.

Delusional or Paranoia, I certainly hoping Rod is sleeping!

Wilf

question for group

>> >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

>> >

>> >

>> >

>> >-I have a question I know this is not an American

>> >group per SE but what is the level of care most of the

>> >places you work at? Like I work at a remote Gold Mine

>> >here in Alaska and it is currently a Paramedic level

>> >care but they feel that EMT3 level care is good enough

>> >so I am trying to put together a argument that

>> >standard of care is Paramedic care or higher is

>> >standard. But I need proof, this is a Canadian based

>> >company that I work for and so maybe I am wrong. Is

>> >Canada rated at Paramedic or do they have a different

>> >system..

>> >

>> >

>> >thanks

>> >

>> >Bill Witmer

>> >NREMTP, RT

>> > >

>> >

>> >

>> >

>> >

>

>

>

>

> Member Information:

>

> List owner: Ian Sharpe Owner@...

> Editor: Ross Boardman Editor@...

>

> ALL list admin messages (subscriptions & unsubscriptions) should be sent

> to the list owner.

>

> Post message: egroups

>

> Please visit our website http://www.remotemedics.co.uk

>

> Regards

>

> The Remote Medics Team

>

>

>

> ---------------------------------

>

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Guest guest

Tetleys is a beverage made of hops, water etc...............which cause

people to do silly stuff!

As for offshore medic course accepted in the U.S. its a sad state of affiars

to admit this since I am a yank but am willing to bet most offshore medic

providing companies in the states would not even know what it is never mind

accept it. the current standard is NREMT-P at the very least. The better

outfits then run you thru a offshore advance scope course intenaly

Cheers

Tom

>From: Bill Witmer <billemtp2000@...>

>Reply-

>

>Subject: RE: Re: question for group

>Date: Sun, 19 Jun 2005 09:03:33 -0700 (PDT)

>

>

>

>Do you know if the remotemedic course is accepted in

>the US. the Doctor out there has used my miltary

>exsperience to cover for the procedures I do Outside

>of the normal medic stuff.

>

>Bill

>

>

>

>

>

>--- Parkinson

><gary.parkinson@...> wrote:

>

> > Hi Bill

> > I agree with all the below comments, but how about

> > asking your company

> > to send you on a remote medics course - the one we

> > in the UK do for

> > offshore would be a benefit for you providing that

> > you find the correct

> > course provider ...

> > just a thought!

> > best wishes

> >

> >

> > question for group

> > > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > > >

> > > >

> > > >

> > > >-I have a question I know this is not an American

> > > >group per SE but what is the level of care most

> > of the places you

> > > >work at? Like I work at a remote Gold Mine here

> > in Alaska and it is

> > > >currently a Paramedic level care but they feel

> > that EMT3 level care

> > > >is good enough so I am trying to put together a

> > argument that

> > > >standard of care is Paramedic care or higher is

> > > >standard. But I need proof, this is a Canadian

> > based

> > > >company that I work for and so maybe I am wrong.

> > Is

> > > >Canada rated at Paramedic or do they have a

> > different

> > > >system..

> > > >

> > > >

> > > >thanks

> > > >

> > > >Bill Witmer

> > > >NREMTP, RT

> > > > >

> > > >

> > > >

> > > >

> > > >

> >

> >

> >

> >

> > Member Information:

> >

> > List owner: Ian Sharpe Owner@...

> > Editor: Ross Boardman Editor@...

> >

> > ALL list admin messages (subscriptions &

> > unsubscriptions) should be sent

> > to the list owner.

> >

> > Post message: egroups

> >

> > Please visit our website

> > http://www.remotemedics.co.uk

> >

> > Regards

> >

> > The Remote Medics Team

> >

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Guest guest

Gerry

I m actually working in Alaska as a medic, its a

American MD looking over what we do. but the owner or

Company is Foreign

by the way YKHC out at Bethel

been there a bunch when I was flying medivac

Bill

--- gerry keenan <gkeenanpa@...> wrote:

> Hi Bill,

> I practiced in remote Western Alaska with many a

> fine

> paramedic...I am worried that standards of practice

> in

> Non US locations could get you in trouble in Alaska.

>

> Be sure you don't run afoul of the Alaskan/USlaws

> and

> " Standard of Care " by performing care beyond your

> licensed " scope of care " . Alot of what you are

> describing to us is what is licensed to the Nurse

> Practioner or Physician Assistant level in US.It is

> a

> common problem in the US( and of course

> elsewhere)that

> competent and experiensed paramedics with former

> military backgrounds are not used effectively.Many

> an

> IDC( independent duty corpsman) has returned to the

> US

> and been unable to practice at his competency level

> also , rather they were relegated to the regulatory

> level which currently has a gap..

> Being land based has differant laws. A Forgein

> physician WILL NOT cover you under these

> circumstances

> I assure you.They cannot delegate to a licensed

> medical provider tasks beyonf the scope of

> practice.If

> you were unlicensed they could !!! And then they are

> on the hook for the standard of performance.

> Better check with the regional EMS and State Medical

> board before you go further and wind up in hot

> water.

> Sorry to be the yellow flag on your race.

>

> Gerry Keenan PA-C, MMS

> formerly at YKHC in Bethel,AK

> now at an ER in Maine and

> Principal Consultant, Partners in Practice,Physician

> Extender Consulting Services

> --- Parkinson

> <gary.parkinson@...> wrote:

>

> > Hi Bill,

> > I'm not sure but I bet that someone on the list

> will

> > know - a while ago

> > I remember we had quite a few US medics going on

> the

> > UK offshore medics

> > course as it has been seen as the 'gold standard'

> > for the industry - it

> > was discussed on the group but I'm not sure when

> > (maybe about 6 months

> > ago...?)

> > hope that helps

> > Best wishes

> >

> >

> > Re: question for

> > group

> > >

> > >

> > > Hi Bill,

> > >

> > > Concur completely with 's comments. We

> > > offshore medics have a

> > > lot of autonomy, given the isolation and

> inherent

> > > difficulties. That

> > > being said, we also have communications with

> > expert

> > > help onshore

> > > 24/7.

> > >

> > > If your people are three hours from the nearest

> > > specialised care, I

> > > expect this can become six hours through weather

> > > problems etc. Much

> > > will be dictated by the emergency equipment you

> > hold

> > > also. In my

> > > experience, anything more than one hour

> > availability

> > > of hospital

> > > care will require top notch personnel and

> > equipment.

> > > As this is a

> > > Canadian outfit, I expect the consequences of

> > > litigation could loom

> > > large. Better if they pay for the best now or

> pay

> > > huge if found not

> > > providing " adequate care " to their employees.

> Its

> > a

> > > situation I knew

> > > well from American vessels running in the

> Caspian

> > > with no Medics at

> > > all.

> > >

> > > It sounds like you have a good case for the

> > > provision of very highly

> > > qualified and experienced paramedics at this

> > > location. In the UK,

> > > such things are formally dictated by a risk

> > > appraisal of the

> > > situation - including worst case scenarios.

> > >

> > > Good luck

> > >

> > > Buck

> > > Medic

> > > Ninian Southern

> > >

> > >

> > > In , " thomas

> > > greaber "

> > > <tom5255@h...> wrote:

> > > > Hi bill

> > > > Most if not all of us whom work offhsore and

> on

> > > remote sites

> > > function at a

> > > > level above " paramedic " as it what a paramedic

> > > does ona ambulance

> > > we all

> > > > tend to have very liberal protocals and

> > routinely

> > > provide primary

> > > care to

> > > > our patient load. such as antibodics, dental

> > care,

> > > basicly the

> > > same stuff

> > > > that your aver GP sees in his office. We also

> > dela

> > > with other

> > > issues a

> > > > paramedic never deals with...health and

> hygenie.

> > > occ heath issues

> > > and a pile

> > > > of other crap. Ranging form inventory to

> advisng

> > > the client on

> > > equipment,

> > > > training ERT teams etc;

> > > > If I remenber correctly EMT 3 is basicly

> trauma

>

=== message truncated ===

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Guest guest

Hey Bill,

Sorry if I got your situation confused- I thought it

was a Canadian Company with a remote Canadian Med/doc

supervising a landbased US EMT3 and wanting higher

levels of coverage.

i was last there in '99. We may have met- I'm the

baldheaded , bearded fella with the North Irish

accent.

BTW- Gene Vitlla(sp) the chair at YKHC had a gold mine

is Jim Keates still around?

Gerry

--- Bill Witmer <billemtp2000@...> wrote:

>

> Gerry

>

>

> I m actually working in Alaska as a medic, its a

> American MD looking over what we do. but the owner

> or

> Company is Foreign

>

> by the way YKHC out at Bethel

> been there a bunch when I was flying medivac

>

> Bill

>

>

> --- gerry keenan <gkeenanpa@...> wrote:

>

> > Hi Bill,

> > I practiced in remote Western Alaska with many a

> > fine

> > paramedic...I am worried that standards of

> practice

> > in

> > Non US locations could get you in trouble in

> Alaska.

> >

> > Be sure you don't run afoul of the Alaskan/USlaws

> > and

> > " Standard of Care " by performing care beyond your

> > licensed " scope of care " . Alot of what you are

> > describing to us is what is licensed to the Nurse

> > Practioner or Physician Assistant level in US.It

> is

> > a

> > common problem in the US( and of course

> > elsewhere)that

> > competent and experiensed paramedics with former

> > military backgrounds are not used effectively.Many

> > an

> > IDC( independent duty corpsman) has returned to

> the

> > US

> > and been unable to practice at his competency

> level

> > also , rather they were relegated to the

> regulatory

> > level which currently has a gap..

> > Being land based has differant laws. A Forgein

> > physician WILL NOT cover you under these

> > circumstances

> > I assure you.They cannot delegate to a licensed

> > medical provider tasks beyonf the scope of

> > practice.If

> > you were unlicensed they could !!! And then they

> are

> > on the hook for the standard of performance.

> > Better check with the regional EMS and State

> Medical

> > board before you go further and wind up in hot

> > water.

> > Sorry to be the yellow flag on your race.

> >

> > Gerry Keenan PA-C, MMS

> > formerly at YKHC in Bethel,AK

> > now at an ER in Maine and

> > Principal Consultant, Partners in

> Practice,Physician

> > Extender Consulting Services

> > --- Parkinson

> > <gary.parkinson@...> wrote:

> >

> > > Hi Bill,

> > > I'm not sure but I bet that someone on the list

> > will

> > > know - a while ago

> > > I remember we had quite a few US medics going on

> > the

> > > UK offshore medics

> > > course as it has been seen as the 'gold

> standard'

> > > for the industry - it

> > > was discussed on the group but I'm not sure when

>

> > > (maybe about 6 months

> > > ago...?)

> > > hope that helps

> > > Best wishes

> > >

> > >

> > > Re: question for

> > > group

> > > >

> > > >

> > > > Hi Bill,

> > > >

> > > > Concur completely with 's comments. We

> > > > offshore medics have a

> > > > lot of autonomy, given the isolation and

> > inherent

> > > > difficulties. That

> > > > being said, we also have communications with

> > > expert

> > > > help onshore

> > > > 24/7.

> > > >

> > > > If your people are three hours from the

> nearest

> > > > specialised care, I

> > > > expect this can become six hours through

> weather

> > > > problems etc. Much

> > > > will be dictated by the emergency equipment

> you

> > > hold

> > > > also. In my

> > > > experience, anything more than one hour

> > > availability

> > > > of hospital

> > > > care will require top notch personnel and

> > > equipment.

> > > > As this is a

> > > > Canadian outfit, I expect the consequences of

> > > > litigation could loom

> > > > large. Better if they pay for the best now or

> > pay

> > > > huge if found not

> > > > providing " adequate care " to their employees.

> > Its

> > > a

> > > > situation I knew

> > > > well from American vessels running in the

> > Caspian

> > > > with no Medics at

> > > > all.

> > > >

> > > > It sounds like you have a good case for the

> > > > provision of very highly

> > > > qualified and experienced paramedics at this

> > > > location. In the UK,

> > > > such things are formally dictated by a risk

> > > > appraisal of the

> > > > situation - including worst case scenarios.

> > > >

> > > > Good luck

> > > >

> > > > Buck

> > > > Medic

> > > > Ninian Southern

>

=== message truncated ===

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Guest guest

Gerry

Oh yes Jim Keates is still around I see him down at

southern region EMS symposium

Bill

--- gerry keenan <gkeenanpa@...> wrote:

> Hey Bill,

> Sorry if I got your situation confused- I thought it

> was a Canadian Company with a remote Canadian

> Med/doc

> supervising a landbased US EMT3 and wanting higher

> levels of coverage.

> i was last there in '99. We may have met- I'm the

> baldheaded , bearded fella with the North Irish

> accent.

> BTW- Gene Vitlla(sp) the chair at YKHC had a gold

> mine

> is Jim Keates still around?

> Gerry

>

> --- Bill Witmer <billemtp2000@...> wrote:

>

> >

> > Gerry

> >

> >

> > I m actually working in Alaska as a medic, its a

> > American MD looking over what we do. but the owner

> > or

> > Company is Foreign

> >

> > by the way YKHC out at Bethel

> > been there a bunch when I was flying medivac

> >

> > Bill

> >

> >

> > --- gerry keenan <gkeenanpa@...> wrote:

> >

> > > Hi Bill,

> > > I practiced in remote Western Alaska with many a

> > > fine

> > > paramedic...I am worried that standards of

> > practice

> > > in

> > > Non US locations could get you in trouble in

> > Alaska.

> > >

> > > Be sure you don't run afoul of the

> Alaskan/USlaws

> > > and

> > > " Standard of Care " by performing care beyond

> your

> > > licensed " scope of care " . Alot of what you are

> > > describing to us is what is licensed to the

> Nurse

> > > Practioner or Physician Assistant level in US.It

> > is

> > > a

> > > common problem in the US( and of course

> > > elsewhere)that

> > > competent and experiensed paramedics with former

> > > military backgrounds are not used

> effectively.Many

> > > an

> > > IDC( independent duty corpsman) has returned to

> > the

> > > US

> > > and been unable to practice at his competency

> > level

> > > also , rather they were relegated to the

> > regulatory

> > > level which currently has a gap..

> > > Being land based has differant laws. A Forgein

> > > physician WILL NOT cover you under these

> > > circumstances

> > > I assure you.They cannot delegate to a licensed

> > > medical provider tasks beyonf the scope of

> > > practice.If

> > > you were unlicensed they could !!! And then they

> > are

> > > on the hook for the standard of performance.

> > > Better check with the regional EMS and State

> > Medical

> > > board before you go further and wind up in hot

> > > water.

> > > Sorry to be the yellow flag on your race.

> > >

> > > Gerry Keenan PA-C, MMS

> > > formerly at YKHC in Bethel,AK

> > > now at an ER in Maine and

> > > Principal Consultant, Partners in

> > Practice,Physician

> > > Extender Consulting Services

> > > --- Parkinson

> > > <gary.parkinson@...> wrote:

> > >

> > > > Hi Bill,

> > > > I'm not sure but I bet that someone on the

> list

> > > will

> > > > know - a while ago

> > > > I remember we had quite a few US medics going

> on

> > > the

> > > > UK offshore medics

> > > > course as it has been seen as the 'gold

> > standard'

> > > > for the industry - it

> > > > was discussed on the group but I'm not sure

> when

> >

> > > > (maybe about 6 months

> > > > ago...?)

> > > > hope that helps

> > > > Best wishes

> > > >

> > > >

> > > > Re: question

> for

> > > > group

> > > > >

> > > > >

> > > > > Hi Bill,

> > > > >

> > > > > Concur completely with 's comments. We

> > > > > offshore medics have a

> > > > > lot of autonomy, given the isolation and

> > > inherent

> > > > > difficulties. That

> > > > > being said, we also have communications with

> > > > expert

> > > > > help onshore

> > > > > 24/7.

> > > > >

> > > > > If your people are three hours from the

> > nearest

> > > > > specialised care, I

> > > > > expect this can become six hours through

> > weather

> > > > > problems etc. Much

> > > > > will be dictated by the emergency equipment

> > you

> > > > hold

> > > > > also. In my

> > > > > experience, anything more than one hour

> > > > availability

> > > > > of hospital

> > > > > care will require top notch personnel and

> > > > equipment.

> > > > > As this is a

>

=== message truncated ===

Bill Witmer

NREMTP,CCEMTP,FP-C

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Guest guest

Bill,

I was asked to rewrite the Maniiliq Flight Program

and Kotzebue EMS protocols about 2 years ago. One of

the most amazing things I discovered was the

felxability of the medical practices act in AK.

Essentially, as long as the program medical director

(who had no EMS experince) signed off on what I wrote

and got it approved by OEMS, anything I wrote was

good. I trained the nurses and medics to place and

monitor chest tubes, perform surgical airways, and

place central lines. Unfortunately, the (non-EMS)

medical director decided she wasn't comfortable beng

responsible for the flight program and 85 hours worth

of work was put on the shelf (although I kept 'em for

myself). So your medical director may just need to

work out protocols with you and get them approved.

Maybe others with more experience in AK can comment.

I'd also be happy to talk with your medical director

if you want.

JMB

--- Bill Witmer <billemtp2000@...> wrote:

>

> Gerry

>

>

> I m actually working in Alaska as a medic, its a

> American MD looking over what we do. but the owner

> or

> Company is Foreign

>

> by the way YKHC out at Bethel

> been there a bunch when I was flying medivac

>

> Bill

>

>

> --- gerry keenan <gkeenanpa@...> wrote:

>

> > Hi Bill,

> > I practiced in remote Western Alaska with many a

> > fine

> > paramedic...I am worried that standards of

> practice

> > in

> > Non US locations could get you in trouble in

> Alaska.

> >

> > Be sure you don't run afoul of the Alaskan/USlaws

> > and

> > " Standard of Care " by performing care beyond your

> > licensed " scope of care " . Alot of what you are

> > describing to us is what is licensed to the Nurse

> > Practioner or Physician Assistant level in US.It

> is

> > a

> > common problem in the US( and of course

> > elsewhere)that

> > competent and experiensed paramedics with former

> > military backgrounds are not used effectively.Many

> > an

> > IDC( independent duty corpsman) has returned to

> the

> > US

> > and been unable to practice at his competency

> level

> > also , rather they were relegated to the

> regulatory

> > level which currently has a gap..

> > Being land based has differant laws. A Forgein

> > physician WILL NOT cover you under these

> > circumstances

> > I assure you.They cannot delegate to a licensed

> > medical provider tasks beyonf the scope of

> > practice.If

> > you were unlicensed they could !!! And then they

> are

> > on the hook for the standard of performance.

> > Better check with the regional EMS and State

> Medical

> > board before you go further and wind up in hot

> > water.

> > Sorry to be the yellow flag on your race.

> >

> > Gerry Keenan PA-C, MMS

> > formerly at YKHC in Bethel,AK

> > now at an ER in Maine and

> > Principal Consultant, Partners in

> Practice,Physician

> > Extender Consulting Services

> > --- Parkinson

> > <gary.parkinson@...> wrote:

> >

> > > Hi Bill,

> > > I'm not sure but I bet that someone on the list

> > will

> > > know - a while ago

> > > I remember we had quite a few US medics going on

> > the

> > > UK offshore medics

> > > course as it has been seen as the 'gold

> standard'

> > > for the industry - it

> > > was discussed on the group but I'm not sure when

>

> > > (maybe about 6 months

> > > ago...?)

> > > hope that helps

> > > Best wishes

> > >

> > >

> > > Re: question for

> > > group

> > > >

> > > >

> > > > Hi Bill,

> > > >

> > > > Concur completely with 's comments. We

> > > > offshore medics have a

> > > > lot of autonomy, given the isolation and

> > inherent

> > > > difficulties. That

> > > > being said, we also have communications with

> > > expert

> > > > help onshore

> > > > 24/7.

> > > >

> > > > If your people are three hours from the

> nearest

> > > > specialised care, I

> > > > expect this can become six hours through

> weather

> > > > problems etc. Much

> > > > will be dictated by the emergency equipment

> you

> > > hold

> > > > also. In my

> > > > experience, anything more than one hour

> > > availability

> > > > of hospital

> > > > care will require top notch personnel and

> > > equipment.

> > > > As this is a

> > > > Canadian outfit, I expect the consequences of

> > > > litigation could loom

> > > > large. Better if they pay for the best now or

> > pay

> > > > huge if found not

> > > > providing " adequate care " to their employees.

> > Its

> > > a

> > > > situation I knew

> > > > well from American vessels running in the

> > Caspian

> > > > with no Medics at

> > > > all.

> > > >

> > > > It sounds like you have a good case for the

> > > > provision of very highly

> > > > qualified and experienced paramedics at this

> > > > location. In the UK,

> > > > such things are formally dictated by a risk

> > > > appraisal of the

> > > > situation - including worst case scenarios.

> > > >

> > > > Good luck

> > > >

> > > > Buck

> > > > Medic

> > > > Ninian Southern

>

=== message truncated ===

____________________________________________________

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Guest guest

I'm still looking for people interested in commenting

on the independant duty medic curriculum for the class

put together for CDS outdoor school. Anyone who is

currently in the business, particularly those fo you

who have taken other offshore courses, your input

would be valid. e-mail me off the list-serv

(jbuskomd@...) and I'll send you a copy of the

syllabus as it stands.

Jonnathan

--- thomas greaber <tom5255@...> wrote:

> Tetleys is a beverage made of hops, water

> etc...............which cause

> people to do silly stuff!

> As for offshore medic course accepted in the U.S.

> its a sad state of affiars

> to admit this since I am a yank but am willing to

> bet most offshore medic

> providing companies in the states would not even

> know what it is never mind

> accept it. the current standard is NREMT-P at the

> very least. The better

> outfits then run you thru a offshore advance scope

> course intenaly

>

>

> Cheers

>

> Tom

>

> >From: Bill Witmer <billemtp2000@...>

> >Reply-

> >

> >Subject: RE: Re: question for

> group

> >Date: Sun, 19 Jun 2005 09:03:33 -0700 (PDT)

> >

> >

> >

> >Do you know if the remotemedic course is accepted

> in

> >the US. the Doctor out there has used my miltary

> >exsperience to cover for the procedures I do

> Outside

> >of the normal medic stuff.

> >

> >Bill

> >

> >

> >

> >

> >

> >--- Parkinson

> ><gary.parkinson@...> wrote:

> >

> > > Hi Bill

> > > I agree with all the below comments, but how

> about

> > > asking your company

> > > to send you on a remote medics course - the one

> we

> > > in the UK do for

> > > offshore would be a benefit for you providing

> that

> > > you find the correct

> > > course provider ...

> > > just a thought!

> > > best wishes

> > >

> > >

> > > question for

> group

> > > > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > > > >

> > > > >

> > > > >

> > > > >-I have a question I know this is not an

> American

> > > > >group per SE but what is the level of care

> most

> > > of the places you

> > > > >work at? Like I work at a remote Gold Mine

> here

> > > in Alaska and it is

> > > > >currently a Paramedic level care but they

> feel

> > > that EMT3 level care

> > > > >is good enough so I am trying to put together

> a

>

=== message truncated ===

__________________________________

Stay connected, organized, and protected. Take the tour:

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Guest guest

Hell, last I knew (and this is a bit dated) the US wouldn't even

accept UK nursing licenses without additional training.

LT

thomas greaber wrote:

> Tetleys is a beverage made of hops, water etc...............which cause

> people to do silly stuff!

> As for offshore medic course accepted in the U.S. its a sad state of affiars

> to admit this since I am a yank but am willing to bet most offshore medic

> providing companies in the states would not even know what it is never mind

> accept it. the current standard is NREMT-P at the very least. The better

> outfits then run you thru a offshore advance scope course intenaly

>

>

> Cheers

>

> Tom

>

>

>>From: Bill Witmer <billemtp2000@...>

>>Reply-

>>

>>Subject: RE: Re: question for group

>>Date: Sun, 19 Jun 2005 09:03:33 -0700 (PDT)

>>

>>

>>

>>Do you know if the remotemedic course is accepted in

>>the US. the Doctor out there has used my miltary

>>exsperience to cover for the procedures I do Outside

>>of the normal medic stuff.

>>

>>Bill

>>

>>

>>

>>

>>

>>--- Parkinson

>><gary.parkinson@...> wrote:

>>

>>

>>>Hi Bill

>>>I agree with all the below comments, but how about

>>>asking your company

>>>to send you on a remote medics course - the one we

>>>in the UK do for

>>>offshore would be a benefit for you providing that

>>>you find the correct

>>>course provider ...

>>>just a thought!

>>>best wishes

>>>

>>>

>>> question for group

>>>>>Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

>>>>>

>>>>>

>>>>>

>>>>>-I have a question I know this is not an American

>>>>>group per SE but what is the level of care most

>>>

>>>of the places you

>>>

>>>>>work at? Like I work at a remote Gold Mine here

>>>

>>>in Alaska and it is

>>>

>>>>>currently a Paramedic level care but they feel

>>>

>>>that EMT3 level care

>>>

>>>>>is good enough so I am trying to put together a

>>>

>>>argument that

>>>

>>>>>standard of care is Paramedic care or higher is

>>>>>standard. But I need proof, this is a Canadian

>>>

>>>based

>>>

>>>>>company that I work for and so maybe I am wrong.

>>>

>>>Is

>>>

>>>>>Canada rated at Paramedic or do they have a

>>>

>>>different

>>>

>>>>>system..

>>>>>

>>>>>

>>>>>thanks

>>>>>

>>>>>Bill Witmer

>>>>>NREMTP, RT

>>>>>

>>>>>

>>>>>

>>>>>

>>>

>>>

>>>

>>>Member Information:

>>>

>>>List owner: Ian Sharpe Owner@...

>>>Editor: Ross Boardman Editor@...

>>>

>>>ALL list admin messages (subscriptions &

>>>unsubscriptions) should be sent

>>>to the list owner.

>>>

>>>Post message: egroups

>>>

>>>Please visit our website

>>>http://www.remotemedics.co.uk

>>>

>>>Regards

>>>

>>>The Remote Medics Team

>>>

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Guest guest

Your right as far as I know that is still the case

don't know why but then I was told I was not qualidied to take the offshore

medic course by companies whom shall remain nameless except one.

Its a plot by the man to keep the brothers down!

Cheers

Tom G

>From: Larry Torrey <ltorrey@...>

>Reply-

>

>Subject: Re: Re: question for group

>Date: Sun, 19 Jun 2005 19:32:14 -0400

>

>Hell, last I knew (and this is a bit dated) the US wouldn't even

>accept UK nursing licenses without additional training.

>

>LT

>

>thomas greaber wrote:

>

> > Tetleys is a beverage made of hops, water etc...............which cause

> > people to do silly stuff!

> > As for offshore medic course accepted in the U.S. its a sad state of

>affiars

> > to admit this since I am a yank but am willing to bet most offshore

>medic

> > providing companies in the states would not even know what it is never

>mind

> > accept it. the current standard is NREMT-P at the very least. The better

> > outfits then run you thru a offshore advance scope course intenaly

> >

> >

> > Cheers

> >

> > Tom

> >

> >

> >>From: Bill Witmer <billemtp2000@...>

> >>Reply-

> >>

> >>Subject: RE: Re: question for group

> >>Date: Sun, 19 Jun 2005 09:03:33 -0700 (PDT)

> >>

> >>

> >>

> >>Do you know if the remotemedic course is accepted in

> >>the US. the Doctor out there has used my miltary

> >>exsperience to cover for the procedures I do Outside

> >>of the normal medic stuff.

> >>

> >>Bill

> >>

> >>

> >>

> >>

> >>

> >>--- Parkinson

> >><gary.parkinson@...> wrote:

> >>

> >>

> >>>Hi Bill

> >>>I agree with all the below comments, but how about

> >>>asking your company

> >>>to send you on a remote medics course - the one we

> >>>in the UK do for

> >>>offshore would be a benefit for you providing that

> >>>you find the correct

> >>>course provider ...

> >>>just a thought!

> >>>best wishes

> >>>

> >>>

> >>> question for group

> >>>>>Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> >>>>>

> >>>>>

> >>>>>

> >>>>>-I have a question I know this is not an American

> >>>>>group per SE but what is the level of care most

> >>>

> >>>of the places you

> >>>

> >>>>>work at? Like I work at a remote Gold Mine here

> >>>

> >>>in Alaska and it is

> >>>

> >>>>>currently a Paramedic level care but they feel

> >>>

> >>>that EMT3 level care

> >>>

> >>>>>is good enough so I am trying to put together a

> >>>

> >>>argument that

> >>>

> >>>>>standard of care is Paramedic care or higher is

> >>>>>standard. But I need proof, this is a Canadian

> >>>

> >>>based

> >>>

> >>>>>company that I work for and so maybe I am wrong.

> >>>

> >>>Is

> >>>

> >>>>>Canada rated at Paramedic or do they have a

> >>>

> >>>different

> >>>

> >>>>>system..

> >>>>>

> >>>>>

> >>>>>thanks

> >>>>>

> >>>>>Bill Witmer

> >>>>>NREMTP, RT

> >>>>>

> >>>>>

> >>>>>

> >>>>>

> >>>

> >>>

> >>>

> >>>Member Information:

> >>>

> >>>List owner: Ian Sharpe Owner@...

> >>>Editor: Ross Boardman Editor@...

> >>>

> >>>ALL list admin messages (subscriptions &

> >>>unsubscriptions) should be sent

> >>>to the list owner.

> >>>

> >>>Post message: egroups

> >>>

> >>>Please visit our website

> >>>http://www.remotemedics.co.uk

> >>>

> >>>Regards

> >>>

> >>>The Remote Medics Team

> >>>

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Guest guest

Hi Pete,

Great to hear from you! How's Christiana? I'm afraid the Harley went

to the scrapyard in the sky!

You may remember the situation we had in Baku, where the Yank ships

(with yank crews) were happily sailing off around the Caspian - with

no medical support whatsoever. We always tried to tell them they

were taking a big litigation risk, but to no avail. I guess you are

right, they are happy to take the risk. Its strange how companies,

including UK ones, can so quickly " turn native " when they leave the

control of the UK HSE.

We might not like the HSE but I can say with some experience, if we

didn't have them, there would be lots of dead people and more Piper

Alphas. In the end its all about producing the product. That's not

scepticism, just pure fact.

As for Bill's situation, this may end up being the Blackspot

Syndrome. Wait till something dreadful happens once or twice before

money finally gets spent.

Work safe all!

Buck T

Pete - I'm on Bxtaylor2@...

> > Hi bill

> > Most if not all of us whom work offhsore and on remote sites

> function at a

> > level above " paramedic " as it what a paramedic does ona

ambulance

> we all

> > tend to have very liberal protocals and routinely provide

primary

> care to

> > our patient load. such as antibodics, dental care, basicly the

> same stuff

> > that your aver GP sees in his office. We also dela with other

> issues a

> > paramedic never deals with...health and hygenie. occ heath

issues

> and a pile

> > of other crap. Ranging form inventory to advisng the client on

> equipment,

> > training ERT teams etc;

> > If I remenber correctly EMT 3 is basicly trauma related or

should

> I say

> > orientated. So the issues of cardiac and the like are out of

thier

> scope.

> > Would submit that any remote site needs staff at the very least

> staff by

> > paramedics ( or as in the case of some of our fellow providers

on

> the list)

> > staff with ED, ICU nursing background) this is a profession

where

> paramedic

> > is where your start.

> >

> > Regards

> >

> > Tom g

> > Sakhalin island

> >

> > >From: Bill Witmer <billemtp2000@y...>

> > >Reply-

> > >

> > >Subject: question for group

> > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > >

> > >

> > >

> > >-I have a question I know this is not an American

> > >group per SE but what is the level of care most of the

> > >places you work at? Like I work at a remote Gold Mine

> > >here in Alaska and it is currently a Paramedic level

> > >care but they feel that EMT3 level care is good enough

> > >so I am trying to put together a argument that

> > >standard of care is Paramedic care or higher is

> > >standard. But I need proof, this is a Canadian based

> > >company that I work for and so maybe I am wrong. Is

> > >Canada rated at Paramedic or do they have a different

> > >system..

> > >

> > >

> > >thanks

> > >

> > >Bill Witmer

> > >NREMTP, RT

> > > >

> > >

> > >

> > >

> > >

>

>

>

>

> Member Information:

>

> List owner: Ian Sharpe Owner@R...

> Editor: Ross Boardman Editor@R...

>

> ALL list admin messages (subscriptions & unsubscriptions) should

be sent to the list owner.

>

> Post message: egroups

>

> Please visit our website http://www.remotemedics.co.uk

>

> Regards

>

> The Remote Medics Team

>

>

>

> ---------------------------------

>

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Guest guest

Hi Bill,

I'm sure won't mind me sticking my nose in!

The UK Offshore Medics course would be really good for you, if you

pick the right one!. The standard does vary considerably.My advice

is ask about on the forum and pick the most challenging to get the

greatest benefit. Given your background I suspect you would have no

problem with the pre-selection criteria.

I think you'll find the course is not recognised outside UK waters

per se but may well credit to other international qualifications.

Cheers

Buck T

> > > Hi bill

> > > Most if not all of us whom work offhsore and on

> > remote sites

> > function at a

> > > level above " paramedic " as it what a paramedic

> > does ona ambulance

> > we all

> > > tend to have very liberal protocals and routinely

> > provide primary

> > care to

> > > our patient load. such as antibodics, dental care,

> > basicly the

> > same stuff

> > > that your aver GP sees in his office. We also dela

> > with other

> > issues a

> > > paramedic never deals with...health and hygenie.

> > occ heath issues

> > and a pile

> > > of other crap. Ranging form inventory to advisng

> > the client on

> > equipment,

> > > training ERT teams etc;

> > > If I remenber correctly EMT 3 is basicly trauma

> > related or should

> > I say

> > > orientated. So the issues of cardiac and the like

> > are out of thier

> > scope.

> > > Would submit that any remote site needs staff at

> > the very least

> > staff by

> > > paramedics ( or as in the case of some of our

> > fellow providers on

> > the list)

> > > staff with ED, ICU nursing background) this is a

> > profession where

> > paramedic

> > > is where your start.

> > >

> > > Regards

> > >

> > > Tom g

> > > Sakhalin island

> > >

> > > >From: Bill Witmer <billemtp2000@y...>

> > > >Reply-

> > > >

> > > >Subject: question for group

> > > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > > >

> > > >

> > > >

> > > >-I have a question I know this is not an American

> > > >group per SE but what is the level of care most

> > of the places you

> > > >work at? Like I work at a remote Gold Mine here

> > in Alaska and it is

> > > >currently a Paramedic level care but they feel

> > that EMT3 level care

> > > >is good enough so I am trying to put together a

> > argument that

> > > >standard of care is Paramedic care or higher is

> > > >standard. But I need proof, this is a Canadian

> > based

> > > >company that I work for and so maybe I am wrong.

> > Is

> > > >Canada rated at Paramedic or do they have a

> > different

> > > >system..

> > > >

> > > >

> > > >thanks

> > > >

> > > >Bill Witmer

> > > >NREMTP, RT

> > > > >

> > > >

> > > >

> > > >

> > > >

> >

> >

> >

> >

> > Member Information:

> >

> > List owner: Ian Sharpe Owner@R...

> > Editor: Ross Boardman Editor@R...

> >

> > ALL list admin messages (subscriptions &

> > unsubscriptions) should be sent

> > to the list owner.

> >

> > Post message: egroups

> >

> > Please visit our website

> > http://www.remotemedics.co.uk

> >

> > Regards

> >

> > The Remote Medics Team

> >

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Guest guest

Hi Bill

Canada has a system that has 3 levels of Paramedics. Primary Care Paramedic,

Advanced Care Paramedic and Critical Care Paramedic. To become a Primary Care

Paramedic takes 2 years, another year or so for advanced care and around 6

months for critical care. There is no paramedic in the world that is trained as

high as Canadian Critical Care Paramedic. A National Registered Paramedic out of

the US would be considered equivelent to an Advanced Care Paramedic. I'm a

Critical Care Paramedic and perform advanced skills such as pericardiocentesis,

chest tubes, insert central lines, do arterial blood gases, etc. And our

knowledge level is very indept. The critical care level is also higher then the

CCEMT.P level out of the US. These levels have been implemented by the Canadian

Medical Association (CMA) and Paramedic Association of Canada (PAC) and are used

in pretty much most of our provinces and territories.

I hope that answers your question. I added some extra info as well, so you are

more aware of the Canadian EMS system.

Best regards,

R2D2, CCP

<bxtaylor2@...> wrote:

Hi Bill,

I'm sure won't mind me sticking my nose in!

The UK Offshore Medics course would be really good for you, if you

pick the right one!. The standard does vary considerably.My advice

is ask about on the forum and pick the most challenging to get the

greatest benefit. Given your background I suspect you would have no

problem with the pre-selection criteria.

I think you'll find the course is not recognised outside UK waters

per se but may well credit to other international qualifications.

Cheers

Buck T

> > > Hi bill

> > > Most if not all of us whom work offhsore and on

> > remote sites

> > function at a

> > > level above " paramedic " as it what a paramedic

> > does ona ambulance

> > we all

> > > tend to have very liberal protocals and routinely

> > provide primary

> > care to

> > > our patient load. such as antibodics, dental care,

> > basicly the

> > same stuff

> > > that your aver GP sees in his office. We also dela

> > with other

> > issues a

> > > paramedic never deals with...health and hygenie.

> > occ heath issues

> > and a pile

> > > of other crap. Ranging form inventory to advisng

> > the client on

> > equipment,

> > > training ERT teams etc;

> > > If I remenber correctly EMT 3 is basicly trauma

> > related or should

> > I say

> > > orientated. So the issues of cardiac and the like

> > are out of thier

> > scope.

> > > Would submit that any remote site needs staff at

> > the very least

> > staff by

> > > paramedics ( or as in the case of some of our

> > fellow providers on

> > the list)

> > > staff with ED, ICU nursing background) this is a

> > profession where

> > paramedic

> > > is where your start.

> > >

> > > Regards

> > >

> > > Tom g

> > > Sakhalin island

> > >

> > > >From: Bill Witmer <billemtp2000@y...>

> > > >Reply-

> > > >

> > > >Subject: question for group

> > > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > > >

> > > >

> > > >

> > > >-I have a question I know this is not an American

> > > >group per SE but what is the level of care most

> > of the places you

> > > >work at? Like I work at a remote Gold Mine here

> > in Alaska and it is

> > > >currently a Paramedic level care but they feel

> > that EMT3 level care

> > > >is good enough so I am trying to put together a

> > argument that

> > > >standard of care is Paramedic care or higher is

> > > >standard. But I need proof, this is a Canadian

> > based

> > > >company that I work for and so maybe I am wrong.

> > Is

> > > >Canada rated at Paramedic or do they have a

> > different

> > > >system..

> > > >

> > > >

> > > >thanks

> > > >

> > > >Bill Witmer

> > > >NREMTP, RT

> > > > >

> > > >

> > > >

> > > >

> > > >

> >

> >

> >

> >

> > Member Information:

> >

> > List owner: Ian Sharpe Owner@R...

> > Editor: Ross Boardman Editor@R...

> >

> > ALL list admin messages (subscriptions &

> > unsubscriptions) should be sent

> > to the list owner.

> >

> > Post message: egroups

> >

> > Please visit our website

> > http://www.remotemedics.co.uk

> >

> > Regards

> >

> > The Remote Medics Team

> >

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Guest guest

Hi Bill,

Sounds like you could do with a couple of these guys!

Pericardiacentesis! Blimey, I can't even say it!

Buck

> > > > Hi bill

> > > > Most if not all of us whom work offhsore and on

> > > remote sites

> > > function at a

> > > > level above " paramedic " as it what a paramedic

> > > does ona ambulance

> > > we all

> > > > tend to have very liberal protocals and routinely

> > > provide primary

> > > care to

> > > > our patient load. such as antibodics, dental care,

> > > basicly the

> > > same stuff

> > > > that your aver GP sees in his office. We also dela

> > > with other

> > > issues a

> > > > paramedic never deals with...health and hygenie.

> > > occ heath issues

> > > and a pile

> > > > of other crap. Ranging form inventory to advisng

> > > the client on

> > > equipment,

> > > > training ERT teams etc;

> > > > If I remenber correctly EMT 3 is basicly trauma

> > > related or should

> > > I say

> > > > orientated. So the issues of cardiac and the like

> > > are out of thier

> > > scope.

> > > > Would submit that any remote site needs staff at

> > > the very least

> > > staff by

> > > > paramedics ( or as in the case of some of our

> > > fellow providers on

> > > the list)

> > > > staff with ED, ICU nursing background) this is a

> > > profession where

> > > paramedic

> > > > is where your start.

> > > >

> > > > Regards

> > > >

> > > > Tom g

> > > > Sakhalin island

> > > >

> > > > >From: Bill Witmer <billemtp2000@y...>

> > > > >Reply-

> > > > >

> > > > >Subject: question for group

> > > > >Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > > > >

> > > > >

> > > > >

> > > > >-I have a question I know this is not an American

> > > > >group per SE but what is the level of care most

> > > of the places you

> > > > >work at? Like I work at a remote Gold Mine here

> > > in Alaska and it is

> > > > >currently a Paramedic level care but they feel

> > > that EMT3 level care

> > > > >is good enough so I am trying to put together a

> > > argument that

> > > > >standard of care is Paramedic care or higher is

> > > > >standard. But I need proof, this is a Canadian

> > > based

> > > > >company that I work for and so maybe I am wrong.

> > > Is

> > > > >Canada rated at Paramedic or do they have a

> > > different

> > > > >system..

> > > > >

> > > > >

> > > > >thanks

> > > > >

> > > > >Bill Witmer

> > > > >NREMTP, RT

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > >

> > >

> > >

> > >

> > > Member Information:

> > >

> > > List owner: Ian Sharpe Owner@R...

> > > Editor: Ross Boardman Editor@R...

> > >

> > > ALL list admin messages (subscriptions &

> > > unsubscriptions) should be sent

> > > to the list owner.

> > >

> > > Post message: egroups

> > >

> > > Please visit our website

> > > http://www.remotemedics.co.uk

> > >

> > > Regards

> > >

> > > The Remote Medics Team

> > >

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Guest guest

Hi /all,

As any of the UK offshore medics will testify, there are training

organisations around that would have you on an offshore medics

course if you knew the colour of a band aid! That's what has ruined

the integrity of the qualification in international eyes.

Buck

> > >>>

> > >>>>Hi bill

> > >>>>Most if not all of us whom work offhsore and on

> > >>>

> > >>>remote sites

> > >>>function at a

> > >>>

> > >>>>level above " paramedic " as it what a paramedic

> > >>>

> > >>>does ona ambulance

> > >>>we all

> > >>>

> > >>>>tend to have very liberal protocals and routinely

> > >>>

> > >>>provide primary

> > >>>care to

> > >>>

> > >>>>our patient load. such as antibodics, dental care,

> > >>>

> > >>>basicly the

> > >>>same stuff

> > >>>

> > >>>>that your aver GP sees in his office. We also dela

> > >>>

> > >>>with other

> > >>>issues a

> > >>>

> > >>>>paramedic never deals with...health and hygenie.

> > >>>

> > >>>occ heath issues

> > >>>and a pile

> > >>>

> > >>>>of other crap. Ranging form inventory to advisng

> > >>>

> > >>>the client on

> > >>>equipment,

> > >>>

> > >>>>training ERT teams etc;

> > >>>>If I remenber correctly EMT 3 is basicly trauma

> > >>>

> > >>>related or should

> > >>>I say

> > >>>

> > >>>>orientated. So the issues of cardiac and the like

> > >>>

> > >>>are out of thier

> > >>>scope.

> > >>>

> > >>>>Would submit that any remote site needs staff at

> > >>>

> > >>>the very least

> > >>>staff by

> > >>>

> > >>>>paramedics ( or as in the case of some of our

> > >>>

> > >>>fellow providers on

> > >>>the list)

> > >>>

> > >>>>staff with ED, ICU nursing background) this is a

> > >>>

> > >>>profession where

> > >>>paramedic

> > >>>

> > >>>>is where your start.

> > >>>>

> > >>>>Regards

> > >>>>

> > >>>>Tom g

> > >>>>Sakhalin island

> > >>>>

> > >>>>

> > >>>>>From: Bill Witmer <billemtp2000@y...>

> > >>>>>Reply-

> > >>>>>

> > >>>>>Subject: question for group

> > >>>>>Date: Fri, 17 Jun 2005 10:55:36 -0700 (PDT)

> > >>>>>

> > >>>>>

> > >>>>>

> > >>>>>-I have a question I know this is not an American

> > >>>>>group per SE but what is the level of care most

> > >>>

> > >>>of the places you

> > >>>

> > >>>>>work at? Like I work at a remote Gold Mine here

> > >>>

> > >>>in Alaska and it is

> > >>>

> > >>>>>currently a Paramedic level care but they feel

> > >>>

> > >>>that EMT3 level care

> > >>>

> > >>>>>is good enough so I am trying to put together a

> > >>>

> > >>>argument that

> > >>>

> > >>>>>standard of care is Paramedic care or higher is

> > >>>>>standard. But I need proof, this is a Canadian

> > >>>

> > >>>based

> > >>>

> > >>>>>company that I work for and so maybe I am wrong.

> > >>>

> > >>>Is

> > >>>

> > >>>>>Canada rated at Paramedic or do they have a

> > >>>

> > >>>different

> > >>>

> > >>>>>system..

> > >>>>>

> > >>>>>

> > >>>>>thanks

> > >>>>>

> > >>>>>Bill Witmer

> > >>>>>NREMTP, RT

> > >>>>>

> > >>>>>

> > >>>>>

> > >>>>>

> > >>>

> > >>>

> > >>>

> > >>>Member Information:

> > >>>

> > >>>List owner: Ian Sharpe Owner@R...

> > >>>Editor: Ross Boardman Editor@R...

> > >>>

> > >>>ALL list admin messages (subscriptions &

> > >>>unsubscriptions) should be sent

> > >>>to the list owner.

> > >>>

> > >>>Post message: egroups

> > >>>

> > >>>Please visit our website

> > >>>http://www.remotemedics.co.uk

> > >>>

> > >>>Regards

> > >>>

> > >>>The Remote Medics Team

> > >>>

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  • 7 months later...

God, don't start those until you have to, start them

the day after the shot. After all, the interferon

reduces the numbers of the virus, and the Riba is

supposed to kill off the reduced numbers. So go in

order. . .and welcome to the IN crowd (in misery, that

is, hah!)

Michele

>

> I'm set to start the pizin on Wednesday night. Do I

> start the pills in the

> morning? Or the day after? Or that night? Ack!!!

__________________________________________________

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  • 2 years later...
Guest guest

Dear Deb,

I had a stroke in 1997. The Ischemic k ind. I went to my Dr. everyday for 3 months with symptoms and he still didn't believe me. Then one day I woke up and as soon as I raised my head off of the pillow, it felt like someone hit me in the back of my head with a ball bat. I went back to my Dr. and FINALLY he said he was going to hook me up with the best Neurologist in the area. I had an ultrasound first, and when the tech went back to the left side of my neck, and said "hhmm" I knew something was there. Then I had a cat scan, an MRI then as final proof, I had an Angiogram, where they shot the dye into your groin area, that's what it took to see for sure, without a doubt that I have a blood clot in my left Carotid artery in my neck. They won't put a stent in there or do anything because it could break loose, and go to my brain, or my lung, or my heart. So at first they put me on an aspirin, Plavix and Coumadin every day, then they finally just put me on the Coumadin and have to have monthly or more bloodwork done. I was working full time and going to school full time. But the point is........DEMAND THAT YOU SEE A NEUROLOGIST......if these symptoms continue. Mine went on for months, the dizzyness, blurry vision, headaches. I couldn't take notes in school and got a recorder for notes and at work, I worked in a call center and my typing suffered drastically. That is when I also found out I have Lupus and a rare blood-clotting disorder.....Leiden Factor V mutation.....which unfortunately I gave to my daughter and when she was pregnant last year, her husband had to inject Heparin (Blood thinner) into her thighs twice a day.

I have a question for you.....Have you started taking any new meds that would make you dizzy and cause blurring vision? Some meds I take do, that's why I am asking. But You need to see a Neurologist, PRONTO.

I hope it isn't a stroke. I was 42 and my Dr. just did not want to believe I could have a stroke at such a young age. I still have problems with typing, and other things, but I am lucky that all I have to take is my Coumadin everyday and the dosage changes on a regular basis. That is why I have to go and have a PT/INR test done on a regular basis. I used to cry just walking in the room. Now I just take a deep breath and ask for the smallest butterfly, and the only vein I have left is on my right hand. But the gals are good and really work with my anxiety, that's what Valium is for.

I have rattled on long enough. If you have to go to the ER, which is what I would do, ask to talk to a Neurologist, ok........But get help now. and I don't mean to scare you, but it could be serious dear. How old are you? I need to go now and take my pills.

Good luck and may God bless you,

let us know what you have done about your symptoms.............. from Tennessee!!!!**************Gas prices getting you down? Search AOL Autos for fuel-efficient used cars. (http://autos.aol.com/used?ncid=aolaut00050000000007)

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Guest guest

Sorry to be a downer, but you are describing stroke symptoms. Did the doctor in Urgent Care test you for stroke? Helen Debbie Halvorson <djh_50fab@...> wrote: I had an eqisode at work where I suddenly became very dizzy and my speech became slightly slurred. I also had very blurry vision in one eye. I hadn't had a lot of sleep in the past

week. I went to Urgent Care and he told me to take Meclizine and gave me sleeping pills as I was out of them and told me to see regular doc, that he would probably want to run tests on me. I hadn't taken Ambien for about a week when this happened. Six days later I had another episode at 10:00 p.m. just before I went to bed. This morning I was feeling fine. Has anyone else had a similar experience? Deb Halvorson

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Guest guest

I thought of that, but Urgent Care doc never mentioned it. Called my doc's office today and he's out of the office. Recept told me nurse would call me really soon--that was this morning and haven't heard from her. I just hate the thought that because I have Fibro they probably just think I'm an alarmist. I have diabetes too and high blood pressure and they did check both of those and they were fine.

Kind of wondering if it is related to my taking Ambien. I hadn't taken any for about 5 days. Do you get withdrawals when you stop taking Ambien?

Deb Halvorson

Re: Question for group

Sorry to be a downer, but you are describing stroke symptoms. Did the doctor in Urgent Care test you for stroke?

Helen

Debbie Halvorson <djh_50fab (DOT) com> wrote:

I had an eqisode at work where I suddenly became very dizzy and my speech became slightly slurred. I also had very blurry vision in one eye. I hadn't had a lot of sleep in the past week. I went to Urgent Care and he told me to take Meclizine and gave me sleeping pills as I was out of them and told me to see regular doc, that he would probably want to run tests on me. I hadn't taken Ambien for about a week when this happened.

Six days later I had another episode at 10:00 p.m. just before I went to bed. This morning I was feeling fine.

Has anyone else had a similar experience?

Deb Halvorson

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