2Fingers wrote: ↑Sun Mar 02, 2025 12:01 am
Four ambulances with primary care paramedics, one ambulance with advanced care paramedics, two advanced care paramedic responder units and one paramedic supervisor responded to the scene.
Mëds, what is the difference between primary care and advance care. I assume advance is higher trained and can do more?
Primary Care is BLS (Basic Life Support), lower scope of practice.
Advanced Care is ALS (Advanced Life Support), higher scope of practice.
Here’s a list of some of the things an Advanced Care can provide that a Primary Care cannot…
-ECG interpretation
-Manual defibrillation
-Synchronized electrical cardio version
-Chemical cardioversion
-ACLS medications (used during cardiac arrest)
-Transdermal cardiac pacing
-Endotracheal Intubation
-Cricothyrotomy
-Chest decompression
-Procedural sedation
-Chemical restraint (sedation in violent psych)
-Opioid analgesia
-Cardiac monitoring
-A much broader scope of independent medications
-Full scope of medication administration under a physician’
orders
If you live in BC and do not reside in Nanaimo, Victoria, Lowermainland as far as Chilliwack, Kelowna, Kamloops, or Prince George, you do not have regular Advanced Care services.
If you live in Penticton, Vernon, Williams Lake, Cranbrook, or Campbell River, you will sometimes have an Advanced Care single responder unit (ACP in a Ford Explorer) who comes and works with the PCP crew. Terrace and Fort St John both have postings for that as well but they are unfilled. BC has some very good ACP level practitioners, but the culture is garbage. Massive arrogance. They don’t want to be bothered dealing with calls that are “beneath them”…..send the Primary Care crew.
I hold an Advanced Care license, I am limited to Primary Care practice by BC Emergency Health Services unless I am willing to travel back and forth or relocate for 6-12 months to go through the BCEHS mentorship pathway. No other province operates this way. They put ACP level wherever they can and those guys go to whatever call comes in. In fact, you could work as an Advanced Care for 20 years in Toronto, then move to BC and be restricted to Orimary Care until you do their mentorship which is essentially a repeat of practicum which we all have to do in order to graduate and apply for licensing. It started as a seniority driven hegemony and is only now starting to change. But the general consensus up until a few years ago was that BC Ambulance had a special place called ACP Island…..everyone who was trying to swim there had to dodge the rocks that the ACP’s were throwing, and when someone finally made it to shore the first thing they were taught was how to throw the rocks at the wannabe’s who were still swimming.
Some people ask me why I don’t go through the process seeing as there is a posting in Terrace for a single response unit. Well myself and a friend of mine both applied but weren’t even considered because we did not have “3 years plus 1 day experience working as ACP’s
for BCEHS. They finally changed that wording last summer, but I did the 50/50 home/away thing for too long. I’m done with that. And the fact is, I don’t want to work as a single responder. It is a viable model in metro areas where you have 50 Primary Care ambulances running around so there is almost always a crew to work with. But in smaller centers some of these guys have shown up at scenes and sat there unable to help because they don’t have a second set of hands and have no capability of transporting a patient by themselves…..thanks but no thanks. Over the past 10 years there has been a steadily growing number of people like me, ACPs who don’t want to relocate to these higher cost centres, don’t want to be run ragged and burnt out at rapid speed…..so we just shove the frustration way down and work at a lower level.
The tax payers of BC doesn’t realize how badly their provincial service is under-serving them compared to the rest of Canada.
