Fire-based EMS

[CBH99]

With the high level of OD's here in the Lower Mainland, it was overwhelming the combined response by EHS/Police/Fire/Social workers and volunteers. Some of the Fire halls despatch a Pickup truck with two guys to medical calls and the remainder stay with the pumper. This cuts down on wear and tear on the main appliances and would allow the pumper to respond to a fire and get setup while the other team is enroute. I think that is the way to go for halls with high medical call outs.

Here in Edmonton we have both ambulances as well as SUVs for EMS. (Known as rapid response units.)

The idea is that one experienced ACP (advanced care paramedic) can handle a majority of calls that don’t require transport. (Minor vehicle accident, call for minor incident at senior home, etc)

This allows the ambulances to be free for when they are needed, so they aren’t attending a call where the ambulance vehicle itself isn’t required.

 

[Good2Golf]

Here in Edmonton we have both ambulances as well as SUVs for EMS. (Known as rapid response units.)

The idea is that one experienced ACP (advanced care paramedic) can handle a majority of calls that don’t require transport. (Minor vehicle accident, call for minor incident at senior home, etc)

This allows the ambulances to be free for when they are needed, so they aren’t attending a call where the ambulance vehicle itself isn’t required.

Hi CBH, I've heard FFs derisively call those EMS SUVs "clock stoppers." Your explanation makes sense, re: balancing responsiveness with the required capability, but is there some element to affecting the performance measurement/numbers with the SUVs as well? Not that the FFs don't have their own issues, as they as well seem to attract otherwise less-than-glowing nicknames from other services.

Regards
G2G

 

[CBH99]

Hi CBH, I've heard FFs derisively call those EMS SUVs "clock stoppers." Your explanation makes sense, re: balancing responsiveness with the required capability, but is there some element to affecting the performance measurement/numbers with the SUVs as well? Not that the FFs don't have their own issues, as they as well seem to attract otherwise less-than-glowing nicknames from other services.

Regards
G2G

So what I’m about to say here is by no means ‘the definitive’ answer, so this does come with a grain of salt. If anybody has any more accurate information, by all means I am open to being corrected.

In Alberta, all EMS is run/operated by Alberta Health Services. There are some private ambulance providers that are contracted by AHS to fill the odd gap, but a majority of the ambulances you see anywhere in Alberta will be AHS ambulances.

That being said, even though EMS is provided by AHS, the way EMS is structured is different in each larger centre. For example the way it is structured just between Calgary and Edmonton has some noticeable differences.

(Edmonton has a greater number of SUVs compared with Calgary, and has trialled an experiment to have an EMR stationed in the hospital ERs to help get ambulance crews back out the door and on the street faster, etc)


I have no doubt that one attractive aspect of the SUVs is a much faster response time - clock stopper is probably an accurate term. But they do provide capability as well.

In regards to traffic accidents, it allows for faster response times during rush hours. It also helps to block traffic that is approaching the accident scene without an ambulance blocking an entire lane. Etc.

It’s primary purpose is to allow for EMS to respond quickly to calls that don’t require an ambulance for transport, as well as quickly supporting ambulances that may need an extra body or set of hands on a call.

A lot of their calls are responding to 911 calls that either

a) require someone there ASAP, and they can get there faster than an ambulance, or

b) respond to a call that doesn’t take an ambulance offline


Because of the way EMS is dispatched (here in Edmonton anyway) - crews don’t work in zones or districts. They can be all over the city, only coming back to their home station at the end of shift. Because of this, sometimes there aren’t many ambulance units near to a 911 call since they are dispatched all over the bloody place. The SUV units allow for that gap in ALS units to be minimized.


(CADS is the dispatch system used by EMS here, and it doesn’t really work as advertised. It’s supposed to dispatch the closest ambulance to the scene of the incident, but it has plenty of bugs. Because of this crews find themselves all over the place - daily.)

I no longer work EMS here, but I haven’t been gone for that long yet. Some of the above may be outdated or mistaken.

 

[mariomike]

For CBH99.

I guess it depends on which province, and which municipality within each province.

This can be seen by the number of applicants to the colleges.

Paramedicine | Joint Programs

Students in Paramedicine earn an Honours Bachelor of Science degree and an Ontario College Diploma while learning from leading academics and professionals.

www.utsc.utoronto.ca

and, among those who graduate, how competive recruiting is. Especially since the Residency Requirement is no longer in effect.

Thanks to the union, they have things now that we never dreamed of.

Meal Allowance.
Meal Breaks.
Language in the collective agreement regarding Early and Late calls.
Stress Leave.
Wash up/Lock uo Time.
And a long list of other good things.

I'm a transportation geek. So, I got on Truck and Bus division. ( We called ambulances cars. That goes back to the Cadillac era. I understand some other juricsictions refer to them trucks or buses. )

Enjoy boating? Transfer to the Marine Unit.

Urban EMS sucks? Transfer to the Islands and enjoy a quiet life in peaceful harmony with nature.

SWAT wannabe? Cross-trained paramedics provide medical support to the Toronto Police Emergency Task Force. ( ETF )

Or, you may be temporarily assigned to a Rescue Task Force RTF. Aka the sitting duck squad at an ASHE. It is not voluntary.

Enjoy rescuing people? Join Heavy Urban Search and Rescue. ( HUSAR )

Enjoy protests / riots? Don't want to settle for just watching them on TV? Join the Public Order Unit.

Can't get along with your partner? Join the Emergency Response Unit and work alone as a one-person "Clock-stopper".

Want to work underground in the subway system? An eight-minute delay can affect over 52, 000 riders. That was over a dozen years ago. Probably more now. Stationing paramedics underground inside the system decreases response time, and gets the patient(s) out of the subway cars an onto the platform so the subway system can stay on schedule.

Enjoy community medicine? Join the Community Paramedic unit.

There's all sorts of programs. Or, if you prefer, you can stay on the same schedule, same station, same partner until you retire. As many are happy to do.

Want clean, inside work with no heavy lifting and a thermostat on the wall? Transfer to Communications.

Are 9-1-1 operations driving you crazy? Here's the deal:

Employees who are placed in a permanent alternate position, due to an occupational injury/illness (as defined by the Workplace Safety & Insurance Board), will receive the wage rate of the position to which they are assigned. If the pre-injury rate of pay is higher than the relocated position rate, then the pre-injury rate is to be maintained. It is understood that the pre-injury rate is subject to all wage increases negotiated.

Pretty simple. Your end of the bargain is a little more interesting. HR will place you into a "suitable" job with the City. ( As there are no "comparable" jobs. )

Think of how many agencies, boards, commissions, departments and services there are in a big city.

And remember, Corporate HR decides what your "suitable employment" will be. Not you.

 

[CBH99]

I don’t remember all of the different units we had in Edmonton, but I guarantee you guys have just a few more

We call the tactical folks the Public Safety Unit. We don’t have a marine unit, fire does though. And the Community Paramedic program actually looked like the best gig out there - a lot of them even take their SUVs home with them at night. (That way they can just start their rounds right away, I’m guessing?)


I enjoyed my fairly short time with AHS. I worked an ALS unit (fancy pancy term for ambulance here) and occasionally an SUV, depending on where our shift supervisor put us that day.

He was an actual leader (in AHS I’ve found that very lacking) and liked each medic to get some alone time taking ERU calls to get comfortable responding to calls by themselves.


Lethbridge Fire Dept is integrated with EMS. Not sure how they structured that, but Fire & EMS is amalgamated there. Seems to work really well for them actually, but geographically they have a fairly small area. And rush hour is like 10 cars.

 

[mariomike]

I was privy to a ‘meeting’ (for lack of a better word) about a year and a half ago in which a 15 year member resigned, due to the constant petty nonsense coming from the top. (In this case he had backed up an ambulance about 8ft without using a spotter - was disciplined, and summoned to a disciplinary board also, which is where he just decided to walk away from the job)

Not a Thank You. No conversation about having him stay. No effort to ‘be a team’. Just a very insincere ‘cool, turn your stuff in by friday, thanks for coming out.’

Funny story. Out on the bus one day, they radioed a rather somber sounding message to bring xxx xxx up to HQ for "a meeting". xxx was very close to retirement, and was a very quiet and obedient man. So, on the way there he starts crying! "What did I do?" "Will they take my pension?"
He was inconsolable.

Anyway, we delivered xxxx. The Chief was there. They gave him a 25-year wall plaque and certificate from the mayor and a warm personal letter from the Chief. Along with a gold watch and a ring, tie and blazer badge and cake. The photographer was there.
This is when they make you a member of the quarter-century club until the day you die.
Funny now. But, I thought he was going to have a heart attack.

We had this in our collective agreement. Gives a man a chance to cool off and come to his senses.

Article 39 – RIGHT TO RESCIND RESIGNATION 39.01 An employee who resigns shall have the right to rescind their resignation, provided that they notify their immediate supervisor in writing, with a copy to the Division Head concerned, within five (5) working days of the date on which they tendered their resignation. Upon receipt of such written notification by the employee’s supervisor, the employee shall be reinstated to their former position upon the commencement of their next scheduled shift. It is understood that such time off shall be without pay, but with seniority and benefits.

 

[CBH99]

That’s a pretty slick provision in the agreement! Someone had their thinking cap on that day

is it sad that when we get ‘called to the office’ our first thought is whether we are getting fired for looking at a cloud the wrong way? We really are the red headed step kids of emergency services!

Quarter century club for life? That’s a cool tradition. I don’t think I ever heard of that in my EMS days (which were relatively few)

Solgen, where I work now, has some cool things like that. I think AHS was of the mindset like “congrats, sign here. Bye.”

 

[mariomike]

Quarter century club for life? That’s a cool tradition. I don’t think I ever heard of that in my EMS days (which were relatively few)

The Toronto Paramedic Services Pioneers is a registered non-profit organization formed on May 24, 1989. The group's objectives are to provide social and informational support to senior Toronto Paramedic Services staff, including those who have retired, and to encourage members to participate in community activities.

The luncheons have been on hold since Covid. There are also informal local "coffee klatches".

Membership is afforded to members of Toronto Paramedic Services that have 25 years of ( full-time ) service.

Since membership is limited to the one department, everybody knows everybody from the old days. I didn't care for some of those guys back then, but now, I love every damn one of them. And it hurts when we go to their funerals.

We really are the red headed step kids of emergency services!

I guess you are right. But, I never looked at it that way. We all had a job to do.

The three emergency services all offer an opportunity to make a contribution to society. Satisfaction in helping people. Of being a vital, important member of the community. I don't remember if any of those things were important to me half a century ago.

But, police officers, firefighters and paramedics get a job with a future, that is exciting, and far from routine. Careers with opportunities, as well as guaranteed security.

That’s a pretty slick provision in the agreement! Someone had their thinking cap on that day

Another far-sighted one was the Quaratine Agreement.

It was funny at union meetings. The executive would explain benefits they were trying to negotiate. But, a lot of the guys would say something like, "That's fine. But, how much of a pay increase?" That's important. But, it seemed like it was all some cared about.

Sometimes, the City would cry poor. So, they would negotiate something like Sick Pay Gratuity when you retire. Things like that meant very little to the taxpayers at the time they were negotiated. But, years later, after I retired, it boiled over as a major labour relations issue.

 

[CBH99]

I enjoyed my time with EMS here in Alberta, very much so. I wasn't with them for long enough to have any real feelings or thoughts about long-term career stuff, such as union agreements, etc. And I think what you described about "How much of a pay increase?" is pretty much standard across the board - most folks were just focused on what affect it would have on their paycheques. (And fair enough.)


Emergency services really is a great place to have a career

 

[mariomike]

- most folks were just focused on what affect it would have on their paycheques.

And the voters were focused on their next property tax bill.

And the Metro Chairmen / mayors were focused on keeping wage increases low, so they could keep property taxes low, so they could get re-elected.

And far-sighted union negotiators understood that, and used it to their member's advantage.

I can tell you there were a lot more "goodies" in our collective agreement by the time I retired compared to when I hired on.

I enjoyed my time with EMS here in Alberta, very much so.

If you don't mind me asking, what were the qualifations to apply in Alberta?

It's a two-year college diploma here. Minimum.

Some have the four-year Honours Bachelor of Science degree.

 

[CBH99]

There have been some recent changes to course names & resulting qualifications, so my info here is outdated slightly. (But not in a way that really matters actually - they just changed some very minor and arbitrary things that actually, in the end, don’t change anything at all)

BUT…

We had to have our BLS, and then EMR. Emergency Medical Responder. Which is a few months long, but can be done in about 3 weeks if done full time. (I did my EMR course in 3 weeks, a few years back. Most schools now seem to offer it 2-3 days a week, so it’s dragged out.)

Write provincial exam for ACP. Written and practical.

If you pass, you are qualified to apply and start EMT. That course is about a year. Classroom for 6 months, then a 2 month hospital practicum and a 4 month ambulance practicum. (In theory, but it’s based on ours and skills developed.)

Once finished EMT course, have to again write the ACP exams and practicums.

If you succeed, that qualifies you to apply to AHS to work as an EMT. Scope is useful, but can be limiting. It does qualify you to apply to special units - albeit not as competitive as someone fully qualified.


Final step is Primary Care Paramedic, which is the 2 year program. It is one year of classroom, and one year of practicum.

Write ACP exams, and if successful then you are licensed as a PCP.

Being qualified as a PCP opens the most doors and significantly boosts an applicant’s competitiveness. (A lot of folks get hired on as an EMT, and do their schooling for PCP on the side.)

Overall, if someone got started on their courses and really buckled down, they could be PCP qualified in about 2.5yrs or so.



**ACP - advanced care paramedic, which some members continue to go to school for after becoming a PCP. Just opens doors, but isn’t required to apply or for most units.

**ACP - also stands for Alberta College of Paramedics. They are notoriously brutal to deal with, and are LOATHED throughout the province. It really is a cash-grab, as it costs an applicant about $700 just to write their EMR exam. And the cost goes up from there.

Once qualified as an EMT or PCP, the costs of annual qualification renewal is pretty minimal, and Alberta Health used to cover it. (I think they still do)


I hope that’s somewhat helpful? We don’t have a dedicated EMS or Police college the way some provinces do.

 

[CBH99]

And the voters were focused on their next property tax bill.

And the Metro Chairmen / mayors were focused on keeping wage increases low, so they could keep property taxes low, so they could get re-elected.

And far-sighted union negotiators understood that, and used it to their member's advantage.

I can tell you there were a lot more "goodies" in our collective agreement by the time I retired compared to when I hired on.



If you don't mind me asking, what were the qualifations to apply in Alberta?

It's a two-year college diploma here. Minimum.

Some have the four-year Honours Bachelor of Science degree.

How does the application process work in Ontario, if you don’t mind me asking?

 

[CBH99]

How does the application process work in Ontario, if you don’t mind me asking?

Actually I’ll PM you so we don’t take over this entire thread

Sorry folks!

 

[mariomike]

How does the application process work in Ontario, if you don’t mind me asking?

The thread is about fire departments taking over paramedic departments. So, qualifications to apply for either in Ontario are relevant.

Emergency services really is a great place to have a career

This may be of interest to young people considering careers in Ontario.

Firefighter

• Must be 18 years of age or older at the time of application.
• Legally entitled to work for any employer in Canada (citizen/landed immigrants).
• Free of any criminal convictions for which a pardon has not been granted.
• Possess an Ontario Secondary School Diploma (OSSD –Grade 12) or academic equivalency.
• Ability to work on rotating shifts, including nights, weekends and holidays.
• Speak, read and write English fluently, and communicate clearly and precisely under demanding, high-pressure.
• Have a Standard First Aid certificate and a CPR level HCP (for Health Care Providers) dated not more than 12 months prior to the closing date of application and maintained current within 12 months throughout the recruitment and selection process.
• Minimum Requirements to become a Firefighter in Ontario | Ontario Fire Administration Inc.

Paramedic

Our 2021 recruitment is now closed. Thank you to those that applied. Please keep checking back here for future opportunities.

1. Successfully completed a MOHLTC-recognized course for Primary Care Paramedic provided by a College of Applied Arts and Technology or equivalent.
2. Successfully completed the Advanced Emergency Medical Care Assistant (AEMCA) examination or be AEMCA pending as specified in the Ontario Ambulance Act.
3. Must be able to achieve and maintain current certification in Symptom Relief and Defibrillation under the Ontario Base Hospital Group and meet cross-certification requirements with Sunnybrook Base Hospital.
4. Must produce proof of mandatory immunization and maintain all immunizations as required and specified by the Ontario Ambulance Act.
5. Must possess a Class F Ontario driver’s licence, or better, and meet all requirements for licence maintenance as set forth in the City of Toronto’s Fleet policy and be able to qualify for the City’s equipment operating permits.
6. Must not be convicted of any crime involving moral turpitude for which a pardon has not been granted.
7. Must meet all requirements for employment as a Paramedic in Ontario as per the Ambulance Act.
8. Must not have had driver’s licence suspended for two years prior to application, and not have more than three demerit points issued against his/her Ontario driver’s licence.
9. Ability to pass oral, written and physical examinations pertaining to procedures used in emergency patient care as set by the Division.
10. Thoroughly familiar with the Highway Traffic Act and Municipal Traffic By-laws.
11. Must be physically capable of performing required duties.
12. Must be available to work rotating shift/weekend/night/overtime/on call duty in all environmental conditions.
13. Must be familiar with the Occupational Health and Safety Act and the regulations that apply to this work.
14. Proficiency in a second language, would be an asset.
15. Relevant work experience (i.e. paramedic, RN, MD, military, policing, any medical field), would be an asset.
16. Relevant volunteer experience (i.e. crisis, community involvement, mental health, shelters, etc.), would be an asset.