Summer 1998

Professional Medical Associates would like to take this opportunity to thank all the service directors, hospital managers, assistant instructors and preceptors for their assistance in the past few years. As PMA moves into its fourth year, we look forward to continuing to work with all of you. On behalf of our students ..... THANK YOU AGAIN !!!!

WHAT'S NEW IN THIS ISSUE??

Starting with the last issue, hyper links have been added to make it a little easier to navigate around the newsletter. Again, thank you for the feedback and suggestions - we look forward to your comments.

NEWSLETTER CONTENTS

PMA NEWS

Thank you one and all .... looking to the future of meeting the needs of EMS

Professional Medical Associates would like to take this opportunity to thank all the service directors, hospital managers, assistant instructors and preceptors for their assistance in the past few years. As PMA moves into its fifth year, we look forward to continuing to work with all of you. On behalf of our students...THANK YOU AGAIN !!!

PMA Continues to Prove our Commitment to Educational Excellence - 4 Years Consistently

Fresh off another successful year, Professional Medical Associates is pleased to complete the range of prehospital education programs. The 1997/98 year brought about the final piece in the seamless curriculum for the programs from Professional Medical Associates. Professional Medical Associates is the first organization, public or privately funded, to have the opportunity to offer all three levels of prehospital care from one organization, inclusive of additional health services - Section 12(1) and 12(2) skills.
A listing of the firsts from Professional Medical Associates include:

EMT-Paramedic Update/Refresher

PMA is pleased to add yet another accomplishment to the list for students and practicum partners - the EMT-Paramedic Refresher Program. The need for it has been voiced for a long period of time. The refresher program is targeted specifically to current ALS providers to ensure skills and knowledge are current. The program is offered in modular format consistent with our commitment to flexible delivery of programs.

The program has recently been approved by APPA, and is now available to practitioners and services alike. The program has been utilized in a pilot format recently as a portion of the preceptor appreciation program in partnership with one of our ambulance practicum sites.

Professional Medical Associates is committed to ensuring that we only offer programs with formal approval from the regulatory body APPA, rather than building programs as we go along. The vision of PMA, the feedback from our students, and our partnerships with ambulance and hospital directors and managers, allows the staff to continue to develop and implement innovative programs that are focused on the needs of the ambulance profession. While the potential for delay is always a possibility, the needs of Professional Medical Associates’ students must come first since, without them, we would have been unable to offer the range of approved programs we currently have under one roof.

PMA Continues To Answer student Needs with Unprecedented Success

PMA EMT-Paramedic Program

The EMT - Paramedic Completer program formed the final link in the seamless curriculum from EMR through to the EMT-P level, first available from Professional Medical Associates. The focus was simple - meet the needs of practitioners and the ambulance profession to streamline the education and training of students so they can continue their employment and remain in their communities. It is also of note that all programs from Professional Medical Associates rely solely on our students and partnership arrangements with our ambulance services and hospitals. Unlike other training organizations, Professional Medical Associates, nor our students, receive base funding from the government. While this may cause the program to be more expensive, it also forces the Professional Medical Associates’ team to ensure the needs of the students are met. One of the cornerstone strengths of the program, aside from the total length, is the ability of the students to maintain current employment while upgrading their education.

Program faculty possess a wide range of educational experience including experience as former instructors with other post-secondary institutions in Alberta. The program’s strength relies on small instructor to student ratios to maximize practical experience, and ensure instructors are readily available should questions arise. In initial programs, student to instructor ratios of 2 to 1 or 3 to 1 produced graduates that have been well received by practicum sites. Students with extensive experience as EMT-A practitioners remove much of the need to review EMT-A information and produces graduates well suited to the changing face of EMS in Alberta.

Program feedback from students, graduates, our preceptors and practicum partners allows Professional Medical Associates to maintain our “Commitment to Educational Excellence” and reports regarding the EMT-P program and the results have been extremely positive.

In response to the needs of our students, Professional Medical Associates has selected the site for the latest PMA EMT-P program, out of the office in St. Albert, and the program has been running for the last few weeks. The initial plan was to offer the program in a Southern Alberta site, though the vast majority of applications where from more northern communities so the Southern Alberta site will be attempted for the next program. Information on the next program, likely centered out of Southern Alberta is available through the office or by our email - registrar@promedics.org.

EMT-Paramedic Program Strategic Alliance to start

Preparations and final negotiations are currently underway to create strategic alliances similar to our EMT-A program to offer the Professional Medical Associates’ EMT-Paramedic program in a co-operative venture with the plan that the course can move to students in Southern Alberta. Final site selection is nearly complete and the program should be starting in the fall of 1998 once final details have been arranged. Selection for the Southern Alberta co-operative program will be held in early August to prepare the class to start in mid-October following the fall preceptor appreciation trip. PMA’s Class of 2000 - our Y2K class.

Training Initiatives

Recently, the Albert Government announced some exciting new initiatives that specifically supports the direction that Professional Medical Associates was designed for. Funding has been identified for those services that are currently going less than 600 calls per year, which is precisely the same services that Professional Medical Associates has been assisting in the past.

Since the inception of PMA, our focus has been on smaller services to assist the services and their employees to increase the training and level of service. From assisting services to move from the EMR to BLS level or from the BLS level to an ALS level though to developing and implementing an annual competency maintenance program are all opportunities available from Professional Medical Associates.
Professional Medical Associates has developed and implemented a large number of program specifically targeted to the needs of rural practitioners. Programs such as our refresher programs for all levels, or the first available bridging programs for EMRs to the EMT-A level or working EMT-As to the EMT-P level inclusive of additional Health Services (12[1] and 12[2] skills).

Funding is available to support and increase the level of training as well as the maintenance of on-going competency - the exact focus that Professional Medical Associates have been doing for the last few years. In terms of cost-effectiveness, limiting overhead and providing the educational opportunities in rural communities are all strategies that have been utilized to prove our “Commitment to Educational Excellence” and our focus on the needs of the smaller services throughout the province.

The training consultants of Professional Medical Associates can assist smaller service to develop, implement and monitor an educational program that meets the needs of the services. With a constant eye on ensuring the very nest education, programs are designed with accessibility, accountability and effectiveness as the cornerstones of programs. For more information, contact the office to discuss your needs.

EMT-A Partnerships Continue to Grow

In response to the needs that have been expressed to us by rural ambulance services, and based on the success of our previous programs, Professional Medical Associates is pleased to announce tentative locations for the next EMT-A programs. Consistent with our commitment to the needs of rural services, there will be three programs offered across the province. The High River Program is slated to commence on August 6, 1998 and selection testing and interviews have been scheduled for July 9 and 10 in Calgary. For details, call the office.

EMT-A and EMT-P Report

The latest review of the preceptor surveys and course evaluations from the students yielded some especially positive results as Professional Medical Associates continues to ensure the needs of our students are met.

The vast majority of surveys have expressed the many strengths of the programs, and the level of preparation and knowledge of the students is consistently identified as one of the major strengths of the programs. A large number of surveys state that the level of preparation of the students, and the preceptor’s opinion of the program is well above other programs in the province. Some suggestions have also been forwarded to the office and there will be some minor changes for future programs beginning in the Fall of 1998. We are always interested in feedback from students, preceptors and the ambulance service directors and hospital site managers. The next round of surveys is due out very shortly.

The last few months have offered staff the opportunity to speak with a large number of graduates from the EMT-A and EMT-P programs. All EMT-P graduates are currently employed in ALS services, which is a very positive achievement for the students.

The EMT-A graduates are also working in a large number of services throughout the province and report that they are very satisfied with their programs and their preparation to enter or further their EMS careers. In fact, some EMT-A graduates have also continued to advance their careers at the ALS level by enrolling in the EMT-P program with one student at each of PMA, NAIT and SAIT. Graduates from Professional Medical Associates are employed by a large group of services including:

• Grande Cache Ambulance	• County of Flagstaff	• Wainwright Ambulance Service
• Yellowhead Ambulance	• Provost Ambulance	• High Prairie Ambulance
• City of Edmonton Transfer Service	• City of Edmonton ERD	• Medi-Care Ambulance
• City of Calgary EMS	• Omnicare Ambulance	• St. Paul and District Ambulance
• Provost Ambulance	• Lakeland Ambulance	• Knutson’s Ambulance
• Interhospital Transfer System	• Fort Saskatchewan Ambulance	• Crown EMS
• Calgary Regional Health Transfer	• Brooks and District Ambulance	• Vermilion Valley Ambulance
• Lakeland Ambulance	• St. Paul Ambulance	• Wetaskiwin EMS
• Guardian Ambulance	• Medicine Hat Ambulance Service	• Bassano Ambulance Service

Fort McMurray and Vermilion

PMA is pleased to announce the successful completion of the didactic portions of the latest EMT-A Completer partnership programs - Fort McMurray and Vermilion. The Fort McMurray program has been an extremely positive venture, and the latest program has utilized an alternative delivery model that had instructional staff travel up to Fort McMurray and offered the program in full-day sessions. The program was very successful, and the small class size contributed to the success of the program. The students have also completed their hospital rotations, with the kind assistance and support of the nurses of the Stony Plain Hospital. The students have reported that the hospital practicum was an excellent learning experience and that they were extremely grateful to the nurses and physicians that committed a great deal of time and effort to their learning.

We would also like to take this opportunity to once again thank those ambulance services and hospital sites that have graciously allowed our students to gain valuable practical experience within their respective organizations. The support for our programs, and for our Preceptor Appreciation initiatives continue to grow and is greatly appreciated. Preceptors are also reminded to see the Preceptor Appreciation Section of this newsletter for information on the latest winners of our preceptor appreciation trip over the September long weekend.

The latest partnership initiative is in conjunction with the Vermilion Valley Ambulance Service. The Vermilion program, as with the Fort McMurray Program, has assisted local students to move from the EMR level to the EMT-A level and ensure their ongoing employment. It is with programs such as these that Professional Medical Associates is able to maintain an extremely high percentage of graduate students actively employed in EMS.

Both programs have offered local students the opportunity to continue their EMS careers, and the ability to partner with the two organizations to provide instructional space, instructional resources and assistant instructors. Partnerships such as these two offer some significant benefits for the students as well - utilization of local assistant instructors help to contain costs which are then passed on to the students.

EMT-A Update

Final site selection is based on the number of applicants from areas sponsoring the program to maximize employability. Negotiations are currently underway with a number of rural ambulance service partners regarding assisting in hosting the program, and the obvious benefit to the EMR practitioners that reside in the communities. The next EMT-A program is slated to start August 6, 1998 in High River and selections for the EMT-A program will be held on July 9th and 10th, 1998 in Calgary. Applicants should contact the office for more information. The application forms should be into the office no later than July 2.

EMT-A Programs are also starting in Fort McMurray in mid-September, in Central Alberta stating in mid-September and the next program for the St. Albert region is slated to start in mid-December. For more information regarding dates for the selection process, contact the office or via email- registrar@promedics.org.

The selection process involves completion of a multiple choice examination, completion of a scenario, and a personal interview for each applicant. Applicants must also supply a copy of their APPA EMR registration, BCLS - Level C within the previous 6 months, and resume detailing work and educational experience. Other supporting documentation includes letters from EMS related employers and other registered practitioners. To date, the selection process has been extremely successful. In fact over 95% of our students complete the program and have been successful on the APPA Provincial Registration Examination.

Program Feedback

PMA continues to send our feedback surveys to our preceptors and Service Directors. The surveys form a portion of the Quality Improvement Program of Professional Medical Associates. This ensures our graduates meet the needs of the ambulance profession, and they are prepared for their hospital and ambulance rotations.

The results are extremely positive, and we would like to thank the preceptors for taking the time to assist us in improving our programs even further. With the assistance of our preceptors and our Quality Improvement Program, PMA can continue to work to improve upon the success of our graduates on the Provincial Registration Examinations. Even though over 95% of our graduates are successful on the EMT-A Provincial Registration Examination on the first attempt, there is still some work to be done to reach complete success. Currently, all EMT-A and EMT-P graduates have successfully completed the APPA Registration Examination - overall a 100% success rate. Our Commitment to Excellence and the assistance of our preceptors and our practicum partners allow us to continue to improve and continue to strive for 100% success in the next few examinations.

SURVEY RESPONSES

The following is a sample of the responses we have received on our program surveys for the EMT-A and EMT-P programs:

EMT-Ambulance Program

EMT-Paramedic Program

EMT-A Competency Assessment and Maintenance Program

The final changes have been made to the pilot competency assessment program for EMT-A practitioners. Following a few trial sessions, the program is ready to be delivered to existing practitioners through our preceptor appreciation program. The program has two goals. The first, from the services perspective, is to have a third party assessment completed of the staff, and second, to identify areas that would benefit from continuing education of competency maintenance sessions.

The process involves completion of an extensive multiple-choice examination, as well as a practical scenario and skills stations on a variety of BLS skills. Upon completion, reports are generated that identify individual members’ strengths and areas for improvements. The process is based on the most recent competency document through APPA. The program includes Section 12(1) skill knowledge, though this can be removed from the process as required.

The competency assessment program is another of the exciting and practical initiatives that has been developed in response to the request of our ambulance service partners throughout the province. In addition, the program can be attended by current EMT-A practitioners that are curious to discover how their competency compares to other practitioners. The program has served as an excellent tool for service directors to review the continuing education needs of their department and practitioners. Empowered with this knowledge, PMA can assist in developing education programs to target specific needs or issues.

Preceptor Awards - Better for ‘98

The draw date for the latest award was June 30, 1998, and the prizes are complimentary spots on our Preceptor Appreciation Program for our next golf and rafting trip. The golf trip has been planned for September 4th - 7th, 1998 and we are heading for the Panorama Resort, details are in the following section.

With the shape of the Canadian dollar, we have decided to look at BC, and we are expecting an even better trip than last year’s excursion to Whitefish. Final details are available by calling the office anytime.

With the level of support that we have received from ambulance and hospital preceptors as well as ambulance service directors and hospital site managers, the preceptor appreciation program has been expanded. Professional Medical Associates on behalf of our students, is now drawing for 4 spots on our next appreciation trip, 2 for ambulance preceptors and 2 for hospital preceptors.

Our congratulations to the latest winners of the ambulance preceptors appreciation award goes to Mike Gurney of the City of Fort McMurray Fire Department and Tony Kendall of the City of Calgary EMS Department. Our winners of the two spots on the appreciation trip for our hospital preceptors are Carline Pratt of the Stony Plain Health Centre and Carol Church of the Red Deer Regional Hospital.

Our preceptors add an extremely valuable perspective for the students. We are extremely proud of our preceptor appreciation and partnership programs. The PMA commitment to our preceptors is to ensure the preceptors have all required support, where and when they need it. PMA continues to improve on our appreciation and support program that benefits all three parties, the service, the preceptors, and most importantly, our students. As a reminder, you can reach the on-call PMA practicum facilitator 24 hours a day, 7 days a week at 1(800) 571-5355 or e-mail us at james@promedics.org.

Winter 98 Appreciation Trip

The Winter Preceptor Appreciation Trip was a much needed weekend getaway to the Panorama Ski Resort. The trip was an unqualified success, and there were a number of new preceptors able to join us, in addition to those preceptors that won complimentary trips for their work with our EMT-A and EMT-P students.

Skiing kept everyone busy, and there was even a chance to sneak in a quick round of golf in Windermere Valley. The trip was a perfect primer for the next golf trip in September. Thank you once again, on behalf of all of our students,

to the preceptors that continue to assist our students in their education.

There was more than a few entries in the karaoke competition though no winner was announced. There was a clear winner in the less than popular “Steve Erckle look-alike” contest, as you can see from the photo to the left.

All preceptors, students, staff and service and hospital directors are cordially invited to the next event, scheduled for the September long weekend.

We hope that all those that continue to assist our students are able to join us.

Summer / Fall Appreciation Golf Trip

The next preceptor event is our annual golf and rafting trip, and it looks like the destination is Panorama with its on-hill accommodation and scenery, not to mention the shape of the Canadian dollar that basically will not allow us to return to Whitefish, Montana this year. There is even enough to do to keep those that don’t golf and just want to take a break in the beauty of the Canadian Rockies from September 4th to September 7th, 1998. The package includes 3 nights accommodation at your choice of hotel or private condo on the hill. The trip also includes return transportation from both Calgary or Edmonton as well as transfers around the area and 2 days of activities including a choice of golf or rafting. Additional activities are also available, as well as the special “R and R” package for those that just want to get away for a few days in the beauty of the BC Interior. Prices start at $215.00 per person for the Pine Inn Hotel and $235.00 per person for the Horsethief Condos, based on quad occupancy. The prices do not include the preceptor appreciation subsidy, preceptor pricing is available from the office. For more information, please contact the office or check out all the details for the golf trip. Availability is limited so make you reservations today, toll-free at (800) 665-6836 or email registrar@promedics.org. Deposits must be received no later than July 22, 1998 to ensure that you can join us for what should prove to be another remarkable break for our staff, students and the most important guests - our preceptors and service directors.

Continuing Education

You have been called to the apartment of a 68 year old female patient at the local retirement village, the kitchen staff state the patient never came for breakfast. It is now 4:30 p.m. and the patient will not wake up to come for supper.

1. Upon arrival to complex your first step is to:
a) locate patient within complex
b) attempt to obtain past medical history from staff
c) notify family members
d) put on gloves and check time

2. You have received pertinent history from staff and have located patient room, you now:
a) check patient airway
b) apply oxygen by nasal cannula at 3 liters per minute
c) determine level of consciousness
d) check patients pulse at neck and wrist

3. You have determined the patient will not respond to verbal stimuli, your next step is to:
a) place an oropharyngeal airway
b) ventilate at 8 breaths per minute by mouth-to-mask
c) determine responsiveness to pain
d) perform head tilt/chin lift

4. Your patient is unconscious and unresponsive to voice or pain, you now:
a) start artificial respiration
b) perform fingerstick glucose
c) administer oral glucose sublingually
d) request for back-up

5. You now know your patient is unconscious and unresponsive, your next step should be to:
a) perform modified jaw thrust
b) attempt to ventilate with bag-valve mask
c) size and insert OPA
d) begin chest compressions

6. The OPA is in place and your patient is breathing at a rate of 12 per minute, you should assist ventilation at a rate of:
a) 20
b) 24
c) 22
d) 14

7. You are now assisting respirations and have checked patient’s pulse. Pulse is 94, strong and regular with the rest of your survey being unremarkable. While initiating transport you should:
a) place paddles on chest and quick look the rhythm
b) determine blood glucose level
c) hyperventilate patient at a rate of 24 breaths per minute
d) start an IV of normal saline and run wide open

8. You have arrived as back-up for the above crew and received a history of patient not eating breakfast, unable to rouse for supper with a past medical history of diabetes. Your EMT crew states blood glucose level is 1.0 mmol/L, your next course of action is to:
a) intubate and hyperoxygenate patient at a rate of 24 a minute
b) use naloxone at 0.4 mg IV push to rule out narcotic overdose
c) start IV normal saline while getting monitor ready
d) administer 12.5 g of D25W solution

9. You have taken a blood glucose level and are awaiting results, you place the cardiac monitor while taking vital signs. The rhythm on the monitor is:
a) sinus tachycardia
b) sinus bradycardia
c) 2nd degree type I heart block
d) 1st degree heart block

10. Your efficient working EMT-A’s have completed the vital signs and your 12(1) qualified partner started a 18 gauge IV in the antecubital fossa. Blood glucose level is 1.0 mmol/L, you decide Dextrose 50% in water is the right choice, the dosage should be:
a) 1 mg/kg to a maximum of 50 mg IVP
b) 0.5 mg/kg to a maximum of 50 g IVP
c) 0.5 g/kg slow IVP diluted with 1:1 sterile water to form 25% solution
d) 25 g of D50W slow IVP

ANSWERS
1. d 2. c 3. c
4. d 5. c 6. a
7. b 8. c d. d
10. d

EMR course update

PMA is pleased to announce the conclusion of our latest programs, and assisting a number of smaller communities to set up initial response organizations. Programs currently running, or about to start, include those in St. Albert and Calgary as well as our continuing focus on rural needs with programs being finalized for northern and eastern regions in the fall. We are also gearing up to commence the next EMR programs in Calgary and St. Albert starting the latter part of July and mid-September. Contact the office for specific details, or try the 24 hour support line at (800) 571-5335.

Professional Medical Associates will have completed programs in the following centres within the 1997/98 year. Programs have been held in Calgary, St, Albert, Consort, Jasper, Cold Lake and programs are soon to commence in Fort McMurray.

Alumni news

With graduates stretching from one end of the province to the other, there is always something happening with our graduates. Got something to share with everyone else? We’d be pleased to pass on the good news - got a new career, promotion - had an interesting call? Let us know and we’ll try to include it in a future issue. To contact any of us, call the office at 1-800-665-6836, facsimile at (403) 460-8277, or via e-mail - james@promedics.org. We are always interested in what our students think of our programs. If there is anything else you have thought of since you completed the post-course questionnaire, feel free to let us know.

Alumni - Congratulations go out to the graduates of our latest programs.
In the last Issue of PMA News the name Candace Nicholson was inadvertently missed from the EMR St. Albert graduating list. We apologize to Candace for the omission.

EMR St. Albert
Tena Adams
Scott Bland
Bradley Boddez
Charlotte Chyzyk
Sue Doughty
Joel Houle
Daniella Kostiw
Deborah Kostiw
Michael Lorenz
Trevor Marchand
Stephen McSweeney
Greg Sybulka

EMR Calgary
Tamara Davis
Jason Fyffe
Nicole Hayes
Katherine Houde
Chris Johnson
Paul Johnson
Jacob Krygier
Christian Lamoureux
Russ McLean
Andre Perreault
Danny Schmick
Jason Terry
Clayton Williams
Amy Winter

EMR Calgary
Kendall Armstrong
Grant Cantin
Sally Cormier
Chris Farnady
Eileen Greffard
Darcey Jenkins
Brenda Kohn
Scott Luxton
Keely Thompson

EMR St. Albert
Christa Bailey
Darren Brenneis
Paul Cote
Andrew DeCoteau
Dylan Dersch
Dave Drugge
Kelly Flewelling
Cameron Haz
Cory Landry
Lance Leith
John Prockiw
Kim Richards
Sheryol Shera
Shane Stewart
Kevin Suetter
Mallory Thomas-Muller
Nova Tremain
Ralf Urzinger

EMT - St. Albert
Collette Campbell
Rachelle Dirk*
Andrew Doering
Sue Doughty
Remon Elyas
Arlent Erickson*
Garry Gerber*
Kim-Marie Haynes
Kathy Holmes
Karrie Kirkpatrick*
Renee LaPorte
Marni McNaughton*
Rory Munro
Candace Nicholson
Heather Pawly
Karla Peddie
Joe Proteau
Joelle Reimer
Allen Vanderkracht

EMT - Fort McMurray
Eddie McCann*
Larry Lalonde*
Aaron Solecki*
Mike DeSeguin*
Paul Fleming*
* Completed didactic
portion of program.

EMT-P - St. Albert
Trevor Cairns
Louise Gottschalk
Darren Orleni
Deb McDonald*
Todd Sikorsky

PMA News

Volume 3, Number 2

Spring/Summer 1999

WHAT'S NEW IN THIS ISSUE??

NEWSLETTER CONTENTS