COVID-19: Clinical Practice Summary - April 3rd We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest? Please take a moment to fill out our Medic Minutes Survey Hosts: Gord Minaker - PCP-IV, UBC Medical Student Kaela Richardson - Respiratory Therapist, UBC Medical Student Date of Episode Release: April 3, 2020 Episode Description & Summary: In this episode, we review the clinical practice changes that have occurred this week at BCEHS in respect to the COVID-19 pandemic.  Please see below for a synopsis of this episode. Please refer to the BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca Contacts: Clinical Questions - clinicalpractice@bcehs.ca Podcast feedback & suggestions - podcast@bcehs.ca Podcast Synopsis & Timeline: 1:45 - A reminder to listen to our PPE episode, to reduce COVID exposure amongst other crew members and to plan ahead for your safety during the COVID-19 pandemic.  3:36 - A reminder to use your full region, call sign, and reason for phoning when calling CliniCall.  4:08 - A reminder about no more nebulizers, and to try to use patient MDI's when possible. MDI's are being distributed in a prioritized fashion. We review ways to safely ensure that the patient's MDI is not expired and how to know when an MDI is empty.  6:48 - A discussion around new oxygen flow rates. https://handbook.bcehs.ca/covid-19/covid-update-march-31/clinical-practice-updates-covid-19-march-31/ 8:30 - A review of the airway management updates to date: https://handbook.bcehs.ca/covid-19/covid-update-march-31/pandemic-airway-practice-update-v7/ 10:10 - We discuss precautions for adult resuscitation, reminder to call CliniCall / EPOS at 15 minutes or ealier for transport discussion. Identify reversible causes early and transport of patients with CPR ongoing will only be recommended in exceptional circumstances. We emphasize good communication with receiving ED if this is case, and how to handle re-arrests en-route to the ED. 14:15 - We discuss where to find all clinical summaries to date with respect to COVD.  https://handbook.bcehs.ca/covid-19/covid-19-clinical-practice-dashboard/ 15:40 - Transport of COVID positive patients in Victoria and Southern Vancouver Island. South Island COVID-19 Transport Directive 18:00 - A reminder to reach out to CISM if you experience Moral Distress. Stay stuned for resilience resources and sessions coming soon! 20:20 - Fire First Responders will not be attending covid positive patients. They will only be dispatched to purple calls, red calls where ambulances are expected to be delayed, and for technical rescues.  21:04 - Skin care with frequent hand washing - use moisturizer! Notify your supervisor and notify the workplace call centre if you think you have dermatitis.  

Medic Minutes

COVID-19: Clinical Practice Summary - April 3rd

We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest? Please take a moment to fill out our Medic Minutes Survey Hosts: Gord Minaker - PCP-IV, UBC Medical Student Kaela Richardson - Respiratory Therapist, UBC Medical Student Date of Episode Release: March 26, 2020   Episode Description & Summary: In this episode, we summarize and consolidate the clinical practice changes that have occurred at BCEHS as of March 26, 2020. We also make a correction to our previous PPE podcast, which can be found here: https://blubrry.com/bcehs/57679523/ppe-precautions-paramedic-safety-covid-19/ Please see below for links to resources. Please refer to the BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca Contacts: Clinical Questions - clinicalpractice@bcehs.ca Podcast feedback & suggestions - podcast@bcehs.ca   References & Links: BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca Clinical Practice Summary Page: https://handbook.bcehs.ca/covid-19/covid-19-pratice-updates-summaries/  

COVID-19: A Summary of Clinical Practice Changes

PPE, Precautions & Paramedic Safety: COVID-19 We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest? Please take a moment to fill out our Medic Minutes Survey   *** March 26th Update ***  The podcast is now current as of March 26th.  Slight changes were edited and re-recorded near the end of the presentation regarding the cleaning of ambulances and the proper PPE to be worn while doing so.  These changes are consistent with the policies found in the BCEHS Handbook under ‘Cleaning and Disinfection’, and have been validated by Janie Nichols, our infection control specialist. These changes include limiting PPE for routine cleaning of ambulances after COVID transports to using gloves and ACCEL wipes, ventilating ambulances for 20 minutes only after an aerosol-generating medical procedure was performed in the back, and very limited scenarios where N95's and full PPE are required for cleaning. Resources for Cleaning & Disinfecting: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/cleaning-and-disinfection/ Hosts: Gord Minaker - PCP-IV, UBC Medical Student Kaela Richardson - Respiratory Therapist, UBC Medical Student Guest: Kevin Lambert - Critical Care Paramedic, Paramedic Practice Educator Acknowledgements: Janie Nichols, Infection Prevention Specialist   Date of Episode Release: March 25, 2020 Episode Description & Summary: In this episode, we review best practices regarding personal protective equipment (PPE), precautions to be taken on COVID calls, and paramedic safety in the context of COVID-19. Please see below for a timeline of the questions we ask during this episode, and for links to resources. Please refer to the BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca   Contacts: Clinical Questions - clinicalpractice@bcehs.ca Podcast feedback & suggestions - podcast@bcehs.ca   Podcast Timeline: 1:03 - How is COVID-19 spread? 2:16 - What can paramedics do on a day-to-day basis? 4:21 - Are calls still being screened for “Influenza Like Illness” waits? 6:00 - What calls should we be wearing PPE on? 7:14 - What should do before we arrive on-scene to prepare? 9:23 - How should we prepare the ambulance for transport? 13:14 - Are surgical masks ever acceptable when encountering COVID cases? 14:59 - What sort of eye protection should we use? 16:35 - Should we use the buddy system for PPE? 18:19 - Reviewing Donning and Doffing 22:00 - Should we be double gloving? 22:44 - Should we wear boot covers? 24:08 - Limiting gear exposure in the ambulance during transport 26:47 - Reverse Isolation for Patients 27:49 - Who do we need to notify of COVID calls? 29:19 - Reducing the number of people exposed on calls 30:33 - When should drivers doff? What PPE should we wear in the cab of the truck? 32:36 - How should we reduce hospital exposure? 36:15 - How should we clean the ambulances? 39:50 - What PPE should we wear to clean? 44:20 - A final word from Kevin Lambert   References & Links: BCEHS Doorway Assessment: https://handbook.bcehs.ca/covid-19/covid-19-update-march-23rd/on-scene-doorway-assessment/ Donning PPE video here: https://youtu.be/btrFMvj3Gm8 Hand Hygiene video here: https://youtu.be/J7aILlTnE78 Doffing PPE video here: https://youtu.be/Rro4RJ5Az88 Donning & Doffing Poster: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/ppe/donning-and-doffing/ Hand Hygiene Poster: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/hand-hygiene/cleaning-your-hands/ Cleaning and Disinfecting Resources: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/cleaning-and-disinfection/    

PPE, Precautions & Paramedic Safety: COVID-19

PPE, Precautions & Paramedic Safety: COVID-19 We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest? Please take a moment to fill out our Medic Minutes Survey   Hosts: Gord Minaker - PCP-IV, UBC Medical Student Kaela Richardson - Respiratory Therapist, UBC Medical Student Guest: Kevin Lambert - Critical Care Paramedic, Paramedic Practice Educator Acknowledgements: Janie Nichols, Infection Prevention Specialist   Date of Episode Release: March 25, 2020 Episode Description & Summary: In this episode, we review best practices regarding personal protective equipment (PPE), precautions to be taken on COVID calls, and paramedic safety in the context of COVID-19. Please see below for a timeline of the questions we ask during this episode, and for links to resources. Please refer to the BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca   Contacts: Clinical Questions - clinicalpractice@bcehs.ca Podcast feedback & suggestions - podcast@bcehs.ca   Podcast Timeline: 1:03 - How is COVID-19 spread? 2:16 - What can paramedics do on a day-to-day basis? 4:21 - Are calls still being screened for “Influenza Like Illness” waits? 6:00 - What calls should we be wearing PPE on? 7:14 - What should do before we arrive on-scene to prepare? 9:23 - How should we prepare the ambulance for transport? 13:14 - Are surgical masks ever acceptable when encountering COVID cases? 14:59 - What sort of eye protection should we use? 16:35 - Should we use the buddy system for PPE? 18:19 - Reviewing Donning and Doffing 22:00 - Should we be double gloving? 22:44 - Should we wear boot covers? 24:08 - Limiting gear exposure in the ambulance during transport 26:47 - Reverse Isolation for Patients 27:49 - Who do we need to notify of COVID calls? 29:19 - Reducing the number of people exposed on calls 30:33 - When should drivers doff? What PPE should we wear in the cab of the truck? 32:36 - How should we reduce hospital exposure? 36:15 - How should we clean the ambulances? 37:46 - What PPE should we wear to clean? 38:12 - A final word from Kevin Lambert   References & Links: BCEHS Doorway Assessment: https://handbook.bcehs.ca/covid-19/covid-19-update-march-23rd/on-scene-doorway-assessment/ Donning PPE video here: https://youtu.be/btrFMvj3Gm8 Hand Hygiene video here: https://youtu.be/J7aILlTnE78 Doffing PPE video here: https://youtu.be/Rro4RJ5Az88 Donning & Doffing Poster: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/ppe/donning-and-doffing/ Hand Hygiene Poster: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/hand-hygiene/cleaning-your-hands/ Cleaning and Disinfecting Resources: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/cleaning-and-disinfection/    

Metered Dose Inhalers (MDIs) & COVID-19 We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest? Please take a moment to fill out our Medic Minutes Survey   Hosts Gord Minaker - PCP-IV, UBC Medical Student Kaela Richardson - Respiratory Therapist, UBC Medical Student   Date of Episode Release: March 23, 2020   Episode Description & Summary In this episode, Gord & Kaela review best practices for the use of Metered Dose Inhalers (MDIs) in the prehospital setting. They discuss the benefit of MDIs over nebulizer medications in the context of the COVID-19 pandemic. Link to BCEHS Education Video on MDIs: (coming soon!) Please refer to the BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca   Contacts: Clinical Questions - clinicalpractice@bcehs.ca Podcast feedback & suggestions - podcast@bcehs.ca    

Metered Dose Inhalers & COVID-19

We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest? Please take a moment to fill out our Medic Minutes Survey Host Ole Olson - Critical Care Paramedic and Paramedic Practice Leader with BCEHS Guests Nina Preto, Ethicist, nina.preto@phsa.ca Alexandra Olmos Perez, Ethicist, alexandra.olmosperez@phsa.ca Date of Episode Release: January 15, 2019 Episode Description & Summary Ethics is a philosophical discipline. It reflects on questions such as: What is valuable? What is good/bad? Is this right/wrong? Why do we think this is right or wrong? When we say we want to act ethically, we mean that we want to act according to our values, to what we think is important. Sometimes, we may encounter a situation in which we are not sure what to do because there are many options or courses of actions to choose from. Our values will help guide us in choosing what the right thing to do is. When the situation is such that we have to choose between two different values, we are encountering an ethical dilemma. In the biomedical ethics field, there are many relevant principles, but there are 4 key principles that constitute the most widespread amongst the contemporary Western tradition: Respect for Autonomy, Beneficence, Non-maleficence, and Justice. In order to have a more clear picture of the situation we are dealing with, there are certain tools that help us understand the situation better, and guide us in breaking down what our options are, and having a thorough analysis of their consequences, but mostly setting the ground for an open discussion, knowing who should be involved and what is really at stake. These are what we call ethics frameworks. The EHS Ethics framework can be found online: https://intranet.bcas.ca/areas/qsrma/qps/pdf/bcehs-ethics-framework.pdf Within an emergency care environment, sometimes there is no time to go through the five steps and engage in discussion with others, and must immediately make a choice and sometimes is hard to make a sound ethically justified decision within seconds. And this is when most providers go to the JAY Tool, which stands for: J – Justifiable: Would I be able to justify my decision. A - Accountable: Would my peers and coworkers perform this action? Do I think other team members would do the same in my situation? Would they make the same choice? Y – You: Would you want this, if you were the patient? To learn more about the BC EHS Ethics Framework or for any ethics related questions please contact the PHSA Ethics Service:  Alice Virani, Director alice.virani@cw.bc.ca Nina Preto, Ethicist nina.preto@phsa.ca Alexandra Olmos Perez, Ethicist alexandra.olmosperez@phsa.ca You can also find more about ethics at PHSA on the POD: http://2pod.phsa.ca/quality-safety/ethics/Pages/default.aspx Question? Comments? Email: podcast@bcehs.ca 

Ethics in Paramedicine

In this episode, Leon Baranowski interviews Mike Christian in a follow-up to Dr. Christian’s Clinical Rounds presentation. He discusses his experiences with London HEMS and gives a unique perspective on exposure to trauma, operational stress, and building resilience. Find the original Clinical Rounds Presentation here: https://youtu.be/WcpEGjKxro0 Host: Leon Baranowski, Paramedic Practice Leader Guest: Dr. Mike Christian, Research & Clinical Effectiveness Lead with London’s Air Ambulancetwitter: @DrMikeChristian , michael.christian@utoronto.ca   We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest?  Please take a moment to fill out our Medic Minutes Survey. Email: podcast@bcehs.ca

Clinical Rounds: Building Resilience to Operational Stress

In this episode, Kaela and Gord talk to Kevin Lambert, CCP and Lead Instructor of Critical Care Education at BCEHS about stroke care. They discuss the basic pathophysiology of stroke and it's mechanisms of injury, including clinical presentations and the use of the FAST-VAN assessment. They identify stroke mimics, prehospital treatment and explain the concept of "hot stroke," including the importance of timelines in hospital treatment. We need your input! Are these podcasts working for you? Do you have an idea for a podcast episode? Know someone that would make an awesome guest?  Please take a moment to fill out our Medic Minutes Survey. Email: podcast@bcehs.ca  

Stroke Care

In this episode, Dr. Floyd Besserer hosts BCEHS Director of Clinical and Professional Practice, Joe Acker, to talk about his 12 days in Mongolia to learn about the emergency medical services system and make recommendations about opportunities for improvement. 

The Mongolia Project

Medic Minutes is a podcast created by paramedics for paramedics. Intended for paramedics who work within BC Emergency Health Services but applicable to any medic keen to learn and advance their skills.

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