McDonalds
What happens if a patient runs away?
Update 911 and say that the patient ran away, but do not chase them even if they tell you to
Explain the travel hours policy, and how much you can claim for meals.
Within Toronto: doesn't matter how long it takes you to get there, you get 45 minutes to the event and 45 minutes from the event (total 1.5 hrs)
Outside of Toronto (mutual aid events): Up to UC or branch discretion
What do you need to do every year to maintain volunteer status?
- 60 duty hours and 40 unit meeting hours
- (for MFRs) 5 CME forms per year
- Attestation Form
- CPR-BLS with AED DR recertification
(bonus points) renew MFR if required, renew PRC if required
Can you smoke tobacco on duty? What about marijuana?
While there is no actual standard for marijuana, smoking marijuana during duty or just before duty is highly unethical and unprofessional, and will breach rules regarding professionalism.
For cigarette smokers, only during authorized breaks and out of public sight (i.e., people should not be able to see a uniformed SJA member smoking)
"Authorized break" means that someone is covering for your post and people know you are unavailable now.
If you require smoking accommodations, you must communicate to the duty coordinator or designate regarding this.
Explain the etiquette surrounding phone use at duties.
It's OK as long as you are not visibly distracted by your phone. Kito to act out some poses...
Individuals may have poor optics on the organization if they see "ambulance people" on their phones. That has a poor connotation on healthcare workers and our organization. The event organizer may not like us and will request other people in the future.
Name 5 occupations that normally, or are required by law, to have a first aid certification.
You cannot name paramedics, firefighters, or police officers, or any occupation related to health care.
Security guards, teachers, city workers, workplace designated first aid attendants, sports coaches, lifeguards, etc
What do we do with DNRs?
Respectfully ignore it, continue CPR, and explain to the person presenting the DNR that the form only authorizes paramedics and firefighters to stop resuscitation, and we are neither of those.
On epaulettes, what do the blue bars, red bars, green bars, and orange bars mean? What does a "red border" mean?
Blue: Paramedic
Red bar: RN
Green bar: RPN
Red border: Medical Doctor (not Dr. Lam, PhD (Music Education))
Orange Bar: MFR
Green flashing light
Do not turn the unit on
An angry person spits on you. What should you do?
Call the SJA event supervisor, or Kito to report this. They will document this incident and advise you to follow up with a physician and to file a police report if you wish
You are presented with a patient with the following history and vitals:
35 year old male who is short of breath after coming out of a burning building.
Pulse = 100 rapid and weak, Resps = 32 shallow and regular, skin is pale cool clammy, SPO2 is 100%, Alert on AVPU scale, pupils 4 PERL
Should you give oxygen to this patient? If so, how and why? If not, why?
Yes you will give 15LPM via NRB. Don't be fooled by SPO2.
Reason 1: Science-y stuff regarding hemoglobin and the binding of gases and the monitor not knowing the difference
Reason 2: The oxygen administration protocol from SJCO says so
Describe the minimum uniform requirements for MFRs.
Describe the minimum uniform requirements for SFA Apprentices.
MFRs: Black MFR shift, issued TAC pants, black shoes. CSA footwear when required.
SFA: Apprentice shirt, black pants (that are not jeans), black shoes. CSA footwear when required.
Long hair must be tied up.
You CANNOT carry unapproved equipment or uniform items with you. This may include: bulletproof vests, "tactical helmets", tourniquets, your own OTC medication of any kind that you intend on handing out, knives (including utility knives) or weapons. You should consult Kito before bringing something that is not outlined in the Uniform Standards Manual.
Explain the rules regarding releasing PCR information at duties.
The patient cannot take the PCR home or take a picture of it. They must request it through the branch and they have to fill out a form.
Other people that are not involved in the "circle of care" may not have access to it either unless lawfully required (warrant, etc.). They should still go through the branch in this case.
Paramedics taking over the patient, or real medical staff taking over the call may have access to it as long as they are directly involved in the care.
What should you do when a doctor comes up to you and starts giving you orders?
Ask them:
Are you a medical doctor licensed in Ontario?
Where do you work?
Do you have a license or identification proving that you are practicing actively with the license?
Will you take full responsibility for the patient?
A very generous community member INSISTS that you take a $50 bill as a tip for your services. You say "no no, we are not allowed to" but they are still shoving it in your face. Explain how you would proceed.
All groups will provide a response, Kito will select the best response as the winner.
You are a volunteer and it goes against the rules to accept tips. You are providing charitable services for the community and it would go against the mission for the organization to provide charitable services by us receiving a personal profit from the services. You can also suggest that they make a donation through the website at sja.ca, register for a first aid course, or purchase a first aid kit if they really support us. If they shove the bill in your pocket... and run away....
You are doing CPR and it's a very hectic situation. 5 people are now filming you and they are clearly live on a platform.
How should you go about this situation? Each team will provide an answer, and Kito will award the points to the team with the best answer.
Unfortunately, if they are not in the way, they are well within their rights to film. They suck. The last thing you want is for you and St. John Ambulance to go viral for starting an altercation with bystanders filming.
If they are touching things and are physically in the way (aside from crowding), then you can tell them to move so you can do your job. But if they are standing around filming, then do your best to cover up the patient to maintain dignity, and stay calm. But also don't screw up.
Security comes up to you asking for a copy of the PCR that you just completed for an employee. You go, "sorry, I cannot release this information due to laws."
Security flashes their security badge and goes: "I am required to collect this information. Let me do my job and give it to me."
How would you respond?
Kito to explain
Walk through the steps on what happens after you use an AED on duty, including what will happen behind the scenes.
1. MFR calls Kito
2. Kito calls the provincial EM officer, Raymond
3. Kito or someone from leadership will deliver a new AED and fresh volunteers to take over if needed
4. Kito debriefs members
5. Kito works with MFRs to ensure that the PCR is documented accurately
6. Within 24 hours post-event, PCR and an AED records download will be submitted to Dr. Wasser
7. Branch contacts Claire Akintoye, the provincial community services manager
8. Lifesaving award application
You are casually talking to someone at a duty. Someone asks you "how long have you been a paramedic?"
You respond: "Oh we actually aren't paramedics, we are St. John Ambulance Medical Responders."
The person in question now gets confused. "But... it says 'ambulance'". "Are you a fraud?" Provide a response the statements, maximum 30 seconds.
All teams will provide an answer, Kito will pick the best team and award the points.
Explain that based on our history, we used to be providing ambulance services in many countries, especially during the war times. Our name is a way of recognizing our history in the past. Our qualification is below the level of a paramedic, but we are fully trained to assist them with their skills when they arrive.
MFR Question: You attend to a patient who is pooooooolllllling with blood. You check their pulse and they are pulseless. You start CPR, and you ask yourself...
Do I apply an AED? Why or why not?
The AED should not be applied to victims in cardiac arrest if there is obvious trauma with gross bleeding. Their cardiac rhythm is seldom ventricular fibrillation and cardiac arrest is due to hypovolemia.
AED assessment delays other necessary interventions and/or rapid transport to an Emergency Department where the resuscitation measures they need are available. Therefore, initiate ventilation and CPR if indicated. If in doubt, and in the absence of other critical intervention, apply the AED and follow the voice prompts. Upon arrival of the paramedics, the paramedic will decide if the defibrillator should be applied subsequent to an assessment.
NOTE: Although victims of electrocution with usually have serious traumatic injuries, you MUST attempt to defibrillate these patients if VSA. These people may be VSA primarily due to an electrical disturbance that can be corrected by the use of the AED.
You are looking after a patient who is just wandering around in a wheelchair. They clearly broke out of a facility, they look like an in-patient.
They are refusing your help, and the more you talk to them, they seem like they have dementia. How would you manage this? What are the rules regarding refusals?
The patient must be aware of the consequences of their actions and must be consulted on what will happen if they refuse your care. While they do not have to SIGN the PCR, you should document it.
In this circumstance, they clearly are incapacitated. Offer to help firmly. Since they cannot deny your consent, you should attempt to stick around and call 911. Be careful of your safety, do not approach any further if they are combative. Note any wristbands or logos on shirts so they may be easily identified by the facility.
BANG! Gunshots emerge in your surroundings. Explain "Run, Hide, Fight" and how you would approach this while on duty.
What about your patient?
Run in the opposite direction from the danger... what about my equipment and my expensive O2 tank?
Hide yourself in a secluded area with locked doors, or out of sight
As a last resort, use whatever APPROPRIATE force necessary to deactivate the threat
https://www.youtube.com/watch?v=5VcSwejU2D0&ab_channel=ReadyHouston