CERN-RCRSP 2019 AGM & Paramedic Research Symposium in Vancouver – May 6, 2019

The 2019 CERN-RCRSP will be held on the afternoon of Monday, May 6, 2019 at UBC Robson Square in Vancouver, BC. The Symposium runs from 1230 to 1800.


Highlights of the CERN-RCRSP Symposium agenda are the following:


 Key note address exploring key concepts and trends in Big Data, and how these can inform EMS and paramedicine research in Canada
 Presentations describing current data-related research initiatives in Canadian EMS and paramedicine
 Poster presentations from researchers across Canada
 Updates on EMS- and Paramedic-related research from across the country
 Presentation of this year’s Canadian EMS Research Mentorship Award
 CERN-RCRSP Annual General Meeting


Registration is free and open to anyone interested in Paramedic research! Click here to register. Participate in the 2019 CERN-RCRSP Symposium: Call for Abstracts and Research Updates
Poster Abstracts


CERN-RCRSP is now accepting abstracts that explore both the Symposium theme of Big Data and Paramedicine and research in EMS and Paramedicine broadly.


An abstract review committee will invite a limited number of abstracts for poster presentation or an oral presentation at the 2019 CERN-RCRSP AGM and Symposium. Abstracts should include:


 Primary presenter’s name and contact information
 Title
 Short description (maximum 350 words) summarizing your research and/or its key points


Please submit your EMS and Paramedicine Research Abstracts to admin@cern-rcrsp.ca NOW!

SPECIAL ANNOUNCEMENT: BCPA Education & Research Symposium – Live Webinar Access

The British Columbia is pleased to announce that thanks to our partnership with the Justice Institute of BC we are now going to be able to provide live webinar access to those members that are not located in the lower mainland.

As with regular tickets, webinar access is FREE to all members or available for purchase online.

Letter of Support for Paramedic Higher Education & Research, BCPA Advisor Dr. Yoon


RE: University Education and Research Programs in Paramedicine


To Whom It May Concern:


I am a Clinical Professor within the Department of Emergency Medicine at the University of British Columbia. As an Emergency Medical Services (EMS) physician, I have been involved in the operations, education, research and promotion of paramedic practice for the last 20 years. It has been my privilege and honour to have worked and to continue to work with numerous talented, dedicated, and inspiring paramedics. I am an enthusiastic supporter of paramedics and a stalwart advocate for advancing paramedicine as a profession. I strongly assert that the need for university level academic programs specific to paramedicine is vitally important to not only the profession, but to the quality of out-of-hospital medical care.


Paramedicine has evolved relatively quickly as a distinct body of knowledge and skills that continue to play a critical role in health care around the globe. University level degree paramedicine programs have been well established in several other countries including Australia, New Zealand, Ireland, South Africa, the United Kingdom, and the United States. Numerous medical schools internationally have recognized EMS as a distinct and major subspecialty of emergency medicine with academic divisions and centres that specialize in out-of-hospital care education and research. Paramedicine is an essential and prominent discipline for virtually all military forces of the world. In this context, the British Columbia Paramedics Association is championing an effort to persuade universities and other organizations to initiate and sustain academic programs specific to paramedicine. We are fortunate to have a critical mass of paramedics who are keenly dedicated and passionate about formalizing paramedicine as an academic discipline. In order to achieve that, university administrations must recognize that our BC paramedics require an organizational vehicle that can establish degree programs, research infrastructure, and an academic milieu that supports excellence in paramedic practice for not only the health care demands of today, but beyond.


We all acknowledge that quality in health care stems from support and achievement in clinical delivery, education, research, innovation and community engagement. We have witnessed paramedic practice in the province move beyond 911 emergency responses and inter-facility patient transfers and into community paramedicine, special operations (including mass gatherings, event medicine and tactical support), disaster management, environmental medicine, HAZMAT management, public health and many other areas of health care. We rely on paramedics to be the front-line providers for mass casualty incidents, pandemics involving substance use and infectious diseases, and time-sensitive life-saving procedures. It is abundantly clear that paramedics are playing a highly prominent and important role in the delivery of health care, but in this province and generally in this country, they are insufficiently supported by our academic institutions.


Paramedics are highly motivated and passionate health care professionals who possess a dedication to life-long learning, inter-disciplinary collaboration, research and clinical excellence. It is long past due for academic institutions and other decision-makers in this province to provide these professionals a formal academic environment to enable them to strengthen and sustain their profession, just like other health professions. Our society takes it for granted that in any person’s moment of medical need, paramedics will be there to use their knowledge and skills to render immediate aid and comfort. I ardently argue that all of us who benefit daily from the security, safety and clinical care that paramedics are always ready to provide us should be doing our best to support paramedicine.
Sincerely,


Philip Yoon, MD, MBA, CCFP(EM), FCFP
Clinical Professor, Department of Emergency Medicine, University of British Columbia
Emergency Physician, Royal Columbian & Eagle Ridge Hospitals, Fraser Health
Reserve Medical Officer, 1 Canadian Field Hospital – Ottawa Detachment, Canadian Armed Forces Medical Director, EMS Physician Online Support, British Columbia Emergency Health Services
Vice-Chair, Emergency Medical Assistants Licensing Board, Ministry of Health, Province of British Columbia

Longer prehospital time was not associated with mortality in major trauma. A retrospective cohort study.

(Photo Credit: Surrey Now-Leader)

Just released in the Journal of Pre-Hospital Emergency Care:

https://www.tandfonline.com/doi/abs/10.1080/10903127.2018.1551451?journalCode=ipec20&

Commentary:

As more and more research presents on the previously perceived validity of the “Golden Hour” of trauma, this research article provides opportunities to consider a balanced approach of critical interventions versus a purely “load and go” approach.  After many years of research showing reduced scene times are the defining factor, much of what is happening with advanced critical interventions with programs such as London HEMS and others, there seems to be a new trend toward advanced practitioners being the defining factor.  This is something that we need to watch closely and participate in further research.

An example of an important question; Would advanced critical care practitioners in rural environments capable of treating severely life threatening conditions in the absence of a local trauma centre be better than rapid transport alone to a local emergency department?  Recent Helicopter EMS (HEMS) studies have shown that advanced practitioners are perhaps the defining factor in those that are survivable and have not already  declare themselves unviable.

Does this support the direction for the future of paramedic practice in British Columbia?

Quote from the study offers some thoughts:

“Our finding of an association between longer on-scene times and longer LOS in those who survived at least 30-days could be attributed to these patients being those who had their immediate life threats corrected in the additional time spent on-scene and thus were less
likely to die.”

Objective: To determine the association between prehospital time and outcomes in adult major trauma patients, transported by ambulance paramedics.

Methods: A retrospective cohort study of major trauma patients (Injury Severity Score >15) attended by St John Ambulance paramedics in Perth, Western Australia, who were transported to hospital between 1st January 2013 and 31st December 2016. Inverse probability of treatment weighting (IPTW) using the propensity score was performed to limit selection bias and confounding. The primary outcome was 30-day mortality and the secondary outcome was the length of hospital stay (LOS) for 30-day survivors. Multivariate logistic and log-linear regression analyses with IPTW were used to determine if prehospital time of more than the one hour (from receipt of the emergency call to arrival at hospital) or any individual prehospital time interval (response, on-scene, transport or total time) was associated with 30-day mortality or LOS.

Results: A total of 1,625 major trauma patients were included and 1,553 included in the IPTW sample. No significant association between prehospital time of one hour and 30-day mortality was found (adjusted odds ratio 1.10, 95% confidence interval (CI) 0.71-1.69). No association between any individual prehospital time interval and 30-day mortality was identified. In the 30-day survivors, one-minute increase of on-scene time was associated with 1.16 times (95% CI 1.03-1.31) longer LOS.

Conclusion: Longer prehospital times were not associated with an increased likelihood of 30-day mortality in major trauma patients transported to hospital by ambulance paramedics. We found no evidence to support the hypothesis that prehospital time longer than one hour resulted in an increased risk of 30-day mortality. However, longer on-scene time was associated with longer hospital LOS (for 30-day survivors). Our recommendation is that prehospital care is delivered in a timely fashion and delivery of the patient to hospital is reasonably prompt.

Disclaimer

As a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also.

BCPA President’s Message [November 2018]

President’s Message [November 2018]

Welcome to the British Columbia Paramedic Association. After over 44 years of paramedic practice in the province of BC, the time has finally arrived for paramedics to take control of their own profession. Professional Leadership, Clinical Practice Excellence, Higher Education, and Paramedic Research will form the basis of this non-partisan advocacy group. I’m proud to be a member of one of the most passionate, patient focused, professions in healthcare. I’m more proud to play a role in giving paramedics the voice of professional advocacy they have historically been without.

Moving forward members can expect the BCPA to advocate for improved education (for new and existing practitioners), improved clinical practice, paramedic practice research, and a self-regulated professional college. As part of this plan, members can expect to see EMALB approved continuing education material, future symposiums focused on clinical practice, advanced education program development advocacy, and paramedic driven research. None of this can happen without membership support. At this critical start-up phase I implore every member to take on as active a membership role as possible. The BCPA board will be seeking educational content creators, advisory board members in all areas of practice, research coordinators, and governance experts. The success of the association relies on the participation of the membership.

Paramedics spend their entire careers caring for the needs of others. It’s time to continue the exceptional care paramedics provide their patients by caring for the needs of the paramedic profession.

Welcome aboard everyone,

Ed Peters

 

BCPA Research Agenda – Why the BCPA?

How does one become a researcher? Or, more importantly, a paramedic researcher? How many paramedics consider themselves a reasercher? Do paramedics contribute to their own unique body of knowledge to enhance patient care and safety, in the specific work environments of pre-hospital, out-of-hospital care and transport medicine? Do paramedics as practitioners translate knowledge to their practice as a result of paramedic led research?

These are all questions that drive the board of directors of the British Columbia Paramedic Association. But, before we look at these questions, let’s first consider why a paramedic association?

There are varied types of representation or regulatory bodies for paramedics in Canada and BC. There are labour unions, licensing boards, employers, and in some provinces self-regulatory bodies know as professional colleges, or a College of Paramedics.

A professional association is meant to be an independent entity, in our case, a corporate (not-for-profit) society under Societies BC. An association’s focus, should be on representing the profession of paramedicine. We do not represent paramedics to an employer for the purposes of wages or working condition, and we should not have conflicts of interest or bias for any one employer. Those interests belong to other representatives. An association should be focused on outcomes that protect and enhance the care to those we serve.

The purpose of an association is to ensure optimal patient care and safety to the patients we serve in our unique work environment, with our unique scope of medical practice, through development of the profession and paramedic professionals, regardless of their employer.

In British Columbia Paramedics carry out many different roles and although the largest employer is BCEHS, there are paramedics that work for the Canadian Military, Search and Rescue Agencies, Ski Patrol, Private Emergency Providers, Hospitals, Corrections Services and Public Health Agencies. Our interest is in how paramedics as a profession can best serve patients through development of our unique body of knowledge, in the environment with which we work, and methods that we use to deliver care to those in need.

The British Columbia Paramedic Association as an initial act by the board has adopted the pillars of professionalism for our association. These are: Professional Leadership, Clinical Practice Excellence, Higher Education, and Paramedic Research. All of these are key elements to professional accountability and ultimately professions with self-regulation. We will explore the associations values and goals in these areas in future articles.

So, let us explore the research agenda a little bit more.

How does one become a researcher or paramedic researcher? There are several types of researchers. The main thing that researchers have in common is development through university academic programs. Some researchers are post-graduate students, some are practicing clinicians, some are professors or academic researchers and some are employed specifically in health care institutions or businesses in research roles. There are very few, if any, actual paid employment roles for paramedic researchers, nor is there a faculty of paramedicine in Canada that staffs academic paramedic researchers. There are some paramedic researchers in academic roles, there are some as post graduate students, there is one in an employment position, and there are many that are practicing clinicians unofficially in ad-hoc research roles participating in various projects. We strive to enhance the research opportunities in paramedicine to better enhance the practice, safety, education and knowledge of the profession and therefore care and safety of patients in our unique environment.

While we have successfully delivered paramedic service to the public for several decades in Canada with an exemplary world-wide reputation, It has typically been as a public safety service or a sub-specialty or extension of emergency medicine, but not as a fully matured health care discipline. This model has served our patients well, but, some of what we have learned is that because things are done certain ways in a hospital, does not necessarily mean that it works the same or has the same benefits or risks in the paramedic environment. Another aspect that we have learned is that the public safety model does not take full advantage of health care system integration in the best interest of the patients journey to optimal care. As well, we have learned that in health care, inter-disciplinary teams of varied practitioner skill-sets and experiences, contribute greatly to patient care, safety and overall system performance.

Which brings us to the role of the British Columbia Paramedic Association in the pursuit of paramedic research. First, we are advocates for the patient and developing paramedic research to enhance care and safety for patients in our unique work environment. Second, paramedics who know this work and provide this care, are best to be engaged to look at the clinical and operational factors that contribute to enhanced patient care delivery in our unique clinical environment. Third, We can provide an independent and focused environment to support paramedic researchers and their development. As an independent corporate entity, without labour interests, we can apply for grants, subsidies, enter into agreements and partnerships to participate; fund; and support paramedics as researchers and their projects. Our focus is on the profession, for the patients.

In development of our research agenda we will enhance the educational opportunities for paramedicine as an academic faculty with opportunities for post-graduate research and university education. Work with any number of employers or agencies with varied paramedic work environments, and develop expertise in knowledge translation for the unique care and environment that paramedics work within.

BCPA already has paramedic researchers as inaugural board directors and members who sit with various research groups such as The McNally Project and the Canadian EMS Research Network. Our leaders have, or are pursuing higher levels of university education and conducting post-graduate research. Our goal is to bring this paramedic led education and research to British Columbia. The unfortunate aspect of those leading the way is that many are contributing to the body of knowledge abroad, taking their courses and conducting research in countries such as the United Kingdom and Australia that have already established university faculties in Paramedicine. In order to best benefit the patients of British Columbia, we need to bring this talent home to research and develop paramedicine in BC within our BC system.

The gold standard of clinical and academic research in most fields is having a peer reviewed journal to submit your research for evaluation and publication. An extended goal of the BCPA research agenda is to work with other associations and professional college’s throughout Canada to establish a Canadian Journal of Paramedicine and share our expertise by participating on the editorial board evaluating the most current paramedic research that ends up being produced in Canada.

Finally, with a desire to be a leader in paramedic research, it is our goal to showcase British Columbia Paramedic research, Canadian Paramedic research and provide learning opportunities for the paramedics of BC through an annual research symposium and Paramedic Gathering (Conference).

Currently, all of these things are  a spectacular ambition with some dedicated front line paramedic clinician leaders. However, with the extremely motivated and passionate team that has come together, we have the right mix of people to move these goals forward. We look forward to engaging with paramedics throughout BC to participate with the association, especially in areas of interest around our four pillars; Professional Leadership, Clinical Practice, Higher Education, Paramedic Research.