The British Columbia Ambulance Service (BCAS) is the sole ambulance service and provider of pre-hospital emergency care in the province of British Columbia, Canada, and is one of the largest Emergency Medical Services (EMS) services in North America. The BCAS also provides inter-facility patient transfer services in circumstances where a patient needs to be moved between health care facilities. The BCAS has a fleet of over 450 ground ambulances operating from 190 stations across the province. Dispatch centers in Vancouver, Victoria, and Kamloops provide call-taking and ambulance dispatching services to the entire province. In addition, BCAS operates an airevac program that utilizes both fixed-wing and rotary aircraft. As of December 1, 2007, the BCAS employs 2,055 part-time paramedics and 1,395 full-time paramedics for a total of 3,450 paramedics. These figures show an increasing trend in the part-time numbers; note that this includes paramedics that work in dispatch and on the transfer fleet, whether at the EMR, PCP, ITT or ACP qualification, but does not include upper management. There are approximately 315 management employees in the BCAS. Image File history File links No higher resolution available. ... In Ontario, Canada, Crown agency is the name given to any board, commission, railway, public utility, university, manufactory, company or agency, which is owned, controlled, or operated by the Queen in Right of Ontario, or else by the Government of Ontario, or under the authority of the Legislature or the... Motto: Splendor sine occasu (Latin: Splendour without diminishment) Capital Victoria Largest city Vancouver Official languages English (de facto) Government Lieutenant-Governor Steven Point Premier Gordon Campbell (BC Liberal) Federal representation in Canadian Parliament House seats 36 Senate seats 6 Confederation July 20, 1871 (6th province) Area  Ranked 5th Total 944... The examples and perspective in this article or section may not represent a worldwide view. ... For the tax agency in Ireland of the same name, see Revenue Commissioners. ... This article is about work. ... A website (alternatively, Web site or web site) is a collection of Web pages, images, videos or other digital assets that is hosted on one or several Web server(s), usually accessible via the Internet, cell phone or a LAN. A Web page is a document, typically written in HTML... An ambulance in San Jose del Cabo, Mexico A Helicopter used as an Ambulance. ... // Band Info Emergency Care is a local band based in Ann Arbor Michigan. ... Motto: Splendor sine occasu (Latin: Splendour without diminishment) Capital Victoria Largest city Vancouver Official languages English (de facto) Government Lieutenant-Governor Steven Point Premier Gordon Campbell (BC Liberal) Federal representation in Canadian Parliament House seats 36 Senate seats 6 Confederation July 20, 1871 (6th province) Area  Ranked 5th Total 944... The examples and perspective in this article or section may not represent a worldwide view. ... This article refers to the city in British Columbia, Canada. ... This article is about the city of Victoria. ... “Kamloops” redirects here. ... Typical view of the defibrillator operator. ...

History

Prior to 1974, ambulance services in British Columbia were generally uncoordinated. Service was provided by a mixture of volunteer ambulance brigades, fire departments, funeral homes, and private operators. As a result of recommendations made by the Foulkes Commission's report on health care, titled "Health Security for British Columbians" and released in 1973, the Government of British Columbia created the Emergency Health Services Commission (EHSC), which in turn, created the BC Ambulance Service on July 4, 1974.

Governance

In British Columbia, responsibility for the provision ambulance services is granted to the Emergency and Health Services Commission (EHSC) under the auspices of the Health Emergency Act. Under the terms of the Act, the EHSC is considered an agent of the government and as such, holds all responsibility for the provision of ambulance services across the province. The members of the Commission act as a Board of Directors to the BC Ambulance Service. The commission membership consists of health service administrators, medical professionals, and government representatives. The commission meets regularly to provide direction to the BCAS Executive Management Team.

The EHSC has recently taken over responsibliity for the operation of HealthLines Services BC (HLSBC). This includes the BC NurseLine telephone triage service (separate from 9-1-1 services), BC BedLine, which assists physicians when it is necessary to transfer a patient to a higher level of care as well as BC HealthGuide, BC HealthFiles, BC HealthGuide OnLine, and Dial-A-Dietitian.

While the EHSC, and consequently the BCAS, are agents of the government and are able to operate independently, in practice they are part of the BC government's Ministry of Health, which provides one-hundred percent funding for operations.

Organization

There are 190 ambulance stations in British Columbia, including three seasonal stations and the Transfer Fleet. Stations may be staffed with part-time paramedics, part-time and full-time paramedics, or only full-time paramedics, depending on where the station is located. Each station is headed up by a Paramedic Chief, who acts as supervisor for the crew at the station. The Paramedic Chief also handles the day-to-day administrative duties required by the station, including payroll management, overseeing station and ambulance maintenance, and crew scheduling.

Each station falls under the responsibility of a District Superintendent. The District Superintendent has responsibility for the operations of all of the stations within a given district. The size of the district, and the number of stations it encompasses, varies depending on factors such as geography, station size, number of paramedics and others.

Each BCAS district is part of a larger region, which is headed by an Executive Director. Each District Superintendent is accountable to the Executive Director for that specific region. In some regions, a Director of Operations assists the Executive Director with day-to-day activities. The District Superintendents are accountable to the Executive Director of the region, who in turn reports to the Chief Operating Officer of the BC Ambulance Service.

• Vancouver Island Region (Headquarters: Victoria, BC)
• Lower Mainland Region (Headquarters: Vancouver, BC)
• Interior Region (Headquarters: Kamloops, BC)
• Northern Region (Headquarters: Prince George, BC)

The BCAS provincial headquarters is located in Victoria, BC. It is staffed by an executive management team, and other support services. The final responsibility for BCAS operations lies with the service's Chief Operating Officer. The Chief Operating Officer is accountable to the Executive Officer, Emergency & Health Services Commission, who in turn reports to the Board of the Emergency & Health Services Commission.

Dispatch Centres

The BCAS operates four dispatch centres located throughout the province. The Victoria Communications Centre is responsible for all ground ambulance dispatching for Vancouver Island and the Gulf Islands; the Vancouver Communications Centre dispatches all ground ambulances in the Lower Mainland (i.e., Metro Vancouver & the Fraser Valley Regional District), the Sunshine Coast, as far east as Boston Bar and as far north as Pemberton; and the Kamloops Communication Centre dispatches crews to the remainder of the province, including the southern interior (Okanagan, Cariboo & Kootenays) and northern BC (Skeena, Northern Interior & Peace Regions, representing west-central, east-central and northern areas of the province, respectively). The fourth dispatch centre, the Provincial Air Ambulance Coordination Centre (PAACC), is located in Victoria and has responsibility for dispatching of all air ambulance resources, whether they are used for scene responses, or for inter-facility transfers. This article is about the city of Victoria. ... Vancouver Island is separated from mainland British Columbia by the Strait of Georgia and the Queen Charlotte Strait, and from Washington by the Juan De Fuca Strait. ... Map showing the location of the Southern Gulf Islands The Gulf Islands is the name collectively given to the islands in the Strait of Georgia between Vancouver Island and the mainland Pacific coast of British Columbia, Canada. ... Motto: Building a sustainable region Location of Greater Vancouver Regional District in British Columbia Coordinates: , Country Province Region Lower Mainland Seat Burnaby Established 1967 Government [1]  - Board GVRD Board of Directors  - Chair Lois Jackson  - MPs List of MPs Don Bell Dawn Black Raymond Chan John Cummins Libby Davies Sukh Dhaliwal... YK NWT AB USA AK Capital Cariboo Cowichan GVRD Nanaimo Stikine The Fraser Valley Regional District (FVRD) is a regional district in British Columbia, Canada. ... For other uses, see Sunshine Coast. ... Boston Bar is a town in the Fraser Canyon of the Canadian province of British Columbia. ... Pemberton is a town north of Whistler in the Pemberton Valley and has a population of about 2,204. ... “Kamloops” redirects here. ... A view overlooking Skaha Lake in the Okanagan Valley The regional districts that comprise the Okanagan are shown in red. ... The Cariboo is a region of British Columbia along a plateau stretching from the Fraser Canyon to the Cariboo Mountains. ... The Kootenay Region (in common parlance The Kootenays) comprises the southeastern portion of British Columbia. ... This article is about the city of Victoria. ...

Each dispatch centre is staffed with a mixture of Emergency Medical Call Takers (EMCT) and Emergency Medical Dispatchers (EMD). A Dispatch Supervisor provides line supervisory support to dispatch centre staff, with a Director of Communications and Dispatch Superintendents who manage the dispatch centre. Training for EMCTs and EMDs is provided in-house by the BC Ambulance Service.

The BC Ambulance Service utilizes the Advanced Medical Priority Dispatch System (AMPDS) to classify calls and dispatch resources. Star of Life AMPDS stands for the Advanced Medical Priority Dispatch System, and is a piece of computer software used by ambulance services worldwide to prioritise calls by priorty. ...

To report a medical emergency, dial 9-1-1, the emergency telephone number in British Columbia. When dialed from a land line or mobile phone (excluding satellite phone and VoIP service), your phone number and address will be provided to the EMCT and EMD. In the case of cellular phones, only your phone number will be made available, although GPS technology will soon make it possible to locate the nearest cell site and possibly your exact co-ordinates. {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... For other uses, see 911 (disambiguation). ... Many countries public telephone networks have a single emergency telephone number, sometimes known as the universal emergency telephone number or occasionally the emergency services number, that allows a caller to contact local emergency services for assistance. ... A landline or main line is a telephone line which travels through a physical, land-based medium. ... A satellite telephone, satellite phone, or satphone is a mobile phone that communicates directly with orbiting communications satellites. ... IP Telephony, also called Internet telephony, is the technology that makes it possible to have a telephone conversation over the Internet or a dedicated Internet Protocol (IP) network instead of dedicated voice transmission lines. ... Over fifty GPS satellites such as this NAVSTAR have been launched since 1978. ... A cleverly mounted base station on top of an Electricity pylon. ...

Deployment

The current system designates a given station (or 'Operator') as either Metropolitan, Urban, Rural or Remote. A Remote-designated station typically has a call-volume of less than 500 calls per year and is staffed entirely by part-time EMR and PCP-qualified paramedics; Rural-designated stations usually have a range between 500 to 2000 calls per year and may have a full-time or part-time Paramedic Chief and might also have a full-time shift pattern for four full-time paramedics during daytime hours. Urban-designated stations generally have call volumes greater than 2000 calls per year and may range up to and over 10,000 calls. A 'Post' is a station or group of stations that are grouped together based on operational needs. The basic difference between Urban and Metro is that metropolitan posts consist of groups of neighbouring urban posts, each of which has a very high call volume; for example, every station in Vancouver Post is designated Metro. When a post incorporates more than one station, it functions as a unit for the purposes of irregularly-scheduled paramedic deployment (including part-time paramedics attached to the post).

In larger Urban and Metro-designated posts, including stations in Metro Vancouver, the Fraser Valley Regional District (i.e., Abbotsford and Chilliwack), Victoria, Nanaimo, Kelowna, Kamloops and Prince George, ground ambulance service is provided by a mix of PCP and ACP-qualified paramedics. In smaller Urban-designated posts (such as Cranbrook, Nelson, Prince Rupert, Terrace, Fort St John, Vernon, Salmon Arm, Penticton, Campbell River, Port Alberni, Squamish, Whistler, Powell River, Sechelt, Williams Lake and Quesnel) there is a core of four to eight full-time, regularly scheduled paramedics at the PCP level but there is also a heavy reliance on part-time, irregularly scheduled paramedics who are also trained to the PCP qualification. These auxiliary staff traditionally rely on paged call-outs and need not stay at the station but should remain in relatively close proximity in case of a call. Motto: Building a sustainable region Location of Greater Vancouver Regional District in British Columbia Coordinates: , Country Province Region Lower Mainland Seat Burnaby Established 1967 Government [1]  - Board GVRD Board of Directors  - Chair Lois Jackson  - MPs List of MPs Don Bell Dawn Black Raymond Chan John Cummins Libby Davies Sukh Dhaliwal... YK NWT AB USA AK Capital Cariboo Cowichan GVRD Nanaimo Stikine The Fraser Valley Regional District (FVRD) is a regional district in British Columbia, Canada. ... Partial skyline of Abbotsford as viewed from Mill Lake. ... Chilliwack is a Canadian city in the Province of British Columbia. ... This article is about the city of Victoria. ... There are several federal and provincial electoral districts with the name Nanaimo. ... Location of Kelowna within the Central Okanagan in British Columbia, Canada Country Province Regional District Central Okanagan Settled 1879 Incorporated 1905 Government  - Mayor Sharon Shepherd  - Governing body Kelowna City Council  - MP Ron Cannan  - MLAs Al Horning Sindi Hawkins Area  - City 283 km²  (109. ... “Kamloops” redirects here. ... These cutbanks on the Nechako River are Prince Georges signature natural landmark. ... Cranbrook, British Columbia ( ) is a city in southeast British Columbia, seat of the Regional District of East Kootenay. ... Nelson (population 10,000) is a city located in the Selkirk Mountains on the extreme west arm of Kootenay Lake in the southern interior of British Columbia, Canada. ... Orthographic projection centred over Prince Rupert BC Coast, showing Prince Rupert and Vancouver Prince Rupert is a city in the province of British Columbia, Canada. ... Mayor Jack Talstra Councillors Lynne Christiansen Marylin Davies Brian Downie Carol Leclerc Rich McDaniel Brad Pollard Land area 42. ... The City of Fort St. ... Vernon is a city in the south-central region of British Columbia, Canada. ... , Salmon Arm is a city in the interior of the Canadian province of British Columbia that has a population of 16,466 as reported in the BC Stats (2004). ... Penticton ( ) is a city in south central British Columbia between Okanagan Lake and Skaha Lake (at one time known officially as Dog Lake). According to the 2001 census its population is 30,985 (41,574 in the greater area). ... Motto: non mangiamo i cervelli (Enriched by land and sea) Location of Campbell River, British Columbia Coordinates: , Country Canada Province British Columbia Region Comox-Strathcona Founded 1855 Incorporated 1947 Government  - Mayor Roger McDonell  - Governing body Campbell River Council Area  - City 143. ... Port Alberni is a city located in the province of British Columbia in Canada. ... Squamish is a growing community in the Canadian province of British Columbia, located at the north end of Howe Sound. ... Location of Whistler within the Squamish-Lillooet District in British Columbia, Canada Coordinates: , Country Canada Province British Columbia Regional District Squamish-Lillooet Settled 1914 by Mrytle and Alex Philip Incorporated 1975 Government  - Mayor Ken Melamed  - Manager Bill Barratt  - Governing body Whistler Town Council  - MP Blair Wilson  - MLA Joan McIntyre Area... Powell River, British Columbia is a small city on the south mainland coast of British Columbia, Canada, located on the shores of the Strait of Georgia. ... The District of Sechelt is centrally located on the Sunshine Coast of British Columbia. ... Williams Lake also known as BCs Stampede Capital (and jokingly refered to as Willies Puddle) is a city in British Columbia, Canada. ... Quesnel is a city in the Cariboo District of British Columbia, Canada. ...

The first step toward a Metro designation (from Urban) requires a population base of 70,000 to 80,000 people. This will maintain a call-volume around 10,000 calls per year and will warrant the addition of Advanced Life Support (ALS) resources to the station (e.g., Chilliwack). The next step would be to split the calls between two separate stations serving a single community (e.g., Kelowna, Kamloops, Prince George & Nanaimo). Finally, as in the case of Abbotsford, when the call volume for the two stations combined reaches in excess of 20,000 calls, the station is re-designated as a Metro Post. When there are enough Metro Posts in a given region, they are reorganized into a larger comprehensive post like Metro Vancouver or Greater Victoria. This will likely be the case for the Fraser Valley Regional District; that is, Abbotsford, Chilliwack, Mission, Agassiz and Hope may well become a 'Fraser Valley Post'; Kelowna and Nanaimo may not be far behind. Advanced Life Support (ALS) is a treatment consensus for cardiopulmonary resuscitation in cardiac arrest and related medical problems, as agreed in Europe by the European Resuscitation Council, most recently in 2005. ... Chilliwack is a Canadian city in the Province of British Columbia. ... Location of Kelowna within the Central Okanagan in British Columbia, Canada Country Province Regional District Central Okanagan Settled 1879 Incorporated 1905 Government  - Mayor Sharon Shepherd  - Governing body Kelowna City Council  - MP Ron Cannan  - MLAs Al Horning Sindi Hawkins Area  - City 283 km²  (109. ... “Kamloops” redirects here. ... These cutbanks on the Nechako River are Prince Georges signature natural landmark. ... There are several federal and provincial electoral districts with the name Nanaimo. ... Partial skyline of Abbotsford as viewed from Mill Lake. ... Motto: Building a sustainable region Location of Greater Vancouver Regional District in British Columbia Coordinates: , Country Province Region Lower Mainland Seat Burnaby Established 1967 Government [1]  - Board GVRD Board of Directors  - Chair Lois Jackson  - MPs List of MPs Don Bell Dawn Black Raymond Chan John Cummins Libby Davies Sukh Dhaliwal... Greater Victoria (also known as the Greater Victoria Region) is located in British Columbia, Canada, on the southern tip of Vancouver Island. ... YK NWT AB USA AK Capital Cariboo Cowichan GVRD Nanaimo Stikine The Fraser Valley Regional District (FVRD) is a regional district in British Columbia, Canada. ... Partial skyline of Abbotsford as viewed from Mill Lake. ... Chilliwack is a Canadian city in the Province of British Columbia. ... Mission is a Canadian district municipality, in the province of British Columbia and is situated on the north bank of the Fraser River, overlooking the Fraser Valley. ... The District of Kent is a district municipality located about 75 kilometres east of Vancouver, British Columbia. ... Hope ( ) is a community of approximately 7,000 people located at the confluence of the Fraser and Coquihalla rivers in the province of British Columbia, Canada. ... Location of Kelowna within the Central Okanagan in British Columbia, Canada Country Province Regional District Central Okanagan Settled 1879 Incorporated 1905 Government  - Mayor Sharon Shepherd  - Governing body Kelowna City Council  - MP Ron Cannan  - MLAs Al Horning Sindi Hawkins Area  - City 283 km²  (109. ... There are several federal and provincial electoral districts with the name Nanaimo. ...

Air Ambulance

The BCAS is responsible for the delivery of air ambulance services throughout the province of British Columbia. There are four dedicated air ambulance bases in BC, located in Richmond, Kelowna, and Prince George at their respective airports (YVR, YLW, & YXS) while the Infant Transport Team (ITT) is based out of BC Children's Hospital in Vancouver. ITT paramedics handle all of the high-risk infant, child, and maternity transports that take place in BC. The ITT is unique in North America, as the first team to use paramedics to perform transports of these critical patients. BC Childrens Hospital is a medical facility located in Vancouver, British Columbia. ...

The BC Ambulance Service air ambulance fleet consists of six fixed-wing aircraft, five Beechcraft Super King Air 350 turboprops and one Bombardier Learjet 31 jet. Additional aircraft are chartered on an as-needed basis. The BCAS also operates three dedicated air ambulance helicopters. Two Sikorsky S-72 helicopters are based in Vancouver, with a Bell 222 helicopter based in Prince Rupert. In addition, patient transfers are routinely performed by BLS crews in charter aircraft (e.g., Beechcraft King Air 100 turboprops). It has been suggested that this article be split into articles entitled Beechcraft King Air and Beechcraft Super King Air, accessible from a disambiguation page. ... The Learjet 31 is an American ten seat (two crew and eight passengers) twin-engined, high speed business jet. ... Wikipedia:Translation/Sikorsky S-72 Sikorsky S-72 modified as the X-Wing testbed The Sikorsky S-72 was an experimental hybrid helicopter/fixed-wing aircraft developed by helicopter manufacturer Sikorsky. ... A Bell 222 Bell 222U The Bell 222 is a helicopter built by Bell Helicopter Textron. ... Orthographic projection centred over Prince Rupert BC Coast, showing Prince Rupert and Vancouver Prince Rupert is a city in the province of British Columbia, Canada. ... The Beechcraft King Air is a line of twin-turboprop aircraft produced by the Beech Aircraft Corporation (now the Beechcraft Division of Raytheon Aircraft). ...

Licensing & Qualifications

Paramedics qualified in British Columbia are broadly referred to as Emergency Medical Assistants and are licensed by the Emergency Medical Assistants (EMA) Licensing Board (EMALB), a government agency, under one of five categories:

• Emergency Medical Responder (EMR)
• Primary Care Paramedic (PCP)
• Advanced Care Paramedic (ACP)
• Critical Care Paramedic (CCP)
• Infant Transport Team Paramedic (ITT)

EMR and PCP are Basic Life Support (BLS) qualifications while ACP is an Advanced Life Support (ALS) qualification; ITT and CCP include additional ALS endorsements. EMALB protocols are universal protocols which a qualified practitioner may employ at any time, up to his or her license qualification, within the provincial borders, given that the required equipment is at hand. A paramedic in Canada is a highly educated medical professional that brings emergency medicine to the patient in their time of need in their home, in the street or in the vast wilderness of the country. ... A paramedic in Canada is a highly educated medical professional that brings emergency medicine to the patient in their time of need in their home, in the street or in the vast wilderness of the country. ... A paramedic in Canada is a highly educated medical professional that brings emergency medicine to the patient in their time of need in their home, in the street or in the vast wilderness of the country. ... Basic life support (BLS) is a specific level of prehospital medical care provided by trained responders, including emergency medical technicians, in the absence of advanced medical care. ... Advanced Life Support (ALS) is a treatment consensus for cardiopulmonary resuscitation in cardiac arrest and related medical problems, as agreed in Europe by the European Resuscitation Council, most recently in 2005. ...

Since BC EMAs are not governed by a college of paramedics, the EMALB controls all aspects of licensing including protocols, evaluations and fees. There is a new fee schedule (effective April 15, 2007). Written exams now cost $50.00 per attempt and practical exams at the EMR and PCP qualifications cost $400.00; practical exams for ACP qualification cost $500.00. There is also a licensing renewal fee of $50.00, due every five years. There is no cost for licensing at the ITT or CCP levels although so-qualified paramedics are still subject to the 5-year license renewal fee. Legislation exists to allow CCP licensure; however, there are currently no CCP-qualified paramedics in BC.

Emergency Medical Responder

An EMR licensee is qualified to deliver a limited number of medications, under the class of 'symptom relief', including ASA, Nitrous Oxide, Nitroglycerin SL and Oral Glucose. They are also qualified in the use of an Automated External Defibrillator (AED) and may monitor an existing IV line. Their protocols include Cardiac Arrest, Cardiac Chest Pain, Diabetic Emergencies and management of pain using Entonox. An automated external defibrillator, open and ready for pads to be attached An Automated External Defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient,[1] and is able to treat them by application...

Primary Care Paramedic

In addition to the EMR protocols, PCP licensees have protocols for Shortness of Breath (SOB), Anaphylaxis, Narcotic Overdose, an expanded Diabetic Emergencies and a catch-all for patients with a decreased level of consciousness Not Yet Diagnosed (NYD) that combines the Diabetic/Hypoglycemic and Narcotic OD protocols. PCP-qualified paramedics may also be endorsed for intravenous cannulation (PCP-IV) and will have an additional protocol for Hypovolemia as well as enhancements to the anaphylaxis, diabetic, narcotic OD and NYD protocols. Additional PCP-level medications include Salbutamol (Ventolin), Naloxone HCL (Narcan), Glucagon, Epinepherine HCL (Adrenaline), Diphenhydramine (Benadryl), Thiamine (Betaxin), Dextrose 10% and Normal Saline.

Infant Transport Team

ITT paramedics are specifically trained for intensive perinatal, neonatal and pediatric care. In addition to the PCP protocols and medications, they may also administer Acetaminophen, Atropine Sulphate, Magnesium Sulphate, Midazolam (Versed), Sodium Bicarbonate and Out-of-Scope medications with orders from a Transport Advisor. Their additional training and skills include the use and monitoring of Incubators, Endotracheal (ET) Intubation, Intraosseous (IO) Access, Nasogastric (NG) tube insertion and suctioning, Manual Defibrillation, Arterial & Central Line Monitoring, Chest Tube Management, Blood Product Infusion, IV Infusion Devices, 'IV with Medication' Maintenance, Mechanical Ventilation, Foreign Body Removal with Laryngoscope and ET/IO/Rectal Drug Administration.

Advanced Care Paramedic

ACP paramedics have protocols to administer all PCP and ITT medications plus Adenosine, Calcium Chloride, Dextrose 50%, Dimenhydrinate (Gravol), Furosemide (Lasix), Heparin, Ipratropium Bromide (Atrovent), Lidocaine, Morphine Sulphate and Procainamide (Pronestyl). Their additional skills include Cardioversion, Combitube, ETT - CO₂ Monitors, External Jugular Vein Cannulation, External Pacing, IV Colloid/Crytalloid Volume Expanders, Nasopharangeal Airways, Needle Thoracentesis and Surgical or Needle Cricothyrotomy.

Critical Care Paramedic

ACP-qualified paramedics can perform advanced protocols under an 'Airevac' endorsement that roughly equates with a CCP qualification. Airevac-endorsed ACP paramedics may also administer Nitroglycerin IV, Meperidine HCL (Demerol), Nitroglycerin Paste, Pancuronium Bromide (Pavulon) and Out-of-Scope medications with orders from a Transport Advisor. Their additional skills include Bladder Catheterization, Central & Parenteral Line Management, Venous & Arterial Blood Sample Collection, Lab & X-ray interpretation, Transvenous Pacing, 12-Lead ECG, Venous Pressure Monitoring, Arterial & Central Line Monitoring, Chest Tube Management, Blood Product Infusion, Mechanical Ventilation.

Note that, while there are some areas of overlap between ACP and ITT, the additional ITT 'Airevac' class of skills that are not included in the standard ACP skill-set are Arterial & Central Line Monitoring, Chest Tube Management, Blood Product Infusion, Mechanical Ventilation and Out-of-Scope Medications by orders. Strictly speaking, the only skill not performed by Airevac-Endorsed ACP (i.e., CCP) paramedics is Incubator usage and monitoring.

Training

EMR training is available through a variety of instructional agencies throughout the province. EMR courses that are approved by the EMA Licensing Board include those offered by the Paramedic Academy of the Justice Institute of BC, the Academy of Emergency Training, EMP Canada, Life Support British Columbia, First Aid Certified Training Systems and Malaspina University College Centre for Continuing Studies.

Primary Care Paramedic training is offered by both the Paramedic Academy and the Academy of Emergency Training. Advanced Care Paramedic training is only available through the Paramedic Academy. All ITT and Airevac training is conducted 'in-house' by the BCAS.

The EMA Licensing Board maintains a list of the approved training courses available to potential students. Those students who do not complete one of the approved courses will not be permitted to apply for a licensing examination.

Labour Relations

Ambulance paramedics, emergency medical call-takers, and emergency medical dispatchers are members of the Ambulance Paramedics of British Columbia (APBC), Local 873 of the Canadian Union of Public Employees (CUPE). Provincial headquarters and administrative staff are members of the British Columbia Government Employees Union (BCGEU).

Hiring Process

The basic requirements to become employed by the BCAS as of August 15, 2007 are:

• A valid EMR, PCP, ITT or ACP license issued by the Emergency Medical Assistants Licensing Board;
• A valid Class 1, 2 or 4 BC Driver's License. If Class 4, then 'unrestricted' is preferred.
• Proof of a 'safe and competent' driving history as demonstrated by a Driver's Licence Abstract;
• A CPR Level 'C' (or HCP) certificate, valid within one year, also known as "BCLS";
• Legal entitlement to work in Canada;
• At least 19 years of age;
• Grade 12 Graduation Diploma or equivalent;
• Satisfactory Criminal Record Search and Criminal Record Review Act Search;
• Fit to safely perform the duties of a paramedic as measured through a medical and physical pre-employment assessment;
• Be of good character;
• Be available on a regular basis for ambulance duty.

At this time, EMR-qualified staff are only permitted to work in remote and rural stations and must upgrade to PCP if they wish to further their career with the BCAS, including lateral transfers to an Urban or Metro-designated station on a part-time basis or application for a full-time posting. The exceptions to this rule include applications to one of the Dispatch Centres or to the Metro Vancouver Transfer Fleet, both of which require only an EMR qualification; these are internal applications for current BCAS employees only.

If the above requirements are not able to be fully met, the applicant can still contact a paramedic chief in their local community for further information on applying. For example, in cases of extreme staff shortages, an attendant may be hired as a "Driver Only" if he or she holds only a Level 3 Occupational First Aid (OFA 3) Certificate or equivalent (OFA 3 is not a prerequisite for an EMR license but it is the current industry standard in BC for remote or high-risk workplaces).

With the imminent abolishment of mandatory retirement, paramedics may work past the age of 65 as part-time employees. Once they retire from service, they must be off work for a period of one month after which they may reapply to become employed by the BCAS in a part-time capacity; it is the pension corporation that requires a formal severance of employment prior to the pension benefits being activated. The details of this process have yet to be fully fleshed out.

On average, it takes approximately 3 to 6 months before an applicant is granted an interview. The interview consists of a behavioural interview with a panel of two to three paramedic chiefs (and may include a Regional Superintendent or HR personnel) and is approximately 1 hour long. It may be held at a regional Human Resources office or at a given ambulance station where the applicant is under consideration. The interview follows the STAR (Situation, Task, Action, Result) format. If the applicant has not yet completed a PCP program, there will also be a written exam based on OFA 3 knowledge of first aid and anatomy. After an applicant completes the interview he or she will not find out the results for another 1-3 months. If unsuccessful at the interview stage, the applicant may be told he or she cannot re-apply for a period of 6 months. The STAR (Situation, Task, Action, Result) format is a job interview technique used by interviewers to gather all the relevant information about a specific capability that the job requires. ...

If the applicant passes the interview, they are entered into the hiring pool and ranked according to their score on the written exam and interview. From this point, the prospective employee may be contacted by a paramedic chief that is hiring. After passing the interview stage, a physical fitness assessment, a medical assessment and two criminal record checks will be conducted. Assuming all goes well, the applicant is then hired into the service at a specific ambulance station, called a 'primary operator'. Once issued an employee number, they are deemed eligible to work and the employee enters into a six-month probationary period. If the applicant is hired as underqualified (i.e., hired without a Class 4 driver's license or other specific training), conditions of probation may be imposed such that the person must obtain certain qualifications before their probation is up or they may be released from the service. During probation, a paramedic may not move to another station (called a lateral transfer) or work at any other BCAS station (often called working at a 'secondary operator'). The probationary period may be extended at the discretion of the Executive Director; this requires both the signature of the Paramedic Chief and the District Superintendent, as well as notification to the individual prior to the extension.

Rank & Qualification Insignia

The BC Ambulance Service is a paramilitary organization and as such, has a similar rank structure to most police or fire departments. The medical qualifications of a uniformed member are denoted with collar insignia, commonly known as 'collar dogs', while rank is denoted using epaulettes. BCAS qualification insignia has not yet caught up to the new license levels of EMR/PCP/ACP/CCP and as such, current collar insignia is out of date. Past insignia had paramedics qualified at the EMA 1 or EMA 2 levels provided bronze and silver circles, respectively, forming the BCAS logo, along with a bar below denoting the EMA 1 (now EMR) or EMA 2 (now PCP) qualification. EMA 3 - Advanced Life Support (now ACP) and EMA 3 - Infant Transport Team paramedics were recognized with gold cauducei, with either "ALS" or "Neonatology" imprinted upon them. Emergency Medical Dispatchers (EMDs) and Emergency Medical Call Takers (EMCTs) presently wear gold and silver shields, respectively.

For rank insignia, field paramedics and dispatchers wear a blank epaulette holder. Paramedics and dispatchers who hold the position of Paramedic Chief, Dispatch Officer or Charge Dispatcher, wear a black epaulette with three gold stripes. District Supervisors, Dispatch Supervisors, Provincial Special Program Managers/Advisors wear the same coloured epaulette, with four gold stripes. Ranks above District Supervisor are management positions and are distinguished by a shoulder flash that is navy blue, with a navy blue trim, as well as a varying number of pips on their epaulette. District and Platoon Superintendents wear an epaulette with three pips, Directors of Operations wear one pip and one crown and the Executive Director of a region will wear two pips plus a crown.

Shoulder flashes for field staff are royal blue with yellow trim, and include the British Columbia Coat of Arms, with the words "Ambulance" above, and "British Columbia" below, in white. Shoulder flashes for management personnel are navy blue with a navy blue trim. The layout of the shoulder flash is the same for both.

Each station and dispatch centre has a staff member designated as its Occupational Safety & Health representative. These paramedics and dispatchers are identified with a navy epaulette with a single royal blue bar. Staff who are designated as OSH representatives hold no supervisory authority, but are available to assist staff with safe work practices.

References

BC Ambulance Service Official Site

Ambulance Paramedics of BC, CUPE Local 873 Official Site