# Advanced Care Paramedic/ACLS



## Badner (28 Mar 2012)

Hey there, civilian paramedic with BC ambulance service been looking at medical professions in the forces. Noticed that med-techs/combat medics only seem to be qualified to a PCP level. My question is, if I enter as an ACP, how will my scope of practice/qualifications transfer over to the forces. Will I still be allowed to practice up to my current skills and abilities/be granted extended parameters? Or will I have to retard my skill set down to that of a standard med-tech? Will having a bachelors degree in health sciences provide any sort of opportunity for officer training/direct entry? 

Any info is appreciated, 
Thanks


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## Adam (28 Mar 2012)

You will not be able to practice or maintain your ACP skills.  If your lucky you may be able to maintain a PCP licence.  The Med Techs scope of practice really depends on where your employed.  Overseas you may have a scope close to an ACP,  In Canada, your Scope of practice will vary from Base to Base and depends on your Base Surgeon (Medical Director), and what the Primary Care nurses feels your Scope should be.  

A Degree will allow you to be a officer.


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## Badner (28 Mar 2012)

Thanks for the reply. So to further on the question (and I know I really should be talking to a recruiter about this, but the one recruiter I talked to on the phone was quite useless in terms of providing helpful insight), if  I was to apply as an officer, how would the recruitment process work? Also, through a bit of research, I noticed that "At the supervisor (Sergeant) level, a Medical Technician is eligible to be selected for training as a Physician Assistant." What is the role of a physicians assistant? 

Also, I have an interest in participating in aero evac, what is the process one would take to move towards a position as an aero-medevac medic?


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## MedCorps (28 Mar 2012)

Aeromedical Evacuation is one of the specialties that a Med Tech can attain.  Once you are in a few years and prove yourself as a Med Tech, as a Cpl you can apply for the 10 week course, realizing that often the course comes with a posting to CFB Trenton in order to be on an aeromedical evacuation flight. Getting selected is a combo of being good at your job, having a boss that likes you and will nominate you for the course, having enough positions on the course for Med Techs, and having position at a flying unit for which you will go into once you have the qualification. There are some people that have done the course never to fly again, but we are trying to move away from that model because of the cost of the course. 

Aeromedical evacuation in this context is fixed wing. They move casualties from field hospitals to staging hospitals (or to Canada) and from staging hospitals to Canada.  

There is also a much shorter specialty for forward aeromedical evacuation which is helicopters.  This specialty often does not require a posting to the Aeromedical Evacuation Flight in Trenton.  They pick people up, often at point of wounding, and move them to a medical facility. This is an operational / exercise position and we do not run a domestic air ambulance service Monday to Friday in the CF.  

Physician Assistant.... 

See the bottom of this page: http://capa-acam.ca/en/Scope_Of_Practice__National_Competency_Profile_55 

It has the Scope of Practice and National Competency Profile. Take this, add on a bunch stuff, and increase the remoteness of the physician that you work for and you will have an idea what CF PAs do.  There are a few PAs here that can speak directly to the job. 

They work as Warrant Officers in leadership and administrative roles. They work as clinicians in clinics, field units, ships, research establishment, dive units, at the aeromedical evacuation flight, and isolated locations like Alert (rotational). They also teach at our CF Health Services Training Centre. 

We are looking for Med Techs.  Having a PCP/ACP already would make you an attractive applicant all other things equal.  Drop on down to a CFRC and put in an application.  

Officer.  Assuming you want to work in the Medical Service and are not a scientist, physiotherapist, social worker, nurse, medical doctor, or pharmacist, we have the Health Care Administrator occupation (HCA).  We are looking for single digits this year for Direct Entry Officer HCAs. People with the right skill sets, attributes, and degrees (generally, Health Care Administration, Business Administration, or Human Resource Management).  Talk to the Recruiting Centre for details. We also sponsor people to go to university to become HCAs, but this number is very low single digits, less than DEO HCAs (in fact, it is even less then officer occupational/component transfer or NCM university training programs).   

Recruitment is the same for Officer and NCM pretty much.  Go to the recruiting centre, fill in a bunch of paperwork, tell them what you want to do (officer and/or NCM), write some tests, get a background check, have a medical inspection, answer a bunch questions in an interview and if all works out you get a job offer for something that you want do.  

I hope that helps.  

MC


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## Hunter (29 Mar 2012)

There isn't much of a requirement for the ACP scope of practice in the CF in a domestic setting.  Most of the calls that would need ALS interventions are for people with conditions that would prevent them from being in the CF in the first place.  However in an operational environment there are some ACP skillsets that you might use, but these are also delegated to QL3/QL5 (PCP) medics.  Needle decompression, cricothyrotomy and initiation of IO access are the three that come to mind off the top of my head.  There's a good possibility of administering naloxone if you are in a place like Afghanistan.  In BC that is a PCP skillset, but here in Ontario it is not only an ACP skill, but it's also a patch point.  Urinary catheters are another ACP skill that you might do a lot in an operational environment.   It's possible that you might need to cardiovert or pace someone, but I think that would be pretty unlikely.  Intubation? Yeah maybe but still rare, certainly not enough to prevent skill fade.  

I would encourage you to join, but I think it's important to manage your expectations.   Don't expect the quality of medical instruction to be of the same calibre as that which you received in college, particularly on your ACP course.  As a QL3 (your first couple of years in the CF) your scope of practice is very limited unless someone makes some exceptions for you.  Don't expect to be carrying/administering any meds. Don't expect to be doing a lot of patient care, that depends entirely on where you are posted.  

Have you ever thought about joining the reserves?  There are a handful of ACPs in the reserves, mostly in Ontario and Alberta.  I've never heard of any ACPs joining the reg force.  By joining the reserves you could continue to make good money as an ACP and keep your skills current, but also get a taste of the military life before you make a full-time commitment.


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## Badner (29 Mar 2012)

Yeah, thanks for the response Hunter,

To be honest, working for a civilian EMS department sounds much more enticing, and interesting than being posted to some ship/base (no offense to all the enlisted medics out there). The high call volume keeps the job interesting, which is why I got into emergency medicine in the first place: the excitement, the rush, and the extremely interesting variety of working conditions, especially as ALS, where you are constantly intercepting BLS units, and almost all your calls are going to be Code 3. It would be different if working in a deployment setting like Afghanistan i'm sure, but joining as reg force for a diminished scope of practice, lower wages, and the ability to be shipped around the country like a rag doll if needed? No thanks... I'll look into the reserves, would be an interesting way to get the best of both worlds like you said.


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## Hunter (29 Mar 2012)

Badner said:
			
		

> ... especially as ALS, where you are constantly intercepting BLS units, and almost all your calls are going to be Code 3.



Here in ottawa most crews are ACP/PCP so ACPs do as many crap calls as everyone else, where someone wants the ambulancetaxi to take them to the hospitalhotel so that the nursewaitress can get them a sandwich


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## mariomike (29 Mar 2012)

Hunter said:
			
		

> Here in ottawa most crews are ACP/PCP so ACPs do as many crap calls as everyone else, where someone wants the ambulancetaxi to take them to the hospitalhotel so that the nursewaitress can get them a sandwich



Sometimes the frequent flyers request their favorite crews.    

Funny 'cuz it's true: 
http://www.youtube.com/watch?v=oT8pkeVJi2c
As long as they walk...  ;D


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