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60-558: The Alexander Grantham was a fireboat operated by the Fire Services Department of Hong Kong . It was named after Governor of Hong Kong , Sir Alexander Grantham . The boat has since retired from service and been replaced by other vessels. On 10 March 2006, the fireboat was successfully hoisted into its new permanent home in the Central Concourse of Quarry Bay Park , where it has been converted into

120-647: A physician medical director , often with the advice of a medical advisory committee composed of paramedics and other health professionals. In California, for example, each county's local emergency medical service agency (LEMSA) issues a list of standard operating procedures or protocols, under the supervision of the California Emergency Medical Services Authority . These procedures often vary from county to county based on local needs, levels of training and clinical experiences. New York State has similar procedures, whereas

180-755: A rigid-hulled inflatable boat or borrow boats from local rescue agencies (EMS, Coast Guard, military). The first recorded fire-float was built in 1765 for the Sun Fire Insurance Company in London. This was a manual pump in a small boat, rowed by its crew to the scene of the fire. A similar craft was built in Bristol by James Hillhouse for the Imperial Fire Insurance Office in the 1780s. All fire fighting in Bristol

240-478: A PCP and ACP may run 40–50 medical codes per year, a CCP may run 1–2 in an entire career. IV/IO starts are nearly non-existent in the field and for this reason CCPs are required to attend nearly double the amount of time in classroom situations or in hospital to keep current. In addition to this, they are trained for other skills such as medication infusion pumps, mechanical ventilation, and arterial line monitoring. CCPs often work in fixed and rotary wing aircraft when

300-434: A benchmarking document to permit inter-provincial labour mobility of practitioners, regardless of how titles are specifically regulated within their own provincial systems. In this manner, the confusing myriad of titles and occupational descriptions can at least be discussed using a common language for comparison sake. Most providers that work in ambulances are identified as "paramedics" by the public. However, in many cases,

360-465: A clinical lead working alongside an emergency care assistant or as assistants themselves to a paramedic. As the role does not have a single defined scope, the skills they have can include: The term emergency medical technician is not commonly used by members of the public in the United Kingdom. Instead, it is common for all ambulance personnel to be referred to as "paramedics", although

420-1035: A few additional medications. Advanced care paramedic (ACP) is a level of practitioner that is in high demand by many services across Canada. However, Quebec only utilizes this level of practice in a very limited fashion as part of a pilot program in Montreal. The ACP typically carries approximately 20 different medications, although the number and type of medications may vary substantially from region to region. ACPs perform advanced airway management including intubation, surgical airways, intravenous therapy, place external jugular IV lines, perform needle thoracotomy, perform and interpret 12-lead ECGs, perform synchronized and chemical cardioversion, transcutaneous pacing, perform obstetrical assessments, and provide pharmacological pain relief for various conditions. Several sites in Canada have adopted pre-hospital fibrinolytics and rapid sequence induction, and prehospital medical research has permitted

480-502: A given level of paramedic practice, each province retains ultimate authority in legislating the actual administration and delivery of emergency medical services within its own borders. For this reason, any discussion of paramedic practice in Canada is necessarily broad, and general. Specific regulatory frameworks and questions related to paramedic practices can only definitively be answered by consulting relevant provincial legislation, although provincial paramedic associations may often offer

540-455: A great number of variations in the scope of practice for ACPs. Current programs include providing ACPs with discretionary direct 24-hour access to PCI labs, bypassing the emergency department, and representing a fundamental change in both the way that patients with S-T segment elevation myocardial infarctions (STEMI) are treated, but also profoundly affecting survival rates, as well as bypassing closer hospitals to get an identified stroke patient to

600-399: A limited set of medications (including oxygen, epinephrine, dextrose, naloxone, albuterol, ipratropium bromide , glucagon, nitroglycerin, nitrous oxide , and acetylsalicylic acid). Some areas may add to the scope of practice, including intravenous access, insertion of supraglottic airway devices, and CPAP . Training requirements and treatment protocols vary from area to area. Advanced EMT

660-660: A loaded displacement of 511 tonnes, it has taken part in numerous fire-fighting and rescue operations, including the Seawise University fire in 1972, the Eastern Gate fire in the 1980s and the New Orient Princess fire in 1993. Alexander Grantham is also a great example of the Hong Kong shipbuilding industry's achievements in the early 1950s. It showcases Hong Kong's sea salvage history of

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720-549: A major concern in light of the COVID-19 pandemic . In response, the U.S. Centers for Disease Control and Prevention and other agencies and organizations have issued guidance regarding workplace hazard controls for COVID-19 . Some specific recommendations include modified call queries, symptom screening, universal PPE use, hand hygiene, physical distancing, and stringent disinfection protocols. Research on ambulance ventilation systems found that aerosols often recirculate throughout

780-600: A regional medical-advisory council (REMAC) determines protocols for one or more counties in a geographical section of the state. Treatments and procedures administered by paramedics fall under one of two categories, off-line medical orders (standing orders) and on-line medical orders. On-line medical orders refers to procedures that must be explicitly approved by a base hospital physician or registered nurse through voice communication (generally by phone or radio) and are generally rare or high risk procedures (e.g. vasopressor initiation). In addition, when multiple levels can perform

840-416: A sense to medical school clinical rotations, EMT students are required to spend a required amount of time in an ambulance and on a variety of hospital services (e.g. obstetrics , emergency medicine , surgery , intensive care unit , psychiatry ) in order to complete a course and become eligible for the certification and licensure exams. The number of clinical hours for both time in an ambulance and time in

900-568: A set of protocols, which are typically written by a physician . EMTs are exposed to a variety of hazards such as lifting patients and equipment, treating those with infectious disease, handling hazardous substances, and transportation via ground or air vehicles. Employers can prevent occupational illness or injury by providing safe patient handling equipment, implementing a training program to educate EMTs on job hazards, and supplying PPE such as respirators, gloves, and isolation gowns when dealing with biological hazards. Infectious disease has become

960-574: A simpler overview of this topic when it is restricted to a province-by-province basis. In Canada, the levels of paramedic practice as defined by the National Occupational Competency Profile are: emergency medical responder (EMR), primary care paramedic, advanced care paramedic, and critical care paramedic. Regulatory frameworks vary from province to province, and include direct government regulation (such as Ontario's method of credentialing its practitioners with

1020-476: A stroke centre. Critical care paramedics (CCPs) are paramedics who generally do not respond to 9-1-1 emergency calls, with the exception of helicopter "scene" calls. Instead they focus on transferring patients from the hospital they are currently in to other hospitals that can provide a higher level of care. CCPs often work in collaboration with registered nurses and respiratory therapists during hospital transfers. This ensures continuity of care. However, when acuity

1080-647: A transporting ambulance. EMT training programs for certification vary greatly from course to course, provided that each course at least meets local and national requirements. In the United States, EMRs receive at least 40–80 hours of classroom training and EMTs receive at least 120–300 hours of classroom training. AEMTs generally have 100-300 hours of additional classroom training beyond the standard EMT training. Paramedics are trained for 1,500–2,500 hours or more. In addition to each level's didactic education, clinical rotations are typically also required. Similar in

1140-441: A variety of medical procedures such as endotracheal intubation, rapid sequence induction , cricothyrotomy , fluid resuscitation , drug administration, obtaining intravenous and intraosseous access, manual defibrillation, electrocardiogram interpretation, capnography, cardioversion , transcutaneous pacing , pericardiocentesis , thoracostomy , ultrasonography , and blood chemistry interpretation. An ambulance with only EMTs

1200-512: Is a level of practice that is least comprehensive (clinically speaking), and is also generally not consistent with any medical acts beyond advanced first-aid and oxygen therapy, administration of ASA, I.M. epinephrine and glucagon, oral glucose and administration of intranasal Narcan with the exception of automated external defibrillation (which is still considered a regulated medical act in most provinces in Canada). Primary care paramedics (PCP) are

1260-505: Is a nonprofit organization which offers certification exams based on NHTSA education guidelines and has been around since the 1970s. Currently, NREMT exams are used by 46 states as the sole basis for certification at one or more EMT certification levels. A NREMT exam consists of skills and patient assessments as well as a written portion. On June 12, 2019, the NREMT changed the rules regarding age limits for EMTs, AEMTs, and paramedics. There

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1320-416: Is considered a basic life support (BLS) unit, an ambulance utilizing AEMTs is dubbed an "intermediate life support" (ILS), or "limited advanced life support" (LALS) unit, and an ambulance with paramedics is dubbed an " advanced life support " (ALS) unit. Many states allow ambulance crews to contain a mix of crews levels (e.g. an EMT and a paramedic or an AEMT and a paramedic) to staff ambulances and operate at

1380-537: Is manageable by a CCP or a registered nurse or respiratory therapist is not available, CCPs will work alone. Providing this care to the patient allows the sending hospital to avoid losing highly trained staff on hospital transfers. CCPs are able to provide all of the care that PCPs and ACPs provide. That being said, CCPs significantly lack practical experience with advanced skills such as IV initiation, peripheral access to cardiovascular system for fluid and drug administration, advanced airway, and many other techniques. While

1440-413: Is no longer an age limit for registered personnel. However, applicants must successfully complete a state-approved EMT course that meets or exceeds the NREMT standards within the past two years of applying. Those applying for the NREMT certification must also complete a state-approved EMT psychomotor exam. It is possible for the candidate to be refused access to a state-approved course due to their age within

1500-431: Is the level of training between EMT and paramedic. They can provide intermediate life support (ILS) care including obtaining intravenous or intraosseous access, basic cardiac monitoring, fluid resuscitation , capnography, and administration of some additional medications. Paramedics typically represent the highest degree of pre-hospital medical provider, providing advanced life support (ALS) care. Paramedics perform

1560-675: Is unavailable, for example, due to earthquake breakage of water mains, as happened in San Francisco due to the 1989 Loma Prieta earthquake . Some modern fireboats are capable of pumping tens of thousands of gallons of water per minute. An example is Fire Boat #2 of the Los Angeles Fire Department , the Warner Lawrence , with the capability to pump up to 38,000 US gallons per minute (2.4 m /s; 32,000 imp gal/min) and up to 400 feet (122 m) in

1620-725: The COVID-19 crisis. EMTs are a vital part of the private, voluntary and auxiliary services where a practitioner must be on board any ambulance in the process of transporting a patient to hospital. This is mandatory for all PHECC registered practitioners to keep their practitioner level and should always be kept in date (two years). This course is the new standard for first aid in the workplace. Basic tactical emergency care A state-level exam needs to be completed before an invitation to register as an EMT. EMT's are trained in basic life support, anatomy - physiology , pathophysiology , pharmacology , ECG monitoring, advanced airway management (supraglottic airways), spinal immobilization and

1680-518: The Fireboat Alexander Grantham Exhibition Gallery and was opened to the public as a museum in 2007, managed by Leisure and Cultural Services Department . In addition to the fireboat itself, the gallery houses a number of multimedia exhibits on the vessel's history and on firefighting in Hong Kong. 3D laser scanning technology in digital recording of structures was applied to capture the 3D images of

1740-516: The Philippines based on the standard set down by the Department of Health . Técnico en Emergencias Sanitarias (TES) are trained a total of 2000hrs in 2 years with 3 months of internship in ambulances at the very end. It's the only level of EMS worker. BLS ambulances can be driven with a B license, ALS with a C1. Emergency medical technician is a term that has existed for many years in

1800-496: The Pre-Hospital Emergency Care Council (PHECC). Emergency medical technician is the entry-level standard of practitioner for employment within the ambulance service . Currently, EMTs are authorized to work on non-emergency ambulances only as the standard for emergency ( 999 ) calls is a minimum of a two-paramedic crew, although this minimum requirement was relaxed to and EMT - paramedic crew during

1860-585: The FAQ Level 4 Diploma for Associate Ambulance Practitioners & QA Level 5 Diploma in First Response Emergency and Urgent Care (RQF) This provided a defined scope of practice agreed nationally by ambulance service trusts . Their role title, however, may still be defined by their employer as emergency medical technician . They can work autonomously, making their own clinical decisions within their training and remit. They may also work as

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1920-596: The Helsinki Rescue Department in Helsinki , Finland has different types of boats for various kind of firefighting, rescue, and oil destruction tasks. Also hydrocopters , rigid-hulled inflatable boats , fanboats and even hovercraft and helicopters are used in fire, rescue and medical emergency situations. Cities with fireboats are usually located on a large body of water with port facilities. Smaller fire departments lacking resources will use

1980-649: The NREMT posted information about a transition to a new system of levels for emergency care providers developed by NHTSA with the National EMS Scope of Practice Project. By 2014, these new levels replaced the fragmented system found around the United States. The new classification includes emergency medical responder (replacing first responder), emergency medical technician (replacing EMT-basic), advanced emergency medical technician (replacing EMT-intermediate/85), and paramedic (replacing EMT-intermediate/99 and EMT-paramedic). Education requirements in transitioning to

2040-593: The US and Canada, as full-time and some part-time departments require their firefighters to at least be EMT certified. In English-speaking countries, paramedics are a separate profession that has additional educational requirements, qualifications, and scope of practice. EMTs are often employed by public ambulance services, municipal EMS agencies, governments , hospitals , and fire departments . Some EMTs are paid employees, while others (particularly those in rural areas ) are volunteers . EMTs provide medical care under

2100-474: The United Kingdom, but has no single defined scope. They may be known as emergency medical technician or simply, ambulance technician . Most EMTs hold an Institute for Healthcare Development Ambulance Technician Certificate and are employed in private ambulance companies or in National Health Service ambulance trusts. As of 2016, The IHCD Ambulance Technician Certificate was replaced with

2160-470: The United States has an EMS lead agency or state office of emergency medical services that regulates and accredits EMT training programs. Most of these offices have web sites to provide information to the public and individuals who are interested in becoming an EMT. In the United States, an EMT's actions in the field are governed by state regulations, local regulations, and by the policies of their EMS organization. The development of these policies are guided by

2220-943: The administration of medication typically oral , intramuscular , inhaled, nebulised or sublingual . Whilst paramedics in Ireland do work on front-line ambulances the PHECC standards for are generally lower than most of the world leaders in pre-hospital care. Paramedics are trained to the EMT standard and additional training in advanced pharmacology, anatomy, advanced airway management (supraglottic airways), some advanced life support skills, 12-leads ECGs, administration of medication typically oral, intramuscular, inhaled, nebulised or sublingual, and they are also allowed to maintain IV lines. Emergency medical technician (EMT), paramedic (P) and advanced paramedic (AP) are legally defined and protected titles in

2280-817: The air. Fireboats are most usually seen by the public when welcoming a fleet or historical ships with a display of their water moving capabilities, throwing large arcs of water in every direction. Occasionally fireboats are used to carry firefighters, Emergency Medical Technicians , and a physician with their equipment to islands and other boats. Some may be used as icebreakers , like the Chicago Fire Department 's Victor L. Schlaeger which can break 8 to 12 inch ice. They may also carry divers or surface water rescue workers. Passengers from ships in danger can be also transferred to various kind of rescue boats. Rescue boats may be used also for oil and chemical destruction on rivers, lakes and seas. For example,

2340-491: The city docks. The 53 ft. (16.61 m.) long craft was equipped with a three- cylinder steam pump supplying two large hose reels; one of these was replaced with a monitor, or water cannon , in 1900. Fire Queen served until 1922. Emergency Medical Technician An emergency medical technician (often, more simply, EMT ) is a medical professional that provides emergency medical services . EMTs are most commonly found serving on ambulances and in fire departments in

2400-586: The city's first powered fireboat in 1866. Prior to the "John Fuller", as early as the late 1700s, the FDNY used hand-pumpers mounted to barges and large rowboats. The first purpose built steam driven boats were introduced by Boston Fire Department ( William F. Flanders ) and FDNY ( William F. Havenmeyer ) in 1873 and 1875 respectively. The first European fireboat to appear in Bristol was the Fire Queen , built by Shand Mason & Co. , London, in 1884 for service in

2460-597: The compartment, creating a health hazard for EMTs when transporting sick patients capable of airborne transmission. Unidirectional airflow design can better protect workers. There is considerable degree of inter-provincial variation in the Canadian paramedic practice. Although a national consensus (by way of the National Occupational Competency Profile) identifies certain knowledge, skills, and abilities as being most synonymous with

Alexander Grantham (fireboat) - Misplaced Pages Continue

2520-778: The crew with patient care and packaging. EMRs provide advanced first aid-level care, CPR, semi-automatic defibrillation, basic airway management (suction/oropharyngeal airway), oxygen therapy, and administration of basic, life-saving medications such as epinephrine and naloxone. EMT is the next level of EMS certification and is considered the most common entry level of training. The procedures and skills allowed at this level include bleeding control, management of burns, splinting of suspected fractures and spinal injuries, childbirth, cardiopulmonary resuscitation, semi-automatic defibrillation, oral suctioning, insertion of oropharyngeal and nasopharyngeal airways, pulse oximetry , blood glucose monitoring, auscultation of lung sounds, and administration of

2580-602: The entry-level of paramedic practice in Canadian provinces. The scope of practice includes performing semi-automated external defibrillation , interpretation of 4-lead ECGs, administration of symptom relief medications for a variety of emergency medical conditions (these include oxygen, epinephrine, dextrose , glucagon, salbutamol , ASA and nitroglycerine ), performing trauma immobilization (including cervical immobilization ), and other fundamental basic medical care. Primary care paramedics may also receive additional training in order to perform certain skills that are normally in

2640-483: The hospital vary depending on local requirements, the level the student is obtaining, and the amount of time it takes the student to show competency. In addition, a minimum of continuing education (CE) hours is required to maintain certification. For example, to maintain NREMT certification, EMTs must obtain at least 48 hours of additional education and either complete a 24-hour refresher course or complete an additional 24 hours of CE that cover, on an hour by hour basis,

2700-592: The length of training may be eight months in British Columbia or two to four years in Ontario, Alberta, and Quebec. The nature of training and how it is regulated, like actual paramedic practice, varies from province to province. Emergency medical technician (EMT), paramedic (P) and advanced paramedic (AP) are legally defined and protected titles in the Republic of Ireland based on the standard set down by

2760-459: The level of the highest trained provider. There is nothing stopping supplemental crew members to be of a certain certification, though (e.g. if an ALS ambulance is required to have two paramedics, then it is acceptable to have two paramedics and an EMT). An emergency vehicle with only EMRs or a combination of both EMRs and EMTs is still dubbed a "basic life support" (BLS) unit. An EMR must usually be overseen by an EMT-level provider or higher to work on

2820-401: The most prevalent level of emergency pre-hospital care is that which is provided by an emergency medical responder (EMR). This is a level of practice recognized under the National Occupational Competency Profile, although unlike the next three successive levels of practice, the high number of EMRs across Canada cannot be ignored as contributing a critical role in the chain of survival, although it

2880-447: The new levels are substantially similar. EMR is the most basic level of training, and is considered the bare minimum certification for rescuers that respond to medical emergencies. EMRs are typically on-call volunteers in rural communities, or are primarily employed as firefighters or search and rescue personnel. EMRs typically arrive quickly and assess and stabilize the patient before the transporting ambulance arrives, and then assist

2940-650: The paramedic title is protected under registration of the Health and Care Professions Council . In the United States, EMTs are certified according to their level of training. Individual states set their own standards of certification (or licensure, in some cases) and all EMT training must meet the minimum requirements as set by the National Highway Traffic Safety Administration 's (NHTSA's) standards for curriculum. The National Registry of Emergency Medical Technicians (NREMT)

3000-680: The past century and provides a glimpse of the territory's social development. The fireboat is accessible within walking distance northeast from Tai Koo station of the MTR . Fireboat A fireboat or fire-float is a specialized watercraft with pumps and nozzles designed for fighting shoreline and shipboard fires. The first fireboats, dating to the late 18th century, were tugboats , retrofitted with firefighting equipment. Older designs derived from tugboats and modern fireboats more closely resembling seafaring ships can both be found in service today. Some departments would give their multi-purpose craft

3060-483: The same procedure (e.g. AEMT-critical care and paramedics in New York), a procedure can be both an on-line and a standing order depending on the level of the provider. Since no set of protocols can cover every patient situation, many systems work with protocols as guidelines. Systems also have policies in place to handle medical direction when communication failures happen or in disaster situations. The NHTSA curriculum

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3120-612: The same topics as the refresher course would. Recertification for other levels follows a similar pattern. EMT training programs vary greatly in calendar length (number of days or months). For example, fast track programs are available for EMTs that are completed in two weeks by holding class for 8 to 12 hours a day for at least two weeks. Other training programs are months long, or up to two years for paramedics in associate degree programs. EMT training programs take place at numerous locations, such as universities, community colleges, technical schools, hospitals or EMS academies. Every state in

3180-544: The scope of practice of advanced care paramedics. This is regulated both provincially (by statute) and locally (by the medical director), and ordinarily entails an aspect of medical oversight by a specific body or group of physicians. This is often referred to as " medical control ", or a role played by a base hospital. For example, in the provinces of Ontario , Quebec and Newfoundland and Labrador, many paramedic services allow primary care paramedics to perform 12-lead ECG interpretation, or initiate intravenous therapy to deliver

3240-578: The state. NHTSA recognizes four levels of certification: Some states also recognize the advanced practice paramedic or critical care paramedic level as a state-specific licensure above that of paramedic. These critical care paramedics generally perform high acuity transports that require skills outside the scope of a standard paramedic (such as mechanical ventilation and management of cardiac assist devices). In addition, EMTs can seek out specialty certifications such as wilderness EMT , wilderness paramedic, tactical EMT, and flight paramedic . In 2009,

3300-666: The structure. The lifting of the 500-tonne historic boat onto land is the first project of its kind ever conducted in Asia. Alexander Grantham is also the first boat preserved as a historic relic in Hong Kong, and is the Hong Kong Museum of History 's largest "Made in Hong Kong" collection item. The landing of the Alexander Grantham marks the end of 50 years of her service in Victoria Harbour , though

3360-402: The title of "fireboat" also. They are frequently used for fighting fires on docks and shore side warehouses as they can directly attack fires in the supporting underpinnings of these structures. They also have an effectively unlimited supply of water available, pumping directly from below the hull. Fireboats can be used to assist shore-based firefighters when other water is in low supply or

3420-528: The title of A-EMCA, or advanced emergency medical care assistant) to professional self-regulating bodies, such as the Alberta College of Paramedics. In Alberta, for instance, only someone registered with the Alberta College of Paramedics can call themselves a paramedic; the title is legally protected. Almost all provinces have moved to adopting the new titles, or have at least recognized the NOCP document as

3480-764: The vessel remains on the waterfront in its new role. Construction of the exhibition gallery was performed with assistance from the Architectural Services Department and the Leisure and Cultural Services Department . Alexander Grantham , the largest in the fleet of fireboats, was built by the Hong Kong Whampoa Dock Company Limited in 1953 and decommissioned in May 2002, after 49 years of service. Measuring 38.9 metres long, 8.8 metres wide, 15 metres tall and with

3540-727: The weather permits and staff are available, but systems such as the Toronto EMS Critical Care Transport Program work in land ambulances. ORNGE transport operates both land and aircraft in Ontario. In British Columbia, CCPs work primarily in aircraft with a dedicated critical care transport crew in Trail for long-distance transfers and a regular CCP street crew stationed in South Vancouver that often also performs medevacs when necessary. Paramedic training in Canada varies regionally; for example,

3600-546: Was carried out either by private insurance companies or the Docks Company until the formation of the Bristol Fire Brigade as a branch of the police in 1876. In New York City, a small boat with a hand-pump was used to fight marine fires as early as 1809. By the middle of the nineteenth century, self-propelled steam-fire-floats were beginning to be introduced. The FDNY leased the salvage tug John Fuller as

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