-
Peter Safar (1924-2003) - Father of Modern CPR
Peter Safar: Father of Modern CPR Safar carries out experiments on colleagues and students rendered unconscious and paralyzed to prove the effectiveness of head tilt, chin lift to open the airway (A) and mouth-to-mouth ventilation (B). Combined with external chest compressions (C), he writes the book “ABC’s of Cardiopulmonary Resuscitation” establishing the basis for mass CPR training. https://www.youtube.com/watch?v=FG2qy4CQy0Q -
Period: to
Les Policiers Ambulanciers
Private companies - mainly funeral homes - operate the city's ambulances. "Ambulance Technicians" require a 15-hour training with St. John Ambulance. They are unable however to meet the city's demand for ambulances leading Mayor Sarto Fournier to create a free ambulance service in downtown Montreal operated by ~120 Police Officers in 14 vehicles. This service remains in place for 24 years. -
America's first trained Paramedics
Freedom House Documentry (trailer) After his 12-year old daughter died from an asthma attack, Peter Safar's interest in providing CPR outside the hospital leads to the establishment of the Freedom House Enterprise Ambulance Service in Pittsburgh. He trains unemployable inner-city African Americans to become the country's first Paramedics. Safar leads the 300-hr training course that includes rotations in the ER, OR, obstetrics, X-ray and morgue. -
180-hour Ambulance Personnel training course
In 1967, Dr. E.D. Monaghan - joined by Dr. Peter Cohen in 1972 - instructs a 180-hour Ambulance Personnel training course at the Royal Victoria Hospital. In 1972, Dr. E.D. Monaghan creates the 'Emergency Medicine' department at the Royal Victoria Hospital and develops the first-ever residency program in emergency medicine in Canada. -
1080-hour Emergency Paramedical Technicians' Program
Emergency Paramedical Technicians' Program - Dawson College In 1974, Dr. Peter Cohen co-founds a 1080-hour Emergency Paramedical Technicians' Program in collaboration with Dawson College & Royal Victoria Hospital - the first of its kind in Canada. The program was certified by the US National Registry of EMTs but was terminated in 1982. -
120-hour "préposé d'ambulance" training course
Some Quebec CÉGEPs offer a 120-hour "préposé d'ambulance" training course. -
"Loi de la protection de la santé publique (Loi 27)" is enforced
"Loi de la protection de la santé publique (Loi 27)" passed in 1972 and enforced in 1976, initiates involvement of the QC Government in various aspects of pre-hospital services, including Ambulance Technician training. Articles 226, 227 and 228 require an ambulance driver to participate in - but not pass - a 40-hour course in "technique ambulancière" and an ambulance attendant (préposé) to pass a 150-hour course in "technique ambulancière". -
Resuscicar Inc.
Dr. Peter Cohen establishes Resuscicar Inc. - a private, non-profit ambulance service in Montreal operating two $50,000 ambulances. Each ambulance is equiped with electrocardiographs and telemetry allowing for two-way communication with doctors at the Royal Victoria Hospital. Resuscicar Inc. acts as a "lab" for Dawson College Paramedic students and also employs graduates of the program. -
Dr. Peter Cohen solicites public for funds
Dr. Peter Cohen asks public for $150,000 to continue the 1080-hour program The Quebec Government decides to terminate funding for the 1080-hour Emergency Paramedical Technicians' Program and refuses to grant graduating Paramedics any official status. Dr. Cohen appeals to the public for $150,000 in order to continue the program and the operation of Resuscicar Inc. -
336-hour training mandated by Pierre Marois Report
Pierre Marois oversees a committee put in place to resolve a strike by Ambulance Technicians over vehicle, equipment and training standardization. Among other recommendations, the Pierre Marois Report issues a requirment for a 336-hour training program for Ambulance Technicians.
The request for a 3-year "diplôme d'études collégiales (DEC)" program is refused. -
CETAM is established
CETAM
La Coopérative des techniciens ambulanciers de la Montérégie (CETAM) is established - a cooperative ambulance service owned & operated by ambulance technicians servicing the Montérégie (southwest Québec). CETAM currently employs 300 Paramedics. -
825-hour training mandated by "Loi sur la santé et les services sociaux"
The "Loi sur la santé et les services sociaux" requires a 825-hour course for Ambulance Technicians, marking a new era in training. -
Period: to
CTSAM
In 1988 the "Coopérative des travailleurs des services ambulanciers du Montréal (CTSAM)" is created. CTSAM is the sole employer of all Ambulance Technicians in Montreal & Laval, replacing all previously operated private ambulance companies. CTSAM remains in operation for 3-years. -
Urgences-santé is created
The Government creates the first "conseil d’administration d’Urgences-santé". Urgences-santé is the only public pre-hospital medical service organization in Quebec. On July 17, 1989 all Ambulance Technicians of "Coopérative des travailleurs des services ambulanciers du Montréal (CTSAM)" are integrated into Urgences-santé. -
Period: to
Urgences-santé
Urgences-santé In 1989 Urgences-santé is created. It remains the sole employer of all Paramedics in Montreal & Laval. Urgences-santé currently employs 891 Paramedics and owns 148 ambulances. -
Rapport d'intervention préhospitalier (RIP)
In 1991, the "rapport d'intervention préhospitalier (RIP)" is introduced. The RIP is a medico-legal document added to the patient's medical file. It describes the patient's signs and symptoms throughout the intervention and records all administered techniques and treatments. In addition, it outlines "refusal of services" procedures. -
810-hour AEC program
Collège Ahuntsic and Cégep de Sainte-Foy offer a 810-hour program leading to an "attestation d’études collégiales (AEC)" in "techniques ambulancières". -
MDSA & Combitube
Urgences-santé introduces: 1) the "moniteur défibrillateur semi-automatique (MDSA)" allowing for defibrillation of cardiac arrests caused by shockable rhythms (VTach, VFib); and 2) the Combitube allowing for intubation and airway protection during respiratory arrest and cardiac arrest. Until now, intubation was a technique previously restricted to physicians. As a result of these new techniques, an additional 30-hours of training are added to the 810-hour AEC program. -
Urgences-santé offers Continuing Education
As the scope of pre-hospital care expands, Urgences-santé offers Continuing Education training to its employees for newly approved medications, techniques and equipment. -
Indice préhospitalier pour traumatismes (IPT)
The Montreal General Hospital and Hôpital du Sacré-Cœur are designated as tertiary trauma centres in Montreal. In order to ensure that all major traumas are transported to either of these two centres, Urgences-santé instates the use of the "indice préhospitalier pour traumatismes (IPT)" to aid in the designation of major versus minor trauma. -
PICTA - 1st edition
The 1st edition of the "protocoles d'intervention clinique à l'usage des techniciens ambulanciers du Quebec (PICTA)" is introduced. The protocols provide an algorithmic approach to patient assessment and treatment for various intervention types, including trauma, pediatrics, psychiatry and obstetrics. -
Vacuum mattress
The vacuum mattress is a medical device used for the immobilisation of patients, especially in the case of vertebra, pelvis or limb trauma. Following a 1-year pilot project by Urgences-santé, the vacuum mattress is added to standard ambulance equipment. -
Epinephrine
In 1998, Ambulance Technicians in some areas of Quebec were trained to administer EpiPen® in cases of anaphylaxis. CETAM saves four patients in the first month of its use. In 2001, sub-cutaneously administered epinephrine is the first medication introduced by Urgences-santé. -
Règlement sur les activités professionnelles pouvant être exercées dans le cadre des services et soins préhospitaliers d'urgence
Règlement sur les activités professionnelles pouvant être exercées dans le cadre des services et soins préhospitaliers d'urgence
Outlining the scope of pre-hospital care in QC, section 3.9.3 allows Ambulance Technicians to "administrer les substances ou les médicaments requis, par voie sublinguale, orale, intranasale, sous-cutanée, intramusculaire, transdermique ou par inhalation". -
NTG, ASA, SAL & GLU
Nitroglycerin, aspirin, salbutamol & glucaon are introduced by Urgences-santé. Along with epinephrine, the "Programme d'administration des 5 médicaments" is based on the Symptom Relief Program developed in Ontario in 1996. Ambulance Technicians can now treat cardiac-related chest pain, respiratory distress, hypoglycemia and anaphylaxis in the pre-hospital setting. -
Advanced Life Support (ALS)
Following 3-years of training provided by Urgences-santé, 18 Paramedics are certified Advanced Care Paramedics (ACP) after successful completion of exams at Durham College in Ontario. However, QC limits the use of ALS to duly evaluated pilot projects, with priority being given to the management of respiratory distress, chest pain and cardiac arrest. Today, 8 ACP Paramedics remain active at Urgences-santé. -
Paramedics recognized in Canada
An Ambulance Technician is now recognized as a Primary Care Paramedic (PCP) or Advanced Care Paramedic (ACP). The Quebec Government will utilize the title "technicien ambulancier paramédic (TAP)". -
3-year (2745-hours) DEC program
John Abbott to offer paramedic training
Collège Ahuntsic - and then John Abbott College - offer a 3-year (2745-hrs) Pre-Hospital Emergency Care program leading to a "diplôme d'études collégiales (DEC)". The curriculum includes anatomy & physiology, medical emergencies, pharmacology, pre-hospital trauma life support, advanced cardiac life support and psychopathology, among its course list. -
12-lead electrocardiogram
In a 2003 pilot project, 200 Paramedics were trained to perform a 12-lead ECG. Six years later, all Paramedics at Urgences-santé are trained in 12-lead ECG to expedite the identification of ST-elevation myocardial infarction (STEMI) in the pre-hospital setting. -
PARAMÉDIC appears on ambulances
-
Programme national d’intégration clinique (PNIC)
PNIC The "ministère de la Santé et des Services sociaux du Québec (MSSS)" introduces the PNIC - a 2-day evaluation of Paramedic candidates following the completion of their DEC. Successful completion is required to obtain the right to practice in Quebec. A maximum of three attempts are permitted. In Montreal, the PNIC is overseen by Urgences-santé. -
PICTAP - 5th edition
The the 5th edition of "protocoles d'intervention clinique à l'usage des techniciens ambulanciers paramédics (PICTAP)" is released. Note the inclusion of the word "paramédics" in the current release. -
DEC replaces AEC
The AEC in Paramedicine allowed entry into this occupation until 2014. Thereafter, the DEC becomes the only diploma giving access to the occupation. -
Paramedic Quebec APP
Paramedic Quebec APP The Paramedic Quebec APP is launched allowing instant access to the most recent protocols from any smart phone. -
Naloxone
Naloxone In response to an increased incidence of narcotic overdose (e.g., fentanyl), naloxone becomes the sixth medication that Paramedics can administer in the pre-hospital setting. -
Boussignac CPAP System
Continuous positive airway pressure (CPAP) is a treatment that uses mild air pressure to keep the airways open. The addition of the Boussignac CPAP System by Urgences-santé allows for the treatment of respiratory fatigue in the pre-hospital setting. -
Expanded scope of practice for ACPs
The "ministère de la Santé et des Services sociaux du Québec (MSSS)" and the "Collège des médecins" expand the scope of practice for ACPs by approving 28 protocols and 26 medications.The protocols include cardioversion for unstable tachycardia, transcutaneous pacing for unstable bradycardia, seizure control, eclampsia management, cricothyrotomy etc. -
New Urgences-santé logo
