<< Can't speak to the whole country, but STRONGLY suspect it is an Ontario thing. Remember that ALS in Canada is VERY poorly distributed. Other than the helicopter program in Ontario, the province only had (in 1996) about 200 ALS Paramedics (Level III). Now thanks to OPALS I believe they are up to about 500. At the same time there were more ALS Paramedics in Alberta (2.5 million pop.) than in the rest of the country combined. Even now, there are more ALS Paramedics west of the Manitoba/Saskatchewan border than east of it despite the population being 4:1 in the opposite direction.
At the same time, most of the scheduled/repatriation/fixed-wing flights in Ontario were done by hospital RN's working as/when for local air charter services, or by EMT-Intermediates (P-1's). DO NOT WANT TO GET INTO RN/MEDIC DEBATE but the reality is that these RN's are, for the most part, not dedicated (job wise) or pre-hospital trained/focussed. So they want an MD along (2nd RN doesn't address initive/autonomous decision making issue, EMT-P unavailable and why take a lower trained EMT-I). Practice begats policy which becomes tradition. Insurance carriers take cues from local government etc. Also in Quebec (until VERY recently - still in process of early change) uses French model of physician/EMT in Montreal, and I suspect physican/RN ithe air.
In Saskatchewan, RN/CCEMT-P team. Alberta EMT-P/EMT-I. British Columbia EMT-P/EMT-I. Manitoba RN/RN. Yukon RN/EMT-B. Northwest Territories (any one or two of two of the following) RN/CCEMT-P/EMT-P, Nunavut (any one or two of the following) MD/RN/EMT-P/EMT-I. No teams in Newfoundland or Prince Edward Island (other than military EMT-I/EMT-I equivalents) New Brunswick RN/EMT-P. Nova Scotia EMT-P/EMT-P .......If I have any of these wrong I am sure someone will correct me (please do - it is hard to stay current on Southern trends from Yellowknife).
Ken Lawson-Williams
SN/CCEMT-P/REMT-P/WMT >>
>Incidentally, this is the same
>procedure we follow when picking up a critical patient in Canada for tx to
>the US....the Canadian hospitals for some reason often require us to have an
>MD on board for serious patients (is this the standard throughout Canada, or
>just a quirk the hospitals in southern Ontario have...?).
