the_negro_puppy

As Kiwi states its much the same here in Aus- Youngest can be usually 20, graduating high school at 17 then 3 years of uni. Having that we have 17-20 year old uni students riding along with us and they vary greatly in life experience and maturity. Many of these young adults still live at home with their parents, are from a middle class background and have never had to deal with a drunk, drugged or aggressive psych patient screaming in their faces. Many have not had a family member die or seen a dead body. There's a first time for everything I guess.

Hi I'm xxxxx and my partner is xxxxx what's happened today? Sometimes I want to say Hi I'm xxxx and this is yyyy what is your emergency today?

We receive SOME mental health training as part of our Diploma program but its not really enough considering just how many patients either have acute mental health conditions are have mental health problems + their presenting condition. There has always been a stigma around mental health patients, with older Paramedics (and those potentially have not had a friend/family member suffer from mental health problems) not understanding their conditions.

We obviously have lots of poisonous snakes here in Aussie land. Our treatment consists of: Restricting patient movement as much as possible. - Obtaining info on snake/identification if possible - Compression bandage(s) aimed at around 60mmhg "tightness" - Splinting the limb - Iv Access - Cardiac Monitoring The problem here is different snakes venom works in different ways. For example- brown snake venom contains mainly neurotoxins and blood coagulants, where as a Red-Bellie black snake venom has neurotoxins, myotoxins, coagulants and also has haemolytic properties. Obviously different venoms = different effects. Most hospitals here carry a range of anti-venins I've only been to a handful of snake bites, none of which were envenomated or bitten by a dangerous species. - Pain relief

It can be difficult to differentiate at times but we have a lot of pseudoseziures here. Risk factors- Female, teenaged, mental health hx There are signs to look for, Obviously if they are appearing to have a tonic/clonic seizure you can look at things like their breathing and eye activity, response to painful stimuli. No post-ictal phase, with the pt telling you they suffer from seizures but unable to elaborate on the hx of their condition, who their neurologist is, and not being on any epilepsy type medication. If in serious doubt always treat it as it presents. If that means giving Midaz/Loraz/Diaz to someone faking it, then so be it. Better than withholding from someone actually having genuine convulsions.

' They've also added it for burns in the new CPM, following Midaz AND Morph

Exactly, if you come prepared you can always quickly work around things. Going to a cardiac arrest in a mall? take a couple of sheets in. If not used for privacy you can kneel on them. We're not talking about NOT checking areas, more waiting or taking steps or measures to do it appropriately to deliver time treatment while preserving dignity

Our indications for Ket: - Adjunct to morphine (0.1-0.2mg/kg) in patient with severe traumatic pain associated with : -Fracture reduction or splinting - Multiple or significant fractures requiring facilitated extricatiln

Unfortunately here in Queensland our scope to not resuscitate isnt as liberal in Kiwi land. Chronic disease or quality of life has no factor for us. I cringe every time I go to an arrest in a Nursing home or the like. The first thing I do is check for rigour, lividity, ANYTHING to prevent me pumping on the chest of the 89 year old bed bound dementia patient's chest. Most of these patients do not have Advanced Healthcare Directives (AHDs). Unless the patient has a no resus order or has had a downtime greater than 10 minutes with asystole, or obvious death/injuries incompatible, we are compelled to attempt resuscitation. It shocks me in this day and age that so few people have AHDs. I've even transferred a jaundiced barely conscious/breathing end stage liver disease pt from home to palliative care at hospital. She was expected to die at any time but at the last minute the family decided they couldnt cope with her dying at home. I was sweating the whole time in the back of the Ambulance and while 'ramped' at the ED as the family had no AHD in place.

Currently use Metoclopramide 10-20mg IV/IM however contraindicated for under 16, Zofran/Ondansetron is being introduced here shortly.

I wonder if you would still hold this view, if one of your family members was in critical condition in couldnt get an ambulance because the only one within 30 minutes was giving a "professional response" to a lazy git who wanted a lift home?