craig

Duhhhhh...................the ambulance[/font:27d421eb24]....

but then again that is very imaginative isn't it.

stay safe

Some thing that I am sorry to say is we ALL want to be seen a professional, HOWEVER how can we be professional if we cant even bloody read instructions and spell correctly.

are some medics in the States DADS?

Dumb As Dog Sh*t............................

stay safe

root

mike you changes TWO letters,,,,you cheated

now it will not work

stay safe

We use to have this supervisor (he is still a supervisor, but i have moved areas) that would drive his car into the plant room, throw the keys at us and say "here you are herb" or "wash this herb", (he called everyone herb), with out saying please or thankyou.

what we used to do was

1. he was a devotee of a certain type of music and his car stereo was tuned into a radio station that broardcast this music. we changed ALL the presets to the local ARABIC music station and then turned the volume up t the highest level, so when he started his car all he got was the arabic whailing at it's highest.

2. we place a 500 ml sachet of saline connected to a pump set under his seat, with the line running under the trim of the car until it came out just next to the sunvisor above him. each time he hit a bump in the road and his seat compressed he got a squirt in the face.

3. and then we worked out that he had to do more left hand turns to get to work from his address than right hand ones. so we wired the horn up to the right hand indicator so that when he was driving and he put the right indcator on the horn activated. and this guy HATES when people blast their horns at him..............

ahhh the things we do....

stay safe.

Ugly medic, nice insult there towards me. anal rententive ha ha ha Well everyone let me set the record straight, my company policy was to call Law enforcement if anyone tampered with our units. We had several very bad experiences with people tampering our units in a pranksterish way.

I no where advocated to fire anyone for pranks but if they got out of hand and it hurt someone like it did me at one time then you bet your arse that you would be fired. no if's ands or buts. Pranks have a place in the workplace but we are supposed to be professional and people pulling pranks that can hurt people or hurt themselves should not be allowed.

If you pulled a prank on a crewmember and it resulted in an injury of a crew member then you could expect a suspension or even termination.

Ruffems

I know we have covered this before.

I read Ugly medics post and no where in it does he call you anal retentive.

what was said that the way you exhibit your stand on pranks you could raise to the rank of a humourless anal retentive ADMINISTRATOR.

BIG DIFFERENCE....................

As I said before to play a prank on some one with the administration of a drug is DANGEROUS AND STUPID

But I am tending to think (in my perception) that you take thing to heart and are a little thin skined when you get a negative post directed your way.

If you feel that in any way I am attempting to insult you, then that is your perception as I do not have that intention, these are my views and my reality therefore this is what I am entitaled to have and voice.

stay safe.

to answer your complaints........

we refer to God a He

YES God is a GUY!!!!!!

He wouldnt do that to one of his own would he.......

stay safe

Hi all,

I caught an episode of "Paramedic" the other night and had a question.

I will post it the best I remember..

Call was for an 80ish female, leg pain after a fall. No loc, not other pain, no other history relevent to the injury ( I believe )

They find a very thin lady on her bed with severe pain, mid femer. She screams in pain with any attempt to move her.

These are my questions:

The paramedic did not remove her pajama bottoms....when he palped her leg, pain seemed to be nearly dead center of her femur. Was there some reason not to cut away her pajamas to expose her leg?

I reviewed my basic manual and didn't see any contraindications for a traction splint relevant to geriatrics (Though it seems that you would need to expose it to reveal joint issues etc.) Yet with the little that was seen on the episode they didn't seem to consider using a traction splint. Are there age contraindications that I'm unaware of?

Pain meds were given and she was transported on her rt side (I believe it was position of comfort)

I will hope that it is obvious that the spirit of this post is not armchair quarterbacking...(I promise I've read those posts and know it's evil) and would not judge the paramedics based on my little bit of knowledge even if I thought I knew the whole story....

I was just curious about these two things.

P.S. Follow up at hospital confirmed mid-shaft femur fracture.

Thanks all!

Dwayne

Just wondering as to why everyone keeps refering to the fact that this patient had a #NOF

I may just be a ambo from down under but my observations and diagnosis is a # femur (mid shaft) due to the fact the post said it WAS CONFIRMED AT HOSPITAL.

discounting that, the clinical signs at the scene lead more to a # of the femur than a # of the NOF due to the swelling and pain to the mid shaft and not the hip. Nothing listed as to the evidence of any shortening and rotation of the injured leg.

The standard for a fracture of the upper leg is normally a traction splint (choice of the officer as to what type and as to what is available). How ever on an elderly patient that has a very thin build and may have a bone disorder (oesteoarthritis or oesteoperosis etc as most 80 yo females have) the splint may cause more damage that is warranted, therefore it may be be better to just splint the leg with a large leg splint and make the patient comfortable for transport.

Therefore I see that the treatment that the officer did was not incorrect as everyone has to be treated as we find them and on the merit of the case that we are attending.

The action of removing the 80 yo females pj bottoms or cutting them off, well would you do this to you grandmother while a TV crew was holding a camera over your shoulder? even though you could make the relevant diagnosis with out this action?

my two bobs worth.....

stay safe

Where is the "D" .........all of the above?

stay safe

Really? I thought it just meant she had short hair. :?

and wore comfortable shoes

and rode a harley

stay safe

Dust from all of your friends here in the land of Oz. stay safe, keep your head down and get back quick and safe son....

prayers are with you

craig

Hi All,

We've yet to have anyone mention that they may consider the possibility of a neuro cause or other differnetials in either case yet we're still debating about BGL's.... :roll: :!: :!: Talk about TUNNEL VISION!!!! :x :shock: :evil: :twisted: :!: :!:

out here,

ACE844

The question was would i take a bsl in both cases.....

there was no mention of pathophysiology, contraindications, adverse effects or the such...just would i and in a nut shell it was YES.

if asked i will add to this.

stay safe

here we have an age limit

yes it is to be able to be employedd in the job. but mainly it is because you need to be a certain age to be able to get the drivers licence to enable you to drive the ambulance. there fore the age limit is a minimum of 22 yrs i think.

stay safe

I am sure that this has been covered but for the original poster, you ever seen narcan given to someone and after they come awake they kick the crap out of the medic for taking away the high they just spent their last 5 bucks to get. I've been that medic and boy did I hurt after the beating I got. I vowed from then on out that I would only bring the patient to a less than verbal response

Plus why give Narcan when all they are is out of it. If they stop breathing tube em, if they sieze, valium them if they get violent while overdosed restrain them.

Why take on the added headache, back ache, rib pain and stomach pain from getting your teeth knocked in just to wake them up.

you must be a really mean looking guy to be bashed when you give a person the narcan.

In 18yrs in ems and working in one of the biggest narcotic using areas in australia i can not remember when i have been majorly assulted by a druggie when they have been awakened by the narcan. yes verbally abused, spat at, hit thrown at (with little power) but i have never been bashed etc for doing it. most times after the narcan administration all the smackie wants to do is roll over and spew......gawd, there were times that we even tried to make them spew......makes it easier to look after them as they dont want to cuss at you and spit on you then.

most times the shitbag will not want you to transport them to hospital anyway, so tubing them, restraining them etc can only be detremental anyway as you will be backout the next night doing the same things to them with the same result...........

Neca eos omnes. Deus sous Agnoset[/font:fb8f0a4c51]

stay safe

I could write a curriculum that gave your basics "extensive training" on the performance of appendectomies in a week. In a week, we could teach any basic to perform an appy just as well most any surgical resident. After all, it's just a skill. Only a few small muscles and vessels involved. Anybody can learn it. And nothing usually goes wrong anyhow. If it does, they can just call for ALS intercept!

How about we do that?

G'day dust

yeah lets do it i 'd like more of a challange........lol

both arguments are flawed.....from my perspective anyway.........like i said before and will say again, i feel better beig here and being treated by ANY level of training than those that have been protrayed on these pages.

basics in the states or even intermediates must be pretty bad NOT to have the backing of higher skill levels on advancing medications and skill levels. goes to show that education is NOT everything....lol

stay safe

i still find it hard to believe that your "intermediates" cant carry out advanced procedures or drug interventions.

they are "intermediate" to what?

to gain the level of ALS here you have to be in the employment of the service for at least three years.

and you then do the minimum of 240 hours in the class room, then 80 hours in the hospital doing pract followed by 160 hrs "on road" with a paramedic crew as third on car, to do a road pract aspect.

this is after doing the three years in the job as well as the training that goes with it.

Even if you attend a school that gives you a "paramedic degree" doesnt mean that you can treat at this level untill you have done the above within the service (after you have been employed- for three years).

stay safe

Inflate our egos? I don't see any medics here asking for more skills than what they have. Especially out of this thread. In fact, I've seen medics explain repeatedly and clearly why we don't feel that EMT-I's should be giving medications. What I have not seen yet, and doubt I will see, is a logical explanation of why an EMT-I would need to give narcan (or other meds)? The only rationale so far is that it might save a medic a few seconds. That reasoning is hardly worth while in my opinion. I also tend to be of the opinion that if someone's giving a medication on my scene, I want them to have the same level of care (and responsibility) that I carry. I'm not going to explain why some EMT or EMT-I screwed up a medication dose based on my order. I'd rather draw up and give the medication. If there's a problem, it falls on me and noone else. There's very few calls (if any) that I can recall being on that I would have found it greatly beneficial to have someone else handing me medications already drawn up.

So the question remains, explain why an EMT-I should be giving Narcan or other medications? And my additional question is where did this topic turn into a discussion of paramedic ego? If being able to explain logically why you feel the way you do about something is having an ego, then I'm happy to have mine. My opinion on the matter still stands.

Shane

NREMT-P

I feel sorry for you guys that you work in an area that is REGRESSIVE to furtherment of ems

here the 'basic' qualified ambo can give narcan, can give iv fluids, can give adrenaline im, can give midazolam in, phernergan in, phyntenal in.....i know that our guys are trained more than the ones in the states but if you give the emt of any level the body of knowledge then why not the skills.

all this bickering about this only goes to show to the uneducated (joe q public) that visit this site that we do not have a united stand on how patients are treated and that paramedics are somewhat medical 'gods' and that what they say goes......

stay safe

Situation 1:

Pt. complaining of sharp 4/10 chest pain worsening on inspiration which completely resolves with oxygen admin. He then complains of dizzyness and general weakness in his arms. Would you take a sugar?

Situation 2:

Pt. was at work and began to feel very light headed. Pt. sat down and rested immediately, but still feels a little bit dizzy. Would you take a sugar?

Neither patient has a Hx of diabetes, either personal or family.

In a nut shell to both cases

YES

stay safe

NALOXONE PHARMACOLOGY 215TYPE:

Opiate antagonist

ACTION:

Reverses respiratory depression, sedation and hypotension caused by opiate analgesics. The duration of action of the opiate may exceed that of naloxone and renarcotisation is always possible. Ideally a patient should be observed and if necessary repeat doses administered.

USE:

The reversal of opiate analgesic overdosage:

· Heroin · Lomotil (loperamide)

· Pethidine · Pentazocine (Fortral)

· Morphine · Digesic (propoxyphene)

· Codeine · Immobilon (veterinary drug)

· Endone (oxycodone) · Buprenorphine

· Various diarrhoea and cough medicines · Methadone

ADVERSE EFFECTS:

· Opiate reversal can cause vomiting, sweating, tachycardia and hypertension. In patients with cardiac disease more serious effects such as VT, VF and pulmonary oedema may occasionally occur

· Rapid reversal of the opiate overdose may lead to combative behaviour in the patient

PREPARATION:

Naloxone – 2mg per 5ml Min-I-Jet

DOSE:

ADULT

Routes of administration: IV, IM

· SUSPECTED NARCOTIC OVERDOSE:

5ml (2mg) NALOXONE IV BOLUS or IM if a vein is not available

Can be repeated twice if inadequate clinical response

· IMMOBILON OR BUPRENORPHINE OVERDOSE REVERSAL

5 ml NALOXONE IV BOLUS or IM if a vein is not available

Can be repeated to a maximum of 30 mls (12mg)

PAEDIATRIC

Routes of administration: IV, IM

· SUSPECTED NARCOTIC OVERDOSE:

0.25 ml/kg (100 mcg/kg) NALOXONE IV as a bolus or IM if a vein is not available

Each bolus dose must not exceed the adult dose of 5mls

Can be repeated once if inadequate clinical response

Naloxone should not be administered to newly born infants, due to the increased risk of withdrawal syndrome.

Above is our protocol/ pharmacology for Narcan

here the primary care officer (basic to you guys) can give it in certain situations

ALS (both I and P) can give it the same.

stay safe

Craig, back off.

YOu are accusing me of stealing something in the past. I have never done so.

You are making broad generalizations about me that you have no right to make.

I don't come here and personally attack you so I expect the same consideration from you.

Yes its a commercial but it still made me mad.

Am I going to go out and do something rash, NO I'm going to send a polite email to Olympus expressing my disapproval and leave it at that.

Yes it made me mad, I'm sure that you have been made mad due to a commercial or something you have seen on tv.

It makes our profession look bad and that is unacceptable to me. We spend so much time trying to get a professional image and one commercial can blow it.

So before you come here making personal attacks on me think again.

i was never personally attacking you

i was making a point that some people winge about thing when they are responsible for doing the same thing

do you get upset when people think we still do the big "flip off" on our drugs like gates and desoto did

what i was implying was that people need to take a chill pill

olympus has one this argument as we are all talking about thier cameras due to this ad

i knew a person that did work for an agency that did an ad that was deemed inappropriate and it only aired 4 times. when it was pulled due to complaints, the company said tat they only paid for 6 screenings of the ad, as they knew it would be controversal.

However they were very happy that it caused so much trouble because they got 1/2 million dollars worth of FREE advertising due to all the people talking about it, showing iot on the news, current affairs shows , radio etc.

like i said if this is all you have to worry about, chill out dude.

i appologise if my comment have upset you , i didnt mean to do that

stay safe

I'm so incensed now that I'm gonna call Olympus

Premise of the commercial

Olympus's new digital camera

Two EMS workers on scene of a motorcycle accident. They find a Olympus camera and it's lanyard is still wrapped around the patients arm.

They cut the lanyard and one of the guys puts the camera in his pocket. He steals the camera.

Just another insult to EMS

for gawds sake grow up

it's a commercial............

the budwiser frogs really dont say it.......

the coco pop monkey is not real and

there are NO pixies in a box of rice bubbles

are you so thin skinned that a commercial gets you upset?

are you worried that you may be caught out about something you have stolen?

commercials are done as MAKE BELIEVE so get the punters in

I have never seen the add , but if that is all you have to worry and complain about.....GET A LIFE

stay safe

So Craig, I would like to know if EMT's in Australia are part of the Civil Service or not.

Thanks...

civil service?

not sure what you mean.

here the state has control over all the emergency services

it is not city municipal based like in the states.

the state has one police force(15000+ employees)

one fire brigade (too bloody many......lol)

one rural fire service (70 000 volunteer and paid memebers- as from their web site) and

one ambulance service (3000+ employees)

the police and fire briagdes/services are under control of the emergency services minister

the ambulance service in under the control of the state health minister via the health department

due to the size of the state in remote areas there are volunteer rescue services (technical rescue not ems) that do some of the work (they being the State Emergency Service and the Volunteer Rescue association), both of these services are accountable to the state emergency services minister as well

as for the other states i really dont know

stay safe

thats

www.asnsw.health.nsw.gov.au

sorry

stay safe

I'm doing a research paper for my Socy class comparing ambulance response times in counties with one county-wide service to counties with multiple companies in service. it seems the only response averages I can find are for companies that messed up and it's reported in an article. The counties that I need info for are:

Plymouth County, MA

Hampden County, MA

Guilford County, NC

Arapahoe County, CO

Washington County, OR

Chester County, PA

(and these are just a start. I don't know yet what type of services these counties have, they just fit the demographic size and population parameters I have set.)

Any help that could be offered would be greatly appreciated. I've tried darned near every combination of ambulance response times, EMS, Jems, everything I can think of....I think my hair is falling out!!!

might help , our services site has all the details about our responses

check them out at

www.asnsw.nsw.gov.au

might help, might not be needed but ives perspective from OS

stay safe

Which will be as soon as they require medics to have a degree and be able to read and write at least 10'th grade level... not holding my breath!

R/r 911

Yep another problem with the system in the states.

Here if you dont pass the entrance exams to become an emt you never will.

helps that it is a government monopoly i suppose

the exam they have is a apptitude test for entrance, reading, comprehension, maths, logistical thought, physical ability etc.

pass this then you get the interview....

it dont matter idf you have the "degree" in prehospital care or not, dont pass the test, NO JOB.

works well

stay safe

All i can say is if you pay peanuts you get monkeys

that is the trouble in the states... but then i will be the same here soon as the dickhead that runs the country (the prime minister John Howard) and his government has changed the labour laws here. ass holes.

at the moment i am looking at my last pay slip

my base hourly rate is 23.05 hr

I get a ALS allowance of 208.91 a fortnight

I get a on call aloowance of 113.80 a fortnight

I get a standby technical reacue alloance of 33.79 a fortnight (it will go to about 70 next week as i get the full allowance)

I get time and a half for the first 2 hrs of OT and then double time each hour after that

If i get a call out after hours i automatically get 4 hour OT irrespective of how long i am out. If the call last longer than 4 hours i get the actual time worked

i get 50% and 75% loading on weekend and night duties

and I get 150% for working public holidays

therefore my last time slip states that i had a gross pay for the two weeks as 3376.38 before tax.

I paid the tax of 1026.00 for the fortnight so my take home pay was $2350.38 for the fortnight just passed.

this year so far (July '05 to June '06) i have a year to date gross of $84024.03

With the difference in AUS to US dollars value makes it about 70K in your money with two months to go before the end of the year.

So i am looking at about 100k AUS this year.

the only difference is that a basic on the same year pay as me will not get the ALS or Rescue allowances.

stay safe