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Well said brent. We tend to forget that we are dispatched on the information provided to dispatch. That information is then relayed nto us by PROFESSIONALS. Lets not forget that people who work on road are not the only professionals. 95% of calls that come in are different to what is stated. How many patients do you take to hospital & have asked how many times in the past they have cad chest pain with a reply of NIL only to find that this is a hypertensive pt with Angina Pectoris? Does that make you any less professional because you have failed to gain that small, but significant & relevant piece of information? No, it highlights the lack of understandiong that the general public have about what Paramedics (dictionary definition - a person who is trained to assist a physician or to give first aid or other health care in the absence of a physician, often as part of a police, rescue, or firefighting squad.) are able to do, the knowledge they have, or the training they have undertaken. Please respect the fact that dispatch work with the information they recieve & have a unique job. They are not there just for you & to want to talk to the pt prior to arrival is a mere waste of resources & ties up a line that could be better served elsewhere

No dispatch system is perfect, we always get & will always get incorrect or insufficient information. To quote the great Dr House, people lie. We have a system called Pro Q & A which i believe is also used in the US, this is to direct a response based on information given. Reality is that frequent flyers & others learn to say the right thing to get an immediate response. I dont believe a direct patch will help, they will just lie to you. Take the case at face value. Tredat what you find when you get there. Phil

Firstly, what is HEMS? How is the comparison to minimising on scene time - ie. the principal of the golden hour of trauma, rushing treatment to an interhospital transfer for a trauma pt. No one denies that pts need difinitive care & if your service doesnt allow for a trauma bypass, then maybe they should look at it. You need to transport appropriate to the patiens clinical needs. That is not par of this discussion. This is about whether getting a patient to difinitive care within 1 hour, the golden hour, of the Trauma occuring increases outcome for patients. To save retyping what has already been typed before me: The Golden Hour - Is it a real principal for EMS?

-50 for repeating a post & ignoring the advice that the search is your friend. Ruff you got that right, it is a trimodal death sequence. The thing to remember, & it is easy to get sidelined, it that the golden hour was initially proposed for trauma. End of Story. The way hospitals are judged is via a Trimodal death sequence as stated above. This does not mean that we, as pre hospital clinitians should sit on scene & delay transport. I personally believe that hospital - difinitive care - is where the sick & injured need to be as soon as possible. That said, to put a specific time fram, in this case an hour, on a trauma, that is from the time the trauma happenned, can be inhibitive & cause clinitians to lose focus on what they should be doing, assessing & treating the patient safely. Experience tells us that there are now ways of clearing for things in the field & I am sure they will progress over time (C-spine comes to mind - Fifthkid has a great protocol for that in Maine) & there is less emphasis on exploratory surgey today than ever before, the use of ultrasound to clear for abdo bleeds for example. Too often we see people lying in an ED that was brought in from a serious trauma that is still on the same bed, in the same spot for hours because their injuries are not serious enough to warrant urgent surgery, they have no indicaators for maor internal injuries & have had spinal clearance via CT. So you have busted your ass for nothing. More people in ems need to use their brains. They need to think before they rush a patient off for 'urgent trauma surgery'. Kown your anatony & patophisiology, look at your mechinism of injury, explore those areas for injury. Properly assess each patient. Transport them in a timley manner, in a way that is appropriate to their presenting condition. That was the point of the discussion.

Your Name:Phil 1. Famous singer/band: Prince 2. 4 letter word: Pill 3. Street name: Pindari 4. Color: Pink 5. Gifts/presents: Penhouse Subscription 6. Vehicle: Proton 7. Items on a menu: Poached Egg 8. Girl Name: Prudence 9. Boy Name: Paul 10. Movie Title: Pirates of the Carribean 11. Drink: Pina Colada 12. Occupation: Paramedic!!!!!!! 13. Flower: Pattersons Curse 14. Famous Person: Prince Phillip 15. Magazine: Penthouse 16. US City: Pittsburg 17. Famous Sports Team: Panthers 18. Reason for Being Late for Work: Pissed myself 19. Something U Throw Away: Playboy Magazines 20. Things You Shout: PISS OFF!!!!!!!!!!!!!!!! 21. Cartoon Character: Porky Pig

You were doing well, until u desecrated the humble rissole. I can almost forgive the tim tam question. http://loveandcooking.blogspot.com/2004/10...at-tim-tam.html

A man is stumbling through the woods, totally drunk, when he comes upon a preacher baptizing people in the river. He proceeds to walk into the water and subsequently bumps into the preacher. The preacher turns around and is almost overcome by the smell of alcohol, whereupon he asks the drunk, "Are you ready to find Jesus?" The drunk answers,"Yes, I am." So the preacher grabs him and dunks him in the water. He pulls him up and asks the drunk, "Brother have you found Jesus?" The drunk replies, "No, I haven't found Jesus." The preacher shocked at the answer, dunks him into the water again for a little longer. He again pulls him out of the water and asks again, "Have you found Jesus yet my brother?" The drunk again answers, "No, I haven't found Jesus." By this time the preacher is at his wits end and dunks the drunk in the water again --- but this time holds him down for about 30 seconds and when he begins kicking his arms and legs he pulls him up. The preacher again asks the drunk, "For the love of God man have you found Jesus?" The drunk wipes his eyes and catches his breath and says to the Preacher, "Are you sure this is where he fell in?"

Try number 6 marty

Marty, thats cheating, but points for effort. At least we dont say 'aboot' :twisted: :twisted: Now Marty, the challenge is on, can you answer the questions??????

2007 Australian Citizenship test 1. Do you understand the meaning, but are unable to explain the origin of, the term "died in the arse"? ___________________________________ 2. What is a bloody little beauty?? ___________________________________ 3. Are these terms related: chuck a sickie; chuck a spaz; chuck a U-ey? ___________________________________ 4. Explain the following passage: "In the arvo last Chrissy the relos rocked up for a barbie, some bevvies and a few snags. After a bit of a Bex and a lie down we opened the pressies, scoffed all the chockies, bickies and lollies. Then we drained a few tinnies and Mum did her block after Dad and Steve had a barney and a bit of biffo." __________________________________ 5. Macca, Chooka and Wanger are driving to Surfers in their Torana. If they are travelling at 100 km/h while listening to Barnsey, Farnsey and Acca Dacca, how many slabs will each person on average consume between flashing a brown eye and having a slash? ___________________________ 6. Complete the following sentences: a) "If the van's rockin' don't bother ? You're going home in the back of a ? c) Fair crack of the ? _________________________________ 7. I've had a gutful and I can't be fagged. Discuss __________________________________ 8. Have you ever been on the giving or receiving end of a wedgie? __________________________________ 9. Do you have a friend or relative who has a car in their front yard "up on blocks"? Is his name Bruce and does he have a wife called Cheryl? __________________________________ 10. Does your family regularly eat a dish involving mincemeat, cabbage, curry powder and a packet of chicken noodle soup called either chow mein, chop suey or kai see ming? __________________________________ 11. What are the ingredients in a rissole? __________________________________ 12. Demonstrate the correct procedure for eating a Tim Tam. __________________________________ 13. Do you have an Aunty Irene who smokes 30 cigarettes a day and sounds like a bloke? __________________________________ 14. In any two-hour period have you ever eaten three-bean salad, a chop and two serves of pav washed down with someone else's beer that has been flogged from a bath full of ice? __________________________________ 15. When you go to a bring- your-own-meat barbie can you eat other people's meat or are you only allowed to eat your own? __________________________________ 16. What purple root vegetable beginning with the letter "b" is required by law to be included in a hamburger with the lot? __________________________________ 17. Do you own or have you ever owned a lawn mower, a pair of thongs, an Esky or Ugg boots? __________________________________ 18. Is it possible to "prang a car" while doing "circle work"? __________________________________ 19. Who would you like to crack on to? __________________________________ 20. Who is the most Australian: Kevin "Bloody" Wilson, John "True Blue" Williamson, Kylie Minogue or Warnie? __________________________________ Bonus Questions 1. Is there someone you are only mates with because they own a trailer or have a pool? _________________________________ 2. What does sinkin piss at a mates joint and getten para mean? _________________________________ You may copy your mates answers, please submit this back to me when you have had a fair old crack.

We use Fentanyl Intra Nasal with good effect here. It appears to be more versatile with a generally shorter half life. That being said, when it was introduced as an addition to our analgesia kits, it was made quite clear that Morphine was & always will be the gold standard in pain managment Phil

Marty did I detect a hint of sarcasm there? Very unlike you :twisted: 8) Phil

Paddy and his missus are lying in bed listening to the next door neighbours dog barking. It had been barking for hours and hours. Suddenly Paddy jumps up out of bed and says, "I've had enough of this" and he goes downstairs. Paddy finally comes back up to bed and his wife says, "The dog is still barking what have you been doing?" Paddy says "I've put the dog in our yard, fookin' see how THEY like it.”

You need to lok at the patient. Are they with us or out to it. Other than the machine result, what other indicators are there? To highlight a point, is a 55Kg female, with a BP of 90/60 Hypotensive? More information please

My bad, try this link Hit this link

If you are sitting next to someone who irritates you follow these instructions: 1. Quietly and calmly open up your laptop case. 2. Remove your laptop. 3. Start up 4. Make sure the guy who is annoying you, can see the screen. 5. Close your eyes, tilt your head up to the sky & move your lips as if praying 6. Then hit this link

Happy Birthday North you OLD BASTARD. I call you an old bastard casue, well, you are old & yr a bastard!!!!!!! :twisted: You know I love your work North.

The question I will ask here is at a code, what is the most important: 1. Airway Management. 2. Effective CPR 3. Early Defibrillation 4. IV Drug Therapy. If you think IV drug therapy is the right answer, then I am sorry, wrong answer. Evidence has proven (leading to the protocol changes for codes) that effective CPR & Early defibrillation are the most important. If you wish to use an example, then please ensure you have the facts right. Oh, sorry, this could be consrued as being childish & child like.

We have a system for ambulatory services in my state where any person who is entitled to claim an aged pension, Vetrans pension & a number of other pensions & benefits (including low income families) recieve FREE, yes 100% completley & utterly free, ambulatory cover, whether that be BLS or, shock horror, Intensive Care!!!!!!!!!!!!!!!! Yes we get some BS calls, but on the whole most people dont abuse the system. A question to consider is; How much money is billed by your companies to people who simply cannot afford to pay & then how much more is spent chasing that bad debt & how much more still is spent writing off that bad debt? Would it not be better to transport them for free & put up with a bit more BS than we already do?

The notion of a national health scheme need not be overtaxed. We have a scheme here that places a 2.75% levy on all working people to provide free basic healthcare for all. That is not to say it is without fault. There are some, however people still have a private insurance option. Healthcare in any first world country should be a right & a social obligation, that is not a communistic view. ALL people deserve to have their medical problems dealt with in a timley & appropriate manner. There is no reason that health systems cannot enter in to Public/Private partnerships where they run both systems bilaterally. With doctors providing services for both types of patients. A system that insists on people being able to access basic healthcare needs via insurance is a third world concept & further increases the divide between the haves & the have nots. We have no argument about governments of any country spending copious amounts of taxpayer monies on defence (or attack as the case may be), massive polititian pay rates just to name a couple, but neglect any form of national free basic health service is, in my opinion, obscene. Phil

No I do not believe it to be valid. My statment refers to the ability of anyone in ems to provide a level of care appropriate to their abilities. The notion that a person who has been a basic for many years & is committed to their vocation, at that level, should not be able to offer opinions to a medic with a piece of paper & no practical experience is fair, as is the ability of a medic to be humble enough to be able to discuss a case with a peer/ colleague. The vast majority of calls the ems attend do not require ALS interventions, but to provide ALS interventions properly, a medic should, as I stated earlier, be able to do the basics well. This is a basic tenet of EMS worldwide. As 4cmk6 stated No one of any level is 'better' than anyone else. We are peers. Some have more skills & abilities that they over time have achieved, but in essence, we should all have a mutual respect for each other & the skills & abilites we posess. Phil

This is the biggest BS topic of all time. 1. EMS is about patient care, not egos of those involved. 2. If you think it is a pissing match about who is better, think again. 3. To serve our patients better, we all need to look at our roles & identify what level of care is needed for each individual patient. 4. How many calls in reality are ALS or BLS calls? & WHO CARES!!!!!!! There is a place in EMS for all levels of training, from basic to medic, volly's included & threads like this do nothing to bridge the gap but conversly widen the gap between the skill levels. Each needs to function with mutual respect for each other. No one is better than the other because of their skill level. The reality is for a medic to be a good medic, then they need to be good at the basics first. Get over it. Phil

Marty did the girls speak?