Kiwiology

Episode Three

Part One

Part Two

Part Three

The audio is pretty badly out of sync for me but it is still an interesting watch. You guys talk funny! haha

I understand the show is designed for laypeople, so it is a bit frustrating for me to watch, knowing how much is being cut out. Did they ever shock the guy in VF or did he just spontaneously regain a rhythm (as depicted in the show)? Did they RSI (the medic was talking about seeing vessiculations), and if so why was he fighting the tube? For the hanging guy, it seemed like they spent a really long time on scene doing nothing, and then transported without securing the guy's head to the backboard....

I'm sure a lot of this has to do with the editing, as you don't really get a sense for what is happening in what order. I enjoyed that though. Thanks!!

I can only assume they shocked him, you hear the medic saying "shock it". They did sedate him with rohypnoval (I hear they also have rocronium and sux) but it's not something that's made its way out of the Auckland service from what I understand.

There are some noises being made about requiring us to tape down people to the board and/or transport them on a board. Our guidelines state that "Spine boards are recommended as extrication aids only and patients should not be routinely transported on them".

Second ep is below (the audio is in sync now)

Episode Two (includes another cardiac arrest)

Part One

Part Two

Part Three

Below are some links to our own local TV series called Rapid Response which follows around our ALS Paramedics in Auckland.

Because the source video was only viewable here in NZ I had to rip and convert then reupload it; go my mad technical skills. New link are below

I have only ripped the first episode that includes acardiac arrest for the time being; the rest will come later today

Episode One

Part One

Part Two

Part Three

You're shitting me I thought I fixed that!! I'll try to rip them and upload 'em

Hey all;

Below are some links to our own local TV series called Rapid Response which follows around our ALS Paramedics in Auckland.

The files are .FLV which is Flash Video but can be played in VLC, Quicktime etc (I think they have native support) or any other player including WMP (but you need FFDShow codec)

You will notice we are a bit quirky in the way we operate, so the following local lingo is essential:

Primary Care Officer - volunteers who are used to augment paid staff and make a 2 person crew (very suprised if you see any on here)

Ambulance Officer - read EMT Basic

Paramedic - read EMT Intermediate

Advanced Paramedic - read EMT Paramedic

Patients are classified as status one to four:

Status 1 - unstable, imminent life threat

Status 2 - unstable, serious life threat

Status 3 - stable with potential to change

Status 4 - stable and not likely to change

I am sure Scotty and I'd love to hear what you think of how we work

Episode One (includes a cardiac arrest)

Part One

Part Two

Part Three

Part Four

Episode Two (includes a cardiac arrest)

Part One

Part Two

Part Three

Episdode Three

Part One

Part Two

Part Three

Episode Four

Part One

Part Two

Part Three

Episode Five

Part One

Part Two

Part Three

Episode Six

Part One

Part Two

Part Three

Affirmative action (yes we have it here in New Zealand too) is simply reverse racisim.

Strikes me as a way for white, middle class, able bodied, well educated males who feel bad about themselves for looking down on minorities to try and find a way to rock up to the Pearly Gates and go "yo St Peter, dude, look what we did!".

I whole heartedly support equal opportunities for all people be they white, black, brown, orange, poor, rich, middle class, disabled or not, college graduate or high school dropout, gangbanger from the ghetto or rich kid from the suburbs or whatever but this shit is crazy.

While not disagreeing that maybe we didn't do so good on that slavery thing (or in the case of the British settlers in New Zealand; getting the Maoris to sign over the country and trying to breed them out of existance) but this was hundred of years ago ... get over it. You can't tell me that any person be they black, white, blue, rich, poor, disabled or not, educated or thick as pigshit who spent high school out back smoking and faunicating behind the sports equipment shed does not have the same opportunies to make something of themselves as any other person.

Pull your heads out your arses and realise that by playing the race card you are ignorant; you are expecting us to feel bad for stuff done generations ago and give you something baed upon that. It's not "righting a wrong" or anything; it's pure manipulation that I see at work EVERY DAY; every day I see people who simply use their skin colour to try and manipulate the system into getting what they want. Makes me puke.

Tell you what, today, in 2009, you go walk your ass across the Edmund Pettus Bridge and I tell you what, if a bunch of Alabama State Police come beat you up then I'll take it all back.

Ben

I am truly shocked and horrified mate. This guy is beyond what I'd class as a whacker and he sounds like he has some mental health problems going on from what you describe. I don't know enough to speculate as to what he might have going on upstairs, and even if he doesn't, his actions are totally unprofessional and apalling to say the least.

I am not sure how your structure works over there in relation to ours but given the behaviour you describe I would document the hell out of it and just give him the boot; its not like he can sue you for wrongful dismissal.

Surely you must have standards, regulations etc ??????

I feel bad for you mate

Ben

When I was with the Johnnos we had a big thick manual of SOPs, regs etc .... mind you we were in the same group as the road vollies but still this guy would be in violation of lots of them over here, sounds like you do things differently .... talk to your operations manager mate

if you have a 23 y/o female Pt. taking a Ca channel blocker, c/o dizzyness and is slightly lathargic and the BP reading is consistently 99/58 to 99/68 (taken q5min), is it considered hypotension, and what would be the definitive treatment.

"Hypo" simply means lower than "normal" which is kind of subjective ... the National Heart Lung & Blood institute's website now says hypotension is a BP of < 90/60.

As for treatment, well .... is the patient physiologically stable or are they showing signs of hypoperfusion? I've seen a guy with a blood presssure of 80/50 up dancing around (well not quite but you get the idea) whereas when I got sick last I was running a pressure of about 90/70 and I was pretty cold and pale.

BP, heart rate etc are helpful in guiding you towards your diagnosis or showing you where to look for further evidence; ok so this guy's pressure is way low, could be cardiac, could be renal, could be that he has a big ass wound and is loosing lots of blood etc

some old dude who was "generally unwell"

This sounds like one of Grandpa Simpson's moments lol

We'd take the patient probably and send the nursing home a large bill for whatever unscheduled patient transfer is .... it's not cheap.

Better late than never

... or when NYC*EMS was run by the Health & Hospitals Corporation and you could find a bus at a station rather than parked on the side of the street at 6am with the crew turning the engine over every hour to get warm.

... and when telemetry was OLD SCHOOL which includes auctually calling for orders (something we never really got into) or when you had to call for valium or dextrose!

http://www.youtube.com/watch?v=xV3gpRyKWLc

My MD friend (yes ... I have friends, don't look at me like that! lol) were discussing it, he says it's called tako tsubo cardiomyopathy, also called broken heart syndrome, where excessive stress with very high catecholamine release causes stunning of the heart, seen in a tumor called a phaeochromocytom that release massive amounts of catecholamines (epi/norepi)

We left an entire truck abandoned at the helicopter pad once because the crew were needed for a cardiac arrest

An autopsy report released earlier this week suggested Fraley's dehydration and cramping may have led to a fatal heart attack

So what this kid had some MASSIVE electrolyte imbalance which caused a cardiac arrest hmm ..... ok sure I've heard of that happening but it's pretty gosh darn rare. I'd expect anybody THAT dehydrated to have some symptoms and ECG changes.

In this case, I would suggest this patient might have been dealing with rhabdomyolosis

I was originally going to post a sarchastic question asking if a building fell on him or something because I've known this as "crush syndrome" but I looked in the journals, and sure enuf excessive muscule use (esp if dehydrated) can cause it. See here for the article

I can't say what I'd have done here but I sure as hell wouldn't get vascular access on this kid because he wanted it. If he couldnt sit still for more than a few seconds and was bitching about cramps I wouldn't leave him at home that's for sure!

Whoever gave us the idea that life was easy needs to be taken out back and brutally tortured

Suicide is a waste, it really is, I've buried enough of my friends to know that.

At the end of the day however ... if that's your chosen method of departure than so be it, who am I to judge you?

Lights are quite common here but the siren is not used a lot; generally only to clear traffic.

Guess this all goes back to the old rhetoric of "treat your patient, not the [numbers/monitor/whatever]"

I remember one old guy with a BP of 80 systolic who was up dancing around and completly haemodynamically stable, me on the other hand last time I got sick I was on the verge of passing out running a pressure of 90 systolic.

Seems that we are (for the better) shifting away from empirical guidelines to those based upon science and valid research. Our guidelines have undergone radical transformation in the last 5 years to reflect the fact it's far better to have a set of options available to you rather than just following a protocol; most of this has been (to my understanding) based upon the evidence coming out in JAMA/JPHC/other studies etc.

One of my good friends started out in the service during the mid seventies; he says common practice back then was to give lots and lots of fluid (so much so he swears patients used to bleed clear!).

What if people don't have text messaging?

Then that phone you bought in about 1995 is probably very out of date

I agree with Dust; now that I've taken/taking A&P, pharm and patho I understand so much more and can really see the limitation of just learning what you have to (i.e. what the cert reqs are)

An ECG course is always a good idea too.

“The unit can’t roll to the hospital without at least one EMT on board.”

So.... it can go to the patient with no EMTs on board but it has to have one onboard to go to the hospital eh; sounds a bit suspicious or perhaps its to keep from getting busted for using unqualified crews?

I hardly think "roll to the hospital" is an appropriate statement to be made to the media.

This guy doesn't sound very smart.

Obama's dog rates pretty low on my list of things to worry about.... probably about 2 above being abducted by aliens.

Are you saying I am being paranoid with my collander and tin foil?

Why the need for an accelerated class ... C90 got you holding at Pullamn or KRENA or something?

For some people a full-time, get-you-in-get-you-out class would work OK so we need some more info

- What is your motivation for getting into EMS if you're becoming an air traffic controller?

- What would you do with your cert, would you move up to AEMT or Paramedic etc?

- Do you have any previous background in medicine, e.g. A&P class(es), FF/CNA/RT etc?

Hope this helps

Ben, BAv, 14 CFR 121 ADXL

Yeah, I gave up planes too .... never understand why!