Kiwiology

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

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. 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!).

Then that phone you bought in about 1995 is probably very out of date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

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.

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!

Whatsay we get an old sixties ford wagon with those ridicilously oversided red lights, a great big four foot tall radio aerial and a mechanical siren? Hot diggity now we talkin y'all!

I know a guy with the SPVM in Montreal Ill ask maybe he knows something. Try here (French) http://www.urgences-sante.qc.ca/indexx.asp?page=22

Congrats to the three of you; I think kids are the most awesome thing out there!!!

I would have to agree. Another problem we have here from what I've seen is the call detriments (A/B/C/D/E) are also tied into our KPIs of response times and Government funding; high levels of over-proritization is just not a good thing.

I don't know what it is but a lot of our people have an attitute problem; they are just arseholes with bad attidues towards patients, subordinates and peers.

Are you kidding, that would make me look bad! We report it to our medical director but we also have "clinical standards" people who are a waste of time that take Paramedics off the road and shove them behind a desk, could go see them.

I am not even going to dignify this with a response I am sickened.

No I do not have a problem with "young" Paramedics provided they have the knowledge and competence to accept such responsibility.

no no that's 624 hour class cookbook firemedics

Wouldn't the world be much easier growing up if we had these instead of the three bears or whatshisface, the tiger with OCD and that manic depressive donkey? You Are Different and That's Bad The Boy Who Died From Eating All His Vegetables Dad's New Wife Robert Fun four-letter Words to Know and Share Hammers, Screwdrivers and Scissors: An I-Can-Do-It Book The Kids' Guide to Hitchhiking Kathy Was So Bad Her Mom Stopped Loving Her Curious George and the High-Voltage Fence All Cats Go to Hell The Little Sissy Who Snitched Some Kittens Can Fly That's it, I'm Putting You Up for Adoption Grandpa Gets a Casket The Magic World Inside the Abandoned Refrigerator Garfield Gets Feline Leukemia The Pop-Up Book of Human Anatomy Strangers Have the Best Candy Whining, Kicking and Crying to Get Your Way You Were an Accident Things Rich Kids Have, But You Never Will Pop! Goes The Hamster...And Other Great Microwave Games The Man in the Moon Is Actually Satan Your Nightmares Are Real Where Would You Like to Be Buried? Eggs, Toilet Paper, and Your School Why Can't Mr. Fork and Ms. Electrical Outlet Be Friends? Places Where Mommy and Daddy Hide Neat Things Daddy Drinks Because You Cry

I do not see a problem with SAMPLE, DCAPBTLS or whatever other fancy wanker acronyms you want but you can't teach "look for A, B, C, D etc" and blindly follow it -- that's as bad as being a cookbook skill monkey. If you have the knowledge of normal physiology and anatomy then you should know what would be abnormal anyway and if you know that and simply use some acronym to make sure you cover your bases that is fine. Example: I love cardiology, I absolutely love it to bits and know how all the systems tie up into the cardiovascular function and what normal and abormal function is and how it affects the body. I know Nana who is having an acute infarct should be hypoperfused so diaphoretic, dizzy, ALOC, maybe SOB if a CPE is involved etc, might have some localized edema due to > ISF .... I don't need a fancy acronym to remember what to look for. If you blindly follow an acronym because that's all you know THEN YOU FAIL AS A MEDICAL PROVIDER and FORESHAME on the education system and the regulators for ALLOWING it. If you take an 18 day course because you want to go from zero to hero with zero previous knowledge THEN YOU FAIL and get the hell away from me. If you have a background of A&P, pharm, med term etc or if you're an RN (etc) who needs the cert then I don't see a problem with it; I mean after all, it's not rocket science, it's a bunch of skills you could teach a fencepost to carry out.

Well I agree; if you have no medical background and auctually want to be a decent provider stay the hell away from these courses; if you have medical background and just need the cert then maybe it's just what you are after.

I agree with Rob. Maybe you can find the local community college program (they are usually 1-2 nights a week and a Saturday of rotations thrown in every month) for a semester, quite cheap, couple hundred bucks probably. Let me make a comparison- I am a certified computer techie, it was two or three days a week for six months; we got time to do stuff, to pull bits apart and rewire them, to break it, remake it and learn from it. We could have done it eight hours a day for a couple weeks and gotten the same cert but we'd never have learnt anything. We're not talking about computers here, we are talking about human lives. Do you have any prior medical background? Do you understand that people's lives will be in your hands potentially after you finish this course? I am not saying don't do it but I am not saying do it either. We can train you to pass a test; but that's rather superficial and very poor. If you're trained to pass a test and follow a set of guidelines you are simply a what we term a "cook book" provider (not to say I am better than you or that I know everything, because I do not nor am I better than you). It's enough to pass the test knowing "do A if B and if not, do C" but it's far better if you can say "do A because of B, B won't work if C, if C is present, do D instead" -- let me give you an example of just what I am talking about. When I very first started out in EMS we had an anaphylaxis patient who crashed and the medic drew up some epinephrine and administered it; it was like this guy's lightblub got switched back on the effect was (for a newcomer) just what was desired but I thought this medic was the greatest thing in the world. I then promptly memorized 0.5mg epi IM ("A") or if that didn't work 1mg:1000cc NS TKO ("B") or 0.01mg IVP PRN ("C") so; see what I mean, I had the "recipe" for treating anaphylaxis - do A, if no result, do B, instead of B can do C. Then I wondered "hey, why do we do that?" and it really wasn't until I began my college A&P that I figured out ... - the body has things called vessels that carry blood, these can dialate (vasodialation) - when that happens there is more suface area for the blood to fill, so blood pressure drops - if blood pressure drops too much the body won't get enough oxygen and nutrients, things start dying and you pass out - the body (the very small airways of the lungs in particular) have smooth muscle which can constract - when that happens its called bronchoconstriction and it's very hard to breathe - breathing is important - the body has things called mast cells which release histamine and these are triggered by an allergy (bee, nuts etc) - histamine triggers histamine (H1) receptors which are found on the smooth muscle of the lungs and resp tract - when that happens your blood vessels dialate, your throat and lungs close up, you pass out and stop breathing which can lead to brain death and cardiac arrest - we give epinephrine because it is a vasoconstrictor (A1 receptor), bronchodailator and antihistamine (B2 receptor) so it 1) increaes blood pressure 2) stops histamine being produced and 3) makes it easier for you to breathe - hey, because epineprhine acts on the A1 receptor that's also responsible for increasing the heart rate and stroke volume, if this guy just had major bypass surgery we might need to reduce the dose a bit! See what I mean, I'm not trying to be a know-all smart bastard but you see the difference? I'm not saying you won't learn that on an 18 day course (but ten bucks says you wont!) and if you do, will you remember it?? It's one thing to know TO do something, its another entirely to know WHY to do it, why and when NOT to do it and WHAT will happen if you do it. Best of luck mate. Ben

Ah hah! I KNEW the Lifepak 10 could do a 12 lead, and people said I was crazy!

LP12 is too heavy, too weird to store and it's queer looking, and it has pads (ewwwww pads) Bring back the Lifepack 10!