Kiwiology

Dude, how could you leave me down in Indyland unable to fend for myself against people who cannot understand my Kiwispeak? I dissapoint! Great news bro!

I agree, in my exp there is the one few and far between young person who is quite mature etc but the vast majority are green as grass and have no idea how it is out on the street in the big wide world because they've never exp'd it and are fresh out of school or uni etc so just do not have the life skills required to do ambo work

The idea of an ALS Paramedic being 18 or 19 is very deeply concerning to me In AU, NZ and UK up until very recently all Ambulance Officers were trained through a vocational on the job program which took three to four years to complete and the Ambulance Service really only looked at people who were in their late 20s at the youngest who had gotten life exp etc. They rightly believed that those who are older with some work and life exp etc made better AOs and it is very true. In NZ you must do a 3 year Bachelor of Health Science to enter the Ambulance Service now and you need your full license for minimum of 3 years so the minimum age is really 21-22 then you go through an internship process so the youngest Intensive Care Paramedic I know is about 26 but many are older even those with the Degree because you must have several years as a Paramedic before applying for selection into the ICP course. So yes, I do not think it's a bad idea at all

Clearly something is not being reported here. Unlike in other jurisdictions where Ambulance Officers/Paramedics can leave patients at home on their own volition this is not the case in the US so he must have declined transport himself. If that is the case then he takes full onus and legal responsibility for his own healthcare, all patients are competent until proven otherwise and a competent patient always has the right to refuse treatment and/or transport so looks like another family in search of their lottery ticket.

The Republic of Texas would not look favourably on you for that ....

It seems in US outside of the regulated professions such as law, medicine, accounting, engineering etc a Bachelors Degree is a "nice to have" i.e. something to work towards, I have numerous US friends who are working and are "going back" to finish their Degree. Here and in Australia you simply would fall flat on your face without one for the overwhelming majority of professional careers Paramedic now requires the Degree and Intensive Care Paramedic requires a Post Bachelors Certificate. The Degree is just the first step, once everybody accepts that at least a two year Degree is required then things will begin to change from there, until then, nothing meaningful will change, including pay.

In NZ pre hospital IV therapy has been around in the hands of the Advanced Care Officer (Paramedic) since the 1972 Life Support Unit (Mobile Intensive Care) pilot project was established in Auckland. It became main stream for Intermediate Care Officers in the mid 1980s where it remains to this day, although Intermediate Care Officer no longer exists but it is a mid level skill.

New Zealand requires a Bachelors Degree for Paramedic and a Post-Bachelors Certificate for Intensive Care Paramedic Paramedic: OPA, NPA, LMA, PEEP, tourniquet, 12 lead ECG interpretation, defibrillation, cardioversion, oxygen, aspirin, GTN, salbutamol, ipatropium, glucose, glucagon, entonox, paracetamol, fentanyl, morphine, ondansetron, adrenaline, normal saline 0.9%, ceftriaxone, midazolam, amiodarone, loratadine, Intensive Care Paramedic: all of the above + endotracheal intubation, intraosseous, pacing, atropine, ketamine, vecuronium

Howdy I am Kiwi, I am a redneck trapped in a Kiwi's body, I love pick up trucks, the Dixie Chicks, oversized cowboy hats, BBQ, tawking like thees with a slow southern drawl, guns, hating on Obama, Sugarland heck ... almost anything redneck! I haz feeling we are going to get along just fine y'all

Look I hate to play devils advocate but the 1,000 hour paramedic operating to "protocols" is probably not worth much more than about $15 an hour If you want more money then convince everybody that higher education is absolutely necessary and that the profession must take responsibility for its own development. New Zealand started doing it in 1972 and it's taken nearly forty years to get to we are now so it's not going to happen overnight

Damn bro that is fucking mental insane in the brainbox seriously! Honestly I wouldn't have done anything differently nor suspected a PE

Entonox is good stuff, been used here for decades, Australia seems to favour methoxyflurane, we have it here in NZ but only for very rural stations where resupply of entonox is a problem or for space or weight limited areas e.g. Motorcycle or Ambulance Rescue

True, you can buy an adrenaline auto injector without an Rx I was thinking more ampoule of adrenaline for draw up

I have a pair of gloves and a high visibility vest in my glovebox and that is it It is interesting you can carry adrenaline for administration; do you have a prescription for it?

Dude that fucking sucks. I feel for you bro. Get your ass down to Indyland, we can find a spare rig, crank up the Sugarland and various other forms of redneck country music, wear giant cowboy hats and go save people when they OD on the Greatness that the Great Nation of Indiana exuded at 300mph in a series of flaming crashes and left turns. You can drive during the night and spot letterbox numbers, other than that we are good to go ... I even know a fire station on the far west side we can go park at who do not hate on Ambulance. Now, be a good sport, hit the air horn for me, HONK HONK, ok works a charm, Medic 302 calls Control, top of Moller Road and 34th St, responding ...

An Ambulance Officer is many things however broadly speaking it is 98% people management, 1.9% fundamental praxis and 0.1% advanced care. Most of the jobs you will go to are acute exacerbations of chronic disease (angina, heart disease, asthma/COPD, diabetes, renal failure etc) and are not glamorous or exciting. Despite what your poorly written textbook tells you, most patients are not in an immediate threat to life. There is nothing exciting about attempting to resuscitate somebody in cardiac arrest on the floor of their home with the family watching you when you know full well there are overwhelming odds he is going to stay dead. There is nothing exciting about having to tell that persons family their loved one is dead and Brown finds it an incredibly undignified way to die. Many Americans it seems are "trauma junkies" well news flash trauma is a horrible disease which has a profoundly devastating effect on society. There is nothing "cool" about assessing and treating somebody who amputated his arm with a rotary saw and may never be able to use it properly meaning he can't work and support his family any longer or going to a road traffic accident where the occupants have died meaning their families are going to forever be burdened with grief, anger and the untold emotional pressure of loosing a loved one. Do you have an interest in talking with people and building meaningful rapport with them in order to provide care? Do you have an interest in biology, chemistry and the inner workings of the body as they relate to physiologic and pathophysiologic states? Do you have an interest in continuing education? Do you think you are able to relate well to people in different circumstances and situations? Do you work well with others?

The bug bite and reasonably rapid onset (20 minutes) are the huge clues that this is not an asthma attack.

They can have any combination of wheezing, hives, stridor, hypotension, angioedema or tachycardia; just because they do not have hives or any other symptom does not mean that it is not an allergic reaction. Nebulised adrenaline is not a treatment for systemic allergic reaction; it is a treatment for angioedema; a patient who is "sick" enough needs parenteral adrenaline.

Her symps and obs do not fit with somebody who has been having an asthma attack for 20 minutes. Patients who present with severe or life threatening asthma have have been having active symps tor many hours that slowly progress to a point where they become so fatigued and hypercapoenic they can no longer compensate. On the other hand, she presents exactly as you would expect somebody who is having a severe allergic reaction. It is not yet what I would call anaphylaxis but its going to go there if you don't do anything. I am struggling to think of whether I would give this child parenteral adrenaline or not, but that is really not what you are asking. Nebulised adrenaline is only appropriate for severe croup or severe stridor. It is theoretically possible to give somebody with asthma or anaphylaxis nebulised adrenaline but probably won't do a lot.

As a former legal resident of the State of New York I take my responsibility to hate on Jersey very, very seriously especially when it comes to EMS, for fuck sake a first world nation relying on "First Aid Squads" fucking clown car style ambulance rocking up with four or five people, one of whom is actually an EMT and some other muppets who are drivers, crew chiefs and trainees and shit bloody hell

Good points raised by all, it is just extremely frustrating when people single out the "bullshit nutters who don't have a problem and just want attention" to rag on or talk trash about. These people have an actual medical problem and I would bet are more likely to suffer from greater morbidity and mortality or premature death than those with the vast majority of other health problems.

The big question is was your program CAAHEP/COAMESP accredited? If not then take it now https://www.nremt.org/nremt/about/para_accred_implementation_policy.asp

Poor canada

Bro why waste your time doing nursing if you want to be a doctor go to medical school

I hear aramine is popular