celticcare

Wonderful news to come out of a dark bleek hole my friend, onwards and upwards and expect to see you as EMT - P soon take care and enjoy the new adventure

Scotty

I have been one to come with a smile with my kit bag and just say "Hi I'm Scotty, what seems to be happening today?" or if it is a knock on the door situation, just knocking and saying "Hello Ambulance service here" if no answer calling again with the added "We got a call for someone from this address, is there anyone home?" this is done whilst one of us is looking around the house to see in through windows for someone on the floor.

I like humour but it is situational, I have used the drop pt routine but again it is situational and gauged on the level of fear or pain the patient is in. I grew up in a rural area and have used the words "feeling like shit basically?" on calls, but that was with people I knew, people near my age and the situation itself, every call is different, every Locale is different, I will not judge anyone on how they open up on a call on here as each on presents with its own set of characteristics, just like no judgement on mine.

When I am at work, I do say when I enter a patients bedspace "Hi I am Scotty, one of the Emergency nurses on duty today, whats brought you into see us today?" All of the nurses in my hospital wear the same uniform and so I say my role to differentiate me from one of the NP's or CNS's.

And in regards to "take your vitals" I don't often use the term vitals I say what I am looking at "I'm just going to check your blood pressure and heart rate, this is so I have a balance to follow against when I am doing them again later, do you know what your normal blood pressure is?"

Some patients who are English as second language and some of the elderly or those with dementia, get agitated to the words Take. Each situation is different and I am sure we are not all as fortunate as Craig to have situations where they dont get antsy over the phrase "take".

All in all, its all just bricks in the wall......... take each call as it comes .... Oh wait, I just took someones call from them

Scotty

Here are some links to some EMS units running at universities, whilst not all are American, perhaps some ideas could be gained.

Could your squad run as an extension of the local EMS provider, like they can advertise that they have a team allocated to your college and that then provides you with a medical director, facilities for continuing ed and an auditor for paperwork?

http://www.sjapeel.ca/node/36

http://uoserres.com/about/

http://www.campusemergencyresponseteam.ca/about.php

http://www.uoguelph.ca/frt/html/about.html

With the use of IV therapy now adays here, every IV has to be justified, inserting an IV in the field whilst the patient has good veins because you know they will need bloods and medications when they reach hospital does not qauntify as a justifiable excuse for inserting a Leur and so less are being inserted in the metropolitan areas. Or because of short transport times, Leurs are often not inserted because of the load and go process.

I have medic textbooks dating back to the Early 70's showing IV insertion Techniques, so has been around in EMS for a while, just the exact date as a whole is difficult to ascertain, though Johnny and Roy inserted them

Scotty

Hi Andrew, welcome to the City. Just a few questions to help us with answering your question

What sort of size campus is it that you are serving?

Are there boarding houses (hostels, fraternities etc) on the grounds?

How far is your campus from a local EMS provider?

Is your campus an alcohol free campus or had problems in the past with drugs and alcohol?

What sort of staff are you wanting to have? EMT? CFR?

Does your campus have a medical/nursing/EMS program that you would utilise students from these faculties within your team?

What sort of access to equipment (Jump bags, uniforms, pagers, RT units, Defibrillators etc) would your team have?

How would your team be dispatched (students call a university operator who then pages you to respond?)

Would your lecturers support the idea if their students had to leave class suddenly to attend to a call?

Who would oversee your reports and medical documentation and medication administration?

All the joyful legal stuff and behind the scenes elements that get set up into running a campus EMS unit, I know people who have set them up before and I have been involved in similar. Would be happy to help as I am sure that others will be too. Post in more forums also though just so we know that you are serious about EMS, just so that we know we are giving the best help we can to someone who is dedicated to the field.

Welcome again to the site, sorry about the bombardment of questions and if you can help answer some of them, then we can begin to help.

Scotty

It may be like here in NZ though where you can buy an EPI Pen at the pharmacy now without a prescription. if it were my kid who were having the severe reaction I would give the Adrenaline and save their life and deal with issues later. Guess its a parent thing

I carry two Kit's when I am about, one being a basic level kit with basic first aid supplies like bandages and band aids etc. The second one, is carried if I am on long drives where EMS support can be a long period of time away and as well as the basics, it also has more equipment in it like Airways, Bagmask, C-collars, IV supplies etc, I do not carry medications in any of my packs except paracetamol, Aspirin and GTN.

I like my old school kit as well as my new school one, below are a picture of the two side by side.

BAZINGA

Our Advanced Cardiac first responders use the I-Gel airway, No messing with trying to inflate it, cheap as well. Simple to use.

I-Gel Airway? I am curious indeed

Cheers Ben. I think that as long as the local EMS providers are aware LMAs are carried I don't see the problem. I think they would be a much better adjunct in these work environments than OPAs. Soon see though

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Ok guys, I am writing a Pre hospital emergency Care course and within this, I am talking about the usage of Airway adjuncts. Now tradtionally I have taught the use of NPA and OPA adjuncts. However, the teams I am training, are a bit out from Emergency Medical Service assistance and are in areas where exposure to chemicals such as amonia is high.

I am wanting to teach the staff how to utilise LMA's. The patient clientelle for these teams would be adults and with the ease of inserting the devices I think they would be beneficial to learn and utlise. My question, is what skill level is LMA with your services - Here in NZ it is EMT -B skill and is introduced on the CFR courses *PHEC* I dont see it as a skill that is reserved for ACLS, nurses in the hospitals are all trained to insert LMA's as a basic life support adjunct.

Please do not deviate to Combi tubes or intubation. I am a firm believer in intubation being the gold standard for airway support and still support pre hospital intubation, but alot of push exists for supraglottic airway use, so if the EMS teams are putting LMA's in instead of ET tubes, then would the insertion of them be beneficial for industrial rescue squads? It then leaves a set of hands free as a bag mask could be attached and easily managed rather than having to hold a jaw thrust with an OPA and c-grip for BVM usage.

Thanks in advance guys

Scotty

Seriously??? In this entire community no one has had any dealings with phone app development or anything like that????? My gosh

Hi guys, hope this post finds you all well and either enjoying the heat in the Northern Hemisphere or keeping warm in the Southern.

I am wanting to develop an Iphone/Ipad app as part of an educators Role. Mainly just to focus on topics pertinent to the work areas I am in. I realise that there are plenty of international applications for topics such as Burns, Trauma, GCS and ACLS etc, but want to develop one that my fellow colleques and myself can have on hand with New Zealand specific protocols and the district health board protocols. It wouldn't contain anything confidential or sensitive as alot of the protocols for the hospitals are generic for the country, just want to have something that looks great and is easy to use.

Has anyone had any experience with making apps, I don't want to pay a huge amount of money to do this as its a project/hobby that I am wanting to undertake.

Anyone who can offer advice, website or their own personal experiences would be forever in my debt.

Scotty

Ok the registration of Paramedics is a good thing and in the reality Ben, I would rather have a registered Paramedic looking after me who is accountable for his skills and updates as I have to be as an RN than someone who isnt'. What is the point of having double crewing or better trucks *which hell you refer to as a faggoty sprinter* if the officers providing the care aren't up to a standard. With the progression of the degrees and skill sets, the in house methodology of EMS education wont exist any more, just like it doesn't exist for nursing here in New Zealand any more.

Ch - the general running is as said above, basically the medics do their training, get an authority to practice which is signed off by the EMS agency and their medical director. Its the medical director for the region that basically lets the medics use the drugs under his license. if that medic screws up, then they have to report to the medical director and sort it out and make sure everything is in line and if anything needs to change for that individual staff member.

I am getting sick of this shite about paramedics whinning about registration, every other health sector provider in NZ has to be registered, what makes EMS so much different. And Ben, don't refer to technicians as the lowest form of staff, because at the end of the day, the achieved the qualification and skill set and got their arse on the ambulance seat. More than I can say about you, and just remember also, that when you finish the degree, you don't get to practice at ILS straight away, you spend a period of time consolidating your knowledge at an EMT level just like I had to do as a Level 1 nurse on registering. So don't you even think of refering to technicians is how you implied, because I know a few who would happily clip you upside the head for that crap!

Just remember craig, Australia is just the West Island of New Zealand, the island we like to forget about most of the time

*sniff sniff* no visit to NZ

I'm still waiting for my sandwiches!!!!! Damn women at gym and socialising, where's a man to get fed and revered around here. I'm off to the gentlemens club now.

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Ah shucks, just get in the kitchen and make me a sammich woman!

*ducks from skillets and old lifepaks being thrown at me*

plus with cling film, you can continue to cool over the top of it. Saline provides great pain relief however, agree with Kiwi *gasp gasp shock gasp* cooling with running water on scene better than what can be done in back of truck.

Man we don't get anything interesting like that here, just topics in general classes about burn management and airway airway airway as well as analgesia analgesia analgesia and cool cool cool *knock knock knock PENNY Knock Knock Knock PENNY Knock Knock Knock Penny*.

Love to hear how the course goes and what the content is like.

Scotty

Oooooooooo Burrnnnnnnnnnnn love it

At least at the end of the day, we all know its us Nurses that run the department and tell the docs to just script something and let us get on with doing the work

Slow that puppy down, especially if it was PSVT on the monitor or anything like that, even if it was AT, slow it down, I agree with Adenosine and then sync cardiovert, with her vitals like that how they were, I'd have looked at fluid's anti pyretic and either DCCV or Adenosine. Why strain all the system with one of them going out of whack, slow the heart then at least one is in control and then able to focus on the others.

Thank you CH, that is exactly what I am needing especially the clinical skills records and what is expected of preceptors etc.

I'll pm you my e-mail addy and can continue from there.

Scotty

Hi guys and gals. This is a post to anyone involved in the paramedic degree programs. I am collaborating information for a project and need assistance for information I am developing a clinical placement program in our local EDs and wanting to talk to others doing placement options there and see what you have set up for students. Am available via pm and chat and this board.

Many thanks in advance

Scotty

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Continuing education is part of a paid process if you are a paid member where you get your classes, regular updates and certification paid for and your shift covered and still paid if you have to do the course during your road shift allocated time. Here in Nursing, we get courses paid for if applicable to our area, such as ACLS,PALS etc and have the opportunity to apply for funding for other courses if they are benefit to our jobs. I haven't had to pay for a course yet as an RN nor when I was doing EMS. If you have to travel out of town to do courses, your accommodation is often covered if it is an arranged course through the service.