celticcare

I don't see why there would be, as you aren't delivering a certification session, it would be no different to a PSA or a promo showing the use of an AED or you going to a school and showing their usage etc. Its just showing that this is an AED this is what it does and you will go to a course soon to be certified in its usage and be able to help save a life *insert touchy feely happy happy joy joy comment* and all should be fine.

Photography is a passion of mine, as well as model railroading *waiting til we buy our house and then I get a train room muwahahaha*, collecting DVD's and enjoying them on wet days with my wife and daughter.

I also play guitar, though am a little rusty at the moment, having had a horrible thing called work taking up most of my time. Here's a clip of me from a few years ago trying to do Under Pressure some justice

Pulse checking is still in if it is in the hands of people who know what they are doing, and deal with codes and arrests etc on a more regular basis than some others in the nursing world. I still have some collegues wendy, that look at the ECG and you can see the colour drain from their face and the poop fill their pants and its down to simply, are they showing signs of an MI? Have you guys covered high take off yet? that still catches a few of my work mates out, but its experience and I was the same when I first started as a telemetry nurse on shift in CCU.

Reporting to you live from the hospital where I am being admitted to await coronary artery angiography. Took myself before it got worse. Keep you all posted and keep my wife and daughter in your prayers, they need the support more than me

(null)

No ignorance at all. I am on the outpatient list. Was on for 17th of December but the inpatient list is so behind they cancelled it. Last admission they said I could be admitted for inpatient but would have been a patient in hospital over Christmas and wouldn't risk missing Christmas for anything. So just waiting now

(null)

Hi all, happy new year and best holiday wishes to you all. 2012 already eh,

Anyway, as some of you may or may not know, my heart hasn't been in the best of health for a few months and awaiting angiography *unsure of when* as they found hypokinesis of the ventricles and recurrent bouts of chest pain at rest and shortness of breath. I am sitting here asking for your help if there is a good resource, a video you use or anything to show my daughter *who turns 7 on the 24th of january* for what to do if daddy collapses. We have written our address down on the fridge and our phone number and what to do *put the puppy in the office and open the front door etc* but want something that she can follow through. I used this one today as she is pretty clued up knowing daddy's heart isnt working as well and he gets weak and short of breath and to show her what an angio is and what the doctors might do for daddy. It's breaking my heart more than it already is to know I have to have these talks with my daughter and for my wife also two months into our marriage and she's been in with me being admitted twice with chest pains and feeling like crap.

Sorry to put that out there like that, I know I will be alright and it will be resolved and fixed, but its just the whole planning ahead thing because it is summer vacation and still another 5 weeks of holidays left before she goes back to school. She is a smart kid doing ambulance cadets *St John Cadet scheme* and I want a way to show her what happens when she dials for help and also what it looks like when the paramedics arrive etc. I don't want it to have to come to that, but if she has an idea, it would reduce, I feel, an element of fear on the whole thing.

Thanks guys, lets make 2012 a good year.

Scotty

As promised, here are some official pictures, these are the ones the photographer is using for official advertising, hence her watermark in the images. Hope you guys like them

Scotty

Sorry hit post twice grr

Scotty

We did it. Three days officially married. Best feeling in the world now off on our hunny moon. Will post some pics on here. For those who are on my facebook the pics from general cameras are there and official ones will be up soon. Thanks for the best wishes and will post more about the day soon.

Scotty

I would love a chance for a get together but airfares to the USA coupled with getting married soon makes that an almost impossible task at the moment. How many of us are in nz or aus? Maybe something southern hemisphere combined at the same time with America. Seeing as dust was an international man of mystery.

I saw dust online a few days before he passed. I wanted to stop and chat and catch up but was working on a big assignment. I have that regret now. But will remember his talks, his advice and his blessing for my marriage. He inspired me to be all I am and will be. Asys thinking of you mate. I never got the pleasure to meet him face to face. But will hold every talk close. I miss him and knowing he was around was a comfort. Many years I've talked with him. But I know he is still here through the work of AK Dwayne lone tniuqs and the seniors of our community.

Scotty

Resistance is futile lone but can't wait. Just over 2 weeks to go. Just trying to finish paying the last bits. Wedding license is 122 bucks YIKES!

18 days remain, looking at this post back in April, had plenty of time, all things sorted and now its getting closer and thinking HOLY HELL still a few things to sort. But Its getting closer and closer, and just for Lone and the other old timer cowboys *and dust had already seen my gal and gave his approval as she is texan hehe* here is a couple shots of my gal and I together.

Scotty

All in the family -

Boy the way Glen Miller played, songs that made the hit parade, guys like us we had it made,

those were the days, and you know where you were then, girls were girls and men were men,

mister we could use a man like Herbert Hoover again, didn't need no welfare states everybody pulled his weight,

gee our old Lasalle ran great, those were the days

Ok here's another one

I've been down this road

Walking the line that's painted by pride.....

Thanks guys for your replies and the ones so far have been helpful as it shows how we have vultures around causing a scene or being intrusive. Dwayne I'll pass on your comments to Rob. Thanks again guys you all rock

Scotty

Hi guys, I am helping a friend with a research topic and thought I would try you lovely people here for some direction or personal interactions.

My friend Rob, is doing a research report on the effects of film crews on EMT's *He is in his second to last paper for his Paramedic Degree*. We have a few shows here in New Zealand where film crews go with paramedics/emt's to calls and film them for the show.

What I want to know, is have any of you had this personally? Or been on a scene where film crews were working *like say on COPS or anything like that* and if so, did it affect you in any way. And no he-man tangents on "I stood up and told them to ***k off" as I know that its a media world we live in and if you stood up and did that on cam, then D'OH.

Also, are there any research articles out there on this and any effect it has on EMT's. Whether it be on the job *we all know what its like trying to put a line in with a heap of people watching* or afterwards like when the show has aired and people give backlash etc. I am just curious as to what resources are out there as my University databases don't include JEMS or any other pre hospital resources.

Thanks in advance guys, I'll do you all up some home baking and dates with hot co-workers all around.

Scotty

How about Promethazine? I've used it twice as an anti emetic at work and surprisingly seemed to work. Helps with reduction of inflamation so could have a double effect?

The only treatment this bloke is getting from me is a sheet put over him

Yeah but Ben, this guy had weak pulses on scene, a pulse is a pulse none the less. I know without seeing the patient I can't make a judgement call, unless there was brain matter splattered, I would have probably looked at maybe a round with some drugs and in this case, wouldn't the IO be utilised for the patient seeing as it was an arrest then at that point, or does it have to be VF/VT arrest? Just curious as I personally feel Io's are underutilised.

Without being there, like I said, I can't make a judgement call on right or wrong, but if they felt it was a total lost cause they could have turned back Helimed, so perhaps called too early. Yes the stats show a lot of things but it is situational.

Scotty

Hey all, I am currently working on my Masters of Nursing to become a Nurse Practitioner however, as Kiwi alluded, there is the Paramedic Practitioner program and pathway here. It is in one service *wellington Free* however it is in the pipelines for here. They are used successfully in the United Kingdom and have a wide range of drugs and procedures that can be utilised.

Paramedic training, like Nursing, requires a Bachelor of Health science with a major in either Paramedics or Nursing respectively. The next stages from the bachelors programs, are post graduate certs, diplomas and degrees *masters* to achieve higher level qualifications and scopes of practice. Currently to be an NP here, you must have a Masters degree with compulsary papers in Pathophysiology, Advanced Nursing assessment, Pharmacology, Nursing research and then option papers *I am doing Clinical education, Leadership and management and a prescribing practicum overseen by Emergency Attendings*.

There was a push for Paramedic Practitioners here a while ago, but it was squashed by the Nursing Council. Everything has its opposition, but then NP's have only been in NZ approx 10 years. We are getting there, I think the fact our health care professionals require a minimum of three years study to be qualified is a good thing. Similar approaches are made in Australia, the UK and Canada.

It's a shame that a worldwide superpower, like the USA, in general, appears to still use the cookbook style of paramedic education, but hopefully *I am an optimist after all* the time will come to have it all degree style. I would love to have both my skills utilised pre hospitally and in hospitally as an NP/PP.

Scotty

Hi magic. I live and work in Auckland but at North Shore hospital. DO you know our area?

Thank you all again for your posts and all are great for this project. I will follow up any patient fir any EMS crew as it's part of the learning circle

Scotty

Thanks for that magic. I am doing this as part of my masters requirements in creating a new nursing role within my working area and its something I think could be beneficial. I dont know if a full time role or even part time is required, more it would be a portfolio held by a staff member to specialise with.

I am stoked to hear that you guys have a good relationship, we dont have anything really like that where I am, I would like it though

Scotty

I would type an intellegent reply, but I am only just seeing out of the left side of my eye

Scotty

A Liaison would need to be well versed and familiar with not only prehospital and ER protocols, but the actual day to day issues each group deals with. A prehospital provider may not understand bed availability issues, delays in admitting/discharging patients because of slow labs, waiting for a transporter, busy procedure rooms, back ups waiting for Xrays, waiting to give reports, waiting for attendings to call back- the list is endless. Many EMS folks only see that they have no ER beds to transfer their patient to. An ER person may not understand the pressures of being told to get back in service, of the horrible conditions we sometimes see, of the weather extremes, of the difficult scenes, of the frustration of waiting for supplies, of the pressures of missing sleep, meals, the frustration of not having housekeeping to clean up the rig after a particularly messy call, of having no down time, of sometimes having to wrestle/restrain a combative patient with no help around, of performing our jobs in less than ideal conditions....

I would like to say that understanding is a 2 way street. I've been in both settings- field and ER- while I can count on one hand how many ER nurses I interact with can say they have done anything more than a mandatory shift or 2 for their critical care nursing class, trauma nurse specialist, or telemetry nurse class. Thus, if I know what happens in an ER, it does not stop the ER nurse from getting snotty. Yes, we can escalate things and make formal complaints about personality conflicts or nasty behavior, but I prefer to handle it on my own.

So who would this liaison be? A staff member of either group that has worked in both capacities. Obviously that would be ideal, but not always possible. Lacking that, the person would need to be actively involved in regular meetings/sessions to discuss the issues of both.

Thanks Herbie, well I wont lie, I would like this role quite a bit if it were to become a reality. I think that it would be a great one to have with a paramedic and RN on the groups together and like I said, I'm one of the only ones in there with an EMS background along with nursing. It would be a great step forward for things I do feel. Plus I am working on my Nurse Practitioner qualifications to be able to man the rapid response jeeps in the future as an emergency care practitioner, so being an RN support for both EMS and the ER would be a role I would enjoy.

Scotty

Defibs stolen from ambulance

This is something happening a bit more here, people see them on tv and have had a few stolen over the years from the back of the truck. Entonox cylinders are commonly stolen as they are NOS for boy racer cars.

Sad state when the trucks have to be locked at a scene because of yobo's.

Scotty

if this was about a patient / client group we'd be talking about 'cultural competence' and that is exactly how the issue should be dealt with ....

I'm sorry I dont follow? Coldral has clogged the brain.

Scotty

Thank you Dwayne, you hit it on the head. The situation that presented itself, was that a patient was bucked from their horse, now the MOI of the patient landing DID NOT indicate a C-collar and the patient met the in field requirements for spinal clearance and the ED physician also concured with this. The nurse questioned the Paramedic in front of the family and I felt this was wrong. When I spoke to her afterwards about it, she didn't know that in the field clearance of C-Spine can take place. This isn't the first instance that it has occured where Nurses have questioned paramedics abilities or knowledge in the field and time and time again I have had to explain things to them about what can and can't be done out in the field.

Another aspect is we upgraded and built a brand new Emergency Department and upgraded all of our patient monitors which utilise the same ecg dots as the ambulance, I had one ambulance crew remove their twelve lead dots as they didn't think that we had monitors to interconnect *which we didn't in the last ER but we do now* and so what I want to learn about, develop and hopefully implement, is a nurse who, along with a med director or other advanced paramedics, give education sessions to RN's about advancements in the field, technology that is being used in the ambulance, organise regular ride alongs and the same for us for paramedics, to come and spend a day in resus/crash rooms with us or continue more assessment, IV or 12 lead assessments with us. I want to see intergration/support for both sides. I am not out to piss anyone off, or say "you are a paramedic you can't do this or shouldn't do this".

I am lucky in the essence I am the only RN in there with an EMS background and credentials *just have had to put EMS riding on hold for a bit balancing the last of a masters degree, getting married, working full time and being a dad, had to put something on hold for a short while*. I don't want to see situations like what occured occur again, hence I am asking if there was an ER liason nurse role, what would you see he/she doing in this role? Organising training together? Organising shifts together? Being a go to with questions about the ER or any problems that may have arisen in the shift?

Thanks Dwayne though, and your feedback has been appreciated, as has the rest of the comments on this thread. Hope this post has clarified it up a bit more.

Scotty