rdenman26

Jumping gates or stopping on rail crossings goes waaaaaaaaaaaaayyyyy beyond stupid :shock:

I gave up watching EMS and medical show, as I just keep hurling abuse at the TV because they wee doing it wrong.

Could not possibly say what we call them. But like every were system abuse is on the increase.

Making driving blindfolded illegal doesn,t sound that bizarre to me. Does it mean its OK in the other US states.

Whilst I cant comment on you training, one thing that is common to ems around the world is that a lot of what you learn as you progress cant be taught in the class room. I would advise you to recognise that the classroom only gives you the basics on which to develope your self an em EMS provider. Do that and your less likely to fall flat on yuor face. I have seen and awful lot of newbies (especially FRs) end up looking very silly because theu think they know it all. Were you thinking of making a career in EMS, have you thought about the full paramedic training? Did that make sense to anyone other than me.

There is evan an address on the front of out national clinical guidelines to write to for questions, challenges, suggestions etc. The medical director of the service encourages sensible questioning (rather than obvious moaning and winging) as a way of learnigng.

Dont take this the wrong easy people, but 120 hous does not seems a lot for front line EMS. Does this include, both driving and clinical stuff?? Just trying to understand your system a bit better.

[quote="fiznat I've never actually done this before, called a doc with an ECG and asked for advice. I imagine it would be really hard to describe the ECG over the radio to the point where the doc's determination would be THAT much better than mine. What do you do, sit there and say "...the deflection of the QRS in V1 is negative. It is approximately .17s in duration. There is some minor slurring on the terminal aspect of the wave.... blah blah..." Ihought you guys had telemetry if you needed to discuss an ECG, ETC. If I had an ECG i needed advise about I can fax it to the reciving hospital CCU for advise. I thought you guys had beed doing that for years. We are restricted on what we can do for a patient like this. We cant cardiovert, and we can only use the amiodarone on the unstable patient. This is contry to national resus council guidlines. When I have to have such a patient under my care for 45 mins, it can get a little worrying.

Before any one points it out, I know I put the puntuation mark in the wrong place in my last post. I really must learn to concentrate more when I'm typing. :oops:

Hehe... yeah, anything I preface with, "Go big or go home!" is meant to be taken tongue-in-cheek. Right, Ill try to remember that.

And you would be called in front of your medical director immediately after doing so. It is TRIgeminy. :wink: Good point well, presented

Not if getting to the hospital two mins earlier means an intervention that prevents them from dying. However TV news seems to suggest that your traffic is worse than ours, so Im sure that would make a difference to how much time could be saved. When I worked in central london there was plenty of time whe no amount of noise and flashy lights were going to help, as there was no were for the other vehicles to move to. London is the only place I have been to where you can get stuck in a traffic jam at 3am.

What I mean is; armed Response Units (ARVs) normally carry their weapons locked away in the car, and not on the officer themselves. So the officers them selves are not acually armed. In the event of an armed incident, they are authorised by a senior officer to "arm up" or in an emergency may "self arm". Maybe its just local terminology. There is a lot of paperwork for UK officers who deploy firearms, but then they have a lot of paperwork if they need a new role of toilet paper. the movie you were refering to is HOT FUZZ, and it is indeed a top film. The real police are becoming mor heavely armed. For example due to the increase in body armour on the streets, the ARVs in the area I work in now went from carrying MP5s and Glock17s to Assault rifles, Glock17s, baton gun and the x26 taser. Our SWAT teams then have various other weapons. Things seem to be taking a worring turn in this country. Police getting chased with samuri swords, poster about the dangers of meth labs appearing on station. People often think (in the UK) because I work in one of the most rural counties in england we dont get guns. But theyre are a hell of a lot of people with firearms, both legal and not. My station is a conveted part of the local police station, and we must be the only staton in the UK with an armery. Although for some reason the police wont let us in there.

we are told that amiodarone is incompatable with saline and should not be given if lidocaine has been given. Are you guys joking around or is this a difference in medical opinion and procedure between our countries. Maybe I should go to be, it is 23:10 over here.

I would called the the first trace ventricular bigemany. Second wide complex tachycardia. O2 and IV access, regular monitoring of ECG, pulses BP etcetc. FAX ecg to recieving hospital and rapid transport. As the patient remains alert with peripheral pulses just monitor and reassure. Of course the fact that not all the QRS complexes have a pulse attached if significant. If the patient became, more unstable; reduced LOC, SOB, CP etc and rate is over 150, I can give amiodarone 150mg over 10 mins. UK resus council guidelines for unstable wide complec tachy are cardioversion and referal to expert advise. But at the moment UK paramedics cant do sync cardioversion. I have seen this sort of dysrythmia converted by speed bumps (do you have those in the US?). Had one VT pt loose consciousness and pulse, gave pre cordial thump whilst mt crew mate was pulling out the defib pads. He came round pretty quick, did the same in hosp. They shocked him so quick he must have still been semi-conc judgeing by the scream and how much he jumped. Still the point Im trying to make is these patients can become very ill very quickly so dont piss about.

Depends on the situation. If a parmedic intercepts a crew and can deal with the patinet them selves then the spare crew will drive to the hospital. Otherwise the car will be locked and left (with out leaving the drugs in it) and collected later. Luckely I have never had a car vandalised or stolen. But it has happended when the medics are in a patients house treating them.

Has their been any proper reasearch that indicates how hot running to hosp affects patient outcomes?

Last time I got hassle from a Doc, I just gave him the thousand yard stare and walked off. He wouldn't look me in the face for the rest of the day. The nurses later told me he new he has pissed me off. Other lines I have used are; fair enough but you were not there Id rather be called a fool by you than the coroner, I appreciate your point -about not cutting umbilical cords- but Im not about to carry a mother down a flight of stone steps covered in sheet ice, whilst the baby is still attached. Or when I alerted the hospital to an agitated head injury patient who had fallen down a flight of stairs, I was told by the nurse, well maybe you should take the collar and board off then! A simple "thats not an option right now" did the job. Luckely we generally hve a pretty good relationship with the staff at my usual hospital. In fact after a particularly serious patient I often ask if there might be anything I can do better, and most of the time the Docs are happy to help and advise. But we are health care professional and expect to be treated as such; Iv'e hot my self all worked up now

Most ambulance personnell dont get resuce training here. There is familarisation with rescue procedure and equipment that may be used by the fire service so we can operate safely at and incident. We are starting to see the development of special operations response teams, who have training to deal with incidents such as HazMat. Also we are developing USAR teams with the fire service and even tactical medics with the police. But mostly rescue is handle by the fire service, cave and mountain rescue, the coast guard, Royal National Lifeboat institution and RAF SAR teams. We used to have light resuce kit such as, prybar, saw boltcroppers and scredrivers but it was taken from us. Because of this I one had to call the fire service to free someone who had fallen and got stuck between there bath and toilet. They sent two pumpers and a heavy resuce truck, which is apparently the standard response to a persons trapped call. Funny thing was only two firefighters could fit in the bathroom, and only one of them at a time could use a small saw to cut the side panel of the bath away. When me and my crewmate wheeled the patient out to the ambulance there were firefighters every were. Another time I had t call the fire service to force a door, luckely the patients friends managed to find a prybar. So basic rescue kit and training is very useful but the use of specialised tools is, well, specialised. This sort of thing needs to be left to people who have extensive training in its use. Which aint the ambulance service. Of course I can only speak for the UK.

Got to be falls, CP and SOB, often ETOH features somewere inthe picture.

Over hear basic level ambulance personnel (the NHS one at least) can in addition to the usual BLS, bandageing spinting, O2 etc; Laryngeal Mask Airway Basic Ventilatiors Automated and manual defib of adults and automated defib of paedicatric pts 12 lead ECG Glucometry Aspirin GTN sublingual spray IM Glucagon, Naloxone, Epi (for anaphylaxis) Hypostop gel Entonox (Nitrous Oxide/Oxygen) Nebulised Salbutamol (albuterol??) and ipratropium