rdenman26

We dont get to much of a problem from ED nurses, as we are quite close and know each other well.

I tend to be OK if I know its going to be bad. Its when Im not expecting it that I get sick. Never actually thrown up yet but come pretty close. I do tend to get travel sick on long runs.

They tried that, and shot a suspect serveral times in the head but he turned out to be an inocent electrician from brazil (I think). They followed hime from a residence, through the streets on a bus and finally shot him on a tube train. Really dodgy thing was the officers accounts did not match the CCTV footage.

We just had a protocol for tased patients. Says threat the barbs as impailed objects.

Yep, I know form bitter experiance that is true. If some ting is wrong it can go round the world faster than broardband. But they are a lot of people were I am that have been together for a long time.

The police over here are just starting to use them. They used one to take down one of the london bombers. It shut him up

We have lots of people that work to gether and are in relaytionships or married. The only people we seem to come across are other ambulance personnell and nurses, so its bound to happen. As far as working together it really depends on the couple. It can be a help to our resource centre as its easier to cover a vehicle if they know theu have a couple. As long as it does not affect the operational capability, management can do nothing about it. In the UK at least.

Used to work for London ambulance. 3500 calls a day. Work in norfolk now only 700 a day. Boring

When I was working in Brixtion, London we had an ambulance with bullet holes in it. I kind of miss that place. Getting bottles thrwn at you every week keeps you on your toes.

I can give salbutamol but only paramedics can give atrovent at the moment. I can use SC adrenaline for life threatening asthma.

I once found a set in an SAR kit when I was an air force medic. I put them rite back were I found them. Apart from that I have only seen them in books. Dont think they are used in the UK.

A study of out of hospital cardiac arrest in scotland showed similar results. I have not seen it so I cant say any more on that. As far as trauma goes we found in the early days of parameidcs in the UK (US has had them a lot longer) trauma patients did worse as paramedics stayed on scene to use all there new skill. Of course we now recognise that trauma patients need a surgeon so are rapidly tranported wit htreatment en route. I would agree that intubated trauma patients do worse as they ar sicker. It seems that we only get to intubated patients with a GCS of three. We are taught that a patient with a GCS of 8 or below should be intubated, but most I have spoken to are afraid of causing laryngospasm or big rises in ICP. I guess that will change as we are movig forward a such a rapid rate. From what I see we could be helping more patient with procedures such as RSI. A lot of our serious trauma has to wait a long time to get to hospital. Cat A calls should have a response in 8 mins but that could be a BLS first responder who then has to wait 20 or 30 mins for an ambualnce to get to some god forsaken part of the county then just as long to get the patient to hospital. We have only on helicoptor in my service that only flies during the day and cant take really bad patients as there in not room. Although they are getting a new one. I guess in places as big as the US canada and austalia 30 or 40 mins is nothing. But when you have a time critical head injury strapped to a board vomiting like a fountain you want him in hospital ASAP.

We have moved away from protocols to guidelines in order for medics to have more say in the patient care, as it was felt that patients dont always conform to protocols. That said if you deviated from the guidelines you have to remember you may have to justify what you did, so it aint made that much difference. The only things we have to get authority for is thromolysis in my service. But thats either the medical director/ chieg executive (both docs) or the clinical manager (senior paramedic) who carry a mobile phone with a screen to transmit the ECG to. We can also ring this phone or just ring the local hospital if we feel we need advice.

Thanks ditch doctor. I know what I'm looking at now. I have never heard of lorazapam called anything but lorazapam. The most common trade name for midazalam over here is hypnoval but is usually just called midazolam. Thanks

can I ask what versed and ativan are. I assume they are trade names that are not used in the UK. Thanks

Ridryder 911, well done on your reply to zippyRN who seems to have opioions that dont help on these boards.

We have a three year degree in paramedic studies avaliable here, but its not mandatory as yet. However its likely that it will be in time. I am led to believe that the european union expects paramedics to have a minimum of a diploma in higher education. Since we becames registered health care professionals along the same lines a nurses and other allied health professions, people are expecting us to be educated along the same lines as well. The degree incorperates the ambulance technician and paramedic training, and there are clinical placements on the road. Some people are a bit sceptical about these people being turned out of university as paramedics with very little real time experiance. Personaly I prefer to judge people as I find them and not on there background. Most of the people that do this degree are 18 year old just out of school. But for those of us that are already in the job, we can do these courses part time. I believe there has been a masters degree introduced. I cant help thinking how long it may be before we get the first PHd paramedic over here. I have also bee told of one medical school that is introducing an 18 month conversion course to become a doctor. Although I see the importance of education in EMS I have to ask my self how far do we need to go.

If the seizure has an identifiable cause that you can treat then you should do that. But some times you may have to control the seizure with rectal diazapam for example before you can safely get near the patient with a needle for glucose or glucagon or IV diazepam,

Hello I'm Glad that this topic is being talked about, as this is quite a hot topic in the UK. At this time RSI is only done pre hospitaly by Docs who turn out the incidents t o assist us. But will soon be introduced to paramedics as soon as the powers to be stop arguing about it. Its a particular interest of mine. Can people tell me what sort of training and education you have for this procedure, what are the protocols for its use over there, do you need medical orders to do it etc. Cheers Guys :shock:

ER Doc We now carry only normal saline and 10% Dextrose in my service. Saline replaced hartmannns (ringers lactate) as this is not for use in hyperglycaemic states Our colloids were withdrawn, due to cost and the risk of allergic reaction I believe. The dextrose infusion replaced 50 % dextrose, as a safer alternative.

Over here in the UK we don't usually hang a bag of fluid unless the clinical situation requires fluids. Most of the time the line is caped and flushed. No idea what a saline lock is so cant comment on that