Vorenus

There is an app for iPhone that let's you talk on the phone, as long as there's wifi, even with no phone signal. It works for the itouch too, as long as you have the microphone.

I'm sorry I don't remember what it's called right now, but it shouldn't be hard to find with a search.

Sent from my iPhone using Tapatalk

Good advice, thanks!

Now I just have to find an otter box that fits my Samsung.

Just out of curiosity - what kind of first-aid-manual is this?

I`ve done a first aid course here primarily before getting my drivers license and I can`t remember being taught anything about internal bleeding, not about how to diagnose it, let alone how to treat. Seems a bit far fetched for first-responders. That being said, in the most cases there would be nothing more to do for a first responder than dial 911.

So, I never wanted to have a Smartphone at all. Now I have a Samsung Touch-Screen-thing (a rather cheap one though).

Up until now I had a very solid normal oldschool mobile phone (the kind where you are amazed in the way like "wooooooah, look, it has even a colour display!!?!?!") which I could even throw down and use it again. I`m very fond of those solid phones, `cause you can carry them all the time with you. With the mobile phone before my last, I could even open beer bottles when nothing else appropriate was anywhere near, though after a half year having started that practice it deserted on me so that could have been possibly too much.

Anyway, my father bought himself a new phone the other day and he is completely useless when it comes to technichal things. So, he bought himself this Touch-Screen-thing - only to realise after using it for about five minutes that he can`t deal with it. So since my old phone is somewhat broke too, he persuaded me to take the Touch-Screen-thing so he could buy himself something that is simpler when it comes to handling.

So, my concern and question to you other carriers: Do you carry your phone at work at all? The thing seems so fragile and the touch-screen so sensible that I don`t think it would survive your average work day (like carrying someone down some stairs while scraping along at the wall with the half side of your body). Any experiences about how solid they are?

Yeah, I know - stupid question...

Yep, also you limit the the bodies own blood coagulation to work its way, or, by a raise of the BP you could destroy the clots that have already established themselves.

The permissive hypotension replaced the aggressive fluid therapy of older times, meaning you tolerate a mild hypotension (low blood pressure) in order not to enhance the blood flow. A good tip is to tolerate on the peripheral pulses. You will want to give just enough fluid (or vasopressors) to have palpable peripheral pulses.

"orientate yourself" - is what I wanted to right. Couldn`t edit it any more...

Raising legs in hypotension has been shown in several to vary between no improvement in B/P to minor (about 10mmHg) to changes that are statisically insignificant. Also, internal bleeding and increasing B/P can be quite counter productive bleeding + high B/P = more bleeding. Personally, i dont raise legs in trauma patients, dont see the point as if i need to raise B/P ive got more effective means of doing it.

Yep, also you limit the the bodies own blood coagulation to work its way, or, by a raise of the BP you could destroy the clots that have already established themselves.

The permissive hypotension replaced the aggressive fluid therapy of older times, meaning you tolerate a mild hypotension (low blood pressure) in order not to enhance the blood flow. A good tip is to tolerate on the peripheral pulses. You will want to give just enough fluid (or vasopressors) to have palpable peripheral pulses.

Hey friends,

got some questions regarding this topic, especially (but not only) for the UK members of the beard.

So, as a preamble.

I`m kind of frustrated of working in the german EMS, even though I`m not that long into the profession, The shitty laws regarding EMS that give you nothing but holes to fall into, regardless of which way you turn, the lack of approved competences, the general concecpt of it being so foolishly thought through!

All the while working at conditions and for money that are quite laughable. Let`s just say that much - when I`m on the rig with a partner, that is a Rettungssanitäter (=something like EMT- B and therefore my subordinate -> guess who`s getting more fricking money? Yep, my partner. Because here, it`s policy to hire you as a lesser rank, to save money, while all the while you are working in your actual position. Meaning - while I`m taking all the resposibility and doing ALS (up to the extent that we are allowed to) I`m getting lesser money then my colleague because we are in the same pay class, but since he`s longer at the firm we are working, he gets more money.

Sorry for ranting, it`s just that... .

Anyway, the more than bleak future prospects here, added with a long-term desire to live outside of Germany, let me think about doing something else.

I`ve been looking into studying Paramedic Science in the UK, and though my researches are just at the first stage, I have still have some questions some of you could propably answer.

I`ve been confused about some aspects. For one thing, there seem to be different finishing titles, but I can`t really see the relevant difference between the single study courses (that may also be due to my lack of knowledge regarding the UK university system in itself, it`s quite different from ours).

Beneath others, I`ve been looking into the University of Hertfordshire. There programme seems really interesting, all with the gap year between the second and the forth being a year where you only work at the London NHS. You end with a Bachelor, which seems good to and you even have the possibiliy to get your Master in Paramedic Science, though I`m still unsure what good that`s gonna give you...?! Also, it`s near to London, a plus in itself.

Is there someone that has experience with the concept in itself, or even with making the course at one specific uni (Hertfordshire even)?

There seem to be a lot of positive remarks about the study route...

As said before, I don`t have any real plans yet, I`m just thinking a little bit around the corner (maybe dreaming ).

The most negative part would be the freaking outstandingly tution fees, which would propably kill me.

Any answers would be greatly appreciated!

Greetings Marius

Can I have a Wiener Schnitzel at discount prices to substituent for beefsteak ?

PLEASE PLEASE looking into flights this minute.

I just can't get enough of that yummy delight !

cheers

Hmmmmmm, Wiener Schnitzel

Funny thing, I wanted to right Wiener Schnitzel in the first place, `cause it`s like my favourite food - but I didn`t remember the english translation. So, due to laziness (didn`t want to look it up), I just wrote beefsteak.

How could I have forgotten that WIENER SCHNITZEL means WIENER SCHNITZEL?!

The answer is because it's advantageous to have uniformed first responders in your restaurant.

Hm, as a shop owner, I would rather keep the money then feel safe the 10 min two EMS dudes throw down their beefsteaks - in the end, most shops open at 8am and close at 18pm.

I guess it`s more divided between these two reasons:

1. giving credit to you for doing your job (that would be mainly smaller, privately-owned restaurants), but mostly:

2. as i`ve said before - the reason for any other discount is to make sure that people come to your shop and better-even, come again. (that would mostly apply to your big chains).

Yup I know I suck with composition, quoty things and underlining sometimes, Although I am the EMT City king of the run on sentence, it is a curse maybe but I like the purple quote within a quote deal

Yeah, I can understand that. It definetely has just something...

Walk a day in a man's moccasins, before you judge him. Debate is a complete different concept.

Never wanted to judge you! Besides, I`d rather take a walk in your moccasins, than in my boots:

http://www.grotec.bi...0-mid-large.jpg

Yep, Í`m with the others on that one. I wouldn`t have asked for a discount either.

Generally, but that`s only my opinion, you can only ask for something that you have the right for. I mean, in a kind of demanding way - sure, you can ask for anything, wether that`s intelligent or tactfull is written on another paper. In that case...Nah!

To Topic:

In our hospitals cantine we get staffs discount (same as nurses, doctors,etc.). As well as in some other hospitals. There are two or three hospitals in our state that give you a meal for free if you brought a patient (nurses and staff can eat there for free too) - obviously, transports to these facilities are highly popular.

The Subways in the near bigger town has a discount for EMTs as well as Joey`s (German pizza franchise) and some other food delivery services (but not only for EMS but also for hospitals, the police, some other municipal officials -> mainly groups of people who often purchase -> therefore, to make them happy is a good business strategy ).

@tniuqs:

I get your point and I too believe that FireEMTs post was too harsh and overjudgemental.

On another note: It`s kind of hard to read your posts when you hide your own sentences between those long quotes. Just my thought, without meaning any offence.

Regarding this, see this cartoon on page 97 (page 2 on the PDF). That's how I feel often...

(The cartoon on the last page is brilliant, too...)

Reminds me of these...

http://www.rippenspreizer.de/

EDIT:

http://www.rippenspreizer.de/4images/details.php?image_id=64

----> "Keep calm, I`m a dentist!"

Here, med students have to do a first-aid-course (16hrs) - which I consider as kind of a joke + a ridealong on the emergency vehicle responding to 911 calls. But as far as I know, they only need about 20 hrs - which is as much as two day shifts with us.

nitro'd a vicious dog who kept snapping at us as we worked his owner.

What were the results of the Nitro on the dog? Unconsciousness? Did the doggie survive?!

EDIT:

Not my own story, but saw the picture and read about it in a local EMS paper.

I think it was in Bavaria, but not sure about it. They were called to a car accident with multiple patients. So there were quite enough crews, but it turned out to be not to bad and there were just few minor injuries. In one of the cars was a dog, which was hurt (don`t remember what he exactly got, I think fracture). Since there were enough teams there and this crew had nothing to do, they treated the dog - with the help of an veterinarian that was also there as a participant of the accident.

The picture showed the crew kneeing on the street beside the hurt dog, while the vet doctor was starting a line on him. In the background you could see the crashed car.

Aside from the population aspect, why do you think EMS calls are higher in urban areas.

What I'm trying to say is that if Rural people don't call 911 unless absolutely necessary then what makes urban callers different?

Are they more apt to call 911 because they are more accustomed to having things their way or getting what they want or is the rural population more self sufficient?

Is it the way they were brought up, In the rural areas, people tend to do things themselves and deal with issues that come up with a "I can fix that" attitude. Do those in urban areas not have that attitude. Do those in urban areas expect for things to be given to them or fixed for them?

In the most cases of industrialized countries life standard is now nearly the same, if you compare rural and urban areas - there are of course differences, but they are minor compared to regions of this world, where there still is a huge difference between those two settings.

Even though that being so, I guess most living in a rural setting have saved that attitude, or got it tutored by the elder generation.

I just changed position 2 months ago - from an urban post to a more rural one (though they are not that far away from each other), and that`s just my personal opinion, but there really are more bullshit-calls in an urban setting (which doesn`t mean they`re non-existent in rural areas ).

So for me, that would be one explanation, but with such differences as you posted above, that can`t be the only `cause. I guess it`s a mixture between attitude, the idea Richard proposed and some other influences (a large crowd being settled in a small space is an adavantage for infectious diseases, some basic points like smog, stress, etc.)

Well, I get your point and I agree with you on most of the above. What I meant was: Even if tolerance could be achieved - it wouldn`t be by such provoking texts. And when it cannot be achieved in the overall way that would be quite welcomed (though unrealistic, I`m with you there, mankind just isn`t able to do that) even then, just because that`s not possible - you don`t need to make it worse.

P.S.: I do believe that tolerance can be achieved/can be found, within single individuals, just not in a group, `cause there`s a certain dynamic to a group within itself that can bring out the worst in people.

Off duty? Another excuse. Would you, as a medical professional, not do CPR at a resturant, ball game, shopping mall because you were off duty?

Yeah, that`s a totally different situation.

Don`t get me wrong, I don`t think the response of that provider was very collegially either, and would I have been asked, I would have done it. But I would as well have thought (and that`s the whole point of that argument) - couldn`t they have done it alone? From what engine told, I figure there were at least (!) six people in that room, all on duty.

That`s totally different from being the only provider in a restaurant and acting as first responder to an arrest.

Just wanted to point that out - again, I`m not saying the medics reaction was nice, but he wasn`t wrong.

Not exactly good style to not helping you if specifically asked, but more or less OK since he was 1. off-duty and 2. not really needed, numerically. There obviously were enough on-duty folks there (you won't tell me that a bunch of emergency room staff, two medics and two first responders aren't enough for a code in a trauma room environment?).

Yep, I`m with Bernhard on that one. There obviously were enough folks there to work that code.

Do you often continue to work your codes in the ER - they should be enough to deal with that on their own.

I once reanimated at the ICU of a smaller rural hospital. We were approximately 2-3 nurses, one physician and my partner and I. They could have dealt with it on their own, but since we would have transported him anyway to the next stroke center if we would have acchieved ROSC and it would have been shown for him to have a neurological incident (which seemed likely), we stayed and helped them out a bit.

Thanks, and how does someone get a stubbed toe at 3 a.m? That's what I wanna know....

It has been shown: A lot of really bad things can happen while being on the way to the bathroom...

As a medic I have to show tolerance to each and every patient I help. In this world we as a society have to show tolerance to almost everything even if we dont agree. If we dont we are racist and many other terms. This was sent to me and I may not agree with it all but in the end it got me thinking of the fact that if I have to be tolerant of others, shouldn't others be tolerant of me?

Tolerance

I am truly perplexed that so many of my friends are against another mosque being built in Sydney.

I think it should be the goal of every Australian to be tolerant.

Thus the Mosque should be allowed, in an effort to promote tolerance.

That is why I also propose that two nightclubs be opened next door to the mosque, thereby promoting tolerance from within the mosque.

We could call one of the clubs, which would be gay, "The Turban Cowboy ", and the other a topless bar called "You Mecca Me Hot."

Next door should be a butcher shop that specializes in pork, and adjacent to that an open-pit barbeque pork restaurant, called "Iraq o' Ribs."

Across the street there could be a lingerie store called "Victoria Keeps Nothing Secret ", with sexy mannequins in the window modeling the goods.

Next door to the lingerie shop there would be room for an adult sex toy shop, "Koranal Knowledge ", its name in flashing neon lights, and on the other side a liquor store called "Morehammered."

All of this would encourage the Muslims to demonstrate the tolerance they demand of us, so the mosque problem would be solved.

Yeah, I`ve read something quite similiar the other day - and I wasn`t impressed.

Maybe leave away the butchers shop and the liquor shop and toy a bit with the names to make them fitting to another setting - you could just as well use that text to demand tolerance from muslims if you write church instead of mosque. And rightly so, if that text would be about demanding tolerance - `cause tolerance should be demanded from anyone!

But in my mind, this text is not a bit about having tolerance, it`s just about provoking. I wonder who really believes, that by that way, tolerance can be achieved...

Take turns with driving vrs attending is one thing you can do if you are both qualified.

Personally, I don`t like changing within one shift. I like to change within a round of shifts when having with the same partner and both being qualified to do so, but I avoid doing it in one particular shift, don`t know why, I just don`t like the concept. Though, if my partner is tired of driving after a long route, and he asks me wether I could drive from now on, that`s obviously different.

But that would be only happening with transports, `cause with our emergency calls, we are kind of lucky. Our main station is in a small city with about 12.000 people and an primary care ER. The second station is in an even smaller settlement, with no attached clinic. But either way, it`s seldom to have times to the ER that are higher than between 15-20 minutes (primary care ER). The next big trauma ER, which is also attached to the nearest hospital with cardiology/neurology and the means to intervene surgical in those fields, is maximum 30-45 minutes away, often even shorter.

I've never use the term "combat gear". I have combat training (close quarters, firearms, hand-to-hand, building searches, raids, vehicle extractions, and so on), but the extent of my "combat gear" is pepper spray (which, as I've stated before, 16 year old girls carry in their purses). That hardly makes up a "combat kit".

Personally, I think if everyone carried OC (not just first responders), the world would be a much safer place. It's a highly effective less-than-lethal weapon, very low risk, and easy to use. This is why even kids can use it.

I only used the terms "combat gear" and "combat kit" as a summary of the items you carry, in absence of a better term.

Well, even if everybody carried OC , I doubt if the world would be a better place.

Imagine, in an unarmed crowd, the one person with pepper spray is possibly the one with the best weapon (yeah, I know, combat training, hand-to-hand...).

So if anybody in the crowd got pepperspray - do you really think the one person that does want to hurt others in that group of people, or wants to threaten them, etc. etc. would also have only pepperspray? Logically he would be better armed, and therefore the people with the OC would be in the shit again... you can follow that line with any other weapons.

Washing a cut with water isn't going to hurt you. Most city water is chlorinated these days. OR you could let your dog lick your wound...they heal thiers just fine....just sayin

Sorry for being Off Topic, but:

I`ve already heard that you guys only have chlorinated water. Do you actually drink your water out of the pipe too, or does that lead to buying more bottled water?

Didn't someone post a study/studies in the last year or two that, opposed to showing any type of benefit with Morphine, that there was like, a 50% increase in mortality with AME/MI?

I can't remember for sure...but I think so. I can't seem to find it now though...

Dwayne

Really?

Never heard of that. Here, Morphine is still the main analgetic in AMI.

50% in itself would seem like a huge figure - if that would be the case, I`m sure that study would have surely been recognized by a wider audience?

Hm, I think you're right, Dwayne, I was a little hasty there. Let's reassess first, and increase that O2 to 15 LPM by NRB if we haven't already.

I`m with Dwayne reffering to the Nitro. Apart from the initial two tabs I wouldn`t give anymore (at least with a transport time of 10 minutes and no new increasing pain after an initial nitro-related relief).

Addittionally I wouldn`t increase the O2. Since my biggest guess would be a cardiac event. The Pt. has a SpO2 of 98%. That`s enough. The ERC 2010 Guidelines (as well as the AHA, I guess) recommend a SpO2 between 94-98% in ACS. According to the Guidelines, hypoxia is to avoid - as well as hyperoxaemia, since it causes intracellular stress.

Instead of fentanyl, morphine would be my choice.

Aside from that - en route the hospital.

Greetings, Marius