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jmac

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    ireland
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  1. none air, strictly a once off, may change in the future but now just suspected cases men-sep, AB's and fluids, the thinking is to get it started because of the wait in A&E, better to have it started.
  2. air, what i was speaking about was dust referencing TB, he is right, but we do not admin AB treatment for TB, we have cases here also, previously eradicated versions that have not been seen since the 50's and 60's , but the difference is that Meningococcal Septicaemia is a rapid killer, therefore AB admin in the field is important while TB, just as much a killer but slower. This is a thread about admin of AB's and recognition for admin of said AB's. while infection control is of the utmost importance, it should in my opinion be a done deal, it is here. It is the doc's here that called for pre-hosp admin of AB's, we have our own guideline on recognition and admin and is part of our training, also we are licenced practitioners and the onus for continued medical education is on ourselves as professionals, to the delight of management, and we have a requisite amount of hours training per year, not a couple of hours in a firehall as dust says. (thats a quote dust not a slag off) To us it makes sense, i am all for education, actually have some myself, but the approach is different here, and the recognition, different strokes for different folks, i have respect for all my fellow professionals in the states at all levels, but things changed here, it seems by all acoounts in discussion that things are not changing in the states, and if there are some, they are not across the board and vary from state to state, though the US started pre-hosp care, countries outside have picked up the flag and are trying to carry it forth, gone are cook-book medics and big overflowing drugbags, today its more if it looks like a duck, walks like a duck and quacks like a duck....hit it with both barrels and break out the plum sauce, back to basics and build on it........agree to differ here.
  3. dust, first things first this is not a personal attack on you, the stats i left up were for you because you like fact, the rest was just my opinion, as for TB, this is a thread about meningitis so what use are all those stats. CC, if you feel i am ignorant, thats your opinion, you are entitled to it, in the context of being with a sick child, sorry lab work for the lab, don't have one on me at the time, i treat my patient, not guess about what results may or may come back from the lab. dust, we don't use protocols or medical direction for these type of cases, we use Clinical practice guidelines, something i have heard you call for in the states, if we feel clinically justified to administer we do, for anything above or outside our CPG's we can call for medical direction. throm's and AB's, these are time related, as hertz says needle to door time is essential, some on here (relax dust, not singling you out) seem to go for the negative aspects of of pre-hosp care in the states, though it was the US that was in the forefront of EMS, it has taken a backseat but i have a lot of good friends in the states at all levels and in discussion it appears that the education that has abandoned them, not their own laziness, CC, in my opinion all the lab courses and such are NICE to knows, well and good to have them but not worth a toss in the field, experience and judgement count, along with clinical responsibility first rule of EMS, treat the patient following the four ethical principles, and staying within my remit, i have respect for a lot of people on here (you too dust ), but there is a lot of negativity, some things work here, why not the states, life goes on, air in air out is a good thing.
  4. wow looks like this thread is going the same way as most here, full blown anaphylaxis???? according to the stats on deaths from anaphylaxis due to allergy to penicillin in the UK over a period of 10 yrs is 27, those are good odds. this is an international forum, why is it if something is done outside of the US it is either done badly or is inappropriate to some here, and why do some here, for all their preaching on the need for education, cut most EMS providers off at the knees in the US and say that they " don't have the education or are too lazy to get it " In other countries (non-US), pre-hosp providers are giving anti-bi's, thrombolytics ect, this is advancement, this is education for the pre-hosp environment, no matter how much time in the lab doing courses on micro or lab work, maybe good education but ain't really gonna help you in the field. why does every thread on here go down the line of a few philosophers telling their opinion on what should be, maybe they should take a leaf from their own books and look outside the box, not stay in the tunnel
  5. ok, don't really like to comment here but lets just say have to say something, better minds then mine outside of the states that are attached to medicines advisery groups have stated passed and allowed the use of IV antibiotics for "suspected" cases, as phil said better to get it then wait. Dust, some cases are more then a 15 min ride to hospital, while the use of steroids as doc says is great, benzy and fluids is all that we are permitted, what i cant understand is those that seem to advocate better education in a system seem to go out of their way sometimes to downplay advances in other systems, this is not an attack on any individuals, just a sit back and watch, in our case, it better to have it and give it then not have it and ponder, hey its up to the labs to diagnose anyway.
  6. we give the benz here pre-hosp as well
  7. just to explain the system http://www.emc.maricopa.edu/faculty/farabe...kINTEGUSYS.html
  8. in my opinion its the carry out that is the problem and not treatment, most of the treatment is basic skills except IV and pain relief, and even that is a basic skill in some areas, good scenario, how did it work out in the end. as i stated at the start of the post this is my opinion.
  9. her weight would not have made any difference, she still has to be extracted, with the firecrew assisting form one end and vehicle making way from another just carry her out, many hands make light work, no point screwing around achieving nothing, get her to definitive care.
  10. immobilize spinal..O2 monitor IV with fluid to maintain BP, light turniquette to delay toxin spread, pain relief, stabilize with standard measures of #, anticipate possible spont- abortion and carry till meet appropriate transport, co-ordinate fire crews to carry and keep contact with patient and monitor.
  11. RD, i am not doubting you, i only asked as there is no mention of a pre-hosp ECG with the rate i wondered if it was Junctional or controlled A-fib. , but as you say you were there, thats why it is hard to try to visualize someone else's patient Just like to bring your attention to the last line of my post "good call anyway", cheers.
  12. Just one question? the patient had a history of A-fib 5 yrs ago, how was it controlled?? Pulse of 56?? good call anyway.
  13. Happy birthday stacy :wink:
  14. ok, now we know that some people here can sling some serious ****, but can we diagnose in the field :roll: :roll: :roll:
  15. whoa whoa whoa whoa, jesus people, does anyone actually read the rules of the forum, http://www.emtcity.com/phpBB2/siterules.php with ref to para 4 and 6. I am not American, i dont hate Americans, I am professional EMS, and could someone please tell me what has all this got to do with diagnosing in the field, before someone tells me to butt out, i was one of the original posters in this thread and it was an interesting discussion before all the **** throwing and defensive posturing, can we get this back on track and act like professional medical people and leave the political debate to those that get the bucks. Jeez guys, you would seriously want to stand back and re-read all these posts.
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