scott33

That's what it looks like to me. Although if this is fishing for "legal" information, the OP may just have made a huge mistake by stating on a public forum that the events are from a "Fictional Situation". Or to put it another way, an admission that said events never actually occurred. Case dismissed!

You are entitled to your opinion. Personally I think it is wrong, dangerous, and just plain stupid to go chasing tornados about, and a lot of my American friends agree. However the next time you go spouting off about what is legal or not legal in certain European countries (as you have been doing on youtube over the past 6 months, and making yourself look pretty dim in the process) at least have the decency to get the geographical location right. Hint - the ambulance wasn't in England.

Anyone from Nassau County PD EMS in the house?

Not taught, but something which is all too common through lack of experience of driving under emergency driving conditions, simulated or otherwise. They can't be blamed, the system does suck. Their FIRST exposure to using lights, sirens, switches etc while driving is on their first actual call after they have passed their road test. Knowing where everything is may be second nature when stationary, and the walkthrough of the warning systems are repeated ad nauseum - while parked up. But it is a different kettle of fish when they are on their first few calls. This sort of introduction to the operation of emergency vehicles is flawed, and yes, a google search of US vs rest of the world ambulance accidents / fatalities may put things into perspective.

As a driver-trainer and recently appointed examiner myself, I have often seen the other side of someone who has performed very well on their driver training, and aced their final exam, only to see them get a flap on when they get their first live call. Hands all over the place trying to find the toggle switches, taking the fact that they are driving to an "emergency" way too literally, excessive speeding, agressive braking, and generally just panicing. Had they previously been exposed to live runs, under a more controlled condition, with immediate feedback and knowing there is no life at stake, they would be more prepared for genuine emergency runs. In the UK, that is the law, something they need to prove proficiency in prior to passing their road test. It has nothing to do with trying to fake the public. There are a million-and-one other analogies where live practice is favored over simulation, due to the element of realism it gives the student. But it seems you will always get those who will oppose any sense of realism in a training environment. Such as weapons drills on live firing ranges, test flights on anything other than a computer simulation, IV access on anything other than a plastic arm, etc etc. Proven fact; the best way to learn, is by doing

Still not 100% what he is getting at, but I know in the UK, ambulances routinely practice simulated emergencies as part of their driver training. This involves runs with lights and sirens with no patient. Their driver training involves a little more than what is taught in CEVO, and a comercial vehicle license is mandatory. Perfectly legal, and much safer than having your first EVER emergency run with a patient in the back (something I have always found a little dangerous). Not to mention the real-time feedback given by instructor sitting beside you. Police and Fire do it to. The OP here, and on you tube, is displaying yet another example of showing the inability to see further than their own borders. Taking your logic a little further, do you think it is right that military aircraft are allowed to practice simulated / fake operations in the skies above (some of) our homes?

"Pass the Dutchie on the leaft heand seide..." As the Doc has already mentioned, viruses need a foreign host in order to reproduce, so they don't fit the typical criteria of a living organism. Calling viruses "less evolved" than ourselves could also be argued, seeing they are responsible for wiping millions of us out, throughout the dawn of man, and will continue to do so as long as we walk the Earth. What viruses lack in not having opposable thumbs, they make up for with the ability to survive higher altitudes, lower depths, as well as being able to withstand a greater variation in temperature and pH. They are everywhere we have ever been, and everywhere we will ever go. Viruses are here to stay, and yes, I would call them living organisms - atypical living organisms.

So let me get this straight. Europe isn't a town?

Me too. For those who don't know, or don't care - Cardizem would be one of the first medications that would be given in the ED in this scenario, whether the patient presents "completely stable" or otherwise.

Sorry, don't think I am picking on you here as I am not. But PAs and NPs do exist in Europe (UK), just not to the same extent as far as numbers go.

No they don't. They are autonimous practitioners in their own right, employed by the NHS. No such thing as medical control in the UK. They are required to carry their own controlled substances (as are all UK paramedics) which they are lawfully allowed to obtain, independantly, from a pharmacy. This can be stored in their own homes / vehicles if they wish. Usually a loaners job in the responder vehicle, they can request ambulance backup for transport, treat and release, or order follow up work / lab tests off their own back. They can even "admit" patients to specialist units if needed, all without the need to "ask mummy". This is just one example of where US EMS should be.

What's the smartest thing ever to come out a woman's mouth? Einstein's C*ck! (sorry laydees) :oops:

It wouldn't require doctor. Works perfectly well in other systems, and frees up much needed space in EDs. Try Googling - "Emergency Care Practitioner".

It's a field diagnosis.

Did you happen to know if the causative agent was viral, or bacterial (or other) with these patients? I believe there is a difference with the indication of CPAP / BiPAP in hospital. My point being however, that apparently, many EMS providers have treated the pneumonia patient as a CHF'er (yes you can have both at the same time, which goes back to ruling in, and ruling out). This is supposedly one of the reasons for CPAP being slow to get off the ground nationally, and one of the reasons we will be moving away from Lasix - too many febrile, tachycardic, and dehydrated old ladies being diuresed in the field :shock:

Yes we do, we do it all the time. Some of us just don't realize it. Take your "diff breather" call. A basic assessment should point to whether it is an asthmatic, COPDer, CHFer, PE, pneumothorax, pneumonia etc, even with PMHx of "all of the above". We should already have ruled out some of the other possibilities prior to treatment beyond that of positioning and O2. The reason the poorer providers out there give nitrates and lasix (and God forbid, CPAP) to patients with pneumonia, is down to poor assessment skills, which neglects a consideration towards other co-morbidities, which present with similar (go figure :roll: ) initial findings. This is the principle behind what AMLS are trying to endorse - possibilities to probabilities / ruling out and ruling in. It makes perfect sense if one knows what to look for, and it also encourages clinical development and a further understanding of common disease processes... …or we can just load and go.

It is actually a lot more "lazy" just to blindly transport every single patient, every single time. Those who would treat and release / treat and refer (for those fortunate enough to have that privilege) are those who have done a complete and thorough assessment, ruling out all your "what ifs". It takes a little more effort and clinical skill than sticking the BS patient on the pram and transporting.

The French are working on a similar idea :?

Welcome. Only stopped off in Keflavik once. Didn't realize that the Icelanders had so many B52s :wink:

Hang on a minute. Are you honestly saying that any time someone sees someone in a bar, at a football game, or a concert, who appears to be under the influence of ETOH, they should immediately dial 911? That's the kind of mentality which contributes to the bottlenecking in the EDs, and causes a delay in care for the more acute patients. Unbelievable ](*,)

No. Although occasionally the RT will, depending on the clinical presentation of the patient.

No, and in general, AMS patients who continue to be so, should be checked out. But someone who willingly, and without question, transports a patient who is alert and orientated x 3, with no complaints, and no desire to go to the hospital for the umpteenth time, only to receive a sandwich and discharge, following a transient change in MS, consistent with a long-standing co-morbidity (long sentence)...does indicate poor clinical judgement. Or perhaps you are advocating taking every piss-head into the ED for a CT brain, because they were slurring their words the night before having downed their 7th Jack and Coke. Your rational is flawed and outdated.

Misfeasance perhaps...

Isn't that known as battery?

What labs and x-rays do you think we do on a S/P hypoglycemic, who presents to the ED alert and orientated, with no complaints, and no real desire to be there? Having previously received either oral glucose or Dex by the ambulance staff - None! It's repeat FS, a sandwich, D/C home and follow up with your PMD. Job done.