fab

We'll probably never get to a conclusion on this. If you say, the law is the law then noone can argue against that. But I guess someday you too may run into a patient where you've got to have the balls to do what's necessary. And you've got to consider that he's still operations manager, they would've at least suspended him if he hadn't been doing a good job before... Not removing the sister from the scene? In her place, I would've wanted to stay there!

Learning the pronounciation may be obsolete soon. So you call Medical Direction with your phone? Who would that be, is it your Medical Director or just a Doc in the ED or dispatch center? As an EMT what would you have to call him for, say iv access? And as a paramedic, thrombolysis, RSI, antidotes, antiarrhythmics, cardioversion? I guess it only has positive effects here because invasive procedures are for pysichians only... We use state of emergency laws, iv lines are common for paramedics, glucose, antiemetics, certain cardiac and respiratory drugs, adrenaline, painkillers. I've intubated a few times (GCS <6) and heard of colleagues who've done stuff like needle decompression. You're only allowed to use the ALS procedures when the physichian is on his way or acutally present. So the Doc at the dispatch centrer enables us to treat patients on our own and keeps the number of runs for the ground-based physician low.

Correct me if I'm wrong, but most veins ending in the superior vena cava lack the valves. Anyways, it makes sense what some have posted earlier, blood flow through the carotids was still possible while the way back through the jugular veins was blocked due to the postition of the head. Who says he dropped dead immediately?

yeah, it is a pilot pragram and it's only been running for 4 weeks now, still a year to go... see what happens. I thought that it was still quite common in the States to call a doctor for advice or ask permission for certain interventions. Has it changed or am I just ill-informed? I really thought I could draw from your experience. I see your point with the critical thinking. So far it has helped improve treatment and sometimes not actually being involved brings a totally different perception or rather view to the scene. If you get my point. You've got to excuse my English, I haven't been abroad for a while so it has suffered a bit

Our station is involved in a study trying to introduce and test the capabilities of Telemedicine in Germany. It's actually a fairly new idea over here since EMS has been pysichian-led for the past 40 years. The data is sent via cellular network only, not digital radio. There are two pysichians available at the dispatch centre, which receive the vitals on our monitor (NiBP, SpO2, live ECG, 12-leads, etCO2), we can send images, they can direct a camera in the back of our ambulance, and of course talk to us via headset. In case the patient is critically ill or severly injured, the ground-based pysician or HEMS would still be dispatched. Now I'm curious on how you work with Telemedicine and if you do at all. By what means would you send the information? What sort of information do you send? Can you send e.g. 12-leads or are you only able to consult with the doctor? What sort of doctor is that , where is he based (ED or somewhere else)? For what sort of emergency or medication would you call in and does that depend on your level of training? Do you have protocols covering most areas or do you have to call in often? Is the equipment reliable, how is the network or radio coverage? What do you do in case the radio breaks down and a patient needs treatment? Just generally, how are your experiences? Would you prefer working in another system without direct medical control? Are there even systems using independent practitioners in the U.S.? I understand that there will be a broad range of answers, just give me an idea on how you work with the technology. I've recently watched the first season of Emergency! so that's basically as much as I know I'll also be happy to answer your questions. Take care

Hi everyone, my name is Fabio, I work the streets in a fairly rural community in western Germany and have been doing so for the past two years. I just got certified as a paramedic, or rather something between intermediate and advanced. I moved to the "city" to get in touch with fellow EMS workers, see how things are handled elsewhere, and maybe learn something about punctuation in English since I never got the hang of that Anyways, for anyone who can spare 10min here's a video quite fitting for the occasion of introducing oneself. take care