Timmy

The fire doors at my hospital are swinging doors with a mechanical arm thing that close after 5 seconds after the alarm sounds. They close pretty slowly so even if you were standing in the way it couldn’t hurt you. You can open them with your scan card on your ID badge or there is a button near the door you can push for a quick release. I don’t like the whole roller shutter coming down from the roof idea.

I’ve done hundreds of motorsport standbys (motocross, freestyle, monster trucks, street racing, burnouts, dune buggies, supercross, super cars, speedway, sprintcars, crusty demonds, quarter mile, trail bikes ect ect) The only incident I’ve had involving an injured spectator was at a sprintcar speedway event a lady was struck in the head with a clay ball from the track. Sometimes at street racing and burnouts you’d have an asthma attack or two from the tire smoke. Generally motorsport is really safe for spectators, occasionally you’ll have a freak accident but again it doesn’t happen very often. Just one of those things I guess.

No, I mean how your paramedics can’t perform certain interventions or give medications without consultation. Most times our paramedics don’t even give a heads up before they rock up at the ED doors.

It’s a shame your paramedics don’t have ‘guidelines’ and your nurses can’t ‘initiate’ treatment and medications.

If I finish my nursing and have the brain power and financial resources to continue on with post graduate study I’d very much like to become an RN with the Royal Flying Doctor service here in Australia. I guess it’s more fitting to refer to RFDS as extremely remote care rather than rural care because there dealing with some seriously sick and injured people in some of the most remote places on earth. Apart from responding to casualties who need stabilization and transport to specialist facilities you also run remote clinics (health promotion, dom mid care, immunization, general medical clinics ect) For some of these people your there only medical care within days and days of traveling along remote/isolated/bumpy/crappy roads and they might only have one fly in every 2 months. I volunteered with one nurse who had worked with RFDS for a few years. She told me that some of her patients have gone to help and back. One call out she attended involved a patient from a car accident, they rolled there 4x4 along an isolated road. It was 48 hours before another vehicle came by and was able to help, the RN and paramedic from the remote clinic took the ambulance out which was a 4 hour drive to reach them, they had to camp at the accident scene over night as you don’t travel at night in the outback, the environment prevented RFDS coming and landing so they had to travel 4 hours back to there little remote clinic with a tube’ed and ventilated patient and waited for the weather conditions to clear for RFDS to fly in. You just can’t imagine looking after someone who is that sick in such conditions. 4 days it tool for a critically injured patient to touch down at an appropriate facility. You have limited diagnostic gear and the patient’s life purely depends on your knowledge and skill and if the whole thing turns to crap mid air there’s only so much you can do. 9 time out of 10 the RFDS is on scene pretty quickly but it all depends on the weather and appropriate places to land. I can’t wait to work in such an environment! Bring it on!

Hi my name is Tim and I'm to poor to afford anything whackerish being a student and all. About the only stuff I have: In my car I carry gloves, bvm, wizlock collar, OPAs, shears, mini fire extinguisher and my fire turn out bag. None of which I paid for. Coensiding with my contract with the football I work with I own: Scoop Stretcher, Collar Bag with full set of collars, 02 kit with - suction, bvms, airway management gear ect ect. big ass on field kit (I own the bag, not the content) 2 walkie talkies - all of which was covered within the my wage. When I joined the nurses union they sent me a giant sticker that says “Nurses, you cant live without them” I also have in my room a model heart which splits in half so you can see all the valves, arteries and assorted peace's which I labelled. A 4 foot skeleton (I labelled all the bones), a model brain which again splits in half and labelled. A adult and child annie CPR doll. My walls are covered in posters (abdominal quadrants, transferring pts safely chart, varies anatomy and physiology posters and posters relating to nursing care ect) I have 30 nursing books and 4 paramedic books all lined up on the top shelf of my desk and a chepo data projector that that clips into my ceiling, pugs into my laptop, with saround sound and projects onto the wall so I can review my nursing powerpoints whilst lying in bed, also good for watching movies lol. I pretty much spent about $300 on all that. This little list is made of presents, work pays for all my nursing books and associated materials and stuff I've collected or been given over the years. I'm not eccentric or anything.... I don't need to put any stickers on my car because the town I live in is so small everyone knows what you drive anyway. I don't have lights on my car because it's illegal and I have no desire to spend money on such items plus were I live there's not enough traffic on the roads to warrant any warning devices. If your slightly speeding to a fire call the police wave because they know who you are and what your up to, hell they sometimes follow you to see what's going on. I have a BLS ambulance parked in my backyard and 4 fire trucks are parked within10mins drive from my house so I have no desire to buy lego vehicles. Hell, I guess I am a whacker lol...

In one of those links there pictures of hamfest, looks as though it’s one of those trash and treasure meets for ham radios. There’s also a website called www.sexyham.com lol!

Yeeeeeehhhhhhhhaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa! I've got my name down for HAMFEST 09!

Don't give up hope, he ends up surviving for a few weeks.

In this case his taken to the primary care hospital but MICA are signal one to the hospital as well. To cut a long story short, he arrested upon arrival at the bandaid station – You and the nurses are it until the doc gets in (15mins) and MICA is 30mins off.

So, the kids had some paroxysmal nocturnal dyspnea trigged by orthopnea.

I'll give you his cardiac history as it will be hard and drawn out to get. He has hypertrophic cardiomyopathy and his vitals begin to take a dip on transit, he becomes extremely short of breath and begins to complain of sub sternal chest pain.

It's 0230. Your called to a 19 year old male with a cardiac history. On arrival you notice the patient is suffering from dyspnea, he is sitting on the couch slightly sitting up. You've been called by the patients mother but the patient is hesitant to receive treatment because he is 'over all this medical crap' and becomes quiet annoyed at you asking questions. The mother states the patient has had a brief syncopal event when he sat up on the couch. The patient is also cyanosed and currently waiting on the transplant list. Vitals: BP: 150/95 Pulse: 101 Resp: 21 Sp02: 90% ECG: AF On auscultation of the chest you hear a loud whooshing heart murmur. Meds: I don't remember the names but they belgoned to: Beta Blockers Calcium antagonists Your the ALS crew in a small country town. The local hospital is a 3 Bed ED, currently on night shift you have a RN with a post grad in emergency care, an RN with a post grad in midwifery and an LPN who is half way through her RN training. The local General Practitioner is on call, about 15 mins drive from the time off calling to arriving at the hospital, this GP has done an a rural ALS course and ACLS course. Your about 50mins drive from the fully staffed emergency department hospital.

If you rocked up at my hospital your still running the show lol. You'd be lucky if two RNs came to help, we only allocate one emergency trained nurse to A&E on any one shift and maybe the student nurse will tag along. It will take around 10 to 15 mins for the doc to arrive after you call them as there only on call and even then there only General Practitioners with a 2 day ALS course. Your nearest bigger hospital is a 40 min bells and whistles drive down a long, dry, boring highway with no town in between. HEMS is 40mins fly time and that's if the closest chopper is available. So, help your self pretty much. It's only 10 meters from the ambo bay to the recus bed. Tube, push meds, defib – knock your self out, chances are you know more than the doc that's about to show up.

I guess it depends on what brand of tube your using and what the weight of the kid is. I've read a peads book at work that had a table on what to use on patients based on weight. I only remember patients over 40KG got a 20 to 24 tube.

lol after having a proper look at there website I was talking about the ‘Statlock PICC stabilization device’. I guess your right if your using the one your on about for a CCP. I’ve some interesting experiences doing nursing on the hospital in the home program. We’ve got a 15 year old kid with a PICC in situ for 6 weeks with a 24/7 IV anti infusion running. He was extremely active before he impaled a motorbike part through his cuneiforms resulting in a nasty case of osteomyelitis. Just a few days ago he though it would be ok to jump in the pool with his mates, needless to say 3 hours later from swimming in chlorinated water we were around there re dressing the site and taking bloods. We had a statlock in situ secured with 3 sheets of IV opsite. micropore tape and a bandage yet the whole thing managed to become stuck in the pool filter. Also have a morbidity obese patient who is chronically diaphoretic, doesn’t matter how much adhesive wipe your put on anything sticky will float away in a pool of perspiration. I guess these devices are great in the medical setting for the most part but you’ll always find someone who will defeat the purpose lol!

It doesn’t work well with bodily fluids, like most sticky things wet surfaces are your worse night mare. My thoughts would be it’s a bit fiddly to use on a trauma pt, your better off using transpore tape or something like that to secure the line in a hurry and worry about neatening it all up when there stable.

We use a similar device on PICC patients. There ok, down side being it’s very hard to remove the statlock sticky thing and the IV3000 dressing with out moving the PICC. We normally use 2 staff, one places there finger over the PICC site to keep the line in situ while the other removes the dressings and statlock. Sometimes it’s hard to remove the clip things to remove the line from the holder.

ahaha

Now yall know what to get for my Birthday

SP02? Using Accessory Muscles? Cynosis? Since we've been outside and come inside acting weird is there any trauma? Bit/punchure marks? Wounds ect evident? Resp rhythm and effort? Any sign of an airway obstruction? If things are still going down hill then: 02, pop in an IV, atropine, adrenaline, neb ipratropium and Salb. And if things are turning to crap maybe prepare for an RSI. Is it a possible that the patient has been exposed to something organophosphate'y?

I've never seen any medical service in Australia use a Tshirt as a uniform. Some services have polo shits for off duty use/civilian wear. I've never seen any nurse here wear scrubs apart from surgical staff. My nursing uniform entails: Navy blue pants. Black polished shoes. Light Blue button up shirt with the hospital name and logo. Black belt. Navy Blue Polar Fleece sleeveless vest Hospital Lanyard with your clinical level printed under your photo. My Volunteer EMS uniform entails: Normal Standbys: White button up shirt. Black pants with black belt. Black polished boots. Black polar fleece jacket. We have to wear a fluorescent green/yellow reflective vest at all times. We also have ties, battle dress jacket and acobra hats for ceremonial/official use. Standbys like Motocross/Speedway/Rodeo ect: Green overalls covered in reflective tape. Fluorescent green/yellow reflective vest Black Boots Your rank is displayed on your eppalettes and your clinical level is displayed on a Velcro attachment that clips onto the front and back of the vest.

All I can say is, If I needed a gun or vest to enter a scene or to feel safe then I’m finding another job. I’m not putting my life in danger or potentially in danger from gunfire to help others.

Are you serious man? Were in that document does it entail anything about firearms? From what I gather it includes data from violent attacks i.e. assaults, some kid stole grandma’s handbag ect. There is no mention in regards to firearms at all, nor does it specially depict anything remotely close to resembling a firearm apart from homicide which you don’t necessary need a firearm to be an offender. Within that document it also states that the rates are not necessarily accurate. You’ll find that Australia has draconian firearm laws for a reason, we have strict licensing and storage laws - not everyone walks around with a weapon. While I take into account your reference to population I think you’ll still find Australia has reasonably low incidences relating to firearms. I’m not taking into consideration incidences relating to drunken pub/club brawls ect. While we still have some gang violence going around shooting people it’s really not all that common. You guys are always rambling on about how the public don’t respect EMS over there, if you start carrying firearms do you think you’ll be winning any popularity contests any time soon? Respect from the public must be gained by displaying professional and trustworthy behaviour, this is why the Australian public voted EMS as one of the most trusted professions ever, once you start carrying firearms around people will become intimidated and if a paramedic shot a patient, how many people would feel comftable calling for help, let alone the beating you guys will have from the media. If you guys have problems with the public harassing EMS or bashing your medics then you need to looking into ways to deal with this, if its not a safe situation to be in then move away. Oh and another thing, when you make reference to whackers lighting up people, wearing badges, driving erratically, wearing radios and papers and the lists growns on and on – how can you possibly trust these people to carry a firearm? Wont they just display the gun and rome around acting like try hard cops provoking the situation so they actually get to shot people? I really dislike guns so I may be biast and I have no idea what’s it’s like in the US but really, paramedics carrying guns? Its insane.