BushyFromOz

Perhaps you blokes from the brains trust need to start typing a bit more then eh

Welcome bloke. Hang around, ask questions. Its a good place. the advice here is honest (sometimes brutal) but fair. Its an excellent learning tool if your prepared to take on board what is said. There is a myriad of EMS people from all over the world, UK, Australia, Canada, a few from germany, USA, and theres more than ambo's. A couple of ER docs and nurses here too. The combined knowldge here is worth waiting to see

Been called worse i guess

Sorry, is that directed at me? My statement is a bit ambiguous, the "truth" bit in my statement wasn't about Oslo specifically but more of a general statement. Even if bill "was" telling the truth (very very unlikely methinks) on any given topic, i still wouldn't pay attention to him...... or Fox news for that matter As for the this character in norway, i have very little knowledge of it other than a couple of newspaper articles. Fox news - fair and balanced? Yeah right....

I wouldn't place any stock in what Bill O'reilly has to say, even when its the truth

When our state trauma uidelines were introdiced, it mandated that time critical patients be triaged to the highest level of ar within 30 mins ( i believe that this will be changed to an hour soon). It was made quite clear that this did not infer increasing speed of tranposrt, but rather be time conscious throughout the entirety of the job. It also did not mean we had to scream lights and sirens to higher level facilities, but rather byapass smaller hospitals for larer ones should the patient require it. The other part was that higher level of care did not have to be a hospital. For example, half and hour transport to a low care rural facility v's half an hour to meet a helicopter that will transport to a major trauma center, the chopper gets picked every time. To back this all up, it came out of a white paper on preventable deaths in road accidents, the system was developed and there was a retrospectivce analysys done last year that showed a significant decrease in road trauma deaths. My point? the 30 min rule is appropriate and proven to beneficial here, not because we drive faster, but because we transport appropriately.

Sounds like one i could use...

Yeah, one here has lights on POV's. Our volly FF's follow all road rules going to station on a call out, and theres a file somewhere with those who have pole axed themselves trying to save 2 minutes of their time.

Cool idea bloke, but if i go sticking my provider level in the tag line, it will misrepresent me to you guys as the vernacular here is different.

save yourself some time and trim it short with scissors. You dont need to remove all the hair, just enough to prevent air spaces between the pad and the skin to prevent arcing. Also, any nicls/lacs you mkae with the razor may call arcing as well. Funny story i got told, back in the 70's, mate of mine did one of his first arrests, went into this house lifepak 5 in hand, pulled out that shitty single bladed disposable BIC razor, whipped of the hair, stuck those gel pads down, got an output and took him to hospital. When they got to hospital, the doc noticed a bit of blood seeping from under the pad. When the tok it off they found out in the haste to shave the chest, they had cut the patients nipple off!

Damn, why did not i think of that I was angling more towards pneumothorax from rapid change in pulmonary pressure from the seatbelt.

Wow, same here, never thought of this before, nor do i recall reading anything on it. Perhaps the point is that they dont have to exhibit a marked change in vital signs, but that they become symptomatic? If patient become symptomatic due to lack of parasympathetic response leading to symptoms even though they still have technically "normal" vital signs they are still symptomatic and hence have reduced cerebral perfusion?

Read the red bits turnip

Way outside my league turnip. D for the first one, not that that they arn't all relevent but im a bit suspect you might by the attending and answer A eems unlikely and i dont understandb answer B Pressurised for the second, though its a guess as i dont know anything about aeromed rhabdo is a consideration. Theres damage to a large muscles group along with the fracture and possibly reduced pefusion distally, possible compartment syndrom. Either one could have similar Signs/Symptoms, severe pain, perfsuions compromise and those 5 P's, (Pallor, parasthesia, paralysis another one which i cant remember and the poliko-whatever it is where they cant regulate temp (looks a bit like polkadot with a thermia on the end)) Supine on a spine baord for how long compressing muscle groups could do the same. Could also see peaked T waves. No idea what a flight paramedic would do? Manage for pain, fluids and ECG with some bicarb ready? like i said, way out of my pay grade

yeah, i suspect that half the fun for this guy. But the guy is still a whacker.

fist bump.... wanna beer?

its happened to me before, last recollection was laying down, next thing i know im standing in the plant room next to the ambulance, scared the hell out of me.

Dont get me wrong, i do agree with your statement, but thats a pretty specific answer to a generally broad topic. My "didn't really have a proper look" is more about those people who jam every IV into the cube without looking in the forearms, so it certainly can become a vein of shame. Having said that, i dont run infusions, so my priorities may be a tad different.

What he said

The caveat with the difference with B/P in disecting thoracic aortic aneurysms is dependent on whether it extends to the brachiocephalic or left subclavian artery. Type A aneurysms start fromt he base of the aorta and extend to the apex of the arch. Type B's are fom the apex of of the arch to the ?? diaphragm (escapes me atm) For there to be a difference in B/P the aneurysm needs to extend to the vessels i mentioned. The loss of vessel wall integrity and reduced resistance in the brachiocephalic (read as right arm) for example, would show as a difference in B/P with the left arm as the left subclavian (read left arm) is not compromised. Its the effect of the difference in peripheral resistance by the vasculature of the right or left arm. What i don't know is its specificity like i said, pub ammo, nice to know, not very useful in a real world setting.

was awesome....

i sort suspect its like pub ammo - an interesting random fact that you dont really have a need for or a way to use it making it essentially useless most of the time

Dude! Talk about trial by fire!

I think perhaps one of the issues with using the "vein of shame" is not that you have placed an IV in it, it's that we have placed an IV in it when there are just as good alternatives lower down, sorta shows we didn't really have a proper look