BushyFromOz

Yeah, the people who pushed the same mantra with me were never able to explain to me how many points of difference i should be expecting in Type A or B ascending aortic aneurysm's, or just how specific it is. Actually, most told me it was for identifying AAA's

Yeah, but its not even all that. The biggest tressers in this job is the sleep deprivation, dealing with the benality of shitty management and boredom that comes with extended "routine" or low volume work.

The anaesthetist wasn't happy as the cubes are large veins and have been essentially wasted by a smaller cannula than is required. The fact that he whacked another 2 in further down probably indicates he had pretty good veins, and the combines flow rate of 4x18g i imagine met the anaesthetists needs. Start from the bottom and work your way up mate. I usually go for a patent 18/16 in a lower arm before and then look to try and duplicate that, but i try and avoid using the cubes if i can.

Hilarious!

Sorry man. We always crap on about some obscure patient presentation or some kind of cool intervention that you *might* get to do someday (i seriously want to try a beta bloker OD with glucagon), but seriously, we never talk about, or does it form any part of our education (that im aware of) about looking after ourselves physically, but more importanlyt, psychologically. I ground myself into the ground within 2 years of hitting the road and its taken a bloody long time to work myself to being content both with work and with home. Im surprised it hasn't been mentioned more often. Oh, and there was a book by some chick (cant remember authors name) but it was called "streetsense", and had some excellent advice in it.

what about a hero in a half shell? Turtlepower!

Good god! Where is the hate button for these posts? Just because we didn't call it PTSD, doesn't mean it didn't exist. During and after WW1 it was called "shell shock", with the signs, symptoms and effects well documemted and still hold true to this day. Civillian's though were general labelled as having a "melancholy" or a "deep neurosis" and quite often ended up in a lunatic asylum for their troubles. Not that they were "nuts" but because we had such a pathetic understanding of it. The exact same sypmtoms were present in soldiers who came home from WW2, Korea and Vietnamam. My grandfather suffered PTSD from the day he was shipped back from korea, and it haunted him till the end of his days, only it was initally labelled as "depression" Labels change asshole, just because we called it something else does not mean it did not exist. For example, sometime in the past, someone with an english accent may have referred to you as being an "confrontational fellow". These days, i suspect you would just be a "F*&#!ng twat"

nice, i like that. Ivan is walking in Belangalo forest with a backpacker he just met. The backpacker says "gee its dark and spooky in here isn't it?" Ivan says "i dont know what your worried about, ive got to come back on my own" (google "ivan milat" if ya'll dont get it)

i wonder if there was a sign by the aircraft, you know, shaped like a clown with its hand held out saying something like "you have to be this tall kiddies to ride the rollercoaster" all he power to the guy, still umping when the odds were stacked againts him. I can see where lone is coming from. Theres so many rules and regs on everything these days, im surprised he was allowed to jump, but all the power to him i say.

Probably turned to alchol. To echo what has been said though, you truly are an asshole, probably part way to being an ankle now.

tactical super medic door kicking in boots?

A mate of mine committed suicide a couple of months back, i the leter to his brother he asked him to clear the history and "photo collection" off his computer and get rid of his sex tys before his parents arrived.

Yeah, i dig this I always wondered with the Malayan / New Mexico one, whether there was a difference in pre-hopital system thats not mentioned? Ive never been able to see the entire article, just the extract.

And there, you self centered egotistical bullshit show you for what you really are. You cant be bothered using a piece of equipment because its to difficult for you If your "whipping" the patient, fumbling, twisting and moving them to get it on you either havn't assessed weather the scene enables you to apply it effectively, or you just dont know how to aply it properly. When applicable and used properly by a competent person, the KED IS part of the proper patient handling. Your just a moron mate, who's own lazyness supercede those of a patient, and you show it time and time again. The old rep system would have shown how many people have taken exception to the benality of your posts So you've just pointed out that using one piece of equipment is too damn hard, but at the same time want whoever "the man" is to let you clear c-spines in the field? Why should they let you, your too lazy to do a proper job now.

Care to share your rationale?

When i followed up on this pt the attending ER Doc (funny bloke, ukraine accent i think) says this. "I a dunno what wrong with him, i look at da blood, it fine, i look at da heart, it fine, i look at a da CT, it fine. I RSI him, send him upstairs, they figure him out" This pt has rapid onset dementia, probably been masked for a couple of months by his depression, the mood swings etc were probably more confusion then lack of social engagement. Its unkown why suddenly developed a GCS of 8 or the blown pupil. he was extubated 2 days after admission and still had a GCS of 8, dementia being diagnosed a week or so afterwards (im not sure how it was arrived at - exclusion i guess) The blown pupil remains a mystery, but he still has it.

A lot of pregnant women treat pregnancy as an illness or disease

Yeah, competent operators do, obviously something you lack Seriously, how many negative points do you need before they get rid of you and your worthless opinions? touche Not specifically MVA, but they should at least have an educated opinion regardig pressure on the abdoman by the belts, say from a KED?

Fair enough for the publci, but i'd expect it to be a bit more specific in here considering the amount tooing and froing we do on professionalism.

Yeah, fair enough, i dont really have an asnwer other than a "what i'd do" response. Funny thing about the KED. guys pull the those straps so damn tight they almost cut patients in half with them, obstruct their chest movement etc. The thing basically splint the head an neck by using your thorax ans an anchor point, and i reckon you can do that without ratcheting them up to the point of making them suffocate or compressing the uterus, so yeah, ferno says its ok and i reckon we have the smarts to use it appropriately to the patients situation. Having said that, if they are well nd truly pregnant we are going to have issues laying them flat on their back anyway (gravid uterus etc) so im not really sure theres a hard answer. Wheres an obtetrician when we need one?

Perhaps we should question your status as a bullshit artist instead?

Interesting question. Whats your rationale for not applying it?

Whats the go woth this "breathing treatment" crap? "on my last shift at work, i perfomred an angina treatment, a broken leg treatmnet and a low blood pressure treatment" It just sounds retarded.

replacement for crotchity? Maybe he is crotchity!

well...sorta...not really...no..... Raising the legs has a couple of goals. One is that by raising the legs you allow the remaining blood to pool in the thorax where it is closest to vital organs. Blood returns to the heart via muscle contractions that in a nutshell squeezes blood thorugh your veins, and that blood is prevented from going back to the extremeties by valves in you veins. Problem being that when your laying down not moving, you dont have the muscle contraction in you limbs to move it. Laying them down with legs up circumvents this a bit as its return is gravity fed and not dependent up movement. the other tid bit is that by raising the legs you increase peripheral vascular resistance, or the pressure your heart is forced to pump against. I ownt flood you with the equation, but increasing resistance within reason increases blood pressure and perfusion. Now, for the truth... Raising legs in hypotension has been shown in several to vary between no improvement in B/P to minor (about 10mmHg) to changes that are statisically insignificant. Also, internal bleeding and increasing B/P can be quite counter productive bleeding + high B/P = more bleeding. Personally, i dont raise legs in trauma patients, dont see the point as if i need to raise B/P ive got more effective means of doing it.