BushyFromOz

No it wouldn't change my opinion of fire based EMS. If they truly want EMS to suceed they need to understand that it is a stand alone health discipline, one of many in the allied health services, it needs it own budget, education system, peak professional body with supporting legislation giving it authority over its constituents and it needs to have mandatory registration and minimum and recognised and enforced standards of those constituents What other parts of the health discipline do you smokeys think you can takeover as well? the answer is none, because even naturopaths have all that "nonsense" i listed above. the only way you can make it grow is leave it alone, it might not be pretty at the moment, but its got no hope with the fire services

pretty poor choice of words eh! My forum-fu is weak today

Name aside, if we are not competantly practicing something, what exactly are we doing then? For sure, grossly undervalued IMHO

Always? Always walking aorund with an inflammatory response? always mucous plugged and brocho-constricted? Your just wrong dude. The cookbookers would throw some salbutamol and/or atrovent at this guy based on an adventitious lung sound, but clearly he doesn't fit any category of respiratory distress that im aware of. Nebulised OMHO is to aggressive, i have however got PMDi's and a single use cardnboard spacers here, so id give him 4 puffs and see how he goes if i felt he was slightly compromised. Yeah, im with you turnip. Anecdotally, patients with a full field wheeze who do not have any perinent history usually turn out to be ex-smokers with essentially asymptomatic COPD (resp rate constantly on the high end of normal and gets a bit puffy when they walk the dog - but nothing acutely abnormal) and/or have a degree of unrecognised failure which is possible as they have a Hx of hypertension.

Rationale, drugs etc are all very good an well bro, but any decent pe-hospital education program should have that anyway so its not exclusive to a fire department Good, the way it should be. Unless your into taking over other service providers as well.... have you guys evert thought about doubling up as meter maids as well, you know, make some extra bucks from fining people for illegal parking, it might bolster your finances and youd still be free to respond Dude, you are gravely mistaken. Spend 20 minutes searching the site and youll find some very honest opinions about the abortion that fire based EMS actually is, a minimum cost revenue raiser designed to keep fire fighters in work and screw the patient. In the end dude, its not about there being great fire medics and poor fire medics, its about having a fulltime, dedicated ambulance provider, a specialist in its health care field, not half a dozen blokes on a pumper. So, i fully recognise you think its awesome the way it is, because that all you know. Its warm and cosy and you can sit back at night and think that all is right with the world. The status quo would do. But if you spent 20 minutes on google, you will realise that what you you accept as normal most other 1st world countries would consider sub-standard. you point me out one other health profession that a skilled labourer could take over with a few weeks of training and ill eat my shirt. FD's caught a boon from Eugene Nagel with his idea, pitty more of the US didn't pay attention to Zafar and Caroline instead. youd have a culture of highly educated health care professionals instead of some smokeys with an extra tool box. This shit filters down you know, crappy systems create crappy data which MD's and administrators use to beat us up with, no wonder we dont place much stock in a lot of the studies coming out of the US, its not even performed by real Paramedics!

from the 2010 annual report 500 community officers (EMTB) 461 First responders 2126 Paramedics 416 IC Paramedics 240 ambulance stations 450+ vehicles 5 helicopters 4 fixed wing aircraft approx 760 000 "emergency" incidents responded to (ground and air) approx 250 000 non emergency patient transports 10,000,000+ kilometers driven 5.5 million people in 227 000 square kilometers of land

Things they didn't teach me at uni: Fatigue management Stress management They dont teach you how to look after yourself

To answer your question, yes, tachycardia does not necessarily mean high B/P I dont know where this guy got the tachycardia = hypertension from. There's a myriad of reasons why a person will be tachycardic, and theres a myriad that will have no effect on, or caused by blood pressure amd they are too numerous to list. Relationship between poorly perfused patients and their vital signs are dynamic, complex and different for each individual and cant be placed into canned responses like this fellow on scene has done.

Of course, he couldn't possibly be asking a technical question, being an EMT-B and all Nerd, i dont really have an answer for you, but to add to what fireman said above, experience would show me that you can occasionally take an educated guess to make some very broad statements about rate and rhythm based on auscultation. Having said that you probably cant really say more than regularly irregular or irregularly irregular You can pobably pick Atrial fib with a resonable level of confidence. Anything regularly irregular would be just a guess as there are a few different rhythms that will have that very broad description. Of course you could make the same generalisations from palpating a pulse, but both would be inadequate assessment and you should either have a look at their ECG or find someone who can. Happy to stand corrected though

Dont hold back nerd!

Do you not see a problem with that statement? If you want it to grow, leave it the hell out of fire fighting and leave it as a stand alone profession, not your adopted orphan.

I didn't read the other replies, so im sure this has already been said SD, ridiculous, childish, moronic thread man. Is this what you do? look for discounts based on your hero status? I guess you deserve it, trail blazing medic that gets results and all? entitled to freebies and you keep a list of where you can get them? -1 for a stupid thread -10 on the dustdevil scale for just being a tool.

Got some gloves with that?

Happiness gave me the idead for this with the "out of the ordinary" thread Whats the saddest moment of your career? I dont mean blood and guts, dead kids etc (though it may be the case). Do you have a moment where you were emotionally touched by a situation? a couple of years back, we had a frequent flyer who livedon his own, wife and kids gone, early 70's i think and about the only thing he had left was his independence. Anyway, he would fall over all the time and as he wa spost polio, he couldn't get up off the floor. Anyway, he slippes off the ede of the bed one night comeing back form the toilet so we head out to pick him up. We stand him up on his feet and he starts crying, talkig about how the "dream is over". Im sort of wondering what he talking about, his dream is to be able to live independently before they "lock him up" in his words. After talking to him for a bit, he says hed like to get back in bed before we leave, but he wont let us help him. He's trying to sort his bed spread out with his one good arm and every time he straightened one side of the bed up the other would be pulled crooked. He walked around the bed for a good 10 minutes trying to sort it out, and his facial expression was one of absolute sadness. I half expected him to throw his hand up and tell us to take him away. Ill never forget him, watching him struggle with something as simple as a blanket because of his disability even though he was sound of mind just about made me cry. And one day, we just stopped getting him.

Took an old bloke to an appointment at the local base hospital a year or so back. He told me about how lonely he was since his wife died a few years ago, and that he had not been able to visit her grave as he could not drive, public ransport wouldn't take him there and a taxi was out of the picture as he was unable to walk once he got there. While he was in his appointment i bought some flowers form the hospitals gift shop and when he was finished, went via the cemetery, wheeled the stretcher right up to his wifes headstone. Poor old bugger cried his eyes out, he'd have hugged me if he didn't have dense L hemiplegia.

I hear ya bro, but it pays to know all of your equipments modes, uses and limitations methinks.

Perhaps their equipment is more modern than yours? I dont know of any monitor that doesnt say "no shock advised" when in AED mode

Wombat would probably work better for that

Is that a "guilding the lilly" reference

Novelty gifts are always a little bit fun so the bear is cool, but everyday working equipment is a bit of a let down IMHO. Why not buy a bedpan for a new nursing grad?

Wow, a pair of scissors is the best gift you guys can come up with? I'd be more inclined to buy something not ambulance orientated.

Im more inclined to go with the "compressions are beneath me" line. If he was truly not able to assist because he's off duty, he shouldn't have gone into the room. Perhaps he felt that he was heading in there to do some sexy medicine rather than breaking ribs. Whatever the reason he went in there the no gloves thing is just a cop out

Nor here, but it was alluded to thought there was not enough info in the OP rule it out, or in

im actually kinda ashamed its supposedly australian in origin

And a canadian made (long branch) made one at that.