zippyRN

I would suspect that the question is in fact aiming for ADA compliance , it doesn;t ask for further details becasue they would be got when you completed your occupational health screening form / had a pre employment medical with an Occ health RN / Doc

interesting, can you post a picture of that

page 7 of the O+H brochure linked below picture and 3 d rendering of a typical UK A+E layout

http://www.oh-vehicleconversions.co.uk/uploads/files/PTS_Ambulance_Low_res.pdf

Not sure what I would do without a bench seat, soooo many patients sit and belong there!

generally in the UK vehicles the (second york type cot used as a ) bench seat was replaced with 2 forward facing or rotating seats

i wonder which engine/ state of tune those complaining about Sprinters being underpowered are inflicted with , there are 2 or 3 different engines and 2.1 l engine is available in a number of power outputs from 90 to 160 PS ... wioth the larger *19 models being the six cylinder engine

the UK has rarely had benchs in the back of ambulances moving directly from twin cot vehicles to single cot and forward facing seats / turntable seats ...

a badge offers nothing over an ID card unless there is a specific piece of law that requires it and gives some sort of 'power ' becasue you have it

the badges worn by most US police officers usually include their badge / warrant number and show that their powers are legit

another random badge from galls or whoever means nothing

It's not the 'worlds first paediatric ambulance', it is however the first ambulance (in Ireland anyway) that's sole purpose is for the conveyance of seriously and terminally sick children. It's not for frontline duties but rather to make a regular journey more comfortable with a child friendly environment. Sent from my iPhone using Tapatalk

also a lot ofthe dedicated paeds vehicles around and about are PICU / NICU retrevial / transfer vehicles rather than high need / specialist PTS

the original article appears to be behind a paywall

NO: what Mike is saying is that people who have served in the military as combat medics are given an intensive course in combat lifesaving.

While there are some advanced skillsets taught and some pharmacology taught. It is however nowhere near the same as a full Paramedic degree college level course of instruction.

Yes there are some senior military medics & corpsman that have many years of experience that could transition to a civilian Paramedic level as they have completed the required education and have experienced many different types of duty over their careers in the military.

We had a Senior Chief corpsman who had served in independent duty stations such as on a sub or in remote duty stations who was every bit as experienced as any P.A .and the one young Doctor we had assigned to us , often went to him for advice and to share in his wisdom gained over 25 years in the Navy.

While you and thousands of others were serving in a war zone it really doesn't make you any more special than the tens of thousands of us that served in past conflicts, so the special benefits being given to the new generation of veterans rubs the wrong way to many people.

that sums it all up

there is often ganshing of teeth and wailing i nthe UK as there qualifications held by military medics in the UK didn;t transition to the EMS qualifications especially in the 'closed shop' era of IHCD - now it;s a case of not having the Educational stuff the HCPC require for paramedic.

the MOS /CEG for military medics is very wide from people working in similar roles to paramedics ( and in some cases holding a paramedic qualification ) through to someone who is effectively a Primary care practice / hospital adminstrator with an EMT cert or a 'Canvas Maintainance Technician' in a Field hospital unit ...

I don't think that there are any Equality Act / ADA issues here; - the issues there are the blanket " no diabetics in patient care roles " which have been all to common in the past

IF there are reasonable adaptations in place they are inadequate to his carrying out the role he is in post to do

suspend pending Occ Health Clearance. If he can;t get OH clearance you are free to have him removed from post and there is no chance of sucessful comeback if it;s properly done

the Commonwealth experience with community paramedicine is generally positive, however the educational stuff was far less of an issue as the development is AFTER education and/or Health Professional registration for paramedics was in place.

EN 1789 is the europe wide standard for ambulance designand safety

http://www.dft.gov.uk/vca/additional/files/vehicle-type-approval/ambulances/vca058.pdf

Could someone make the argument that it is a germ thing (shared pillow) and not a laziness thing ?

to suggest it;s an IPC issue is also laziness

there are various types of impermeable cover available for pillows to go betwee nthe pillow and the pillow case as well as those pillows designed for institutional use whose cover is impermeable

these are wipe clean, you should be wiping the stretcher down and changing linens between runs on an ambulance used as an ambulance - if you are doing event cover you can usually get away with 'elephant's loo roll' over the cot linen for most 'none dripping' casualties...

*thump* * thump * *thump* ♫ another one rides the bus ♫

No offense, but ask Princess Diana of Wales how her "physician ambulance trip" went. I really do not see the advantage of doctors on a transport ambulance. I can see the advantage of a first-responder house-call type of setup, if the physician had the ability to do mobile labs and xrays.

this is nearly 20 years ago and also reflects the physician centric model of of the SAMUs and healthcare in France in General

plenty of dead end in 'stay and play' in other Systems

No advantage, really? How does an extra decade of education make a worse provider? How is a paramedic better than a physician? Cheaper, perhaps, but that's about it.

After racking my brain, I've got about two things I'm better at doing than the average EM doc; (1) Not getting myself killed in unsafe situations, (2) MCI Triage - not that this is particularly difficult, I've just done it for real, more than most of them have. Other than that, I can't think of anything else? Maybe I see more people with hypoglycemia? I doubt a board-certified EM doc is going to miss that one, though.

so you have at least a full years of anaesthesia and Intensive care Medicine training do you ? ( Registrars in EM in the UK have that as part of the Acute Care common Stem PGY 3-5) plus the potential to have done an anaesthetics job in their FOundation programe (PGY1+") and anaesthesia stuff in higher specialist training

surgical skills ? chest drain , surgical airway, amputation, crash Section , surgicla control of bleeding , when was the last time you got a ROSC from traumatic arrest by opening the chest on a pub table ?

full prescribing powers ?

Health tourism as a measure of 'failure' in a health system is a bit of a fake measure

how many Canucks or Brits travelling out of the their home country for 'medicla treatment' are going for purely cosmetic procedures because the in -country price is too high , and how many are gong for convenience becasue of percived long waits for elective procedures or becasue they don;t meet meet the criteria for referral yet ( and these clinical criteria aren;t always solely cost / demand related clinicla criteria but have very good basic science basis )

I smell troll , i see Scott has posted and dispelled some ofthe guff posted .

an interesting side point about Prescription charges in the UK - a significant amount of NHS prescriptions are exempt from the charges (under 16, under 19 and still studying , pensioners, low income exemptions, chronic condition exemptions ,,, ) or paid for with a 'season ticket' ( the pre-payment scheme gives you unlimited prescriptiosn for a little over 100 gbp / year)

mikey's post reflects the unfortunate reality for the US

elsewhere in the World the presence of Physicians on ambluances or as an ambulance resource is rather more developed

the 'French' system sees the majority of ALs providers as Physicians - however a significantp roprtion of these Doctors are junior doctors ( interns and residents to US ears)

the German system has higher specialist trainnee and Specialist docotors in EMS roles the Notarzt system

the UK has limited roles for physicians often tied to the Major Trauma System and Emergency departments or volunteer / sessional posts for Emergency medicine / Critical Care or Anaesthetist Consultants , there are also Surgeons and GPs with additional Pre-hospital care training ( e.g. dipIMC) who work in these roles.

Exactly ruff ...

as a shameless plug for the blog would you like to post a simialr comment on there as well please ...

If you are coming from the US with any EMS qualification don;t expect to be jumped upon by the NHS services or the better end of the private / charitable providers - they will likely want to retrain you in the ways of JRCALC/AACE and you'll be in the same position as any other applicant (assuming you have the right to work in the UK). if you are all ready a US paramedic it will mean very little ( even some US trained RNs have difficulties in getting registered - although it;s mainly Associates only RNS thaty struggle - LPNs are NOT recognised in the UK - although there are / were getouts for civilian posts in US military facilities under the status of forces legislation)

Access to UK Paramedic Education will depend on your immigration status - unless you have IDLR or are on a spouse visa you may well find you cannot apply for any Health professional course due to funding / placement provider restrictions as pre-reg numbers in the UK are centrally managed,l and for none medicla HCP education the numbers of places for none UK /EU students are very very tightly limited and often tied in with International development stuff .

UK paramedics are Health Professionals registered with the HCPC http://www.hcpc-uk.org.uk/ and the university recruited programmes accept applications through UCAS http://www.ucas.com/ , any Student as employee courses will be advertised by the regional NHS Service through NHS Jobs https://www.jobs.nhs.uk/

there is a lot of competition for places

you would also have to get a UK/EU manual car driving licence (cat and a UK/EU cat C1 medium goods vehicle licence (again manual transmission test is preferred although some services do have a mainly 2 pedal fleet) before tyou would be considered for employee routes and the University routes often require a car licence and C1 provisional if not C1 full - and those courseswhich require C1 provisional may expect you to fund your own C1 ...

http://fallacy-world.blogspot.co.uk/2014/07/but-we-are-only-volunteers.html

what do the HCPC say about the acceptability of the courses in PL ?

I know in the late 1990s a lot of work was put into Nursing education in .PL to meet the EU Directive.

We have a contract with the same linen service the hospital uses to provide linen carts at the Hospital and a few key stations. While theoretically we have our own linen cart within the ED's they'll grab from ours and vice versa. The hospital doesn't get too prickly since we have paid for our own linen.

If the hospital(s) are getting snippy over linen this is probably the way to go.

I will take issue with you on this. I know how to use a pulse ox properly and I understand its meaning. I pride myself on doing proper patient assessments and that includes looking at patient presentation. I don't need a machine to tell me that a patient isn't getting enough oxygen.

As for your argument "if the machine didn't serve a purpose, it wouldn't be created" there are plenty of devices in EMS that have been created that are not useful. The most prominent right now being the backboard. Just because something is there doesn't mean it is the end all. I have seen pulse ox be wrong on numerous occassions and I have seen nurses and doctors stymied when they can't figure out why it is wrong or what to do now.

I once went into an ER and got chewed out by an RN and a doc because the triage pulse ox said the patient was sating in the low 80's and had a very high pulse rate and I didn't have the patient on Oxygen. I told both of them that those vitals were wrong and the patient wasn't that bad. While the doctor was chewing my butt the RN got a different vital tree and it was discovered that the original vital tree was broken and I was spot on with my assessment.

Pulse ox, AED's and other devices have their place but only if users understand how to properly use them and understand what to do if they fail. I would like to have a pulse ox on board just because it would be a little easier, but I don't miss it and I am not going to be affected without it. Just like an AED isn't going to change the fact that I do CPR. If I have an AED with me, great I will deploy it, if not then its compressions until ALS gets on scene. An AED, however, isn't appropriate in every case of Cardiac Arrest.

The bottom line is this; an EMT or Paramedic needs to be patient focused, not machine focused. Machines are useful and do have their place in EMS but the provider needs to look at the whole picture not just what the machine says.

an AED is an appropriate device to be carried on every ambulance, even those doing purely PTS work . my 'saves' from suddent cardiac arrest have all be charactierised by one thing - early CPR ( starting at the point of collapse) and early Defib ( within seconds to a minute or two)

From what other posters have said the US has caught up with the European guidelines on Oxygen adminstration and the approrpaite use of SpO2 to guide therapy goals .

others have brought up the issue of the long extrication board and it;s misuse as a evdience of equipment being designed without a purpose or use - rather than the problem being the misuse or oversue of something as part of a dumbed down system of training as preparation for practice rather than education ( for Health Professional providers) or a balance between education and training ( for first responders , assistant grades and associate practitioners)

Hi Zippy, i'm amazed that you think EMT-B doesn't exist in the UK. The statutory services (NHS) don't employ AREMTs but they do employ EMTs (just ask London Ambulance Service). EMT-B and EMT-I are recognised in the private sector in the UK certainly by the 4 companies that I work for and countless other companies I know of both over here and in Europe so that was a bit of a sweepingly dismissive statement. The CEC course i mentioned that includes EMT-I, has the same scope to practise as IHCD Tech although admittedly it's likely to take a while before the NHS recognise it. No, I'm not an ECA I don't work for the statutory ambulance service I have a day job outside of healthcare. I cover private event work or private patient transports. I have no interest in becoming a Paramedic as, although I enjoy the Medical side I can't afford the paycut. AREMT-B, IHCD FPOS-I

EMT-B does not exist in any recognisable form the UK, the NHS or VASes don't put anyone with 110 hours of training on an ambulance, even PTS staff have more than that .

IHCD techs are not equivalent to US DoT EMT- I ( regardess of 85 or 99 ) , they have greater knowledge but a shorter laundry list of monkey-see, monkey-do skills .

EMT-I skill set is not facilitated by UK medicines legislation as there would be no legal means for a none Health Professional to adminster Parenteral Medications not included in the schedule 7 list - as the MHRA have stated they will not be supporting any more exemption requests after the Mountain rescue one .

The NHS service have no interest in recognising any qualification beyond the existing IHCD courses or HCPC registration as a Paramedic

the fact you think a 16 hour course (FPOS-I) is a post nominal demonstrates just how little you actually know aoburt Prew-hospital care preparation for practice .

kiwi

ECAs are fit for purpose as assistants / bag monkeys / drivers , the real issue is the Uniscum morons who thought a 6 week course was enough for band 5 and pushed and pushed for techs in band 5 despite the fact existing staff would have got a 2k pay rise on a rotating shift pattern if they had accepted the ( correct) banding of band 4.