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  1. Hi! People from different countries please write about ambulance service in your countries. 1. who works in ambulance? (paramedic teams?, phisician teams? Nurses? nurse=paramedic?) 2. What drugs do you have and which drugs you can use without a doctor (especially write about sedative/anestetics, muscle relaxants,....)? 3. Are there any drugs that you can administer only after "call" to a doctor? 4. Which procedures can you do without doctor (intubation, cardioversion,...)? 5. EM studies - paramedic studies (years?), team leader-ambulance nurses (EM?/anestesia? specialisation?), phisician (specialisation?) -- I write example about EM in my country - Estonia, European Union. 1. We have 3 kinds of teams: nurse-teams ~65% (nurse+nurse+technician), phisician teams (doctor+nurse+technician), intensive care team/reanimobile (EM doctor or anestesiologist+nurse+technician) 2. Mostly all teams have the same drugs. (injections, tablets...) Inj.: Adrenaline, Dopamine, Noradernaline, Phenylephrine, Diazepam, Midazolam, Propofol, Sodium Oxybutyrate (anesthetic), relaxants (optional), Fentanyl (optional, some teams have in the north, and intensives), Morphine, Pethidine, Tramadol; Diclofenac/Ketoprofen, drotaverine, Metoclopramide, Clemastin, Prednisolon, Dexa., Salbutamol (inhal, inj.), Aminophylline, Metoprolol, Digoxin, Verapamil, Adenosine, Amiodarone, Propafenon, Enalapril, clonidin, Nitroglycerine, phenytoin etc.... 3. Usually relaxants for intubation are not used by nurses, some nurses or phisicians use propofol. In some regions it is possible to call to intensive care team - they come and help to stabilise patient. 4. Mostly all teams can do most of procedures - cardioversion with sedation, in CRP - intubation or LT-tube, live patient airway control with LT or intubation (with sedation or anesthesia). And usually we treat at homes (also nurse teams) - Atrial fibrillations, high BP-s, simple abdominal pains, we assess ECG and put diagnoses - if needed hospitalise. 5. to be team leader nurse must to pass EM exam or to study 1,5 years in EM and intensive care specialisation cource and get intensive care nurse specialisation. Doctor - it can be doc. with different or without specialisations. Thanks!!
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