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New Zealand is OK if you like cold weather, rain, & sheep........

You miss my point. I spoke of a 'Whole of Healthcare' environment. This means that obesity would be addressed, as well as other psychological issues. No, we cant always make a difference, however, we need to make the effort. In some cases, & this is becoming more prevelant today with attitudes as they are, it is lifstyle related & the overabundance of fast food that is high in fats & no exercise, letting kids grow up in front of the TV, or with video games that creates the problem. I say we should put a higher Tax on ALL fast food, that way it can pay for the education & treatment of those who are addicted to it. The same way we tax tobacco products. Lets get the education of helthy lifstyle into our schools so our kids dont end up like we are.

There are a few interesting things that should be commented on here. I find it difficult to understand that a supposed first world country, still has people scared that they cant call an ambulance, or go to hospital because they are scared of the cost. Healthcare is a basic human right. Maybe it should be an amendment to your beloved constitutional rights along with the right to bear arms, the right to free speech etc. Where was the follow up from the hospital, or is it only people with insurance who would get that? Looking at this man from a whole of health perspective, it is obvious that he was obese, he had some depression & should have been receiving some physical therapy. The therapist should have (if they were provided) picked up on the lack of movement. Oh sorry, no insurance, why would we want him to get better, both physically & mentally? What more can one say? Was this a preventable death if a whole of health approach was taken rather than a mentality of who pays?

Some interesting facts turnip & others who continually refer to the above movie. It was released in 1986, as I am only 19, that was before I was born. Can we move into the 21 century? I mean we could talk Steve Irwin, shouldda used sunscreen, but he didnt & the rays got him...... How about Jennifer Hawkins, she had a better wardrobe malfunction than Janet Jackson. What about Hugh Jackman, Heat Ledger Nicole Kidman? They are more recent. Go back to your special olympics turnip. It is also like pissing in a dark suit. Gives you a warm feeling but nobody notices.

Squint & Richard, you know winning an argument on the internet is like winning a gold medal at the special olympics, it gives you a good feeling bu who cares???????

I think the whole debate is a wank personally. What is the main aim in ventilation? Perfusion maintenence in the event of return of spontaneous circulation. Evidence has shown that perfusion rates decrease by approx 50% at the time of arrest. This means we need to maintain less Oxygen during the arrest. Will the size of the bag really effect this? No. In the until an ETT is insitu, you cannot gaurentee the amount of oxygen actually entering the lungs. Poor seals, lack of effective jaw thrust, head tilt can lead to air being pumped into the stomach. Studies that the current guidlines are written from show there should be a primary focus on compression, even before defibrillation in some cases. To me this makes the who debate mute. What would be more interesting is to see how effective -placing a high concentration mask on a pt & see how much O2 enters the system through partial pressure changes with cardiac compressions.

Bluey is a nickname generic to all male redheads

Sheila, the Aussie housewife, stepped out of the shower slipped on the bathroom floor. did the splits and suction-cupped herself to the floor. She yelled out for her husband, "Bruce! Bruce come quick!" Bruce came running in. Bruce, I've bloody suctioned myself to the floor," "S'truth, love. " Bruce said trying to pull her up. "You're stuck fast girl. I'll go across the road and get Bluey to help." They came back and tried to pull her up. "No way, " Bluey says, "she's stuck good, let's try Plan B." "Plan B ?" exclaimed Bruce, "what's that?" "I'll go home and get my hammer and chisel and we'll break the tiles under her," replied Bluey. "Spot on," Bruce said, "while you're away, I'll just play with her nipples." "Hey hold on mate - Play with her nipples? Not exactly a good time for that mate!" says Bluey "No, No" Bruce replied, "but I reckon if I can get her wet enough, we can slide her into the kitchen where the tiles are less expensive".

At this stage turnip we are not asssting in any way. Having said that, following an outbreak of avian flu in south east asia a couple of years ago, it was decided that due to our proximity to asia, Ambulance could be utilised if necesarry for mass innoculations. Protocols & pharmacologies were written. So the potential is there for us to be used, but, we are fortunate in that is is the wrongs time of year for us & we have a number of months to get organised to have them done. Phil

Herbie, were not sexist but realists.

Who let them out? Lets face it, they are a throwback, maybe we should send some to science to prove we found the missing link

But you are more ass than class tezza

So Mat, whats next, do we start to search for the recessive hero gene that firmen need? Or the one they are missing for intelligence? But seriously, do we start to screen these people & refuse them permission to drive based on there genetics? Imagine if we did that to women, the roads would be safer, but we would never hear the end of it.

I can se it you know. Lets blame this on genetics, along with moronic attitudes, poor judgment, and any number of other illnessess, disorders & general stuff ups. Whay cant we accept that some people are bad drivers because they drive too fast, drink drive, talk or text on their cell while driving, or maybe, just maybe some people are geneticly predisposed to microsleeps while driving & it isnt really fatigue. Lets get over it & stop trying to blame everything on someone. People need to accept perosnal responsibility without trying to blame it elswhere.

May be worth looking into so you can see what impact that money may have on the overall healthcare (or as it is for profit Wealthcare) system in the US

Here here. Is it that people are to ill informed to make comment, or just to arrogant to think that it wont happen to them?

Just a question Richard. How much does the US spend on attempting to stop the importation of drugs into the US every year? If that was then redirected into healthcare, would it begin to alleviate the overall healthcare problems that are faced not only by the US, but also by countries like the UK & Australia?

Maybe we should use it for all polititians everywhere, thanks Arnie. He'll be back.....

There is a difference. That difference is at the patients bedside. A person at 45 generally has fully developed social skills & the ability to deal with a wide range of people in many & varied circumstances. The 16 year old does not. People need social skills to do this job, not just book knowledge.

funkytomtom, glad to hear you are feeling better & I have waited to post because i think there are some principals we all need to remember here. It has been so well put before but we do need to remember patients do die. Trauma patients especially & the younger they are, the harder it is. Your reaction is/was a normal reaction to an abnormal situation. Self criticism, while at times can be self destructive is a necesarry part of the way we in EMS grieve (yes we grieve the loss as well as the family). What we need to remember is this should only last 2-5 days. If it persists then you really need some further help. The longer you have been in the system, the more likly you are to suffer from PTSD. There can be a cumulative effect. What I have read from you is what we would expect to see over a few days. Acceptance that you did your best. There are many jobs where the patient has a negative outcome, & in reality no matter what we do, nothing would save them. Not even 0.001% of a chance. Take heart, it gets better & those jobs are few & far between. When you dont think about it, leave the profession, you have become to callous.

Debatable, have you ever seen a person who has smoked on a daily basis for 10+ years? Drug induced psycosis is directly attributed to heavy short to medium term use. (remember the World Health Organisation figures predict mental illness will be the secondmost leading cause of death behind trauma come 2020) Having said that I am all for the medical use of it. I have been with cancer patients who (although not legal here) prefered to use it as they were more lucid than using morphine & were able to 'enjoy' they last days on this lonely planet. Lets face it, what harm will they do to themselves? Legalisation is a good option, it does a couple of things. Firstly it takes the mystery out of it. How many kids go & buy some weed for a smoke 'cause it is illegal'? Secondly, through legalisation you will reduce the need for drug operations & the funds that were spent on it can be redirected to healthcare. Thirdly, as it is legal, crime related to the importation & back street dealings will subsidise. While there would be an initial increase, it has been shown that through legalisation useage rates actually decrease over time, along with the associated medical costs. The problem is, where do you stop, do we legalise heroin? cocain? ice? ecsatsy? the list goes on & when one is legalised, another will flood the marker to take its place. It will be an eternal problem with no end.

Age is irrellevant. Age of entry & attitude is completly relevant. I have seen people who have joined EMS at a young age, spent 30+ years in the job & be completly incompetent. Why? Because they choose not to upgrade their skills.They like to look at the old ways of doing things as the best way & are biding their time to retirement, still clinging to the old ways of doing things. However, they have had the tenacity to stick at it for so long, but they are a minority. Gen 'y' is the opposite They want it all now. They want to start at the top & if they cant they ask 'Y?'. However, we see that career wise they tend to drift more, lack stability chasing the top of the tree, lacking the appropriate skills to do the job properly. The secret is to find the balance. The balance of the young enthusiastic person, who will take the time to listen to those in the know (yest dust, squint & ak, this means you) take it on board & learn from their experience, without being a know it all, but is willing to show their commitment to the industry & to learning. Not just blindly following what they are told & hiding behind a protocol book.

Well said Dr Bledsoe. I hink we need to remember that routine vaccination of children have seen the demise pedominantly of diseases such as Polio, TB as well as many others. We dont see Tetnus much any more. Why, because of Immunisation. We have, as a part of the Healthcare system, must take a leadership role in this & show that we support immunisation for 2 reasons. Firstly we need to ensure that we do not unwittingly transmit this illnes to our patients & secondly to not onknowingly pass it to our families. Immunisation works. Our health department have now made it mandatory for all persons with patient contact to have not just the H1N1 vaccine, but the Fluvax every year. Failure to do so will result in relocation to altenate duties, or if none can be found you will get a referal for social security. Bring it on & lets be sensible about it. Phil PS: how was that squint you moose shagger??????

Just look for the goats & you will find AK......... Stay safe guys

EH Happy now?