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Happyness, I think asys & Mr Meaner got u on this lot!!!!!!!!!

8)

http://www.news.com.au/story/0,23599,22314779-29277,00.html http://www.news.com.au/story/0,23599,22325965-1702,00.html The NSW government had proved bloody minded in this. But should ambulance officers & paramedics be allowed to strike?

I will not comment on the grounds of selfincrimination

We always hear ' the rules ' From the female side. Now here are the rules from the male side. These are our rules! Please note.. these are all numbered '1 ' ON PURPOSE! 1. Men are NOT mind readers. 1. Learn to work the toilet seat. You're a big girl. If it's up, put it down. We need it up, you need it down. You don't hear us complaining about you leaving it down. 1. Sunday sports It's like the full moon or the changing of the tides. Let it be. 1. Crying is blackmail. 1. Ask for what you want. Let us be clear on this one: Subtle hints do not work! Strong hints do not work! Obvious hints do not work! Just say it! 1. Yes and No are perfectly acceptable answers to almost every question. 1. Come to us with a problem only if you want help solving it. That's what we do. Sympathy is what your girlfriends are for. 1. Anything we said 6 months ago is inadmissible in an argument. In fact, all comments become Null and void after 7 Days. 1. If you think you're fat, you probably are. Don't ask us. 1. If something we said can be interpreted two ways and one of the ways makes you sad or angry, we meant the other one 1. You can either ask us to do something Or tell us how you want it done. Not both. If you already know best how to do it, just do it yourself. 1. Whenever possible, Please say whatever you have to say during commercials.. 1. Christopher Columbus did NOT need directions and neither do we. 1. ALL men see in only 16 colors, like Windows default settings. Peach, for example, is a fruit, not A color. Pumpkin is also a fruit. We have no idea what mauve is. 1. If it itches, it will be scratched. We do that. 1. If we ask what is wrong and you say 'nothing,' We will act like nothing's wrong. We know you are lying, but it is just not worth the hassle. 1. If you ask a question you don't want an answer to, Expect an answer you don't want to hear. 1. When we have to go somewhere, absolutely anything you wear is fine... Really . 1. Don't ask us what we're thinking about unless you are prepared to discuss such topics as baseball or golf. 1. You have enough clothes. 1. You have too many shoes. 1. I am in shape. Round IS a shape! 1. Thank you for reading this. Yes, I know, I have to sleep on the couch tonight; But did you know men really don't mind that? It's like camping.

I think the differentiation here needs to be for pre hospital & in hospital cardiac arrests. I read rid's post with interests, but it appeared all in hospital. Pre hospital presents its own problems. I am in a small community & we have, if we are lucky, 4 people to assist with an arrest and in most cases 2 are off duty so the family will watch us because we have no one spare to talk to them (1 person on drug therapy & defib, 1 on airway managment & ventilation, one doing CPR & one getting stretchers & running for equipment as needed). In hospital, there will usually be at least 1 or 2 spare bodies to be with the family & keep an eye on them. I think we need to respect the families wishes, but we also need to have a medical professional to explain what is happening & observe the family. They can also be prepared to call for chaplains as necesarry. They are also in the position to explain to the family the reality that the majority of people who arrest will not survive & prepare them for that.

Were we in the same chat terri, cause i dont remember the begging. I do remember the echos i the sounds of silence.........

Post by itku2er in the chat & it lasted for a while as well

Happy birthday old boy!!! Have fun & have a few drinks for me Phil

Note for AK, substitute GOAT for sheep[/font:be73488b4b]

Happy Birthday you old shagger!!!!!!!!!!!!!!!!!!!!!!!![/font:29c1076b26]

My point is that we need to re educate people right across EMS that in many cases we do have time on our side. We need to make right decisions regarding patient care & what will be best for the long term outcome of the patient. Not work on the 3 P's - Pick em up, Pack em in & Piss em off. AZCEP, we perform a service that is pre hospital medicine. It is protocol/guideline driven. We have limited diagnostic tools & much of our Provisional Diagnosis is supposition, not coming from diagnostic tools, & yes in the initial instance they will continue to treat a patient symptomatically, until they have the ability to confirm the persons illness through the appropriate diagnostic testing & then amend their treatment accordingly. Do you consider yourself to be as educated & medically knowledgable as a doctor, specifically an ER specialist & will they continue the treatment you have instigated without doing their own assessment first? Then where do we start? It has to have a starting point & pre hospital medicine, along with all medicine needs to have its education of things like trauma, Acute Coronary syndrome & many others treatments based on Evidence Based Practice. To put your head in the sand & say we are condoning the old ways that will not allow us to move forward. We need to challenge our medical directors, those on protocol committees etc to change, but we need to do it with evidence. We need to prove they are teaching the wrong thing & start the change now. This is a generational problem, but until we allow each person to take ownership, the same crap will be sprouted in 100 years from now with no change.

My point is that we need to re educate people right across EMS that in many cases we do have time on our side. We need to make right decisions regarding patient care & what will be best for the long term outcome of the patient. Not work on the 3 P's - Pick em up, Pack em in & Piss em off. AZCEP, we perform a service that is pre hospital medicine. It is protocol/guideline driven. We have limitied diagnostic tools & much of our Provisional Diagnosis is supposition, not coming from diagnostic tools, & yes in the initial instance they will continue to treat a patient symptomatically, until they have the ability to confirm the persons illness through the appropriate diagnostic testing & then amend their treatment accordingly. Do you consider yourself to be as educated & medically knowledgable as a doctor, specifically an ER specialist & will they continue the treatment you have instigated without doing their own assessment first? Then where do we start? It has to have a starting point & pre hospital medicine, along with all medicine needs to have its education of things like traume, Acute Coronary Syndrone & many others treatments based on Evidence Based Practice. To put your head in the sand & say we are condoning the old ways that will not allow us to move forward. We need to challenge our medical directors, those on protocol committees etc to change, but we need to do it with evidence. We need to prove they are teaching the wrong thing & start the change now. This is a generational problem, but until we allow each person to take ownership, the same crap will be sprouted in 100 years from now with no change.

The sprinters are good to work out of, they have good room for patients & crews, provided everything is in its right place. The only time that it can be an issue is if anyone is tall, then there can be a lack of headroom, but hey, how often do you really need to walk around during transport? Dust I can relate to working out of a landcruiser, we have them here as well as the sprinter, they can be cramped & difficult to use if you have a tall patient. Phil

Varies between the states. They will look at the qualifications you have & make a determination compared to what is taught & the skills required here. Sorry I cant give a difinitive answer!

nr, finally someone who wants to come to Gods Great Garden. Firstly, do you have any idea where in Aussieland you might want to go? I ask this as each state has its own service & conditions pay & RPL (Recognition of prior learning) will vary depending on where you go. RPL will also only go so far. Queensland & NSW are both on recruitment drives & currency & how recently you have been working will allcome into play with any RPL. The main thing to remember with any application, we are all government run & as such the wheels of action turn slowly. http://www.asnsw.health.nsw.gov.au/employm...employment.html. http://www.dhhs.tas.gov.au/services/view.php?id=412 http://www.ambulance.act.gov.au/ http://www.saambulance.com.au/ http://www.ambulance.net.au/ (Western Australia) http://www.ambulance-vic.com.au/ http://www.rav.vic.gov.au/ Timmy gave you the contact for Queensland. If you have any questions, feel free to PM me & I will halp as much as I can. Phil

Marty I couldn't agree more, I think the issue is really how much trust is placed in those pre hospital on getting the patient to the most appropriate hospital for their definitive treatment, commencement of care, & their ability to make that call. As the good Dr Bledsoe has said, if this was a marketing strategy that has been pushed worldwide, then we need to be looking at more evidence based practice to determine what is the best resolution for patients. For example, we here no longer have to rush every patient at breakneck speed to the nearest hospital. We are able to transport each patient to the most appropriate hospital, provided they are stable, for their injury/illness. In many cases this may be the nearest Band Aid centre, but the choice is ours. The main problem that ems comes across & the lowest common denominator is the emt/medic who wants to think that they can provide more than pre hospital primary care. We are not, & should never think we are medical practitioners. We are pre hospital care providers & as such treat problems symptomatically. We need education to make our assessments of the patients conditions & to make our provisional diagnosis & in many cases we are correct, this doesn't put us on par with a Doctor. EMS Should delete the olden Hour Mantra & teach a more realistic approach, explaining the trimodal distribution of death by trauma & fully explaining the concept of expeditious transport of patients to hospital.

A store that sells new husbands has just opened in London, where a Woman may go to choose a husband. Among the instructions at the Entrance is a description of how the store operates: You may visit this store ONLY ONCE! There are six floors and the Value of the products increase as the shopper ascends the flights. The shopper may choose any item from a particular floor, or may Choose to go up to the next floor, but you cannot go back down Except to exit the building! So, a woman goes to the Husband Store to find a husband. On the first floor the sign on the door reads: [align=center:f8d100c178]Floor 1 - These men Have Jobs. [/align:f8d100c178] She is intrigued, but continues to the second floor, where the sign Reads: [align=center:f8d100c178]Floor 2 - These men Have Jobs and Love Kids. [/align:f8d100c178] "That's nice", she thinks, "but I want more." So she continues Upward. The third floor sign reads: [align=center:f8d100c178]Floor 3 - These men Have Jobs, Love Kids, and are Extremely Good Looking. [/align:f8d100c178] "Wow," she thinks, but feels compelled to keep going. She goes to the fourth floor and sign reads: [align=center:f8d100c178]Floor 4 - These men Have Jobs, Love Kids, are Drop-dead Good Looking and Help With Housework.[/align:f8d100c178] "Oh, mercy me!" she exclaims, "I can hardly stand it!" [align=center:f8d100c178]Still, she goes to the fifth floor and sign reads: Floor 5 - These Men Have Jobs, Love Kids, are Drop-dead Gorgeous, Help with Housework, and Have a Strong Romantic Streak.[/align:f8d100c178] She is so tempted to stay, but she goes to the sixth floor, where The sign reads: [align=center:f8d100c178]Floor 6 - You are visitor 31,456,012 to this floor. There are no men on this floor. This floor exists solely as proof That women are impossible to please. Thank you for shopping at the Husband Store.[/align:f8d100c178] PLEASE NOTE: **To avoid gender bias charges, the store's owner Opens a New Wives store just across the street.** The first floor has wives that love sex. The second floor has wives that love sex and have money. The third through sixth floors have never been visited.

Or the use & acceptance of it as a principal that ems is quick to quote, but appears no one is really prepared to defend. There are a lot of people looking, a few have voted, but not too many that have voted yes are prepared to say why they believe we should cling to it. Plus 5 for Dust for saying how he feels & backing it up. Thanks for your input Dr B

minus 5 for you as well dust for missing prefere :wink:

I agree completely dust, but, I have highlighted a couple of points of yours. They both indicate the same thing to me & that cant be taught, but comes with EXPERIENCE. Life experience & experience in practice. A solid education is needed before anyone can practice any sort of medicine, however, the knowledge of when to do what & the skill to do it expeditiously, comes with time. A good reason why you should work at each level for a period of time before stepping up. I think that alternatives need to be looked at as to specify a time is, and be implemented with no evidence based practice to support puts lives at risk & increases the possibility of civilians, EMS workers & those who are already injured at a greater risk of injury, or further injury. I think that no matter what you say or do, there will always be those who will perform an action(s) that in most cases be unnecessary, but the majority of us know the difference & use our brains as God intended.

Minus 5 for not noting that on 2 separate occasions this was referred to as for Civilian Trauma. No mention of CVA or Cardiac issues This is why I raised the issue, all too often the adrenaline can take over & unnecessary risks are taken. There is a place for helicopter transport & the issue raised it the use of the Golden Hour theory to proliferate helicopter usage. I am also in a rural setting & the use of aeromedical is not for this purpose, but to ensure the patient receives timely treatment in the most appropriate hospital environment.

It is a curiosity that in my discussions with many in EMS, that there is a constant reference to 'The Golden Hour' in trauma. Given that the majority of us work in civilian services, I wondered on the evidence to support this & what the implications were. The basic belief held in the golden hour theory is that we have an hour to get into difinitive care & this would increase survival rate. Is this true??????? We need to look at this subject in a logical manner & consider things a little differently. Bryan Bedsloe in an article in JEMS (March 2007 Vol32 Issue 3) discusses a Trimodal distribution of death from civilian trauma & quotes trauma surgeon Dr Donald Trunkey : Do we, as EMS providors need to think more about our patients & look more closley paying more attention to our Primary & secondary assessments? People in EMS are all to keen to quote the benefits of the golden hour in civilian trauma, without fully researching it & considering all the implications. I admit I was one of those. But this principal, that we need to rush people at breaknect speed to a hospital for them to lie on a hospital bed for hours is in reality putting the saftey of EMS providors & civilians at a greater risk of injury through increased potential of a severe MVC. I will be curious to read the thoughts of others. Here is the full article: http://www.jems.com/survivability/articles/281937/

only a 10 point deduction Dust? I would have thought more. Oh well

Great job. I love it. My advice, at 16 is to look at finishing your education first, then get some life experience. EMS is firstly about education & understanding what you are doing. However, EMS is about people & knowing how to deal with people & the crap in their lives. That comes fromlife experience. I know there are those who will shoot me down in flames, but i have seen the difference between someone who has experience in indusries other than health, that come into the industry. They seem to be able to relate better to people than those who come in straight from school. Please hold onto your dream, but get some life experience first, then decide what you want to do with it. Phil