aussiephil

BEorP, Aussieland (or Gods great garden) is about the same geographic size as the USA, but we only have 6 states & 2 territories. Each state has its own state run Ambulance service & i can only speak for mine, others can speak for the states they are in. NSW is the largest service in Australia with approx 4000 officers on road. http://www.asnsw.health.nsw.gov.au/employm...employment.html The above link describes our entry requirements. There can be Recognition of Prior Learning (RPL) & each case is assessed by the education centre on an individual basis. If you come through general entry, then we pay for your education & you will be employed initiall for 8 weeks & based at our Education Centre. During this time you will recieve both Clinical instruction, as well as Protocol/Proceedure instruction. There are 2 exams 1 in week 4, the other in week 8. There is also an on road observation period of 1 week during that time also. On completion of this, you are asigned to a station & training officers for 10-12 months, with your treatment etc assessed but your training officers & education continuse during this period. At the end of this time you return to the education centre for further clinical & proceedural instruction for 3 weeks. Sucessful completion of this allows the officer to act independantly & the officer is posted to a station. This is for a period of 12-24 months. Following the 12-24 months the officer is then returned to the Education Centre for another 3 week period, & sucessful completion qualifies the officer. To progress further is at the officers choice & done on a competitive basis with applications, examinations & interviews to gain medic positions. Our service also has specialties such as rescue etc that are also filled on a competitive basis. Hope this answers your questions & if you have any others, let me know. Phil

Ummmmmmm AK, yr hand doesnt count Phil

Timmy our american friends wouldnt have heard of Chopper. To appreciate the first video fully, i would sugest some 'light'readin about Chopper. http://www.chopperread.com/ Phil

Without being judmental, do I detect a pattern here? Great Grandmother is 63. Mother is 27 Arrested child 12. HMMMMMM. My maths isnt the best but to me that means mom was 15 when he was born, & when om was born, Great Grandmother was 36? Shouldnt this 12 years old be commended for tryin to et a profession to support his chils that will be due in the next 2-3 years? :naka:

[/font:09492a8e5e] ONCE AGAIN ENGLAND HAVE SNATCHED DEFEAT FROM THE JAWS OF VICTORY. ANDY THERE IS NO EXCUSES FOR PATHETIC PLAY. AUSSIES 2 POMMIES NIL

:twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted: :twisted:

andy, u really r a sick individual [-X

bbb, i agree that we make a form of diagnosis, this determines our treatment, however, my point is the type of diagnosis. We can ascertain from signs, symptoms & history a likely or provisional diagnosis, however, to truly definitively diagnose any patient requires the type of testing only available in hospital. For those doubters, with due respect, there are a number of conditions that can only be diagnosed by a physician following extensive testing, such as stiff person syndrome (http://www.med.yale.edu/neurol/programs/neuromuscular/stiff_man.html ) and our pre hospital treatment is for a person with acute pain. Our original provisional diagnosis would probably be arthritic pain, or similar, but testing will reveal a degenerative disease that may take years to diagnose. These can not & will never be available in an ambulance. Yes it is semantics, but we need to be aware of the difference & i will always maintain that we treat the way the patient presents, based on a provisional diagnosis, leaving final determination to those with more qualifications & facilities.

Andy, I know when u live in a country that is permanently under cloud cover, where constant drizzle is a way of life, & there is little hope, you need to cling to something. Lets face reality, this test is headed for a draw. But a quick recap so far, series:- Aussie 1, Pathetic Pasty Poms 0 Phil[/font:dd8d0890f5]

Cardiologist’s Elaborate Funeral A cardiologist died and was given an elaborate funeral. A huge heart covered in flowers stood behind the casket during the service. Following the eulogy, the heart opened, and the casket rolled inside. The heart then closed, sealing the doctor in the beautiful heart forever. At that point, one of the mourners burst into laughter. When all eyes stared at him, he said, "I'm sorry, I was just thinking of my own funeral. "I'm a gynecologist." The proctologist fainted.[/font:d165998de9]

1. Yourself: Sensational 2. Your boyfriend/girlfriend?: Pass 3. Your hair: Mullet 4. Your mother? bossy 5. Your Father? patient 6. Your Favorite Item: puter 7. Your dream last night: none 8. Your favorite drink: Latte 9. Your dream car: Maclaren 10. The room you are in: cool 11. Your Ex: meh 12. Your Fears: numerous 13. What do you want to be in 10 years: lazier 14. Who you hung out with tonight? family 15. What You're Not? pub 16. Muffins: chocolate 17: One of Your Wish List Items: sex 18. Time: 2001 19. Last thing you did? masticate 20. What You Are Wearing? nothing 21. Your Favorite Weather: heat 22. Your Favorite Book: fiction 23. The last thing you ate: fish & chips 24. Your Life: disorderly 25. Your Mood: apathetic 26. Your friends: understanding 27. What are you thinking about right now? home 28. Your car: Kia 29. What are you doing at the moment?: survey 30. Your summer: Christmas 31. Your relationship status: undecided 32. What is on your tv? Home improvement 33. When is the last time you laughed? afternoon 34. last time you cried? pass 35. School? left

nope they didnt learn yet, series Aussies 1, poms 0

I agree completly Rid, &i really do believe that Mental Health is really the thing we, pre hospital do worst. Education will go a long way & in 3 years in EMS i have had a total of 3 hours trainin on mental health & that was all touchy feely. Not what it is like in reality. Having said that, what suggestions could be made to improve the per hospital delivery of mental health services around the globe?

The reason I bring this point up is that we, as pre hospital clinicians are not doctors, we do not have the full picture, and, as anyone with any experience will testify, all patients lie, or at least tell their own version of the truth. We need to make our provisional dianosis & treat what we are presented with, & monitor, monitor, monitor. I encourage us all to educate, but to consider experience of other officers, who may be clinically junior to us, as education as well. Too often do we write off the experiences of others & not learn from them. Their knowledge & experiences can be more beneficial than what is learned in a text book. To further emphasise the point ruffems, where should we, as pre hospital care providors learn to, or should we train alongside doctors, should we make that the minimum standard? Or, more pointedly, is the education provided worldwide to those whoi want to study paramedicine, to in depth for what we are capable of doing on the street?

When i peruse the forums i see al lot of posts on the usual stuff like trauma, chest pain, etc. These are reat & good to stimulate the mind, however, for the most they are no brainers. So, i thought it would be interesting to see how challenging others find mental health patients & cases to deal with. Currently in Australia we are going throught the worst drought in 100 years & this has lead to an increase in the number of severe mental health issues. While a majority are dealt with by local Doctors traditionally ambulances & pre-hiospital care providors see these patients at their most extreme. My questions are:- With the number of diagnosed mental health illnesses, personality disorders etc, how do we know how to diagnose these patients? What is the most effective way to treat these patients? Lastly, how well do you believe you are trained to cope with & adquatle provide pre hospital care to mental health patients in your area? :twisted: Phil

Somedic, one could say the same for may sports, including that American favourite, baseball, if u dont like cricket, dont read the post. Phil

I think we can also add to that personal experience on top of education. I know when I have had a patient with an unusual illness, I have researched it to find out more. Education, while vital, and provides the grounding for everything we do, can never be replaced by hands on experience. This is something that as an industry we need to recognise & nurture. The more exposure one ets, the more accurate their provisional diagnostic skills become. As AZCEP stated we can only provsionally diagnose & exclude but difinitive requires further testing.

That would mean that canada is dominant in a sport now, & that is a big call mate. LMAO What sport are the Canadians top in? :twisted: :twisted: :twisted: :twisted: :twisted:

I agree with jmac (for a change) I think our role is to provisionally diagnose what we have indicated by the signs & symptoms presented to us. That is what we then use our Protocols for. The difference here is can we differentially diagnose in the field? In some cases, i believe yes we can, as has been sighted in some cases earlier. But let me question paramedic mike further on the question of a stroke patient. In essence there are a number of types of 'strokes' a person can have, but the main 2 are Ischaemic & haemhorragic. Will the patiernt not present to you clinically the same in the early stages & can you, without the use of a CT scan differentially diagnose the type of stroke the patient is having & what their likelihood of recovery is? I think it is important to provisionally diagnose & initiate treatment, but, differential can really only be undertaken in hospital where there are full testing facilities to confirm or deny the provisional diagnosis. Sorry, had to throm my bit in. Phil

With all the hype to this current Ashes series, i was ewxpecting some sort of competition. Second day of the first test & YAWN!!!!!!!!!!!!!!! The presbyterian under 12 girls team would provide more competition. Come on guys, whats the story?????????????

I agree Dust, there seems to be the necessity to manhandle the patient to get them into the device, wouldnt u be far better using the old collar & KED? Phil

Wow, i will die in 2027 by shark attack some iguanas time unknown Phil was killed by enemy fire in Afghanistan on March 4, 2002 (dont remember that one) At age 18, on February 25, 1966 near Da Nang, Phil was killed by "friendly fire". (Having trouble remembering this one too) Phil was killed by the criminal syndicate known as The 100 - ????????????????????????????? I was also killed in iraq, an IRA bomb (damn u jmac), & the one that really gor me was that i was killed by a server!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!! Dont know which one i prefer, but 2027 is a bit close...........................................

My point is that we, as health professionals probably do, but Joe Average has been conditioned to just accept that the doctor is right. I am not saying this is right, but what is taught, what too many people believe

AK, I understand your sentiments here completely, but i think in this case you missed the point. The sad fact is unless we are aware of what all the numbers mean, or we ask the Doctor & he says its high & we dig more, we are all ignorant. How many patients do we see with hypertension treatment regime of either Beta Blockers or ACE inhibitors that have no idea what their Blood Pressure normally is? Moreso we are taught a 'normal' blood pressure in an adult is 120/80. Lets be real, as a percentage, how many have you taken at that range? I agree that we should take more responsibility for our own health & health problems, however, unless we try & educate the population on what it all means & that their cheap home electronic BP cuffs really are crap, we are left in the same boat. The other side is that a little knowledge is a dangerous thing. Some will have their BP taken & be consistently 135/85. Is this hypertension that needs treating? In some maybe, in others no way, but if they get together than we r in all sorts of trouble. While personal responsibility needs to be increased, I think that the Doctors still need to be accountable for their decision to treat, or in the case sighted here, not to treat. We have the benefit of knowledge & our friend here has only just aquired it recently.

Timmy, again check your facts, i have not been to uni. If you wish to have a discussion, i am here to talk to you & am more than happy to help you in any way i can