Kiwiology

If you're vomiting you need to take some anti emetics with your opiates man! Speaking of anti emetics, I got intravenous metaclopramide (maloxon) once and oh gawd it was awful, it was horrendous and made me feel like I wanted to die, I mean damn near literally, gave me the most horrid dysphoric feeling I've ever had, it was horrible! Last time I went to the hospital I got loaded up on morphine, paracetamol, codeine, oromorph, buscopan, ondansetron and something else. It was pretty badass. What can I say, pain is seen as bad in New Zed? Is ketamine very popular in teh Mittenz for analgesia? It's great stuff, love it to bits, we'd be lost without it here.

Bloody hell you were keen ... I'm not sure about a submarine, there might be some sort of contrapulator to make it go faster

I'd like to try and see you work a nuclear sub with that whole one physics class you took in undergrad ...

Silly Emergentologist, its the patient we want to deliver the shock to It is very nice and the indicator dealie that you can look at while doing chest compressions is very handy.

Oh that's nice, I've used it and it works great.

Hopefully with ePRF linking to the National Health Index we'll just be able to put in a few details and it'll populate all the information including sex. Or hell you could just ask politely

We recently had a presentation from our American colleagues on the ACA and changes to HIPAA It went something like this "So has anybody ever worked or lived in US?" *Kiwi raises hand "Oh, so you would have dealt with insurance?" "No, it was easier not to get sick" "What do you mean?" "Exactly that, it was just easier not to get sick" She was a bit confused, poor thing. Most of my friends in US are having changes to their premium, some go up, some go down, some get a small refund check because of the 80:20 thing but most people I know still have deductibles of like $5,000 or more, one of my friends' deductible is $10,000. How can you expect an average person to pony up ten grand? WTF?

Migraines are funny business; I hear they are often not best treated with narcotics but I don't know much more than that; the line of thinking in the ambo realm is if the patient is in severe pain then give them morphine or fentanyl. If you're interested the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists deals with chronic pain down here. http://www.fpm.anzca.edu.au/ As an aside, what are y'all using in-hospital for acute pain; some bloke with angulated femurs or something?

I like it how the Medical Council here has vocational registration so that, e.g. an infectious diseases physician would be limited in the amount of narcotics he could prescribe and would have to refer the patient to a pain physician (such a speciality doesn't exist but the pain clinic is run by the anaesthetists). Not exactly sure how it works but the general principle with practicing and prescribing within your vocational scope is to prevent a GP from practicing and prescribing that which is the realm of e.g. a specialist psychiatrist or a dermatologist practicing oncology. What's that? Why yes Emergentologist you can exchange your FACEP for a FACEM and yes ... it's summer here and none of that pesky being sued stuff to worry about

Damn Emergentologist you scary! When I lived in US I was amazed at how many average people were on a shopping bag full of meds, and how many of them were on some sort of narcotic; oral morphine, fentanyl patches, percocet, percodan, methadone, you name it ... As an aside I notice in US pain management is pretty poor especially for acute pain in the ED; lots of fentanyl and hydromorphone and not a lot else being used but then again damn US is so big and variance so wide who the hell knows ....

So I was rolling in teh Canada and ended up at Squint's house. He fed me moose and beer and tried to have his ways with me by luring me into the woods under the pretext of a "hunting trip" I walked six miles in a blizzard and waist deep snow to the local RCMP detachment to report him, the Mounted Officer said he could not investigate because his horse was running low on fuel and that I was probably some sort of demonic witch because he could not understand what I was saying and was speaking in Tongue. When I told him I was from New Zed and such he called AHS EMS who came and loaded me up on haloperidol and ketamine Now I am a dribbling mess in the corner at the hospital until these meds wear off and I can escape, But who the hell cares, the hospital is free in Canada eh?

Emergentologistisapoopoohead911 Kiwiisfuckeditheheadandlikeslorazepamz123 I have no imagination today, so sorry

If he is in no overt distress then without taking the piss, put child in ambulance and take to hospital; status is three - not life threatening nor time critical/safe to wait up to one hour to be seen by a Doctor. I'm just no fun anymore am I?

12 lead ECG +/- right sided ECG +/- posterior leads? Hmm ... as I understand with "cardiac asthma" (wheeze from constriction of irritated bronchioles due to pulmonary edema) there is usually a degree of crackle and wheeze. Are there crackles? If there are no crackles and her ECG has no signs of ischaemia, infarction or wide complex tachycardia I'd give her some salbutamol and ipratropium. If so then I guess we could try one spray of GTN and see how that went Regardless, let's get her on the way to hospital. Current status is two - urgent/needs to be seen by a Doctor within 10 minutes of arrival.

PMHx? Meds? HPI? O/E (ROS)? Obs? At first glance lets give her some salbutamol and ipratropium while we gather more information. If she is very, very hypoxic and near arrest then forego the nebules and just give her high flow oxygen (NRB 15 LPM) +/- parenteral adrenaline

Well said mate, clearly this bloke is a muppet. Seeing as how AREMT has no valid way to issue certifications as it is a play group for hack dreamers that doesn't count and FPOS is hardly much better. Clearly this guy should be nick round to jobs in the Skoda BASICS Doctor wheels. Best be off, need to get some kip, but before I do time for a spot of grub Nee naw, nee naw, air horn, air horn, out of the way! .... Red base November 100 on location, yes, can I have some toasted muffins and jam with my tea please? need to eat before I sleep for work tonight!

Welcome. Ignore everything I say and you'll be fine

Maybe you can buy an app for that which will translate?

I guess I will have to wait until the Android version comes out to have a looksy at it ... seeing as how I am not an Apple drone And you are right Emergentologist; its FACEP whereas we have ACEM (Australasian College for Emergency Medicine). Doesn't change the fact it summer down here tho and you are guaranteed to earn $150 k a year minimum. One of the Consultants at MMH ED is American, nice bloke.

See I wouldn't know about that; we don't seem to have the same level of "chronic pain" people who are on a bunch of different narcotics. And yes, you can swap out the A in FACEM for Australasian pretty easy your Consultantship ... plus its summer here

That sounds bloody awesome, especially now as every GP has their patients loaded up on 300 different pills and most of the patients are old and confused and hold up a grocery bag full of medicines in the unlabelled blister packs and go "I don't know love, these are what the doctor has me, I take them, I didn't say I understood them!" Damn doctors ....

I will vow to my dying breath that ECA is the worst level ever introduced. Absolute rubbish, if I am a Paramedic (in UK terms) I want somebody to work with who can actually touch patients and do more than be a stretcher fetcher / driver and not leave me alone to make all the clinical decisions and carry full legal responsibility, somebody who can help me by putting in an IV or something while I do other things, not some muppet with a six week course who I can't turn to and say "does this look like a STEMI imposter to you" or "gosh is this the flu or early meningococcal septicaemia, do you think we should leave this person at home?" We have a level similar to ECA called an Ambulance Assistant but they are only used as a last resort in rural areas where we cannot get a second person who is at least an EMT. It would never be utilised as a business as usual concept. Damn UK you crazy ... but um, can you make me some fish and chips now please?

Stop stealing my lorazepam! I actually need a refill on that; let's see hmm, I know, I will call 911 for an ambulance and have them take me to ER where Emergentologist can Rx me some more. I mean, that is the right thing to do right?

When i was doing your wife she seemed to like the big toys This is why I like having oral ondansetron; means that we have anti emetic at all levels.

Maybe this bloke is an ECA? (the worst level ever designed ... way to go UK, way to go, not) Anyway, the basic lowdown is that down in Australasia you now require a Bachelors Degree to become a Paramedic and a PGDip ontop to become an Intensive Care Paramedic; think of an Australasian Paramedic as like a super educated upskilled UK Paramedic (SRP) and an ICP as more towards the CCP level in the UK. AREMT is a joke, it's even more of a joke than me, and it will get you nowhere. Believe nothing you are told by anybody from there, its run by some hack muppet dreamer and is laughed at by anybody even remotely connected to the professional Ambulance Services.