Kiwiology

you know Emergentologist I need a script for large amounts of benzos its easer to get wasted on valiums than face reality either that or beat me over the head with DSM

I dno bout that nobody would understand what we are saying ERDoc to English translator Anesthesiologist = Anaesthetist Attending = Consultant BP cuff = not a requirement for buff NYS vollies CT = An expensive test; also a state EMT = A requirement for buff NYS vollies ER = ED Fuggetaboudit = Don't worry bout it bro Health insurance/HMO = Tool of the devil Intern = House Surgeon/SHO MD = Very expensive degree on how to order expensive tests financied mainly with loans Pie = Pizza Resident = Registrar The match = finding out if you're going to pay off your loans before you die or not The Mitten = just the worst place on earth to even consider living, I mean seriously?

The point I was making is that unlike other industralised nations the US has no rules regarding fatigue, rest breaks or duty hour limitations for ambos; some individual companies might but in other nations the ambulance service is regulated the same as other commercial drivers. Consider also no state requires a commercial grade of driver license and the tougher licensing and testing requirements that come with it; California requires a knowledge test and a DL51 CDL medical which is good but it's still not requiring a commercial drivers license Driver education is also pretty poor (usually a one or two day class if that) and then you're let loose; again just because a couple ompanies might require more is not good enough. In my time in the US it was very much evident that driver training and standards were extremely lacking and that many people liked to drive lights and sirens because they could and thought it was a good thing to do i.e. it was fun or some sort of novelty. Generally there seemed to be a societal acceptance of driving safety as not being that important e.g. talking on your phone and driving was something you just did and not something to be worried about. Sure I accept I am painting with a bit of a broad brush but again, like in many things, the US seems to have the lowest standard and you know what I've never heard from an ambo here that "I know it's only a matter of time before I am in another ambulance wreck"; I've heard that in US Makes me sad

yes sir you can see here http://www.emtcity.com/topic/21652-the-kiwi-erdoc-love-fest-continues/page__st__60

Kiwi to English Translator Adrenaline = epinephrine Ambo = Person who works in the ambulance AO = Ambulance Officer; a person who works in the ambulance AOS = Armed Offenders Squad (SWAT) Bikkies = sweet biscuits (go great with a cuppa) Bloke = person (generally male) Buggered = screwed up / in a bad way Consultant = specialist physician / attending Copper(s) = a Police Officer / the Police Cuppa = cup of e.g. coffee or tea Drip = intravenous cannula (may also refer to an IV infusion) ED = emergency department / ER Fireys = Fire Service House surgeon / SHO = PGY1/PGY2 doctor on rotating internship ICP = Intensive Care Paramedic; top clinical qualification MBChB = medical degree Midazolam / midaz = versed Muppet = silly person Muppeting = being a muppet or pissing about doing nothing useful Nunngered = broken / messed up Registrar / reg = specialist physician trainee / resident Resus = resuscitation suite in ED Rooted = completely fucked; also used to mean sex Salbutamol = ventolin Suxamethonium / sux = succinylcholine Taking a piss = urinating Taking the piss = taking the mickey Technician = lowest clinical level of an AO (almost exclusively volunteers)

esp when u drop them out of the microwave at the servo running back to the car for a job eh?

i think in US we could look at the following - your ambulances are much larger and heavier (14,000lb (7,000kg) US ambo vs a 2,500kg (~5,000lb) AU/NZ/UK vanbusprinter) - most states have minimal driver licensing reqs (theory test, practical, warm pulse and a working eye) - most ambulance services have bare-bones driver education (or none whatsoever) - no regulations re fatigue or rest breaks ? driver fatigue - a much higher proportion of lights and sirens responses - there is no real restrictions on who can drive e.g. an 18 year old with a car license can drive if the boss says OK - no state requires any commercial or professional grade license (and associated tests) to drive an ambulance And the biggie is having spent four of last six years in US I can say first-hand that driver behaviour generally is much looser and people don't seem to take safety as seriously. I've had people call me "weird" or a "safety Nazi" for driving at the speed limit (mostly) and not texting or talking on my phone, always wearing my seat belt etc and also for not riding with people who I knew were technologically challenged and couldn't put their phone down while they drove. Driving is the most dangerous part of being an ambo and you should bloody treat it as such. Once again, US seems to fall to bottom of heap, breaks my heart

josh you muppet just use bloody glad wrap

fixed that for you

so if i understands correctly this bloke has partially severed his trachea? we had a case here about three years ago that stands out as being very similar to this; a guy who was shot thru the neck and in that patient the very brave (or totally fucking insane) Intensive Care Paramedic had a dig around the wound and clamped the trachea together then anaesthetised, paralysed and intubated the patient. despite being totally insane don't expect me to be that brave if the guy has a reasonable SpO2 and is in no immediate (like next few minutes) danger i would be inclined to simple management and quick transport to the surgeons

Get a box of glad wrap from the supermarket You can wrap small infants in it and it is also great for covering burns and protruding abdominal contents Talk to your Medical Director about it

Let's get the internationaloscope out Australia - class LR required UK and Europe - Class C1 required Canada - Class 4 (in Ontario Class F) required South Africa - Code 10 required Each of these are a higher standard than a regular car license, a commercial class medical exam and a theory and driving test Each of these jurisdictions (not sure about SA) also has very strict rules about rest breaks and limits of driving Once again US falls to bottom, breaks my heart

Bloody hell Emergentologist lets get you a pizza stat! Use two layers of glad wrap, works wonders

This. In New Zealand our Ambulance Officers are ... - required to have held a drivers license for three years minimum, - required to have a clean license i.e. no tickets or points for anything - required to pass a two day theory and practical driving course, - required to complete a driving logbook and peer-review to show competence, - not allowed to work for more than 5.5 hours without a 30 minute break, - not allowed to work for more than 13 hours in any 24 hour period, - required to have a 10 hour break between shifts nb "work" does not mean "driving" work means being AT WORK e.g. if you start at 0600 come 1130 you MUST have a 30 minute break These are the same rules as truck drivers

If the local hospital is not equipped to handle obstetrics then any obstetric patient must go to the appropriate hospital? There's your policy or am I missing something? OB/Gynae is not my thing, seriously, the whole four hours of education I haz on "pregnancy, birth and the newborn" is just not adequate, but rather oddly I can remember the risk factors for ectopic pregnancy off the top of my head cold from memory like if you asked me "what are the risk factors for ectopic pregnancy?" regardless of whether I am having a massive shit, mowing the lawn or viciously dehumanising somebody i dislike with a tire iron I can tell you

The hospital here is all to happy to load you up on ondansetron while you are in hospital but if you need a script for some antiemetics post discharge they religiously use metaclopramide because (and I quote a Consultant Physician) "its cheap!" It's also crap (but hey look who is talking)

He is going to need a hospital with ICU capability at least so lets get on the telephone machine to the orange clad ones who arrive from the sky to whisk away the patients I can't handle. Phew, I do love the retrieval team, massively limits my medico-legal liability by providing an out for people who I look at and go "WTF?" at. Anyway, it could be some weird ass virus or mold exposure but I'd not think a mold exposure would produce such severe symps so quickly? For right now I'd give him a little bit of midazolam to see if we can settle him to reduce his distress and try some non invasive ventilation. How about a chest x ray?

Yes I am pretty sure this is what he means, the anaesthetists use it all the time on youngins

This. I think septic shock is fairly easily recognised but that sepsis (in particular meningococcaemia) is an absolute atrocious bastard of a thing to recognise as it can present very subtly especially in early stages and you know how it goes leave patient at home with some panadol next minute dead whoops Now technically sixty hundred billion of the people that present to ambo have "sepsis" because they meet SIRS physiologic signs and symptoms of an infection (which are also symptoms of sixty hundred billion other things). The trick is to differentiate between the fit young man who is a bit tachycardic and has been febrile for two days and just needs some antibiotics and panadol and can stay at home vs. nana with a morphine pump in the rest home who has been febrile and tachycardic for two days who is probably the latest victim of community acquired sepsis and needs to go to the hospital. I've updated my living will to include limited resuscitation (no adrenaline and no intubation or ventilation until ROSC) and no long term care facility

I need the tan mate honestly I got picked up by the Police thinking I am escaped corpse and I could use the Skywards miles on Emirates A colleague of mine used to work for some sheikh in Mid East and got $5,000 USD and a solid gold Rolex as an end-of-year perk I could use that kind of shit And lets face it, a sweet job in expat land would fix up my soul crushing depression quite nicely

Let's not forget Emily Robinson and her banjo it's probably got a mean schwak to it, truth be told I should be more scared of Jennifer Nettles and that bloody stage of hers considering I narrowly avoided being crushed by it! Bloody hell the things us rednecks get ourselves into guess I should have just stayed sittin' swingin' on the front porch ...

Honestly I don't think that extra year really counts for anything except extra debt and time studying but if you aren't doing the fifth year of secondary education then perhaps it might be a good thing but should be limited to the first year only. The University of Auckland (one of the 50 top uni's in the world) has a requirement that two classes in each degree be general education or outside the scope of your degree one in first year, one in second year I think, certain degrees only have one gen ed class req e.g. medicine and nursing Nursing is a pain in the ass to be honest we have no national curricula and no interest in getting one so each degree teaches slightly different things e.g. the University of Auckland teaches the nurses the same biology and physiology (and biochem if the student wishes) that they teach to a first year student doctor and it's not hard per-se but it's intense compared to what the local polytechnic where I am teaches. At MIT in South Auckland they teach hard out Maori and Pacifica health because let's face it there are no white people south of Ellerslie/Mt Wellington but down here we barely even touch upon it. In my city we have both a University and a Polytech teaching nursing and while I'm not hating on the polytech nurses the difference is marked when you get into the science content and pathophysiology. I am taking pathophysiology next semester and it's what the second year medical students learn and I've had a look at the old exams, I'm scared, I mean I'm worried and I usually eat biomedical type stuff for breakfast. The polytech's took the Diploma and dressed it up to become a "Degree" back in 1993 but the Universities can pull in the expertise of their science or medicine faculty to teach that part or the psychology school to teach psych ... god how i hate psych i hate it with a passion so much, i hate it more than i hate DNA and genetics, and I hate them so much! Anyway little bit of a side rant there, I guess its how you structure your education Oh and for the record, the "graduate entry only MD" style education that exists only in the US and Canada is something I strongly disagree with. There are two programs in Australia that are now graduate entry only styling themselves as "MD" as opposed to MBBS and I am very worried it will become the standard in AU too.

The question is mate can we fit Earl easier into the bed of your truck or in the back of the Jeep? You know I am suspicious of strawberry jam now was well ... nah nah nah nah!

Bloody hell man I speak English eh? Igloo you say hmm sounds interesting, as long as I can get 4G service for me smartypants phone. It was probably the lack of shooting and stabbings

Now it wasn't mine but I remember a dude from back in the day with a six inch nail stuck in the lumen of his dick HMMMMM