Kiwiology

Yes but when the acceptable standard is some vocational training with no college education required and a high school diplowmer is "recommended" then you have to wonder as to why that might be?

Bloody Australians, getting all nostalgic and such because MICA (Mobile Intensive Care Ambulance) turned 40 last year and they probably don't know this, but Melbourne was one year ahead of Auckland because we introduced the Life Support Unit pilot project (sometimes called the Mobile Intensive Care project) in 1972.

There are no EMS specific studies that I know of however you can probably find something related to medicine generally on PubMed or Ovid or the like

You must recognise your own biases and how they affect your ability to provide care. This is something that was taught on day 3 of nursing school. Me? I have no biases, for I am Kiwi (which reminds me to get that Weasel fucker, thinks he can steal my line) Hey, I think that makes Dwayne I R Baboon

Yes, like a 1950s big Cadillac hearse that's perfect for running Robert Frazier over in

Yeah but you can't crank one out to Toby Keith unless you're gay (or a chick) hell Jennifer Nettles or Natalie Maines is where its at

Ambulance calls Bumblescum station, Bumblescum Medic 1, Tumbleweed station, Tumbleweed Medic 10, priority one, county road 102, mile marker 201, code redneck Righto Slim, looks like some bloke was playing his Toby Keith a bit loud, got distracted and rolled his tractor, best we be off ...

See now Target shooting with a capital T implies this Whereas target with a little t implies this I am now wondering if you go to the gun range and shoot at a target, or go to the store and shoot people? (not that some of the people who go to Target don't deserve to get shot but still ...) Capitalisation and grammerz is important people Yes, I'm jokng

Driving is arguably the most dangerous, and most important, skill an ambo can have; if you cannot arrive safely then your medical knowledge is no good to anybody. Take it seriously

Good on you mate, glad to see somebody taking an active interest in learning more for the benefit of their patient!

You could very strongly argue that the dismal results in the "Paramedics make intubation studies" from North America and the San Diego RSI trial are your answer. More ALS people is not the answer; you get a large number of people vying for a small number of opportunities to use procedures requiring complex cognitive process and experience not gained leads to attrition of that knowledge and poor performance, just look at all these "Paramedics make intubation worse" studies. Let's be clear, a bit of midazolam for a fitting kid or cardioverting somebody who is Super CrookTM with VT is not a complex medical procedure requiring high levels of cognitive knowledge and clinical decision making, parenteral analgesia is a bit more towards the requiring a high level of knowledge and clinical nouse side of things but is still not quite at he top end of the scale. Now on the other hand, things like rapid sequence intubation, thrombolysis and a few other bits and pieces are procedures that require high levels of clinical knowledge and decision making ability because they represent disproportional risk compared to putting a drip into some bloke. The trend internationally is to up-educate and upskill whatever level is below ALS in the respective jurisdiction (e.g. Paramedic in AU/NZ or Emergency Care Technician in South Africa) so that your "ALS" people are kept free for those patients who are crook thus ensuring maximum possible exposure to use their ALS-specific clinical knowledge and experience.

Physical assessment is tied to knowledge of anatomy, physiology and pathology. The value of diagnostic testing e.g. biochemistry or imaging is to add to the physical exam and in most cases the majority of what will lead you to suspect X or Y comes from your assessment and history. A book can teach you how to palpate for hepatomegaly or listen to cardiac sounds but unless you understand all the normal and abnormal reasoning behind it you are learning very little of value. I suggest mastering something like Porths pathophysiology in tandem with Bates' guide to physical examination

Can I help you?

You don't have to worry about that mate, I talked to EOC, you are on active area cover from now until forever while I have been made operationally single and sent to Slow Station (part of Extremely Quiet Complex) to await a partner. Is that a suspended I see on your MDT? Gosh mate, sucks for you Did I mention that Peter Bradley used to run the Auckland Ambulance Service back in the day? It's not what you know, its who you know!

1. Only call for back up if the patient requires or is very likely to require an intervention you cannot provide Calling for back up because the patient looks "unwell" or "they have tachycardia" is probably a waste of time. What does your patient need that you cannot provide? If your patient is "unwell" is it because they have a cold for which your back up has nothing or is it because they have decompensated septic shock and need fluid, inotrope and antibiotics? If your patient has "tachycardia" is it because they're a bit upset for which your back up has nothing or is it because they have monomorphic ventricular tachycardia for which they require cardioversion? 2. Meet back up en route unless the patient is unmovable or moving toward hospital will move you away from back up Begin moving the patient toward hospital rather than staying at the scene. Only wait at the scene if you cannot extricate and transport the patient (for example pain, trapped, cardiac arrest) or your backup is coming from the opposite direction to hospital 3. Call for back up only if they can locate faster than you can deliver the patient to an appropriate hospital If it is going to be significantly faster to deliver the patient to an appropriate hospital vs waiting for backup then transport the patient unless you can't begin to transport your patient because e.g. they are trapped, in cardiac arrest or require pain relief 4. Helicopters take time, call a helicopter only if one hour or more from hospital by road and patient is time-critical Helicopters are over-rated and over-used. There is little evidence that helicopters make a difference in determining positive outcome on morbidity and mortality. Helicopters also take time and in many cases transporting by road is faster. You need to be more than sixty minutes from a hospital before helicopter transport will significantly reduce the total time it takes to transport the patient to hospital, unless a helicopter has already been dispatched or extrication is going to be very prolonged.

Not at all mate, not at all

You'll just be picking up my Purdue mates who got way to pissed I told you, get your ass to Indianapolis, you can translate for me (seeing as how you're a native) and whatnot Medic 100 calls Control, Medics Kiwi and Native available ...

Where is this service and how do I apply?

True, that is an old photo as you blokes now have the blue jumpsuit or two-piece which I quite like Oh and exchange rates pale into insignificance when compared to the hat!

The ADA says you cannot be discriminated against if the accommodation your disability requires is "reasonable" and does not cause "undue hardship" on your employer. Can you work at night? can you map-read at night? can you move about in and out of the vehicle and in and out of scenes at night? can you stick a drip in somebody upside down in a ditch at night? can you read drug snapoules or ampoules at night? basically can you function as an ambo at night? this question is much broader than can you drive at night Because the US is so large with so many variables in shift patterns you need to ask each individual employer whereas outside the US it's pretty simple, the answer would almost certainly be no.

so what, you had a root under the homecoming float and she decided not to charge you?

We had a guy decline transport once, rang back next night for transport because the chick he tried to pick up at the bar didn't end up panning out Had another young bloke who drank 13 beers and tried to jump a 3m concrete retaining wall on his BMX and ended up second best

That's pretty impressive, but you know what's even more awesome, the hats you guys get, it's not pay or clinical ability or anything else that makes an ambo, it's the hat!

Stop spending money on beer and hookers then duh eh

When I figure it out I will let you know