Kiwiology

Since 2009 each Ambulance Officer regardless of practice level must do 40 hours of CCE CCE is either, as Scotty says, allocated as part of your roster for paid staff or on weekly training nights for volunteers It is a blend of online, DVD and face-to-face learning. Ambulance does not participate in nor do they require the merit badge cookie cutter classes which I personally think are largely a waste of time TBH

Edwardo ambulancia juarez se dfib is in mexico he gets paid in tortillas lol

What band on the agenda for change that doesnt end up in your pocket are the ECAs? I cannot believe the UK, the tend worldwide is towards upgrading people at the base level not completely deskilling them bloody hell A paramedic here is about 55000 NZD and intensive care about 65000 NZD intensive care are our ALS and a paramedic is the old IV/cardiac technician on steroids with a bachelors degree

No, we use isotonic saline

OMG I used to work with Pepe ... Disclaimer: was not the same Pepe but it sounded cool right?

I told you, you're my bitch to work the radio and translate for me because you're a native and nobody can understand what I say! "I think his salbutamol ran out" "What?" "His salbutamol has run out" "What?" "In the nebuliser bowl, there is no salbutamol left in it, you know?" "Oh he needs more ventolin" Crazy Hoosier ambo's

You know you give yourself too much at night mate Yes, he did, it was an insulin overdose Shit you guys are too good for me!

The fact Monster.com Ambulance Service still uses the big orange tackleboxes from the 1980s/1990s is highly concerning .....

If his BGL does up then down what could that mean is happening inside him?

Don't listen to that Hoosier bloke, we are neither helpful nor friendly Oh, and do not feed the Kiwi ....

The EOC Allocator in me is forseeing active area cover for the next forever in your future as well as being paired with a brand new ECA Hang on it's the phone Why yes this is Extremely Busy Station oh hello red base, what's what? Mike is on another complex you say, I'm operationally single you say, no brand new ECA's to pair me up with? what a shame, I've been moved to Sleepy Station (part of Nice Quiet Complex) you say? sure, I can head on over. Gosh, sucks for you mate

When ASNSW asked if I had a Class LR I told them "No, don't need it, those Sprinters should be put through a car crusher anyway wouldn't catch me behind the wheel of that thing" ... he laughed, then told me I needed Class LR Dramitisation, may not have happened

I think it's more important that this bloke establishes whether a prospective employer is willing to accommodate him first i.e. days only or if he works nights no driving rather than getting a clinical qualification

You need to ask each individual employer

Any job is stressful, I think some things Paramedics have the potential to be more stressful than other things encountered in civilian life but it is how you handle them; if you go home and think about it 24/7 yes you will become a debilitated wreck and burn out. You must remain empathetic yet objective. Shifts can be anywhere from 8 to 10 to 12 to 14 or 16 or 24 or 48 hours long depending on which part of the world you are in. Again, this depends entirely on which part of the world you are in Locally speaking yes it most likely would because we swap driving-attending each call and our standard roster includes 2 night shifts

It's a suspended, there's your prezzie, now move over, I'm driving, which of these is the nee naw button? Still waiting for some more info on LVADs in NZ

Yes it is possible, however any chronic condition such as a deficiency of a glycolytic enzyme (e.g. hexokinase) would manifest itself long ago I would think An acute problem on the other hand ... if he is becoming hypoglycaemic even with the administration of glucose what does this suggest to you? I read somewhere that half of all smoker deaths are from COPD but that only X percent of smokers will get COPD, it wasn't a huge number and that they had to be smoking something like 5 or 7 years on average, I think it was in one of my General Practice (family medicine) books And this a good lesson in not assuming

He's probably off spanking the monkey because he can supply-to-administer penicillin Lactic acidosis is a metabolic acidosis Nobody has said he has renal failure or COPD The Kreb's cycle does not create pyruvate; the Kreb's cycle takes Acteyl CoA (made from pyruvate (glycolysis/pyruvate dehydrogenase), amino acids (from fatty acids - lipolysis) or acetate (gluconeogenesis) and creates two molecules of ATP as well as NADH + H+ and FAD(2H) In anaerobic respiration pyruvate is reduced to lactate by NADH + H+, regenerating NAD+ which is where the lactate comes from Since you gave this bloke an amp of glucose, lets say 20 minutes went by and he became hypoglycaemic again so you gave him some more glucose, does that help narrow down what might be the cause?

Antibiotics are necessary but they are the most wrongly prescribed medicine on the planet hence why we now have these abx resistant super infections that turn you to soup or some shit Sure it might make some trailer trash medic get hard that he can "prescribe" an antibiotic because "it makes him a doctor" but he's an idiot I know a little about antibiotics and when to give them and what for and how they work and such and I keep a supply of relevant texts handy for guidance because I know I know only a little

I'll ask around the ACH CVICU staff and see what I can find out re numbers of LVADs LOL @ East of Everywhere Hmm, I forsee November 100 going on a long distance transfer

I know some trusts require D1 Now, back on topic

12 lead ECG AF with no ischaemic changes CK 24 CKmb 1 LDH 160 Trop-T 0.1 CRP 7 BNP 9 You're right in saying that muscle death can cause increased lactate, but what are other causes? Close but no cigar as of yet

Where's the fun in meeting 'zilla I want to meet that Emergentologist bloke! That zilla probably ain't even a Consultant Physician gah

After two amps of D50 his LOC improves a bit His fingerstick glucose is now 80 or 4mmol/l His pH is 7.37 What else might cause it?

Things Kiwi likes more than fish and chips (in no particular order) Pick up trucks Guns Ford F series walkthrough Type 3 ambulances Ten gallon hats Natalie Maines and Jennifer Nettles (awesome bootleg sex tape material there, preferably in the bed of a pick up truck) Triple bacon cheeseburgers BBQ Hating on Obama (preferably while driving my pick up truck to the gun range wearing a ten gallon hat and eating a triple bacon cheeseburger) Physiology Kick ass clinical scenarios John Grisham and Robin Cook novels Cooking Going to church Oh, and my Ambulance is only yellow when the HPC give me registration as an SRP and the LAS overlooks the lack of C1+D1