Kiwiology

Hey he is from new york and I did see that on an episode of friends once hmmm that makes it true right? I think ERDoc is really Matt LeBlanc's prodigy, hmm glucose of 1200 thats not good love, so how you doin'?

I was taking the piss, duh fuggetabhutid and continue eating your pizza

Oxygen ..... thats it, in some areas they can contact medical control physician to "assist" with salbutamol and GTN Likewise I am curious to see what medications could the old IHCD Technician give? You know I know there was an IHCD Module J which was the last part of the Paramedic Award, shucks, should have been extended to include a Module K, we all know how important a dose of Kiwi in prehospital medicine is

True that mate, you know I'd be inclined to accept an admission, an apology and an explanation. The primitive animal part of me wants to inflict comparable suffering on him however at heart I'm not that sort of person doesn't mean I wouldn't run him over a few times .... I can't sort of wrap my head around why he needed to tell such an extensive and ongoing fallacy of lies and total untruths, I mean its one thing to sort of take the piss a little bit like others (and myself) do in good humour and then there's spending nearly a year creating an entirely false identity with multiple social network accounts, photos, phone numbers, for months and months "live" this bullshit each day and perpetuate it to about a dozen people ... then it is another thing entirely to take things somebody dredges up from the darkest corner of their soul and tells you in confidence and then spin more lies revolving around that so several people are so upset and angry they are unable to sleep for days at a time Oh here's a tip - if you're going to make up lies don't invite somebody to a conference in your city with people from the places you supposedly work for because you will get busted Stupid fuck

Harassing that funny tawking Emergentologist bloke is awesome fun! I also like planes; I have my CPL/IFR and MEL theory as well my B747-400 and B757/767 ground school and Level D courses I've spent a bit of time at Boeing-Alteon at Daugherty Field in Long Beach which is now their training centre, but was where they build the Mustangs or Lightning fighters (I forget which) during World War II at the old Lockheed Plant Was a Project Consultant/Analyst attached to United Airlines as well I haven't seriously dabbled in FSX for over two years; I used to post wicked sets of Photoshopped screenshots around the place My other interests include plant based nutrition in the reversal of chronic disease, cooking, travelling and getting high on ketamine Oh I also like reading John Grisham and Robin Cook novels and having sex with attractive women ... but who of us doesnt? Hey Emergentologist bloke, nice looking wife you have ... you should stop spending so much time at work

This is unfortunately no pissing matter, I have a good right to report him to the TN State Board of Nursing and have him denied a license as I am sure they do not look kindly on somebody perpetuating a charade for months and months that he was an ACNP Ah, and the best part is all the evidence is still in my back pocket and I have witnesses. I don't think he is going to fess up I think he's going to slink away with his head between his legs ....

Not even a batch of fish and chips are going to fix this one mate, best get on the BASICSphone and ring up an orange suit to come dish out some ketamine. You know it'd be easier if they just give you a bat-signal thing to shine rather than placing a blue call on PD09? See, I knew such a thing existed! Y'know what, I happened past a Johnny Rocket's a couple months ago and thought of you Rob, the first thought I had was how it was a shame your face was not being pressed in the burning hot grill as Kate and I savoured listening to your agonising screams like the internal and mental ones we exhibited over your lies

I don't think there is much role for Paramedics carrying naloxone any more but will concede it is beneficial as it allows us to wake people up and leave them at home e.g. Nana who has chronic pain syndrome and scoffed down too much oromorph accidently People are "found down" in the street hmm it's probably a better idea to just ensure adequate oxygenation and take them to the hospital because we do not know how long they've been down for and waking somebody with a blue brain up probably is not a good idea. Plus if you bring them up and they're hypoxically brain injured and combative you're going to have to put them down again and that's going to be ten times more difficult than if you didnt

I am a Kiwiologist not an Ambologist, I do know an Ambologist tho, and tea, ew no way I don't drink that pansy shit

Yeah bro (sarcasm) I love to make up stuff about people that is not true just because I a sick mofo y'know (end sarcasm) ... of course there's a reason I said it. Look in Rob's favour, he is quite a personable bloke with a good sense of humour who may know what he is talking about or may be really good at copying and pasting shit off wikipedia, I'm not sure. Also in his favour he has toned down his story from the last time I met him, it was pretty outrageous, now let's see, what was it you said to all of us again? Oh yes, it was ... - You were an Acute Care Nurse Practitioner - You had a BSc (Chemistry) degree - You were an academic tutor at Tennessee Technical University - You were a Paramedic (EMTP) - You worked on the Trauma ICU at Vanderbilt - You worked for the helicopter emergency medical service one or two days a week - You worked on the burn ICU one day a week or thereabouts - Your boss was Jeffrey Guy, MD of the ICU Rounds and Prehospital Pharmacology podcasts (who is head of the burn ICU at VMC) - You were studying to get FDA approval to prescribe - You used books I gave you to study for the FDA exam - You were moving into a downtown condo - You taught your son to recognise cardiac murmurs - You flew to LA to study and pass the FDA exams - You owned a 1950s Chevrolet, a BMW motorbike and a couch that looked like the back of 50s station wagon - You were going to try and get me work on the Nashville Fire Department as a single-role Paramedic - You were going to give us a spare bedroom if we wanted to move down to Tennessee - You had contracts worth over $500,000 to develop medical software for Apple and Google - You took the MCAT exam and were going to medical school - You were going to look after our kids because we trusted you enough because you'd sucked us in with your lies - One of your academic contacts was involved in research to cure something one of us had and you were going to see if we could get enrolled ... it wasn't just single comments made in passing either was it mate? You had Facebook, Gmail, Google Voice, Twitter and other accounts set up with photos, daily updates and the like perpetuating these lies for months and months and months, you lived these lies in your head the purported them to many people daily for months .... what, about a year? It was not until somebody you invited to Nashville found it odd that you refused to meet him (because you knew your fantasy world did not exist and you'd get found out) so he asked several people who worked where you claimed to said they had never heard of you, so he looked up you up in the phone book or something similar and found out you lived in the ghetto projects that you were busted. Unfortunately for us, you might have gotten busted and slunk off into the background but the incredible pain and anguish you inflicted upon us did not vanish as quickly as you did from our lives. I mean its good you have toned down your story and aren't further perpetuating this fantasy world any more but that doesn't mean you can just run away from what you have done. You deeply, irrevocably hurt me and the one I loved as well as hurt many other people. You have no idea of the all consuming anguish you put us through. Go the fuck away.

Yes, our Clinical Practice Guidelines allow Ambulance Officers to treat and not refer immediately to a Doctor in the following circumstances - Where the injury is very minor - Where significant treatment has not been provided - Hypoglycaemia - Known epilepsy - Paracetamol for minor discomfort - Where the patient is receiving end of life or palliative care

True. I think these Paramedics kind of nunngered this one up real good, makes me wonder how many Paramedics out there would attempt to intubate such a patient and /or how many would bag the snot out of them because their ETCO2 is very high and it needs to be "bought down to normal" and/or the good ole ambo trick of "more is better" so lets cram 10-20 manual ventilations per minute down their gob because "they needz more of teh oxygen!" We have had enough problems with people wrapping their heads around permissive hypercapnea here ...

I still say intubating an asthmatic patient is bad ju ju Our medical director has stated it is the consensus opinion of himself (a consultant anaesthetist + consultant intensevist), three other consultant emergency physicians and another consultant intensevist who collectively make up our clinical management group that it's something they do not want us doing, even with our near-perfect* RSi program * yet to be proven but highly likely, not valid with any other offer, 150mg of ketamine maximum per customer, no rainchecks, batteries not included

Intubating an asthmatic patient might actually increase their risk of death, the problems of hyperdynamic inflation are not well understood by American Paramedics it seems, we've had enough problems making it understood here. If you intubate an asthmatic patient you will improve ventilation but you probably won't increase oxygenation much, not sure but my money is on not really. And since when is oxygenation the problem in asthma? It's not, the problem is ventilation and the exchange of CO2? ... and even if you do decide to intubate them, ETCO2 is going to be extremely high and might not actually be of much use? Even at Intensive Care Paramedic level I would be extremely hesitant to intubate an asthmatic patient Oh and news flash, you can give adrenaline as an IV infusion for asthma now too, it's good stuff, you bloke might want to try it some time

It was me, the patient does not appear to be suffering from hypovolaemic shock therefore does not require intravascular volume replacement

I think personally peoples fear of morphine and histamine or nausea is over-rated but like chbare, its just a personal thing. Ketamine is a better analgesic than morphine in a patient who has haemodynamic problems and we think it is particularly good for traumatic pain.

You're in luck I make my own deep dish pizza crust from scratch (as in mix flour and yeast and herbs etc together, let it rise and beat it up before baking it) then top with my own home made thick pizza sauce, pepperoni and four kinds of cheese It's so fucking unhealthy I can hear the rotor blades of the helicopter starting up to fly me 20 minutes to the cath lab after the regional hospital here has thrombolysed me ... but its just like Mama used to make, bloody delicious I am unfamiliar with the culinary staples of the great Western MItten so I dno, and how the bloody hell did you end up there anyway, shit talk about your pile of crap

Yo you can't tawk to me that way yooz stupid yutz i oughta come over there n bust your freakin skull I wonder what people in the great untamed Western Mitten think of a doctwa with the funny tawk

Good day to you sir, welcome to our community I'm sure you wouldn't like me to discuss the litany of lies you spread elsewhere and the intense charade you perpetrated for months, promising everything from work or a place to stay at your non-existent condo or how I trusted you and thought of you as such a friend we were going to let you deliver our children or how enrolment in a study which you purported to be involved in aimed at providing a cure for somebodies chronic lifelong medical condition has destroyed them psychologically inside? How about the fantasy job, certifications and association with a world-class research facility you claimed to have? I am sure you wouldn't like me to tell people about that. Would you like me to disclose the intense mental anguish you put us through? No, I don't think you would .... A leopard may change venues but his spots do not change ... but it's good to see you've toned it down a bit. Anyway, enough of this, best nick off, looks like an RTA with entrapment I have to grab a replacement bougie for the Thomas Pack before we lift, the door at the back of the locker room is the way out, you may wish to consider using it. Ambulance, Medevac, airborne .... Oh and just for the record I'm taking the piss so you know exactly who I am, I don't work for the Air Ambulance.

Some bloke going for a walk who happens across a house fire and decides to run in and save several small cute children exposing himself to mortal danger is probably a "hero" NB this does not include you Fire Service An ambo who is doing what he is paid to do not so much

Here are some general guidelines we use when calling for back up and hopefully they can be of help to you 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 and antiarrythmatics? 2. Meet back up en route unless the patient is unmovable or moving toward hospital will move you further 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 is making move them impossible or they are trapped) or your backup is coming from the opposite direction to hospital 3. Only call for back up if they can locate you significantly 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 or require pain relief 4. Helicopters take time, call a helicopter only if the patient one hour or more from hospital by road and 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. Here are some examples i) A patient fell from a roof and had a GCS of 6 with poor airway and breathing. The scene was 30 minutes by road to hospital and the crew called for a helicopter. The helicopter located at the scene 18 minutes after dispatch, was on scene for 15 minutes and took another 15 minutes to fly back to the hospital. The patient arrived in hospital 48 minutes after helicopter dispatch and 18 minutes later than if taken by road. ii) A patient was found unconscious as home, 25 minutes by road to hospital. A PRIME Ambulance Doctor was already on scene. The patient arrived in hospital one hour and forty minutes after helicopter dispatch and one hour fifteen minutes later than if taken by road. iii) A patient had been shot and was 25 minutes by road to hospital. A helicopter was dispatched and arrived 26 minutes later, was on scene for 24 minutes and took 11 minutes to fly back to the hospital. The patient arrived in hospital forty minutes later than if taken by road. In all the above cases the decision to use helicopter transport significantly increased the total transport time to hospital. Our audit process is revealing a number of cases where this happens. Note that in general: 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.

Yes although it is far rarer than the telly wants you to believe No Yes I don't know

It sounds like bleeding has been relatively well controlled and there are no signs of hypovolaemia which is why I wouldn't be administering any fluid. There is no contraindication to ondansetron in trauma patients or in patients receiving concurrent opiate analgesia however there is also probably no role for prophylactic anti emetic either. For pain relief in this patient I'd be more inclined to use ketamine. If he required pain relief very quickly and we didn't have a drip in him I'd get the fireys to stop extrication, give him some entonox and IN fentanyl then have them resume cutting him out.

Sure, sure; lying bastard Don't be afraid of the geritol and the walker mate ....